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.

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Katherine Bouton speaks about her own experience with hearing loss.

A transcript of this interview can be found here.

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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.

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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.

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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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Tool Kit: How to Make Your Video Go Viral

It would take 72 hours to watch all the videos uploaded to YouTube every minute by would-be commentators, comedians, cosmetologists and various other content creators all hoping for a breakout hit.

And, let’s be honest, most of it is cringe-worthy.

While the vagaries of taste and timing determine which videos go viral and which YouTube channels develop large and loyal followings, it’s easier to tell which videos will make viewers feel as if they can’t click away fast enough.

It boils down to narcissism. If you’re an aspiring video blogger, remember, it’s not about you, it’s about your audience. You need to be conscious and considerate of your audience and its needs, rather than getting mired in your own egotism or insecurity. (It’s good advice for life but essential to making quality video.)

Of course you want to have a decent camera. “If you have an iPhone or Android phone, you pretty much do,” said Eddie Codel, a video consultant in San Francisco, who produces content mostly for corporate clients. A hand-held video camera is nice and offers more features and flexibility, but your smartphone is fine.

The only additional equipment you might consider is a separate lavaliere or lapel microphone ($100-$200) for clearer audio. And if there isn’t enough ambient light to illuminate your face, spring for a clamp lamp ($10-$20) that you can find at most hardware stores. No one wants to watch you talking in the dark like someone in a witness protection program. For a flattering glow, Mr. Codel suggested putting wax paper in front of the lamp to diffuse the light.

O.K., so now you’re ready to perform — and you are always performing when the camera is rolling. “If you can’t communicate in an interesting, entertaining, energetic way — I don’t care how much education you have, how brilliant you are, how many degrees you have — it’s going to be painful to watch you,” said Karen Melamed, a television producer and online video consultant in Los Angeles. “Dr. Phil is not on TV because he’s the best therapist in the world, and Paula Deen is not the best chef in the world. They are good performers.”

That’s not to say you have to have an outsize personality or acting experience. But you do need to be comfortable in front of the camera, which is no easy feat. “There’s something sort of horrifying and anxiety-producing about shooting when you are alone,” said Ze Frank, who has more than 126,000 subscribers to his YouTube channel and whose quirky videos can attract as many as 20 million views.

The camera lens is a dark, bottomless void that doesn’t provide the feedback you get in normal face-to-face conversation, like a nod, a raised eyebrow and utterances like “hmmm” and “aah.” Lacking that, people tend to focus more on themselves and, in their self-consciousness, become either bland and monotone (as interesting as a lecture on the Hawley-Smoot Tariff) or hyper-excited and agitated (as annoying as a used-car commercial).

Mr. Frank, who lives in Los Angeles, said he tended to “over-gesticulate and mug too aggressively to the camera” when he first started posting Web videos in 2006. Now he has another person in the room operating the camera. “It’s wonderful to have someone else there to tell you if you are falling a little flat or that look was so cheesy it’s just ridiculous,” Mr. Frank said. Buzzfeed bought his channel last year, and he is now the company’s executive vice president for video, while continuing to create his own content.

If you don’t have the money to hire a camera operator or a willing friend to watch you record, just imagine you are talking to your typical viewer. “Your only concern should be how it’s going to benefit who is watching,” said Eileen Winnick, a media consultant and former actress whose past clients include the celebrity chefs Ina Garten and Bobby Flay. “When you do that, you take the focus off yourself and put it into what you want to get across, which changes the way you communicate,” she said.

You don’t even necessarily have to be on camera. John Mitzewich, of the YouTube channel “Food Wishes,” never appears in his cooking tutorials, which can attract as many as two million views. All you see are his hands at work in his San Francisco kitchen.

“It’s not, ‘Here I am, check out my personality.’ It’s, ‘Let’s make this thing,’ ” said Mr. Mitzewich, whose clever voice-over might compare peaking egg whites to “a voluptuous woman under a white cotton sheet.” Allrecipes.com bought his channel, which has 308,000 subscribers, last year, but he continues to have creative control. “The whole ‘follow your bliss’ thing totally works out,” he said.

Online video is different from television or film in that the audience is often watching on a small screen (laptop, tablet or smartphone). Viewers are up close, leaning in and may also be interacting with the content by posting comments, so it feels more intimate. “The viewer wants to be spoken to as a friend would talk to them,” said Ben Relles, head of programming strategy for YouTube, a division of Google. “They view these channels as friendships.”

