“Storage Wars” porn lawsuit: alleged Brandi Passante video distributor found in contempt

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Armstrong to admit doping in Oprah interview

AUSTIN, Texas (AP) — Lance Armstrong will make a limited confession to doping during his televised interview with Oprah Winfrey next week, according to a person with knowledge of the situation.

Armstrong, who has long denied doping, will also offer an apology during the interview scheduled to be taped Monday at his home in Austin, according to the person who spoke on condition of anonymity because there was no authorization to speak publicly on the matter.

While not directly saying he would confess or apologize, Armstrong sent a text message to The Associated Press early Saturday that said: "I told her (Winfrey) to go wherever she wants and I'll answer the questions directly, honestly and candidly. That's all I can say."

The 41-year-old Armstrong, who vehemently denied doping for years, has not spoken publicly about the U.S. Anti-Doping Agency report last year that cast him as the leader of a sophisticated and brazen doping program on his U.S. Postal Service teams that included use of steroids, blood boosters and illegal blood transfusions.

The USADA report led to Armstrong being stripped of his seven Tour de France titles and given a lifetime ban from the sport.

Several outlets had reported that Armstrong was considering a confession. The interview will be broadcast Thursday on the Oprah Winfrey Network and oprah.com.

A confession would come at a time when Armstrong is still facing some legal troubles.

Armstrong faces a federal whistle-blower lawsuit filed by former teammate Floyd Landis accusing him of defrauding the U.S. Postal Service, but the U.S. Department of Justice has yet to announce if it will join the case. The British newspaper The Sunday Times is suing Armstrong to recover about $500,000 it paid him to settle a libel lawsuit.

A Dallas-based promotions company has threatened to sue Armstrong to recover more than $7.5 million it paid him as a bonus for winning the Tour de France.

But potential perjury charges stemming from his sworn testimony denying doping in a 2005 arbitration fight over the bonus payments have passed the statute of limitations.

Armstrong lost most of his personal sponsorship — worth tens of millions of dollars — after USADA issued its report and he left the board of the Livestrong cancer-fighting charity he founded in 1997. He is still said to be worth an estimated $100 million.

Livestrong might be one reason to issue an apology or make a confession. The charity supports cancer patients and still faces an image problem because of its association with its famous founder.

Armstrong could also be hoping a confession would allow him to return to competition in elite triathlon or running events, but World Anti-Doping Code rules state his lifetime ban cannot be reduced to less than eight years. WADA and U.S. Anti-Doping officials could agree to reduce the ban further depending on what new information Armstrong provides and his level of cooperation.

Armstrong met with USADA officials recently to explore a "pathway to redemption," according to a report by "60 Minutes Sports" aired Wednesday on Showtime.

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AP Sports Columnist Jim Litke contributed to this report.

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‘Bodega Clinicas’ Draw Interest of Health Officials

HUNTINGTON PARK, Calif. — The “bodega clinicas” that line the bustling commercial streets of immigrant neighborhoods around Los Angeles are wedged between money order kiosks and pawnshops. These storefront offices, staffed with Spanish-speaking medical providers, treat ailments for cash: a doctor’s visit is $20 to $40; a cardiology exam is $120; and at one bustling clinic, a colonoscopy is advertised on an erasable board for $700.

County health officials describe the clinics as a parallel health care system, serving a vast number of uninsured Latino residents. Yet they say they have little understanding of who owns and operates them, how they are regulated and what quality of medical care they provide. Few of these low-rent corner clinics accept private insurance or participate in Medicaid managed care plans.

“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, the chairman of the family medicine department at the David Geffen School of Medicine at the University of California, Los Angeles.

Not that researchers have not tried. Dr. Dowling, for one, has canvassed the clinics for years to document physician shortages as part of his research for the state. What he and others found was that the owners were reluctant to answer questions. Indeed, multiple attempts in recent weeks to interview owners and employees at a half-dozen of the clinics in Southern California proved fruitless.

What is certain, however, is that despite their name, many of these clinics are actually private doctor’s offices, not licensed clinics, which are required to report regularly to federal and state oversight bodies.

