From The AP:

SAN FRANCISCO — During Cindy Cool's almost daily visits to the nursing home, she would routinely find her Alzheimer's-suffering father wearing urine-soaked clothes.

The Blue Lake, Calif. resident said it would take upwards of 20 minutes for the apparently short-handed staff of Eureka Healthcare and Rehabilitation to respond and help Cool clean her father. Other patients fared worse, she said.

"A lot of times I walked out of there crying because of the things I saw," Cool said an interview.

She provided key testimony before a Humboldt County jury last month slammed the owners of her father's nursing home with a $677 million verdict, sending shock waves through the industry and rekindling calls for tort reform.

The verdict as it stands is already thought to be the largest in the country this year and its ramifications are still being sorted out weeks after the jury surprised even the plantiffs' lawyers with the size of their verdict. Tort reformers have seized on the verdict as the latest example of litigation abuse.

The company's stock price has plunged on fears it will have to file bankruptcy. Cool, 58, was part of a class-action lawsuit representing 32,000 patients that blamed the nursing home staff shortage for the misery she encountered — echoing a common complaint across the country that for-profit nursing homes are too concerned with the bottom line.

After Wall Street investment firms went on a nursing home buying spree during the early years of the new century, critics charge that many companies drastically cut payroll expenses to prop up stock prices.

"The major problem for most nursing homes in California and in the nation is staffing," said Pat McGinnis, executive director and founder of the California Advocates for Nursing Home Reform.

Many of the 16,100 homes nationwide are owned by public companies. The home where Cool father's lived and died in 2006 is owned by Skilled Healthcare Group Inc., which is traded on the New York Stock Exchange.

On July 6, the Humboldt County jury found that Skilled Healthcare on numerous occasions violated state regulations requiring it to keep a minimum number of nurses on duty at its 22 homes in the state.

James Gomez, president and chief executive of the California Association of Health Facilities, called the verdict "outlandish, excessive and extreme" and said a "good provider of skilled nursing care" is likely bound for bankruptcy if the verdict holds up, threatening the livelihoods of 14,000 California workers.

The lawsuit accused Orange County-based Skilled Healthcare of failing to maintain 3.2 nursing hours per patient per day at its 22 nursing homes in California. The company is just the 10th largest, based on beds, in an industry that struggles to keep workers.

"The verdict is a statement that facilities must follow the law and meet minimum standards," McGinnis said.

McGinnis said the 3.2 nursing hours required by California should be an easy standard to meet because it's nearly a full hour less than the federal recommendation of 4.1 nursing hours per patient.

"The fact that this company couldn't maintain these minimum standards makes you wonder why it was in the nursing home business to begin with," McGinnis said.

Skilled Healthcare Chairman and CEO Boyd Hendrickson said in a statement immediately after the verdict that the company is "deeply disappointed" in the verdict and believes its nursing homes are appropriately staffed.

"We strongly disagree with the outcome of this legal matter, and we intend to vigorously challenge it," he said.

The company's options, however, appear to be shrinking.

On Thursday, Humboldt County Superior Court Judge Bruce Watson shot down one of the company's challenges when he denied its demand for a mistrial based on juror misconduct.

Meanwhile, the company's ability to appeal is in question. Typically, parties challenging a trial court decision are required to post 150 percent of the verdict as a bond. The company doesn't have the cash or credit to post the $1 billion-plus bond. It also likely faces bankruptcy if the jury's verdict stands up.

Both sides are currently in settlement negotiations, and legal analysts said there's good chance that the sizable verdict will be reduced.

That is what happened in another high-profile nursing home verdict won in 1998 by Michael Thamer, who is now lead lawyer in the Skilled Healthcare lawsuit.

A Siskiyou County Superior Court jury awarded his client Reba Gregory $95 million after a nursing home attendant dropped her during a bed transfer, fracturing her hip and shoulder. Thamer convinced the jury that two attendants should have attempted the transfer and that Gregory's injuries were the result of staff shortages.

A judge later reduced the $95 million verdict to $3.1 million.

From Cosmic Log at MSNBC:


Archaeologists have found a cave in Israel that was clearly used for funerals and feasts 12,000 years ago, during a time when humans were just starting to settle down in villages. Among the menu items: piles of steak and tortoise meat.

"We guess that people were having communal meals previously, but this is different from that," said Natalie Munro, a zooarchaeologist from the University of Connecticut and co-author of a study on the find appearing in the Proceedings of the National Academy of Sciences. "It's more than just an opportunity. It's an intentional, planned event."

The evidence suggests that the feasts and the funerals were connected — sort of like the dinners that were served after funerals at the American Legion Hall when I was growing up in Iowa. There's no sign that the Hilazon Tachtit Cave in the Galilee region of northern Israel was used as a residence 12,000 years ago, but there's plenty of evidence of funerals: Earlier excavation work turned up at least 28 human skeletons buried there, including a woman who appeared to be interred with ritual items as a shaman.

Munro and her colleagues estimate that the woman priestess was about 45 years old when she died — which would make her an elder in the Natufian culture. Bone spurs were found on her skeleton, leading researchers to conclude that she was disabled and may have walked with a limp. Based on the way the woman's grave was hollowed out, archaeologists think she was the first person to be buried in the cave.

That makes it sound as if the cave served not only as a prehistoric Legion Hall but also as a Westminster Abbey, with a fallen spiritual leader in the place of honor. But Munro said she couldn't take the story quite that far. "We don't know if it was a shrine," she told me, "but certainly she was buried with many special things, so she was very important in the culture."

The people who lived in the area 12,000 years ago are known as the Natufians. "These are really the last of what we would call hunting and gathering cultures," Munro said. "They're on the brink of agriculture. ... If you compared them to earlier cultures in the area, they're of interest because they seem to be settling down into permanent communities."

She and the study's other co-author, Leore Grosman of The Hebrew University in Jerusalem, theorize that as individual family groups banded together in these communities, they needed ways to blow off steam.

"People were coming into contact with each other a lot, and that can create friction," Munro said in a news release. "Before, they could get up and leave when they had problems with the neighbors. Now, these public events served as community-building opportunities, which helped to relieve tensions and solidify social relationships."

And what events they were: When the archaeologists excavated two hollows that were carved out in the cave, they counted up the remains of at least 71 tortoises and three wild cattle, also known as aurochs. They said the bones and shells showed signs of being carved up and cooked for human consumption. The tortoise shells were found surrounding the shaman's skeleton, in such a way as to suggest that they were thrown in during the burial ceremony.

The tortoises alone would provide enough meat to feed 35 people, although many more than that may have been in attendance. "We don't know exactly how many people attended this particular feast, or what the average attendance was at similar events, since we don't know how much meat was actually available in the cave," Munro said in the news release. "The best we can do is give a minimum estimate based on the bones that are present."

Munro and Grosman consider their find to be the first clear evidence of communal feasting, but there's ample evidence that humans had meals together thousands of years earlier. Last year, archaeologists reported finding a barbecue pit in the Czech Republic that was used about 30,000 years ago for roasting mammoth meat and other morsels, luau-style. In 2007, scientists turned up evidence that humans cooked up mussels, clams and snails on South Africa's seashore 164,000 years ago — and perhaps even gussied themselves up for the clambake.

Munro said the important thing about the feasts that took place in the Hilazon Tachtit Cave is that they weren't just meals. They were community events that signaled an important turning point for ancient civilizations.

"Taken together, this community integration and the changes in economics were happening at the very beginning when incipient cultivation was getting going," she said. "These kinds of social changes are the beginnings of significant changes in human social complexity that lead into the beginning of the agricultural transition."

From Entertainment Weekly's Popwatch:


Who is Temple Grandin? Her name was called out seven times at last night’s Emmy Awards, where the rancher-attired Grandin herself was “a palpable presence,” in the L.A. Times‘ words, “at one point, rising and excitedly swinging her hand lasso style from the audience.” Grandin (pictured) was there, of course, as part of the HBO movie named after her, in which she was played by the Best Actress in a Miniseries or Movie-winning Claire Danes.

