Cruise executive: 'Sorry for what guests had to endure'








MOBILE, Alabama—





Reeking of raw sewage, a crippled cruise ship carrying more than 4,200 people was limping into Mobile, Alabama, on Thursday as passengers awaited the end of a vacation voyage some described as hellish.

The Carnival Triumph was being towed into port by tugboats as the drama played out live on U.S. cable news stations, creating another public relations nightmare for cruise giant Carnival Corp. Last year, its Costa Concordia luxury ship grounded off the coast of Italy, with 32 people killed.


Passengers described an overpowering stench on board the ship four days after an engine room fire knocked out power and plumbing across most of the 893-foot vessel and left it adrift in the Gulf of Mexico. The ship, which went into service in 1999, was on a four-day cruise and on its way back from a stop in Cozumel, Mexico.

After the mishap, toilets and drainpipes overflowed, soaking many cabins and interior passages in sewage and turning the vessel into what some have described as a giant Petri dish.

"The thing I'm looking forward to most is having a working toilet and not having to breathe in the smell of fecal matter," said Jacob Combs, an Austin, Texas-based sales executive with a healthcare and hospice company.

Combs, 30, who said he had been traveling with friends and family on the Triumph, had nothing but praise for its crew members, saying they had gone through "hell" cleaning up after some of the passengers on the sea cruise.

"Just imagine the filth," Combs told Reuters. "People were doing crazy things and going to the bathroom in sinks and showers. It was inhuman. The stewards would go in and clean it all up. They were constantly cleaning," he said.

Terry Thornton, a Carnival Cruise Lines senior vice president, told reporters in Mobile that additional provisions were laid in on Wednesday and the ship was now "in excellent shape."

Passenger Donna Gutzman said those aboard the ship were treated to steak and lobster for lunch on Thursday afternoon.

"Our basic needs are being met. For the most part, they are making us happy," Gutzman told CNN.

The ship was expected to arrive in port around midnight CST, Carnival said. A senior Carnival official said it could take up to five hours to remove all the passengers from the ship, which has only one functioning elevator.

Operated by Carnival Cruise Lines, the flagship brand of Carnival Corp, the ship left Galveston, Texas, a week ago carrying 3,143 passengers and 1,086 crew. It was supposed to return there on Monday.

A Coast Guard cutter has been escorting the Triumph on its long voyage into port since Monday, and a Coast Guard helicopter ferried about 3,000 pounds of equipment including a generator to the stricken ship late on Wednesday.

Earlier in the week, some passengers reported on the poor conditions on the Triumph when they contacted relatives and media before their cell phone batteries died. They said people were getting sick and passengers had been told to use plastic "biohazard" bags as makeshift toilets.

'VERY CHALLENGING CIRCUMSTANCES'

Carnival Cruise Lines Chief Executive Gerry Cahill said in a statement late on Wednesday that the company had decided to add further payment of $500 a person to help compensate passengers for "very challenging circumstances" aboard the ship.

"We are very sorry for what our guests have had to endure," Cahill said.

Mary Poret, who spoke to her 12-year-old daughter aboard the Triumph on Monday, rejected Cahill's apology in comments to CNN on Thursday, as she waited anxiously in Mobile with a friend for the Triumph's arrival.

"Seeing urine and feces sloshing in the halls, sleeping on the floor, nothing to eat, people fighting over food, $500? What's the emotional cost? You can't put money on that," Porte said.

Carnival Corp Chairman and CEO Micky Arison faced criticism in January 2012 for failing to travel to Italy and take personal charge of the Costa Concordia crisis after the luxury cruise shop operated by Carnival's Costa Cruises brand grounded on rocks off the Tuscan island of Giglio. The tragedy unleashed numerous lawsuits against his company.

The cruise ship mogul has taken a low-key approach to the Triumph situation as well, even as it grabbed a growing share of the U.S. media spotlight. His only known public appearance since Sunday was courtside on Tuesday at a game played by his Miami Heat championship professional basketball team.

