October 28, 2009
Push to Legalize Marijuana Gains Ground in California
By JESSE McKINLEY
SAN FRANCISCO — These are heady times for advocates of legalized marijuana in California — and only in small part because of the newly relaxed approach of the federal government toward medical marijuana.
State lawmakers are holding a hearing on Wednesday on the effects of a bill that would legalize, tax and regulate the drug — in what would be the first such law in the United States. Tax officials estimate the legislation could bring the struggling state about $1.4 billion a year, and though the bill’s fate in the Legislature is uncertain, Gov. Arnold Schwarzenegger, a Republican, has indicated he would be open to a “robust debate” on the issue.
California voters are also taking up legalization. Three separate initiatives are being circulated for signatures to appear on the ballot next year, all of which would permit adults to possess marijuana for personal use and allow local governments to tax it. Even opponents of legalization suggest that an initiative is likely to qualify for a statewide vote.
“All of us in the movement have had the feeling that we’ve been running into the wind for years,” said James P. Gray, a retired judge in Orange County who has been outspoken in support of legalization. “Now we sense we are running with the wind.”
Proponents of the leading ballot initiative have collected nearly 300,000 signatures since late September, supporters say, easily on pace to qualify for the November 2010 general election. Richard Lee, a longtime marijuana activist who is behind the measure, says he has raised nearly $1 million to hire professionals to assist volunteers in gathering the signatures.
“Voters are ripping the petitions out of our hands,” Mr. Lee said.
That said, the bids to legalize marijuana are opposed by law enforcement groups across the state and, if successful, would undoubtedly set up a legal showdown with the federal government, which classifies marijuana as an illegal drug.
California was the first state to legalize marijuana for medical purposes, in 1996, but court after court — including the United States Supreme Court — has ruled that the federal government can continue to enforce its ban. Only this month, with the Department of Justice announcement that it would not prosecute users and providers of medical marijuana who obey state law, has that threat subsided.
But federal authorities have also made it clear that their tolerance stops at recreational use. In a memorandum on Oct. 19 outlining the medical marijuana guidelines, Deputy Attorney General David W. Ogden said marijuana was “a dangerous drug, and the illegal distribution and sale of marijuana is a serious crime,” adding that “no state can authorize violations of federal law.”
Still, Mr. Lee anticipates spending up to $20 million on a campaign to win passage of his ballot measure in California, raising some of it from the hundreds of already legal medical marijuana dispensaries in Los Angeles, which have been recently fighting efforts by Los Angeles city officials to tighten restrictions on their operations.
“It’s a $2 billion industry,” Mr. Lee said of the medical marijuana sales.
Opponents said they are also preparing for a battle next year.
“I fully expect they will qualify,” said John Lovell, a Sacramento lobbyist for several groups of California law enforcement officials that oppose legalization.
Any vote would take place in a state where attitudes toward marijuana border on the schizophrenic. Last year, the state made some 78,500 arrests on felony and misdemeanors related to the drug, up from about 74,000 in 2007, according to the California attorney general.
Seizures of illegal marijuana plants, often grown by Mexican gangs on public lands in forests and parks, hit an all-time high in 2009, and last week, federal authorities announced a series of arrests in the state’s Central Valley, where homes have been converted into “indoor grows.”
At the same time, however, there are also pockets of California where marijuana can seem practically legal already. At least seven California cities have formally declared marijuana a low priority for law enforcement, with ballot measures or legislative actions. In Los Angeles, some 800 to 1,000 dispensaries of medical marijuana are in business, officials say, complete with consultants offering public relations services and “canna-business management.”
Assemblyman Tom Ammiano, a San Francisco Democrat and author of the legalization bill, said momentum for legalization has built in recent years, especially as the state’s finances have remained sour.
“A lot of people that were initially resistant or even ridiculed it have come aboard,” Mr. Ammiano said.
In Oakland, which passed a tax on medical cannabis sales in July, several people who signed a petition backing Mr. Lee’s initiative said they were motivated in part by the cost of imprisoning drug offenders and the toll of drug-related violence in Mexico.
“Personally I don’t see a way of getting it under control other than legalizing it and taxing it,” said Jim Quinn, 60, a production manager. “We’ve got to get it out of the hands of criminals both domestic and international.”
Mr. Lovell, the law enforcement lobbyist, however, said those arguments paled in comparison to the potential pitfalls of legalization, including people driving under the influence. He also questioned how much net revenue a tax like Mr. Ammiano is proposing would actually raise. “We get revenue from alcohol,” he said. “But there’s way more in social costs than we retain in revenues.”
The recent history of voter-approved drug reform laws in California is not encouraging for supporters of legalization. Last November, voters rejected a proposition that would have increased spending for drug treatment programs and loosened parole and prison requirements for drug offenders.
None of which seems to faze Mr. Lee, 47, a former roadie who founded Oaksterdam University, a medical marijuana trade school in Oakland, in 2007. Mr. Lee says he plans to use the Internet to raise money, as well as tapping out-of state sources for campaign money.
More than anything, however, Mr. Lee said he was banking on a basic shift in people’s attitudes toward the drug.
“For a lot of people,” he said, “it’s just another brand of beer.”
Wednesday, October 28, 2009
Tuesday, March 03, 2009
March 3, 2009
Basics
In a Helpless Baby, the Roots of Our Social Glue
By NATALIE ANGIER
In seeking bipartisan support for his economic policies, President Obama has tried every tip on the standard hospitality crib sheet: beer and football, milk and cookies, Earth, Wind and Fire.
Maybe the president needs to borrow a new crib sheet — the kind with a genuine baby wrapped inside.
A baby may look helpless. It can’t walk, talk, think symbolically or overhaul the nation’s banking system. Yet as social emulsifiers go, nothing can beat a happily babbling baby. A baby is born knowing how to work the crowd. A toothless smile here, a musical squeal there, and even hard-nosed cynics grow soft in the head and weak in the knees.
In the view of the primatologist Sarah Blaffer Hrdy, the extraordinary social skills of an infant are at the heart of what makes us human. Through its ability to solicit and secure the attentive care not just of its mother but of many others in its sensory purview, a baby promotes many of the behaviors and emotions that we prize in ourselves and that often distinguish us from other animals, including a willingness to share, to cooperate with strangers, to relax one’s guard, uncurl one’s lip and widen one’s pronoun circle beyond the stifling confines of me, myself and mine.
As Dr. Hrdy argues in her latest book, “Mothers and Others: The Evolutionary Origins of Mutual Understanding,” which will be published by Harvard University Press in April, human babies are so outrageously dependent on their elders for such a long time that humanity would never have made it without a break from the great ape model of child-rearing. Chimpanzee and gorilla mothers are capable of rearing their offspring pretty much through their own powers, but human mothers are not.
Human beings evolved as cooperative breeders, says Dr. Hrdy, a reproductive strategy in which mothers are assisted by as-if mothers, or “allomothers,” individuals of either sex who help care for and feed the young. Most biologists would concur that humans have evolved the need for shared child care, but Dr. Hrdy takes it a step further, arguing that our status as cooperative breeders, rather than our exceptionally complex brains, helps explain many aspects of our temperament. Our relative pacifism, for example, or the expectation that we can fly from New York to Los Angeles without fear of personal dismemberment. Chimpanzees are pretty smart, but were you to board an airplane filled with chimpanzees, you “would be lucky to disembark with all 10 fingers and toes still attached,” Dr. Hrdy writes.
