Medications for Treating a Common Infection Are Losing Effectiveness

The misuse and overuse of antibiotics continues to be a vexing problem in the United States, particularly in the southeastern part of the country, according to a new report that tracks antibiotic resistance patterns.

The survey found a decline in the number of MRSA infections—methicillin-resistant staphylococcus aureus—a potentially dangerous skin infection. However, more antibiotics are becoming resistant to the bacteria that cause urinary tract infections, which is a common infection that had been fairly easy to treat until recently.

The data were released by Extending the Cure, a project of the Center for Disease Dynamics, Economics & Policy, a nonprofit think tank with offices in Washington, D.C. and New Dehli. The organization’s mission is to gather evidence on antibiotic overuse and resistance.

“People don’t realize we’ve only had antibiotics for about 70 years. That is a very, very short period of time,” Ramanan Laxminarayan, director of Extending the Cure, told Take Part. “We have these wonderful, helpful drugs that are able to do things that we’ve never done before—and now we’re about to lose them again. I don’t think people realize how much we depend on them.”

Unnecessary use makes antibiotics less effective in fighting off infections because, when repeatedly exposed to certain drugs, microbes change and become resistant. Widespread publicity about antibiotic overuse has led to some positive changes in prescribing patterns. Antibiotic prescriptions in the United States fell 17 percent from 1999 to 2012, according to the report. Far fewer pediatricians, for example, prescribe antibiotics for children’s mild respiratory symptoms and earaches.

“That is really good news,” Laxminarayan says. “There is progress at reducing antibiotic use at things where people think they should never have been prescribed in the first place. We’re not denying antibiotics when people really need it. We are denying antibiotics when we don’t need it.”

MORE: The Verdict Is in: Antibiotics in Animal Feed Create Superbugs

Moreover, the ability to treat skin infections has improved since the peak days of MRSA cases in the mid-2000s. MRSA infections have fallen by about half due to efforts to find new therapies and interventions.

However, antibiotic resistance is still a huge problem, Laxminarayan says. The report found that some of the drugs used to treat urinary tract infections are failing because bacterial resistance to those medications has increased by more than 30 percent since 1999.

Urinary tract infections, which are caused by the E. coli bacteria, account for more than 8.6 million visits to healthcare professionals each year, according to the Centers for Disease Control and Prevention. If untreated, these infections can turn into life-threatening bloodstream infections.

“Things that were commonly treatable are not as treatable anymore,” Laxminarayan says.

MORE: Study Uncovers Alarming Worldwide Rates of Drug-Resistant TB

Hospitals remain at the center of the antibiotic-resistance problem, he says. Hospital patients are typically older and sicker, and heavy antibiotic use is often necessary. But hospitals can help address antibiotic resistance by taking steps to curb the spread of infections within the hospital, he says. Five to eight percent of people develop an infection while in the hospital.

“We have sharply increased resistance around the country because it is not going down in hospitals, and hospitals are where the worse kinds of resistance are found,” he says. “We’ve advocated for having stronger hospital infection control. If you stop the infection from spreading, you don’t have to worry about resistance. We need pretty much a revolution regarding infection control in hospitals.”

The survey also found eye-opening regional differences regarding antibiotic resistance, such as higher levels of antibiotic overuse in the southeastern United States. It’s not clear why that area of the country has lagged behind, he says.

MORE: Judge to FDA on Antibiotics: Prove They’re Safe

The survey found that residents of Appalachian and Gulf Coast states, where antibiotic use rates are highest, take about twice as many antibiotics per capita as people living in Western states. In 2010, the five states with the highest rates of antibiotic use in the nation were Kentucky, West Virginia, Tennessee, Mississippi, and Louisiana. The five states with the lowest antibiotic use in the nation were Alaska, Hawaii, California, Oregon, and Washington.

Extending the Cure displays its data online via the ResistanceMap, a tool created to track changes in antibiotic drug use and resistance. People can see how the area they live in compares to other regions.

“We want people to be knowledgeable and therefore empowered about what they can do about the problem,” Laxminarayan says.

