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 12, 2013

An earlier version of this article misstated the location of the Medical College of Wisconsin. It is in Milwaukee, not Madison.

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Chicago leads nation in gas-price spikes









Drivers in Chicago are seeing a painful rise in gas prices get even worse this month.

The average price of regular unleaded in the Chicago metro area on Tuesday is $3.93, according to AAA. That's up 12 cents from a week ago. A month ago, the average was $3.42. Statewide, the average is about $3.79, up 8 cents from last week and 46 cents last month.






Prices are rising at pumps across the country, too, but not as dramatically. The national average is $3.60, up about 7 cents from a week ago and 30 cents higher than this time last month.

It's not typical to see gas price spikes at this time of year. Demand is typically low and picks up in the spring before driving season. And in general, gas is cheaper to produce in the winter because refineries can use less expensive blends.

The main reason for the spike is the higher price of crude oil. The price of oil has gone from around $85 a barrel in December to around $97 now because of improving economic certainty as the country moved past the election and the fiscal cliff deadline, according to energy analyst Phil Flynn. It's also being driven by better-than-expected growth in China, the world's second largest economy.

Prices in the Chicago area are typically some the highest in the nation, but the cost of a local fill-up is accelerating at almost double the national rate.

Flynn attributes this to a number of refinery issues in the region. Some scheduled maintenance at refineries -- where gasoline and other products are produced from oil -- occurred earlier than usual, which cut off some supply, affecting prices. Many close at this time of year to start the switchover to lower-emission summer blends of gasoline.

Besides a major overhaul of BP's Whiting refinery, the largest supplier of gasoline to Midwest markets, that's believed to be driving prices higher, a fire temporarily shut down a refinery in northwest Ohio.

AAA, which tracks daily gasoline prices around the country, predicts they will continue their rapid climb as local refinery issues continue into the beginning of peak driving season.

Flynn is more optimistic.

He believes that once the major Whiting refinery overhaul is complete later this year, gas prices will stabilize.

"I'm probably in the minority but I think we are starting to see some light at the end of the tunnel," he said.

sbomkamp@tribune.com | Twitter: @SamWillTravel



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Slain teen's dad: 'The healing can start' after 2 charged with murder









Announcing charges in a case that has drawn national attention, police say 15-year-old Hadiya Pendleton was shot to death by two reputed gang members who were bent on retaliation for a shooting last summer and mistook the group of teens she was with for rivals.

Michael Ward, 18, and Kenneth Williams, 20, are charged with first-degree murder, attempted murder and aggravated battery with a firearm in the attack that also left two other teens wounded in Harsh Park late last month, about a mile from President Barack Obama's Kenwood home.






Ward, of the 3900 block of South Lake Park Avenue, told police the shooting was in retaliation for Williams getting wounded last July on the South Side, according to Superintendent Garry McCarthy.

Williams, of the 300 block of West 59th Street, had been shot July 12 near Pershing Road and Lake Park Avenue, police said. But he refused to sign a complaint against those suspected in the attack, McCarthy said.

Williams and Ward targeted Hadiya and other teens in the park Jan. 29 because they believed, mistakenly, they were members of the gang responsible for the shooting, he said. Ward fired the gun, police said.

Hours after Hadiya's funeral, attended by first lady Michelle Obama, police stopped Ward and Williams as they were on their way in separate cars to a strip club in Harvey Saturday night, McCarthy said at a news conference at Area Central police headquarters this evening.

Hearing news of the charges, Hadiya's father Nathaniel Pendleton said this is the first time since the shooting he's had a "legitimate" smile on his face.

"I'm ecstatic that they found the two guys," he told the Tribune by phone from a Washington, D.C. restaurant, where he was with his wife, Cleopatra Cowley-Pendleton, and other relatives. "(I'm) thanking God that these two guys are off the streets, so that this doesn't happen to another innocent person."

Pendleton and his family were in the nation's capital to be guests of Obama during the State of the Union address Tuesday night.

Still, Pendleton said true closure won't come until the men are convicted. "Right now, I can say to you that the healing can start," he said.

Hadiya was shot in Vivian Gordon Harsh Park, about a mile north of President Barack Obama's Kenwood neighborhood home on the South Side. Her slaying took place a little more than a week after the honor student performed with the King College Prep band in Washington during inauguration festivities.

The shooting in the 4400 block of South Oakenwald Avenue happened after classes were dismissed for the day during finals week at King. Hadiya, a sophomore at King, was at the park with a group of teens, primarily other students from the school, when a gunman climbed over a fence, ran to the group and started firing, police have said.

The shooter escaped in what has been described as a white Nissan vehicle, possibly driven by a getaway driver.