Our capacity to cooperate in groups, to empathize with others and to wonder what others are thinking and feeling — all these traits, Dr. Hrdy argues, probably arose in response to the selective pressures of being in a cooperatively breeding social group, and the need to trust and rely on others and be deemed trustworthy and reliable in turn. Babies became adorable and keen to make connections with every passing adult gaze. Mothers became willing to play pass the baby. Dr. Hrdy points out that mother chimpanzees and gorillas jealously hold on to their infants for the first six months or more of life. Other females may express real interest in the newborn, but the mother does not let go: you never know when one of those females will turn infanticidal, or be unwilling or unable to defend the young ape against an infanticidal male.
By contrast, human mothers in virtually every culture studied allow others to hold their babies from birth onward, to a greater or lesser extent depending on tradition. Among the !Kung foragers of the Kalahari, babies are held by a father, grandmother, older sibling or some other allomother maybe 25 percent of the time. Among the Efe foragers of Central Africa, babies spend 60 percent of their daylight hours being toted around by somebody other than their mother. In 87 percent of foraging societies, mothers sometimes suckle each other’s children, another remarkable display of social trust.
Dr. Hrdy wrote her book in part to counter what she sees as the reigning dogma among evolutionary scholars that humans evolved their extreme sociality and cooperative behavior to better compete with other humans. “I’m not comfortable accepting this idea that the origins of hypersociality can be found in warfare, or that in-group amity arose in the interest of out-group enmity,” she said in a telephone interview. Sure, humans have been notably violent and militaristic for the last 12,000 or so years, she said, when hunter-gatherers started settling down and defending territories, and populations started getting seriously dense. But before then? There weren’t enough people around to wage wars. By the latest estimates, the average population size during the hundreds of thousands of years of human evolution that preceded the Neolithic Age may have been around 2,000 breeding adults. “What would humans have been fighting over?” Dr. Hrdy said. “They were too busy trying to keep themselves and their children alive.”
Dr. Hrdy also argues that our human ancestors became emotionally modern long before the human brain had reached its current average volume of 1,300 cubic centimeters, which is about three times the size of a chimpanzee brain — in other words, that we became the nicest apes before becoming the smartest. You don’t need a bulging brain to evolve cooperative breeding. Many species of birds breed cooperatively, as do lions, rats, meerkats, wolves and marmosets, among others. But to become a cooperatively breeding ape, and to persuade a bunch of smart, hot-tempered, suspicious, politically cunning primates to start sharing child care and provisionings, now that took a novel evolutionary development, the advent of this thing called trust.
To explain the rise of cooperative breeding among our forebears, Dr. Hrdy synthesizes an array of new research in anthropology, genetics, infant development, comparative biology. She notes that recent research has overturned the longstanding insistence that humans are a patrilocal species, that is, with women moving away from their birth families to join their husbands. Instead, it seems that young mothers in many traditional societies have their own mothers and other female relatives close at hand, and who better to trust with baby care than your mom or your aunt? New studies have also shown the importance of postmenopausal women to gathering roots and tubers, the sort of unsexy foods that are difficult to disinter and lack the succulent status of, say, a freshly killed oryx, but that just may help feed the kids in hard times. Other anthropologists have made the startling discovery that children have entertainment value, and that among traditional cultures without television or Internet access, a bobble-headed baby is the best show in town.
However cooperative breeding got started, its impact on human evolution was profound. With helpers in the nest, women could give birth to offspring with ever longer childhoods — the better to build big brains and stout immune systems — and, paradoxically, at ever shrinking intervals. The average time between births for a chimpanzee mother is about six years; for a human mother, it’s two or three years. As a result of our combined braininess and fecundity, humans have managed to colonize the planet; exploit, marginalize or exterminate all competing forms of life; build a vast military-industrial complex all under the auspices of Bernard Madoff and with one yeti of a carbon footprint, and will somebody please hand me that baby before it’s too late.
Basics
In a Helpless Baby, the Roots of Our Social Glue
By NATALIE ANGIER
In seeking bipartisan support for his economic policies, President Obama has tried every tip on the standard hospitality crib sheet: beer and football, milk and cookies, Earth, Wind and Fire.
Maybe the president needs to borrow a new crib sheet — the kind with a genuine baby wrapped inside.
A baby may look helpless. It can’t walk, talk, think symbolically or overhaul the nation’s banking system. Yet as social emulsifiers go, nothing can beat a happily babbling baby. A baby is born knowing how to work the crowd. A toothless smile here, a musical squeal there, and even hard-nosed cynics grow soft in the head and weak in the knees.
In the view of the primatologist Sarah Blaffer Hrdy, the extraordinary social skills of an infant are at the heart of what makes us human. Through its ability to solicit and secure the attentive care not just of its mother but of many others in its sensory purview, a baby promotes many of the behaviors and emotions that we prize in ourselves and that often distinguish us from other animals, including a willingness to share, to cooperate with strangers, to relax one’s guard, uncurl one’s lip and widen one’s pronoun circle beyond the stifling confines of me, myself and mine.
As Dr. Hrdy argues in her latest book, “Mothers and Others: The Evolutionary Origins of Mutual Understanding,” which will be published by Harvard University Press in April, human babies are so outrageously dependent on their elders for such a long time that humanity would never have made it without a break from the great ape model of child-rearing. Chimpanzee and gorilla mothers are capable of rearing their offspring pretty much through their own powers, but human mothers are not.
Human beings evolved as cooperative breeders, says Dr. Hrdy, a reproductive strategy in which mothers are assisted by as-if mothers, or “allomothers,” individuals of either sex who help care for and feed the young. Most biologists would concur that humans have evolved the need for shared child care, but Dr. Hrdy takes it a step further, arguing that our status as cooperative breeders, rather than our exceptionally complex brains, helps explain many aspects of our temperament. Our relative pacifism, for example, or the expectation that we can fly from New York to Los Angeles without fear of personal dismemberment. Chimpanzees are pretty smart, but were you to board an airplane filled with chimpanzees, you “would be lucky to disembark with all 10 fingers and toes still attached,” Dr. Hrdy writes.
Our capacity to cooperate in groups, to empathize with others and to wonder what others are thinking and feeling — all these traits, Dr. Hrdy argues, probably arose in response to the selective pressures of being in a cooperatively breeding social group, and the need to trust and rely on others and be deemed trustworthy and reliable in turn. Babies became adorable and keen to make connections with every passing adult gaze. Mothers became willing to play pass the baby. Dr. Hrdy points out that mother chimpanzees and gorillas jealously hold on to their infants for the first six months or more of life. Other females may express real interest in the newborn, but the mother does not let go: you never know when one of those females will turn infanticidal, or be unwilling or unable to defend the young ape against an infanticidal male.
By contrast, human mothers in virtually every culture studied allow others to hold their babies from birth onward, to a greater or lesser extent depending on tradition. Among the !Kung foragers of the Kalahari, babies are held by a father, grandmother, older sibling or some other allomother maybe 25 percent of the time. Among the Efe foragers of Central Africa, babies spend 60 percent of their daylight hours being toted around by somebody other than their mother. In 87 percent of foraging societies, mothers sometimes suckle each other’s children, another remarkable display of social trust.
Dr. Hrdy wrote her book in part to counter what she sees as the reigning dogma among evolutionary scholars that humans evolved their extreme sociality and cooperative behavior to better compete with other humans. “I’m not comfortable accepting this idea that the origins of hypersociality can be found in warfare, or that in-group amity arose in the interest of out-group enmity,” she said in a telephone interview. Sure, humans have been notably violent and militaristic for the last 12,000 or so years, she said, when hunter-gatherers started settling down and defending territories, and populations started getting seriously dense. But before then? There weren’t enough people around to wage wars. By the latest estimates, the average population size during the hundreds of thousands of years of human evolution that preceded the Neolithic Age may have been around 2,000 breeding adults. “What would humans have been fighting over?” Dr. Hrdy said. “They were too busy trying to keep themselves and their children alive.”