"I think they really are trying to do the right thing, but I don't think they have been able to communicate it effectively," said Marcia Horowitz, an executive who handles crisis management at Rubenstein Associates, a New York-based public relations firm.

"Most of all, you really need a face for Carnival," she added. "You can do all the right things. But unless you communicate it effectively, it will not see the light of day."

Carnival Corp shares closed down $0.11 at $37.35 in trading on Thursday on the New York Stock Exchange. The shares closed down 4 percent at $37.46 on Wednesday after the company said voyage disruptions and repair costs related to Carnival Triumph could shave up to 10 cents a share off its second-half earnings.

The Triumph is a Bahamian-flagged vessel and the Bahamas Maritime Authority will be the primary agency investigating the cause of its engine room fire.

For all the passengers' grievances, they will likely find it difficult to sue the cruise operator for any damages, legal sources said. Over the years, the cruise industry has put in place a legal structure that ring-fences operators from big-money lawsuits.

Rules for seeking redress are spelled out in complex, multi-page ticket contracts that have been the subject of decades of court battles. Victims are often required to proceed with any litigation in remote jurisdictions.

(Reporting by Tom Brown, Kevin Gray and David Adams; Editing by Peter Cooney)






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”Downton Abbey” star Maggie Smith never watches TV show






LOS ANGELES (Reuters) – Maggie Smith‘s sarcastic dowager Countess may be the star of British period drama “Downton Abbey,” but the award-winning actress says she has never watched the TV series.


Smith, 78, who has won two Emmy Awards and a Golden Globe for her role as the acid-tongued Lady Grantham, tells CBS in an upcoming TV interview that she is amazed by the popularity of the show both in Britain and the United States.






Asked whether she is proud of “Downton Abbey”, Smith said, “I haven’t actually seen it. So I don’t, I don’t sit down and watch it,” she told CBS reporter Steve Kroft in the interview to be broadcast on Sunday.


“Never?” Kroft asked. “No, I haven’t watched it,” Smith replied, according to an advance excerpt released on Thursday.


Smith, known as a perfectionist, said that watching herself would make her worry about her performance. “It’s frustrating. I always see things that I would like to do differently and think, ‘Oh, why in the name of God did I do that?’”


“Downton Abbey,” a drama about the lives of aristocratic Britons and their servants in the early 20th century, attracted some 7.9 million viewers for its third season premiere in January on U.S. television.


Smith’s snobbish Lady Grantham and her withering remarks like “No-one wants to kiss a girl in black,” and “What is a weekend?”, have made her the show’s biggest star.


Smith also has two Oscars for her roles in 1969 film “The Prime of Miss Jean Brodie” and 1978 comedy “California Suite” but she said she had no interest in her recent fame. The actress is a rare face at Hollywood award ceremonies.


“I don’t feel any different to the way I felt before and I’m not quite sure what (being a star) means. I am familiar to people now, which is what I was not before,” she told Kroft. “That is entirely due to the television set.”


Smith also acknowledged her reputation as an actress who doesn’t suffer fools gladly.


“Old people are scary and I have to face it, I am old and I am scary and I am very sorry about it, but I don’t know what you do,” she quipped.


The full interview can be seen on “60 Minutes” on February 17 on CBS television.


(Reporting By Jill Serjeant; Editing by David Brunnstrom)


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Doctor and Patient: Afraid to Speak Up to Medical Power

The slender, weather-beaten, elderly Polish immigrant had been diagnosed with lung cancer nearly a year earlier and was receiving chemotherapy as part of a clinical trial. I was a surgical consultant, called in to help control the fluid that kept accumulating in his lungs.

During one visit, he motioned for me to come closer. His voice was hoarse from a tumor that spread, and the constant hissing from his humidified oxygen mask meant I had to press my face nearly against his to understand his words.

“This is getting harder, doctor,” he rasped. “I’m not sure I’m up to anymore chemo.”

I was not the only doctor that he confided to. But what I quickly learned was that none of us was eager to broach the topic of stopping treatment with his primary cancer doctor.