While police and neighbors have generally described Harsh Park and its immediate surroundings as safe, there has been an internal gang conflict brewing in the area between factions of the Gangster Disciples, police said.

The playground where Hadiya was shot was the setting for an amateur rap video posted to YouTube. The video, which also highlights the intersection at South Oakenwald and East 44th Place, uses the moniker of a local gang in an opening credit and features a rapper shown leaving the Cook County Jail, then threatening to shoot down his foes.

The video ends at a house party with a smiling teenage girl flashing gang signs at the camera.

Ward and Williams are members of the Gangster Disciples, sources said.

Ward pleaded guilty early last year in a 2011 aggravated unlawful use of a weapon case and was given two years probation, according to court records. After an arrest on criminal trespass to a vehicle last summer, he was held without bond for a few weeks, but was released after a Sept. 9, 2012, hearing.

Williams was arrested on a misdemeanor retail theft charge in October 2011, but the charge was dismissed.


Tribune reporter Carlos Sadovi contributed to this story.

tlighty@tribune.com

jgorner@tribune.com

Jdelgado@tribune.com





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Health Testing on Mice Is Found Misleading in Some Cases


Evan McGlinn for The New York Times


Dr. H. Shaw Warren is one of the authors of a new study that questions the use of laboratory mice as models for all human diseases.







For decades, mice have been the species of choice in the study of human diseases. But now, researchers report evidence that the mouse model has been totally misleading for at least three major killers — sepsis, burns and trauma. As a result, years and billions of dollars have been wasted following false leads, they say.




The study’s findings do not mean that mice are useless models for all human diseases. But, its authors said, they do raise troubling questions about diseases like the ones in the study that involve the immune system, including cancer and heart disease.


“Our article raises at least the possibility that a parallel situation may be present,” said Dr. H. Shaw Warren, a sepsis researcher at Massachusetts General Hospital and a lead author of the new study.


The paper, published Monday in Proceedings of the National Academy of Sciences, helps explain why every one of nearly 150 drugs tested at a huge expense in patients with sepsis has failed. The drug tests all were based on studies in mice. And mice, it turns out, can have something that looks like sepsis in humans, but is very different from the condition in humans.


Medical experts not associated with the study said that the findings should change the course of research worldwide for a deadly and frustrating condition. Sepsis, a potentially deadly reaction that occurs as the body tries to fight an infection, afflicts 750,000 patients a year in the United States, kills one-fourth to one-half of them, and costs the nation $17 billion a year. It is the leading cause of death in intensive-care units.


“This is a game changer,” said Dr. Mitchell Fink, a sepsis expert at the University of California, Los Angeles, of the new study.


“It’s amazing,” said Dr. Richard Wenzel, a former chairman at the department of internal medicine at Virginia Commonwealth University and a former editor of The New England Journal of Medicine. “They are absolutely right on.”


Potentially deadly immune responses occur when a person’s immune system overreacts to what it perceives as danger signals, including toxic molecules from bacteria, viruses, fungi, or proteins released from cells damaged by trauma or burns, said Dr. Clifford S. Deutschman, who directs sepsis research at the University of Pennsylvania and was not part of the study.


The ramped-up immune system releases its own proteins in such overwhelming amounts that capillaries begin to leak. The leak becomes excessive, and serum seeps out of the tiny blood vessels. Blood pressure falls, and vital organs do not get enough blood. Despite efforts, doctors and nurses in an intensive-care unit or an emergency room may be unable to keep up with the leaks, stop the infection or halt the tissue damage. Vital organs eventually fail.


The new study, which took 10 years and involved 39 researchers from across the country, began by studying white blood cells from hundreds of patients with severe burns, trauma or sepsis to see what genes were being used by white blood cells when responding to these danger signals.


The researchers found some interesting patterns and accumulated a large, rigorously collected data set that should help move the field forward, said Ronald W. Davis, a genomics expert at Stanford University and a lead author of the new paper. Some patterns seemed to predict who would survive and who would end up in intensive care, clinging to life and, often, dying.


The group had tried to publish its findings in several papers. One objection, Dr. Davis said, was that the researchers had not shown the same gene response had happened in mice.


“They were so used to doing mouse studies that they thought that was how you validate things,” he said. “They are so ingrained in trying to cure mice that they forget we are trying to cure humans.”


“That started us thinking,” he continued. “Is it the same in the mouse or not?”


The group decided to look, expecting to find some similarities. But when the data were analyzed, there were none at all.


“We were kind of blown away,” Dr. Davis said.


The drug failures became clear. For example, often in mice, a gene would be used, while in humans, the comparable gene would be suppressed. A drug that worked in mice by disabling that gene could make the response even more deadly in humans.


