Report Faults Priorities in Breast Cancer Research


Too little of the money the federal government spends on breast cancer research goes toward finding environmental causes of the disease and ways to prevent it, according to a new report from a group of scientists, government officials and patient advocates established by Congress to examine the research.


The report, “Breast Cancer and the Environment — Prioritizing Prevention,” published on Tuesday, focuses on environmental factors, which it defines broadly to include behaviors, like alcohol intake and exercise; exposures to chemicals like pesticides, industrial pollutants, consumer products and drugs; radiation; and social and socioeconomic factors.


The 270-page report notes that scientists have long known that genetic and environmental factors contribute individually and also interact with one another to affect breast cancer risk. Studies of women who have moved from Japan to the United States, for instance, show that their breast cancer risk increases to match that of American women. Their genetics have not changed, so something in the environment must be having an effect. But what? Not much is known about exactly what the environmental factors are or how they affect the breast.


“We know things like radiation might cause breast cancer, but we don’t know much that we can say specifically causes breast cancer in terms of chemicals,” said Michael Gould, a professor of oncology at the University of Wisconsin, Madison, and a co-chairman of the 23-member committee that prepared the report.


At the two federal agencies that spend the most on breast cancer, only about 10 percent of the research in recent years involved environment and prevention. From 2008 to 2010, the National Institutes of Health spent $357 million on environmental and prevention-related research in breast cancer, about 16 percent of all the financing for the disease. From 2006 to 2010, the Department of Defense spent $52.2 million on prevention-oriented research, about 8.6 percent of the money devoted to breast cancer. Those proportions were too low, the group said, though it declined to say what the level should be.


“We’re hedging on that on purpose,” Dr. Gould said. “It wasn’t the role of the committee to suggest how much.”


He added, “We’re saying: ‘We’re not getting the job done. We don’t have the money to get the job done.’ The government will have to figure out what we need.”


Jeanne Rizzo, another member of the committee and a member of the Breast Cancer Fund, an advocacy group, said there was an urgent need to study and regulate chemical exposures and inform the public about potential risks. “We’re extending life with breast cancer, making it a chronic disease, but we’re not preventing it,” she said.


“We have to look at early life exposures, in utero, childhood, puberty, pregnancy and lactation,” Ms. Rizzo said. “Those are the periods when you get set up for breast cancer. How does a pregnant woman protect her child? How do we create policy so that she doesn’t have to be a toxicologist when she goes shopping?”


Michele Forman, a co-chairwoman of the committee and an epidemiologist and professor of nutritional sciences at the University of Texas, Austin, said the group found that breast cancer research at various government agencies was not well coordinated and that it was difficult to determine whether there was duplication of efforts.


She said that it was essential to study how environmental exposures at different times of life affected breast-cancer risk, and that certain animals were good models for human breast cancer and should be used more.


The report is the result of the Breast Cancer and Environmental Research Act, which was passed in 2008 and required the secretary of health and human services to create a committee to study breast cancer research. A third of the members were scientists, a third were from government and a third were from advocacy groups. The advocates, Dr. Forman said, brought a sense of urgency to the group


“People who are not survivors need to have that urgency there,” she said.


Pointing to the vaccine now being offered to girls to prevent cervical cancer, Dr. Forman said, “I look forward to the day when we have an early preventive strategy for breast cancer.”


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DealBook: Nexen Secures U.S. Approval of Its Sale to Cnooc

Nexen said on Tuesday that it had received the last regulatory approval needed for its $15 billion sale to a major Chinese oil company, after the Obama administration declared the deal free from national security concerns.

With all necessary regulatory approvals in place, Nexen is set to become the latest acquisition by the Chinese oil industry, as the country seeks more and more sources of oil and natural gas to fuel its economy.

The deal is expected to close around Feb. 25.

The buyer in this transaction, the Chinese National Offshore Oil Corporation, or Cnooc, has been among the most acquisitive. It has announced six deals in the last two years, according to Standard & Poor’s Capital IQ. Nexen, based in Calgary, is the biggest proposed deal by Cnooc since its failed attempt to buy Unocal for $18.5 billion in 2005.