That doctor was a rising superstar in the world of oncology, a brilliant physician-researcher who had helped discover treatments for other cancers and who had been recruited to lead our hospital’s then lackluster cancer center. Within a few months of the doctor’s arrival, the once sleepy department began offering a dazzling array of experimental drugs. Calls came in from outside doctors eager to send their patients in for treatment, and every patient who was seen was promptly enrolled in one of more than a dozen well-documented treatment protocols.

But now, no doctors felt comfortable suggesting anything but the most cutting-edge, aggressive treatments.

Even the No. 2 doctor in the cancer center, Robin to the chief’s cancer-battling Batman, was momentarily taken aback when I suggested we reconsider the patient’s chemotherapy plan. “I don’t want to tell him,” he said, eyes widening. He reeled off his chief’s vast accomplishments. “I mean, who am I to tell him what to do?”

We stood for a moment in silence before he pointed his index finger at me. “You tell him,” he said with a smile. “You tell him to consider stopping treatment.”

Memories of this conversation came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.

For several decades, medical educators and sociologists have documented the existence of hierarchies and an intense awareness of rank among doctors. The bulk of studies have focused on medical education, a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviors. Aspiring doctors quickly learn whose opinions, experiences and voices count, and it is rarely their own. Ask a group of interns who’ve been on the wards for but a week, and they will quickly raise their hands up to the level of their heads to indicate their teachers’ status and importance, then lower them toward their feet to demonstrate their own.

It turns out that this keen awareness of ranking is not limited to students and interns. Other research has shown that fully trained physicians are acutely aware of a tacit professional hierarchy based on specialties, like primary care versus neurosurgery, or even on diseases different specialists might treat, like hemorrhoids and constipation versus heart attacks and certain cancers.

But while such professional preoccupation with privilege can make for interesting sociological fodder, the real issue, warns the author of a courageous essay published recently in The New England Journal of Medicine, is that such an overly developed sense of hierarchy comes at an unacceptable price: good patient care.

Dr. Ranjana Srivastava, a medical oncologist at the Monash Medical Centre in Melbourne, Australia, recalls a patient she helped to care for who died after an operation. Before the surgery, Dr. Srivastava had been hesitant to voice her concerns, assuming that the patient’s surgeon must be “unequivocally right, unassailable, or simply not worth antagonizing.” When she confesses her earlier uncertainty to the surgeon after the patient’s death, Dr. Srivastava learns that the surgeon had been just as loath to question her expertise and had assumed that her silence before the surgery meant she agreed with his plan to operate.

“Each of us was trying our best to help a patient, but we were also respecting the boundaries and hierarchy imposed by our professional culture,” Dr. Srivastava said. “The tragedy was that the patient died, when speaking up would have made all the difference.”

Compounding the problem is an increasing sense of self-doubt among many doctors. With rapid advances in treatment, there is often no single correct “answer” for a patient’s problem, and doctors, struggling to stay up-to-date in their own particular specialty niches, are more tentative about making suggestions that cross over to other doctors’ “turf.” Even as some clinicians attempt to compensate by organizing multidisciplinary meetings, inviting doctors from all specialties to discuss a patient’s therapeutic options, “there will inevitably be a hierarchy at those meetings of who is speaking,” Dr. Srivastava noted. “And it won’t always be the ones who know the most about the patient who will be taking the lead.”

It is the potentially disastrous repercussions for patients that make this overly developed awareness of rank and boundaries a critical issue in medicine. Recent efforts to raise safety standards and improve patient care have shown that teams are a critical ingredient for success. But simply organizing multidisciplinary lineups of clinicians isn’t enough. What is required are teams that recognize the importance of all voices and encourage active and open debate.

Since their patient’s death, Dr. Srivastava and the surgeon have worked together to discuss patient cases, articulate questions and describe their own uncertainties to each other and in patients’ notes. “We have tried to remain cognizant of the fact that we are susceptible to thinking about hierarchy,” Dr. Srivastava said. “We have tried to remember that sometimes, despite our best intentions, we do not speak up for our patients because we are fearful of the consequences.”

