Well: Exercise and the Ever-Smarter Human Brain

Anyone whose resolve to exercise in 2013 is a bit shaky might want to consider an emerging scientific view of human evolution. It suggests that we are clever today in part because a million years ago, we could outrun and outwalk most other mammals over long distances. Our brains were shaped and sharpened by movement, the idea goes, and we continue to require regular physical activity in order for our brains to function optimally.

Phys Ed

Gretchen Reynolds on the science of fitness.

The role of physical endurance in shaping humankind has intrigued anthropologists and gripped the popular imagination for some time. In 2004, the evolutionary biologists Daniel E. Lieberman of Harvard and Dennis M. Bramble of the University of Utah published a seminal article in the journal Nature titled “Endurance Running and the Evolution of Homo,” in which they posited that our bipedal ancestors survived by becoming endurance athletes, able to bring down swifter prey through sheer doggedness, jogging and plodding along behind them until the animals dropped.

Endurance produced meals, which provided energy for mating, which meant that adept early joggers passed along their genes. In this way, natural selection drove early humans to become even more athletic, Dr. Lieberman and other scientists have written, their bodies developing longer legs, shorter toes, less hair and complicated inner-ear mechanisms to maintain balance and stability during upright ambulation. Movement shaped the human body.

But simultaneously, in a development that until recently many scientists viewed as unrelated, humans were becoming smarter. Their brains were increasing rapidly in size.

Today, humans have a brain that is about three times larger than would be expected, anthropologists say, given our species’ body size in comparison with that of other mammals.

To explain those outsized brains, evolutionary scientists have pointed to such occurrences as meat eating and, perhaps most determinatively, our early ancestors’ need for social interaction. Early humans had to plan and execute hunts as a group, which required complicated thinking patterns and, it’s been thought, rewarded the social and brainy with evolutionary success. According to that hypothesis, the evolution of the brain was driven by the need to think.

But now some scientists are suggesting that physical activity also played a critical role in making our brains larger.

To reach that conclusion, anthropologists began by looking at existing data about brain size and endurance capacity in a variety of mammals, including dogs, guinea pigs, foxes, mice, wolves, rats, civet cats, antelope, mongooses, goats, sheep and elands. They found a notable pattern. Species like dogs and rats that had a high innate endurance capacity, which presumably had evolved over millenniums, also had large brain volumes relative to their body size.

The researchers also looked at recent experiments in which mice and rats were systematically bred to be marathon runners. Lab animals that willingly put in the most miles on running wheels were interbred, resulting in the creation of a line of lab animals that excelled at running.

Interestingly, after multiple generations, these animals began to develop innately high levels of substances that promote tissue growth and health, including a protein called brain-derived neurotrophic factor, or BDNF. These substances are important for endurance performance. They also are known to drive brain growth.

What all of this means, says David A. Raichlen, an anthropologist at the University of Arizona and an author of a new article about the evolution of human brains appearing in the January issue of Proceedings of the Royal Society Biology, is that physical activity may have helped to make early humans smarter.

“We think that what happened” in our early hunter-gatherer ancestors, he says, is that the more athletic and active survived and, as with the lab mice, passed along physiological characteristics that improved their endurance, including elevated levels of BDNF. Eventually, these early athletes had enough BDNF coursing through their bodies that some could migrate from the muscles to the brain, where it nudged the growth of brain tissue.

Those particular early humans then applied their growing ability to think and reason toward better tracking prey, becoming the best-fed and most successful from an evolutionary standpoint. Being in motion made them smarter, and being smarter now allowed them to move more efficiently.

And out of all of this came, eventually, an ability to understand higher math and invent iPads. But that was some time later.

The broad point of this new notion is that if physical activity helped to mold the structure of our brains, then it most likely remains essential to brain health today, says John D. Polk, an associate professor of anthropology at the University of Illinois at Urbana-Champaign, and co-author, with Dr. Raichlen, of the new article.

And there is scientific support for that idea. Recent studies have shown, he says, that “regular exercise, even walking,” leads to more robust mental abilities, “beginning in childhood and continuing into old age.”