Earlier this month, the CDC, Extending the Cure and 25 other national health organizations issued a joint consensus statement on the need to preserve antibiotic effectiveness and fight over-use.

“When so many government agencies and public organizations have signed on it indicates we’re all pointing in the same direction,” Laxminarayan says.

Question: What should be done to reduce the overuse of antibiotics? Tell us what you think in the Comments.

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Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.

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Asian shares, euro rise on Greek debt deal

TOKYO (Reuters) – The euro hit a one-month high and Asian shares climbed for a seventh consecutive day on Tuesday while commodities rose and the dollar eased after a deal on new debt targets for Greece and a political agreement on disbursing the next installment of aid.

After 12 hours of talks at their third meeting in as many weeks, Greece’s international lenders agreed on a package of measures to cut Greek debt to 124 percent of gross domestic product by 2020, and pledged to take further steps to lower the debt below 110 percent of GDP in 2022.

Eurogroup Chairman Jean-Claude Juncker said ministers would formally approve the release of crucial aid for debt-stricken Greece, removing uncertainty over whether Athens could avoid a near-term bankruptcy.

Investors’ focus is likely to shift now to another major concern hanging over markets, a looming U.S. fiscal crisis.

MSCI’s broadest index of Asia-Pacific shares outside Japan <.MIAPJ0000PUS> gained 0.6 percent to its highest level in nearly three weeks, led by a 1 percent advance in Korean shares <.KS11> and a 0.6 percent rise in Australian shares <.AXJO>.

“The news of the Greek debt deal, plus U.S. fiscal cliff talks resuming this week, has spurred investor appetite,” Kim Young-joon, an analyst at SK Securities, said of Korean stocks.

Republicans in the U.S. Congress on Monday called on President Barack Obama to detail long-term spending cuts to help solve the country’s fiscal crisis, while holding firm against the income tax rate increases for the wealthy that Democrats seek.

“Now people will start focusing on the U.S. fiscal cliff and there could be some nervousness there, particularly if it drags on,” said Burrell & Co dealer Jamie Elgar of Australian shares.

The euro gained as much as about 0.3 percent to $ 1.3010, its highest level since October 31, in reaction to the Greek news, before paring most gains to be up 0.1 percent at $ 1.2982.

Hiroshi Maeba, head of FX trading Japan for UBS in Tokyo, cautioned that the euro still faced downside risks as the latest agreement does not offer a fundamental resolution to the euro zone’s debt crisis.

“The euro gained but the rise is small, and it’s unlikely that it will climb further, with big funds winding down their positions ahead of the year-end. Any rise will be countered by selling to cap the euro’s upside,” Maeba said.

Japan’s Nikkei stock average <.N225> edged up 0.4 percent, nearing Monday’s seven-month closing high. The benchmark has climbed more than 8 percent in two weeks as the yen has weakened on expectations of easier monetary policy with the likely election of a new government. <.T>

WEAK USD, CHINA HELP COMMODITIES

The dollar was down 0.1 percent against the yen at 82 yen.

Traders said some investors unwound long positions in the dollar built up in recent weeks on expectations that a new government for Japan, which is likely to be installed after next month’s election, will pressure the central bank to pursue aggressive monetary easing.

The dollar eased 0.2 percent against a basket of key currencies <.DXY>, helping to underpin dollar-based commodities.

U.S. crude futures rose 0.3 percent to $ 88.03 a barrel and Brent was up 0.2 percent to $ 111.12.

Spot gold was up 0.1 percent to $ 1,749.30 an ounce, just below a six-week high of $ 1,754.10 hit on Friday.

London copper inched up 0.1 percent and hit a near one-month high as the Greek debt deal added to confidence over demand for copper after recent positive data from its top consumer China.

Sentiment may be further underpinned by a report saying China has approved construction of two city subway projects worth 49 billion yuan ($ 7.87 billion), adding to the list of recent railway project approvals aimed at boosting growth in the world’s second biggest economy.