Even more surprising, Dr. Warren said, was that different conditions in mice — burns, trauma, sepsis — did not fit the same pattern. Each condition used different groups of genes. In humans, though, similar genes were used in all three conditions. That means, Dr. Warren said, that if researchers can find a drug that works for one of those conditions in people, it might work for all three.


This article has been revised to reflect the following correction:

Correction: February 11, 2013

An earlier version of this article misstated the position of Dr. Richard Wenzel. He is a former chairman of the department of internal medicine at Virginia Commonwealth University. He is not currently the chairman.



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Maker's Mark lowering proof to meet demand









Maker's Mark announced it is reducing the amount of alcohol in the spirit to keep pace with rapidly increasing consumer demand.

In an email to its fans, representatives of the brand said the entire bourbon category is "exploding" and demand for Maker's Mark is growing even faster. Some customers have even reported empty shelves in their local stores, it said.

After looking at "all possible solutions," the total alcohol by volume of Maker's Mark is being reduced by 3 percent. Representatives said the change will allow it to maintain the same taste while making sure there's "enough Maker's Mark to go around." It's working to expand its distillery and production capacity, too.

Maker's Mark, made by Deerfield-based Beam Inc., said it's done extensive testing to ensure the same taste. It says bourbon drinkers couldn't tell the difference. It also underscored the fact that nothing else in the production process has changed.

"In other words, we've made sure we didn't screw up your whisky," the note said.

Rob Samuels, chief operating officer and grandson of Maker's Mark Founder Bill Samuels, Sr., said this is a permanent decision that won’t be reversed when demand for bourbon slows down. Samuels said that bourbon has gone from the slowest growing spirits category to the fastest over the last 18 months, driven by growth overseas and demand from younger drinkers. An average bottle of Maker’s Mark takes six and half years to produce from start to finish, and since the company doesn’t buy or trade whiskey, it’s been impossible to keep up. 

The first bottle of Maker's Mark, with its signature red wax closure, was produced in 1958.

Beam is the country's second-largest spirits company by volume. It also makes Jim Beam, Sauza tequila and Pinnacle vodka. It's still dwarfed by industry-leading Diageo, the London-based maker of Smirnoff, Tanqueray, Captain Morgan and Johnnie Walker.

It's a tough time to take a risk with one of its oldest and most popular brands. Beam has promised that 25 percent of sales will come from new products, a difficult goal to attain but a critical one for investor confidence.The move met some backlash on social media sites, where some said they would boycott the bourbon if the company went ahead with its plans.

Many also complained that they'd rather see an increase in its price than a decrease in the alcohol. But observers say that by raising the price, Beam would have hurt itself by positioning Maker's Mark to compete against its own higher end brands like Basil Hayden's.

sbomkamp@tribune.com | Twitter: @SamWillTravel



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Grammy Awards: Fun., Frank Ocean, Adele win









And now for a few of our own award winners from the night’s nationally televised performances, speeches and other tomfoolery:


The saints go marching in: The Black Keys stormed down the streets of Treme, rocking up “Lonely Boy” with a jazz band and Dr. John in ceremonial, feathered “Night Tripper” head dress.


Revenge of the nerds: Though fun. often comes across as just another bland pop-rock band in the tradition of Train, matchbox20 and Hootie and the Blowfish, at least they have a self-deprecating sense of humor. In winning song of the year for “We are Young” over some strong competition, fun. singer Nate Ruess acknowledged, "We are not very young" and guitarist Jack Antonoff thanked "our families” who “let us live at home" for 12 years.








Best promotional plug: Justin Timberlake paved the way for his new album by fusing a ‘40s Cotton Club vibe, with the musicians and backing singers arrayed behind him on a Duke Ellington-style band stand, and then brought out Jay-Z, while channeling some Michael Jackson falsetto.


Least likely acid head: Taylor Swift got her surrealism on as she opened the broadcast by recasting her single “We Are Never Ever Getting Back Together” as a kind of Little Bunny Foo Foo/Alice in Wonderland fantasia. Somewhere Lady Gaga was cackling. It sure put a new spin on Swift’s ultra-earnest, ultra-confessional singer-songwriter persona. Could a meat dress be next?


Country time machine: Last year it was electronic dance music, so this year the Grammys took a hard right and went for some Nashville twang as they presented a series of country entertainers. Miranda Lambert and Dierks Bentley may have been playing new tunes from their recent albums, but they weren’t that far removed from vintage ‘70s-style country-rockers.


Soul lives: Dapper Miguel, on bended kneed, crooned “Adore,” even with the distraction of Wiz Khalifa, who seemed greatly under-utilized in one of those duets-that-didn't work.