Of course, the hypothesis that jogging after prey helped to drive human brain evolution is just a hypothesis, Dr. Raichlen says, and almost unprovable.

But it is compelling, says Harvard’s Dr. Lieberman, who has worked with the authors of the new article. “I fundamentally agree that there is a deep evolutionary basis for the relationship between a healthy body and a healthy mind,” he says, a relationship that makes the term “jogging your memory” more literal than most of us might have expected and provides a powerful incentive to be active in 2013.

Read More..

Well: Exercise and the Ever-Smarter Human Brain

Anyone whose resolve to exercise in 2013 is a bit shaky might want to consider an emerging scientific view of human evolution. It suggests that we are clever today in part because a million years ago, we could outrun and outwalk most other mammals over long distances. Our brains were shaped and sharpened by movement, the idea goes, and we continue to require regular physical activity in order for our brains to function optimally.

Phys Ed

Gretchen Reynolds on the science of fitness.

The role of physical endurance in shaping humankind has intrigued anthropologists and gripped the popular imagination for some time. In 2004, the evolutionary biologists Daniel E. Lieberman of Harvard and Dennis M. Bramble of the University of Utah published a seminal article in the journal Nature titled “Endurance Running and the Evolution of Homo,” in which they posited that our bipedal ancestors survived by becoming endurance athletes, able to bring down swifter prey through sheer doggedness, jogging and plodding along behind them until the animals dropped.

Endurance produced meals, which provided energy for mating, which meant that adept early joggers passed along their genes. In this way, natural selection drove early humans to become even more athletic, Dr. Lieberman and other scientists have written, their bodies developing longer legs, shorter toes, less hair and complicated inner-ear mechanisms to maintain balance and stability during upright ambulation. Movement shaped the human body.

But simultaneously, in a development that until recently many scientists viewed as unrelated, humans were becoming smarter. Their brains were increasing rapidly in size.

Today, humans have a brain that is about three times larger than would be expected, anthropologists say, given our species’ body size in comparison with that of other mammals.

To explain those outsized brains, evolutionary scientists have pointed to such occurrences as meat eating and, perhaps most determinatively, our early ancestors’ need for social interaction. Early humans had to plan and execute hunts as a group, which required complicated thinking patterns and, it’s been thought, rewarded the social and brainy with evolutionary success. According to that hypothesis, the evolution of the brain was driven by the need to think.

But now some scientists are suggesting that physical activity also played a critical role in making our brains larger.

To reach that conclusion, anthropologists began by looking at existing data about brain size and endurance capacity in a variety of mammals, including dogs, guinea pigs, foxes, mice, wolves, rats, civet cats, antelope, mongooses, goats, sheep and elands. They found a notable pattern. Species like dogs and rats that had a high innate endurance capacity, which presumably had evolved over millenniums, also had large brain volumes relative to their body size.

The researchers also looked at recent experiments in which mice and rats were systematically bred to be marathon runners. Lab animals that willingly put in the most miles on running wheels were interbred, resulting in the creation of a line of lab animals that excelled at running.

Interestingly, after multiple generations, these animals began to develop innately high levels of substances that promote tissue growth and health, including a protein called brain-derived neurotrophic factor, or BDNF. These substances are important for endurance performance. They also are known to drive brain growth.

What all of this means, says David A. Raichlen, an anthropologist at the University of Arizona and an author of a new article about the evolution of human brains appearing in the January issue of Proceedings of the Royal Society Biology, is that physical activity may have helped to make early humans smarter.

“We think that what happened” in our early hunter-gatherer ancestors, he says, is that the more athletic and active survived and, as with the lab mice, passed along physiological characteristics that improved their endurance, including elevated levels of BDNF. Eventually, these early athletes had enough BDNF coursing through their bodies that some could migrate from the muscles to the brain, where it nudged the growth of brain tissue.

Those particular early humans then applied their growing ability to think and reason toward better tracking prey, becoming the best-fed and most successful from an evolutionary standpoint. Being in motion made them smarter, and being smarter now allowed them to move more efficiently.