Born in 1947, Grandin was diagnosed as autistic at a young age due to her inability to speak or function socially like other children. As an adult, Grandin became a renowned public advocate for those born on the autistic spectrum. Her high-functioning autism ultimately allowed her to earn a doctorate in animal science, become a university professor, and pen an autobiography about her experiences. She has also made notable contributions to the ethical treatment of livestock. Grandin, who believes that her autism helps gives her insight into the feelings of farm creatures, famously designed more humane corrals for cows headed for slaughter.

Grandin has been the subject of several film treatments before HBO’s award-winning movie, including a BBC documentary (“The Woman Who Thinks Like A Cow”) and an episode of director Errol Morris’ First Person. (Click through to the jump to see clips from both of those shows.)

In our review this February, EW’s Jennifer Armstrong said HBO’s Temple Grandin “put[s] us right inside the mind of its subject” and praised Danes for “transcend[ing] a standard awards-bait performance.” According to Deadline Hollywood, Danes said after the Emmys last night that she “never worked harder on a performance.”

From The Oklahoman:



Wanda Felty (pictured) picked up the telephone and sobbed.

"I think I'm going to have a breakdown if I don't get help,” cried the mother of three girls, including a brain-damaged daughter who bit herself and others, couldn't talk or see and hadn't slept longer than three or four hours a day over the entire eight years of her life.

"I remember thinking I was losing it. I cried my eyes out,” Felty said, recalling a blur of loving but sleep-deprived care of her child Kayla White (pictured).

Felty was one of thousands of parents or guardians of disabled children who have been on the state's waiting list for years. Those on the list need help ranging from after-school child-sitting to job training to a monthly case of diapers to additional therapy.

She felt overwhelmed, forgotten and was languishing on a list that never seemed to change. Then someone with the state — she can't remember who — reached out to her.

Felty had waited about five years. She got one of the state's first emergency in-home support waivers, providing a few hours' after-school help.

But more than 5,700 other disabled Oklahomans are waiting for help. And they've all been waiting for years.

The next person likely to get help has been waiting on that first-come, first-served list since April 26, 2004.

There's just not enough state money to pay for all the needs of those on the list, said James Nicholson, the state director of the Department of Human Service's developmental disabilities services. More than $50 million in state money has been budgeted this fiscal year for the programs designed to help people who were once on the waiting list.

"You can only serve as many people as you have dollars to serve,” he said.

"I think that, obviously, the magic bullet ... would be a tremendous economic turnaround.”

The list was started in 1993 with requests for people ages 3 to 70 years old. Each year, another 1,000 or so people apply to get on the list as word spreads of its existence.

"I don't expect we will ever get help from the program. The list is not moving,” said Stacy Bauter, the divorced mother of 13-year-old Jacob Gaches, born without part of his brain and with fluid on the brain.

Jacob has extensive medical problems, autism, attention deficit disorder, obsessive-compulsive disorder and a developmental delay that prevents him from getting dressed on his own or caring for himself. When he was little, he had a shunt placed with a tube to relieve the fluid on his brain. Years later, he had to spend a summer in a body cast after surgery to realign his hips.

Bauter said she was able to work full time while he was in day care.

But she was suddenly told that he was too old for the day care and had to make emergency arrangements with a family friend. Bauter has a college degree and loves her work helping disabled farmers return to their work. She said she could return to her work full time and be less financially strapped if she could get a little funding for diapers and proper day care for her disabled son.

"People who know me know that when I say help, I need it. I'm not someone that is going to live off the system. I'm not going to do it,” she said.

Sandra Kirkpatrick's 13-year-old son, Bryson Matula, has Down syndrome. He has been on the waiting list since April 2006 and she calls the chances of ever getting help "dismal.”

Kirkpatrick said she worries because every dollar she spends on private therapy, at $120 per hour, is a dollar she can't spend on his future.

"He will need some support throughout his lifetime,” she said. She said research shows that earlier training means disabled people will need less public money later in life.

"Some do jump to the front of the line because it's a critical situation,” Kirkpatrick said. "I'm not opposed to people in more dire situations being in front of me.”

Nicholson said more than 5,100 people are getting help through the waiver services program that Kirkpatrick and other moms are seeking to tap into. The services are capped at about $14,000 yearly for disabled children and about $19,000 yearly for disabled adults.

The parents say they all want to keep their children at home. For the majority, the additional money would do that by covering some expenses not already covered through Medicaid.

The state runs two live-in centers for the disabled, Southern Oklahoma Resource Center in Pauls Valley and Northern Oklahoma Resource Center of Enid.

Ken Talley, president of the Pauls Valley center's Parent-Guardian Association, said they don't want their loved ones moved, despite downsizing and a perceived history of attempts to close the centers.

And Trish Frazier, director of policy and research for the Oklahoma Public Employees Association, said the southern center shouldn't be shut down so the money could be shifted to people on the waiting list.

Nicholson said the demands on the state are so great that better ways of supporting those families must be devised.

"The days of the state accepting sole responsibility for total care and treatment are gone,” Nicholson said.

He said the department is working on a set of programs costing about $9.8 million to provide respite care, some medical supplies and vocational or day programs for adults. The services cap would be lowered to $7,500 yearly per disabled person, if the Legislature approves the proposal.

Meanwhile, there's little relief ahead for the thousands who wait for help.

Felty got the help her family needed. They are still raising their daughter at home. Kayla is a thriving 21-year-old who recently learned to say, "I love you,” in her own special language.

Felty said she's so thankful for the assistance she received that she now works with parents who have loved ones on the waiting list.

"When you see one of us hurting, reach your hand out,” she said. "That's what I'm asking the state to do.

"I see more than 5,000 people asking for help. I'm just one hand. I'd like to see the state reach out a hand and help these families.”

The DOT press release:

The U.S. Department of Transportation (DOT) August 30 assessed a civil penalty against AirTran Airways for violating rules protecting air travelers with disabilities. The carrier was assessed a civil penalty of $500,000, of which up to $200,000 may be used to improve its service to disabled passengers beyond what is required by law.

“People with disabilities have the right to expect fair treatment when they fly, and we will continue to take enforcement action when their rights are violated,” said U.S. Transportation Secretary Ray LaHood.

The Air Carrier Access Act of 1986 requires airlines to provide assistance to passengers with disabilities in boarding and deplaning aircraft, including the use of wheelchairs, ramps, mechanical lifts or service personnel where needed. U.S. Department of Transportation rules also require carriers to respond within 30 days to written complaints about their treatment of disabled passengers, and to specifically address the issues raised in the complaint. In addition, airlines must submit annual reports to the Department on disability-related complaints from passengers, noting the type of disability and nature of the complaint.

An investigation by the Department of Transportation’s Aviation Enforcement Office of disability complaints filed with AirTran and DOT revealed a number of violations of the requirement for boarding assistance. In addition, the carrier’s complaint files showed that it frequently did not provide an adequate written response to complaints from passengers. AirTran also failed to properly categorize disability complaints in reports filed with the Department, the Aviation Enforcement Office found.

Of the $500,000 penalty, up to $60,000 may be used to establish a council to help the carrier comply with federal disability rules and hire a manager for disability accommodations. Up to $140,000 may be used to develop and employ an automated wheelchair tracking system at AirTran’s major hub airports within one year that will generate real-time reports of the carrier’s wheelchair assistance performance.

The consent order is available on the Internet at www.regulations.gov, docket DOT-OST-2010-0005.

From The NY Times:


ALEPPO, Syria — For five years, Chavia Ali’s attempts to start a disability rights group were thwarted — by prejudice, a lack of money and the Syrian government’s stranglehold on civic life. The government gave her a license, but prevented the group from meeting because of what Ms. Ali believes was a whisper campaign against her, a Kurd with a growing profile.

Then everything changed.

Last year, Ms. Ali (pictured) was told that a third of her budget would be paid by a group led by Asma al-Assad, the wife of the Syrian president, Bashar al-Assad. Now Ms. Ali, 29, is everywhere, giving television interviews, speaking at ministry conferences and having her picture taken with the first lady.

The reversal of her group’s fortunes is part of an overture that government officials have described as a new embrace of civil society.

But the embrace is complicated. Even as doors have opened for a few people, like Ms. Ali, they have shut with increasing frequency on activists demanding greater political rights, according to human rights lawyers here. While some rights advocates welcome any opening, no matter how small, others say it extends only to groups that pose no challenge to the established order.