As a result, they gravitate toward creators who seem genuine and responsive, such as Charlie McDonnell, a musician and professed nerd with soulful eyes, who has 1.8 million subscribers to the video blog, or vlog, he films in his London apartment. Or Jenna Marbles, who has attracted almost six million subscribers by her Tourette-like revelations of whatever is on her peculiar and profane mind.

Moreover, viewers appreciate content that they can’t get elsewhere. Creators are successful when they tap into “narrow but deep niches,” said Steve Woolf, senior vice president for content at Blip, a curated Web video site.

Paul Klusman, an engineer in Wichita, Kan., gained fame from his cat videos, in which he talks comically yet earnestly about the pleasures (companionship) and pains (kitty constipation) of cat ownership. The first video he made, “Engineer’s Guide to Cats,” was rejected by a short-film festival. But when he posted it on YouTube in 2008, it went viral with almost six million views and several marriage proposals.

He now has more than 33,000 subscribers with whom he regularly communicates (and sometimes dates). “I’m not a YouTube superstar, but I’m on the map,” said Mr. Klusman, who added that he also earns a nice supplemental income through advertising on his channel but “not enough for me to want to live on.”

While Mr. Klusman’s videos can be as long as seven minutes, most online media specialists say it’s better to crisply edit videos down to two to four minutes. That means getting rid of any vanity shots and self-indulgent rambling. “You want to be clean and concise, and if you don’t grab viewers in the first 15 seconds, they’re gone and aren’t coming back,” said Ms. Melamed, the producer and consultant. You don’t need fancy editing software either. Programs like iMovie and Windows Movie Maker, which come standard on many computers, are adequate.

A last bit of advice is to be consistent in churning out content. Post at least weekly if your vlog is topical. If you are more interested in building a library of content such as tutorials, the time between postings can be longer.

“Be patient and realize you are probably going to be a bit terrible in the beginning,” Mr. Frank said. “If you don’t end up making a living at it, there are other reasons to create online media. It’s certainly a validation of life.”

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Ex-Bell officials defend themselves as honorable public servants

Less than three years ago, they were handcuffed and taken away in a case alleged to be so extensive that the district attorney called it "corruption on steroids."

But on Monday, two of the six former Bell council members accused of misappropriating money from the small, mostly immigrant town took to the witness stand and defended themselves as honorable public servants who earned their near-$100,000 salaries by working long hours behind the scenes.

During her three days on the stand, Teresa Jacobo said she responded to constituents who called her cell and home phone at all hours. She put in time at the city's food bank, organized breast cancer awareness marches, sometimes paid for hotel rooms for the homeless and was a staunch advocate for education.

"I was working very hard to improve the lives of the citizens of Bell," she said. "I was bringing in programs and working with them to build leadership and good families, strong families."

Jacobo, 60, said she didn't question the appropriateness of her salary, which made her one of the highest-paid part-time council members in the state.

Former Councilman George Mirabal said he too worked a long, irregular schedule when it came to city affairs.

"I keep hearing time frames over and over again, but there's no clock when you're working on the council," he said Monday. "You're working on the circumstances that are facing you. If a family calls … you don't say, '4 o'clock, work's over.' "

Mirabal, 65, said he often reached out to low-income residents who didn't make it to council meetings, attended workshops to learn how to improve civic affairs and once even made a trip to a San Diego high school to research opening a similar tech charter school in Bell.

"Do you believe you gave everything you could to the citizens of Bell?" asked his attorney, Alex Kessel.

"I'd give more," Mirabal replied.

Both Mirabal and Jacobo testified that not only did they perceive their salaries to be reasonable, but they believed them to be lawful because they were drawn up by the city manager and voted on in open session with the city attorney present.

Mirabal, who once served as Bell's city clerk, even went so far as to say that he was still a firm supporter of the city charter that passed in 2005, viewing it as Bell's "constitution." In a taped interview with authorities, one of Mirabal's council colleagues — Victor Bello — said the city manager told him the charter cleared the way for higher council salaries.

Prosecutors have depicted the defendants as salary gluttons who put their city on a path toward bankruptcy. Mirabal and Jacobo, along with Bello, Luis Artiga, George Cole and Oscar Hernandez, are accused of drawing those paychecks from boards that seldom met and did little work. All face potential prison terms if convicted.

Prosecutors have cited the city's Solid Waste and Recycling Authority as a phantom committee, created only as a device for increasing the council's pay. But defense attorneys said the authority had a very real function, even in a city that contracted with an outside trash company.