And out of all of this came, eventually, an ability to understand higher math and invent iPads. But that was some time later.

The broad point of this new notion is that if physical activity helped to mold the structure of our brains, then it most likely remains essential to brain health today, says John D. Polk, an associate professor of anthropology at the University of Illinois at Urbana-Champaign, and co-author, with Dr. Raichlen, of the new article.

And there is scientific support for that idea. Recent studies have shown, he says, that “regular exercise, even walking,” leads to more robust mental abilities, “beginning in childhood and continuing into old age.”

Of course, the hypothesis that jogging after prey helped to drive human brain evolution is just a hypothesis, Dr. Raichlen says, and almost unprovable.

But it is compelling, says Harvard’s Dr. Lieberman, who has worked with the authors of the new article. “I fundamentally agree that there is a deep evolutionary basis for the relationship between a healthy body and a healthy mind,” he says, a relationship that makes the term “jogging your memory” more literal than most of us might have expected and provides a powerful incentive to be active in 2013.

Read More..

Bits Blog: Facebook Poke and the Tedium of Success Theater

There’s a big problem in social media right now.

It’s boring.

A crucial and indispensable source of news and information, absolutely. But more often than not, it’s also tedious and predictable.

Don’t get me wrong: My use of Instagram, Tumblr, Twitter and Facebook has never been greater. But I’m growing tired of seeing everyone’s perfectly framed, glittering nightscapes of the Manhattan skyline, their impeccably prepared meals, those beautifully blurred views of the world from an airplane window seat. I’m getting tired of carefully crafting and sharing them myself.

As these media have matured and more of our colleagues, former flings, in-laws and friends have migrated to them, our use of them has changed. We’ve become better at choreographing ourselves and showing our best sides to the screen, capturing the most flattering angle of our faces, our homes, our evenings out, our loved ones and our trips.

It’s success theater, and we’ve mastered it. We’ve gotten better at it because it matters more. You never know who is looking or how it might affect your relationships and career down the road, and as a result, we have become more cautious about the version of ourselves that we present to each other and the world. Even Twitter, a service steeped in real-time and right-nowness, has added filters to its photo uploads, letting its users add a washed-out effect to their posts. It makes me miss the raw and unfiltered glimpses those services used to provide of the lives of my friends and the people I follow.

But the ubiquity of success theater is why I’ve become so fascinated with Snapchat and, more recently, Facebook Poke, services that let you send photos, messages and videos with a built-in shelf life, that self-destruct after a time interval that you choose. The beauty of these applications, perhaps their main redemptive quality, is that you can only send photos, messages and videos that you have created within the application. You cannot access your phone’s photo library for a more attractive self-portrait or an exotic locale to mask that you’re really sitting on the couch on Friday night in pajamas, wearing a face mask.

These applications are the opposite of groomed; they practically require imperfection, a sloppiness and a grittiness that conveys a sense of realness, something I’ve been craving in my communication. They transform the screen of your phone into a window into the life of your friend, wherever they are at that exact moment.

All of this is not to say that Snapchat or Facebook Poke have any permanent home in our daily routines. The applications, in their current iterations, have yet to gain significant traction in any of my social circles. Part of the fun is the novelty, as with any new service. And both have specific uses that are not as mainstream as services like Facebook, Instagram, Twitter or even Tumblr. After all, it’s much harder to find your comfort level within them. It’s startling, at first, to see the poorly lit, grainy pictures of your friends’ unfiltered faces, to adjust to the intimacy of realizing that the video of your friend that just landed in your in-box is meant for your eyes only, and that you are expected to send something of equal or greater intimacy in return. It is also possible that over time, Snapchat, VidBurn and Facebook Poke will become warped by their own versions of success theater, or lose steam if they gain seedier reputations.

But they capture a behavior my closest friends and I had already begun to adopt: The practice of showing each other where we are at any given moment in time, either through a short video or photo of our workstations, our faces as we lie half-asleep in bed on rainy Sunday afternoons, a look into our lives that is reserved for only those closest to each other. It is an acknowledgement that the version of ourselves we share through other social media is not the truest one, and has not been for a long time.