Dr. Hrdy also argues that our human ancestors became emotionally modern long before the human brain had reached its current average volume of 1,300 cubic centimeters, which is about three times the size of a chimpanzee brain — in other words, that we became the nicest apes before becoming the smartest. You don’t need a bulging brain to evolve cooperative breeding. Many species of birds breed cooperatively, as do lions, rats, meerkats, wolves and marmosets, among others. But to become a cooperatively breeding ape, and to persuade a bunch of smart, hot-tempered, suspicious, politically cunning primates to start sharing child care and provisionings, now that took a novel evolutionary development, the advent of this thing called trust.
To explain the rise of cooperative breeding among our forebears, Dr. Hrdy synthesizes an array of new research in anthropology, genetics, infant development, comparative biology. She notes that recent research has overturned the longstanding insistence that humans are a patrilocal species, that is, with women moving away from their birth families to join their husbands. Instead, it seems that young mothers in many traditional societies have their own mothers and other female relatives close at hand, and who better to trust with baby care than your mom or your aunt? New studies have also shown the importance of postmenopausal women to gathering roots and tubers, the sort of unsexy foods that are difficult to disinter and lack the succulent status of, say, a freshly killed oryx, but that just may help feed the kids in hard times. Other anthropologists have made the startling discovery that children have entertainment value, and that among traditional cultures without television or Internet access, a bobble-headed baby is the best show in town.
However cooperative breeding got started, its impact on human evolution was profound. With helpers in the nest, women could give birth to offspring with ever longer childhoods — the better to build big brains and stout immune systems — and, paradoxically, at ever shrinking intervals. The average time between births for a chimpanzee mother is about six years; for a human mother, it’s two or three years. As a result of our combined braininess and fecundity, humans have managed to colonize the planet; exploit, marginalize or exterminate all competing forms of life; build a vast military-industrial complex all under the auspices of Bernard Madoff and with one yeti of a carbon footprint, and will somebody please hand me that baby before it’s too late.
March 3, 2009
Short of Dentists, Maine Adds Teeth to Doctors’ Training
By KATIE ZEZIMA
FAIRFIELD, Me. — Cindy Merrithew was nervous about having her teeth pulled, mainly because a doctor would be doing the work.
“I was skeptical,” said Ms. Merrithew, 47, a nurse’s assistant whose mouth is filled with damaged, brittle teeth. “I didn’t know if they knew much about the dentistry field.”
Dentists are in such short supply in Maine that primary care doctors who do their medical residency in the state are learning to lance abscesses, pull teeth and perform other basic dental skills through a program that began in 2005.
“Doctors typically approach the mouth from a distance,” said Dr. William Alto, a physician at the Maine Dartmouth Family Practice Residency here in rural Fairfield, which conducts one of two dental clinics for medical residents (the other is at Maine General Hospital in Augusta).
“They say ‘say aah,’ take a look at the back of the throat and are done,” Dr. Alto said. “Many physicians, even family physicians, have given up that part of the body because they don’t have the skills.”
Maine has one dentist for every 2,300 people, compared with one doctor for every 640, and the gap is expected to widen as both dentists and doctors retire over the next decade.
Nationally there is one dentist for every 1,600 people.
Maine has trouble recruiting dentists because many young graduates do not want to work in rural areas. The shortage is much less acute in Portland, the state’s largest city. Maine also does not have a dental school — the closest are in Boston, about 50 miles from the state’s southernmost town.
Last year the American Dental Association and the American Academy of Pediatrics announced a program to train pediatricians to apply fluoride and look for signs of tooth decay, a step already taken by some other states, including Illinois, Iowa, North Carolina and Washington.
In Maine, training physicians in dentistry provides a dental safety net for the rural poor who have never had one, doctors and dentists said. About two-thirds of the residents who have trained at the dental clinic now practice in the state, many in rural areas.
“I see dental complaints all the time from people who come into the E.R.,” said Dr. Andrew Fletcher, who learned dentistry at Maine Dartmouth during his residency. He now works at Northern Maine Medical Center in Fort Kent, on the Canadian border. “It’s mostly Medicaid patients who don’t have money to see dentists.”
Maine Dartmouth’s office here is emblematic of the chasm between medicine and dentistry in the state: the office has 31 physicians in a county with only 12 dentists.
Ronald Smart, 51, who had not been to a dentist in five years, came to the Fairfield clinic on a Wednesday to have an infected tooth pulled; he has had three teeth pulled here before, and most likely will have more.
“It’s hard when you don’t have insurance,” Mr. Smart said. The severe decay of teeth like Mr. Smart’s can make simple dental procedures difficult.
Natalie Karishev, a third-year resident, pulled the tooth with Dr. Alto’s assistance. Dr. Karishev injected a painkiller in Mr. Smart’s gums and cheek, loosened the tooth and started to pull. Mr. Smart yelled; the painkiller was not working.
After injecting three more syringes of painkiller and applying a nerve block, Dr. Karishev was able to extract the tooth.
“It hurt, and I have a high tolerance for pain,” Mr. Smart said. “But once it numbed, it was fine.”
He has no issues with doctors pulling his teeth. “I don’t mind at all,” Mr. Smart said. “I think it’s great. It’s convenient.”
The doctors must also step in for dentists in urging patients to break bad habits — namely smoking and drinking soda.
Nicholas Noyes, 24, recently quit smoking and is trying to kick his two-liter-a-day soda habit.
“It’s so hard for me not to drink Mountain Dew every day,” said Mr. Noyes, who came to the Augusta clinic for tooth pain. He, like all the patients here, was referred to the dental clinic by his primary care doctor.
But after hearing Dr. James Schmidt, the co-founder of the dental training program, and the resident, Katje Musgrave, warn Mr. Noyes that he was in danger of losing all his teeth, Mr. Noyes decided to mend his ways.
“When they said I wouldn’t have teeth by the time I’m 34, that’s a biggie,” Mr. Noyes said.
Ms. Merrithew, unfortunately, is close to losing all her teeth. She needed three pulled on a recent afternoon. They were the first teeth Dr. Mark Winiecki had ever extracted.
Under the direction of Dr. Alto, Dr. Winiecki applied a topical anesthetic to Ms. Merrithew’s gums and palate, then started loosening a tooth.
“That’s good,” Dr. Alto said. “I like how you’re doing this. It’s going to save you work later.”
The doctors were only able to extract two of Ms. Merrithew’s teeth. The third kept shattering as Dr. Winiecki tried to loosen it, and they made an appointment for her with an oral surgeon.
After finishing the procedure, Dr. Winiecki was thrilled and relieved. “I’m excited,” he said. “It’s another tool in the doctor’s kit.”
While the Maine Dental Association supports the program, its executive director, Frances Miliano, said it would prefer to recruit more dentists to the state.
“Medical residents are only going to be doing this in really dire circumstances,” Ms. Miliano said. “They’re not going to be the alternatives to dentists in rural areas. It’s not a total solution by any means.”
Other places are trying similar approaches. The University of New Mexico School of Medicine runs a yearlong residency program for dentists, and medical residents are allowed to participate to learn basic dentistry.
“If that is a skill they would like to have in practicing medicine, we by all means want them to have that skill,” said Mark Moores, president of the New Mexico Dental Association.
Here in Maine, Dr. Alto and Dr. Schmidt, president of the Maine Dental Association, see the program continuing to train doctors, even as dentists move to the state. It helps both patients and doctors, they said.
“If you want to be a real doctor, you have to know how to do all the simple things in the field and refer out as appropriate,” Dr. Alto said. “We try to give experience not only looking in the mouth, but with all the things you can do.”