Though most of its holdings are abroad, Nexen has major operations in the Gulf of Mexico, which fall under the jurisdiction of the Committee on Foreign Investment in the United States, or Cfius.

The approval by the Obama administration comes two months after the Canadian government approved the deal. That was regarded as perhaps the biggest hurdle, given spurts of nationalistic concern over foreign buyers claiming big tracts of natural resources in Canada.

A review by Cfius (pronounced SIF-ee-us) is still regarded as potentially tough, however. The organization, which is chaired by the Treasury secretary, makes its decisions behind closed doors, and buyers are not always told why a deal is rejected.

But Cfius has approved several potentially sensitive deals recently, including the sale of the bankrupt car battery maker A123 Systems to the Wanxiang Group.

Lawyers at Cleary Gottlieb Steen & Hamilton wrote in a note to clients on Monday that the A123 approval “is evidence that even when politics, protectionism and xenophobia all appear to be significant obstacles, Cfius will not raise objections if it believes no security issues exist.”

“With proper planning and transparency,” Cleary Gottlieb added, “even politically controversial transactions can successfully negotiate the Cfius process.”

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Grammys 2013: Fun., Mumford, Gotye lead a newer generation









Grammy Awards voters gave their top honor to British roots music band Mumford & Sons for their album "Babel" on Sunday at the 55th awards ceremony. Other top honors were distributed to a broad array of younger acts, including indie trio Fun., electronic pop artist Gotye, rapper-R&B singer Frank Ocean and rock group the Black Keys.


"We figured we weren't going to win because the Black Keys have been sweeping up all day — and deservedly so," Mumford & Sons front man Marcus Mumford said after he and his band members strode to the stage at Staples Center in Los Angeles to collect the award from last year's winner, R&B-soul singer Adele.


Pop culture historians may look back at 2013, however, as the year the Grammy Awards gave up its long fight against new forms of music dissemination, embracing songs and videos that consumers soaked up by way of YouTube and other Internet outlets as opposed to purchasing them.








PHOTOS: 2013 Grammy Award winners


"Somebody That I Used to Know," the wildly popular collaboration between Gotye and New Zealand pop singer Kimbra, took the top award presented for a single recording upon being named record of the year, which recognizes performance and record production.


"Somebody…" not only was one of the biggest-selling singles of 2012 but also has notched nearly 400 million views on YouTube, powerfully demonstrating the increasingly vital role of the "broadcast yourself" video Internet phenomenon. Different YouTube posts of Ocean's "Thinking About You" single have totaled nearly 60 million views.


New York indie rock trio Fun. was named best new artist, an acknowledgment of the good-time music the group brought to listeners and viewers last summer largely through its runaway hit single "We Are Young," which has racked up nearly 200 million YouTube views. It also was named song of the year, bringing awards for the group's songwriters, Jack Antonoff, Andrew Dost and Nate Ruess, and collaborator Jeff Bhasker.


GRAMMYS 2013: Full coverage | Pre-show winners | Winners | Ballot


"Everyone can see our faces, and we are not very young — we've been doing this for 12 years," Ruess said as they collected the award.


The song's title could also serve as a theme for the evening, which was dominated by other relatively young acts in the most prestigious Grammy categories.


Singer, rapper and songwriter Ocean emerged the victor in the one category that pitted him directly against real-life rival Chris Brown, as his critically acclaimed solo debut album, "Channel Orange," won the urban contemporary album award. A few minutes later Ocean got a second Grammy with Kanye West, Jay-Z and the Dream in the rap-sung collaboration category for their single "No Church in the Wild."


GRAMMYS 2013: Winners list | Best & WorstRed carpet | Timeline | Fashion | Highlights


Ocean's tuxedo covered all but his hands, but it appeared as he picked up the urban album award that his left arm remained in a wrist brace he'd exhibited Thursday at rehearsals for this year's broadcast, a remnant of his scuffle last month with Brown over a parking space at a recording studio. Los Angeles Police Department investigators said Ocean informed them that he would not press charges against Brown.