In another possible sign of economic recovery, China’s industrial profits in October were up 20.5 percent from a year earlier, accelerating from 7.8 percent growth in September.

Asian credit markets firmed slightly, narrowing the spreads on the iTraxx Asia ex-Japan investment-grade index by 1 basis point.

(Additional reporting by Ayai Tomisawa in Tokyo, Joyce Lee in Seoul and Victoria Thieberger in Melbourne; Editing by Edwina Gibbs & Kim Coghill)

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Dog days in Cuba: from shih tzus to schnauzers

HAVANA (AP) — The Cuban capital has played host to political summits and art festivals, ballet tributes and international baseball competitions. Now dog lovers are getting their chance to take center stage.

Hundreds of people from all over Cuba and several other countries came to a scruffy field near Revolution Plaza this past week to preen and fuss over the shih tzus, beagles, schnauzers and cocker spaniels that are the annual Fall Canine Expo’s star attractions. There were even about a dozen bichon habaneros, a mid-sized dog bred on the island since the 17th century.

As dog lovers talked shop, the merely curious strolled the field, checking out the more than 50 breeds on display while carefully dodging the prodigious output of so many dogs.

The four-day competition, which ended Sunday, included competitions in several breeding categories, and judges were flown in from Nicaragua, Colombia and Mexico.

“This is a small, poor country, but Cubans love dogs,” said Miguel Calvo, the president of Cuba’s dog federation, which organized the show. “We make a great effort to breed purebred animals of quality.”

Winners don’t receive any trophy or prize money, but that doesn’t mean the competition is any less fierce.

Anabel Perez, owner of a cocker spaniel named Lisamineli after the U.S. actress, spent more than half an hour coifing the dog’s hair in preparation for the competition, while the owner of a shih tzu named Tiguer meticulously brushed his coat nearby.

“I’m a hairdresser for humans,” explained Tiguer’s owner, Miguel Lopez. “So it’s easy for me. I like shih tzus because they are a lot of work to keep well groomed.”

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Nokia imaging chief to quit

HELSINKI (Reuters) – Nokia‘s long-time imaging chief Damian Dinning has decided to leave the loss-making cellphone maker at the end of this month, the company said in a statement.

The strong imaging capabilities of the new Lumia smartphone models are a key sales argument for the former market leader, which has been burning through cash while losing share in both high-end smartphones and cheaper handsets.

Nokia’s Chief Executive Stephen Elop has replaced most of the top management since he joined in late 2010 and Dinnig is the latest of several executives to leave.

Dinning did not want to move to Finland as part of the phonemakers’ effort to concentrate operations and will join Jaguar Land Rover to head innovations in the field of connected cars, he said on Nokia’s imaging fan site PureViewclub.com.

(Reporting By Tarmo Virki, editing by William Hardy)

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“Rise of the Guardians” Barrier-Breaker: The First African-American to Direct a CG Animation Film

LOS ANGELES (TheWrap.com) – Peter Ramsey didn’t just have the pressure of making his feature directing debut on an $ 145 million tentpole film, he also had to deal with the expectations that came with being a barrier-breaker.

By sliding behind the camera on DreamWorks Animation‘s “Rise of the Guardians” Ramsey made history as the first African-American to helm a major CG animated film.

“Rise of the Guardians,” a sort of “Avengers” for the fairy-tale set, opened Wednesday. It tells the story of a group of mythological heroes like Santa Claus (voiced by Alec Baldwin), Jack Frost (Chris Pine) and the Easter Bunny (Hugh Jackman) who team up to prevent the Nightmare King (Jude Law) from plunging children around the world into a state of despair and hopelessness. The film is an adaptation of a popular series of children’s books by William Joyce.

Ramsey talked with TheWrap about the responsibility of being a role model, the need to inject a little darkness into children’s entertainment and the possibility of a “Guardians” sequel.

What does it mean to be the first African American to direct a CG movie on this scale?

I really wasn’t thinking, “Oh, I’m a pioneer” when I first got the project. It wasn’t until my mom and dad saw an article that mentioned that fact – and I saw that my dad had tears in his eyes – that it really snapped back to me and I realized this is kind of a big deal. That’s the way it is any time some hurdle falls away.