It is a distinction that deeply concerns Kimberly Wyard, the chief executive of the Northeast Valley Health Corporation, a nonprofit group that runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Ms. Wyard of the bodega clinicas, “and it’s unclear what they’re doing.”

But with deadlines set by the federal Affordable Care Act quickly approaching, health officials in Los Angeles are vexed over whether to embrace the clinics and bring them — selectively and gingerly — into the network of tightly regulated public and nonprofit health centers that are driven more by mission than by profit to serve the uninsured.

Health officials see in the clinics an opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to two million uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care.

And the clinics, public health officials point out, are already well established in the county’s poorest neighborhoods, where they are meeting the needs of Spanish-speaking residents. The clinics also could continue to serve a market that the Affordable Care Act does not touch: illegal immigrants who are prohibited from getting health insurance under the law.

Dr. Mark Ghaly, the deputy director of community health for the Los Angeles County Department of Health Services, said bodega clinicas — a term he seems to have coined — that agree to some scrutiny could be a good way of addressing the physician shortage in those neighborhoods.

“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”

Los Angeles is not the only city with a sizable Latino population where the clinics have become a part of the streetscape. Health care providers in Phoenix and Miami say there are clinics in many Latino neighborhoods.

But their presence in parts of the Los Angeles area can be striking, with dozens in certain areas. Visits to more than two dozen clinics in South Los Angeles and the San Fernando Valley found Latino women in brightly colored scrubs handing out cards and coupons that promised a range of services like pregnancy tests and endoscopies. Others advertised evening and weekend hours, and some were open around the clock.

Such all-hours access and upfront pricing are critical, Latino health experts say, to a population that often works around the clock for low wages.

Also important, officials say, is that new immigrants from Mexico and Central America are more accustomed to corner clinics, which are common in their home countries, than to the sprawling medical complexes or large community health centers found in the United States. And they can get the kind of medical treatments — including injections of hypertension drugs, intravenous vitamins and liberally dispensed antibiotics — that are frowned upon in traditional American medicine.

The waiting rooms at the clinics reflected the everyday maladies of peoples’ lives: a glassy-eyed child resting listlessly on his mother’s lap, a fit-looking young woman waiting with a bag of ice on her wrist, a pensive middle-aged man in work boots staring straight ahead.

For many ordinary complaints, the medical care at these clinics may be suitable, county health officials and medical experts say. But they say problems arise when an illness exceeds the boundaries of a physician’s skills or the patient’s ability to pay cash.

Dr. Raul Joaquin Bendana, who has been practicing general medicine in South Los Angeles for more than 20 years, said the clinics would refer patients to him when, for example, they had uncontrolled diabetes. “They refer to me because they don’t know how to handle the situation,” he said.

The clinic physicians by and large appear to have current medical licenses, a sample showed, but experts say they are unlikely to be board certified or have admitting privileges at area hospitals. That can mean that some clinics try to treat patients who face serious illness.

Olivia Cardenas, 40, a restaurant worker who lives in Woodland Hills, Calif., got a free Pap smear at a clinic that advertises “especialistas,” including in gynecology. The test came back abnormal, and the doctor told Ms. Cardenas that she had cervical cancer. “Come back in a week with $5,000 in cash, and I’ll operate on you,” Ms. Cardenas said the doctor told her. “Otherwise you could die.”

She declined to pay the $5,000. Instead, a family friend helped her apply for Medicaid, and she went to a hospital. The diagnosis, it turned out, was correct.

Health care experts say the clinics’ medical practices would come under greater scrutiny if they were brought closer into the fold.

But being connected would mean the clinics’ cash-only business model would need to change. Dr. Dowling said the lure of newly insured patients in 2014 might draw them in. “To the extent there are payments available,” he said, “the legitimate ones might step up to the plate.”

This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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Aaron Swartz, Internet Activist, Dies at 26

Michael Francis McElroy for The New York Times

Aaron Swartz in 2009.

Aaron Swartz, a wizardly programmer who as a teenager helped develop code that delivered ever-changing Web content to users and later became a steadfast crusader to make that information freely available, was found dead on Friday in his New York apartment.

He was 26.

 An uncle, Michael Wolf, said that Mr. Swartz had apparently hanged himself, and that Mr. Swartz’s girlfriend had discovered the body.