It was the Black Keys' Dan Auerbach who quickly built up steam as the front-runner to dominate this year's awards, taking several statuettes barely an hour into the show, including producer of the year for himself and three with his group including rock performance, rock song and rock album for "El Camino."


The Black Keys homed in on the fundamentals of rock 'n' roll — big guitar riffs, lustful lyrics and a bevy of musical hooks on "El Camino," one of the best reviewed albums of the group's career.


FULL COVERAGE: Grammy Awards 2013


Auerbach picked up another award as producer of the blues album winner, Dr. John's "Locked Down."


Carrie Underwood grabbed the country solo performance Grammy for the title track from her album "Blown Away," which also won the country song award for writers Josh Kear and Chris Tompkins earlier during the pre-telecast ceremony at Nokia Theatre, across the street from Staples Center.


The Zac Brown Band added to its growing place as a new-generation country powerhouse with a win of the country album trophy for its "Uncaged," built on muscular Southern rock guitar riffs, elaborate multipart vocal harmonies and jam-band instrumental excursions.


Last year's big winner, Adele, collected the first statuette of the night for her single "Set Fire to the Rain" in the pop solo performance category.


The show got off to an eye-popping start with a Cirque du Soleil-inspired performance by Taylor Swift of her nominated single "We Are Never Ever Getting Back Together."


The preponderance of youthful acts not broadly known to mainstream TV audiences heightened the use of cross-generational pairings. Rising songwriter and singer Ed Sheeran shared the stage early with veteran Grammy darling Elton John, while Bruno Mars teamed with Sting and Rihanna in a Bob Marley tribute later in the show. Several members of Americana acts, including Alabama Shakes and Mumford & Sons, sang alongside veterans John, Mavis Staples and T Bone Burnett in a salute to drummer Levon Helm of the Band.


But it was the young guns to whom the evening — and perhaps the future — of the Grammy Awards belonged.


The Grammys are determined by about 13,000 voting members of the Recording Academy. The eligibility period for nominated recordings was Oct. 1, 2011, to Sept. 30, 2012. The show aired on CBS live except on the West Coast, which gets a tape delay.


randy.lewis@latimes.com


Twitter: @RandyLewis2






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Under the Gun: When Less Time Can Mean Better Problem-Solving






I’m working on an Alien costume. I’ve got the suit. It was built for me, and it’s gorgeous. But I’m making the head myself, and it’s kicking my butt. The problem: I have too much time.


I’ve learned over decades of building that a deadline is a potent tool for problem-solving. This is counterintuitive, because complaining about deadlines is a near-universal pastime. When I worked with the amazing sculptor Ira Keeler on the space shuttle for Clint Eastwood’s Space Cowboys, Keeler was always proclaiming, “With a couple more weeks, this could be a nice model.” We’re conditioned to believe that the deadline is working against us. But I’m not so sure.


I’d like the head I’m building to be animatronic. The lips would curl back and the jaws would open and snap out, just like in the movie. I’d also like all of these to be controlled by the wearer’s facial movements. I know how each of these actions should work individually, but I keep getting stumped when it comes to choreographing them all to operate together. And when I’m stumped without a deadline, I tend to let things go. So the head has pretty much sat on my bench for seven months.


Any cursory perusal of a fan/maker forum on the web reveals two distinct kinds of projects: the long, meandering, inconsistently updated but impressively detailed effort and the hell-bent-for-leather, tearing-toward-a-deadline build. Solutions to problems of the first type are often methodical and obvious. Solutions for the second type are much more likely to be innovative, elegant, and shockingly simple.


Invariably, the second type of project is propelled by an upcoming event: Comic-Con, Halloween, or even just a visit to a children’s hospital with the 501st Legion (a loosely knit group of Star Wars costumers). Deadlines refine the mind. They remove variables like exotic materials and processes that take too long. The closer the deadline, the more likely you’ll start thinking waaay outside the box.


