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Paper Tying Rat Cancer to Herbicide Is Retracted

Written By Unknown on Jumat, 29 November 2013 | 13.57

A food safety journal has decided to retract a paper that seemed to show that genetically modified corn and the herbicide Roundup can cause cancer and premature death in rats.

The editor of the journal, Food and Chemical Toxicology, said in a letter to the paper's main author that the study's results, while not incorrect or fraudulent, were "inconclusive, and therefore do not reach the threshold of publication."

The paper, published 14 months ago, has been cited by opponents of biotech foods and proponents of labeling such foods. But it has been vociferously criticized as flawed, sensationalistic and possibly even fraudulent by many scientists, some allied with the biotechnology industry. The main author of the study, Gilles-Eric Séralini, of the University of Caen in France, had done other studies challenging the safety of genetically engineered foods, some of which had also been questioned.

In his letter to Dr. Séralini, A. Wallace Hayes, the editor in chief of the journal, said that "unequivocally" he had found "no evidence of fraud or intentional misrepresentation of the data."

He said that Dr. Séralini had cooperated in providing his raw data to a review panel formed by the journal.

However, Dr. Hayes said there was "legitimate cause for concern" that the number of rats in each arm of the study was too small and that the strain of rat used was prone to cancer. That made it difficult to rule out that the results were not explained by "normal variability," he said.

The letter was posted on the website of GMWatch, a British organization that opposes genetically engineered crops. GMWatch called the journal's action "illicit, unscientific and unethical," saying that inconclusive data was not sufficient grounds for a retraction.

Dr. Hayes, while confirming he wrote the letter, referred questions to an executive at Elsevier, the publisher of the journal.

An email to that executive received an automatic reply saying she was away for Thanksgiving.

The study followed 200 rats for two years, essentially their entire lives. They were divided into 10 groups, each with 10 males and 10 females. Some groups were fed different amounts of a Monsanto corn genetically engineered to resist the herbicide Roundup, also known as glyphosate.

Some of the corn had been sprayed in the field with Roundup and some not. Some other groups were fed different doses of glyphosate in drinking water.

The rats that ate either the corn or the glyphosate tended to have more tumors and die earlier than the 20 rats in the control group, which were fed nonengineered corn and plain water.

The study passed the peer review process of the journal, which is considered one of the leading publications in toxicology. But many letters to the journal then criticized the study, as did food safety authorities in Europe.

Dr. Séralini and some other scientists had defended the paper in letters to the journal. They said the same strain of rats was used by Monsanto in its 90-day feeding study that led to European approval of the corn.

They also said that even though the rats had a high natural rate of cancer, what mattered was the difference in tumor incidence between the rats fed the corn or herbicide and the controls.


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Bits Blog: The Vaccination Effect: 100 Million Cases of Contagious Disease Prevented

Vaccination programs for children have prevented more than 100 million cases of serious contagious disease in the United States since 1924, according to a new study published in The New England Journal of Medicine.

The research, led by scientists at the University of Pittsburgh's graduate school of public health, analyzed public health reports going back to the 19th century. The reports covered 56 diseases, but the article in the journal focused on seven: polio, measles, rubella, mumps, hepatitis A, diphtheria and pertussis, or whooping cough.

Researchers analyzed disease reports before and after the times when vaccines became commercially available. Put simply, the estimates for prevented cases came from the falloff in disease reports after vaccines were licensed and widely available. The researchers projected the number of cases that would have occurred had the pre-vaccination patterns continued as the nation's population increased.

The journal article is one example of the kind of analysis that can be done when enormous data sets are built and mined. The project, which started in 2009, required assembling 88 million reports of individual cases of disease, much of it from the weekly morbidity reports in the library of the Centers for Disease Control and Prevention. Then the reports had to be converted to digital formats.

Most of the data entry — 200 million keystrokes — was done by Digital Divide Data, a social enterprise that provides jobs and technology training to young people in Cambodia, Laos and Kenya.

Still, data entry was just a start. The information was put into spreadsheets for making tables, but was later sorted and standardized so it could be searched, manipulated and queried on the project's website.

"Collecting all this data is one thing, but making the data computable is where the big payoff should be," said Dr. Irene Eckstrand, a program director and science officer for the N.I.H.'s Models of Infectious Disease Agent Study.

The University of Pittsburgh researchers also looked at death rates, but decided against including an estimate in the journal article, largely because death certificate data became more reliable and consistent only in the 1960s, the researchers said.

But Dr. Donald S. Burke, the dean of Pittsburgh's graduate school of public health and an author of the medical journal article, said that a reasonable projection of prevented deaths based on known mortality rates in the disease categories would be three million to four million.

The scientists said their research should help inform the debate on the risks and benefits of vaccinating American children.

Pointing to the research results, Dr. Burke said, "If you're anti-vaccine, that's the price you pay."

The medical journal article notes the recent resurgence of some diseases as some parents have resisted vaccinating their children. For example, the worst whooping cough epidemic since 1959 occurred last year, with more than 38,000 reported cases nationwide.

The disease data is on the project's website, available for use by other researchers, students, the news media and members of the public who may be curious about the outbreak and spread of a particular disease. Much of the data is searchable by disease, year and location. The project was funded by the National Institutes of Health and the Bill and Melinda Gates Foundation.

"I'm very excited to see what people will find in this data, what patterns and insights are there waiting to be discovered," said Dr. Willem G. van Panhuis, an epidemiologist at Pittsburgh and lead author of the journal article.

The project's name itself is a nod to the notion that data is a powerful tool for scientific discovery. It is called Project Tycho, after the 16th century Danish nobleman Tycho Brahe, whose careful, detailed astronomical observations were the foundation on which Johannes Kepler made the creative leap to devise his laws of planetary motion.

The open-access model for the project at Pittsburgh is increasingly the pattern with government data. The United States government has opened up thousands of data sets to the public.

Just how these assets will be exploited commercially is still in the experimental stage, other than a few well-known applications like using government weather data for forecasting services and insurance products.

But the potential seems to be considerable. Last month, the McKinsey Global Institute, the research arm of the consulting firm, projected that the total economic benefit to companies and consumers of open data could reach $3 trillion worldwide.


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Britain Reconsiders Cigarette Regulation

LONDON — Until recently, the British government appeared to be on the verge of rejecting sweeping restrictions on cigarette packaging. But on Thursday it changed course, announcing a policy review that could lead to curbs on labeling and require the use of neutral colors on packages.

Suzanne Plunkett/Reuters

The British government is reviewing cigarette packaging rules it had been expected to reject.

The effort is the latest in a series of health initiatives across Europe meant to force the tobacco industry to make cigarettes appear less attractive to younger people, and in that way prevent them from taking up the habit.

Britain's inquiry, which would conclude by next March, will focus on the experience of Australia, which has introduced standardized packaging. Similar plans may soon be adopted in Ireland and New Zealand.

This could mean that brand names would be restricted to a limited display in uniform fonts and that the color of packs would be standardized in Britain.

Such measures would go further than new minimum requirements currently being legislated by the European Union, which wants to increase the size of health warnings to 65 percent of the pack size, up from the current minimum requirement of 30 percent on the front and 40 percent on the back.

Under the European legislation, which is now being completed, the use of fruit and menthol flavorings for cigarettes would be banned, as would packets of fewer than 20 cigarettes. This would aim at packs of 10, which are seen as more affordable for teenagers.

Britain's move to study tougher labeling guidelines took many by surprise. While the government had officially said it would keep an open mind on the adoption of standardized packaging, all the signs earlier this year were that it had slipped off the legislative radar.

But on Thursday Jane Ellison, a junior health minister, told lawmakers that with the onset of the anniversary of the passing of legislation in Australia, "new evidence is emerging rapidly."

"We must do all we can to stop young people from taking up smoking in the first place," she said, adding that each year in England more than 300,000 children under the age of 16 try smoking for the first time and that most smokers start before they are 18. The new inquiry will be headed by a prominent pediatrician, Cyril Chantler, Ms. Ellison added.

Some libertarians dislike, on principle, the idea of such curbs being imposed by the state. One Conservative lawmaker, Philip Davies, on Thursday dismissed ideas like plain packaging as "idiotic, nanny-state proposals."

Luciana Berger, speaking for the Labour Party, in the opposition, accused the government of a "shambolic" U-turn, arguing that it had been forced to change course because of pressure in the House of Lords, Britain's upper house of Parliament. Amendments to one piece of legislation have been proposed there that would have given ministers the power, though not the obligation, to impose packaging regulations.

The Labour Party also suggested a link between the government's earlier reluctance to introduce standardized packaging and the role of Lynton Crosby, an election strategist for Prime Minister David Cameron's Conservative Party. Mr. Crosby has worked as a consultant for the tobacco industry.

That claim was rejected by Mr. Cameron in July, when he seemed to put the packaging issue on the back burner.

Ireland's draft legislation would outlaw forms of branding like trademarks and logos on cigarette packs and would determine the size and positioning of the health warning. The name would be presented in a uniform typeface for all brands, and the packs would all be in one plain, neutral color.

"Cigarette packs have been described as the last billboard for the tobacco industry," Ireland's health minister, James Reilly, said in a statement this week. "This legislation will force the industry to show with greater clarity the potential devastating effects of smoking on health."

"As it stands the tobacco companies use packets of various shapes and colors to attract young people to take up the killer habit," he said.


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World Briefing | Asia: North Korea: Malnutrition Persists

The World Food Program said Thursday that North Korea's food production had increased for the third year in a row but that mothers and children still lacked sufficient vitamins, fat and protein in their diets. The agency's representative in North Korea, Dierk Stegen, said that many children remained stunted because of those deficiencies. Mr. Stegen said that the government had focused on producing cereals, but that it needed a more diverse food supply. He said that about 80 percent of North Korean households lacked the essential amount of vitamins, minerals, fats and proteins in their diets. He said staple food production in 2013 had increased about 5 percent compared with last year, with about five million tons of milled cereals produced. There is a food deficit of 340,000 tons, most of which is expected to be filled by imports.


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Online Health Law Sign-Up Is Delayed for Small Business

Written By Unknown on Kamis, 28 November 2013 | 13.58

WASHINGTON — The Obama administration on Wednesday announced a one-year delay in a major element of the new health care law that would allow small businesses to buy insurance online for their employees through the new federal marketplace.

It was yet another setback for the rollout of the health care law and resulted, in part, from the well-documented problems of the insurance marketplace website. Administration officials said they had to focus on the basic functions of the website, so that individuals could shop for insurance, before offering online enrollment for small businesses. In the meantime, businesses and their employees can apply through brokers.

Many employees of small businesses are uninsured, and the businesses themselves are much less likely than big companies to provide coverage to workers and their families.

The latest delay, coming just as the White House was boasting of major improvements in the health insurance website, HealthCare.gov, opens the door to more complaints about the health care law and could increase pressure to delay other provisions.

"The president bit off more than he can chew with this health care law, and small businesses are now forced to bear the consequences," said Speaker John A. Boehner of Ohio. "Business owners across the country are already having health care plans for their employees canceled by this law, and now they're told they won't have access to the system the president promised them to find different coverage. Instead, they'll have to resort to a system you'd expect to see in the 1950s."

It was not the first delay for small businesses. The administration had previously delayed online enrollment for them to the end of this month from Oct. 1.

The date has now been pushed back to November 2014 for coverage that takes effect in January 2015, according to the Health and Human Services Department.

The announcement, just before Thanksgiving, was reminiscent of the way the White House announced, just before the Fourth of July weekend, a one-year delay in the requirement for larger employers to offer health insurance to employees.

The marketplace for small businesses — the Small Business Health Options Program, or SHOP exchange — was one of the few provisions of the 2010 law with some Republican support, and it was originally championed by Senator Olympia J. Snowe, Republican of Maine.