------------------------


Live Grammy Awards updates from the LA Times:


9:01 p.m.: It took nearly two hours, but the Grammys finally received a wake-up call, courtesy of the Black Keys, Dr. John and the Preservation Hall Jazz Band. “Lonely Boy,” the Keys’ nominated single, is electric. The song is full of riffs that are constantly recharging, and the gospel-inspired chorus comes out of nowhere. It’s a rock ‘n’ roll blitz, and performing with Dr. John only heightened the band’s bluesy, swampy foundation. It would have been nice for something from Dr. John’s “Locked Down,” which the Keys’ Dan Auerbach produced, but hey, had to get that Maroon 5/Alicia Keys performance in there. 


8:53 p.m.: We were promised Rihanna “like we had never seen her before,” as host LL Cool J put it, and for most of her performance of “Stay,” it looked exactly like the Rihanna we had seen on “Saturday Night Live.” Yet here she was joined by Mikky Ekko, who was among the writers on “Stay.” As far as Rihanna performances go, this was one of the better ones. Rihanna is always best when she pulls back, when she opts to rely on her uniquely delicate voice rather than a dominatrix outfit and a flashy performance. At the Grammys, she proved she can in fact be a rather dramatic vocalist, as long as she drops all the accessories that typically come with her performances.


Shortly after, “No Church in the Wild” from Jay-Z and Kanye West won the Grammy for rap/sung collaboration. The song features Frank Ocean and the Dream, who joined Jay-Z onstage.“I didn’t think I’d be the first one speaking,” said Ocean, who kept trying to bring Jay-Z over to the microphone. But Jay-Z let his collaborators have the stage, and poked a little fun at them. “I’d like to thank the swap meet for his hat,” he said, pointing at the Dream’s winter stylings.  


8:41 p.m.: The Grammy for rap/sung collaboration goes to "No Church in the Wild" from Jay-Z and Kanye West and featuring Frank Ocean and the Dream.


8:39 p.m.: You know the Grammys are having a tough night when the acceptance speeches are outshining the performances. That’s exactly what happened when Kelly Clarkson won pop vocal album, besting releases from Florence & the Machine, Fun., Maroon 5 and Pink. A surprised Clarkson gave a shout-out to the very fine vocals of R&B singer Miguel.


“Miguel,” she screamed, “I don’t know who the hell you are but we need to sing together. That was the sexiest damn thing I’ve ever seen. What!”


Hopefully, those watching at home had a similar reaction, but Clarkson’s declaration confirmed our belief that Miguel deserved more airtime.


As an aside: Clarkson’s win here ends any chance of Fun. winning album of the year.


8:38 p.m.: It’s a big night for the Black Keys, whose “El Camino” is filled with one hard-to-resist scorcher after another. If there’s anything passing as drama tonight, it’s the album of the year race between the Black Keys and Frank Ocean.

But getting there isn’t going to be easy. The next Grammy mash-up no one ever needed was the pairing of Maroon 5 and Alicia Keys. The former’s “Daylight” is the sort of simple-enough tune you can ignore if you’re walking around the mall, but when it’s in your face, as it was tonight, it only highlight’s Adam Levine’s weightless vocals and the band’s rent-a-hooks. Keys’ “Girl on Fire” is already played out, and though she tried to stark-it-up by adding a rhythmic punch to its opening verse, it soon became an uncomfortable back-and-forth between Keys and Maroon 5.  



8:22 p.m. (Central time): A clearly nervous Frank Ocean accepted his Grammy for urban contemporary album. He made a nod to the old adage that you imagine a crowd naked if you want to calm your nerves, but the adventurous artist said, “I want to look at you as kids in tuxedos and being fancy and all that.” In the category, he was competing against albums from Miguel and Chris Brown. Ocean and Brown, of course, were recently in the gossip pages, but Pop & Hiss is going to try and mention’s the latter’s name as little as possible tonight. OK, just one last time: Our reporters in Staples Center tell us that it was dead silent when Brown’s name was read. 





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For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness





When a life starts to unravel, where do you turn for help?




Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.


In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.


“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”


That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”


Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.


One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.


“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”


On a recent afternoon, she described in her Midtown office the range of her practice.


“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”


Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”


Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.


One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.


“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”


Her son cut her off. “Are you comparing me to the guy that shot those people?”


“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”


“Did you really just compare me to that guy?”


“No, I didn’t compare you.”


“Then what did you say?”


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Is Southwest Airlines losing the love?









Southwest Airlines' reputation as an industry maverick seems to be going the way of flight attendants in hot pants and $20 one-way fares.