This is a variation of the same impulse that made Chatroulette a viral hit, and something that Apple has tried to capture with FaceTime, Google with its Hangouts, even Color’s ill-fated last and final iteration. It’s enough to make me think that the real real-time social Web is coming, in one form or another.

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Gérard Depardieu Stirs Belgian Border Town


Benoit Tessier/Reuters


French actor Gérard Depardieu is accused by the French government of trying to dodge taxes by moving to Belgium.







NÉCHIN, Belgium — The last time a big star lit up this sleepy village of potato fields and rain-drenched pastures was in 1667, when the Sun King, Louis XIV of France, stopped by for the day. But even he may not have created quite the commotion caused by Gérard Depardieu, the celebrated actor, turbulent bon vivant and, since a visit to the mayor’s office here on Dec. 7 to register as a resident, France’s most reviled tax exile.




“I thought it was a joke,” said the mayor, Daniel Senesael, recalling his disbelief when he was first told that Mr. Depardieu intended to leave his mansion in Paris and move to Néchin, a rural settlement in Belgium with just 2,200 people, two cafes, a fast-food fry shop, a ruined chateau and no cinema.


“Let’s be honest, this is not Las Vegas,” Mr. Senesael said. “There are no lights and no discos. I get flooded with complaints when anyone suggests opening even a wind farm.”


Michel Sardou, a veteran French singer who has joined a frenzy of criticism directed at Mr. Depardieu in France, mocked the actor’s flight to Néchin, predicting that he would be “as bored as a rat” here. “So, there is some divine justice after all,” the singer joked on French television.


For Mr. Depardieu, and scores of wealthy French citizens who already live here, however, Néchin does have one seductive asset: it is beyond the reach of the French tax authorities but so close to France that an unmarked border running through the village puts the gardens of some properties in France and adjoining houses in Belgium.


“Our geographic situation makes us very attractive,” said Mr. Senesael, noting that Néchin is an easy place to get into and out of, with a nearby airport, a major highway and a railway station just a few miles away in the French city of Lille with regular high-speed trains to Paris, Brussels and London.


“Nobody should be astonished that big fortunes have found a certain fiscal advantage” in moving to this side of the border, said the mayor, whose domain covers Néchin and a cluster of other hamlets that form what is known as the Entity of Estaimpuis. Mr. Depardieu’s critics, he said, should direct their ire not at the actor but at the failure of European governments to harmonize tax rates across the 27 nations of the European Union.


A customs post and border guards disappeared decades ago from the end of Néchin’s main street, swept away by Europe’s effort after World War II to break down barriers that led to past conflicts and to allow for the free flow of goods, services and people.


Still firmly in place, however, are rigidly defined tax frontiers that mean that people living just a few yards from one another can pay vastly different levels of tax, particularly if they happen to be wealthy.


Belgium has higher income taxes for most people than in much of Europe, but the country is much easier on the rich than France, where the government of President François Hollande has announced a “temporary supertax” of 75 percent on annual incomes of more than 1 million euros, or about $1.3 million. France’s Constitutional Council on Saturday declared the tax unconstitutional, prompting the government to announce that it would introduce a revised version next year. France also has a “wealth tax” on assets worth more than $1.7 million, something that does not exist in Belgium, as well as far higher taxes on capital gains and inheritance.


“We’ve abolished border controls but not all the other stupidities,” said Philippe Vandenhemel, the owner of a garage just outside Néchin that sells and repairs imported American cars and was visited several times by Mr. Depardieu. (The actor apparently likes old American cars.)


Mr. Vandenhemel scoffed at attacks on the movie star by French politicians and commentators. “If I were in his shoes, I would do exactly the same thing and leave,” he said. Mr. Depardieu, he added, will benefit not only from lower taxes in Belgium but also from the fact that “we Belgians are not jealous and don’t mind people getting rich.”


“Jealousy is France’s national disease,” he said.