John C. Arensmeyer, the chief executive of Small Business Majority, an advocacy group that supports the health care law, said, "It's disappointing that the online portion of the federal small business marketplace through Healthcare.gov will be delayed, and it's important it get up and running as soon as possible."

The marketplace, he said, "is still the most important provision in the Affordable Care Act for small businesses."

For years, small businesses have had difficulty getting affordable insurance. Many owners cite the rising cost of health insurance as their top concern.

The administration said that small businesses and their employees seeking coverage in the federal exchange could still apply and enroll through an agent or broker, as many do now. "Agents and brokers are essential to making this happen," an administration official said.

However, the high-tech capability once promised by the White House will not be available until late next year.

"The agent, broker or insurer will help the employer fill out a paper application for SHOP eligibility and send it in to the SHOP marketplace," the administration said. The insurer can also tell employers what premiums they would have to pay and can enroll employees.

Some small businesses may qualify for tax credits worth up to 50 percent of their premium costs. The tax credits will be available only for plans purchased through the small business exchange.

Amanda L. Austin, a lobbyist at the National Federation of Independent Business, a trade group, said she had heard rumors that the online small business exchange might be delayed, but was surprised that it had been put off for a year. "That's pretty significant," Ms. Austin said. "The online exchange is a key component of the Affordable Care Act, and administration officials have hailed it as the answer to small businesses' health care concerns."

While the online exchange is being delayed, she said, "many small businesses face higher premiums in 2014 because of new taxes, including a new federal tax on the health insurance they purchase."

Kathleen Sebelius, the secretary of health and human services, said that the website was "vastly improved each and every day," with hardware upgrades and software fixes that produced lower error rates and faster response times for users.

An employer using the SHOP exchange must offer coverage to all full-time employees — generally those working at least 30 hours a week, on average.

In April, the Obama administration delayed a requirement that SHOP exchanges offer a variety of competing insurance plans to employees. The administration cited "operational challenges" as a reason for that delay.

Congress had wanted to provide small business employees with a range of health plan options. While some state-run exchanges will allow employers to offer such choices to employees, the federal exchange will not do so until 2015.

E. Neil Trautwein, a vice president of the National Retail Federation, said, "If the law is so burdensome for the administration to implement, just think how hard it is for small businesses."

In a separate announcement, officials at the Health and Human Services Department said Wednesday that they would replace the contractor that manages computer servers handling the enormous load of data collected by HealthCare.gov.

Terremark, a subsidiary of Verizon Communications that now provides the service, will be replaced in March by Hewlett-Packard, officials said. A spokeswoman at the Centers for Medicare and Medicaid Services said the change had been planned at least since July. Issues related to the raw computing capacity of the servers provided by Terremark have been cited as a factor in the website problems. A spokesman for Verizon declined to comment.

The problems engulfing President Obama's health care law are remarkable because administration officials had repeatedly brushed aside doubts about whether they would be ready.

Testifying before a congressional panel on Oct. 29, Marilyn B. Tavenner, the administrator of the Medicare agency, said, in response to a question, that the website for the small business exchange would be in operation by the end of this month.

Eric Lipton contributed reporting.


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National Briefing | Health: Abortion Numbers Down Again

Abortions in the United States have continued to decline, but not quite as steeply as in the past, figures released Wednesday by the Centers for Disease Control and Prevention show. The number and rate of reported abortions fell 3 percent in 2010, the most recent year for which statistics are available. Those statistics fell 5 percent in 2009 — the biggest one-year decrease in a decade. Before 2009, abortions seemed to have leveled off. The agency draws its statistics from about 45 states and cities that sent in data consistently for at least 10 years. They reported about 753,000 abortions in 2010. About 60 percent of the women who had abortions were in their 20s.


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A Part of Utah Built on Coal Wonders What Comes Next

PRICE, Utah — For generations, coal has been the lifeblood of this mineral-rich stretch of eastern Utah. Mining families proudly recall all the years they toiled underground. Supply companies line the town streets. Above the road that winds toward the mines, a soot-smudged miner peers out from a billboard with the slogan "Coal = Jobs."

But recently, fear has settled in. The state's oldest coal-fired power plant, tucked among the canyons near town, is set to close, a result of new, stricter federal pollution regulations.

As energy companies tack away from coal, toward cleaner, cheaper natural gas, people here have grown increasingly afraid that their community may soon slip away. Dozens of workers at the facility here, the Carbon Power Plant, have learned that they must retire early or seek other jobs. Local trucking and equipment outfits are preparing to take business elsewhere.

"There are a lot of people worried," said Kyle Davis, who has been employed at the plant since he was 18.

Mr. Davis, 56, worked his way up from sweeping floors to managing operations at the plant, whose furnaces have been burning since 1954.

"I would have liked to be here for another five years," he said. "I'm too young to retire."

But Rocky Mountain Power, the utility that operates the plant, has determined that it would be too expensive to retrofit the aging plant to meet new federal standards on mercury emissions. The plant is scheduled to be shut by April 2015.

"We had been working for the better part of three years, testing compliance strategies," said David Eskelsen, a spokesman for the utility. "None of the ones we investigated really would produce the results that would meet the requirements."

For the last several years, coal plants have been shutting down across the country, driven by tougher environmental regulations, flattening electricity demand and a move by utilities toward natural gas.

This month, the board of directors of the Tennessee Valley Authority, the country's largest public power utility, voted to shut eight coal-powered plants in Alabama and Kentucky and partly replace them with gas-fired power. Since 2010, more than 150 coal plants have been closed or scheduled for retirement.

The Environmental Protection Agency estimates that the stricter emissions regulations for the plants will result in billions of dollars in related health savings, and will have a sweeping impact on air quality.

In recent weeks, the agency held 11 "listening sessions" around the country in advance of proposing additional rules for carbon dioxide emissions.

"Coal plants are the single largest source of dangerous carbon pollution in the United States, and we have ready alternatives like wind and solar to replace them," said Bruce Nilles, director of the Sierra Club's Beyond Coal campaign, which wants to shut all of the nation's coal plants.

"We have a choice," he said, "which in most cases is cheaper and doesn't have any of the pollution."

Coal's downward turn has hit Appalachia hardest, but the effects of the transition toward other energy sources has started to ripple westward.

Mr. Eskelsen said Rocky Mountain Power would place some of the 70 Carbon facility employees at its two other Utah coal plants. Other workers will take early retirement or look for different jobs.

Still, the notion that this pocket of Utah, where Greek, Italian and Mexican immigrants came to mine coal more than a century ago, could survive without it, is hard for people here to comprehend.

"The attack on coal is so broad-reaching in our little community," said Casey Hopes, a Carbon County commissioner, whose grandfather was a coal miner. "The power plants, the mines — they support so many smaller businesses. We don't have another industry."

Like others in Price, Mr. Hopes voiced frustration with the Obama administration, saying it should be investing more in clean coal technology rather than discarding coal altogether.

Annual Utah coal production, though, has been slowly declining for a decade according to the federal Energy Information Administration.

Last year, mines here produced about 17 million tons of coal, the lowest level since 1987, though production has crept up this year.

"This is the worst we've seen it," said David Palacios, who works for a trucking company that hauls coal to the power plants, and whose business will slow once the Carbon plant closes.

Mr. Palacios, president of the Southeastern Utah Energy Producers Association, noted that the demand for coal has always ebbed and flowed here.

"But this has been two to three years we're struggling through," he said.

Compounding the problem, according to some mining experts, is that until now, most of the state's coal has been sold and used within the region, rather than being exported overseas. That has left the industry here more vulnerable to local plant closings.

Cindy Crane, chairwoman of the Utah Mining Association, said demand for Utah coal could eventually drop as much as 50 percent. "For most players in Utah coal, this a tough time," said Ms. Crane, vice president of PacifiCorp, a Western utility and mining company that owns the Carbon plant.

Mr. Nilles of the Sierra Club acknowledged that the shift from coal would not be easy on communities like Carbon County. But employees could be retrained or compensated for lost jobs, he said, and new industries could be drawn to the region.

Washington State, for example, has worked with municipalities and utilities to ease the transition from coal plants while ensuring that workers are transferred to other energy jobs or paid, if nearing retirement, Mr. Nilles said.

"Coal has been good to Utah," Mr. Nilles said, "but markets for coal are drying up. You need to get ahead of this and make sure the jobs don't all leave."

For many here, coal jobs are all they know. The industry united the area during hard times, too, especially during the dark days after nine men died in a 2007 mining accident some 35 miles down the highway. Virtually everyone around Price knew the men, six of whom remain entombed in the mountainside.

But there is quiet acknowledgment that Carbon County will have to change — if not now, soon.

David Palacios's father, Pete, who worked in the mines for 43 years, has seen coal roar and fade here. Now 86, his eyes grew cloudy as he recalled his first mining job. He was 12, and earned $1 a day.

"I'm retired, so I'll be fine. But these young guys?" Pete Palacios said, his voice trailing off.

Clifford Krauss contributed reporting from Houston.


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Bits Blog: The Vaccination Effect: 100 Million Cases of Contagious Disease Prevented

Vaccination programs for children have prevented more than 100 million cases of serious contagious disease in the United States since 1924, according to a new study published in The New England Journal of Medicine.

The research, led by scientists at the University of Pittsburgh's graduate school of public health, analyzed public health reports going back to the 19th century. The reports covered 56 diseases, but the article in the journal focused on seven: polio, measles, rubella, mumps, hepatitis A, diphtheria and pertussis, or whooping cough.

Researchers analyzed disease reports before and after the times when vaccines became commercially available. Put simply, the estimates for prevented cases came from the falloff in disease reports after vaccines were licensed and widely available. The researchers projected the number of cases that would have occurred had the pre-vaccination patterns continued as the nation's population increased.

The journal article is one example of the kind of analysis that can be done when enormous data sets are built and mined. The project, which started in 2009, required assembling 88 million reports of individual cases of disease, much of it from the weekly morbidity reports in the library of the Centers for Disease Control and Prevention. Then the reports had to be converted to digital formats.

Most of the data entry — 200 million keystrokes — was done by Digital Divide Data, a social enterprise that provides jobs and technology training to young people in Cambodia, Laos and Kenya.

Still, data entry was just a start. The information was put into spreadsheets for making tables, but was later sorted and standardized so it could be searched, manipulated and queried on the project's website.

"Collecting all this data is one thing, but making the data computable is where the big payoff should be," said Dr. Irene Eckstrand, a program director and science officer for the N.I.H.'s Models of Infectious Disease Agent Study.

The University of Pittsburgh researchers also looked at death rates, but decided against including an estimate in the journal article, largely because death certificate data became more reliable and consistent only in the 1960s, the researchers said.

But Dr. Donald S. Burke, the dean of Pittsburgh's graduate school of public health and an author of the medical journal article, said that a reasonable projection of prevented deaths based on known mortality rates in the disease categories would be three million to four million.

The scientists said their research should help inform the debate on the risks and benefits of vaccinating American children.

Pointing to the research results, Dr. Burke said, "If you're anti-vaccine, that's the price you pay."

The medical journal article notes the recent resurgence of some diseases as some parents have resisted vaccinating their children. For example, the worst whooping cough epidemic since 1959 occurred last year, with more than 38,000 reported cases nationwide.

The disease data is on the project's website, available for use by other researchers, students, the news media and members of the public who may be curious about the outbreak and spread of a particular disease. Much of the data is searchable by disease, year and location. The project was funded by the National Institutes of Health and the Bill and Melinda Gates Foundation.

"I'm very excited to see what people will find in this data, what patterns and insights are there waiting to be discovered," said Dr. Willem G. van Panhuis, an epidemiologist at Pittsburgh and lead author of the journal article.

The project's name itself is a nod to the notion that data is a powerful tool for scientific discovery. It is called Project Tycho, after the 16th century Danish nobleman Tycho Brahe, whose careful, detailed astronomical observations were the foundation on which Johannes Kepler made the creative leap to devise his laws of planetary motion.