Jacobo testified that she understood the introduction of that authority to be merely a legal process and that its purpose was to discuss how Bell might start its own city-run trash service.

A former contract manager for Consolidated Disposal Service testified that Bell officials had been unhappy with the response time to bulky item pickups, terminating their contract about 2005, but that it took about six years to finalize because of an agreement that automatically renewed every year.

Deputy Dist. Atty. Edward Miller questioned Mirabal about the day shortly after his 2010 arrest that he voluntarily told prosecutors that no work was done on authorities outside of meetings.

Mirabal said that if he had made such a statement, it was incorrect. He said he couldn't remember what was said back then and "might have heed and hawed."

"So it's easy to remember now?" Miller asked.

"Yes, actually."

"More than two years after charges have been filed, it's easier for you to remember now that you did work outside of the meetings for the Public Finance Authority?"

"Yes, sir."

Miller later asked Mirabal to explain a paragraph included on City Council agendas that began with the phrase, "City Council members are like you."

After some clarification of the question, Mirabal answered: "That everybody is equal and that if they look into themselves, they would see us."

corina.knoll@latimes.com

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Here's How Geology Shows North Korea's Nukes Are Getting Bigger

You don’t want to be woken up by a magnitude 5.1 earthquake under any circumstances. But you really don’t want to be woken up by one that indicates North Korea’s just tested a nuclear weapon. Especially this one, since it means North Korea’s nukes are getting larger.

North Korea’s third nuclear test, conducted overnight while much of the United States slept, follows a pattern set by its first atomic detonations in 2006 and 2009. It doesn’t occur outside, where satellite imagery might spot it and where radioactive fallout could block back on the testers. That means understanding the detonation requires understanding the geology of it. (Just a bit.)

For one thing, the earthquake in North Korea is unlikely to be a routine geological event. Check out this chart on seismic patterns in northeast Asia since 2005, offered by the Vienna-based organization that oversees the international ban on nuclear testing, known as CTBTO: North Korea is typically spared. (Though seven years may be an insufficient period of time to for geological data.) CTBTO terms the North Korean earthquake a “seismic event with explosion-like characteristics.”

More saliently, according to Robert Avagyan, a research analyst with the Institute for Science and International Security, international seismic monitoring stations around North Korea pick up seismic waves emanating from the center of the blast, believed to be at Punggye-ri. Seismic waves don’t travel uniformly through the earth, but the size and speed of their travel — as well as their wave patterns — enable an extrapolation that indicates the yield of a nuclear device. If you want to get really technical, here’s the raw data from the seismic event, compiled by the United States Geological Survey.

That seismic data may be difficult for laymen to interpret, but there’s a clear conclusion from it. The North Koreans “have a bigger yield than previous [nuclear] devices,” Avagyan says. “They’re getting better at doing this.”

In 2006, the North’s first nuclear test led to a seismic blast of magnitude 4.3. That allowed nuclear experts to estimate that its device yielded a blast of less than 1 kiloton. The 2009 nuclear test was around magnitude 4.7, leading scientists to estimate the North had reached a much higher yield, of between 4 and 7 kilotons. (The estimated relationship between earthquake magnitude and blast yield isn’t linear.)

The overnight seismic event, according to the U.S. Geological Survey, was magnitude 5.1. Avagyan estimates the device the North detonated was 10 kilotons. The Director of National Intelligence hedges and estimates only a “several kiloton” yield.

There are caveats to all of this. The world now has more and better monitoring stations closer to North Korea than in previous tests, Avagyan says, which might mean that the 2006 or 2009 detections of Pyongyang’s nuclear tests might have been inexact. And North Korea might have used “boosters, specialized materials,” he adds, for bigger explosive yields unrelated to the nuclear device itself to make a bigger boom.

There’s another big unknown in the North Korean nuclear test: what nuclear material Pyongyang used. North Korean bombs often rely on plutonium, but in 2010, a former Los Alamos National Laboratories director revealed that North Korean officials had showed him an advanced and heretofore unknown plant for enriching uranium. The plant appeared configured for a crash program. Since bombs reliant on high-enriched uranium are considered more powerful than plutonium ones, a switch in nuclear material might indicate — and, perhaps, account for — a decision to go for more powerful bombs.

Avagyan says it’ll take another day or two for atmospheric readings to indicate if the third North Korean nuclear test used highly enriched uranium or plutonium. Until then, the geologic record from the detonation says plenty, and none of it welcome in Washington.