Mr. Hollande, who made a pledge to squeeze the rich to help reduce the government’s budget deficit a cornerstone of his successful election campaign this year, once said on television, “I don’t like the rich.” His right-wing predecessor and rival and in the May election, Nicolas Sarkozy, lost in part because he flaunted a liking for expensive watches and other accessories and the company of rich friends, a habit that earned him mockery as “Le Président Bling-Bling.”


Scott Sayare contributed reporting from Paris.



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Well: Spinach Recipes for Health

Spinach goes well with all kinds of foods. It’s also a green that is easy to find year-round. As Martha Rose Shulman writes in this week’s Recipes for Health:

Spinach has remained a part of my holiday ritual. I love the convenience of bagged spinach, but I prefer the richness of the lush bunches I get at the farmers’ market. I don’t mind stemming and washing it, but if you are pressed for time the bagged spinach is a godsend, especially if you live in a cold climate and don’t have access to farmers’ market spinach in December.

Below are five new ways to add spinach to your meal. And for more spinach recipes, see “Making Spinach the Star of the Meal.”


Spinach and Millet Timbale With Tomato Sauce
A timbale is a molded custard, somewhat similar to a quiche without a crust.


Garlic Soup With Spinach
A quick and easy soup that is a great way to use any leftover turkey stock from Thanksgiving.


Penne With Mushroom Ragout and Spinach
This is a delicious meal no matter what variety of mushrooms you have on hand.


Spinach Gnocchi
A considerably lighter version of the classic gnocchi made with spinach and ricotta.


Spinach, Sardine and Rice Gratin
This classic Provençal gratin is a good way to work fish that is high in omega-3s into your diet.

Read More..

Well: Spinach Recipes for Health

Spinach goes well with all kinds of foods. It’s also a green that is easy to find year-round. As Martha Rose Shulman writes in this week’s Recipes for Health:

Spinach has remained a part of my holiday ritual. I love the convenience of bagged spinach, but I prefer the richness of the lush bunches I get at the farmers’ market. I don’t mind stemming and washing it, but if you are pressed for time the bagged spinach is a godsend, especially if you live in a cold climate and don’t have access to farmers’ market spinach in December.

Below are five new ways to add spinach to your meal. And for more spinach recipes, see “Making Spinach the Star of the Meal.”


Spinach and Millet Timbale With Tomato Sauce
A timbale is a molded custard, somewhat similar to a quiche without a crust.


Garlic Soup With Spinach
A quick and easy soup that is a great way to use any leftover turkey stock from Thanksgiving.


Penne With Mushroom Ragout and Spinach
This is a delicious meal no matter what variety of mushrooms you have on hand.


Spinach Gnocchi
A considerably lighter version of the classic gnocchi made with spinach and ricotta.


Spinach, Sardine and Rice Gratin
This classic Provençal gratin is a good way to work fish that is high in omega-3s into your diet.

Read More..

World Briefing | Africa: South Africa’s President Gives a Biting Critique of Pets





President Jacob Zuma, left, said in a speech that the idea of having a pet was part of “white culture” and that people should focus on family welfare, the newspaper The Star reported Thursday. The president’s office sought to clarify the remarks, saying that he was encouraging “the previously oppressed African majority” to uphold its own culture. It also suggested the way in which the comments were reported, rather than the comments themselves, was divisive.




During his speech on Wednesday to a crowd in KwaZulu-Natal, Mr. Zuma’s home province, the president said that people who loved dogs more than people had a “lack of humanity” and that some people were trying in vain to “emulate whiteness,” The Star reported. In a statement, the South African presidency said that Mr. Zuma was trying to “decolonize the African mind post-liberation” and enable people to take pride in their heritage and not feel pressure to adopt customs of minority cultures. Animals can be cared for, was the message, but not at the expense of people.


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New York’s Mental Health System Thrashed by Services Lost to Storm


Marcus Yam for The New York Times


Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum hospitals, at St. Luke’s-Roosevelt Hospital Center.