The open-access model for the project at Pittsburgh is increasingly the pattern with government data. The United States government has opened up thousands of data sets to the public.

Just how these assets will be exploited commercially is still in the experimental stage, other than a few well-known applications like using government weather data for forecasting services and insurance products.

But the potential seems to be considerable. Last month, the McKinsey Global Institute, the research arm of the consulting firm, projected that the total economic benefit to companies and consumers of open government data could reach $3 trillion worldwide.


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The Cancer Divide: In Israel, a Push to Screen for Cancer Gene Leaves Many Conflicted

Written By Unknown on Rabu, 27 November 2013 | 13.57

KFAR SABA, Israel — Ever since she tested positive for a defective gene that causes breast cancer, Tamar Modiano has harbored a mother's fear: that she had passed it on to her two daughters. Ms. Modiano had her breasts removed at 47 to prevent the disease and said that the day she found out her older daughter tested negative was one of the happiest of her life.

Now she wants her younger daughter, Hadas, 24, to be tested so she can start a family early if she is positive and then have a double mastectomy too. Ms. Modiano's elder daughter, Suzi Gattegno, 29, disagrees.

"You're keeping her from living her life," Ms. Gattegno told her mother. "You want to marry her off early."

"If she's a carrier, she should marry early," her mother countered.

"She doesn't even have a boyfriend," the daughter said. "You need to stop pressuring her."

"I want to protect her!" Ms. Modiano replied.

Such family debates are playing out across Israel these days. The country has one of the highest rates of breast cancer in the world, according to a World Health Organization report. And some leading scientists here are advocating what may be the first national screening campaign to test women for cancer-causing genetic mutations common among Jews — tests that are already forcing young women to make agonizing choices about what they want to know, when they want to know it and what to do with the information.

The so-called Jewish breast cancer genes have preoccupied women here for years, but after the actress Angelina Jolie revealed in May that she had undergone a double mastectomy because she had tested positive for such a mutation, coverage here exploded, with radio and TV talk shows featuring Israeli women grappling with similar decisions.

Jews of Ashkenazi, or central and eastern European, backgrounds, who make up about half the Jews in Israel and the vast majority of those in the United States, are much more likely to carry mutations that increase the risks for both breast and ovarian cancers, according to the National Cancer Institute.

A number of influential geneticists and cancer doctors from various medical centers here say that the Israeli Health Ministry should pay for free voluntary genetic testing of all Ashkenazi women over the age of 25. About a million women would be covered, at a cost of less than $100 per test. Jews of Iraqi descent, whose families also often carry a harmful mutation, might also be screened.

The goal of a proposed universal screening program would be to identify an estimated 30,000 Israeli women who have the mutations. So far, with sporadic testing, about 6,000 of them have been found, many only after a cancer diagnosis, said Dr. Ephrat Levy-Lahad, the coordinator of the Israel Genetics Consortium.

"That's our target population," said Dr. Oded Olsha, a breast surgeon at Shaare Zedek Medical Center in Jerusalem. "If we can find them, we can save their lives."

Women who tested positive for mutations in the BRCA1 and BRCA2 genes, which suppress tumors, would be strongly encouraged to complete child bearing by their late 30s so they could have their ovaries removed by age 40. Risk-reducing mastectomies would also be offered.

The profoundly controversial idea of broad-based screening has already set off debate in Israel among advocates for women and those in the medical and scientific fields. Critics say it may lead to social stigma and a rash of unnecessary operations, and also burden some women with information they may not want or know how to use.

The choice is not a simple one. Removing the breasts and ovaries sharply reduces the risk of cancer, but mastectomies are disfiguring and women often experience scarring and numbness after breast reconstruction. Loss of the ovaries plunges women into menopause, potentially leading to hot flashes, a reduced sex drive and heightened risks of heart disease and bone loss.

But already demand for genetic testing is very high here — there are yearlong waiting lists — and national health insurance generally covers it as long as a woman is referred by her doctor or a genetic counselor.

While poor countries struggle to provide even basic cancer care to women, wealthier societies like Israel and the United States are increasingly using sophisticated technologies to identify those at greatest risk in an effort to thwart the disease before it gets started. Several American Jewish organizations have recently undertaken a campaign to raise awareness about the genetic susceptibility to breast and ovarian cancer among Ashkenazi Jews.

The cancer divide here in Israel is more ethnic than economic. Will only Ashkenazi Jews be routinely tested? Though they are much more likely to carry one of the common harmful mutations in the BRCA1 and BRCA2 genes, Israel is a melting pot of both Arab citizens and Jews from all over the world, and only half of the country's six million Jews are of Ashkenazi ancestry.

Under the proposal being put forward by some Israeli geneticists, it is likely that Israeli Arab citizens and Jews of Sephardic ancestry — whose families originate in North Africa and the Middle East — would not routinely be included among those screened for BRCA mutations, a point of contention in a country where a social and ethnic rift already divides Sephardic and Ashkenazi Jews.

Families of Iraqi origin, like Ms. Modiano's, may be covered because of their higher genetic risks. She always knew there was cancer in her father's family. Three of his sisters died of breast cancer at young ages.

But she was tested for cancer-causing mutations only three years ago after finding out her relatives were being screened. The result stunned her.

"I thought about what it meant for me, and then I thought, 'What about my daughters?' " Ms. Modiano said recently, shuddering slightly. "I was petrified. I still am."

Within three months, Ms. Modiano had a risk-reducing double mastectomy and an operation to remove her ovaries. But the decisions facing her daughters, both in their 20s, were far more complicated. Neither was married, and each had a 50 percent chance of carrying the mutation.

Ms. Gattegno, who was in nursing school at the time, decided to be tested.

"I told my boyfriend that if I turned out to be a carrier, I would quit school for a while and we'd have kids right away," she said. "And then I'd have a prophylactic mastectomy."

Difficult Questions

At the Shaare Zedek Medical Center in Jerusalem, Dr. Levy-Lahad, who started one of the first genetic testing programs in Israel, is among the main champions of universal screening for Ashkenazi women. She has worked closely with the American scientist who identified the BRCA1 gene, Mary-Claire King.

"If you're only testing women after they've been affected, you've lost the game," Dr. Levy-Lahad said. "Genetic testing is about prevention."

She pointed to the risks. One in 40 Ashkenazi women carry a harmful genetic mutation, compared to less than one in 100 women generally.

Women with these mutations are four to five times more likely to develop aggressive breast cancers, according to the National Cancer Institute. The disease often comes at an early age and in both breasts, said Dr. Gad Rennert, the director of Israel's National Cancer Control Center.

The potential for preventing ovarian cancer, a rarer but more lethal disease, is even greater. The common harmful mutations found in Ashkenazis are implicated in about 30 percent of ovarian cancers in Israeli women — and 40 percent or more of cases in women under 60, Dr. Rennert said.

Practical and ethical questions abound. Should men — who are just as likely to pass the mutations to their children and who are themselves at increased risk for some cancers — also be tested? Will ultra-Orthodox Jews participate in screening, knowing a positive test could hurt their family's chances of making a good marriage match?

Identifying people as carriers can change their perceptions of themselves and the way they envision their futures, said Dr. Gail P. Jarvik, the head of the division of medical genetics at University of Washington Medical Center in Seattle.

Even though the testing would be voluntary, women could feel pressured to participate, said Barbara A. Koenig, a professor of medical anthropology and bioethics at the University of California, San Francisco. "When you institute mass screening, you're making a collective decision that this is a good thing."

There are also lingering scientific questions. While much is known about the three common Ashkenazi BRCA1 and BRCA2 mutations, the risk they confer varies. Some families may have other genetic factors that modify their risk, which explains why some carriers never develop cancer while others die in their 20s.

Women identified as mutation carriers are showered with resources for early detection and prevention. These women's risk for developing breast cancer ranges from 45 to 65 percent or higher, depending on family history, and their risk for ovarian cancer can be as high as 39 percent.

Routine mammography screening for most Israeli women starts at 50, but carriers are eligible for frequent clinical breast exams and expensive magnetic resonance imaging of the breast, all covered by national health insurance. They are also eligible for regular blood tests and vaginal ultrasounds to screen for ovarian cancer.

Cultural Obstacles

Many Israeli women who have the harmful mutations complain that male doctors display sexist attitudes about the importance of breasts and are loath to do mastectomies on healthy women.

Dr. Moshe Inbar, an outspoken oncologist in Tel Aviv who opposes preventive mastectomies, has said that a woman cannot have an orgasm after her breasts are removed, an assertion not supported by evidence.

"Would you like to live without your breasts?" Dr. Inbar, the director of the oncology division at Tel Aviv Sourasky Medical Center, asked. "I try to dissuade women from doing this. Surgery is not something that should be done on patient demand; it should be done when indicated."

While more than a third of American women carrying the harmful genetic mutations choose preventive mastectomies, only 4 percent of Israeli women do, according to a 2008 International Journal of Cancer study that compared risk-reducing procedures for samples of BRCA1 and BRCA2 mutation carriers in Canada, the United States, Israel and six European countries.

By contrast, well over half the carriers in all countries but Poland had their ovaries removed, a procedure that also reduces breast cancer risk.

But there are signs that attitudes are beginning to change here, as women take to the Internet to research their options, challenge the medical profession and shop for doctors.

Tamar Horesh, 35, a computer programmer from central Israel, has vivid memories of her mother's painful death from ovarian cancer at 51.

When Ms. Horesh tested positive for a BRCA1 mutation, she said her husband supported her decision to surgically remove her ovaries and breasts. They had three young children to raise.

Finding a doctor to do it was another matter.

"The first doctor I went to said I was insane, and he said, 'If you have brain cancer, are you going to chop off your head?' " said Ms. Horesh. "The second doctor said that he noticed I had a small chest, and he thought I just wanted an excuse to have my breasts enlarged."

A third doctor told her what many women hear, "Come back when you have cancer," and "Nobody dies of breast cancer nowadays."

In fact, some 900 Israeli women die of breast cancer each year, according to the Israel Cancer Association.

Ms. Horesh eventually got referrals from Bracha, a group founded to raise awareness by Lisa Cohen, who has a BRCA mutation.

Ms. Cohen's mother died of cancer at 49, and then her sister, who had four young children, died at 36. "I felt like I was going to be next in line," said Ms. Cohen, a divorced mother of three who was determined to stay alive for her children.

A Personal Decision

Hadas Modiano, a university student in Jerusalem, is waiting a couple of years before she seriously considers being tested as her mother insists. But her mother's example has given her strength.

"I think I'm not as scared as I might have been because I saw what my mother went through," she said. "It was hard, but she has managed and overcome."

But for many women, the choices are harrowing. A Tel Aviv lawyer, 43, who asked that her name not be used to protect her privacy, was devastated when she found out at 26 that she had one of the bad mutations.

The lawyer, who was only 4 when her mother died of breast cancer, said she was among the first to line up for the genetic test when it became available in Israel in the 1990s.

"You may think you're prepared for this information, but you aren't," she said. "My blood went cold when I found out." Afterward, she said she realized, "The only solutions are so radical — amputating parts of your body."

When she first met the man who became her husband, she told him that she could never marry or have children. He convinced her otherwise. She goes for frequent scans and checkups but postponed having a mastectomy so she could breast-feed their children.

She chose to become pregnant through in vitro fertilization so female embryos that did not carry harmful mutations could be selected in the lab.

"Finally, there was something positive to do with the information," she said.

Preventive surgeries are not always successful. Tali Shalev had what was supposed to be a preventive double mastectomy, but pathologists found a cancerous lesion in the removed breast tissue. "I'm an example of someone who did everything possible," said Ms. Shalev, 40, who has three children.

The dilemmas of genetic testing are compounded in the ultra-Orthodox community, where the emphasis on modesty often dampens open discussion.