At 14, Mr. Swartz helped create RSS, the nearly ubiquitous tool that allows users to subscribe to online information. He later became an Internet folk hero, pushing to make many Web files free and open to the public. But in July 2011, he was indicted on federal charges of gaining illegal access to JSTOR, a subscription-only service for distributing scientific and literary journals, and downloading 4.8 million articles and documents, nearly the entire library.

Charges in the case, including wire fraud and computer fraud, were pending at the time of Mr. Swartz’s death, carrying potential penalties of up to 35 years in prison and $1 million in fines.

“Aaron built surprising new things that changed the flow of information around the world,” said Susan Crawford, a professor at the Cardozo School of Law in New York who served in the Obama administration as a technology adviser. She called Mr. Swartz “a complicated prodigy” and said “graybeards approached him with awe.”

Mr. Wolf said he would remember his nephew as a young man who “looked at the world, and had a certain logic in his brain, and the world didn’t necessarily fit in with that logic, and that was sometimes difficult.”

The Tech, a newspaper of the Massachusetts Institute of Technology, reported Mr. Swartz’s death early Saturday.

Mr. Swartz led an often itinerant life that included dropping out of Stanford, forming companies and organizations, and becoming a fellow at Harvard University’s Edmond J. Safra Center for Ethics.

He formed a company that merged with Reddit, the popular news and information site. He also co-founded Demand Progress, a group that promotes online campaigns on social justice issues — including a successful effort, with other groups, to oppose a Hollywood-backed Internet piracy bill.

But he also found trouble when he took part in efforts to release information to the public that he felt should be freely available. In 2008, he took on PACER, or Public Access to Court Electronic Records, the repository for federal judicial documents.

The database charges 10 cents a page for documents; activists like Carl Malamud, the founder of public.resource.org, have long argued that such documents should be free because they are produced at public expense. Joining Mr. Malamud’s efforts to make the documents public by posting legally obtained files to the Internet for free access, Mr. Swartz wrote an elegant little program to download 20 million pages of documents from free library accounts, or roughly 20 percent of the enormous database.

 The government abruptly shut down the free library program, and Mr. Malamud feared that legal trouble might follow even though he felt they had violated no laws. As he recalled in a newspaper account of the events, “I immediately saw the potential for overreaction by the courts.” He recalled telling Mr. Swartz: “You need to talk to a lawyer. I need to talk to a lawyer.”

 Mr. Swartz recalled in a 2009 interview, “I had this vision of the feds crashing down the door, taking everything away.” He said he locked the deadbolt on his door, lay down on the bed for a while and then called his mother.

 

When an article about his Pacer exploit was published in The New York Times, Mr. Swartz responded in a blog post in a typically puckish manner, announcing the story in the form of a personal ad: “Attention attractive people: Are you looking for someone respectable enough that they’ve been personally vetted by The New York Times, but has enough of a bad-boy streak that the vetting was because they ‘liberated’ millions of dollars of government documents? If so, look no further than page A14 of today’s New York Times.

The federal government investigated but decided not to prosecute.

In 2011, however, Mr. Swartz went beyond that, according to a federal indictment. In an effort to provide free public access to JSTOR, he broke into computer networks at M.I.T. by means that included gaining entry to a utility closet on campus and leaving a laptop that signed into the university network under a false account, federal officials said.

Ravi Somaiya contributed reporting.

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At War Blog: Highlights From Karzai, Obama News Conference

President Obama, after meeting with President Hamid Karzai of Afghanistan, said Friday that the United States would be able to accelerate the withdrawal of troops from Afghanistan in coming months because of gains made by Afghan security forces.

As the Times’s Mark Landler reported, Mr. Obama also made it clear that he contemplated leaving relatively few troops in Afghanistan after the NATO combat mission ends in 2014, saying that the mission will be focused on advising and supporting Afghan troops and targeting the remnants of Al Qaeda.

You can watch the full video here:

You can also find the joint statement, released by President Obama and President Karzai here.

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Video game retail sales continued to slide in December, down 22% from 2011

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Alabama's Lacy, Milliner, Fluker enter NFL draft

TUSCALOOSA, Ala. (AP) — Alabama tailback Eddie Lacy, cornerback Dee Milliner and right tackle D.J. Fluker are entering the NFL draft after helping lead the Crimson Tide to a second straight national title.