Short of Dentists, Maine Adds Teeth to Doctors’ Training
By KATIE ZEZIMA
FAIRFIELD, Me. — Cindy Merrithew was nervous about having her teeth pulled, mainly because a doctor would be doing the work.
“I was skeptical,” said Ms. Merrithew, 47, a nurse’s assistant whose mouth is filled with damaged, brittle teeth. “I didn’t know if they knew much about the dentistry field.”
Dentists are in such short supply in Maine that primary care doctors who do their medical residency in the state are learning to lance abscesses, pull teeth and perform other basic dental skills through a program that began in 2005.
“Doctors typically approach the mouth from a distance,” said Dr. William Alto, a physician at the Maine Dartmouth Family Practice Residency here in rural Fairfield, which conducts one of two dental clinics for medical residents (the other is at Maine General Hospital in Augusta).
“They say ‘say aah,’ take a look at the back of the throat and are done,” Dr. Alto said. “Many physicians, even family physicians, have given up that part of the body because they don’t have the skills.”
Maine has one dentist for every 2,300 people, compared with one doctor for every 640, and the gap is expected to widen as both dentists and doctors retire over the next decade.
Nationally there is one dentist for every 1,600 people.
Maine has trouble recruiting dentists because many young graduates do not want to work in rural areas. The shortage is much less acute in Portland, the state’s largest city. Maine also does not have a dental school — the closest are in Boston, about 50 miles from the state’s southernmost town.
Last year the American Dental Association and the American Academy of Pediatrics announced a program to train pediatricians to apply fluoride and look for signs of tooth decay, a step already taken by some other states, including Illinois, Iowa, North Carolina and Washington.
In Maine, training physicians in dentistry provides a dental safety net for the rural poor who have never had one, doctors and dentists said. About two-thirds of the residents who have trained at the dental clinic now practice in the state, many in rural areas.
“I see dental complaints all the time from people who come into the E.R.,” said Dr. Andrew Fletcher, who learned dentistry at Maine Dartmouth during his residency. He now works at Northern Maine Medical Center in Fort Kent, on the Canadian border. “It’s mostly Medicaid patients who don’t have money to see dentists.”
Maine Dartmouth’s office here is emblematic of the chasm between medicine and dentistry in the state: the office has 31 physicians in a county with only 12 dentists.
Ronald Smart, 51, who had not been to a dentist in five years, came to the Fairfield clinic on a Wednesday to have an infected tooth pulled; he has had three teeth pulled here before, and most likely will have more.
“It’s hard when you don’t have insurance,” Mr. Smart said. The severe decay of teeth like Mr. Smart’s can make simple dental procedures difficult.
Natalie Karishev, a third-year resident, pulled the tooth with Dr. Alto’s assistance. Dr. Karishev injected a painkiller in Mr. Smart’s gums and cheek, loosened the tooth and started to pull. Mr. Smart yelled; the painkiller was not working.
After injecting three more syringes of painkiller and applying a nerve block, Dr. Karishev was able to extract the tooth.
“It hurt, and I have a high tolerance for pain,” Mr. Smart said. “But once it numbed, it was fine.”
He has no issues with doctors pulling his teeth. “I don’t mind at all,” Mr. Smart said. “I think it’s great. It’s convenient.”
The doctors must also step in for dentists in urging patients to break bad habits — namely smoking and drinking soda.
Nicholas Noyes, 24, recently quit smoking and is trying to kick his two-liter-a-day soda habit.
“It’s so hard for me not to drink Mountain Dew every day,” said Mr. Noyes, who came to the Augusta clinic for tooth pain. He, like all the patients here, was referred to the dental clinic by his primary care doctor.
But after hearing Dr. James Schmidt, the co-founder of the dental training program, and the resident, Katje Musgrave, warn Mr. Noyes that he was in danger of losing all his teeth, Mr. Noyes decided to mend his ways.
“When they said I wouldn’t have teeth by the time I’m 34, that’s a biggie,” Mr. Noyes said.
Ms. Merrithew, unfortunately, is close to losing all her teeth. She needed three pulled on a recent afternoon. They were the first teeth Dr. Mark Winiecki had ever extracted.
Under the direction of Dr. Alto, Dr. Winiecki applied a topical anesthetic to Ms. Merrithew’s gums and palate, then started loosening a tooth.
“That’s good,” Dr. Alto said. “I like how you’re doing this. It’s going to save you work later.”
The doctors were only able to extract two of Ms. Merrithew’s teeth. The third kept shattering as Dr. Winiecki tried to loosen it, and they made an appointment for her with an oral surgeon.
After finishing the procedure, Dr. Winiecki was thrilled and relieved. “I’m excited,” he said. “It’s another tool in the doctor’s kit.”
While the Maine Dental Association supports the program, its executive director, Frances Miliano, said it would prefer to recruit more dentists to the state.
“Medical residents are only going to be doing this in really dire circumstances,” Ms. Miliano said. “They’re not going to be the alternatives to dentists in rural areas. It’s not a total solution by any means.”
Other places are trying similar approaches. The University of New Mexico School of Medicine runs a yearlong residency program for dentists, and medical residents are allowed to participate to learn basic dentistry.
“If that is a skill they would like to have in practicing medicine, we by all means want them to have that skill,” said Mark Moores, president of the New Mexico Dental Association.
Here in Maine, Dr. Alto and Dr. Schmidt, president of the Maine Dental Association, see the program continuing to train doctors, even as dentists move to the state. It helps both patients and doctors, they said.
“If you want to be a real doctor, you have to know how to do all the simple things in the field and refer out as appropriate,” Dr. Alto said. “We try to give experience not only looking in the mouth, but with all the things you can do.”
Wednesday, February 18, 2009
February 17, 2009
The Cellphone, Navigating Our Lives
By JOHN MARKOFF
The cellphone is the world’s most ubiquitous computer. The four billion cellphones in use around the globe carry personal information, provide access to the Web and are being used more and more to navigate the real world. And as cellphones change how we live, computer scientists say, they are also changing how we think about information.
It has been 25 years since the desktop, with its files and folders, was introduced as a way to think about what went on inside a personal computer. The World Wide Web brought other ways of imagining the flow of data. With the dominance of the cellphone, a new metaphor is emerging for how we organize, find and use information. New in one sense, that is. It is also as ancient as humanity itself. That metaphor is the map.
“The map underlies man’s ability to perceive,” said Richard Saul Wurman, a graphic designer who was a pioneer in the use of maps as a generalized way to search for information of all kinds before the emergence of the online world.
As this metaphor takes over, it will change the way we behave, the way we think and the way we find our way around new neighborhoods. As researchers and businesses learn how to use all the information about a user’s location that phones can provide, new privacy issues will emerge. You may use your phone to find friends and restaurants, but somebody else may be using your phone to find you and find out about you.
Digital map displays on hand-held phones can now show the nearest gas station or A.T.M., reviews of nearby restaurants posted online by diners, or the location of friends. In the latest and biggest example of the map’s power and versatility, Google started a location-aware friend-finding system called Latitude in 27 countries early this month.
On its face, Google’s new service — available on dozens of mobile systems — is simply a way for friends to keep track of one another and meet up, for families to stay in touch or for parents to find comfort in knowing where their children are.
But it will generate a gold mine of new information about where millions of people travel each day, and there is no doubt that Google and others are planning to dig in that mine. “Everyone is watching Google, and this will open a floodgate of location-oriented applications and services,” said Greg Skibiski, the chief executive of Sense Networks, a New York City firm that mines the millions of digital trails left by cellphone users for marketing purposes.