Still, Tziporah, 38, a Canadian-born Orthodox mother of seven who now lives in Israel, talks openly about her experience because she wants to reach other religious women. Tziporah, who goes by her nickname, Tzippy, asked that her last name not be used to protect the privacy of her extended family members, who also may carry the gene. Her mother died of breast cancer at 42, when she was 5, and when Tzippy was pregnant with her last child a few years ago, she tested positive for a BRCA1 mutation.

She sought advice from several rabbis about whether she should go forward with risk-reducing surgeries. They reassured her that preserving life is one of the supreme values of Judaism.

So three years ago, after her youngest child was born, she had her breasts and ovaries removed. The operations were grueling, but she said she wanted to make sure her children would not suffer the same loss she had. And she said she felt she had a mission to encourage other women to be tested.

"You know why God did this to me?" she said. "Because I've got a really big mouth."

So she is spreading the word within the Orthodox community that genetic screening can save lives.

"Women don't have to be dying on their kids," she said.


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Merrell Williams Jr., Paralegal Who Bared Big Tobacco, Dies at 72

Merrell Williams Jr., a former paralegal who leaked mountains of internal documents of the Brown & Williamson Tobacco Company in 1994, fueling lawsuits that resulted in an industry payout of billions of dollars to pay smokers' medical bills, died on Nov. 18 in Ocean Springs, Miss. He was 72.

The cause was a heart attack, his wife, Christina Daltro, said.

Mr. Williams was working for a law firm in Louisville, Ky., that represented tobacco companies when he copied and passed on the documents. Mike Moore, a former attorney general of Mississippi who had handled his state's litigation, said in a recent email to The Associated Press that the files refuted "the three big lies" of the tobacco industry — that "cigarettes don't cause cancer, nicotine is not addictive and we don't market to kids."

Many hailed Mr. Williams's courage, likening him to Daniel Ellsberg, who leaked the Vietnam War history known as the Pentagon Papers in 1971. Others, notably Brown & Williamson, accused him of theft and abuse of the attorney-client privilege.

The episode was further complicated when it became known that Mr. Williams had accepted a house, two cars, a boat and a $3,000-a-month no-show job from the lawyer leading the charge against the tobacco industry.

When Mr. Williams came to work at the firm, Wyatt, Tarrant & Combs, in January 1988 as a $9-an-hour paralegal, it was his latest stop in a checkered career. By his own account he had squandered his education, which included a Ph.D. in theater arts from the University of Denver. He was in the middle of his third divorce and behind in child support and had declared bankruptcy four times. He told The Dallas Morning News in 1997 that he was "a full-blown alcoholic."

At the law firm, he was one of a dozen employees assigned to review thousands of boxes of documents that Brown & Williamson, the nation's third-largest tobacco company, had squirreled away over the years. The purpose was to prepare defenses for the accelerating attacks on the industry in the courts and legislatures.

Mr. Williams had no sympathy for the tobacco industry, even though he was a heavy smoker of Kools, a Brown & Williamson brand. His father had died of a heart attack in his early 50s that Mr. Williams attributed to his chain smoking. He said he was appalled to learn that the company had covered up research by its own scientists that raised questions about smoking.

Mr. Williams started smuggling documents out of the law firm around Christmas 1988, stuffing them in an exercise girdle he wore under loose clothing. He copied them at print shops, never going to the same one two days in a row, and returned them the next morning.

From 1990 to 1992, Mr. Williams unsuccessfully tried to interest law enforcement officials and tobacco industry opponents in the documents. In March 1992 he was laid off. That month he had emergency heart surgery, which he believed was caused by smoking.

In July 1993 he notified the law firm that he was planning to file a liability claim for health damage and job stress, and planned to use his documents as evidence. The firm and Brown & Williamson struck first, suing him for theft, fraud and breach of contract. His defense was that the documents revealed criminal activity.

In April 1994 he met with Richard Scruggs, a personal injury lawyer who had won enormous victories over the asbestos industry. In Orlando, Fla., he showed Mr. Scruggs about 4,000 pages of documents that he had stashed with a friend.

It was Mr. Scruggs who gave him the house and other gifts and arranged for a job that did not require him to show up. Mr. Scruggs denied that the gifts — or loans, as he sometimes characterized them — were a quid pro quo for getting the stolen documents. But when The St. Petersburg Times asked him if he would have been so generous if Mr. Williams had not provided the documents, Mr. Scruggs said: "That's a hard question. I don't know."

In 1994 the documents were debated in Congress, entered into court proceedings, posted on the Internet and printed in The New York Times. The case against the companies was further buttressed when Jeffrey Wigand, a onetime Brown & Williamson executive, revealed industry secrets on the CBS News program "60 Minutes" in 1996.

The case resulted in a settlement agreement in 1998 in which 46 states would recover tobacco-related health costs estimated at $246 billion over 25 years from the country's four largest tobacco companies.

Merrell Williams Jr. was born in Baton Rouge, La., on Jan. 26, 1941, to middle-class parents, both of whom smoked heavily. The family moved to West Texas and then to Mississippi, where he delivered newspapers, played football and smoked his first cigarette in a high school play, though he eventually quit.

He graduated from Baylor University and earned a master's degree from the University of Mississippi. He was 30 when he was awarded his doctorate in Denver. He then taught at a succession of junior colleges. By the early 1980s, he was tending bar on the Mississippi Gulf Coast.

Mr. Williams was divorced at least three times. Besides Ms. Daltro, his wife of five months, he is survived by his daughters, Jennifer Smith and Sarah Ridpath, and five grandchildren.

Ms. Daltro said that Mr. Williams had been upset about the introduction of electronic cigarettes, which simulate smoking and have fewer harmful chemicals, though they contain nicotine. "He was really, really angry about that," she said.


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Where is Breast Cancer?

Published: November 26, 2013


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Well: The Power of a Daily Bout of Exercise

Phys Ed

Gretchen Reynolds on the science of fitness.

This week marks the start of the annual eat-too-much and move-too-little holiday season, with its attendant declining health and surging regrets. But a well-timed new study suggests that a daily bout of exercise should erase or lessen many of the injurious effects, even if you otherwise lounge all day on the couch and load up on pie.

To undertake this valuable experiment, which was published online last month in The Journal of Physiology, scientists at the University of Bath in England rounded up a group of 26 healthy young men. All exercised regularly. None were obese. Baseline health assessments, including biopsies of fat tissue, confirmed that each had normal metabolisms and blood sugar control, with no symptoms of incipient diabetes.

The scientists then asked their volunteers to impair their laudable health by doing a lot of sitting and gorging themselves.

Energy surplus is the technical name for those occasions when people consume more energy, in the form of calories, than they burn. If unchecked, energy surplus contributes, as we all know, to a variety of poor health outcomes, including insulin resistance — often the first step toward diabetes — and other metabolic problems.

Overeating and inactivity can each, on its own, produce an energy surplus. Together, their ill effects are exacerbated, often in a very short period of time. Earlier studies have found that even a few days of inactivity and overeating spark detrimental changes in previously healthy bodies.

Some of these experiments have also concluded that exercise blunts the ill effects of these behaviors, in large part, it has been assumed, by reducing the energy surplus. It burns some of the excess calories. But a few scientists have suspected that exercise might do more; it might have physiological effects that extend beyond just incinerating surplus energy.

To test that possibility, of course, it would be necessary to maintain an energy surplus, even with exercise. So that is what the University of Bath researchers decided to do.

Their method was simple. They randomly divided their volunteers into two groups, one of which was assigned to run every day at a moderately intense pace on a treadmill for 45 minutes. The other group did not exercise.

Meanwhile, the men in both groups were told to generally stop moving so much, decreasing the number of steps that they took each day from more than 10,000 on average to fewer than 4,000, as gauged by pedometers. The exercising group's treadmill workouts were not included in their step counts. Except when they were running, they were as inactive as the other group.

Both groups also were directed to start substantially overeating. The group that was not exercising increased their daily caloric intake by 50 percent, compared with what it had been before, while the exercising group consumed almost 75 percent more calories than previously, with the additional 25 percent replacing the energy burned during training.

Over all, the two groups' net daily energy surplus was the same.

The experiment continued for seven days. Then both groups returned to the lab for additional testing, including new insulin measurements and another biopsy of fat tissue.

The results were striking. After only a week, the young men who had not exercised displayed a significant and unhealthy decline in their blood sugar control, and, equally worrying, their biopsied fat cells seemed to have developed a malicious streak. Those cells, examined using sophisticated genetic testing techniques, were now overexpressing various genes that may contribute to unhealthy metabolic changes and underexpressing other genes potentially important for a well-functioning metabolism.

But the volunteers who had exercised once a day, despite comparable energy surpluses, were not similarly afflicted. Their blood sugar control remained robust, and their fat cells exhibited far fewer of the potentially undesirable alterations in gene expression than among the sedentary men.

"Exercise seemed to completely cancel out many of the changes induced by overfeeding and reduced activity," said Dylan Thompson, a professor of health sciences at the University of Bath and senior author of the study. And where it did not countermand the impacts, he continued, it "softened" them, leaving the exercise group "better off than the nonexercise group," despite engaging in equivalently insalubrious behavior.

From a scientific standpoint, this finding intimates that the metabolic effects of overeating and inactivity are multifaceted, Dr. Thompson said, with an energy surplus sparking genetic as well as other physiological changes. But just how exercise countermands those effects is impossible to say based on the new experiment, he added. Differences in how each group's metabolism utilized fats and carbohydrates could play a role, he said, as could the release of certain molecules from exercising muscles, which only occurred among the men who ran.

Of more pressing interest, though, is the study's practical message that "if you are facing a period of overconsumption and inactivity" — also known as the holidays — "a daily bout of exercise will prevent many of the negative changes, at least in the short term," Dr. Thompson said. Of course, his study involved young, fit men and a relatively prolonged period of exercise. But the findings likely apply, he said, to other groups, like older adults and women, and perhaps to lesser amounts of training. That's a possibility worth embracing as the pie servings accumulate.


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As Homeless Line Up for Food, Los Angeles Weighs Restrictions

Written By Unknown on Selasa, 26 November 2013 | 13.57

Monica Almeida/The New York Times

A security guard from the Business Improvement District keeping an eye on a food truck operated by the Greater West Hollywood Food Coalition.

LOS ANGELES — They began showing up at dusk last week, wandering the streets, slumped in wheelchairs and sitting on sidewalks, paper plates perched on their knees. By 6:30 p.m., more than 100 homeless people had lined up at a barren corner in Hollywood, drawn by free meals handed out from the back of a truck every night by volunteers.

But these days, 27 years after the Greater West Hollywood Food Coalition began feeding people in a county that has one of the worst homeless problems in the nation, the charity is under fire, a flashpoint in the national debate over the homeless and the programs that serve them.

Facing an uproar from homeowners, two members of the Los Angeles City Council have called for the city to follow the lead of dozens of other communities and ban the feeding of homeless people in public spaces.

"If you give out free food on the street with no other services to deal with the collateral damage, you get hundreds of people beginning to squat," said Alexander Polinsky, an actor who lives two blocks from the bread line. "They are living in my bushes and they are living in my next door neighbor's crawl spaces. We have a neighborhood which now seems like a mental ward."

Should Los Angeles enact such an ordinance, it would join a roster of more than 30 cities, including Philadelphia, Raleigh, N.C., Seattle and Orlando, Fla., that have adopted or debated some form of legislation intended to restrict the public feeding of the homeless, according to the National Coalition of the Homeless.

"Dozens of cities in recent years," said Jerry Jones, the coalition's executive director. "It's a common but misguided tactic to drive homeless people out of downtown areas."

"This is an attempt to make difficult problems disappear," he said, adding, "It's both callous and ineffective."

The notion that Los Angeles might join this roster is striking given the breadth of the problem here. Encampments of homeless can be found from downtown to West Hollywood, from the streets of Brentwood to the beaches of Venice. The situation that has stirred no small amount of frustration and embarrassment among civic leaders, now amplified by fears of the hungry and mostly homeless people, who have come to count on these meals.