I grew up in South-Central L.A. at a time before there was Spike Lee or John Singleton, so there was really no conception that I could make films. It’s super fulfilling that kids growing up like I did can now have it permanently in mind that it’s a possibility for them.

What films inspired your approach to the film?

I always knew that I wanted to make a fun, action-packed, big, epic fantasy movie rather than a quaint little fairy tale. So I thought of “Star Wars” and “Harry Potter,” where there were big ensemble casts. But stylistically I also thought of Michael Powell’s “Black Narcissus.” I really wanted Santa’s world to have the same dreamlike feel with bold, striking visuals.

There are some really dark elements in the film. Were you worried about it becoming too scary?

It’s important that we acknowledge the existence of some darkness in the world. Part of the point of the film is to say that these characters are real because kids believe in them, that kids know fear, too. We didn’t want to present a world that was free of the shadow that the Guardians fight, because they are using imagination to combat fear and hopelessness.

What drew you to the material?

For me, it was just hearing about Bill Joyce’s notion that all these characters are real and knew each other and had a common purpose.

It seemed like it had this epic fantasy, “Lord of the Rings” potential.

And when I started looking at what Bill had done, I was blown away. The mythologies are so wild and ornate. It’s an entirely new universe, and our movie just scratches the surface. We just started to go down the rabbit hole.

I’m beginning to smell “franchise.” Would you want to direct the sequels?

Yeah, I would love to. I’ve fallen in love with the characters. I feel like there’s plenty of fertile ground for more good stories. There’s more opportunities to push it further. I almost wish I could do the first feature again, to do it more justice.

You are self-taught, no? You came into this industry not as a director, but as a storyboard artist, is that correct?

Yeah, I am. It’s the old thing about how do you get to Carnegie Hall? Practice, practice, practice. I’ve been drawing ever since I was 3. But I wanted to be a comic-book artist, and it was not until quite a bit later that I realized I could work in the movie business.

I stumbled into story boarding through a lucky confluence of things. I realized the work I was doing for comics was similar to helping directors visualize a story. I took maybe a couple of film history classes in college, but I couldn’t afford to make films in film school. I needed to get in on the fringes of the industry to get the on the job training I needed to become a director.

Did you have a favorite Guardian?

If I had to say one, it would be North. It was great to give him a real presence, and casting Alec did a lot to help that. It was slightly unexpected, but it feels so right. I would just love to hang out with that guy and it helps that he reminds me of Guillermo del Toro.

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Prescribe morning-after pills in advance, say pediatricians

NEW YORK (Reuters) – Wading into the incendiary subject of birth control for young teenagers, the American Academy of Pediatrics (AAP) on Monday called on the nation’s pediatricians to counsel all of their adolescent patients about emergency contraception and make advance prescriptions for it available to girls under 17.

Because current federal policy bans over-the-counter sales of the pills to girls under 17, having a prescription on hand could help younger teens obtain emergency contraception more quickly than if they have to contact a physician only after they need it.

Calling the AAP decision “significant,” Susan Wood, former assistant commissioner for women’s health at the Food and Drug Administration (FDA), said, “it’s not often you see physician organizations saying that their patients are better off without the physician involvement.”

It is anyone’s guess whether pediatricians will heed their organization’s recommendation, but AAP leaders are optimistic.

“We do hope that pediatricians read the policy statement and follow the recommendations,” said Dr. Cora Breuner, a pediatrician at Seattle Children’s Hospital who led the AAP panel that produced the recommendations. “The Academy prides itself on a devoted membership.”

Emergency contraception for adolescents has been one of the most politically fraught areas in healthcare for almost a decade.

In 2005 the FDA declined to approve any over-the-counter sales of Plan B, a “morning-after pill,” overruling its panel of outside experts as well as its own scientists. Last December the FDA reversed that stance and moved to approve over-the-counter sales with no age limits. But Health and Human Services Secretary Kathleen Sebelius overruled it, ordering that for girls under 17 the pills remain available only by prescription.