Lacy and Milliner announced their plans to skip their senior seasons Friday at a news conference. Fluker couldn't be there for the announcement because he was traveling.

It's another exodus of talented underclassmen for a team that has won three of the past four national championships. Most of the four first-round picks in each of the past two drafts that left Alabama were underclassmen.

"I appreciate what they've done for the University of Alabama but we also acknowledge the fact that from a business standpoint, these guys are making good decisions about their future and what they can do," coach Nick Saban said.

Unlike recent groups of departing juniors from Alabama, only Milliner is pegged as a sure first-round pick.

He was a Jim Thorpe Award finalist and unanimous All-American after recording two interceptions and 22 pass deflections. He and guard Chance Warmack, who was a senior, are projected as the Tide's top current prospects.

"I think while I was here, I met all the goals and team affirmations that I set for myself as a freshman by winning a championship, becoming an All-American, just being part of a team that always loved to win," Milliner said. "I think I fulfilled all my goals and am ready and prepared to go to the next level."

Lacy was MVP of the national championship game against Notre Dame after rushing for 140 yards and scoring two touchdowns. He said he wasn't 100 percent healthy all season until the title game Monday night, but Lacy still ran for 1,322 yards and 17 touchdowns while averaging 6.5 yards per carry.

"We don't have a lot of years to play this position, so you have to go while you can," Lacy said. "I would love to come back. This is a great place. We have the best fans, but I really didn't want to risk coming back and not having such a good year or maybe even risking injury. I've had my share of injuries this year. I feel like you've got to get out while you can."

Lacy thinks he "made a pretty solid statement" in the title game, when he made a spin move into the end zone on a TD catch and on another run pushed 248-pound linebacker Danny Spond away with one hand.

Lacy was recruited in the same class as Trent Richardson, last year's No. 3 pick by Cleveland, but redshirted and then spent two seasons as a backup. He's not widely projected to follow Richardson and 2009 Heisman Trophy winner Mark Ingram into the first round. Lacy said he was projected as a second- or third-round pick in feedback from the NFL, but was impressive in the finale. Ordinarily, Saban only recommends projected first-round picks leave early.

"I'm fully supportive of what Eddie's doing," Saban said. "It's a little bit of a different situation than we've had in the past, but it's a little bit unique as well. Every one of these situations is unique to that particular individual and what his situation is. "

The 6-foot-6, 335-pound Fluker started 35 games for the Tide and was a second-team Associated Press All-American.

He was one of the Tide's top-rated signees in 2009 but came in overweight at about 395 pounds and was redshirted.

"I certainly feel like this year has been his best year as a player, and I feel that he's made a good decision about what he wants to do," said Saban, adding that Fluker has improved as much as any player on the team.

The mammoth Fluker, who wears a size-22 shoe, said in a statement that leaving early "is never an easy decision when you are playing at a place like Alabama."

"''These four years in Tuscaloosa have been the best four years of my life and I appreciate everyone who helped me along the way," he said.

Quarterback AJ McCarron, All-America linebacker C.J. Moseley and guard Anthony Steen have already said they're returning for their senior seasons. Saban didn't rule out other juniors possibly declaring for the draft before Tuesday's deadline.

The Tide does have promising players who have logged plenty of playing time behind Lacy and Milliner, especially. Two freshmen — tailback T.J. Yeldon (1,108 yards, 12 touchdowns) — and cornerback Geno Smith saw significant action.

"You've got people that are going to go to the NFL each year and you've got people behind them that are going to do the same things when their time comes," Milliner said.

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Doctor and Patient: When the Doctor Returns to Doctoring

Several years ago, a highly respected medical expert I had just met shared a little-known detail of his illustrious career: as a young doctor, he had stopped practicing medicine for a few years to homeschool his son.

His revelation took me completely by surprise. Doctors rarely talked about taking time off for fear that colleagues would assume them incompetent or in possession of some serious personal flaw.

I understood my colleagues’ hesitation because I always avoided bringing up my own decision to take a professional hiatus.