When a young woman in the grip of paranoid delusions threatened a neighbor with a meat cleaver one Saturday last month, the police took her by ambulance to the nearest psychiatric emergency room. Or rather, they took her to Beth Israel Medical Center, the only comprehensive psychiatric E.R. functioning in Lower Manhattan since Hurricane Sandy shrank and strained New York’s mental health resources.




The case was one of 9,548 “emotionally disturbed person” calls that the Police Department answered in November, and one of the 2,848 that resulted in transportation to a hospital, a small increase over a year earlier.


But the woman was discharged within hours, to the shock of the mental health professionals who had called the police. It took four more days, and strong protests from her psychiatrist and caseworkers, to get her admitted for two weeks of inpatient treatment, said Tony Lee, who works for Community Access, a nonprofit agency that provides supportive housing to people with mental illness, managing the Lower East Side apartment building where she lives.


Psychiatric hospital admission is always a judgment call. But in the city, according to hospital records and interviews with psychiatrists and veteran advocates of community care, the odds of securing mental health treatment in a crisis have worsened significantly since the hurricane. The storm’s surge knocked out several of the city’s largest psychiatric hospitals, disrupted outpatient services and flooded scores of coastal nursing homes and “adult homes” where many mentally ill people had found housing of last resort.


One of the most affected hospitals, Beth Israel, recorded a 69 percent spike in psychiatric emergency room cases last month, with its inpatient slots overflowing. Instead of admitting more than one out of three such cases, as it did in November 2011, it admitted only one out of four of the 691 emergency arrivals this November, records show. Capacity was so overtaxed that ambulances had to be diverted to other hospitals 15 times in the month, almost double the rate last year, in periods typically lasting for eight hours, officials said.


Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum Health Partners, Beth Israel’s parent organization, said he was proud of how much Continuum’s hospitals had done to handle psychiatric overflow since storm damage shuttered Bellevue Hospital Center, the city’s flagship public hospital; NYU Langone Medical Center; and the Veterans Affairs Hospital. But these days, he said, as he walks on Amsterdam Avenue between Continuum’s Roosevelt hospital on West 59th Street and its St. Luke’s hospital on West 114th Street, he notices more mentally ill people in the streets than he has seen in years.


“When you have the most vulnerable folks, all you need is one chink in the system and you lose them,” Dr. Rosenthal said. “Whether they lost their housing, or the outpatient services they usually go to were closed and they were lost to follow-up, they have become disconnected, with predictable results.”


Similar patterns are playing out in Brooklyn, where Maimonides Medical Center has been overwhelmed with mental health emergencies from the Coney Island vicinity since Coney Island Hospital, one of the city’s largest acute care psychiatric hospitals, suspended operations, hospital officials said.


“Triage has reached a different level: You have to get sicker to get in,” said Dr. Andrew Kolodny, the chairman of psychiatry at Maimonides, citing a 56 percent increase in psychiatric emergency room visits there from Oct. 26 to Dec. 7, compared with the same period last year, and a 24 percent rise in admissions. The increase in admissions was possible only with emergency permission from the state to exceed licensed limits.


“Not only is there decreased capacity, because Bellevue and Coney Island are off line,” Dr. Kolodny added, “but there’s increased demand because the storm or the loss of their residence has been a stressor for mental illness.”


The storm battered a mental health system that still relies heavily on private nursing homes and substandard adult homes to house people with mental illness. Such institutions have a sordid history of neglect and exploitation, and the courts have repeatedly found that their overuse by the state isolated thousands of people in violation of the Americans With Disabilities Act.


Plans are under way to increase supportive housing — dwellings where mentally ill people can live relatively independently, with support services. But even before Hurricane Sandy, the expansion fell far short of demand.


The storm underscored the fragility of the system. Many disabled evacuees who were sent first to makeshift school shelters lost access to the psychiatric medications that kept their symptoms at bay, Dr. Kolodny said. Even those lucky enough to have the drugs they need are at greater risk of relapse as they experience crowded living conditions. “If they’re now sleeping in a gym with 100 people, that can tip them over the edge and start making them really paranoid,” he said.