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The New Old Age Blog: Debate Over Brain Scans and Alzheimer's

Should brain scans for older adults with suspected Alzheimer’s disease be covered by Medicare?

Many medical experts say yes. But late last month, an expert panel convened by the Centers for Medicare and Medicaid Services concluded that data supporting use of the scans was weak.

Specifically, the panel noted there is no solid evidence that these imaging tests have a meaningful impact on patients’ health; studies that might establish this have not yet been done.

This controversy deserves attention because positron emission tomography, known as PET scans, are becoming available across the country, and proposed guidelines for their use have just been published by the Alzheimer’s Association and the Society of Nuclear Medicine and Molecular Imaging.

Currently, Medicare does not pay for the tests, which cost about $3,000 — an amount that puts them out of reach for many families. The expert panel’s findings will be used by the government later this year to determine whether Medicare should change this policy.

Nearly 400 medical centers already offer this technology or are preparing to do so, according to Eli Lilly, which makes a radioactive agent used in the scans. That agent binds to protein clusters known as amyloid plaques that are a signature characteristic of Alzheimer’s disease, making it possible to see them for the first time in the brains of living patients.

The Medicare panel confronted the question: “How useful is this information, for which patients and under what conditions?” Several experts who testified in late January suggested that the PET imaging tests could help physicians diagnose Alzheimer’s disease or other types of dementia. Currently, diagnosis proceeds from a comprehensive medical evaluation, a careful patient history, and typically, a round of neuropsychiatric tests.

“Should I tell my patients that we have a test available to help clarify their diagnosis but we can’t use it because Medicare doesn’t cover it?” asked Dr. Stephen Salloway, a professor of neurology at the Warren Alpert Medical School at Brown University.

If scans show a lack of amyloid plaques, the “worried well” could be reassured that they don’t have Alzheimer’s and doctors could pursue other lines of medical inquiry, like investigating the potential for thyroid problems, depression or vitamin B12 deficiency, said Dr. Paul Aisen, a professor of neuroscience at the University of California, San Diego, School of Medicine.

If the tests are positive, they could rule out conditions like frontotemporal dementia and motivate patients to start taking medications for Alzheimer’s, enroll in clinical trials and get their financial, legal and household affairs in order, other experts said.

But while amyloid plaques are closely associated with Alzheimer’s, their role has not yet been definitively established. They could be a cause of this condition, a byproduct or serve another function not yet understood. Underscoring this is a notable research finding: about 30 percent of older adults with no symptoms of dementia have been found to have amyloid plaque buildup in their brains.

That means the brain scans cannot ensure the accurate diagnosis of Alzheimer’s. “I see a big potential for overuse and misuse,” warned Dr. Raymond Faught, Jr., a member of the Medicare advisory panel and a professor of neurology at Emory University in Atlanta.

Given that large caveat, the question emerges of which patients would benefit most from getting the tests.

The Alzheimer’s Association and the Society of Nuclear Medicine and Molecular Imaging tried to address that in their recently published “appropriate use” guidelines. The guidelines, which have no binding force, suggest that scans should be considered for patients with Alzheimer’s-type symptoms but “an unclear clinical presentation”; those who develop dementia symptoms before age 65; and those with “persistent” mild cognitive impairment, a condition that often precedes Alzheimer’s.

Tests should not be given to “normal” patients or those who have Alzheimer’s disease already, they say. In other words, if you’re getting older, have mild memory loss, but are still functioning well, you’re not a candidate. Nor is there any value in giving the tests to people who are already deep in the throes of dementia.

The recommendations assume that there is value in knowing test results for physicians, patients and families; that physicians will be better able to manage patients’ care as a consequence; and that doctors will order fewer diagnostic tests or more appropriate tests once they have findings from amyloid PET imaging in hand.

But those assumptions are not backed up by solid evidence yet. Medications for patients with Alzheimer’s have a modest impact on symptoms for a limited period of time and no impact on the underlying illness. Given this, “the clinical utility of a diagnostic test to alter patient management and result in a quantifiable benefit is very difficult to establish,” the panel writes in the journal Alzheimer’s & Dementia. Also, they note, “data supporting specific outcomes for amyloid PET are not yet available.”