The policy means that women in their 20s, 30s, or beyond must also present proof of age, and that teenagers “face a significant barrier if they suddenly need emergency contraception at midnight on a Saturday,” said Wood, who resigned from the FDA in 2005 over its Plan B decision and is now director of the Jacobs Institute of Women’s Health at George Washington University in Washington, D.C.

The most common form of emergency contraception is a high dose of a regular birth-control pill such as Plan B and Plan B One-Step from Teva Pharmaceutical Industries Ltd or Next Choice from Watson Pharmaceuticals Inc. They generally sell for $ 10 to $ 80 and, although they can work as long as 120 hours after unprotected sex, are most effective in the first 24 hours.

All work by preventing ovulation, not by stopping the implantation of a fertilized egg. “These are not abortifacients,” said Breuner.

GREATER USE OF EMERGENCY CONTRACEPTION

A 2006-08 survey found that 14 percent of sexually experienced girls had used emergency contraception, up from 8 percent in a 2002 survey. The most common reason was condom failure, but 13 percent of the girls said it was because of rape.

A 2010 analysis of seven randomized studies of emergency contraception found that having a morning-after prescription in hand did not increase teens’ sexual activity or decrease use of standard contraceptives but did increase use of the pill and shorten the time before a teenager used it after sex.

“It’s just common sense that requiring a prescription is a barrier,” said Bill Alpert, chief program officer of the National Campaign to Prevent Teen and Unplanned Pregnancy. “If an august and respected medical group like AAP is suggesting providing emergency contraception to minors is OK, that is a big deal.”

That is especially so when teens face other obstacles to getting emergency contraception. For instance, in a 2012 study that had 17-year-olds telephone pharmacies asking about morning-after pills, only 57 percent of them correctly told the caller that she could get the drugs without a prescription.

Another barrier is that some physicians refuse to provide the prescriptions to teenagers, while others do so only in cases of rape, AAP’s research shows, suggesting that the refusal “may be related to the physician’s beliefs about whether it is OK for teenagers to have sex.”

But pediatricians, said AAP in its policy statement, “have a duty to inform their patients about relevant, legally available treatment options,” even those “to which they object.”

There are no good data on how many physicians write prescriptions ahead of time for emergency contraception. “But we do know that pediatricians don’t even talk about it, let alone offer advance prescriptions,” said Breuner. “We tend not to like bringing up stuff that’s controversial.”

One factor in the AAP’s recommendation, which is being published in the journal “Pediatrics,” is that although teen pregnancies in the United States have declined since 1991, the rate is higher than in most other developed countries. The percent of 15- to 18-year-olds who report ever having intercourse – just over 40 percent, according to the U.S. Centers for Disease Control and Prevention – is, however, lower than in many developed countries. In other words, fewer of America’s teens are having sex but more are getting pregnant.

“We think this is a big deal,” Breuner said of the new recommendation. “The mothership of pediatricians has come out in favor of encouraging routine counseling and advance emergency-contraception prescriptions as one part of a public health strategy to reduce teen pregnancy.”

(Reporting by Sharon Begley; editing by Prudence Crowther)

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The Man With a China Growth Plan

China’s premier-elect, Li Keqiang, ran a province of 93 million people that endured three deadly fire disasters and an HIV blood scandal on his watch. His run of bad luck as Governor of Henan from 1998 to 2004 earned him the nickname Three-Fires Li in the foreign press. Beijing’s Communist officialdom, however, has high hopes for Li, an award-winning economist for his work on urbanization, in his new role as the country’s top economic policymaker.

In March, Li, 57, will inherit an economy forecast to grow at 7 percent in 2013, the slowest pace in at least 23 years, according to investment fund company Pimco. It will take major economic reforms to arrest the slowdown, encourage growth of globally competitive private sector companies, and address a widening income gap. China’s new leadership team, led by incoming Communist Party General Secretary and President-elect Xi Jinping, needs to roll back the dominant state-owned enterprises that receive the majority of loans from government-controlled banks, according to the World Bank’s “China 2030” study, which Li has publicly endorsed. Another task: Allow the markets—not bureaucrats—to determine the prices for everything from bank loans to raw materials.