The nation's largest domestic carrier just marked its 40th straight profitable year, an unmatched feat in a time of economic turbulence, fluctuating fuel prices and airline bankruptcies. It did so by undercutting the competition with no-frills flights and, in the process, building an army of budget-minded fans.


Now many of those longtime customers say the Dallas-based carrier that calls itself LUV airlines has been losing their love since it recently began to shift its focus away from low fares and friendly service toward swelling its bottom line.





Among the changes that critics say show Southwest's new profit-boosting attitude: It cut the legroom on many planes to fit more seats, retooled its frequent flier program to make passengers spend more money to collect points and adopted new fees to board early.


"Southwest used to be a great airline," said Lance Malkind, a semi-retired consulting actuary from Phoenix, who has been flying Southwest for 33 years. "The fares were reasonable, onboard service was excellent, and the frequent flier plan was simple and very good. Now the fares are no longer that good compared to other airlines, and the frequent flier plan has gone from being one of the best to one of the worst."


Southwest is still the country's only major airline to waive fees for the first two checked bags. It also ranks high in on-time performance. But even airline officials conceded that Southwest had to find new ways to make money to compete.


"Yes, we have to keep up with the times and, yes, we have to change," said Whitney Eichinger, a spokeswoman for the airline. "But the truth is that Southwest remains a maverick in the industry."


Many of the new fees adopted in the last couple of years are for optional services, such as early boarding and wireless Internet access, she said. But what has long been included in the price of the fare — two checked bags, snacks and drinks — remains free, Eichinger added.


"If we were charging for peanuts, that is something that our customers would find outrageous," she said.


Because Southwest has forgone millions of dollars in revenue from baggage fees, analysts say, it was no surprise that the airline would look for other ways to generate extra cash to offset rising labor and fuel costs.


"Southwest is in the middle between customers who are very sensitive to higher fares and investors, on the other hand, complaining that the airline is not doing enough," said Seth Kaplan, a managing partner at Airlines Weekly, a trade publication.


With the economy rebounding and demand for air travel still relatively strong, airline industry experts say now is the best time for Southwest to test new moneymaking ideas without risking the loss of too many loyal fans.


"I'm not surprised by this," said Betsy Snyder, an analyst with Standard & Poor's. "They want to increase their profits and this is the way to do it. They could lose passengers, but in some markets what's the option? Do other airlines offer anything better?"


Southwest was born in 1971, serving Dallas, Houston and San Antonio with three Boeing 737s — a plane that still represents nearly 90% of its fleet. It made its headquarters at Dallas' Love Field, which later earned it the stock symbol LUV.


The airline took to the air amid tough competition from now-defunct Braniff and Texas International and fought back by offering free bottles of liquor and half-price fares for overnight flights.


Almost from the beginning, Southwest has pushed its niche — low fares but no extra frills like seat assignments, in-flight meals or roomy first-class seats. The hot-pants uniforms worn by flight attendants in the 1970s were replaced with shorts and pants in the '80s.


Southwest enjoyed its best years in the late 1990s when it saved millions of dollars with fuel hedging contracts that enabled the airline to buy fuel at a fixed price to avoid the exposure of price fluctuations. But the hedging advantage ended around 2008 when fuel prices dropped.


As the Great Recession took hold, most other airlines added baggage fees to boost revenue. Southwest, instead, broke from the trend and adopted a "bags fly free" policy. JetBlue is the only other airline to waive fees for the first checked bag, but it doesn't for the second.


Southwest officials said the bags-fly-free policy is probably responsible for increasing Southwest's market share about 2% since 2008 and generates up to $1 billion annually.


To further expand its customer base, Southwest announced a $1.4-billion deal in 2010 to acquire Orlando, Fla.-based AirTran Airways.





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Pendleton's aunt: Hadiya's 'inner light' connected her with humanity









Slain teen Hadiya Pendleton was remembered today as a laughing youth who brought love and happiness to all her family and friends.

Despite the heavy security because of the attendance of first lady Michelle Obama and other dignitaries, Hadiya's funeral at the Greater Harvest Baptist Church only occasionally touched on politics and the gun violence that ended Hadiya's life, instead focusing on a 15-year-old girl whose smile lit up the room.

Her mother, Cleopatra Cowley-Pendleton, briefly spoke to the standing room only crowd, often with a smile and even a laugh.

“My baby did all this,’’ she said, wearing a big red flower on her chest and a sparkly scarf, and clearly enjoying the music. "This is all Hadiya.’’

“The outpouring of support has been absolutely amazing,’’ she said.
 
She explained that at points, “you kinda do not know how to act,’’ and some people might not understand “our sense of humor’’ or “why I have a smile on my face.’’

“But I’m not worried about her soul,’’ she said.