I had had a harrowing pregnancy, marked by bleeding that worsened anytime I operated. I stopped seeing patients soon after my first trimester and made the decision to extend that break after the birth of healthy twin daughters. But I did so without realizing just how difficult it would be to return.

In all the articles, essays and books on the growing trend among professionals to “opt out” of their careers, doctors, I would discover, remained strangely absent. While the lawyers, accountants, business executives and teachers seemed to ease back into their careers after a few years raising children, attending to their own or loved ones’ health issues or even pursuing entirely new careers, I couldn’t find answers to even my most basic questions. Did I need to be tested, proctored or re-trained? Would I work as an assistant, a doctor-in-training equivalent or a fully trained physician? Were there rules and “industry standards” I needed to pass in order to assure patients I was safe? And in the world of practicing doctors, would the time I spent away from medicine always remain “That-Period-Which-Shall-Not-Be-Named?”

Now, nearly a decade later, studies have shown that more doctors than ever are choosing to take time off, at least twice as many as in previous generations. But while these physicians have more company and support than their predecessors, returning to practice remains daunting in large part because of the persistent stigma. (Interestingly, most of the re-entry doctors I spoke to hesitated or declined to be quoted for this article.)

Although concerns about the competency of returning doctors are justified, the profession’s aversion to discussing the issue and reluctance even to recognize it has had perverse results. There are no national standards for doctors who want to return to clinical practice, only a helter-skelter set of hurdles, hoops and headaches.

“The safety net has big holes in it,” said Dr. Claudette Dalton, the former chair of the American Medical Association’s task force on re-entry who has interrupted her own medical career and re-entered clinical practice twice. For example, roughly half of all the state medical boards, including New York’s, have no policy for doctors attempting to return to clinical practice after an extended period of time away. But even in those states with requirements that range from mandatory completion of an official re-entry training program to passing a written exam, it’s unclear that such policies really do ensure competence. Research on physician re-entry is scarce; and no one really knows when time away begins to affect a doctor’s clinical skills and what might best remediate any deficiencies. Indeed, aside from a few surveys, little is even known about who the re-entering doctors are.

“Our profession needs to be able to reassure patients that the doctor they are seeing knows what he or she is doing and isn’t rusty and creaky like some unoiled door hinge,” Dr. Dalton said.

One particularly promising initiative is a mentored clinical program that slowly re-introduces doctors to practice. At the physician re-entry program at Cedars-Sinai Medical Center in Los Angeles, one of fewer than a dozen such programs throughout the country, re-entering doctors work with three different experienced senior physicians in their field, attend lectures, participate in teaching and work rounds, take call and progressively shoulder more responsibility. At the end of two or three months, the doctors submit to a rigorous exit interview, where they can be drilled on any of the cases they have seen.

Of the 14 doctors who have gone through the Cedars-Sinai program, 13 have successfully returned to practice. But with the costs for such programs ranging from $5,000 to $10,000 a month or more, many doctors cannot even consider enrolling in one even if their state licensing boards mandates them.

“We’ve had a blind spot when it comes to physician re-entry,” said Dr. Leo A. Gordon, who heads the Cedars-Sinai program, “even though it really should be part of the profession’s obligation, especially with the upcoming physician shortage.”

That doctor deficit is expected to surpass 100,000 physicians within the next 15 years. But according to the American Medical Association, at least 10,000 doctors each year are currently looking to return to clinical practice. Re-entry experts believe that these doctors, if successfully returned to practice, could not only help to alleviate the doctor shortage but would do so quickly.

“This is not a seven-year pipeline,” said Dr. Dalton, referring to the usual time required to educate and train a new doctor. “This is a 6-month to a year pipeline at most because a lot of those doctors when assessed could be perfectly fine.”

Although the A.M.A. and a few professional organizations like the American Academy of Pediatrics have increased their efforts to support returning physicians and create national standards, those initiatives will only falter without a major shift in the attitude of the profession itself.

“We have to realize that it’s not about abdicating your profession,” Dr. Dalton said. “It’s about having some sensibility about the priority in your life at a certain moment, then returning to your clinical roots and coming back to serve your profession.”