“Civil society means free people create free initiatives,” said one Syrian activist, one of many who, fearing government reprisal, requested anonymity. “How can un-free people do that?”

Ms. Ali embodies the conundrum. Her cousin was arrested this summer by the security services during one of their regular sweeps through Kurdish villages, but she refuses to talk about what happened.

“Some ideas you can’t touch,” she said. “I don’t want to go outside of my case. I am working on disabilities.”

It is a quandary faced by activists across the Middle East. In the narrow alleyways of civic life permitted by authoritarian governments in the region, opportunities exist as long as certain limits are observed. While foreign aid groups often cheer the explosive growth of organizations that help women, children or the environment, there are questions about whether the groups can change the political order.

As the world watches Syria emerge from years of international isolation, Syrians are watching the government play its strengthened hand at home.

“We are seeing changes,” said Bassam Haddad, director of the Middle East studies program at George Mason University. “The number of associations that are emerging is increasing. The number of concerns that are allowed to become public is also increasing. The whole process is blessed by the government. It has good intentions but built-in structural limitations.”

Professor Haddad said that in the 1990s, during a similar embrace of civil society groups, activists knew the changes were cosmetic but assumed that the very existence of new groups might hasten change. Few people have those illusions today, he said.

“I think the first thing that Syrians need to see is an end to arbitrary rulings that put away people based on their viewpoints,” he said. “That is something that stifles any kind of public debate about the important issues.”

Many rights advocates go further, dismissing the talk of civil society by the government as window-dressing while it continues to arrest Islamists, Kurds and other political opponents, along with the lawyers who represent them.

Civil society figures who cross the line, like Muhannad al-Hassani, can end up in jail. Mr. Hassani, a lawyer who used to monitor the trials of dissidents in the Supreme State Security Court, was disbarred for life last year, and in June was sentenced to three years in prison on charges that included “weakening national sentiment.”

Mrs. Assad’s efforts put a softer face on her husband’s policies and, within limits, appear to be doing some good. An organization she directs, the Syria Trust for Development, finances groups that work with women, rural residents, children and entrepreneurs. Its Web site says the trust is “at the forefront of the emerging N.G.O. sector in Syria, at a time when the country is actively pursuing a substantial agenda for change.”

The new groups might represent progress, but they also fill a need, as Syria copes with growing numbers of impoverished citizens. “The cultural reliance on the government for everything is not attuned to modern society,” said Imad Moustapha, Syria’s ambassador to Washington.

For her part, Ms. Ali has seized on the opening to find ways to integrate people with disabilities into society, and to help them become independent in a country that makes that nearly impossible. To spend time with her this month as she traveled around the country was to understand the depth of that challenge. Nearly everyone she met had to ask for help, to reach a second floor, to get more time to take an exam or just to be taken seriously.

Dependent on a wheelchair since contracting polio as a child, Ms. Ali began her journey as a rights activist when a college administrator laughed her out of his office when she asked him to repair an elevator.

He did not fix the elevator. She moved on to other battles.

One day this month in the Kurdish village where Ms. Ali was born, she visited a 27-year-old blind woman, Zahra Sheikhi, whose parents kept her and her sister, who is also blind, at home for all of their childhood, out of shame, Ms. Ali said.

With Ms. Ali’s help, Ms. Sheikhi has learned to play a lutelike instrument called the tanbour, occasionally performs in public and is hoping to move away from home. “My family is always around,” she said. “They don’t allow me to live.”

In Aleppo, where Ms. Ali lives with her parents, she visited Saghatel Basil, 33, a university student who lost his sight because of diabetes a few years ago. Mr. Basil said that Syria had recently installed traffic signals for blind people but that many of them did not work.

His disability had prompted Mr. Basil to try his hand at local government. “I am trying to improve the idea of citizenship,” he said. “It is still weak. Maybe because I’m blind, I have a big hope that things will change.”

A conference in Damascus this month, attended by Ms. Ali and the first lady, reflected another type of opening blessed by the government, the spate of recent visits by international groups.

An American nonprofit group, the Open Hands Initiative, brought young Syrians and Americans with disabilities together for what the group’s founder, Jay Snyder, said was an attempt at person-to-person diplomacy. Mr. Snyder said that his group’s trip to Syria was approved quickly and that no one from the government restricted what they could discuss.

“Part of the challenge we face in Syria,” Mrs. Assad said at the gathering, “is how do you take incredible people and incredible ideas and make them an incredible reality?”

A young man in a wheelchair, Abdulrahman Hussein, 20, offered an answer. “We should be doing something in our own countries,” he said. “We should not be sitting in a corner.”

From the Asbury Park Press:

TINTON FALLS, N.J. — Tyshon Woods, a student at the Arc of Monmouth's Dorothy B. Hersh High School here, pulls no punches as to how the word "retarded" makes him feel when directed at him and his friends.

"It makes me feel like less than what we are," said Woods, 20, of Long Branch.

A movement to end the use of that word, once used medically and professionally but now viewed by the special-needs community as a derogatory term, is growing throughout the country. On Aug. 16, Gov. Chris Christie signed a bill removing all usage of the word from state law.

Instead, the terms "intellectual disability" or "developmental disability" are to be used, according to the governor's office.

The terms "mentally retarded," "mental retardation" and "feeble-minded" are also to be changed to "developmentally disabled" and "developmental disability," according to the bill.

"Using antiquated, degrading terms to describe individuals with disabilities is an affront to the integrity of the person and their family, and below our common decency as a people," Christie said in a statement.

In addition to removing the offending language, another component of the legislation stresses the importance of "people first" language, referring to "people with disabilities" as such, rather than saying "disabled people."

The Arc of Monmouth is a nonprofit organization that supplies support, resources, education and job training and opportunities to people in Monmouth County with intellectual or developmental disabilities.

It is a local branch of the Arc of New Jersey, and larger, the Arc of the United States, which was once called the Association for Retarded Citizens, but dropped that name in 1991 because of complaints from members.

At the Arc of Monmouth's Work Opportunity Center in Long Branch, where about 150 people perform subcontracted work for hospitals and local manufacturers from Monday through Friday and receive a small wage for their work, a group of adults said the bill was important.

"We don't like to be called retarded," said Diana Donato, 54, of Ocean Township. "Some people do that, and they can hurt somebody else's feelings."

Matthew Nepper, 42, of Middletown recently attended a rally at Rutgers with Arc vocational counselor Heather Warner to speak out against the offensive word.

"It's a curse word to us," Nepper said.

Donato and Nepper are both members of an Arc-affiliated self-advocacy group, along with Craig Goldenthal, 50, of Marlboro, the group's president.

"I think it should be banned; I think it's not nice," Goldenthal said of the word. "That word should not be used at all. People should think twice before they talk."

Celine Fortin, associate executive director for the Arc of New Jersey, said the passage of the bill resulted from a largely grass-roots campaign organized by people with disabilities and their communities throughout the state, going back several years.

The N.J. Statewide Self Advocacy Network consists of more that 110 advocacy groups throughout the state, Fortin said.

For the 2007 general election, the network succeeded in getting a question placed on the ballot that asked to have the words "idiot" and "feeble minded" removed from the state constitution. The question ultimately passed.

From there, the network set forth on an even bigger goal, writing letters to legislators and newspapers, and visiting communities and schools, as members did with the ballot question, to limit the offending language even more, Fortin said.

Around that time, national discussion grew about the use of derogatory language to refer to those with special needs, Fortin said, spurred by the release of the movie "Tropic Thunder," which contained material offensive to some disability advocacy groups.

Through those discussions, it was revealed that many people did not realize they were causing harm through their choice of language, Fortin said.

"Words are critically important," said Renay Zamloot, a special education advocate based in Annandale, Clinton Township in Hunterdon County. "When people in a position of authority eliminate the use of derogatory language . . . it has the effect of trickling down into other areas of life."

Zamloot said she never hears the word "retarded" used professionally anymore. However, it is still prevalent in bullying cases, meaning young people are still using it as a slur to refer to their peers.

She hopes that the new legislation will set a trend to dispel offensive language against all forms of disabilities, she said.