"They are helping human beings," said Debra Morris, seated in a wheelchair as she ate the evening's offering of pasta with tomato sauce. "I can barely pay my own rent."

There are now about 53,800 homeless people in Los Angeles County, according to the 2013 Annual Homeless Assessment Report released by the Department of Housing and Urban Development last week, a 27 percent increase over last year. Only New York had a higher homeless population.

The problem is particularly severe here because of the temperate climate that makes it easier to live outdoors, cuts in federal spending on the homeless, and a court-ordered effort by California to shrink its prison population, said Mike Arnold, the executive director of the Los Angeles Homeless Services Authority, an agency created by the city and county in 1993.

All told, about $82 million in government funds is spent each year on helping homeless here, Mr. Arnold said.

Tom LaBonge, one of the two City Council members who introduced the resolution (the other, also a Democrat, was Mitch O'Farrell), said food lines should be moved indoors, out of consideration to the homeless and neighborhoods. "There are well-intentioned people on both sides," Mr. LaBonge said.

But, he added: "This has overwhelmed what is a residential neighborhood. When dinner is served, everybody comes and it's kind of a free-for-all."

Ted Landreth, the founder of the food coalition, said his group had fought back community opposition before — it moved to this corner after being ordered out of Plummer Park in West Hollywood in 1990 because of similar complaints — and would do so again.

"The people who want to get rid of us see dollar signs, property values, ahead of pretty much everything else," he said.

"We have stood our ground," he added. "We are not breaking any law."

Communities that have sought to implement feeding restriction laws have faced strong resistance. In Philadelphia, advocates for the homeless won an injunction in federal court blocking a law there that would have banned food lines in public parks. Even before the court action, religious groups had moved in and began setting up indoor food lines.

In many ways the agonies of the national battle over dealing with homelessness are etched into this four-block-square section of Hollywood, where industrial buildings, including the Cemex cement factory, film production facilities and the stately former headquarters of Howard Hughes's enterprises, sit two blocks up North Sycamore Avenue away from a middle-class neighborhood of Spanish Mission homes. Construction in the area is bustling, reflecting the gentrification that is taking place across this city.

The coalition's truck, a Grumman Kurbmaster, arrives every night at 6:15, drawing as many as 200 people from across the region.

Matt Hamilton contributed reporting.


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The Changing American Family

American households have never been more diverse, more surprising, more baffling. In this special issue of Science Times, NATALIE ANGIER takes stock of our changing definition of family.

Fabrizio Costantini for The New York Times

Kristi and Michael Burns, whose marriage was the third for each, with three of their four children at home in Chelsea, Mich. All are from previous relationships. More Photos »

Gretchen Ertl for The New York Times

The daughter of a prison inmate left for school. More than half of the 2.3 million adults incarcerated in the United States are parents of children under 18. More Photos »

The Changing American Family

The Burnses' sprawling, sometimes uneasy ensemble is typical of newly blended households.

CHELSEA, MICH. — Kristi and Michael Burns have a lot in common. They love crossword puzzles, football, going to museums and reading five or six books at a time. They describe themselves as mild-mannered introverts who suffer from an array of chronic medical problems. The two share similar marital résumés, too. On their wedding day in 2011, the groom was 43 years old and the bride 39, yet it was marriage No. 3 for both.

Today, their blended family is a sprawling, sometimes uneasy ensemble of two sharp-eyed sons from her two previous husbands, a daughter and son from his second marriage, ex-spouses of varying degrees of involvement, the partners of ex-spouses, the bemused in-laws and a kitten named Agnes that likes to sleep on computer keyboards.

If the Burnses seem atypical as an American nuclear family, how about the Schulte-Waysers, a merry band of two married dads, six kids and two dogs? Or the Indrakrishnans, a successful immigrant couple in Atlanta whose teenage daughter divides her time between prosaic homework and the precision footwork of ancient Hindu dance; the Glusacs of Los Angeles, with their two nearly grown children and their litany of middle-class challenges that seem like minor sagas; Ana Perez and Julian Hill of Harlem, unmarried and just getting by, but with Warren Buffett-size dreams for their three young children; and the alarming number families with incarcerated parents, a sorry byproduct of America's status as the world's leading jailer.

The typical American family, if it ever lived anywhere but on Norman Rockwell's Thanksgiving canvas, has become as multilayered and full of surprises as a holiday turducken — the all-American seasonal portmanteau of deboned turkey, duck and chicken.

Researchers who study the structure and evolution of the American family express unsullied astonishment at how rapidly the family has changed in recent years, the transformations often exceeding or capsizing those same experts' predictions of just a few journal articles ago.

"This churning, this turnover in our intimate partnerships is creating complex families on a scale we've not seen before," said Andrew J. Cherlin, a professor of public policy at Johns Hopkins University. "It's a mistake to think this is the endpoint of enormous change. We are still very much in the midst of it."

Yet for all the restless shape-shifting of the American family, researchers who comb through census, survey and historical data and conduct field studies of ordinary home life have identified a number of key emerging themes.

Families, they say, are becoming more socially egalitarian over all, even as economic disparities widen. Families are more ethnically, racially, religiously and stylistically diverse than half a generation ago — than even half a year ago.

In increasing numbers, blacks marry whites, atheists marry Baptists, men marry men and women women, Democrats marry Republicans and start talk shows. Good friends join forces as part of the "voluntary kin" movement, sharing medical directives, wills, even adopting one another legally.

Single people live alone and proudly consider themselves families of one — more generous and civic-minded than so-called "greedy marrieds."

"There are really good studies showing that single people are more likely than married couples to be in touch with friends, neighbors, siblings and parents," said Bella DePaulo, author of "Singled Out" and a visiting professor of psychology at the University of California, Santa Barbara.

But that doesn't mean they'll be single forever. "There are not just more types of families and living arrangements than there used to be," said Stephanie Coontz, author of the coming book "Intimate Revolutions," and a social historian at Evergreen State College in Olympia, Wash. "Most people will move through several different types over the course of their lives."

At the same time, the old-fashioned family plan of stably married parents residing with their children remains a source of considerable power in America — but one that is increasingly seen as out of reach to all but the educated elite.

"We're seeing a class divide not only between the haves and the have-nots, but between the I do's and the I do nots," Dr. Coontz said. Those who are enjoying the perks of a good marriage "wouldn't stand for any other kind," she said, while those who would benefit most from marital stability "are the ones least likely to have the resources to sustain it."

Yet across the divide runs a white picket fence, our unshakable star-spangled belief in the value of marriage and family. We marry, divorce and remarry at rates not seen anywhere else in the developed world. We lavish $70 billion a year on weddings, more than we spend on pets, coffee, toothpaste and toilet paper combined.

We're sappy family romantics. When an informal sample of 52 Americans of different ages, professions and hometowns were asked the first thought that came to mind on hearing the word "family," the answers varied hardly at all. Love! Kids! Mom! Dinner!

"It's the backbone of how we live," said David Anderson, 52, an insurance claims adjuster from Chicago. "It means everything," said Linda McAdam, 28, who is in human resources on Long Island.

Yes, everything, and sometimes too many things. "It's almost like a weight," said Rob Fee, 26, a financial analyst in San Francisco, "a heavy weight." Or as the comedian George Burns said, "Happiness is having a large, loving, caring, close-knit family in another city."

In charting the differences between today's families and those of the past, demographers start with the kids — or rather the lack of them.

The nation's birthrate today is half what it was in 1960, and last year hit its lowest point ever. At the end of the baby boom, in 1964, 36 percent of all Americans were under 18 years old; last year, children accounted for just 23.5 percent of the population, and the proportion is dropping, to a projected 21 percent by 2050. Fewer women are becoming mothers — about 80 percent of those of childbearing age today versus 90 percent in the 1970s — and those who reproduce do so more sparingly, averaging two children apiece now, compared with three in the 1970s.

One big reason is the soaring cost of ushering offspring to functional independence. According to the Department of Agriculture, the average middle-class couple will spend $241,080 to raise a child to age 18. Factor in four years of college and maybe graduate school, or a parentally subsidized internship with the local theater company, and say hello to your million-dollar bundle of oh joy.

As steep as the fertility decline has been, the marriage rate has fallen more sharply, particularly among young women, who do most of the nation's childbearing. As a result, 41 percent of babies are now born out of wedlock, a fourfold increase since 1970.

The trend is not demographically uniform, instead tracking the nation's widening gap in income and opportunity. Among women with a bachelor's degrees or higher, 90 percent adhere to the old playground song and put marriage before a baby carriage. For everybody else, maternity is often decoupled from matrimony: 40 percent of women with some college but no degree, and 57 percent of women with high school diplomas or less, are unmarried when they give birth to their first child.

More than one-quarter of these unwed mothers are living with a partner who may or may not be their child's biological father. The rise of the cohabiting couple is another striking feature of the evolving American family: From 1996 to 2012, the number jumped almost 170 percent, to 7.8 million from 2.9 million.

Nor are unmarried mothers typically in their teens; contrary to all the talk of an epidemic of teenage motherhood, the birthrate among adolescent girls has dropped by nearly half since 1991 and last year hit an all-time low, a public health triumph that experts attribute to better sex education and birth-control methods. Most unmarried mothers today, demographers say, are in their 20s and early 30s.

Also démodé is the old debate over whether mothers of dependent children should work outside the home. The facts have voted, the issue is settled, and Paycheck Mommy is now a central organizing principle of the modern American family.

The share of mothers employed full or part time has quadrupled since the 1950s and today accounts for nearly three-quarters of women with children at home. The number of women who are their families' sole or primary breadwinner also has soared, to 40 percent today from 11 percent in 1960.

"Yes, I wear the pants in the family," said Ana Perez, 35, a mother of three and a vice president at a financial services company in New York, who was, indeed, wearing pants. "I can say it brings me joy to know I can take care of my family."

Cultural attitudes are adapting accordingly. Sixty-two percent of the public, and 72 percent of adults under 30, view the ideal marriage as one in which husband and wife both work and share child care and household duties; back when Jimmy Carter was president, less than half of the population approved of the dual-income family, and less than half of 1 percent of husbands knew how to operate a sponge mop.

Mothers are bringing home more of the bacon, and of the mortarboards, too. While most couples are an even match scholastically, 28 percent of married women are better educated than their mates; that is true of just 19 percent of married men. Forty years ago, the asymmetry went the other way.

Some experts argue that the growing legion of mothers with advanced degrees has helped sharpen the already brutal competition for admission to the nation's elite universities, which stress the importance of extracurricular activities. Nothing predicts the breadth and busyness of a child's after-school schedule better, it turns out, than the mother's level of education.

One change that caught many family researchers by surprise was the recent dip in the divorce rate. After many decades of upward march, followed by a long, stubborn stay at the familiar 50 percent mark that made every nuptial feel like a coin flip, the rate began falling in 1996 and is now just above 40 percent for first-time marriages.

The decline has been even more striking among middle- and upper-middle-income couples with college degrees. For them, fewer than one in three marriages is expected to end in divorce, a degree of stability that allows elite couples to merge their resources with confidence, maximally invest in their children and otherwise widen the gap between themselves and the struggling masses.

There are exceptions, of course. Among baby boomers, the rate of marriage failure has surged 50 percent in the past 20 years — perhaps out of an irritable nostalgia, researchers said, for the days of free love, better love, anything but this love. Nor do divorce rates appear to have fallen among those who take the old Samuel Johnson quip as a prescription, allowing hope to triumph over experience, and marrying again and again.

For both Mike and Kristi Burns, now in their 40s, the first marriage came young and left early, and the second stuck around for more than a dozen years.

Kristi was 19, living in South Carolina, and her Marine boyfriend was about to be shipped to Japan. "I wasn't attached to him, really," she said, "but for some reason I felt this might be my only chance at marriage."

In Japan, Kristi gave birth to her son Brandon, realized she was lonely and miserable, and left the marriage seven weeks after their first anniversary. Back in the States, Kristi studied to be a travel agent, moved to Michigan and married her second husband at age 23.