“I just want to say thank you. Thank you to everyone who had something to do with rounding her or having something to do with who she was,’’ she said.

Then appearing more serious, she said, “No mother, no father should ever have to experience this.’’

“I kept her living,’’ she said, saying she helped her daughter stay away from negative influences. "When your children try to talk to you, listen. Don’t judge them. This should be a judge-free zone. You made them. You deal with that."
 
“All right, I love you all,’’ she said before ending her remarks.

Earlier the crowd was addressed by Damon Stewart, Hadiya's godfather, who said, “I’m going to speak as if we’re family,’’ adding that he had “two spiritual thoughts’’ he wanted to stress.

“God makes no mistakes,’’ he said. “I don’t believe in coincidence; I believe in divine intervention.’’

Wearing a black suit and black shirt, he also wore purple in honor of Hadiya -- a purple tie and ribbon on his chest, and a purple handkerchief in chest pocket.
 
“I loved that child,’’ he said.

Stewart quoted Hadiya's father, Nathaniel Anthony Pendleton, as saying, "This isn't political, this is personal."

Then Stewart said: "This should break the hearts of everyone who has someone they love."

He said he read a Facebook post that said: "I'm not going to buy into the hype. What makes this girl so much better than the others?"

"She is important because all those other people who died are important," Stewart said. "She is important because all of the families who were silent, she speaks for them. She is a representative of the people across the nation who have lost their lives."

"Don't let this turn into a political thing. Keep it personal," he said. "A lot of politicians will try to wield it as a sword. They want to use it for votes."

While family and friends kept the focus on the 15-year-old girl who was shot dead in a South Side park, the first lady's appearance inevitably brought attention to anti-gun efforts nationwide.

The back of the funeral program has a copy of a handwritten note from President Barack Obama: "Dear Cleopatra and Nathaniel, Michelle and I just wanted you to know how heartbroken we are to have heard about Hadiya's passing. We know that no words from us can soothe the pain, but rest assured that we are praying for you, and that we will continue to work as hard as we can to end this senseless violence. God Bless.”

In addition to Michelle Obama, dignitaries in the crowd included Gov. Pat Quinn, Mayor Rahm Emanuel, Cook County Board President Toni Preckwinkle, Ill. Attorney General Lisa Madigan, Rev. Jesse Jackson,  Secretary of Education Arne Duncan and Valerie Jarrett, senior adviser to Barack Obama.

Prior to the service, the first lady met privately with about 30 of Hadiya's friends and classmates, and then with members of Hadiya's family, according to a White House official.

Father Michael Pfleger spoke and called Hadiya an "innocent victim of gun violence,’’ asking,  “When did we lose our soul?”

He told the crowd that “we must become like Jesus’’ and become “the interrupters’’ of genocide, an evil that is killing our children.
 
“Welcome home, sweet Hadiya. See you on the other side," he said.

Hadiya was killed Jan. 29 at Harsh Park, in the 4400 block of South Oakenwald Avenue, not far from the Obama family home. Although Hadiya and the friends that were with her had no gang ties, a gunman fired into the park in what police said was a gang-connected shooting causing her death to become a symbol of Chicago's gun violence.

But most of the funeral service was about Hadiya's life, and the love she brought to so many.

Hadiya's pastor, Courtney C. Maxwell from the Greater Deliverance Temple Church of Christ, opened the services about 11:15 a.m. after a heart-shaped balloon was placed near her casket.
 
He thanked everyone for being at the Greater Harvest Baptist Church, including elected officials. “The family says thank you and God bless you.’’ He asked for round of applause for the Pendleton family.
 
“Only God can keep you and strengthen you, for God is our refuge and our strength,’’ the pastor said.

The pastor said Hadiya was “genuine and real.’’

“She was energetic, loved music, loved the arts,’’ the pastor said.

After the pastor spoke, a female reverend dressed in white addressed the crowd and a choir behind her began singing.

“Blessed are they that mourn, for they shall be comforted,’’ she said, as the choir sang after her.

An assistant pastor read from scriptures: "She is more precious than rubies. … Her ways are of pleasantness.’’

Pastor Elder Eric Thomas of the host Greater Harvest Baptist Church described Hadiya as a “beloved angel.’’
 
“Her life has not been in vain,’’ Thomas said.
 
A female singer and organist the played a religious song, as about 30 others in the choir, all dress in white, stood and swayed gently from side to side before the large cross that was draped in white.

Kenya Edwards, who identified herself as a radio personality and a friend, read a poem called “Walking’’ written for Hadiya by Zora Howard, then said: “Ladies and gentlemen, it’s time for us to start walking. It’s time to take a stand.’’