"It's an important step in creating a more accepting atmosphere and also of understanding that we're speaking about people," she said.

Fortin said the next step is to remove the offensive language from federal legislation. The advocacy network has been speaking out in the community and continues to work with legislators to accomplish this goal, she said.

"With the passage of this bill, it's great because it's very visible, very public, and it makes everyone think about their language," she said. "We take that and we keep moving."

From The NY Times. In the picture, Elise Schoux has been more careful to exercise regularly and eat right as preventive measures since her husband, Bill, learned last year that he has Alzheimer’s.


BETHESDA, Md. — The scene was a kind of science court. On trial was the question “Can anything — running on a treadmill, eating more spinach, learning Arabic — prevent Alzheimer’s disease or delay its progression?”

To try to answer that question, the National Institutes of Health sponsored the court, appointing a jury of 15 medical scientists with no vested interests in Alzheimer’s research. They would hear the evidence and reach a judgment on what the data showed.

For a day and a half last spring, researchers presented their cases, describing studies and explaining what they had hoped to show. The jury also heard from scientists from Duke University who had been commissioned to look at the body of evidence — hundreds of research papers — and weigh it. And the jury members had read the papers themselves, preparing for this day.

The studies included research on nearly everything proposed to prevent the disease: exercise, mental stimulation, healthy diet, social engagement, nutritional supplements, anti-inflammatory drugs or those that lower cholesterol or blood pressure, even the idea that people who marry or stay trim might be saved from dementia. And they included research on traits that might hasten Alzheimer’s onset, like not having much of an education or being a loner.

It is an issue that has taken on intense importance because scientists recently reported compelling evidence that two types of tests, PET scans of Alzheimer’s plaque in the brain and tests of spinal fluid, can find signs of the disease years before people have symptoms. That gives rise to the question: What, if anything, can people do to prevent it?

But the jury’s verdict was depressing and distressing. So far, nothing has been found to prevent or delay this devastating disease, which ceaselessly kills brain cells, eventually leaving people mute, incontinent, unable to feed themselves, unaware of who they are or who their family and friends are.

“Currently,” the panel wrote, “no evidence of even moderate scientific quality exists to support the association of any modifiable factor (such as nutritional supplements, herbal preparations, dietary factors, prescription or nonprescription drugs, social or economic factors, medical conditions, toxins or environmental exposures) with reduced risk of Alzheimer’s disease.”

“I was surprised and, at the same time, very sad” about the lack of evidence, said Dr. Martha L. Daviglus, the panel chairwoman and a professor of preventive medicine and medicine at the Feinberg School of Medicine at Northwestern University. “This is something that could happen to any of us, and yet we are at such a primitive state of research.”

She said, “In the end, we concluded that the evidence is the evidence and we have to say what it is.”

The state of the evidence reflects in part the long time it took before researchers even realized that Alzheimer’s was a disease, said Dr. Richard J. Hodes, director of the National Institute on Aging. Until the mid-1980s, many thought dementia was a normal part of aging, and so serious studies of its causes and prevention did not really begin until then. Scientists have spent the years since searching for factors that might affect risk, checking data from other studies to see if, for example, diet or blood pressure or years of education might be associated with the disease.

In the meantime, doctors are in a bind. Should they tell people to do things like walk briskly or eat vegetables — activities that might someday be shown to protect against Alzheimer’s and that certainly cannot hurt? Or should they wait for absolute proof, confirmation that a diet or a drug or an exercise regimen prevents Alzheimer’s?

The Alzheimer’s Association tells people to exercise, challenge themselves mentally, remain socially engaged and keep their hearts healthy. Such measures can only help, says Dr. Maria C. Carrillo, a senior director of the organization.

But, she said, “The Alzheimer’s Association certainly agrees that there is not enough evidence to say anything definitive about the prevention of Alzheimer’s disease and any kind of intervention.”

Of course, Dr. Hodes said, there are many reasons to follow practices to improve general health. But, he said, researchers have to be careful about implying that any measures will protect against this degenerative brain disease.

“We don’t know that yet,” Dr. Hodes said.

Dr. John W. Williams Jr., head of the Duke group that evaluated the studies, thought the task would not be too arduous. He expected relatively few studies and clear results.

To its great surprise, the Duke group discovered a vast amount of literature on Alzheimer’s prevention. Instead of coming up empty on many topics, Dr. Williams said, “We came up empty on very few.”

The problem, the group wrote, was that “the quality of the evidence was typically low.”

Most studies observed people who happened to use or not use a possible preventive measure and then determined whether they got Alzheimer’s or not.

Such studies, known as observational ones, are not the gold standard, like those in which people are randomly assigned to take a pill or do something like exercise, or not. Observational studies are useful in generating hypotheses but are not proof. Still, if several well-done studies of this type come to the same conclusion, they can be valuable evidence.

In the case of Alzheimer’s prevention, though, the studies tended to have problems, Dr. Williams said.

Often it was not clear precisely what subjects were doing. They might have been using a drug or a supplement at the start of the study but the dose was not specified, nor was it clear whether subjects were taking the same doses, or for how long.

Some studies of drugs to lower blood pressure used self-reports as opposed to, for example, pharmacy data. A 12-year study asked participants about their use of cholesterol-lowering statins at the start of the study but never did again. A nine-year statin study used pharmacy records but included as users those who took the drugs at any time during the study period.

Definitions of conditions, like high blood pressure, tended to vary from study to study.

Descriptions of factors like “strong social support” were vague or idiosyncratic. For example, some studies classified married people as having strong social support for that reason alone, with no evaluation of whether the marriage was good or bad.

Often, there were vague assessments of Alzheimer’s disease. And often studies did not take into account other differences among subjects, like age or family history of Alzheimer’s, that might have independently led some to get the disease and others not.

Looking over the piles of studies, the group rated evidence as high, moderate or low, depending on how confident they were in the findings.

Low confidence did not necessarily mean the measures did not work — it meant the evidence was so faulty that there was no way of deciding.

In the end, it said it was highly confident in the findings for just one thing, the herb ginkgo biloba. But in that case the evidence pointed in only one direction: it did not prevent Alzheimer’s.

Moderate evidence, not totally convincing but not worthless, applied to only four factors studied.

Two were factors that increased risk. They were a particular gene, ApoE4, which, moderate evidence showed, increased risk about threefold, and menopause therapy with a combination of estrogens and progestins, which doubled risk.

The other moderate evidence indicated that certain things that had been hoped to be protective were not. For instance, there was moderate evidence that vitamin E, found in nuts, vegetable oils, green leafy vegetables and fortified cereals, had no effect on risk. There was also moderate evidence that cholinesterase inhibitors, drugs often used to treat Alzheimer’s symptoms, had no effect.

Other than that, evidence was poor.

There is only poor evidence, for example, that keeping your brain active, having a high level of education or exercising has a protective effect. There is also only poor evidence that eating a Mediterranean diet — high in fruits and vegetables, fish and olive oil — will help stave off Alzheimer’s.

There is only poor evidence that having poor social support or smoking increases risk.

In a way, it is not surprising that many thought the evidence was stronger than it was, says Dr. James R. Burke, a member of the Duke group and director of the Memory Disorders Clinic at Duke.

“You remember the positive studies,” Dr. Burke said. “The ones that are more marginal, you tend to put them out of your mind.”

And many things thought to protect against Alzheimer’s — a healthy diet, vigorous exercise and an active brain — just seem to be common sense. The science jury said it was still possible that those measures might be found to help and urged that better quality studies be done.

But that may not be so easy if studies have to follow people until they get the disease. Alzheimer’s seems to progress silently in the brain for a decade before the earliest symptoms of memory problems surface. It can take another decade until the distinctive signs of Alzheimer’s appear: profound memory loss and an inability to handle the normal activities of daily life like bathing and dressing.

“Once there is even minimal cognitive impairment, the brain is damaged, inflamed, burning like a bonfire,” said Dr. Caleb Finch, director of the Gerontology Research Institute at the University of Southern California.

As a result, high-quality studies of possible factors like diet and exercise or mental stimulation before the disease’s onset might have to last for decades.

In the meantime, patients, like those at Dr. Burke’s Memory Disorders Clinic, and their frightened family members want advice about things they can do now.