He was an electrician. He adopted Brandon, and the couple had a son, Griffin. The marriage lasted 13 years.

"We were really great friends, but we weren't a great husband and wife," Kristi said. "Our parenting styles were too different."

Besides, she went on, "he didn't verbalize a lot, but he was mad a lot, and I was tired of walking around on eggshells."

After the divorce, friends persuaded her to try the online dating service match.com, and just as her free trial week was about to expire, she noticed a new profile in the mix.

"Kristi was one of the first people to ping me," said Mike Burns, an engineer for an e-commerce company. "This was at 3 in the morning."

They started chatting. Mike told Kristi how he'd married his first wife while he was still in college — "definitely too young," he said — and divorced her two years later. He met his second wife through mutual friends, they had a big church wedding, started a software publishing company together, sold it and had two children, Brianna and Alec.

When the marriage started going downhill, Mike ignored signs of trouble, like the comments from neighbors who noticed his wife was never around on weekends.

"I was delusional, I was depressed," he said. "I still had the attitude that divorce wasn't something you did."

After 15 years of marriage, his wife did it for him, and kicked him out of the house. His divorce papers hadn't yet been finalized, he told Kristi that first chat night. I'll help you get through it, she replied.

Mike and Kristi admit their own three-year-old marriage isn't perfect. The kids are still adjusting to one another. Sometimes Kristi, a homemaker, feels jealous of how much attention her husband showers on his daughter Brianna, 13. Sometimes Mike retreats into his computer. Yet they are determined to stay together.

"I know everyone thinks this marriage is a joke and people expect it to fail," said Kristi . "But that just makes me work harder at it."

"I'd say our chances of success are better than average," her husband added.

In America, family is at once about home and the next great frontier.

The Baby Boom for Gay Parents

A growing number of same-sex couples are pursuing parenthood any way they can.

LOS ANGELES — The Schulte-Wayser family is like the Jetsons: a blend of midcentury traditional and postmodern cool.

One parent is the breadwinner, a corporate lawyer who is Type A when it comes to schoolwork, bedtime and the importance of rules. The other parent is the self-described "baby whisperer," staying home to care for the couple's two daughters and four sons, who dash through their days as if wearing jetpacks.

Both parents know when rules and roles are made for subverting. "We are each of us very maternal in our own way," said Joshua Wayser, 50, the lawyer. "I take my girls shopping, and I'm in charge of beauty and hair care." Mr. Wayser glanced at Richard Schulte, 61, his homemaker-artist husband, who was sitting nearby.

"Of course," Mr. Wayser added dryly, "he doesn't think I do a good job."

Mr. Wayser, Mr. Schulte and their six adopted children are part of one of the more emphatic reinventions of the standard family flow chart. A growing number of gay men and lesbians are pursuing parenthood any way they can: adoption, surrogacy, donor sperm.

"There's a gayby boom, that's for sure," Mr. Wayser said. "So many of our friends are having kids."

Some critics have expressed concern that the children of gay parents may suffer from social stigma and the lack of conventional adult role models, or that same-sex couples are not suited to the monotonous rigors of family life. Earlier studies, often invoked in the culture wars over same-sex marriage, suggested that children who lived with gay parents were prone to lower grades, conduct disorders and a heightened risk of drug and alcohol problems.

But new research suggests that such fears are misplaced. Through a preliminary analysis of census data and other sources, Michael J. Rosenfeld of Stanford University has found that whatever problems their children may display are more likely to stem from other factors, like the rupture of the heterosexual marriage that produced the children in the first place.

Once these factors are taken into account, said Dr. Rosenfeld, author of "The Age of Independence: Interracial Unions, Same-sex Unions, and the Changing American Family," the children of same-sex parents are academically and emotionally indistinguishable from those of heterosexual parents.

And two-father couples, in defiance of stereotype, turn out to be exemplars of domesticity. In her long-term studies of unconventional families, Judith Stacey, a professor of social and cultural analysis at New York University, found that the most stable of all were those headed by gay men who'd had their children together.

Over 14 years, she said, "I was shocked to find that none of the male couples with children had broken up, not one." Dr. Stacey, author of "Unhitched: Love, Marriage and Family Values From West Hollywood to Western China," attributed that success to self-selection. "For men to become parents without women is very difficult," she said. "Only a small percentage are willing and able to make the commitment."

There's no maybe about the gayby boom. According to the Williams Institute at the University of California, Los Angeles, the number of gay couples with children has doubled in the past decade, and today well over 100,000 same-sex couples are raising children. Other estimates put the number of children living with gay parents — couples and singletons combined — at close to two million, or one out of 37 children under age 18.

Driving the rise in same-sex parenthood is the resonant success of the marriage equality movement, which has led to the legalization of same-sex marriage in 16 states and has helped ease adoption policies elsewhere. In 2009, 19 percent of same-sex couples raising children reported having an adopted child, up from just 10 percent in 2000. Gay parents are four times as likely as straight ones to be raising adoptees, and six times as likely to be caring for foster children, whom they often end up adopting.

Some crave the fetters of DNA, and here women have an advantage. Many of the children of lesbian couples are the biological offspring of one of the women and a semen donor — who may be anonymous, a friend, the brother of the nongestating woman, or Mark Ruffalo.

The Schulte-Wayser family started out unhyphenated, as the Waysers. The two men had broken up; Mr. Wayser was living alone in Los Angeles, his law career was in flux, and he was tired of obsessing about work. "I thought, 'I've got to do something else,' " he said. "I had to come out to myself as a father."

His mother was thrilled, and she offered to pay the costs for a surrogate mother to carry a baby conceived with his sperm. Mr. Wayser said no.

"I wanted the clarity of having someone who didn't share my genetics, who was completely different from me," he said.

He met with an adoption lawyer in March 2000, and by June he had a newborn daughter, Julie. Several months later, Mr. Schulte called to chat, heard Julie in the background and stopped by to meet her.

The baby reminded him of Don King, the boxing promoter. "It was love at first sight," Mr. Schulte said, and Mr. Wayser acknowledged, "I used Julie as bait."

His old boyfriend took it. "We were a couple again," Mr. Schulte said. Or rather, he amended, "we were a family." He and Mr. Wayser later married in Malibu.

From 2002 to 2009, four brothers and a sister followed — Derek, A J, Isaac (all from one mother), Shayna and Joey. "That's my line in the sand," Mr. Wayser said. "We've run out of room."

Yet he believes it's easier to manage a large family than a small one. "They entertain each other. They organize themselves," he said. "We send the kids out. We say, 'Go ride your bike, go out and play.' We want them to have a very traditional childhood in a nontraditional setting."

He admits to being a worrier. Some of the children have learning disabilities and require extensive tutoring, and he doesn't know what risks the birth mothers might have taken during pregnancy.

But he resents people who note the color of his children's skin as well as his obvious financial resources, and cluck about how noble he is and how lucky the children are.

"No, I'm the one who's lucky here," he said. "I'm not trying to save the world."

The Wedding Will Have to Wait

The idea of marriage can be intimidating, so some couples choose cohabitation instead.

Ana Perez, 35, who moved to New York from the Dominican Republic at age 5, has an open smile, a firm handshake and a vivid, scrappy manner just this side of a fireplug. But as she recalled the night she threw the father of her two older children out of her Harlem apartment, her voice cracked into a dozen pieces and her eyes blurred with tears.

She might have accepted his infidelities if he'd kept them discreet, cheap and away from the neighborhood. "I had this mentality that men will be men." she said.

But when he began lavishly dating the younger sister of a friend of hers, Ms. Perez confronted him in a fury.

"I said, 'You've been spending money on this person when you have children who need diapers and milk?' " she said. "The last straw was, we had this huge fight in the kitchen and I pulled a knife on him. For a second, I saw my children without a mother — because I would be in jail."

Their relationship ended that night a decade ago, she said, "and I never looked back."

He still visits with George, 16, and Bryana, 10, "as a friend figure," Ms. Perez said, but he has no say in their upbringing.

For the past six years, Ms. Perez has lived with Julian Hill, 39, the father of her third child, Bubba, 4. Mr. Hill is tall and African-American, his head shaved, his cream-colored suit impeccably paired with a blue-checked banker's shirt and yellow tie. He is devoted to all three children and involved in their everyday lives.

"I come home every night," he said. "They might be asleep when I get home, but I'm here every night. I'm always pushing them hard to do their very best, maybe sometimes a little too hard."

Until this fall, Ms. Perez worked for a financial services firm, and she has been the family's primary earner. Mr. Hill, equally ambitious, has worked as a notary public, mortgage closer and occasional stock investor. He and Ms. Perez recently started a small notary-mortgage business.

"I think like Warren Buffett," Mr. Hill said. "My plan is to be a billionaire, but if I fall short and end up a millionaire, that would be fine."

Yet he admits that for now even that downsized goal remains elusive. "If you're talking about income," he said, "we're lower, lower middle class."

If you're talking about their relationship status, he and Ms. Perez have been engaged for more than a year, and they plan to go more than another year before getting married.

Of the many changes to the design, packaging and content of family life over the past generation, researchers cite two as especially significant.

One is the sharp increase in out-of-wedlock births among all but the most highly educated women. The second is the repositioning of marriage from cornerstone to capstone, from a foundational act of early adulthood to a crowning event of later adulthood — an event that follows such previous achievements as finishing college, starting a career and owning furniture not made from fruit crates.

The two trends are interrelated, researchers say, but for reasons that are often misunderstood. Unmarried parents are not necessarily the careless and shortsighted hedonists of stereotype. Instead, a growing number of Americans are simply intimidated by the whole idea of marriage: It has assumed ever greater cultural status, becoming the mark of established winners rather than of modestly optimistic beginners (while weddings have become extravagant pageants where doves and butterflies are released but still, nobody gets the bridesmaid dresses right).

Childbearing, on the other hand, happens naturally, and offers what marriage all too often does not: lifelong bonds of love.

"For many cohabiting couples, there's a high bar for marriage, high expectations of where they should be at economically or emotionally, and if they don't meet that bar they'll put off getting married," said Kelly Musick, an associate professor of policy analysis and management at Cornell University, who has studied cohabitation patterns.

"But if they're reasonably pleased with the relationship and happen to find themselves pregnant," she continued, "they may realize they're not in a great place financially to become parents but they're still happy to have the child." They find "a sense of purpose and fulfillment in parenthood" even when the rest of life is withholding the goods.

Kathryn Edin, a professor of public policy and management at Harvard University, has interviewed hundreds of low-income Americans. In her latest book, "Doing the Best I Can: Fatherhood in the Inner City," which she wrote with her colleague Timothy J. Nelson, Dr. Edin describes the enormous instability of family life among the working class and the poor.

"In the middle class, the divorce rate has gone down, and family life is in many ways simpler than it used to be," she said in an interview. "There's far more complexity and churning of households among the poor, a turnover of partnerships, lots of half-siblings."

Yet Dr. Edin also punctures the myth of the low-income father as a deadbeat who deposits his sperm and runs. Instead, the young men in her study were eager to establish their paternity.

"They're showing up at the hospital and signing birth certificates in droves," she said. "They're doing all this voluntarily, even though they know that by having their name on the certificate they'll be liable for child support and could go to jail if they don't pay."

The fathers also proved to be more involved in their children's lives than previously believed. "Even five years in, about two-thirds of fathers are seeing their kids at least monthly, and just under half are seeing their kids several times a week," Dr. Edin said.

Most of Ms. Perez's previous co-workers were younger than she was and came from middle-class backgrounds, and she acknowledges that their timing of life events has its benefits.

"You go to college, you build your finances, you marry, you build more finances, then you have children," she said. "If you wait longer, you have the foundation, you're more educated, and you have the confidence in yourself that you're able to survive."

Then again, she laughed, "in Spanish culture, we do everything early."