That was certainly true for my lung cancer patient. Like all the other doctors involved in his care, I hesitated to talk to the chief medical oncologist. I questioned my own credentials, my lack of expertise in this particular area of oncology and even my own clinical judgment. When the patient appeared to fare better, requiring less oxygen and joking and laughing more than I had ever seen in the past, I took his improvement to be yet another sign that my attempt to talk about holding back chemotherapy was surely some surgical folly.

But a couple of days later, the humidified oxygen mask came back on. And not long after that, the patient again asked for me to come close.

This time he said: “I’m tired. I want to stop the chemo.”

Just before he died, a little over a week later, he was off all treatment except for what might make him comfortable. He thanked me and the other doctors for our care, but really, we should have thanked him and apologized. Because he had pushed us out of our comfortable, well-delineated professional zones. He had prodded us to talk to one another. And he showed us how to work as a team in order to do, at last, what we should have done weeks earlier.

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Buffet, 3G to buy Heinz for $23B









Warren Buffett's Berkshire Hathaway and private equity firm 3G Capital will buy ketchup and baby food maker H.J. Heinz Co for $23.2 billion in cash, a deal that combines 3G's ambitions in the food industry with Buffett's hunt for growth.


Including debt assumption, Heinz valued the transaction, which it called the largest in its industry's history, at $28 billion. Berkshire and 3G will pay $72.50 per share, a 19 percent premium to the stock's previous all-time high. Heinz shares actually rose slightly above the offer price, although Buffett cautioned he had no intention of raising his bid.


Analysts said the deal could be the first step in a broader wave of mergers for the food and beverage industry.








"Maybe for the consumer staples group in general this may start some talk about consolidation. Even corporate entities are flush with cash, interest rates are low, it would seemingly make sense," Edward Jones analyst Jack Russo said.


Companies like General Mills and Campbell Soup - itself long seen as a potential Heinz merge partner - rose on the news.


BUFFETT HUNTING GROWTH


The surprise purchase satisfies, at least in part, Buffett's hunt for growth through acquisition. He was frustrated in 2012 by the collapse of at least two deals in excess of $20 billion and said he might have to do a $30 billion deal this year to help fuel Berkshire's growth engine. In this case, Berkshire is putting up about $12 billion to $13 billion cash, Buffett told CNBC, leaving it ample room for another major transaction.


Berkshire Hathaway already has a variety of food assets, including the Dairy Queen ice cream chain, chocolatier See's Candies and the food distributor McLane. Buffett, famed for a love of cheeseburgers, joked he was well acquainted with Heinz's products already and that this was "my kind of deal."


It does represent an unusual teaming of Berkshire with private equity, though; historically, Buffett's purchases have been outright his own. He and 3G founder Jorge Paulo Lemann have known each other for years, and Buffett said Lemann approached him with the Heinz idea in December. One Berkshire investor said he had mixed feelings about the deal because of the limited growth prospects domestically.


"We're a little hesitant on the staple companies because they don't have any leverage in the United States," said Bill Smead, chief investment officer of Smead Capital Management in Seattle. But at the same time, he said, Buffett was likely willing to accept a bond-like steady return even if it was not necessarily a "home run."


3G EXPANDS


For 3G, a little-known firm with Brazilian roots, the purchase is something of a natural complement to its investment in fast-food chain Burger King, which it acquired in late 2010 and in which it still holds a major stake. Lemann, a globe-trotting financier with Swiss roots, made his money in banking and gained notoriety for helping to pull together the deals that ultimately formed the beer brewing giant AB InBev.


3G's Alex Behring runs the fund out of New York. He appeared at a Pittsburgh news conference on Thursday with Heinz management to discuss the deal - and to reassure anxious local crowds that the company will remain based there and will continue to support local philanthropy.


But at the same time, Behring said it was too soon to talk about cost cuts at the company. Unlike Berkshire, which is a hands-off operator, 3G is known for aggressively controlling costs at its operations.