He tells them to do all they can to stay healthy: keep their heart disease risk factors under control, eat a good diet, exercise. He tells them that even if good health cannot prevent Alzheimer’s, it might delay its onset.

“We don’t have compelling evidence or proof that this will prevent Alzheimer’s disease,” he says. But those measures, he adds, “would improve quality of life.”

But Dr. Williams, head of the Duke group, said it was also important to keep an open mind; the measures may or may not affect a person’s chances of getting Alzheimer’s.

“Unfortunately, in medicine,” he said, “things that are logical and make good sense don’t necessarily work out.”

The Problem, Personified

Elise Schoux of Washington is facing the prevention problem. She is 53, an age when prevention might make sense — when Alzheimer’s strikes, people usually are in their 70s and 80s — and she is watching her 70-year-old husband’s slow decline into the dread disease.

Bill Schoux’s memory had been deteriorating for years, but in July 2009, when he got the diagnosis, Mrs. Schoux was devastated.

“For two weeks, we were at a loss, we would burst into tears,” she said. “How could this be?”

Mr. Schoux had been an athlete all his life, he ate a healthy diet, he was friendly and outgoing. He had been an expert on foreign aid, traveling around the world, and had certainly had a mentally stimulating career. Mrs. Schoux is not sure how much more her husband could have done to ward off Alzheimer’s. But she wants to do everything she can to protect herself from getting it and to slow the disease in him.

So Mrs. Schoux now unfailingly goes to the gym with her husband several days a week, lifting weights and spending 30 minutes on a treadmill or an elliptical cross trainer.

Her husband always worked crossword puzzles. Now she does them, too. She and her husband have a subscription to a local theater. And they read the newspaper every day.

“It can’t hurt to keep the brain cells moving,” Mrs. Schoux said.

Mrs. Schoux also tries to eat blueberries, salmon, intensely colored fruits and dark leafy vegetables, in case that helps.

She knows that much of what she is trying is unproved but feels that it can, at worst, be harmless.

“I don’t know what the answers are,” Mrs. Schoux said. “I hope they find something. It is a seriously debilitating disease.”

From The AP:


LONDON — London will mark the two-year countdown to the homecoming of the Paralympics on August 29, celebrating the growing prominence of the event and its start in England in 1948.

More than 500,000 people have already registered interest in buying tickets on the London 2012 website for the 12-day event, and organizers hope to attract a global TV audience of 4 billion.

The official mascot Mandeville is a nod to the location of the first games, which coincided with the 1948 London Olympics. That event featured only 16 patients British soldiers paralyzed in World War II who were recovering at Stoke Mandeville hospital near London and advised to engage in sport as part of treatment.

London 2012 organizers are hoping the Aug. 29-Sept. 9 Paralympics will bring in the most lucrative TV deals yet for the event, having already secured unprecedented coverage on Britain's Channel 4.

"We're breaking new ground with the revenue that we're bringing in," said London 2012 director of Paralympic integration Chris Holmes a former Paralympic swimming champion. "And Mandeville will be an incredibly important piece of how we connect and engage with the public. It's really fantastic that we've got that history in Stoke Mandeville and it's coming home in 2012 with a modern international festival of Paralympic sport."

The 1948 games were not just the starting gun for a sporting revolution, but to technological improvements that changed the lives of disabled people and led to their growing acceptance in society.

"If you look back to the early years, the view of disability was inherently negative," 11-time British Paralympic champion Tanni Grey-Thompson said. "Now the Paralympics have been raised to a whole new level in terms of sponsors and highlighting what the disabled can achieve."

Grey-Thompson, Britain's most successful disabled athlete, highlights the rapid advances in treatment since 1948.

"Until that point, if you had a spinal cord injury you were left in hospital to die and life expectancy was seven years," she said. "Now if you have a spinal cord injury you are likely to live as long as anyone else.

"Sport has helped drive medical changes and that medical technology has helped change sport."

Medical technology such as the carbon-fiber prosthetic limbs are used by South African sprinter Oscar Pistorius. The "Blade Runner" is hoping to be the first track and field athlete to compete in both the Paralympic and Olympic Games.

Natalie du Toit of South Africa achieved that in the pool at Beijing 2008.

Britain was second only to China in the Paralympic medal table in Beijing, winning 42 gold and 102 medals.

British hopes in London will be led by 15-year-old swimmer Eleanor Simmonds, who this month won four world championship gold medals.

From The Bulletin in Philadelphia:

In a ruling involving a mentally disabled man whose legal guardians sought the power to end his medical care, the Pennsylvania Supreme Court has determined that state law requires life-preserving treatment for people who are not near death and have not refused treatment.

The Alliance Defense Fund and allied attorneys filed a friend-of-the-court brief on behalf of 53-year-old David Hockenberry of Ebensburg, Pennsylvania, who has had acute mental disabilities since birth, arguing that his legal guardians should not be allowed to deny him life-preserving treatment while he is not terminal or unconscious. Hockenberry’s guardians unsuccessfully attempted to deny him temporary life-preserving medical treatment for pneumonia.

“Having a disability shouldn’t be a death sentence when treatable medical complications arise,” said Independence Law Center Chief Counsel Randall L. Wenger. “The court made the right decision to protect Mr. Hockenberry’s right to live. He is not dying or unconscious, and his life isn’t worthless just because he has a disability that may lead others to view his life as less worthy to live.”

“A person’s value isn’t based on his or her physical or mental abilities,” said ADF Legal Counsel Matt Bowman. “No one should be allowed to decide that a person’s life is not worth saving just because he or she has a disability or medical condition.”

In December 2007, Mr. Hockenberry developed aspiration pneumonia. Hockenberry’s guardians–appointed as his legal guardians in 2002 by a trial court–tried to decline his required ventilator treatment to assist his breathing, but the hospital proceeded despite their objection. After three weeks on the mechanical ventilator, he recovered from pneumonia and no longer required the treatment.

Mr. Hockenberry’s guardians filed a petition with a trial court in January 2008 that would allow them to end his care if a similar situation were to arise in the future. The Department of Public Welfare objected, stating that Mr. Hockenberry was neither terminally ill nor permanently unconscious and never appointed a third party with the power to refuse healthcare necessary to the preservation of his life. Mr. Hockenberry’s guardians filed a series of appeals until their case reached the Pennsylvania Supreme Court, which agreed to hear the case. In March, ADF and allied attorneys argued in a friend-of-the-court brief that people should not be considered better off dead just because of a disability. The high court concurred that the Health Care Agents and Representatives Act requires life-preserving care for such persons.

“We hold that where, as here, life-preserving treatment is at issue for an incompetent person who is not suffering from an end-stage condition or permanent unconsciousness, and that person has no health-care agent, the Act mandates that the care must be provided,” the opinion states. “The enactment...regulates the situation in which the incompetent person suffers from a life-threatening but treatable condition, obviously reflecting the Legislature’s assertion of a policy position of greater state involvement to preserve life in such circumstances.”

From The AP:


SPRINGFIELD, Ill. — An Illinois appeals court has agreed to allow a central Illinois student to keep his autism helper dog in school.

The Fourth District Appellate Court sided with the family of Kaleb Drew (pictured). They had argued that the boy's yellow Labrador retriever is a service animal allowed in schools under state law.

The boy's mother had testified that the dog prevents the boy from running away, helps him focus on his homework and calms him when he has a tantrum.

The appeals court upheld the November decision of a Douglas County judge. The court issued its opinion August 24.

The Villa Grove school district had opposed the dog's presence and argued that it isn't a true service animal. A telephone message for the school district's attorney was not immediately returned.

From The NY Times:


Residents in 14 states and Washington can now appeal to their doctors for prescriptions for medical marijuana to help them with their pain.

Their employers, however, may not be so understanding.

In some cases, workers have been fired for failing drug tests despite having prescriptions saying, in effect, that what they are doing is legal according to the laws of their states.

Though the number of such cases appears to be small, they are exposing a new legal gray area, with workers complaining of rights violations and company officials scratching their heads over how to enforce a uniform policy for a drug that the federal government has not recognized as having a legitimate medical purpose.