It was the arrival of the so-called WIMP interface — for windows, icons, menus, pointer — in the 1980s on both the Apple Macintosh and computers using Microsoft Windows that made personal computers personal and moved them beyond the world of hobbyists and business. Now many of the software designers who created those interfaces say they see a change of similar magnitude with phones and maps.
“We’re way early on, and we don’t know what the Macintosh of maps will be yet,” said Paul Mercer, a former Apple Computer software designer who more recently worked on the development of the Palm Pre smartphone. “But because of their relationship to the real world, maps will be a metaphor for a huge swath of mobile computing.”
Indeed, a new generation of smartphones like the G1, with Android software developed by Google, and a range of Japanese phones now “augment” reality by painting a map over a phone-screen image of the user’s surroundings produced by the phone’s camera.
With this sort of map it is possible to see a three-dimensional view of one’s surroundings, including the annotated distance to objects that may be obscured by buildings in the foreground. For starters, map-based cellphones simply translate paper maps into a digital medium, but future systems will probably begin to blur the boundaries between the display and the real world.
“I always said the next interface would be Quake,” said Steve Capps, one of the designers of the original Macintosh interface, referring to the popular video game. “How long will it be before you come out of the subway and you hold up your screen to get a better view of what you’re looking at in the physical world?”
Increasingly, phones will allow users to look at an image of what is around them. You could be surrounded by skyscrapers but have an immediate reference map showing your destination and features of the landscape, along with your progress in real time. Part of what drives the emergence of map-based services is the vast marketing potential of analyzing consumers’ travel patterns. For example, it is now possible for marketers to identify users who are shopping for cars because they have traveled to multiple car dealerships.
“When I go from point A to point B with my feet, there is something of real value there,” said Tony Jebara, a Columbia University computer scientist who is a co-founder of Sense Networks.
A full-blown map-based, location-aware mobile world would entail rethinking basic American notions of privacy. For a generation of older Americans, exposing their precise location around the clock to an army of little brothers for marketing and advertising purposes is a privacy invasion.
Today the vast majority of cellphone users in the United States still use the devices primarily for just one function: talking. About 10 percent of cellphone users take advantage of map features, according to the market research firm M:Metrics. But the number is growing, the company said. And a survey by another market research firm, LJS, showed that 24 percent of those interviewed wanted GPS mapping capabilities on their next phone, but only 19 percent wanted an Internet connection.
On the other hand, there is a generation of smartphone users in their 20s that has grown up sharing the most intimate details of their lives on MySpace and Facebook. They may have a different point of view.
Recently, for example, Sam Altman, a 23-year-old Stanford University computer science graduate and the founder of Loopt, a pioneering friend-finding service, was having dinner in Palo Alto, Calif., when he noticed from the screen on his phone that his freshman college roommate was having dinner just two restaurants away. The two met after dinner at a bar, where they were joined by another former Stanford student who noticed on his display that they were socializing together.
Mr. Altman said his willingness to display his location was just as valuable in his business dealings. At the Consumer Electronics Show in Las Vegas last month, he turned on a feature that broadcasts his location and his name. He had more than a dozen business contacts as he traveled around the vast trade show, and he said he was able to kick off four deals from his random contacts.
The map interface even seems to have a biological basis, as suggested by new brain studies showing how the world is represented in brain maps.
“Humans evolved with amazing navigational abilities in our brains from an evolutionary perspective,” said Eric Schmidt, Google’s chief executive. He argues that the correlation between the map on the phone and the internal map in your head is a natural way to navigate all kinds of information.
For example, neuroscientists have discovered that people who have occupations that require them to maintain complex mental maps of the world, like London taxi drivers, have an enlarged hippocampus. What happens when our hand-held computers become extensions of the way we think?
“I have wondered about the fact that we might as a culture lose the skill of mapping our environment, relying on the Web to tell us how to navigate,” said Hugo Spiers, a neurobiologist at University College London. “Thus, it might reduce the growth of cells in the hippocampus, which we think stores our internal maps.”
Among cellphone makers, the map metaphor has been adopted most aggressively by Nokia, the world’s largest maker of mobile phones. The company has acquired digital maps of 69 countries and is now rushing to deliver to developers the tools to create software for Nokia phones oriented toward maps and navigation. In many ways this is similar to the tool kit that early computer designers gave programmers to develop Windows applications.
“This is a new metaphor upon which others can build,” said Michael Halbherr, Nokia’s vice president for social location services.
The Cellphone, Navigating Our Lives
By JOHN MARKOFF
The cellphone is the world’s most ubiquitous computer. The four billion cellphones in use around the globe carry personal information, provide access to the Web and are being used more and more to navigate the real world. And as cellphones change how we live, computer scientists say, they are also changing how we think about information.
It has been 25 years since the desktop, with its files and folders, was introduced as a way to think about what went on inside a personal computer. The World Wide Web brought other ways of imagining the flow of data. With the dominance of the cellphone, a new metaphor is emerging for how we organize, find and use information. New in one sense, that is. It is also as ancient as humanity itself. That metaphor is the map.
“The map underlies man’s ability to perceive,” said Richard Saul Wurman, a graphic designer who was a pioneer in the use of maps as a generalized way to search for information of all kinds before the emergence of the online world.
As this metaphor takes over, it will change the way we behave, the way we think and the way we find our way around new neighborhoods. As researchers and businesses learn how to use all the information about a user’s location that phones can provide, new privacy issues will emerge. You may use your phone to find friends and restaurants, but somebody else may be using your phone to find you and find out about you.
Digital map displays on hand-held phones can now show the nearest gas station or A.T.M., reviews of nearby restaurants posted online by diners, or the location of friends. In the latest and biggest example of the map’s power and versatility, Google started a location-aware friend-finding system called Latitude in 27 countries early this month.
On its face, Google’s new service — available on dozens of mobile systems — is simply a way for friends to keep track of one another and meet up, for families to stay in touch or for parents to find comfort in knowing where their children are.
But it will generate a gold mine of new information about where millions of people travel each day, and there is no doubt that Google and others are planning to dig in that mine. “Everyone is watching Google, and this will open a floodgate of location-oriented applications and services,” said Greg Skibiski, the chief executive of Sense Networks, a New York City firm that mines the millions of digital trails left by cellphone users for marketing purposes.
It was the arrival of the so-called WIMP interface — for windows, icons, menus, pointer — in the 1980s on both the Apple Macintosh and computers using Microsoft Windows that made personal computers personal and moved them beyond the world of hobbyists and business. Now many of the software designers who created those interfaces say they see a change of similar magnitude with phones and maps.
“We’re way early on, and we don’t know what the Macintosh of maps will be yet,” said Paul Mercer, a former Apple Computer software designer who more recently worked on the development of the Palm Pre smartphone. “But because of their relationship to the real world, maps will be a metaphor for a huge swath of mobile computing.”
Indeed, a new generation of smartphones like the G1, with Android software developed by Google, and a range of Japanese phones now “augment” reality by painting a map over a phone-screen image of the user’s surroundings produced by the phone’s camera.
With this sort of map it is possible to see a three-dimensional view of one’s surroundings, including the annotated distance to objects that may be obscured by buildings in the foreground. For starters, map-based cellphones simply translate paper maps into a digital medium, but future systems will probably begin to blur the boundaries between the display and the real world.
“I always said the next interface would be Quake,” said Steve Capps, one of the designers of the original Macintosh interface, referring to the popular video game. “How long will it be before you come out of the subway and you hold up your screen to get a better view of what you’re looking at in the physical world?”