Hadiya’s aunt Linda Wilks then spoke, asking, “What was inside Hadiya that connected her to those who didn’t know her?”

“It was her inner light’’ that connected her with humanity’s inner light, she said. “Light has power and has potent force,’’ and can cause "mankind to feel an inner awakening and a sense of love.’’

“Light can pursue darkness ... it diffuses darkness,’’
her aunt said. "Hadiya. The light.’’

Several girls who all identified themselves as Hadiya’s best friends got up, one by one, to share warm and funny and very sad memories.
 
One girl, Kaylen Jones, drew laughter when she said Hadiya’s mom “guilted me’’ into talking, then said one of the things she will remember most is Hadiya's smile.
 
“That smile lit up a room’’ she said. “It was the last thing I saw before they put her into the ambulance.’’

“I loved her. These past few weeks I felt like there’s a part of me missing,’’ Jones said.

“But she’s right here, whispering the answers to us in chemistry,’’ she said, drawing huge laughs and applause.
 
Another girlfriend, Giselle, was holding a tissue and broke down in tears, having to stop at least twice during her thoughts.
 
“Hadiya always pushed me to do my very best,’’ she said, wiping her eyes. “We were going to go to college together.’’

Giselle said after losing Hadiya she had tweeted to friends "I just wanted a last hug," and two days later "I had a dream that she gave me a hug."

“I believe that she came back and gave me a last hug,’’ she said.
 
Many others remembered her laughter and her smile. Others had short songs they sang to the crowd and shared favorite memories of her.
 
Her King College Prep majorette team also got up, and presented her jacket in a frame to Hadiya's mother, who embraced her in a long hug.
 
Kierrra Wilson, the captain of the majorette team, which had performed for festivities during the weekend before President Obama's second inauguration, spoke first.

“It’s really hard being up here,’’ she said. “Hadiya was close to all of us.’’

The entire team, dressed in their black and gold outfits, engaged in a group hug.
 
Another teammate also recalled the Washington trip, saying Hadiya never lost her sense of humor even though they were “so tired.’’

She said she would always remember Hadiya’s laughter, and told a story that caused the crowd to chuckle. “She tries to tell a scary story and nobody can believe it,’’ she said. "She had a little baby voice.’’


Hadiya’s cousin got up and told the crowd Hadiya often talked about college.

“She always wanted to go to Harvard,’’ he said, before reading a poem he wrote about her that included the lines: “Sweeter than a tomato from the garden of fruit. You will always be loved. ... Save a spot for me above."

Hadiya’s little brother spoke briefly, recalling how his big sister would think of funny names.

A Nation of Islam representative spoke, offering condolences and saying, “We have come here to celebrate the life and light of this star of God."

"We pray for peace. We thank God for this beautiful gift … Hadiya,’’ he said.


The service ended about 2:37 p.m. as pallbearers began to move the casket, covered in a white cloth emblazoned with a gold cross, and the choir continued singing.
 
“There's a new name written in glory,’’ one of the pastors said. “Thank you, God, for our angel Hadiya."

By 2:44 p.m. people were moving out of the church. After the service, the first lady remained seated until the immediate family was out of the church. She was then escorted out though a private exit and left without public comment.

Hundreds of mourners had lined up early today at the church in the Washington Park neighborhood, which was under tight security.

Guests who were invited by the family were given orange wristbands and were able to enter through a shorter security line. Classmates and friends of Pendleton were given green wristbands and allowed to enter through that same line.

Trinity Dishmon, 40, said her daughter Deja, 15, and Hadiya were close friends in middle school. The two girls stayed in touch and were texting about their upcoming 16th birthdays while Hadiya was in D.C. for the president's inauguration in January.

"Hadiya was a gift to everyone that knew her," Dishmon said, tearing up. "These last 12 days have been unbelievably numbing. It's not six degrees of separation anymore, it's one. It's just unreal."

Dishmon said she feared that the day was less about the teenager and more about a larger issue.

"This is Hadiya's day and should be about her -- not something sensational," Dishmon said. "But maybe by honoring her life we can help make a difference."

Inside the church, Hadiya’s silver casket was placed in the front, surrounded by flowers and two large hearts, one with her picture on it. Behind the casket, a TV screen showed pictures of Hadiya with her family, from birth to her teenage years.

A funeral director wearing a suit and white gloves came outside at 9:40 a.m. to announce to the hundreds still waiting in line that the church was “at capacity.” Those still in line could come in and view the body, he said, but would have to leave before the services.

The funeral procession arrived at about 9:45 a.m., including three limousines and dozens of cars.

The first lady’s motorcade pulled into the church parking lot at about 10:15 a.m. She went in through a separate side entrance at the rear of the church, stepping directly from a vehicle into the building.