She is convinced that having her first child at 19 was the right thing to do. Without that incentive, "I would have had such a different life," she said. "I would have been much less productive. I would have spent all my time just hanging out."

But between the spur of her family's needs and a work ethic she describes as "awesome," Ms. Perez rose to a vice presidency at her previous company, "and I didn't even graduate high school," she said.

Nevertheless, she frets incessantly about the future. She'd like to go back to school and set something aside for her children's college educations; she won't buy cereal that's not on sale; and the last thing she wants to spend money on right now is a wedding.

"I'm O.K. just going to City Hall," she said.

Mr. Hill won't hear of it. "I can't do that, I can't just go downtown," he said. "I want to do something big, a wedding with friends and family standing together."

So he'll wait until he's saved enough to pay for the wedding of his dreams, when he can celebrate the family he loves and know it has arrived.

To Atlanta, by Way of Sri Lanka

The Indrakrishnans are part of a new tide of immigration with traditionally strong family ties.

ATLANTA — When people first meet Dr. Indran Indrakrishnan, a gastroenterologist with a busy private practice near Atlanta, they take note of his unusual name, his crisply lilting accent, his tan complexion and wavy black hair, and they ask, "So, doctor, where are you from?"

"See if you can guess," Dr. Indrakrishnan replies cheerfully. India? No. Pakistan? No. Iran, Egypt, Turkey, Afghanistan? Negatives all around.

"At that point they're stumped, and they move on to South America," he said, "and when I finally tell them I was born in Sri Lanka, they look more confused than ever. 'Sri Lanka? Where is that?' "

Such casual geographic illiteracy may soon give way under the sheer force of numbers. Dr. Indrakrishnan is part of a new tide of immigration that has been sweeping America, upending old voting blocs, reconfiguring neighborhoods, diversifying local restaurant options and casting a fresh perspective on the meaning of traditional family values.

Though much of the immigration debate has focused on Latinos, the fastest-growing immigrant groups are not Hispanic but Asian. The Asian-American population soared by 46 percent from 2000 to 2010, compared with 43 percent for Hispanics and 1 percent for non-Hispanic whites, and the Asian share of new immigrants nearly doubled, to 36 percent from 19 percent.

The 1950s stereotype of the ideal American family, of Dick, Jane and Wonder Bread homogeneity, arose at a time when the immigration rate was near historic lows. Today, the best place to find a traditional, G-rated American family may be in an immigrant community. Asian-American families, in particular, are exceptionally stable. They are half as likely to be divorced as Americans in general; only 16 percent of Asian-American infants are born out of wedlock, compared with 41 percent over all; and 80 percent of Asian-American children are raised by two married parents, versus 63 percent over all, according to Pew Research data.

Many of the new Asian immigrants come from solidly middle-class backgrounds, and many, though by no means all, do as well or better after moving to the United States. Fifty-one percent hold college degrees, compared with 31 percent of all adults. According to recent studies, Asian-Americans have the highest average household income of any racial group, roughly $68,000 a year, compared with $55,000 for whites and $34,000 for African-Americans.

At the front edge of the Asian-American boom are immigrants from South Asia, including India, Pakistan and Sri Lanka.

Dr. Indrakrishnan, 53, who also teaches at the Emory University School of Medicine, is something of a celebrity among South Asian immigrants — the sociable, civic-minded and highly successful professional everyone wants to schmooze with at the local Hindu temple each week.

"Sometimes I have to go to temple during off hours," he said, "or I'll get caught up chatting there the entire day."

He lives with his wife, Gayathri, 49, a tax accountant, and their daughter, Harini, a high school senior, in a gated enclave on the banks of a glistening artificial lake, not far from the former residence of the football quarterback Michael Vick. The house feels like a castle, only bigger — 15,000 square feet of vaulted, chandeliered ceilings, an enormous alabaster fireplace, matching ornate staircases that curve together like an upside-down heart, and an elevator if you're too tired for the stairs.

Personal statements can be found throughout: in one corner, an elegant bronze sculpture of the Hindu deity Shiva; in another, a bulbous-bodied stringed instrument called a Saraswati vina that Gayathri Indrakrishnan wishes she had more time to play; and in the basement, a custom-built studio where Harini practices Bharatanatyam, a highly structured, almost geometric form of classical Indian dance that has become a defining feature of her otherwise all-American life.

"Dance keeps me connected to my culture," she said. "I've got the best of both worlds."

Her parents grew up in the same part of Sri Lanka and had friends, a family doctor and a cleaning woman in common. But the two didn't really meet until they were young adults living in North America — he finishing his medical training, she pursuing microbiology — and their older brothers decided to play matchmakers.

He flew to Toronto for a rendezvous. If it wasn't exactly love at first sight, she said, "the chemistry was there." The couple spent a year exchanging phone calls and letters and were married in 1991.

"We had what's called a semi-arranged marriage," Dr. Indrakrishnan said. "It's quite common back in India and Sri Lanka." Families are involved, but they don't push; "we had to like each other and get along."

After they married and settled in the United States, Ms. Indrakrishnan traded microbiology for an M.B.A. and a numbers-crunching career. She and her husband became American citizens a decade ago.

"I love living here!" he said. "It is truly the land of opportunities." Yet he said he would not have wanted to marry an American woman, and when asked the first word that came to mind on hearing the word "family," he said, "Gayathri, my wife."

The Census Bureau does not track the frequency of arranged marriages, but researchers believe the numbers are rising. Among other signs, they said, is the growing number of immigrant matchmaking websites like bharatmatrimony.com, aimed not just at eager singletons but at their parents and relatives.

And though many Americans may bridle at the idea, studies suggest there is little downside to letting the family do your advance work. Kathryn Klement, a doctoral candidate in psychology at Northern Illinois University, surveyed 329 married Indian women, 176 of them in arranged marriages, and said, "I didn't find any significant differences" between the two groups in marital happiness, feelings of intimacy, trust and commitment, sexual satisfaction and the ease with which the women could express their desires.

Indran and Gayathri Indrakrishnan independently identified the same key to long-lasting marital harmony. "It's tolerance," she said. Many of Dr. Indrakrishnan's American patients "are not very tolerant of their spouses," he said. "They want the chemistry to be perfect, and if it isn't, pfft, they split up."

Tolerance extends to their parenting style. Their expectations for Harini are quite high, but they care less whether she aces every class than that she is always trying, always seeking to improve.

"If there is homework due or a test the next day and she's goofing off and not listening to me, yes, I'll be upset," her mother said. Harini, it seems, has absorbed the parental credo. When she sensed that Facebook was interfering with her schoolwork, she deactivated her account.

Also poised for deactivation is a certain cliché symbolized by fangs and stripes.

It is no secret that many Asian-American students excel academically; their average SAT scores, for example, are the highest of any ethnic group.

One theory to gain traction lately is that Asian-American parents are harsh taskmasters who virtually chain their children to their desks and pianos, a view reinforced by Amy Chua in her best-selling book "Battle Hymn of the Tiger Mother."

But a long-term study of 300 Chinese-American families suggests that view is nothing but a stereotype. The researchers, led by Su Yeong Kim, an associate professor of human development and family sciences at the University of Texas at Austin, administered lengthy questionnaires to parents and children, asking about school, work, home life, grades, extracurricular activities and emotions. The researchers determined that the parents most likely to raise high-achieving offspring were not cold authoritarians but ones who combined "the right amount of parental control" with a "high level of warmth," Dr. Kim said.

"Supportive parenting always yields the best outcome academically and socio-emotionally, too," she added. "These kids outperform the kids of tiger parents by quite a lot."

She and her colleagues proposed other factors that might help explain the good report cards: family pride; cultural traditions that extol education, like Confucianism; and children's acute awareness of parental sacrifice.

"They gave up everything for their kids," as Dr. Kim characterized this attitude, "so I'd better not blow it." And when they succeed, they bring honor to ancestors, descendants, the entire high-fiving clan.

For Career Jugglers, Life Goes by Fast

With two children, the Glusacs may seem typical, but their story is more complicated.

LOS ANGELES — Jan Glusac, 51, is blond and heigh-ho friendly, a first-grade teacher with a first-rate tolerance for contradictory ideas. A few years ago, she and her family participated in a landmark study by researchers from the University of California, Los Angeles — a close anthropological look at the daily lives of 32 typical middle-class American families.

Does she feel that her family is, in fact, typical?

"I do and I don't," Ms. Glusac says.

She wears a long white skirt, black blouse, jeans jacket and a silver necklace, and is sitting on a plump aubergine couch in a comfortable, recently renovated postwar bungalow in Westchester, a solidly middle-class neighborhood not far from the Los Angeles airport.

On the typical side of the ledger: The average middle-class family has two children, and seated next to Ms. Glusac are her two children, Katie and Chris.

Katie, 17, is a high school senior, a star of her cross-country and soccer teams, an intern at a local veterinary clinic and these days a captive player in that all-American combat sport called applying to college. Chris, 21, is a Santa Monica College engineering student who still lives at home but plans to transfer next year to the University of California, Santa Barbara.

"We may soon be empty nesters," Ms. Glusac says. "That's one phase of life we're not ready for."

But at least they'll still have Ollie, she says — "the best dog ever!" Katie chimes in — and dogs, it so happens, are the most popular pet in America, preferred over cats by more than two to one.

Around 6 p.m., Srdan Glusac, 50, arrives home from his job as an avionics engineer at Federal Express. Mr. Glusac, who goes by the nickname Serg (pronounced surge), was born in Sarajevo, Bosnia, but grew up in Montreal. He looks like the original from which Chris was cloned: the same mild face, the same fine, sandy hair.

Mr. Glusac generally gets home an hour or two after his wife, a scheduling disparity common among two-career households: American men spend 35 to 55 minutes longer on the job each day than women do, while working mothers devote eight more hours a week to child care and housekeeping compared with working fathers.

Less typical is Mr. Glusac's Bosnian mother, Ilinka Volk, who lives nearby and has long acted as the fantasy super-grandma, obviating the need for day care, chauffeuring the kids to soccer games and serving up Old World comfort food like stuffed cabbage, goulash and a revelatory Bosnian custard called snow clouds.

Jan Glusac points out that her family is better off than most, with a household income nearly four times the national median of about $51,000. For example, Chris recently bought a black BMW convertible, which meant Katie got his Prius.

"And now we're a four-car family," Chris says sheepishly. "That sounds pretty bad, doesn't it?" The average number of cars per American family is 2.28.

The family has had its share of frame shifts and body blows. Ms. Glusac was treated for breast cancer eight years ago. In middle school, Chris became extremely introverted and barely left his room. "I feel like I'm a key in the wrong lock," he confessed in a note to his parents.

"That made me start crying," Ms. Glusac says. "I knew exactly what he meant."

As a ninth grader, Katie was arrested after shoplifting more than $100 worth of clothing from a department store. Her parents were devastated. She was grounded for the summer and had to perform community service, help pay her legal fees by handing over most of the money she'd saved since elementary school, and endure the humiliation of hearing her mother tell other parents that if they didn't want their children associating with Katie, she'd understand.

"That was the hardest part, the strain on my relationship with my parents," Katie says. "But what came out of it was a stronger relationship than before" — and lucky for her, no permanent record.

In the U.C.L.A. study, a team of researchers associated with the Center on Everyday Lives of Families focused on dual-income families with two or more school-age children at home in the Los Angeles area. The investigators spent weeks with each family, staying in the background as they observed and recorded every aspect of home life: the banter, the spats, the struggles over homework and piano practice, the laundry, the meals.

As recounted in the books "Fast-Forward Family" and "Life at Home in the 21st Century," the scientists learned that American families are just this side of clinically compulsive hoarders, owning "more material goods per household than any society in history," in the words of one investigator, Jeanne E. Arnold, a professor of anthropology.

The researchers also particularized the centrality of the kitchen, where the largest and most visible clocks are displayed and where the greatest number of calendars, school memos and to-do lists are posted.