This lack of data was the reason the Medicare panel gave amyloid brain imaging such low marks late last month. Dr. Rita Redberg, chairwoman of the Medicare Evidence Development and Coverage Advisory Committee and a professor of medicine at the University of California, San Francisco, summed up that group’s deliberations this way:

We were there to evaluate the impact of this test on patient outcomes. But all of the speakers said there wasn’t any data linking amyloid scans to outcomes . . . They presented evidence that the test is very good at identifying amyloid, but they did not present evidence that it was very good at identifying the clinical presence of Alzheimer’s disease.

Wei-Li Shao, senior director of the Alzheimer’s business division of Eli Lilly, which stands to benefit from the greater use of the scans, disagreed, saying, “Lilly remains steadfast and resolved in its belief that amyloid imaging provides significant clinical value for clinicians and patients.” The company will work with Medicare going forward to try to secure coverage, he said.

For Dr. Redberg, the essential question is this: “Would you want to know you have an increased chance of getting a disease in (the future) when there are no effective treatments available and you might not even get it in the end? Is that of benefit to patients?”

What do you think, readers?

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DealBook Column: Relationship Science Plans Database of Names and Connections

It sounds like a Rolodex for the 1 percent: two million deal makers, power brokers and business executives — not only their names, but in many cases the names of their spouses and children and associates, their political donations, their charity work and more — all at a banker’s fingertips.

Such is the promise of a new company called Relationship Science.

Never heard of it? Until recently, neither had I. But a few months ago, whispers began that this young company was assembling a vast trove of information about big names in corporate America. What really piqued my interest was that bankrolling this start-up were some Wall Street heavyweights, including Henry R. Kravis, Ronald O. Perelman, Kenneth G. Langone, Joseph R. Perella, Stanley F. Druckenmiller and Andrew Tisch.

It turns out that over the last two years, with a staff of more than 800 people, mostly in India, Relationship Science has been quietly building what it hopes will be the ultimate business Who’s Who. If it succeeds, it could radically change the way Wall Street does business.

That’s a big if, of course. There are plenty of other databases out there. And there’s always Google. Normally I wouldn’t write about a technology company, but I kept hearing chatter about it from people on Wall Street.

Then I got a glimpse of this new system. Forget six degrees of Kevin Bacon. This is six degrees of Henry Kravis.

Here’s how it works: Let’s say a banker wants to get in touch with Mr. Kravis, the private equity deal maker, but doesn’t know him personally. The banker can type Mr. Kravis’s name into a Relationship Science search bar, and the system will scan personal contacts for people the banker knows who also know Mr. Kravis, or perhaps secondary or tertiary connections.

The system shows how the searcher is connected — perhaps a friend, or a friend of a friend, is on a charitable board — and also grades the quality of those connections by identifying them as “strong,” “average” or “weak.” You will be surprised at the many ways the database finds connections.

The major innovation is that, unlike Facebook or LinkedIn, it doesn’t matter if people have signed up for the service. Many business leaders aren’t on Facebook or LinkedIn, but Relationship Science doesn’t rely on user-generated content. It just scrapes the Web.

Relationship Science is the brainchild of Neal Goldman, a co-founder of CapitalIQ, a financial database service that is used by many Wall Street firms. Mr. Goldman sold CapitalIQ, which has 4,200 clients worldwide, to McGraw-Hill in 2004 for more than $200 million. That may explain why he was able to easily round up about $60 million in funds for Relationship Science from many boldface names in finance. He raised the first $6 million in three days.

“I knew there had to be a better way,” Mr. Goldman said about the way people search out others. Most people use Google to learn about people and ask friends and colleagues if they or someone they know can provide an introduction.

Relationship Science essentially does this automatically. It will even show you every connection you have to a specific company or organization.

“We live in a service economy,” Mr. Goldman said. “Building relationships is the most important part for selling and growing.”

Kenneth Langone, a financier and co-founder in Home Depot, said that when he saw a demonstration of the system he nearly fell off his chair. He used an unprintable four-letter word.

“My life is all about networking,” said Mr. Langone, who was so enthusiastic he became an investor and recently joined the board of Relationship Science. “How many times do I say, ‘How do I get to this guy?’ It is scary how much it helps.”

Mr. Goldman’s version of networking isn’t for everyone. His company charges $3,000 a year for a person to have access to the site. (That might sound expensive, but by Wall Street standards, it’s not.)

Price aside, the possibility that this system could lead to a deal or to a new wealth management client means it just might pay for itself.

“If you get one extra deal, the price is irrelevant,” Mr. Goldman said.