Increasingly, phones will allow users to look at an image of what is around them. You could be surrounded by skyscrapers but have an immediate reference map showing your destination and features of the landscape, along with your progress in real time. Part of what drives the emergence of map-based services is the vast marketing potential of analyzing consumers’ travel patterns. For example, it is now possible for marketers to identify users who are shopping for cars because they have traveled to multiple car dealerships.
“When I go from point A to point B with my feet, there is something of real value there,” said Tony Jebara, a Columbia University computer scientist who is a co-founder of Sense Networks.
A full-blown map-based, location-aware mobile world would entail rethinking basic American notions of privacy. For a generation of older Americans, exposing their precise location around the clock to an army of little brothers for marketing and advertising purposes is a privacy invasion.
Today the vast majority of cellphone users in the United States still use the devices primarily for just one function: talking. About 10 percent of cellphone users take advantage of map features, according to the market research firm M:Metrics. But the number is growing, the company said. And a survey by another market research firm, LJS, showed that 24 percent of those interviewed wanted GPS mapping capabilities on their next phone, but only 19 percent wanted an Internet connection.
On the other hand, there is a generation of smartphone users in their 20s that has grown up sharing the most intimate details of their lives on MySpace and Facebook. They may have a different point of view.
Recently, for example, Sam Altman, a 23-year-old Stanford University computer science graduate and the founder of Loopt, a pioneering friend-finding service, was having dinner in Palo Alto, Calif., when he noticed from the screen on his phone that his freshman college roommate was having dinner just two restaurants away. The two met after dinner at a bar, where they were joined by another former Stanford student who noticed on his display that they were socializing together.
Mr. Altman said his willingness to display his location was just as valuable in his business dealings. At the Consumer Electronics Show in Las Vegas last month, he turned on a feature that broadcasts his location and his name. He had more than a dozen business contacts as he traveled around the vast trade show, and he said he was able to kick off four deals from his random contacts.
The map interface even seems to have a biological basis, as suggested by new brain studies showing how the world is represented in brain maps.
“Humans evolved with amazing navigational abilities in our brains from an evolutionary perspective,” said Eric Schmidt, Google’s chief executive. He argues that the correlation between the map on the phone and the internal map in your head is a natural way to navigate all kinds of information.
For example, neuroscientists have discovered that people who have occupations that require them to maintain complex mental maps of the world, like London taxi drivers, have an enlarged hippocampus. What happens when our hand-held computers become extensions of the way we think?
“I have wondered about the fact that we might as a culture lose the skill of mapping our environment, relying on the Web to tell us how to navigate,” said Hugo Spiers, a neurobiologist at University College London. “Thus, it might reduce the growth of cells in the hippocampus, which we think stores our internal maps.”
Among cellphone makers, the map metaphor has been adopted most aggressively by Nokia, the world’s largest maker of mobile phones. The company has acquired digital maps of 69 countries and is now rushing to deliver to developers the tools to create software for Nokia phones oriented toward maps and navigation. In many ways this is similar to the tool kit that early computer designers gave programmers to develop Windows applications.
“This is a new metaphor upon which others can build,” said Michael Halbherr, Nokia’s vice president for social location services.
February 17, 2009
Well
Vitamin Pills: A False Hope?
By TARA PARKER-POPE
Ever since the Nobel Prize-winning biochemist Linus Pauling first promoted “megadoses” of essential nutrients 40 years ago, Americans have been devoted to their vitamins. Today about half of all adults use some form of dietary supplement, at a cost of $23 billion a year.
But are vitamins worth it? In the past few years, several high-quality studies have failed to show that extra vitamins, at least in pill form, help prevent chronic disease or prolong life.
The latest news came last week after researchers in the Women’s Health Initiative study tracked eight years of multivitamin use among more than 161,000 older women. Despite earlier findings suggesting that multivitamins might lower the risk for heart disease and certain cancers, the study, published in The Archives of Internal Medicine, found no such benefit.
Last year, a study that tracked almost 15,000 male physicians for a decade reported no differences in cancer or heart disease rates among those using vitamins E and C compared with those taking a placebo. And in October, a study of 35,000 men dashed hopes that high doses of vitamin E and selenium could lower the risk of prostate cancer.
Of course, consumers are regularly subjected to conflicting reports and claims about the benefits of vitamins, and they seem undeterred by the news — to the dismay of some experts.
“I’m puzzled why the public in general ignores the results of well-done trials,” said Dr. Eric Klein, national study coordinator for the prostate cancer trial and chairman of the Cleveland Clinic’s Glickman Urological and Kidney Institute. “The public’s belief in the benefits of vitamins and nutrients is not supported by the available scientific data.”
Everyone needs vitamins, which are essential nutrients that the body can’t produce on its own. Inadequate vitamin C leads to scurvy, for instance, and a lack of vitamin D can cause rickets.
But a balanced diet typically provides an adequate level of these nutrients, and today many popular foods are fortified with extra vitamins and minerals. As a result, diseases caused by nutrient deficiency are rare in the United States.
In any event, most major vitamin studies in recent years have focused not on deficiencies but on whether high doses of vitamins can prevent or treat a host of chronic illnesses. While people who eat lots of nutrient-rich fruits and vegetables have long been known to have lower rates of heart disease and cancer, it hasn’t been clear whether ingesting high doses of those same nutrients in pill form results in a similar benefit.
In January, an editorial in The Journal of the National Cancer Institute noted that most trials had shown no cancer benefits from vitamins — with a few exceptions, like a finding that calcium appeared to lower the recurrence of precancerous colon polyps by 15 percent.
But some vitamin studies have also shown unexpected harm, like higher lung cancer rates in two studies of beta carotene use. Another study suggested a higher risk of precancerous polyps among users of folic acid compared with those in a placebo group.
In 2007, The Journal of the American Medical Association reviewed mortality rates in randomized trials of antioxidant supplements. In 47 trials of 181,000 participants, the rate was 5 percent higher among the antioxidant users. The main culprits were vitamin A, beta carotene and vitamin E; vitamin C and selenium seemed to have no meaningful effect.
“We call them essential nutrients because they are,” said Marian L. Neuhouser, an associate member in cancer prevention at the Fred Hutchinson Cancer Research Center in Seattle. “But there has been a leap into thinking that vitamins and minerals can prevent anything from fatigue to cancer to Alzheimer’s. That’s where the science didn’t pan out.”
Everyone is struggling to make sense of the conflicting data, said Andrew Shao, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, a vitamin industry trade group. Consumers and researchers need to “redefine our expectations for these nutrients,” he said. “They aren’t magic bullets.”
Part of the problem, he said, may stem from an inherent flaw in the way vitamins are studied. With drugs, the gold standard for research is a randomized clinical trial in which some patients take a drug and others a placebo. But vitamins are essential nutrients that people ingest in their daily diets; there is no way to withhold them altogether from research subjects.
Vitamins given in high doses may also have effects that science is only beginning to understand. In a test tube, cancer cells gobble up vitamin C, and studies have shown far higher levels of vitamin C in tumor cells than are found in normal tissue.
The selling point of antioxidant vitamins is that they mop up free radicals, the damaging molecular fragments linked to aging and disease. But some free radicals are essential to proper immune function, and wiping them out may inadvertently cause harm.
In a study at the University of North Carolina, mice with brain cancer were given both normal and vitamin-depleted diets. The ones who were deprived of antioxidants had smaller tumors, and 20 percent of the tumor cells were undergoing a type of cell death called apoptosis, which is fueled by free radicals. In the fully nourished mice, only 3 percent of tumor cells were dying.
“Most antioxidants are also pro-oxidants,” said Dr. Peter H. Gann, professor and director of research in the department of pathology at the University of Illinois at Chicago. “In the right context and the right dose, they may be able to cause problems rather than prevent them.”