On Staten Island, where the chief of psychiatry at Richmond University Medical Center says psychiatric resources have been stretched to the limit, clergy members report that mentally ill people transferred to a large adult home in New Brighton from one that was washed away in Far Rockaway, Queens, are now showing up at church rectories, begging for socks and underwear.


“It’s heartbreaking, because they just found us by chance,” said Margaret Moschetto, a missionary at the Church of Assumption-St. Paul in New Brighton. “They were just walking around the neighborhood. They really didn’t know where they were.”


Read More..

New York’s Mental Health System Thrashed by Services Lost to Storm


Marcus Yam for The New York Times


Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum hospitals, at St. Luke’s-Roosevelt Hospital Center.







When a young woman in the grip of paranoid delusions threatened a neighbor with a meat cleaver one Saturday last month, the police took her by ambulance to the nearest psychiatric emergency room. Or rather, they took her to Beth Israel Medical Center, the only comprehensive psychiatric E.R. functioning in Lower Manhattan since Hurricane Sandy shrank and strained New York’s mental health resources.




The case was one of 9,548 “emotionally disturbed person” calls that the Police Department answered in November, and one of the 2,848 that resulted in transportation to a hospital, a small increase over a year earlier.


But the woman was discharged within hours, to the shock of the mental health professionals who had called the police. It took four more days, and strong protests from her psychiatrist and caseworkers, to get her admitted for two weeks of inpatient treatment, said Tony Lee, who works for Community Access, a nonprofit agency that provides supportive housing to people with mental illness, managing the Lower East Side apartment building where she lives.


Psychiatric hospital admission is always a judgment call. But in the city, according to hospital records and interviews with psychiatrists and veteran advocates of community care, the odds of securing mental health treatment in a crisis have worsened significantly since the hurricane. The storm’s surge knocked out several of the city’s largest psychiatric hospitals, disrupted outpatient services and flooded scores of coastal nursing homes and “adult homes” where many mentally ill people had found housing of last resort.


One of the most affected hospitals, Beth Israel, recorded a 69 percent spike in psychiatric emergency room cases last month, with its inpatient slots overflowing. Instead of admitting more than one out of three such cases, as it did in November 2011, it admitted only one out of four of the 691 emergency arrivals this November, records show. Capacity was so overtaxed that ambulances had to be diverted to other hospitals 15 times in the month, almost double the rate last year, in periods typically lasting for eight hours, officials said.


Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum Health Partners, Beth Israel’s parent organization, said he was proud of how much Continuum’s hospitals had done to handle psychiatric overflow since storm damage shuttered Bellevue Hospital Center, the city’s flagship public hospital; NYU Langone Medical Center; and the Veterans Affairs Hospital. But these days, he said, as he walks on Amsterdam Avenue between Continuum’s Roosevelt hospital on West 59th Street and its St. Luke’s hospital on West 114th Street, he notices more mentally ill people in the streets than he has seen in years.


“When you have the most vulnerable folks, all you need is one chink in the system and you lose them,” Dr. Rosenthal said. “Whether they lost their housing, or the outpatient services they usually go to were closed and they were lost to follow-up, they have become disconnected, with predictable results.”


Similar patterns are playing out in Brooklyn, where Maimonides Medical Center has been overwhelmed with mental health emergencies from the Coney Island vicinity since Coney Island Hospital, one of the city’s largest acute care psychiatric hospitals, suspended operations, hospital officials said.


“Triage has reached a different level: You have to get sicker to get in,” said Dr. Andrew Kolodny, the chairman of psychiatry at Maimonides, citing a 56 percent increase in psychiatric emergency room visits there from Oct. 26 to Dec. 7, compared with the same period last year, and a 24 percent rise in admissions. The increase in admissions was possible only with emergency permission from the state to exceed licensed limits.


“Not only is there decreased capacity, because Bellevue and Coney Island are off line,” Dr. Kolodny added, “but there’s increased demand because the storm or the loss of their residence has been a stressor for mental illness.”