Although millions have escaped poverty since Deng Xiaoping opened China to foreign investment and put in place limited reforms in 1978, the world’s second biggest economy faces new challenges—namely, what economists call the middle-income trap. That refers to the slower growth developing economies encounter when they fail to implement political, financial, and legal reforms needed to create a bigger middle class. Of 101 middle-income economies in 1960, only 13 became high-income societies by 2008, the World Bank estimates. The bank defines high-income as $ 12,476 or more in per-capita gross national income.

In speeches, Li hasn’t been shy about pointing to what he thinks are China’s economic shortcomings: an unsustainable rate of investment, an overdependence on exports, weak domestic consumption, and an underdeveloped service sector. Li has also emphasized the growing income inequality that resulted in city dwellers earning 3.3 times more than their rural counterparts in 2009.

More than 100 million people left farms for cities during Hu Jintao’s presidency, many for jobs in factories, and Li wants to see even faster urban migration to boost incomes. By 2030 as many as 300 million more people will have moved from the countryside to join 600 million already living in cities, the Organisation for Economic Co-operation and Development estimates. Urbanization “is the fuel for a sustained high-investment ratio in Chinese GDP,” says Stephen Roach, former nonexecutive chairman at Morgan Stanley (MS) in Asia and a senior fellow at Yale University. “But here’s the catch—urbanization is a transition strategy at best. It will have to have an increasingly services-led job creation to absorb the influx of surplus labor, and only then can the urbanization strategy really come to life.”

Rebalancing Chinese growth away from exports and expanding middle-class incomes will require taking on provincial governments and state-run companies and banks that have grown rich off the current system. “The big question is whether China will change before a crisis forces it to,” says David Loevinger, former senior coordinator for China affairs at the U.S. Treasury Department.

Few dispute Li’s economic credentials. During the years he spent running Henan and then Liaoning, these regions grew at more than 10 percent annually. He has a law degree and a Ph.D. in economics from Peking University. “He is a new generation of leader,” says Robert Lawrence Kuhn, author of How China’s Leaders Think and an adviser to the Chinese government. Yet it will take more than economic savvy to push through controversial economic reforms. Big state companies and bureaucrats “won’t be listening to a weak premier,” says Lam Wo Lap Willy, an adjunct professor of history at the Chinese University of Hong Kong. China needs an iron-fisted reformer like Premier Zhu Rongji, who fought government corruption and forced state-owned banks to deal with dud loans during the 1990s, he says. “People feared Zhu Rongji,” says Lam. “But nobody is going to fear Li Keqiang.”

The bottom line: China’s new reformist premier aims to expand migration to cities, where incomes are three times higher than in the countryside.

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Israel successfully tests missile defense system

JERUSALEM (AP) — Israel successfully tested its newest missile defense system Sunday, the military said, a step toward making the third leg of what Israel calls its “multilayer missile defense” operational.

The “David’s Sling” system is designed to stop mid-range missiles. It successfully passed its test, shooting down its first missile in a drill Sunday in southern Israel, the military said.

The system is designed to intercept projectiles with ranges of up to 300 kilometers (180 miles).

Israel has also deployed Arrow systems for longer-range threats from Iran. The Iron Dome protects against short-range rockets fired by militants in the Gaza Strip and Hezbollah guerrillas in Lebanon. Iron Dome shot down hundreds of rockets from Gaza in this month’s round of fighting.

Israeli Defense Minister Ehud Barak said the success of Iron Dome highlighted the “immense importance” of such systems.

“David’s Sling,” also known “Magic Wand,” is developed by Israel’s Rafael Advanced Defense Systems and U.S.-based Raytheon Co. and is primarily designed to counter the large arsenal of Hezbollah rockets in Lebanon.

The military said the program, which is on schedule for deployment in 2014, would “provide an additional layer of defense against ballistic missiles.”