PITTSBURGH ROOTS Also to be determined is whether CEO Bill Johnson would stay on. Only the fifth chairman in the company's history, Johnson is widely credited with Heinz's recent strong growth.


"I am way too young to retire," he told the news conference, adding that discussions had not yet started with 3G over the details of Heinz's future management.


The company, known for its iconic ketchup bottles, Heinz 57 sauces as well as other brands including Ore-Ida frozen potatoes, has increased net sales for the last eight fiscal years in a row.


Heinz said the transaction would be financed with cash from Berkshire and 3G, debt rollover and debt financing from J.P. Morgan and Wells Fargo. Buffett told CNBC that Berkshire and 3G would be equal equity partners.


Heinz shares soared 19.9 percent, or $12.06, to $72.54 on the New York Stock Exchange. A week ago the stock hit a long-term high of $61 a share - near records it set in 1998 - having risen almost 5 percent this year and nearly 12 percent since the beginning of 2012.


The deal is also a potential boon for new U.S. Secretary of State John Kerry, whose wife Teresa is the widow of H.J. Heinz Co heir John Heinz.


Kerry's most recent financial disclosures from his time in the U.S. Senate show a position in Heinz shares of more than $1 million, although the precise size is unclear.


Centerview Partners and BofA Merrill Lynch were financial advisers to Heinz, with Davis Polk & Wardwell LLP the legal adviser. Moelis & Company was financial adviser to the transaction committee of Heinz's board and Wachtell, Lipton, Rosen & Katz served as its legal adviser. Lazard served as lead financial adviser. J.P. Morgan and Wells Fargo also served as financial advisers to the investment consortium. Kirkland & Ellis LLP was legal adviser to 3G Capital, and Munger, Tolles & Olson LLP was legal adviser to Berkshire Hathaway.





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Sources: American, US Airways boards approve merger









The boards of AMR Corp and US Airways Group Inc each met on Wednesday to approve a merger that would create the world's largest airline with an expected market value of around $11 billion, people familiar with the matter said.

The all-stock merger, which is set to be announced early on Thursday, would finalize the consolidation of legacy U.S. air carriers that helped put the industry on a more solid financial footing.

AMR's bankruptcy creditors will own 72 percent of the combined airline, which will do business under the American Airlines brand and be based in Fort Worth, Texas, the people said. US Airways shareholders will own the rest.

The board approval came after AMR's unsecured creditors committee, which includes all three of AMR's major unions, met earlier on Wednesday to approve a proposed merger agreement, the people said.

The merged company will have a board of 12 members: four from US Airways including its chief executive Doug Parker, three from AMR including chief executive Tom Horton and five to be designated by the AMR creditors, two of the people said.

That will shrink to 11 members in 2014 after Horton steps down following the combined company's first annual meeting, the person added. Parker becomes chief executive of the new airline.

AMR's unsecured creditors are expected to be made whole on their claims in the form of stock in the merged company and also get accrued interest, the people said. AMR's shareholders will get a small equity stake as well, they added.

All the sources asked not to be named because the matter was not public. US Airways declined to comment while AMR representatives could not be immediately reached for comment.

The deal comes more than 14 months after the bankrupt parent of American Airlines filed for bankruptcy in November 2011, and would mark the last combination of legacy U.S. carriers, following the Delta-Northwest and United-Continental mergers.

A tie-up with US Airways would create the world's top airline by passenger traffic and help American and US Air better compete with United Continental Holdings and Delta Air Lines.

Some $11 billion valuation of the combined American-US Airways compares to the roughly $12.4 billion market capitalization for Delta, and $8.7 billion for United Continental.

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Kevin Spacey, Eva Longoria find starring roles online






(Reuters) – “Desperate Housewives” alum Eva Longoria‘s new project won’t bring her back to ABC, or any traditional U.S. television network. The actress will produce and lend her voice to “Mother Up!,” a 13-episode adult animated comedy available in the U.S. this fall only on the online video site Hulu.