“The current state of affairs puts employers in a very difficult situation,” said Barbara L. Johnson, an employment lawyer in Washington. “But the reality is that there are no federal guidelines like there are when dealing with other types of prescription medications.”

Some workers have learned about this legal quandary first-hand, at the cost of their jobs.

Nick Stennet (pictured), 20, has a congenital disorder called Poland’s syndrome, which left him without a chest muscle on the right side of his body and with a right hand with fingers substantially shorter than those on his left.

Doctors prescribed one or two inhalations of marijuana each night before bed to relieve severe muscle stiffness and shooting pains in his arms.

Mr. Stennet said he told the human resources manager at the Home Depot in Hilo, Hawaii, about his prescription when he was being hired. But after his drug test came back positive for tetrahydrocannabinol, or THC, the active chemical in marijuana, he was out a job.

“Why would they send me down there when they know I am going to test positive?” he said. “I feel like they put me through ridicule when it was so avoidable.”

Steve Holmes, a Home Depot spokesman, said the company followed federal guidelines for its drug policy. Employees are allowed to take a leave if they choose to use marijuana to combat the side effects of treatment for a serious ailment. When they return, however, the THC must be out of their systems.

“It’s a safety issue for us,” Mr. Holmes said.

Cynthia Estlund, a professor of labor and employment law at New York University, said that only one state that had legalized medical marijuana had taken the additional step of saying explicitly that it was unlawful to fire someone for using a lawful substance.

At the same time, Ms. Estlund said, “Nothing in the law tells employers what to do, so they don’t have to fire them under federal law.”

That is the objection raised by Scott Michelman, a lawyer for the American Civil Liberties Union, on behalf of his client, Joseph Casias.

In 2008, Mr. Casias, a father of two who medicates with marijuana to relieve the pain of inoperable brain and sinus cancer, was named associate of the year at the Wal-Mart in Battle Creek, Mich. But when he injured his knee last year, company policy required a drug test. The positive result cost him his job.

In June, the A.C.L.U. filed a complaint in state court on his behalf, citing wrongful termination. He is seeking reinstatement and damages.

“The cancer is not what’s keeping him from earning a living — Wal-Mart is,” Mr. Michelman said. “There’s actually no law to require Wal-Mart to do what they did.”

Greg Rossiter, a spokesman for Wal-Mart, said: “This is obviously an unfortunate situation all around. But we have to consider the overall safety of our customers and our associates.”

On the broader legal question, Mr. Rossiter added: “As more states allow this treatment, employers are left without guidelines.”

Only the Rhode Island Medical Marijuana Act offers protection to medical marijuana cardholders for students, employees and tenants. Michigan’s law does not compel an employer to make accommodations for marijuana consumption “in any workplace” or for “any employee working while under the influence of marijuana,” according to the legislation.

While that addresses marijuana smoking at work or just before work, the Michigan law does not speak to what employees can do away from work. Mr. Michelman of the A.C.L.U. said he believed that there was no gray area and that federal law does not govern the relationship between a private employer and an employee.

“There is only one law governing this situation, and that’s Michigan law,” he said.

John Vasconcellos, a California state senator who was a leading advocate for medical marijuana legislation there, said lawmakers had not anticipated such a collision of state and federal law in employment practices.

“I think they’re hiding from common sense, and they’re hiding from the science that shows it might help their employee be more healthy and feel less pain,” Mr. Vasconcellos said of companies that fired employees with medical marijuana registry cards, prescriptions or endorsements from doctors.

In Colorado, the right to use medical marijuana for a debilitating medical condition is protected by the State Constitution — though with limitations — making it unique among states where it is legal. But Brandon Coats, 30, a phone operator at Dish Network who has used a wheelchair since he was paralyzed in a car accident 14 years go, was fired after a random drug test came back positive.

Mr. Coats’s doctors had recommended medical marijuana to control his involuntary muscle spasms and seizures after prescription drugs were no longer effective for him. A few puffs before bed allows him to work comfortably the next day, said his lawyer, Michael Evans.

Mr. Evans said that Mr. Coats — who, he said, had consistently received good performance reviews — was terminated for conduct that was legal and outside of work.

In an e-mail, Francie Bauer, the company’s corporate communications manager, said: “Dish Network does not comment on the specifics of employee matters. As a national company with more than 21,000 employees, Dish Network is committed to its drug-free workplace policy and compliance with federal law, which does not permit the use of marijuana, even for medicinal purposes.”

The issue has not worked its way through the Colorado courts.

Some companies have begun to recognize marijuana as a legitimate therapy. Jian Software, based in Chico, Calif., recently consulted with the National Organization of Marijuana Reform Laws, or Norml, in an effort to institute a drug policy that accounts for the medicinal use of marijuana.

This is necessary, said R. Keith Stroup, legal counsel for Norml, because the courts have not yet held that medical marijuana users enjoy “a legally enforceable, fundamental right” to smoke.

“Employers in states that have legalized the medical use of marijuana under state law unfortunately remain free to fire employees who test positive for THC,” Mr. Stroup said in an e-mail. “It is terribly unfair to these patients, but at this time it is not illegal.”

From The AP:

WASHINGTON — A federal appeals court on August 27 upheld a ruling that vaccines are not to blame for autism.

The U.S. Court of Appeals for the Federal Circuit upheld a decision last year by a special vaccine court, which concluded there's little if any evidence to support claims of a vaccine-autism link.

Scientist years ago reached that conclusion, but more than 5,500 families sought compensation through the government's Vaccine Injury Compensation Program.

The August 27 ruling came in the case of Michelle Cedillo of Yuma, Ariz., who is disabled with autism, inflammatory bowel disease and other disorders that her parents blame on a measles vaccine given at 15 months.

In the 2009 ruling Special Master Denise Vowell wrote that the evidence "is weak, contradictory and unpersuasive. Sadly, the petitioners in this litigation have been the victims of bad science conducted to support litigation rather than to advance medical and scientific understanding" of autism.

In its ruling Friday the appeals panel said "we have carefully reviewed the decision of the special master and we find that it is rationally supported by the evidence, well-articulated, and reasonable. We, therefore, affirm the denial of the Cedillos' petition for compensation."

Earlier this year the so-called vaccine court also concluded that the additive thimerosal is not to blame for autism, an added setback in a long-running battle by parents convinced there is a connection.

The decisions help to offer reassurance to parents scared about vaccinating their babies because of a small but vocal anti-vaccine movement. Some vaccine-preventable diseases, including measles, are on the rise.

From the San Francisco Chronicle:

A former partner at a well-known law firm and his marketing consultant wife were arrested August 25 on felony charges of bilking the San Francisco school district and private insurers out of about $400,000 via fraudulent bills for treatment of their autistic son, officials say.

The San Francisco couple, Jonathan S. Dickstein and Barclay J. Lynn, both 43, surrendered Wednesday and are expected to appear in court this morning for arraignment on 30 counts of fraud, theft and conspiracy, authorities say.

They were briefly jailed Wednesday on $100,000 bail each but were released on bond.

"This was an elaborate scheme to defraud the school district and insurance companies out of a lot of money," said Chief Assistant District Attorney David Pfeifer. "They used this scheme to make money off their child's special needs - that's terrible."

Until this year, Dickstein, who graduated from Stanford and then Harvard Law School, was a partner at the internationally recognized San Francisco firm of Morrison & Foerster, specializing in intellectual property issues and the law surrounding life sciences. He has since started his own practice, according to his Facebook page.

He and his wife had arranged for the home care of their young son through another school district before transferring to the San Francisco school district. Under state guidelines, school districts are obligated to provide or compensate parents for home education of autistic or other severely disabled children.

By law, parents are required to use licensed private educational providers to develop individual treatment plans that meet state guidelines for their disabled children.

Dickstein and Lynn had employed such a private provider, but in 2006, they created their own: Puzzle Pieces. Prosecutors said it was actually a dummy company that was not licensed to develop autism education.

Double dipping
In fact, they say, the couple used Puzzle Pieces to overbill and "double dip" - charging both the school district and insurers for the exact same services - from 2006 to 2008. They billed for counselors and doctors at allegedly inflated rates and charged both the district and insurers for the same hours of treatment. They allegedly told insurers the district would not pay.