I have been back in clinical practice for several years now. My path of return was neither obvious nor straightforward, but I have always remained grateful to the doctor who oversaw my re-entry process. He and his colleagues willingly took me on, persisted in putting me through the paces and displayed an unfailing and contagious devotion to the highest standards of care.

Through it all, they understood that stopping working as a doctor temporarily to be a mother never meant I had stopped loving patient care.

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Correction: The head of the Cedars-Sinair re-entry program is Leo A. Gordon, not Leo G. Gordon.

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France Near Deal to Simplify Labor Regulations

PARIS — French labor unions and business leaders appeared close to striking a deal Friday to make it easier to hire and fire employees in France’s notoriously rigid labor market. An accord would tame some of the most confounding rules in the 3,200-page labor code, as the country tries to increase its competitiveness and curb unemployment.

After weeks of sparring among the five major labor unions and the main employers’ lobby, both sides were edging toward a breakthrough that could pave the way for a series of changes that President François Hollande has said are needed to burnish France’s international allure as a place to do business.

Those ambitions were clouded recently by a series of high-profile episodes, including a recent government threat to nationalize an ArcelorMittal plant in northeastern France to preserve jobs. There was also the audacious decision during the past week by the French actor Gérard Depardieu to take Russian citizenship to escape a proposed 75 percent marginal tax rate on incomes of more than €1 million, or €1.3 million.

The labor measures expected to be cemented in the accord still being worked out late Friday would help address what Louis Gallois, Mr. Hollande’s investment commissioner, has dubbed a “two-speed” labor market in France. Under that system, employees on long-term contracts enjoy extensive, costly job protections and benefits, while temporary workers, whose ranks have surged to one-third of the French labor force, have minimal job security and relatively few benefits.

The changes under discussion would include giving employers more flexibility to reduce working hours in times of economic distress without incurring union strikes. High levels of compensation that courts can award to laid-off workers would be trimmed, and the five-year period that ex-employees now have to contest layoffs would be reduced.

In November, the government introduced a tax credit for companies, potentially worth a total of €20 billion, aimed at easing high employment costs.

In exchange, business negotiators on Friday agreed, as a concession to unions, to pay higher taxes for short-term work contracts. Two unions objected that the offer was not enough, a hitch that could still scuttle the talks. But if approved, that move would expand government coffers meant to support the unemployed, while also nudging employers toward favoring long-term contracts. Employers would also pay somewhat higher contributions for private health insurance.

But whether any of the changes, even if nailed down in a binding agreement, will come fast enough to fix France’s problems is an open question. Some economists now say that France could become the next sick man of Europe if it does not improve the environment for investment and hiring.

“Given the gap we still have between the level of labor market regulation in France and in countries like the United States, Britain and Ireland, it is very clear that when observers look at the outcome, they will say it’s a step in the right direction, but not enough,” said Dominique Barbet, the European economist for BNP Paribas in Paris.

“But we also need to keep in mind that in France, if you want to make reforms, you have to go through small steps first,” he said. “You can’t try to change the system overnight. That usually results in mass protests in the streets.”

Mr. Hollande’s government is expected to sign off on the deal. He has said it will help him keep a promise of reducing unemployment, now at a 13-year high of 10.7 percent, by the end of 2013. Youth unemployment is now around 25 percent.

Mr. Hollande sought the accord after Mr. Gallois issued a stark assessment of the French economy in November, saying the country needed a “competitiveness shock” that would require politicians to curb the “cult of regulation” that the Mr. Gallois said was choking business.

Under current labor rules, many entrepreneurs in France hesitate to hire large numbers of workers. Some employers even resort to operating several companies with no more than 49 employees each, instead of running larger ones that employ hundreds.

That is because after the 50th person is hired, a stack of new regulations come into play, including lengthy firing procedures even for underperforming employees, and requirements for numerous union representatives.

Temporary contracts fall on the other end of the scale: they are often lower-paid and offer far fewer protections, something that has alarmed French labor unions. More than 80 percent of new contracts now issued in France are short term, a trend that has grown steadily as employers turn to them to escape the costly rules protecting permanent workers.