Meanwhile, my alien head sits there, taunting me, awaiting its resurrection.


Adam Savage (adamsavage.com) is a sculptor, special-effects fabricator, and cohost of Discovery Channel’s MythBusters.


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Well: 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.


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

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DealBook: British Regulators to Investigate Accounting at Autonomy

LONDON – British accounting regulators said on Monday that they would investigate the financial reporting at the British software maker Autonomy before its $11.1 billion acquisition by Hewlett-Packard in 2011.

The announcement comes after accusations from H.P. that Autonomy inflated its sales and carried out improper accounting practices that misled the American technology giant ahead of the multibillion-dollar takeover.

In November, H.P. took a charge of $8.8 billion after it wrote down the acquisition of Autonomy. The figure included around $5 billion related to what H.P. called accounting and disclosure abuses at Autonomy.

Investigations by American authorities, including the Justice Department, are under way. The Financial Reporting Council, the British accounting watchdog, said on Wednesday that it would also examine Autonomy’s financial accounts from the beginning of 2009 to the middle of 2011.

The investigation may take around a year to reach disciplinary proceedings if wrongdoing is discovered, according to a spokeswoman for the council.

Mike Lynch, the founder of Autonomy who has denied the charges of accounting misconduct leveled by H.P., said he welcomed the investigation by British regulators.

“We are fully confident in the financial reporting of the company and look forward to the opportunity to demonstrate this to the F.R.C.,” he said in a statement on behalf of the former management team of Autonomy.

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Ambitious makeover planned for old housing project









Denise Penegar puts a little extra effort into the teenage girls, the ones who've dropped out of high school to care for their firstborns.


Don't be afraid, the outreach worker tells them. Come down to the housing project's community center, get your GED and some job skills. Change your life.


"I was one of those girls," said Penegar, now 51 and still living in Jordan Downs, the Watts housing project where she was born.





Sometimes, she imagines how different her life might have been if someone had knocked on her door when she was 17, caring for her first baby. What would it have meant just to have "someone who is here who can help pick me up"?


Penegar is on the front lines of a bold social experiment underway at Jordan Downs, a project notorious to outsiders for its poverty, blight and violence but seen by many longtime residents, for all its problems, as a close-knit community worth preserving.


In the last year, the Housing Authority of the City of Los Angeles has begun an effort to transform Jordan that could cost more than $600 million. The plan is to turn the complex of 700 aging units into a mixed-income community of up to 1,400 apartments and condominiums, with shops and restaurants and fancy touches such as native plant gardens. The city hopes to draw in hundreds of more-affluent residents willing to pay market rate to live side by side with the city's poorest.


Spurred by changes in federal funding and policy, such "mixed use" developments have sprung up in place of infamous housing projects all over the country. But experts say Jordan is taking an approach that has not been tried on this scale.


Typically, public housing residents are moved out ahead of the bulldozers, scattered to search for new shelter. In Los Angeles, the housing authority has promised that any of the 2,300 Jordan residents "in good standing" can stay in their old units until the day they move into new ones. The project is to be built in phases, beginning with units on 21 acres of adjacent land purchased by the authority in 2008 for $31 million.


To ease the transition, the city has dispatched "community coaches" like Penegar, along with teachers, social workers, therapists — even police officers whose charge is not to make arrests but to coach youth football and triathlon teams.


In essence, officials intend to raze the buildings, not the community — and radically change its character.


It will be an enormous challenge, with success likely to be measured in tiny increments.


Only 47% of adults at Jordan reported any wages to the housing authority last year. As in many urban projects, poverty and social ills have multiplied through the generations, leaving some residents unfamiliar with opportunities and expectations beyond the neighborhood. Some rarely leave the area.