The next generation of the Arrow, now in the development stage, is set to be deployed in 2016. Called the Arrow 3, it is designed to strike its target outside the atmosphere, intercepting missiles closer to their launch sites. Together, the two Arrow systems would provide two chances to strike down incoming missiles.

Israel also uses U.S.-made Patriot missile defense batteries against mid-range missiles, though these failed to hit any of the 39 Scud missiles fired at Israel from Iraq In the first Gulf War 20 years ago. Manufacturers say the Patriot system has been improved since then.

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Review: “Liz & Dick” Is Bad, But You Knew That

NEW YORK (TheWrap.com) – Lifetime’s “Liz & Dick” is very bad, just as you knew it would be.

Let’s not pretend it ever had a shot at being decent. The decision to cast Lindsay Lohan as Oscar-winning screen legend Elizabeth Taylor told us right up front that the filmmakers were more interested in trashy publicity than quality. She isn’t good, but no one could be good with this dialogue.

On an online “Saturday Night Live” skit this week, Bobby Moynihan portrayed celebrity chef Guy Fieri responding to a New York Times review of his new Times Square restaurant, saying the paper shouldn’t have had high expectations.

“If you come in expecting Le Cirque, then you’re a le jerk,” he says.

That applies here, too. But “Liz & Dick” isn’t even good as junk food goes. It’s redundant and boring in a way no star could save.

It’s been suggested that the movie could at least be dopey fun, the stuff of drinking games. But that seems a perverse way to watch a movie about two people who, as portrayed here, were messy drunks. The only appropriate drinking game might be one where you take a shot of water every time you scream at the screen, “STOP DRINKING.”

Because the producers invested nearly all their energies in stunt casting, the only point of interest is how Lohan looks and sounds as Taylor. Though she often looks lovely – nice to see after her years of battling drugs and alcohol – Lohan doesn’t look like Taylor, just like someone wearing knockoffs of her clothes and diamonds. She also doesn’t sound like her, or seem to be making any attempt to.

Taylor and Richard Burton (Grant Bowler) meet cute while making “Cleopatra” together and quickly fall into a dull cycle of making out, breaking up, drinking too much, fleeing the paparazzi, and conniving to make movies together. This takes up the middle hour or so of the two-hour movie, and requires that the last 15 minutes be stuffed with an absurd number of events, including (spoiler alert) a cancer scare, a remarriage, and a death.

It’s impossible to feel any emotional connection with the characters, because, as portrayed here, they’re self-centered asses. It doesn’t help that the dialogue is awful, and that many scenes are less than 30 seconds long, which doesn’t allow us into the character’s heads. The scenes are strung together by sub-sitcom transitional music that at least tips us off to the disposability of the entire movie.

Lohan will probably make the case, somewhere down the line, that her flat, vacant line readings were a campy attempt to distance herself from the film’s many bad lines. One of the worst comes when Taylor’s mother notes her tendency to get married a lot.

Mom: “Not that I’m counting, but if I’m not mistaken you’ve just ended, what, you’re fourth marriage?”

Liz: “Who’s counting?”

Well, not her mother, since she just said… never mind.

Bowler is better, handling his lines with the professionalism of a good soaps actor. At one point he gets to call Liz a “harridan” in an amusing Welsh accent. But he has none of Burton’s gravity or grit. He may also be too generically handsome for the role, no surprise in a movie with no pretensions of depth.

Lohan’s costumery is especially silly near the end, when her hair has grey streaks but she still looks far too young to play a woman in her sixties. We’re also told throughout the movie how fat Liz and Dick are getting – usually by Liz and Dick themselves – but we have to pretend to see it, since the actors who play them remain trim.

Perhaps because of her own awful relationship with the press, Lohan seems unwilling to let herself appear vulnerable. It’s become a major impediment to her performances.

Her idol, Marilyn Monroe, continued to study acting well into her stardom, and turned in some very good performances as a result. Lohan might want to imitate Monroe’s interest in her craft, rather than just dressing like her for magazine spreads.

It’s too late for her to do more than dress like Taylor.

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