Apparently, his sales pitch is working. Already, some big financial firms have signed up for the service, which is still in a test phase. Investment bankers, wealth managers, private equity and venture capital investors have been trying to arrange meetings to see it, egged on, no doubt, by many of Mr. Goldman’s well-heeled investors. Even some development offices of charities have taken an interest.

The system I had a peek at was still a bit buggy. In some cases, it was missing information; in other cases the information was outdated. In still other instances, the program missed connections. For example, it didn’t seem to notice that Lloyd C. Blankfein, the chief executive of Goldman Sachs, should obviously know a certain senior partner at Goldman.

But the promise is there, if the initial kinks are worked out. I discovered I had paths I never knew existed to certain people or companies. (Mr. Goldman should market his product to reporters, too.)

One of the most vexing and perhaps unusual choices Mr. Goldman seems to have made with Relationship Science is to omit what would be truly valuable information: phone numbers and e-mail addresses.

Mr. Goldman explained the decision. “This isn’t about spamming people.” He said supplying phone numbers wouldn’t offer any value because people don’t like being cold-called, which he said was the antithesis of the purpose of his database.

Ultimately, he said, as valuable as the technology can be in discovering the path to a relationship, an artful introduction is what really counts.

“We bring the science,” he said. “You bring the art.”

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This post has been revised to reflect the following correction:

Correction: February 12, 2013

An earlier version of this column misspelled the surname of one of the backers of Relationship Science. He is Ron O. Perelman, not Pearlman.

A version of this article appeared in print on 02/12/2013, on page B1 of the NewYork edition with the headline: A Database Of Names, And How They Connect.

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Catch a Nostalgic Glimpse of Geocities on Tumblr

The digital remnants of the long since deleted world of Geocities are slowly being reborn, page by page, on Tumblr.

One Terabyte of Kilobyte Age may be the best Tumblr blog we’ve seen, posting screenshots of old Geocities pages for a nostalgic look at the early web, back when everything was “Under Construction.”

For a brief time in the early ’90s Geocities was the web. And, for all its shortcomings, Geocities did nevertheless usher in much of what makes the web great — that anyone can create nearly anything.

The One Terabyte of Kilobyte Age Tumblr project is part of a Geocities research blog by Olia Lialina and Dragan Espenschied. The Tumblr portion consists of automatically generated screenshots from the massive torrent of old Geocities homepages rescued by the Archive Team back in 2009. For posterity’s sake each post also carries the original URL (which obviously goes to a 404 page) and the date the page was last modified.

With Geocities long since deleted from Yahoo’s servers, browsing through One Terabyte of Kilobyte Age is as close as you’re likely to get to a trip down Geocities memory lane.

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Famous film couple back 9 years on in “Before Midnight”

BERLIN (Reuters) – Ethan Hawke and Julie Delpy reprise the roles of Jesse and Celine in “Before Midnight”, the third but not necessarily the last movie in their long-running series based on the same characters as they age over time.

In this film, set 18 years after “Before Sunrise”, the couple is on holiday in Greece and we learn that they live with their twin daughters in Paris while Jesse’s son has stayed with his mother in Chicago.

Screening at the Berlin film festival on Monday, “Before Midnight” examines how life’s twists have taken their toll on the American tourist and French student who met on a train bound for Vienna in 1995 and again in Paris nine years later in “Before Sunset”.

They still love each other but this time they are older, heavier, and bicker more, and the forces pulling Jesse back towards his teenage son and Celine’s determination to pursue her career in France test that bond to its limits.

Director Richard Linklater, on board throughout the series, underlined the organic nature of the “Before…” films when he was asked whether there might be a fourth installment, presumably sometime around 2022.

“The fact that we’ve made two sequels, I guess it begs the question, but I think I speak for the group here, I’m sure we have absolutely no idea what that (sequel) could possibly be,” he told reporters at the 11-day film festival.

“We probably won’t for another six years. Who knows the future?”

French actress Delpy joked that the final film in the series would be a remake of Michael Haneke’s Oscar-nominated drama “Amour”, about an elderly couple aged in their 80s facing the inevitability of imminent death.

“STIFLING” EXPECTATIONS

Critical reaction to “Before Midnight” has been mixed.

In its review, the Guardian newspaper said the movie felt forced, but The Hollywood Reporter wrote: “Though this stage is harder to watch, audiences who have aged along with Celine and Jesse will treasure this new episode.”

Hawke said he, Delpy and Linklater, who jointly developed the script over two years, felt the weight of expectation as they embarked on the third part of a story which many viewers identified with so closely.