Scientists suspect that the benefits of a healthful diet come from eating the whole fruit or vegetable, not just the individual vitamins found in it. “There may not be a single component of broccoli or green leafy vegetables that is responsible for the health benefits,” Dr. Gann said. “Why are we taking a reductionist approach and plucking out one or two chemicals given in isolation?”
Even so, some individual vitamin research is continuing. Scientists are beginning to study whether high doses of whole-food extracts can replicate the benefits of a vegetable-rich diet. And Harvard researchers are planning to study whether higher doses of vitamin D in 20,000 men and women can lower risk for cancer and other chronic diseases.
“Vitamin D looks really promising,” said Dr. JoAnn E. Manson, the chief of preventive medicine at Brigham and Women’s Hospital and an investigator on several Harvard vitamin studies. “But we need to learn the lessons from the past. We should wait for large-scale clinical trials before jumping on the vitamin bandwagon and taking high doses.”
Well
Vitamin Pills: A False Hope?
By TARA PARKER-POPE
Ever since the Nobel Prize-winning biochemist Linus Pauling first promoted “megadoses” of essential nutrients 40 years ago, Americans have been devoted to their vitamins. Today about half of all adults use some form of dietary supplement, at a cost of $23 billion a year.
But are vitamins worth it? In the past few years, several high-quality studies have failed to show that extra vitamins, at least in pill form, help prevent chronic disease or prolong life.
The latest news came last week after researchers in the Women’s Health Initiative study tracked eight years of multivitamin use among more than 161,000 older women. Despite earlier findings suggesting that multivitamins might lower the risk for heart disease and certain cancers, the study, published in The Archives of Internal Medicine, found no such benefit.
Last year, a study that tracked almost 15,000 male physicians for a decade reported no differences in cancer or heart disease rates among those using vitamins E and C compared with those taking a placebo. And in October, a study of 35,000 men dashed hopes that high doses of vitamin E and selenium could lower the risk of prostate cancer.
Of course, consumers are regularly subjected to conflicting reports and claims about the benefits of vitamins, and they seem undeterred by the news — to the dismay of some experts.
“I’m puzzled why the public in general ignores the results of well-done trials,” said Dr. Eric Klein, national study coordinator for the prostate cancer trial and chairman of the Cleveland Clinic’s Glickman Urological and Kidney Institute. “The public’s belief in the benefits of vitamins and nutrients is not supported by the available scientific data.”
Everyone needs vitamins, which are essential nutrients that the body can’t produce on its own. Inadequate vitamin C leads to scurvy, for instance, and a lack of vitamin D can cause rickets.
But a balanced diet typically provides an adequate level of these nutrients, and today many popular foods are fortified with extra vitamins and minerals. As a result, diseases caused by nutrient deficiency are rare in the United States.
In any event, most major vitamin studies in recent years have focused not on deficiencies but on whether high doses of vitamins can prevent or treat a host of chronic illnesses. While people who eat lots of nutrient-rich fruits and vegetables have long been known to have lower rates of heart disease and cancer, it hasn’t been clear whether ingesting high doses of those same nutrients in pill form results in a similar benefit.
In January, an editorial in The Journal of the National Cancer Institute noted that most trials had shown no cancer benefits from vitamins — with a few exceptions, like a finding that calcium appeared to lower the recurrence of precancerous colon polyps by 15 percent.
But some vitamin studies have also shown unexpected harm, like higher lung cancer rates in two studies of beta carotene use. Another study suggested a higher risk of precancerous polyps among users of folic acid compared with those in a placebo group.
In 2007, The Journal of the American Medical Association reviewed mortality rates in randomized trials of antioxidant supplements. In 47 trials of 181,000 participants, the rate was 5 percent higher among the antioxidant users. The main culprits were vitamin A, beta carotene and vitamin E; vitamin C and selenium seemed to have no meaningful effect.
“We call them essential nutrients because they are,” said Marian L. Neuhouser, an associate member in cancer prevention at the Fred Hutchinson Cancer Research Center in Seattle. “But there has been a leap into thinking that vitamins and minerals can prevent anything from fatigue to cancer to Alzheimer’s. That’s where the science didn’t pan out.”
Everyone is struggling to make sense of the conflicting data, said Andrew Shao, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, a vitamin industry trade group. Consumers and researchers need to “redefine our expectations for these nutrients,” he said. “They aren’t magic bullets.”
Part of the problem, he said, may stem from an inherent flaw in the way vitamins are studied. With drugs, the gold standard for research is a randomized clinical trial in which some patients take a drug and others a placebo. But vitamins are essential nutrients that people ingest in their daily diets; there is no way to withhold them altogether from research subjects.
Vitamins given in high doses may also have effects that science is only beginning to understand. In a test tube, cancer cells gobble up vitamin C, and studies have shown far higher levels of vitamin C in tumor cells than are found in normal tissue.
The selling point of antioxidant vitamins is that they mop up free radicals, the damaging molecular fragments linked to aging and disease. But some free radicals are essential to proper immune function, and wiping them out may inadvertently cause harm.
In a study at the University of North Carolina, mice with brain cancer were given both normal and vitamin-depleted diets. The ones who were deprived of antioxidants had smaller tumors, and 20 percent of the tumor cells were undergoing a type of cell death called apoptosis, which is fueled by free radicals. In the fully nourished mice, only 3 percent of tumor cells were dying.
“Most antioxidants are also pro-oxidants,” said Dr. Peter H. Gann, professor and director of research in the department of pathology at the University of Illinois at Chicago. “In the right context and the right dose, they may be able to cause problems rather than prevent them.”
Scientists suspect that the benefits of a healthful diet come from eating the whole fruit or vegetable, not just the individual vitamins found in it. “There may not be a single component of broccoli or green leafy vegetables that is responsible for the health benefits,” Dr. Gann said. “Why are we taking a reductionist approach and plucking out one or two chemicals given in isolation?”
Even so, some individual vitamin research is continuing. Scientists are beginning to study whether high doses of whole-food extracts can replicate the benefits of a vegetable-rich diet. And Harvard researchers are planning to study whether higher doses of vitamin D in 20,000 men and women can lower risk for cancer and other chronic diseases.
“Vitamin D looks really promising,” said Dr. JoAnn E. Manson, the chief of preventive medicine at Brigham and Women’s Hospital and an investigator on several Harvard vitamin studies. “But we need to learn the lessons from the past. We should wait for large-scale clinical trials before jumping on the vitamin bandwagon and taking high doses.”
Wednesday, February 04, 2009
February 4, 2009
Square Feet
On Madison Avenue, Shops Pack Their Hand-Tooled Bags
By TERRY PRISTIN
After more than 30 years on Madison Avenue, the retailer E. Braun & Company is packing up its $3,500 hand-embroidered tablecloths and $2,390 bedding sets and will defect in April for cheaper space on Park Avenue.
And it is not alone. New York’s most elegant shopping corridor, the Gold Coast of Madison Avenue, from 57th Street to 72nd Street, is pockmarked with vacancies as retailers flee sky-high rents. More than two dozen retail spaces are on the market and are either empty now or about to be. Windows that once showcased hand-tooled leather suitcases are now plastered with for-rent signs.
“This is as bad as I’ve ever seen it,” said Alan Victor, a broker who has worked the street for more than four decades and who is an executive vice president of the Lansco Corporation.
Another broker, Gene P. Spiegelman, an executive director at Cushman & Wakefield, said that 13 percent of the retail spaces on Madison Avenue were available either as a direct lease or a sublet. Not included are those with tenants who would move if the right offer turned up.