Mr. Gallois’s report said that unless France relaxed its labor rules, the country would continue on an industrial decline that had destroyed more than 750,000 jobs in a decade and helped shrink France’s share of exports to the European Union to 9.3 percent from 12.7 percent. The report also called for cuts to a variety of business taxes used to pay for government and France’s expensive social safety net.

The International Monetary Fund in December warned that France needed to lift competitiveness or risk rising unemployment. Because of continued impediments in the functioning of labor and product markets, the fund added, French companies were earning lower profit margins than in other European countries, in turn affecting the ability of enterprises to invest and innovate.

While the impact of such changes will take time, France has already taken a series of steps that could help it skirt the worst in coming years. A fiscal consolidation begun in 2010 is continuing, in which tax increases and spending cuts are being applied to bring the overall budget deficit down to 3 percent of gross domestic product in 2013, from an estimated 4.5 percent in 2012.

The economy is expected to grow about 0.4 percent in 2013, according to the I.M.F.

“What’s most important is that France get an economic recovery,” said Mr. Barbet, of BNP Paribas. “If we don’t have that, people won’t hire no matter what the new labor rules are.”

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Blasts in Pakistan Kill at Least 88 and Raise Fears Over Elections

Waheed Khan/European Pressphoto Agency

The worst violence was concentrated in the southwestern city of Quetta, where two explosions killed at least 57 people and wounded more than 110, the police said.

ISLAMABAD, Pakistan — Bomb blasts in two Pakistani cities killed at least 88 people on Thursday and wounded more than 270, offering harrowing evidence of how the country’s myriad internal conflicts may destabilize it as elections approach.

The worst violence was concentrated in the southwestern city of Quetta, where two explosions a few minutes apart in the evening ripped through a billiards hall in a neighborhood dominated by ethnic Hazara Shiites, killing at least 57 people and wounding more than 110, the police said.

A suicide bomber detonated his explosives inside the hall, and a second attacker then blew up his vehicle outside the club as police officers and journalists arrived, a senior police officer, Mir Zubair Mehmood, told reporters. The television channel Samaa said one of its camera operators was killed by the second explosion after rushing to the scene. Hospitals were overwhelmed as casualties arrived through the evening.

Quetta is no stranger to sectarian, nationalist and Islamist violence. Most violence against Shiites there has been directed by Lashkar-e-Jhangvi, a Sunni militant group with strong ties to the Pakistani Taliban. But there was no immediate claim of responsibility for the billiard hall attack.

An ethnic Baluch separatist group claimed responsibility for another bombing earlier on Thursday, aimed at paramilitary soldiers in a commercial part of Quetta, which killed 12 people.

The Hazara, minority Shiites who migrated from Afghanistan more than a century ago, have been the target of dozens of attacks from sectarian death squads led by Lashkar-e-Jhangvi in Quetta over the past year, but the billiard hall attack was by far the bloodiest.

Human rights activists said the police and the security forces failed to protect the vulnerable community. “The callousness and indifference of authorities offers a damning indictment of the state, its military and security agencies,” said Ali Dayan Hasan, the Pakistan director at Human Rights Watch.

The other focus of violence on Thursday was the Swat Valley, in the Hindu Kush mountains in northwestern Pakistan, where an explosion in the basement of a religious seminary killed at least 22 people and wounded an additional 60. It was not clear why the seminary, run by the Islamic missionary group Tableeghi Jamaat, was a target.

Initial reports said a gas leak had caused the explosion, but police and hospital officials later said that there was clear evidence of a bomb.

Doctors at a hospital in Saidu Sharif, near the site, said blast victims were being treated for wounds caused by ball bearings, which are sometimes packed into suicide bombs to make them more deadly.

“There was a smell of explosives,” Muhammad Iqbal, a senior doctor, said by telephone.

The violence underscores the fragility of state authority in parts of Pakistan as the country prepares for a general election that analysts say is likely to take place before June. Many Pakistanis worry that increasing instability could cause the elections to be postponed.

Islamist violence in Swat drew international condemnation in October after Taliban gunmen shot a teenage schoolgirl and education activist, Malala Yousafzai. The episode highlighted how Islamist fighters were slowly returning to the valley three years after a Pakistani military operation drove them away.

Ismail Khan contributed reporting from Peshawar, Pakistan.

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