“I haven’t met a director in the last nine years that didn’t tell me what he or she thought the third film should be. So we knew we were up against a lot of people having an agenda about where Jesse and Celine should be. That agenda is stifling.”

“Before Midnight” consists of a handful of long, single-shot scenes focusing on the couple as they navigate a life complicated by broken families, work pressures and the familiarity of living together.

In the first scene Jesse sees his son off at the airport in an awkward exchange that underlines how the two have grown apart. In the next Jesse and Celine discuss children, work and their relationship in frank and often funny exchanges.

At one point Celine says men measure themselves against leading figures from history. When Jesse counters that women do too, he mentions Joan of Arc.

“She was burned at the stake and was a virgin,” jokes Celine. “Who wants to be Joan of Arc?”

As the film goes on, banter becomes bickering, then descends into a blazing row. Linklater stressed that the dialogue may seem off-the-cuff but it required a lot of hard work.

“It feels improvised. It’s not,” he said. “It’s meticulously rehearsed and structured.”

(Reporting by Mike Collett-White; Editing by Belinda Goldsmith)

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Personal Health: Getting the Right Addiction Treatment

“Treatment is not a prerequisite to surviving addiction.” This bold statement opens the treatment chapter in a helpful new book, “Now What? An Insider’s Guide to Addiction and Recovery,” by William Cope Moyers, a man who nonetheless needed “four intense treatment experiences over five years” before he broke free of alcohol and drugs.

As the son of Judith and Bill Moyers, successful parents who watched helplessly during a 15-year pursuit of oblivion through alcohol and drugs, William Moyers said his near-fatal battle with addiction demonstrates that this “illness of the mind, body and spirit” has no respect for status or opportunity.

“My parents raised me to become anything I wanted, but when it came to this chronic incurable illness, I couldn’t get on top of it by myself,” he said in an interview.

He finally emerged from his drug-induced nadir when he gave up “trying to do it my way” and instead listened to professional therapists and assumed responsibility for his behavior. For the last “18 years and four months, one day at a time,” he said, he has lived drug-free.

“Treatment is not the end, it’s the beginning,” he said. “My problem was not drinking or drugs. My problem was learning how to live life without drinking or drugs.”

Mr. Moyers acknowledges that treatment is not a magic bullet. Even after a monthlong stay at a highly reputable treatment center like Hazelden in Center City, Minn., where Mr. Moyers is a vice president of public affairs and community relations, the probability of remaining sober and clean a year later is only about 55 percent.

“Be wary of any program that claims a 100 percent success rate,” Mr. Moyers warned. “There is no such thing.”

“Treatment works to make recovery possible. But recovery is also possible without treatment,” Mr. Moyers said. “There’s no one-size-fits-all approach. What I needed and what worked for me isn’t necessarily what you or your loved one require.”

As with many smokers who must make multiple attempts to quit before finally overcoming an addiction to nicotine, people hooked on alcohol or drugs often must try and try again.

Nor does treatment have as good a chance at succeeding if it is forced upon a person who is not ready to recover. “Treatment does work, but only if the person wants it to,” Mr. Moyers said.

Routes to Success

For those who need a structured program, Mr. Moyers described what to consider to maximize the chances of overcoming addiction to alcohol or drugs.

Most important is to get a thorough assessment before deciding where to go for help. Do you or your loved one meet the criteria for substance dependence? Are there “co-occurring mental illnesses, traumatic or physical disabilities, socioeconomic influences, cultural issues, or family dynamics” that may be complicating the addiction and that can sabotage treatment success?

While most reputable treatment centers do a full assessment before admitting someone, it is important to know if the center or clinic provides the services of professionals who can address any underlying issues revealed by the assessment. For example, if needed, is a psychiatrist or other medical doctor available who could provide therapy and prescribe medication?

Is there a social worker on staff to address challenging family, occupational or other living problems? If a recovering addict goes home to the same problems that precipitated the dependence on alcohol or drugs, the chances of remaining sober or drug-free are greatly reduced.

Is there a program for family members who can participate with the addict in learning the essentials of recovery and how to prepare for the return home once treatment ends?

Finally, does the program offer aftercare and follow-up services? Addiction is now recognized to be a chronic illness that lurks indefinitely within an addict in recovery. As with other chronic ailments, like diabetes or hypertension, lasting control requires hard work and diligence. One slip need not result in a return to abuse, and a good program will help addicts who have completed treatment cope effectively with future challenges to their recovery.