Longoria, Kevin Spacey, John Goodman and other top Hollywood actors are being wooed by the growing number of Silicon Valley companies rushing to get a foothold in consumers’ living rooms with exclusive shows that feature big names and hefty budgets.






As video streaming technology makes watching videos on laptops and mobile devices as easy as flicking on a TV set, Amazon.com Inc, Google Inc’s YouTube, Yahoo and Microsoft Corp are setting up shop in Hollywood to produce or license their own series.


Their models are pay TV channels like HBO and Showtime that built their subscriber rolls by creating shows like HBO‘s “Sopranos” or Showtime’s “Homeland” that a TV viewer couldn’t get anywhere else.


“Content creators think they’ve hit the lottery,” said Bernard Gershon, head of digital consultancy Gershon Media and a former Walt Disney Co executive. “Those companies are throwing a lot of dollars for content they can use to create a following.”


With 33 million global subscribers to its streaming service, Netflix can afford to plunk down what analysts estimate was up to $ 100 million for the rights to “House of Cards,” a slickly produced political drama starring two-time Oscar winner Spacey and produced by “The Social Network” film director David Fincher.


Upcoming only-on-Netflix series include the revival of one-time Fox comedy “Arrested Development” starring Will Arnett, and murder mystery “Hemlock Grove,” directed by horror movie producer Eli Roth.


On Tuesday, the Los Gatos, California-based company announced the December release of its first original children’s series, a show based on DreamWorks Animation’s coming summer movie “Turbo” about a fast-moving snail.


The companies have different business models — Amazon, Netflix and Microsoft have subscription services, YouTube sells advertising, while Intel Corp and Apple Inc may introduce cable-like services that offer channels online.


But they all sense an opening as consumers increasingly chafe at their mounting cable and satellite TV bills. A small, but increasing, number are starting to “cut the cord,” or drop their service, say analysts.


“We may be sowing the seeds of our own destruction,” Charlie Ergen, chairman of satellite operator Dish Network Corp, said at the AllThingsD “Dive into Media” conference on February 12. “A lot of people can live with Netflix and be perfectly happy.”


Netflix has won fans in Hollywood by giving writers and directors a “high level of autonomy as well as an increasingly global distribution platform,” Morgan Stanley analyst Scott Devitt said in a note to clients.


“There is plenty of room for multiple producers and licensors of original content,” Devitt added.


Amazon.com’s Prime subscription, which combines a video streaming service with free shipping for products it sells online, stepped up its Hollywood dealmaking in the last month with pacts to be the exclusive online home for popular PBS drama “Downton Abbey” and upcoming CBS show “Under the Dome,” a series based on a Stephen King novel.


The Seattle-based company, seen by some analysts as Netflix‘s biggest threat, said last month it plans to air 11 original pilot episodes before deciding which to produce as ongoing series.


One of the pilots, “Alpha House,” follows four senators who live together in a rented house. “Roseanne” and “Argo” actor John Goodman will star, according to a person close to the situation.


Overall, Amazon Studios has 48 movie and TV shows in development, an Amazon spokeswoman said.


Hulu, owned by media giants Disney, News Corp and Comcast Corp’s NBCUniversal, is beefing up its own original and exclusive content for its free, ad-supported service and its monthly subscription plan. Hulu already has distributed than two dozen exclusive or original shows, including Morgan Spurlock documentary series “A Day in the Life.”


Upcoming Hulu programs include Longoria’s “Mother Up!” about a former music executive navigating life as a suburban mom.


Microsoft, which offers services such as Netflix on its XBox video game console, intends to produce its own content later this year for its 40 million subscribers, said Nancy Tellem, a former CBS entertainment president who joined Microsoft last year to run its fledging Hollywood production studio.


“We’re not as constrained as other content creators,” Tellem said at the AllThingsD conference. “We can produce something that’s 10 minutes or an hour.”


The XBox’s benefit, Tellem said, is its interactivity. To generate added revenue, the service can sell tickets to concerts by stars of its comedies, or copies of the clothes worn by stars on red carpet events.