The storm battered a mental health system that still relies heavily on private nursing homes and substandard adult homes to house people with mental illness. Such institutions have a sordid history of neglect and exploitation, and the courts have repeatedly found that their overuse by the state isolated thousands of people in violation of the Americans With Disabilities Act.


Plans are under way to increase supportive housing — dwellings where mentally ill people can live relatively independently, with support services. But even before Hurricane Sandy, the expansion fell far short of demand.


The storm underscored the fragility of the system. Many disabled evacuees who were sent first to makeshift school shelters lost access to the psychiatric medications that kept their symptoms at bay, Dr. Kolodny said. Even those lucky enough to have the drugs they need are at greater risk of relapse as they experience crowded living conditions. “If they’re now sleeping in a gym with 100 people, that can tip them over the edge and start making them really paranoid,” he said.


On Staten Island, where the chief of psychiatry at Richmond University Medical Center says psychiatric resources have been stretched to the limit, clergy members report that mentally ill people transferred to a large adult home in New Brighton from one that was washed away in Far Rockaway, Queens, are now showing up at church rectories, begging for socks and underwear.


“It’s heartbreaking, because they just found us by chance,” said Margaret Moschetto, a missionary at the Church of Assumption-St. Paul in New Brighton. “They were just walking around the neighborhood. They really didn’t know where they were.”


Read More..

Marvell Ordered to Pay $1.17 Billion in Patent Case


Carnegie Mellon University said it was awarded $1.17 billion by a federal jury in Pittsburgh on Wednesday in a unanimous verdict that found the Marvell Technology Group had sold billions of semiconductors using technology developed at the university without a license.


The award is one of the largest in a patent infringement case, and comes after a $1 billion verdict awarded to Apple this summer over its smartphone design.


Carnegie claimed that Marvell had infringed on a pair of patents relating to fundamental technology for increasing the accuracy with which hard drive circuits read data from high-speed magnetic disks.


The patents were developed by José Moura, a professor in the department of electrical and computer engineering, and Aleksandar Kavcic, a former Ph.D. student now a professor at the University of Hawaii. Their work was supported by Carnegie’s Data Storage Systems Center, a university research organization.


During the trial, Marvell argued that it had not used the university’s technology and that those patents were invalid because similar systems had been developed elsewhere before the university filed for its patents. A company spokesman said Marvell would seek lower damages from the judge in post-trial hearings, which are scheduled for May, and might appeal the ruling otherwise.


Patent infringement lawsuits have become a big issue in recent years as the pace of innovation and competition speeds up and technology firms increasingly seek to shield their products behind patents. As the number of technology patents filed in the United States has risen rapidly in the last decade, so have patent-related lawsuits. Recent cases have involved Microsoft, Motorola, Research in Motion, Visto, Google and many others.


In August, Apple won a $1 billion infringement judgment against Samsung over iPhone design patents. Since then, the companies have argued over the size of the verdict and how the jury reached its conclusion. Samsung has argued the figure is excessive, while Apple has sought a court injunction to bar Samsung from selling various products that the jury found infringed on its patents.


Since the jury found the infringement by Marvell had been “willful,” meaning the company knew it was using the patented technology, the judge can award up to three times the verdict amount, according to a statement by K&L Gates, the law firm representing Carnegie Mellon.


The case was tried before Judge Nora Barry Fischer of United States District Court for the Western District of Pennsylvania.


Marvell ships more than one billion chips a year to a variety of electronics manufacturers, including Panasonic, Sony and Dell.


After Wednesday’s verdict, Marvell’s share price dropped 10.3 percent, to $7.40 on the Nasdaq, valuing the company at about $4 billion.


The university said the verdict was a victory for academic research and collaboration. “Protection of the discoveries of our faculty and students is very important to us,” the university said in a statement.


“The university’s singular success, particularly over the past 40 years, has been achieved in large measure through collaboration with industry. We value those relationships greatly.”


Carnegie Mellon was represented by Douglas B. Greenswag and Patrick J. McElhinny of K&L Gates.


Marvell was represented by Quinn Emanuel Urquhart & Sullivan.


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