How Families Can Help

“Addiction is a family illness,” Mr. Moyers wrote. Families suffer when someone they love descends into the purgatory of addiction. But contrary to the belief that families should cut off contact with addicts and allow them to reach “rock-bottom” before they can begin recovery, Mr. Moyers said that the bottom is sometimes death.

“It is a dangerous, though popular, misconception that a sick addict can only quit using and start to get well when he ‘hits bottom,’ that is, reaches a point at which he is desperate enough to willingly accept help,” Mr. Moyers wrote.

Rather, he urged families to remain engaged, to keep open the lines of communication and regularly remind the addict of their love and willingness to help if and when help is wanted. But, he added, families must also set firm boundaries — no money, no car, nothing that can be quickly converted into the substance of abuse.

Whether or not the addict ever gets well, Mr. Moyers said, “families have to take care of themselves. They can’t let the addict walk over their lives.”

Sometimes families or friends of an addict decide to do an intervention, confronting the addict with what they see happening and urging the person to seek help, often providing possible therapeutic contacts.

“An intervention can be the key that interrupts the process and enables the addict to recognize the extent of their illness and the need to take responsibility for their behavior,”Mr. Moyers said.

But for an intervention to work, Mr. Moyers said, “the sick person should not be belittled or demeaned.” He also cautioned families to “avoid threats.” He noted that the mind of “the desperate, fearful addict” is subsumed by drugs and alcohol that strip it of logic, empathy and understanding. It “can’t process your threat any better than it can a tearful, emotional plea.”

Resource Network

Mr. Moyer’s book lists nearly two dozen sources of help for addicts and their families. Among them:

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

Substance Abuse and Mental Health Services Administration treatment finder www.samhsa.gov/treatment/;

Al-Anon Family Groups www.Al-anon.alateen.org;

Nar-Anon Family Groups www.nar-anon.org;

Co-Dependents Anonymous World Fellowship www.coda.org.

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This is the second of two articles on addiction treatment. The first can be found here.

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Bits Blog: Reporter's Notebook: Snapchat's Path From Stanford to the Beach

Over the weekend, I reported about the recent successes of an up-and-coming start-up, Snapchat, that lets people send messages that disappear after they are viewed. I spent two days with the founders of the company, Evan Spiegel and Bobby Murphy, in Los Angeles, interviewing them and learning about their business.

Snapchat’s headquarters are on the sunny stretch of the Venice Beach boardwalk, steps from surf and sand, in an airy beach house whose previous tenants include a medical marijuana dispensary and a Nike party house.

Their offices have a glowing, life-size replication of their app icon positioned outside the main entrance.

The company also has security detail, 24 hours a day, seven days a week, to keep anyone wandering by from trying to break into the offices.

The company also has a lot of Snapchat-themed art in its offices, including a series of prints that say “No photographs please” and a glitter portrait of their company mascot, “Ghostface Chillah.”

Snapchat does not currently generate any revenue, but its founders envision a future where the company could partner with brands or advertisers that want to show certain Snapchat users a glimpse of a new device, a preview of a new movie or a sneak peek of an upcoming line of clothing. Or, they say, they could show “exploding coupons,” an image that gives information about a deal or discount that expires after a certain amount of time.

Mr. Spiegel and Mr. Murphy met at Stanford, and eventually became roommates. Mr. Spiegel said he would often ask Mr. Murphy for help with computer science and Mr. Murphy recalled being impressed with a line of shirts that Mr. Spiegel designed for their fraternity, which set the precedent for their future business partnership.

One of Snapchat’s defining features is that it allows users to take screenshots of photos they receive, which sends a notification to the sender, alerting them that an image of their photo was taken. This, of course, means that nimble-fingered Snapchat users can make copies of photos that would otherwise disappear after a few seconds. Snapchat’s founders say that feature can also be considered akin to a “like” or a “favorite,” a signal to the sender that their image was favorably received.

Before working on Snapchat, Mr. Spiegel and Mr. Murphy collaborated on a Web product, Future Freshman, a guide for high school students who were applying to college. The product failed to gain any significant traction, however, and the founders went back to the drawing board before coming up with Snapchat.

Snapchat’s original name was Pickaboo — a riff on the kid’s game Peekaboo. But that name was taken by another photo company, and after a brainstorm session, the founders settled on Snapchat.

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This post has been revised to reflect the following correction:

Correction: February 11, 2013

An earlier version of this post misspelled the surname of one of Snapchat's founders on some references. He is Evan Spiegel, not Siegel.

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