Deep-pocketed Apple Inc could also step into the entertainment production game. Industry insiders continue to believe that Apple intends to unveil a TV-based device that has the potential to shake up the television content and distribution industry the way the iPod and iPhone disrupted music and mobile content.


Sources say Apple, which already sells a $ 99 set top box called Apple TV that streams Netflix and other content, has opened discussions with providers, though its progress with the cozy club of Hollywood producers and distributors is unknown.


Chip maker Intel plans to launch an Internet television service this year with live and on-demand content, said Erik Huggers, vice president and general manager of Intel Media, who said he is negotiating with content providers.


The Silicon Valley newcomers may be taking aim at siphoning off cable subscribers, but executives at Time Warner’s HBO premium service, don’t seem particularly worried.


Hulu and Amazon will be just another 200 hours on top of the 145,000 hours that are already available to the consumer,” said HBO president Eric Kessler. “What matters is that our content is exclusive. If you want ‘Game of Thrones,’ there is only one place you can get it.”


(Reporting By Ronald Grover and Lisa Richwine in Los Angeles and Alistair Barr in San Francisco; Editing by M.D. Golan)


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Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.


Katherine Bouton speaks about her own experience with hearing loss.


A transcript of this interview can be found here.


Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.


Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.


This post has been revised to reflect the following correction:

Correction: February 14, 2013

An article on Tuesday about hearing loss and dementia misidentified the city in which the Medical College of Wisconsin is located. It is in Milwaukee, not in Madison.

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Sources: American, US Airways boards approve merger









The boards of AMR Corp and US Airways Group Inc each met on Wednesday to approve a merger that would create the world's largest airline with an expected market value of around $11 billion, people familiar with the matter said.

The all-stock merger, which is set to be announced early on Thursday, would finalize the consolidation of legacy U.S. air carriers that helped put the industry on a more solid financial footing.

AMR's bankruptcy creditors will own 72 percent of the combined airline, which will do business under the American Airlines brand and be based in Fort Worth, Texas, the people said. US Airways shareholders will own the rest.

The board approval came after AMR's unsecured creditors committee, which includes all three of AMR's major unions, met earlier on Wednesday to approve a proposed merger agreement, the people said.

The merged company will have a board of 12 members: four from US Airways including its chief executive Doug Parker, three from AMR including chief executive Tom Horton and five to be designated by the AMR creditors, two of the people said.

That will shrink to 11 members in 2014 after Horton steps down following the combined company's first annual meeting, the person added. Parker becomes chief executive of the new airline.

AMR's unsecured creditors are expected to be made whole on their claims in the form of stock in the merged company and also get accrued interest, the people said. AMR's shareholders will get a small equity stake as well, they added.

All the sources asked not to be named because the matter was not public. US Airways declined to comment while AMR representatives could not be immediately reached for comment.

The deal comes more than 14 months after the bankrupt parent of American Airlines filed for bankruptcy in November 2011, and would mark the last combination of legacy U.S. carriers, following the Delta-Northwest and United-Continental mergers.

A tie-up with US Airways would create the world's top airline by passenger traffic and help American and US Air better compete with United Continental Holdings and Delta Air Lines.

Some $11 billion valuation of the combined American-US Airways compares to the roughly $12.4 billion market capitalization for Delta, and $8.7 billion for United Continental.

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Attorney convicted in slaying of Eddy Curry's ex-girlfriend, child









A Chicago attorney was found guilty Tuesday night of fatally shooting a former girlfriend of ex-Chicago Bulls player Eddy Curry and their infant daughter.


Frederick Goings, 40, was convicted of two counts of first-degree murder by a Cook County jury that deliberated a little more than four hours.


The victims, Nova Henry, 24, and her 10-month-old daughter, Ava, were found shot to death inside their South Loop town house in January 2009. Henry's 3-year-old son Noah, who also was Curry’s child, was found in the town house unharmed.





“We're very pleased with the verdict,” said Lisa Newman, Nova Henry's godmother. “We never doubted for a minute that it would be anything other than guilty.”