Yet the lure of a festively pushpinned corkboard has its limits. The researchers determined that even when all of the family members were at home and awake together, they were in the same room only 14 percent of the time.

The researchers have since done comparative studies of families in Italy, Sweden, Samoa and the Peruvian Amazon, and have concluded that American families are outliers in their fixation on children's needs and children's success.

"In other societies, school-aged children are expected to be vigilant and see what needs to be done around the house, and they routinely do chores without being asked," said Elinor Ochs, a director of the study. "But here, in middle-class mainstream households, you can't ask kids to do anything. It's incredible."

Instead, given today's single-digit admission rates at the nation's elite universities, middle-class American parents want their children to focus almost exclusively on homework and extracurricular activities. In a study of the after-school life of students in the Philadelphia area, Annette Lareau of the University of Pennsylvania and her colleagues found that virtually all the middle-class children remained as tightly scripted outside the classroom as they had been during the school day.

At one suburban school, she said, "I went through the schedules of 100 fourth graders and couldn't find a single child who did not have any organized activities." The researchers also determined that the time children spent in such activities rose in tandem with the mother's education: 4 hours 54 minutes per week for the children of mothers with some college, 5 hours 37 minutes for the offspring of college graduates, and 6 hours 33 minutes for the children of mothers with graduate degrees.

"I remember feeling like that was all I ever did — I was always in the car driving someone someplace," Jan Glusac says of her family's two-car days. "I don't think I could keep that schedule up at this point in my life," she adds. Nowadays, the kids largely take care of themselves, Ms. Glusac says, and they're either out of the house or working in their rooms. "We love being together as a family," she says, even if that means little more than sharing the same roof.

Wanting Marriage and Pursuit of Happiness

The clues to an American paradox, and family changes, can be found in the past.

The American family began life in the raggedness of the Colonial era as a kind of organizational Swiss Army knife — many institutions in one convenient package.

The home was a place of business, of relentless industry, where there was always more flax to spin and tallow to drip; all able-bodied family members from toddlerhood onward were expected to work for the family economy. (In fact, the word "family" comes from the Latin for servant.)

The home was a delivery ward, schoolroom, hospital and funeral parlor. And in an age before centralized government or even a reliable town sheriff, the home served as the primary locus of social control. Everyone had to reside in the all-encompassing embrace of a bustling household, and adults who tried to live alone, particularly single men, were viewed with suspicion, advised to marry, find room and board with a "decent" family or get out of town.

As recently as the 1950s, according to Andrew J. Cherlin, a professor of public policy at Johns Hopkins University, unattached adults could arouse community ire. "If you didn't get married by a certain point, there had to be something wrong with you," he said. "People suspected you were mentally ill."

Yet as a young nation of wide horizons and Powerball opportunities, America also encouraged a degree of footlooseness, a scorn for the settled and a yen for the new. That novelty-seeking spirit applied as much to conjugal matters as economic ones, and the divorce rate rose steadily along with the number of stars on the flag. By the turn of the 20th century, the United States had the highest divorce rate in the Western world, a title it retains to this day.

It's the great American paradox. We value marriage as "the center of civilized society," Dr. Cherlin said. At the same time, we value our liberty, the pursuit of personal happiness and the right to leave a bad marriage behind.

Other factors helped give the American family its distinctive cast. As the population shifted westward and the distances between dwellings opened, Americans grew accustomed to a degree of privacy and personal space that few other earthlings could share.

The passion for privacy accelerated as the Industrial Revolution pulled productive activity out of the house and into the factory, leaving the home as a private sanctum for the family. Americans went wild for the privatized family and family-themed activities: the family vacation, kiddie birthday parties, decorating the Christmas tree, and the ultimate American family holiday, Thanksgiving, signed into law by the man who saved the Union, Abraham Lincoln.

And "over the river and through the woods" notwithstanding, that family mostly meant nuclear, with ties to older or second-order relatives increasingly frayed.

Industrialization and the entry of women into the work force changed the nature of marriage as well, from the pragmatic merging of skill sets that prevailed in the agricultural era to a relationship of choice based on friendship, personal compatibility and love.

"Marriage as an institution lost much of its power over our lives, but marriage as a relationship became more powerful than ever," said the social historian Stephanie Coontz.

The trend has only intensified with time. "The less we need marriage," she said, "the more we expect from it."

Bonding From Behind Bars

The children of more than a million inmates are left to cope as best they can.

One variant of the modern American family — sadly characteristic, if often ignored — is the family struggling with the impact of an incarcerated parent. Largely as a result of harsh drug laws and mandatory minimum sentences, the nation's prison population has almost quadrupled over the past 30 years, according to a 2010 Pew Charitable Trusts study.

Today the United States is the world's leading jailer by far, housing more of its citizens behind bars than the top 35 European countries combined. And of the estimated 2.3 million inmates serving time, more than half are parents of children under age 18. That translates into 2.7 million affected children nationwide, or one of every 28, up from one in 125 in 1990.

Some groups have been hit much harder than others. "African-American children living in lower-income, low-education neighborhoods are seven and a half times more likely than white kids to experience the incarceration of a parent," said Julie Poehlmann, professor of human development and family studies at the University of Wisconsin. "And by age 14, more than half of these kids with a low-education parent will have an imprisoned parent."

Families are left to cope as best they can, not only with the deafening absence, the economic hardship, the grief and loneliness that separation from a loved one can bring, but also with the stigma that accompanies a criminal conviction, the feelings of humiliation, debasement and failure.

It's one thing if your father is taken away by disease or divorce; it's another if he's taken away in handcuffs. Studies have shown that even accounting for factors like poverty, the children of incarcerated parents are at heightened risk of serious behavioral problems, of doing poorly in school or dropping out, of substance misuse, of getting in trouble with the law and starting the cycle anew.

In a telling sign, "Sesame Street" recently introduced a Muppet named Alex, who looks as glum as Eeyore and is ashamed to admit why only his mother shows up at school events: Dad is in prison. The show offers an online tool kit for children and their caregivers, "Little Children, Big Challenges: Incarceration," with a coloring book, cutout mobile and "how am I feeling?" cards (angry, upset, sad).

"We know a lot of kids who need help understanding what is happening with their parents, and caregivers who need to know how to talk about it," said Dr. Poehlmann, who helped develop the tool kit.

Nearly half the caregivers never talk about the imprisoned parent, while another third simply lie, Dr. Poehlmann said. "They don't have the words, they don't know what the kids will understand," she said. "But kids have big ears, and if no one talks about it directly, the kids will feel they should keep it secret."

Caregivers are also often hesitant to take children to visit incarcerated parents, either out of fear the visit will be traumatic, or because the prison is usually in a remote rural area hours from public transportation.

Whatever the reason, a vast majority of prisoners get no visits, from their children or anybody else, Dr. Poehlmann said, "and they feel very sad about that."

During several recent visits to a men's low-security federal prison in rural New Jersey, the joy, pain and unsettling ordinariness of family time, penitentiary style, were on fluorescent-lit display.

Women brought babies, children, teenagers and bags of quarters for the vending machines. Fathers wearing prison khakis and work boots were required to stay seated in their molded plastic chairs, but as family members filed in, the men's Humpty Dumpty grins threatened to split their faces.

Older children settled into seats beside their fathers, while younger ones played at kiddie tables in the corner. Everybody ate chips, microwaved sandwiches, bags of M&Ms. The prison photographer snapped family portraits in front of fake backdrops of palm trees and sunsets.

One day at the end of visiting hours, as family members lined up to await escorted passage through multiple locked doors, a 10-year-old boy in a striped polo shirt stood next to his mother, crying and crying. She pulled him close, but the boy didn't stop. He was weeping his quiet ocean of loss and would give no thought to the shore.

In interviews, conducted in person and through an intermediary, the prisoners, too, teared up when they talked about their children, and the great difficulty they had maintaining bonds through sentences long enough to turn those children into adults.

All are nonviolent offenders, as are about two-thirds of prisoners over all. They spoke on condition that only their first names be used.

Sing, a tall, slim man in his early 40s, has been in prison for 15 years on drug charges, with two years to go. His son and daughter are now 17 and 23, but he has been "adamant" about staying involved in their lives — through letters, phone calls and emails.

"They are doing very well," he said. "They have no criminal problems."

Yet because they live in Florida, 1,000 miles away, Sing hasn't seen them in five years. He and other inmates expressed frustration at how often the Bureau of Prisons flouted its official policy of trying to house inmates in facilities within 500 miles of their families. The authorities are supposed to do as much as possible to keep families together, Sing said bitterly, "but they do more to keep families apart."

Other inmates said that no matter where it was, prison had a way of corroding emotional ties to the outside world. Jon, who is 55 and three years into a five-year sentence, scoffed when he first arrived and a seasoned inmate told him he'd soon stop caring about the everyday concerns of the people he left behind, including those of his only child, a teenage girl.

The veteran, Jon sighed, was right. "I have to make a special effort now to stay emotionally connected with my daughter and to keep up with her daily experiences," he said. "It's hard for me to do. She'll start talking about her friends and I'll have no idea who they are."

Perseverance helps. "My top priority is to stay relevant in my kids' lives," said Rob, an athletic 46-year-old who has been in prison four years and has three teenage daughters. "I put them first as much as I can."

He calls each girl once a week and prepares conversation notes ahead of time. He sends gifts he's drawn or crocheted. They have a family book club. His daughters seem to be doing well: One is at Bryn Mawr College, and another is at Tabor Academy, a highly competitive prep school. But with nine years of hard time yet to go, who knows if all the threads will hold?

Simply Deciding to Be Related

Circumstances can lead to friendships becoming something more.

The night Beki Reese's 22-year-old son, Caleb, went into a coma, three months before he would die of lung cancer, she asked his best friend, "Matt, are we going to lose you too, when this is all over?"

After meeting at a heavy metal concert in 2001, Matthew Tanksley, now 33, became the big brother Caleb never had. When Caleb got sick, Matt visited him in the hospital almost daily, and briefly took on the role of nurse during a memorable trip to Cabo San Lucas, Mexico. But he was also there for Ms. Reese, of Costa Mesa, Calif., who says she depended on him for emotional support as her son's illness progressed.

"Through that ordeal, that nine-month period, I became like a full-fledged member of the family," Mr. Tanksley said. "We were having family dinners together, we were going out to eat, we were talking to each other every day on the phone. Hard times build bonds, and that definitely happened."

Mr. Tanksley's own mother had died when he was 13, so he welcomed the Reese clan's embrace. Seven years later, he and Caleb's mother remain close: She calls him her son, and he introduces her as "Mom."

Relationships like these — independent of biology but closer and more enduring than friendship — have been documented in various cultures throughout history. In the United States, they are particularly common within African-American and immigrant communities, as well as gay and lesbian social networks. Anthropologists have traditionally used the term "fictive kin" to separate such relationships from "true" kinship based on blood or law, but many researchers have recently pushed back against that distinction, arguing that self-constructed families are no less real or meaningful than conventional ones.

"They see these folks as family, and so I'm going to honor that," said Dawn O. Braithwaite, head of communication studies at the University of Nebraska. "We want to think about it more as a continuum from friendship to family, and I don't know when the bell rings. But definitely, for these people, nobody had a doubt that it was a family to them."

Dr. Braithwaite and her colleagues have termed such families "voluntary kin." For a study published in 2010, they interviewed 110 people in such relationships; they found that for some people, voluntary kinship filled a void left by death or estrangement from biological family, while for others the relationships were supplemental or temporary.

One thing that distinguishes these relationships from friendship, Dr. Braithwaite said, is that they often become central to one's identity. And many serve important life functions: They may provide a sense of belonging, as well as financial and emotional relief.

Mr. Tanksley's own family expanded three years ago, when he married Caleb Reese's former girlfriend, Shannon. Their two children call Ms. Reese "Nana." — Roni Jacobson

 


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