The family filed down the aisle a little after 10 a.m. and viewed the body in the still open casket. The pastor led the procession down the aisle chanting "the Lord is my shepherd" as soft organ music played in the background.

Ushers walked down the aisle handing out tissues, and those without wristbands were asked to give up their seats so that family members could be seated in the sanctuary. Every seat was filled by 9:45 a.m.

Purple, Hadiya’s favorite color, is represented in many of the flowers in the church and the lining of her casket. Ushers handed out a glossy funeral program booklet printed on purple paper. The front cover says "Celebrating The Life Of ... Hadiya Zaymara Pendleton.” Inside are more than 50 photos of Hadiya throughout her life.
 
Her obituary printed in the booklet describes her work in the church and even her favorite foods: Chinese, cheeseburgers, ice cream and Fig Newtons. It includes tributes from her grandmother, her cousin and an aunt as well as close friends.

About 10:15 a.m., the funeral director came back out and announced to the hundreds still waiting in line that no one else would be allowed inside — not for the viewing or the funeral.

Even after those outside were told they would not be allowed in, many continued to gather around the church's front gate.

Some began to file out, having to hop over the metal barricades to exit the long line.

One man asked the funeral staff member if he could at least have a pamphlet from the funeral before he left.

"Oh sir, those are long gone. They only printed 1,500," the funeral staff member said.

Activists, religious groups and others passed out printed material to those standing in line. Some kept the papers, others were left on the snowy ground as some of the crowd left.








A group of people who were not allowed inside the church after it reached capacity stood outside in the freezing weather for hours as the funeral went on.

Police put up additional barricades near the church entrance gate to keep new people arriving back.

At 2 p.m. a few people trickled out of the church, including a handful of King College Prep majorettes. Police were not allowing anyone else in for the service, even as people left.

Some had been standing outside for hours, hunched over in the cold. The group continued to talk as the hours passed.

A number of police cars circled the block during funeral services -- including officers in vans, SUVs and undercover cars. Helicopters could be seen and heard overhead.

Michelle Obama's attendance puts Chicago solidly in the middle of a national debate over gun violence that has polarized Congress and forced President Obama to take his gun control initiatives on the road to garner more public support.

The first lady's visit is being seen not only as a gesture of condolence to the family but as part of an effort to draw attention and support for the president's gun initiatives.

But the visit also meant scores of security, police and Secret Service agents, metal detectors and other security measures.

The church is surrounded by an iron fence and all of the openings -- a pedestrian gate in the front, front and side doors to the church, and a driveway to the north -- are guarded by city police or men in white shirts, ties and long black coats. Chicago police vehicles -- two wagons, a handful of squads and SUVs -- guarded the outside of the church while other vehicles circle the block.

Chicago police staffing the event are wearing dress blues -- a blue overcoat with pockets that allow access to the duty belt, creased navy pants, and a hat.

King College Prep math and engineering teacher Alonzo Hoskins stood quietly in line with others. He said he taught Hadiya in his first-period geometry class, where he now has an empty desk.

"She was full of life," Hoskins said.

Nate Weathers, 16,  Jeramy Brown, 16, and Antoine Fuller, 15, all stood in line to see their former classmate. The three young men said they attended Carter G. Woodson Middle School with Hadiya.

“This tears me up,” Fuller said. “She was my 7th grade crush.”

Brown described Hadiya as “sweet and innocent.”

“Something like this should have never happened to her,” Brown said.


Police took two men into custody after they got into an altercation near the back of the long line of mourners waiting to get into the church. One man was agitated, complaining about the long wait to get in. A second man confronted him and they began shoving each other before police intervened.


Local and national pool reports contributed.

chicagobreaking@tribune.com


Twitter: @chicagobreaking 



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Beyonce, Jay-Z, Rihanna hang at Roc Nation brunch






LOS ANGELES (AP) — Jay-Z and Beyonce sat tightly with Solange. Kelly Rowland embraced Beyonce with a huge hug. And Rihanna spilled some of her drink laughing with Rowland.


Music’s top stars attended the annual pre-Grammy Roc Nation brunch Saturday at the Soho House.






Grammy nominee Miguel, Timbaland, Jill Scott and Kylie Mingoue also attended the exclusive event.


Jay-Z is one of six acts nominated for six awards at Sunday’s Grammys. Rihanna is up for three trophies, and Beyonce is nominated for one award.


The crowd Saturday was full of members of music industry, who mingled with performers like The-Dream, Jordin Sparks, Melanie Fiona, Diane Warren, Christina Milian, MC Lyte and Santigold.


Entertainment News Headlines – Yahoo! News





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