Before inviting in new neighbors with expectations of safety and comfort, the housing authority has begun flooding Jordan Downs with social services. Many of the programs are focused on women, because more than 60% of Jordan Downs' tenants live in households headed by single mothers. But men are targeted too — for job training and lessons in parenting, for instance.


By December, 10 months into the effort, more than 450 families had been surveyed by intake workers and 280 signed up for intensive services.


"Most people would say it's ambitious, but I think it's essential," said Kathryn Icenhower, executive director of Shields for Families, the South Los Angeles nonprofit that is running many of the new programs under a more than $1-million annual contract with the housing authority.


It is unknown, however, how effective the social services will be, how easy it will be to draw in wealthier residents and how many millions of dollars the federal government — a major source of funding — will provide.


Already, the housing authority has picked a development team — the for-profit Michaels Organization and the nonprofit Bridge Housing, both with respectable track records in other cities. But with financing still uncertain, it is unclear exactly how many units will be built or how much various occupants would pay.


Ultimately, a working family could pay hundreds of dollars more in rent than unemployed tenants next door for a nearly identical unit. Officials say they do not expect Watts to draw the same kind of high-income residents as the former Cabrini Green project in Chicago, which sat on prime real estate near downtown. But Jordan is in a convenient location, near the intersection of the 105 and 110 Freeways; and in a high-rent city like Los Angeles, even the steepest rates at Jordan are likely to seem a bargain.


Despite the onslaught of social services and some palpable changes — including a 53% plunge in the violent crime rate at Jordan last year — financial risks abound.


Later this spring, the authority plans to put in an application for $30 million from the federal government's Choice Neighborhoods Program as seed money. Without it, the project could be delayed.





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Wired Science Space Photo of the Day: Wings of the Seagull Nebula


This image shows the intricate structure of part of the Seagull Nebula, known more formally as IC 2177. These wisps of gas and dust are known as Sharpless 2-296 (officially Sh 2-296) and form part of the “wings” of the celestial bird. This region of the sky is a fascinating muddle of intriguing astronomical objects — a mix of dark and glowing red clouds, weaving amongst bright stars. This new view was captured by the Wide Field Imager on the MPG/ESO 2.2-metre telescope at ESO’s La Silla Observatory in Chile.


Image: ESO [high-resolution]


Caption: ESO

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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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Boeing 787 Completes Test Flight





A Boeing 787 test plane flew for more than two hours on Saturday to gather information about the problems with the batteries that led to a worldwide grounding of the new jets more than three weeks ago.




The flight was the first since the Federal Aviation Administration gave Boeing permission on Thursday to conduct in-flight tests. Federal investigators and the company are trying to determine what caused one of the new lithium-ion batteries to catch fire and how to fix the problems.


The plane took off from Boeing Field in Seattle heading mostly east and then looped around to the south before flying back past the airport to the west. It covered about 900 miles and landed at 2:51 p.m. Pacific time.


Marc R. Birtel, a Boeing spokesman, said the flight was conducted to monitor the performance of the plane’s batteries. He said the crew, which included 13 pilots and test personnel, said the flight was uneventful.


He said special equipment let the crew check status messages involving the batteries and their chargers, as well as data about battery temperature and voltage.


FlightAware, an aviation data provider, said the jet reached 36,000 feet. Its speed ranged from 435 to 626 miles per hour.


All 50 of the 787s delivered so far were grounded after a battery on one of the jets caught fire at a Boston airport on Jan. 7 and another made an emergency landing in Japan with smoke coming from the battery.


The new 787s are the most technically advanced commercial airplanes, and Boeing has a lot riding on their success. Half of the planes’ structural parts are made of lightweight carbon composites to save fuel.


Boeing also decided to switch from conventional nickel cadmium batteries to the lighter lithium-ion ones. But they are more volatile, and federal investigators said Thursday that Boeing had underestimated the risks.


The F.A.A. has set strict operating conditions on the test flights. The flights are expected to resume early this week, Mr. Birtel said.


Battery experts have said it could take weeks for Boeing to fix the problems.


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