Gentle Blythe, spokeswoman for the district, said it was school officials who raised red flags to prosecutors last year.

"The parents weren't allowing the district personnel to talk to the service providers," Blythe said. She said it was then that the district uncovered the fact that Puzzle Pieces was not a licensed provider and in fact had been started by Lynn in 2006.

Dickstein's attorney, Garrick Lew, said the couple were devoted to their severely challenged son, but admittedly took efforts too far.

"They put a lot of work into getting whatever the child needed," he said. "In the process of getting all those needs met, there were problems."

He said he hopes to "try to work something out" with prosecutors.

Douglas Rappaport, Lynn's attorney, said that it was too soon to comment in detail but that there was "some indication that their conduct could be construed as lawful."

He said the couple volunteered many hours of their time to causes associated with autism.

The alleged fraud went undetected for about three years, until the school district assigned a new case supervisor over the education and treatment of the child last year.

Blythe said the district's earlier efforts to supervise the child's care met with resistance from the couple, but officials acted quickly when the problem was uncovered by the new supervisor.

The new supervisor noticed that Puzzle Pieces was charging twice what would typically be paid for in-home autism care and counseling for autistic children, prosecutors say.

A doctor who supposedly provided help had no specialty in autism, prosecutors say. Dr. Robert Schenck describes himself on the Internet as a specialist in depression in adults. He declined to comment.

When confronted about the questionable billings, the couple told authorities at the district that they did not have copies of the checks used to pay Puzzle Pieces.

Prosecutors said the couple attempted to pass off Puzzle Pieces as a company that they were not directly involved in, saying they would have to talk to the company people and get back to the district. But, Pfeifer noted: "They are the company."

Thousands in losses
According to prosecutors, the district lost as much as $240,000 while Anthem Blue Cross lost an estimated $100,000 and CIGNA, which administered the law firm's health plan, lost about $40,000.

In an Internet profile, Lynn said that from March 2006 until June of this year, she was a "director" of "private autism services" and that she "designed and directed (an) individualized home education program for (a) child affected by Autism" that combined "best practices" in " therapies and techniques ..."

She said that the "10 year old child in question went from an 'untestable' IQ in 2004 to being able to reach (sic) at a 2nd grade level, write several pages of text and is able to do 2nd grade math."

Lew, Dickstein's attorney, said the couple got overwhelmed as they worked with the many intricacies involved in securing care for their son.

"They were dealing with multiple agencies," he said. "Somehow things kind of went south. It's really unfortunate for them, as people, and also for their kid."

From The Fresno Bee:


A Fresno man was sentenced August 25 to seven years and eight months in prison for running over an undercover officer's foot during his escape from a north Fresno store parking lot in January 2008.

Gilbert Jimenez apologized in Fresno County Superior Court for his actions, but said he acted in self-defense.

Police said Jimenez, 37, is a Bulldog gang member who got into a fight with Corben Whitney of the California Highway Patrol and Chris Wagner of the Department of Motor Vehicles outside the Ross Dress for Less store at First Street and Shaw Avenue.

Training police to handle situations involving people with mental illness is much-needed as officers deal with an increasing number of such calls, Fresno Police Jerry Dyer said Tuesday.

At a news conference announcing a three-day crisis intervention program that's under way in east-central Fresno, Dyer said his department had 8,500 mental illness-related cases last year -- and that number is growing.

The goal of the training, which ended August 27, is to better prepare officers when they respond to mental-illness incidents, known as "5150" calls, Dyer said.

Richard A. Ciummo & Associates has thrived by offering governments cut-rate contracts to provide public defender services in Fresno, Madera and five other California counties.

The Madera-based law firm has been called the Walmart of legal defense for the poor -- and just like the mega-retailer, the firm has created a lot of controversy.

While Ciummo & Associates has strong support from government administrators, it's drawn criticism from law professors and legal-aid groups who fear the firm's flat-rate contracts cheat indigent defendants of adequate representation.

Relatives of a Fresno man who was stabbed to death inside his Tower District home a year ago tearfully told a judge August 26 that they have lost faith in the jury system.

They wanted Darshae Dews, 19, to get life in prison without parole for murdering 44-year-old Arthur Lopez, who was stabbed 20 times.

But Fresno County Superior Court Judge Hilary Chittick said the law doesn't give her the authority to sentence Dews to that punishment.

At least one in three inmates released early from Fresno County Jail since 2008 has landed back in jail for new crimes -- sometimes within hours, an analysis by The Fresno Bee has found.

Many inmates were arrested and released repeatedly -- up to five times -- over a 28-month period.

It's unclear how many of the crimes might have occurred without early release. But Fresno police say the jail's revolving door is contributing to a recent spike in burglaries and auto thefts -- in part because repeat offenders know they have a good chance of getting released early.

Only two years after it started, a Fresno County program for criminal defendants with mental illness may fall victim to budget cuts, ending a model that has reduced crime in other places.

Started by Superior Court Judge Hilary Chittick, Behavioral Health Court places participants in treatment for drug abuse and psychological problems and tries to steer them away from crime.

Studies have found that mental health courts can keep the mentally ill out of trouble. Although it's too early for a complete report on Fresno County's program, initial results have been promising, Chittick said.

But county budget cuts have put the future of the program in doubt. The county funds most of the court's personnel, and department heads say it's uncertain whether they can continue. The state budget -- when approved -- may determine the court's fate.

Chittick and others in Behavioral Health Court said they hope the program will survive.

"Mental illness leads to recidivism," Chittick said. "In the long run, it's better to keep these people out of trouble and prevent future victimization."

The Behavioral Health Court is something of a hybrid -- part probation office, part support group. Court officials use a combination of discipline and feel-good measures to try to keep participants on the right path.

State officials say more attention must be given to the mentally ill in California's courts. More than half of the people behind bars in the country have a mental illness, according to a task force convened by Ronald M. George, chief justice of the California Supreme Court. The task force recently recommended that trial courts adopt specialized approaches to the mentally ill, such as mental health courts.

Statewide, 41 of 58 counties have a mental health court, according to the state Administrative Office of the Courts.

Mental health courts reduce re-arrest rates by up to 45%, according to a report by the state task force.

Chittick and other Fresno County officials started the Behavioral Health Court in July 2008 after touring similar courts in other counties. Chittick said she has been concerned about the lack of assistance for mentally ill defendants since she worked in the Public Defender's Office about 20 years ago and represented a disturbed man who threatened a television personality.

In Fresno County, mental health court takes defendants after conviction in a traditional court, instead of determining their guilt, as some mental health courts do. Behavioral Health Court essentially serves as an expanded probation program. Individuals convicted of certain crimes -- including drug dealing, gang activity, and crimes causing serious injury -- are ineligible.

Participants also must be certified by a health professional as having a severe mental illness such as schizophrenia or bipolar disorder. Such illnesses make people lose touch with reality and more prone to commit crime, said Kristine Ruiz, a probation officer. The court's only full time employee, Ruiz meets with participants regularly to make sure they're meeting program requirements and otherwise find out what's happening in their lives.

Defendants in court recently showed how mental illness can create problems for themselves. The program's 15 participants must show up for court every other week and have Chittick review their cases.

In one recent session, Robert Posey, 48, tried to explain to Chittick how he was having problems with a woman who owed him money. Posey was previously convicted of assault.

From the Seattle Times:


A group of parents, teachers and concerned citizens are fighting a decision in Renton to tear down an alternative high school and relocate the students, saying the school district has ignored its input and is violating a state policy that encourages community feedback.

Black River High School, a 150-student school for students who failed in regular comprehensive high schools and need special teacher attention, soon will be demolished. Students will be redistributed throughout other high schools when the school year begins, and by 2011 a bond-funded new school called the Secondary Learning Center will open its doors at the current Black River site.

Leaders with the community group say the Renton School District changed the allocation of bond money without voters' approval and did not consult the community before closing the school.

Michele Savelle, a member of the community group, is concerned about student and staff separation. Alternative schools, which are much smaller than regular high schools, are close-knit communities that, if ripped apart, destroy at-risk students' motivation to stay in school, said Savelle, who also is the founder of the community-revitalization organization Skyway Solutions.