Goings' attorneys argued during the trial  that there was no physical evidence linking him to the double murder. They also accused Chicago police investigators of failing to seriously weigh other possible suspects.


Prosecutor Jim McKay, however, told the jury during closing arguments that “A mountain of evidence became an avalanche, and now [Goings is) buried.”


Goings expressed no emotion as the verdict was read. During McKay’s animated closing argument, Goings leaned on the left arm of his chair and hardly flinched.
At one point, McKay flung his arms in Goings' direction after counting off on his fingers several pieces of evidence. “Reasonable doubt? There is no reasonable doubt in this case,” McKay said. “None.”


Prosecutors said earlier in the trial that Goings, a family attorney, had “dollar signs in his eyes” when he took Nova Henry on as a client in a child-support case against Curry, who was then playing for the New York Knicks. Curry did not testify in the trial.


Goings and Nova Henry developed a romantic relationship that prosecutors said stretched over two years. But their relationship took a tumultuous turn when Nova Henry hired a new lawyer and made plans to contest $24,000 in legal fees charged by Goings.


In 2007, Nova Henry took out an order of protection against Goings after she said he threatened her and her son, but she let it expire, McKay said.


On Jan. 24, 2009, Goings opened fire on Nova Henry as she stood at the bottom of the stairs in her South Loop town home, according to prosecutors. Earlier this month, Noah’s grandmother Yolan Henry testified that she and her boyfriend found the bodies a few hours later. They also discovered Noah and asked him what happen.


“He turned around and looked at me and said, ‘Frederick,’” Yolan Henry testified. “He repeated, ‘Frederick did it.’”


McKay described Goings as a “true coward” for fleeing on that day to a hotel in LaPorte County, Ind.. Prosecutors alleged he tried to erase any trace of the double murder by jumping naked into a swimming pool, wandering in a nearby forest and washing his fingernails to try to get rid of gunshot residue. A bullet matching linked to the murder weapon was later found in Goings’ car, they said.


“How do I get out of this one?” McKay said Goings thought in the hours after the crime.


As he wrapped up his closing argument, McKay had one final plea for the jurors. “You stop Frederick Goings now,” McKay told the jury. “You stop him. You do justice.”


Family members declined to comment as they left the courtroom. They plan to speak at a news conference Wednesday morning.


A post-trial hearing is set for March 11.


psvitek@tribune.com





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Dave Clark Five bassist Rick Huxley dies aged 72






(Reuters) – Rick Huxley, the bassist for the 1960s British Invasion pop-rock group the Dave Clark Five, has died, the band’s leader said on Tuesday. He was 72.


Huxley died unexpectedly at his home in the English countryside on Monday, Dave Clark told Reuters.






The band scored No. 1 hits on both sides of the Atlantic during its decade-long run from 1960-1970.


“Glad All Over” holds the honor of knocking the Beatles’ “I Want to Hold Your Hand” out of the top spot on the UK chart in 1964, while “Over and Over” topped the U.S. chart in 1965.


The cause of death was not immediately known, said Clark, who added that Huxley had been “sprightly and in good shape” despite suffering from emphysema for several years.


“I spoke to him on Friday and he was in great spirits,” Clark said in a telephone call. “He went through a recent doctor’s check and had a good, clean bill of health. This came totally out of the blue, and I’m just devastated.”


Clark remembered Huxley for his modest demeanor and humor.


“He always made me smile and I’ll miss that immensely,” Clark said. “He was never arrogant and flashy. He was a gentleman and very low key. He was a very, very talented musician and a great friend.”


The Dave Clark Five was inducted into the Rock and Roll Hall of Fame in 2008.


Huxley was born in Dartford, England, east of London, the same town that is home to the Rolling Stones lead singer Mick Jagger and guitarist Keith Richards.


Huxley is survived by two sons and a daughter.


(Reporting by Eric Kelsey in Los Angeles; Editing by Jill Serjeant and Mohammad Zargham)


Music News Headlines – Yahoo! News





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