Separating students is "essentially throwing away students who are already at risk and had just gotten their confidence back in school," Savelle said. The closure left students "really mad and they're really hurt. And when teenagers get mad and they don't have really good support at home, they get into trouble," she said.

The group has said the district is not following a state policy that requires 90 days of community feedback before a school is closed.

The district maintains that it followed the rules because the district isn't closing the school, just rebuilding it, said district spokesman Randy Matheson.

"They say you should run your district like a business, and that's what we do," Matheson said. "The curriculum we set up, it has parent input. We get student input. But we can't accommodate all that input."

Wendy Bluhm, whose son goes to Black River, said her ideas haven't been welcome at the district. She also was upset that along with the changes, the district decided to cut a popular horticulture program because it didn't meet state science requirements.

She said cutting horticulture will force the students, many of whom have ADHD (attention deficit/hyperactivity disorder) and other learning disabilities, to take more advanced classes such as biology and chemistry, whose textbooks are "too thick." Horticulture, she said, provided students with hands-on learning.

"That's how they learn, that's how they pass," Bluhm said.

The teacher of the class, Carol Grimes, said she could have "changed the class to fit requirements," but was given little notice of the change.

The Renton School District has rebuilt and reopened 13 schools with the bond money since voters approved a bond measure in May 2008, Matheson said — "and we're doing the same thing with Black River."

But unlike previous school reconstructions, where students and teachers traveled together to a temporary site, just over half of Black River students and teachers will be housed together at nearby Sartori High School, another alternative school. The rest will go to regular comprehensive schools in the district.

Then, after the school is demolished and reconstructed, the district expects to give the replacement school a new name, and its student population will be different.

The district's plan blurs the lines between closure and reconstruction, which aren't differentiated or defined in the state policy, said Dave Stolier, chief of the education division at the state Attorney General's Office. But a state document says the policy doesn't apply when schools are temporarily closed for renovation and students are relocated to another school in the meantime. Whether the exception still holds true when the "renovation" is a total tear-down and when students are relocated to multiple schools rather than just one is unknown, Stolier said.

"It sounds like it's a little bit of an eye-of-the-beholder question," he said.

It's also a question the state can't answer because the project isn't using state money, according to Scott Black at the state Office of the Superintendent of Public Instruction.

If the project were state-funded, "there would usually be a swing facility where the school would put all the kids in temporarily," Black said, but "the fact that the district didn't do that is a local decision that they have a right to make."

For now, this handful of concerned residents have tried to get the district's attention with letters and by trying to involve others in fighting the decision, but group members say they can't afford the roughly $3,500 needed to file for the injunction their lawyer suggested. They attempted to raise money with carwashes and community donations, but many of the school's families don't make much money and can't donate.

Instead of seeking an injunction, the group plans to use the money it raised to print informational fliers about their fight and distribute them in neighborhoods by the Black River campus.

Though the community group isn't taking legal action, it is fighting to keep the students from Black River together, something the district's current plan doesn't do.

At the new school, called the Secondary Learning Center and expected to be completed in 2011, the school's population will be a combination of students who now attend Sartori and students from Black River who this fall will be housed at Sartori. The students who will be redistributed to comprehensive schools this fall will not reunite with their fellow Black River students after the school's reconstruction.

Though Sartori, like Black River, is an alternative school, it's for people who dropped out of high school and have returned as adults to earn GEDs at their own pace. Black River is for teens who failed in their regular comprehensive high schools and require more teacher attention to succeed in school.

The district didn't solicit the entire Sartori community's input before deciding to move Black River students in with Sartori students, said Sartori math teacher Tim McIntosh.

But, he said, if the two schools are kept separate, they can coexist well in the same building — now and in the future.

"One answer for everybody won't work," McIntosh said. "That's why these students failed in their regular comprehensive high schools."

From BBC News:


A teenage wheelchair user from Sheffield has paid his first cheque into his local bank after a four year battle to get access.

David Allen (pictured), 19, took the Royal Bank of Scotland to court after it failed to provide disabled access at its Church Street branch.

In November 2009 judges dismissed the bank's appeal against a ruling ordering it to pay damages and install a lift.

The estimated cost for installing the platform lift was £200,000.

David's mother, Ceri, said: "We are absolutely thrilled about it."

She said the lift was very good and added: "David will be able to come and do his own banking. And a young man of 19 should be able to do their own banking business."

The Church Street branch is a 19th century listed building where access to all entrances was by flights of stone steps.

From Physorg.com:

An international study led by University of Montreal scientists suggests family history may not be a good predictor of the presence of mutations predisposing to autism or schizophrenia.

The findings show how new or de novo gene mutations - alterations of the cell's DNA - play a role in these devastating conditions. Published in the American Journal of Human Genetics, this study has implications for disease prevalence and severity.

"This study emphasizes the importance of de novo mutations as genetic factors predisposing to autism and schizophrenia. We found an increased frequency of severe de novo mutations in critical brain genes in both of these diseases," says senior author and University of Montreal professor, Guy Rouleau.

"Harmful de novo mutations, as observed in this study, may in part explain the high global incidences of autism and schizophrenia," adds Dr. Rouleau, who is also director of the Sainte-Justine University Hospital Research Center and a scientist at the University of Montreal Hospital Research Centre.

The team analyzed 400 genes that are turned on in nerve cells from patients with autism or schizophrenia spectrum disorders. Their results showed that there is an excess of de novo gene mutations associated with the two diseases.

Their study revealed that DNA taken directly from the patient's blood was superior to that taken from patient-derived cell lines. "The source of biological material is crucial for these types of experiments," says lead author Philip Awadalla, a University of Montreal pediatrics professor, scientist at the Sainte-Justine University Hospital Research Center and scientific director of the CARTaGENE project.

"In the process of confirming our findings, we were also able to provide one of the first direct estimates of the human mutation rate," continues Dr. Awadalla. "The number of mutations per generation is extremely small but on the order of what was previously indirectly inferred for human-chimpanzee comparisons. We also discovered that mutations can be introduced when cell lines are produced, which creates false-positive results. This artefact can significantly bias results and therefore great care needs to taken when analyzing these samples."

Mutations are alterations of the cell's DNA that can occur because of errors in the DNA replication, which happen prior to cell division. Once DNA is changed, this mutation is passed down to a next generation. A mutation that is newly formed and therefore not inherited from either parent is called a de novo mutation.

From UKPA:


A humbled Paralympic champion David Weir (pictured) said he was "truly honoured" at having an art exhibition in south London mark his success on the track.

Oil paintings, photos and sculptures from at least six different artists will be among the items paying homage to the wheelchair racer who aims to defend his 800m, 1500m titles plus win the 5,000m at London 2012.

The exhibition has been set up by Sutton Council where Weir, 31, was born and began training.

He said: "I am truly honoured that my borough has brought this event together and really looking forward to the exhibition.

"Sunday August 29 marks two years to the start of the Paralympics in London and I can't wait now; it's already two years since Beijing!"

The exhibition featuring work by artists including Jeremy Houghton, Richard Booth, Dominic Pearce, Sam Hunt and Teresa Witz will be held alongside an Olympic poster exhibition at Sutton Library from September 1 to October 31.

Weir was the only gold medal winner in Britain's athletics team at the Bird's Nest as he ended a 12-year wait for Paralympic glory.

Weir has continued to improve his times, although this summer he lost two world records to Marcel Hug of Switzerland.

Sutton Council's deputy leader Ruth Dombey said: "David is one of London's most successful athletes.

"This exhibition shows just how proud Sutton is of his achievements and will hopefully inspire more young people to follow his lead."

From The AP:

ATLANTA -- Georgia Tech and other colleges have received a $10 million federal grant to develop a computer system that can screen young children for developmental disorders like autism.

The National Science Foundation award will go to researchers collecting behavioral data from children to help develop an automated system of analysis and identification. The computer-based system will help increase the number of children who can be screened and get them the critical treatments they need earlier in life.

Other colleges involved are: Boston University, Carnegie Mellon, Emory University, Massachusetts Institute of Technology, the University of Illinois at Urbana-Champaign, the University of Pittsburgh, the University of Southern California and the Marcus Institute autism research center in Atlanta.