“There are tenants that say, ‘If you get me a good sublease, I’ll take it and run,’ ” said E. William Judson, a broker who is also the chairman of the Madison Avenue Business Improvement District, a group made up of property owners and retailers. “Some people are thinking, ‘Maybe I’ll either downsize or I’ll close the store.’ If they have a lousy day, they say, ‘Let’s get out of here.’ If they have a good day, they say, ‘Let’s stay.’ ”
Lately, the people who sell $2,400 leather bags and $1,600 satin-and-rhinestone evening sandals are more likely to have bad days. Of all retail chain categories, luxury stores had the greatest decline in sales in 2008, falling 7.5 percent from 2007, according to the International Council of Shopping Centers, a trade group. From 2004 to 2007, by contrast, the luxury sector outperformed all other categories by a wide margin.
The recent holiday season was the worst in four decades for the retail industry. Sales at Neiman Marcus’s specialty division, which includes Bergdorf Goodman, declined 31.2 percent. Tiffany reported that sales in stores open at least a year were down 24 percent.
“If you’re in New York, and you’ve got the financial services industry in a depression, how can you possibly do well in high-level goods?” asked Howard L. Davidowitz, chairman of Davidowitz & Associates, a retail consulting and investment banking firm.
Madison Avenue has traditionally catered to the wealthy, but until Polo Ralph Lauren opened at the former Rhinelander Mansion on 72nd Street in 1986, most of the shops were private boutiques like E. Braun. In 1998, the stretch on Madison Avenue known as the Gold Coast surpassed Causeway Bay in Hong Kong as the most expensive shopping strip in the world, Cushman & Wakefield reported, with annual rents averaging $550 a square foot. By then, Giorgio Armani had two 16,000-square-foot stores on Madison and Hermès was about to move there from 57th Street.
For many international retailers, a Madison Avenue address was viewed as essential for promoting their brand, even if sales were not robust enough to justify the rent. Often, part of the rent came out of the marketing budget — a practice that brokers say is fast disappearing.
Rents began escalating rapidly a few years ago, after the stores on the Madison Avenue side of the General Motors Building, at Fifth Avenue on 58th and 59th Streets, were expanded and began commanding annual rent of more than $1,000 a square foot, said Benjamin Fox, the president of Winick Realty Group, a New York retail brokerage.
In 2007, fancy jewelers clustered on the avenue, especially between 61st and 64th Streets. They were able to afford higher rents because their costly merchandise could fit into smaller spaces and more revenue could be squeezed out of every inch. Rents skyrocketed to $1,250 a foot or even more. (Even so, Fifth Avenue between 49th and 59th Streets is now ranked as the world’s costliest shopping strip, with asking rents as high as $2,000 a foot. Its luxury tenants share the avenue, however, with shopping-mall clothing chains like Diesel and Abercrombie & Fitch.)
Retailers typically expect their rent to equal about one-tenth of their sales volume. “In a prime location like Madison Avenue, most retailers will change that to 25 percent,” said Joel Isaacs, the president of Isaacs & Company, a retail brokerage. Even under that formula, a tenant paying $1.25 million for 1,000 square feet would need to have nearly $5 million in annual sales.
Today, however, asking rents on Madison and elsewhere are dropping by as much as one-third, brokers say. And many landlords will offer more concessions than before, like additional months of free rent. “If you’re a good retailer and you’ve got a good product, the landlord wants you,” said Faith Hope Consolo, the chairwoman of the retail group at Prudential Douglas Elliman. “The word ‘no’ no longer exists.”
Taking advantage of the softening market, Lalique, which sells crystal goods, gave up its two-level store near 63rd Street — now occupied by the watchmaker Mauboussin — and is moving into smaller quarters five blocks to the south, with lower rent than it would have paid six months ago, Ms. Consolo said.
The astronomical rise in rents did not cause all the impending vacancies on Madison. Some tenants, like the jeweler Graff, have moved to larger quarters nearby. (Hublot, a Swiss watchmaker, recently came close to leasing Graff’s former store but got cold feet and withdrew, said Robert C. Fink, director of leasing for the landlord, the Winter Organization.)
William Friedland, the Gold Coast’s largest property owner, is emptying out a building that houses the restaurant La Goulue and several stores in order to redevelop it.
Frederic L. Barbatelli, a co-owner of E. Braun, said he was moving to be closer to D. Porthault and other Park Avenue purveyors of luxury home goods. But Ms. Consolo, who is offering a Mini Cooper to the broker who snags a lease for E. Braun’s Madison Avenue space, between 63rd and 64th Streets, said the store had been driven out by high rents.
Mr. Victor of Lansco said that lower rents would be good for Madison Avenue. “The market reached a crazy level,” he said. “A lot of people who wanted to look at Madison Avenue couldn’t make it pencil out. This may be a reality check. It will still be high-end, but it will be a healthier Madison Avenue.”
Square Feet
On Madison Avenue, Shops Pack Their Hand-Tooled Bags
By TERRY PRISTIN
After more than 30 years on Madison Avenue, the retailer E. Braun & Company is packing up its $3,500 hand-embroidered tablecloths and $2,390 bedding sets and will defect in April for cheaper space on Park Avenue.
And it is not alone. New York’s most elegant shopping corridor, the Gold Coast of Madison Avenue, from 57th Street to 72nd Street, is pockmarked with vacancies as retailers flee sky-high rents. More than two dozen retail spaces are on the market and are either empty now or about to be. Windows that once showcased hand-tooled leather suitcases are now plastered with for-rent signs.
“This is as bad as I’ve ever seen it,” said Alan Victor, a broker who has worked the street for more than four decades and who is an executive vice president of the Lansco Corporation.
Another broker, Gene P. Spiegelman, an executive director at Cushman & Wakefield, said that 13 percent of the retail spaces on Madison Avenue were available either as a direct lease or a sublet. Not included are those with tenants who would move if the right offer turned up.
“There are tenants that say, ‘If you get me a good sublease, I’ll take it and run,’ ” said E. William Judson, a broker who is also the chairman of the Madison Avenue Business Improvement District, a group made up of property owners and retailers. “Some people are thinking, ‘Maybe I’ll either downsize or I’ll close the store.’ If they have a lousy day, they say, ‘Let’s get out of here.’ If they have a good day, they say, ‘Let’s stay.’ ”
Lately, the people who sell $2,400 leather bags and $1,600 satin-and-rhinestone evening sandals are more likely to have bad days. Of all retail chain categories, luxury stores had the greatest decline in sales in 2008, falling 7.5 percent from 2007, according to the International Council of Shopping Centers, a trade group. From 2004 to 2007, by contrast, the luxury sector outperformed all other categories by a wide margin.
The recent holiday season was the worst in four decades for the retail industry. Sales at Neiman Marcus’s specialty division, which includes Bergdorf Goodman, declined 31.2 percent. Tiffany reported that sales in stores open at least a year were down 24 percent.
“If you’re in New York, and you’ve got the financial services industry in a depression, how can you possibly do well in high-level goods?” asked Howard L. Davidowitz, chairman of Davidowitz & Associates, a retail consulting and investment banking firm.
Madison Avenue has traditionally catered to the wealthy, but until Polo Ralph Lauren opened at the former Rhinelander Mansion on 72nd Street in 1986, most of the shops were private boutiques like E. Braun. In 1998, the stretch on Madison Avenue known as the Gold Coast surpassed Causeway Bay in Hong Kong as the most expensive shopping strip in the world, Cushman & Wakefield reported, with annual rents averaging $550 a square foot. By then, Giorgio Armani had two 16,000-square-foot stores on Madison and Hermès was about to move there from 57th Street.
For many international retailers, a Madison Avenue address was viewed as essential for promoting their brand, even if sales were not robust enough to justify the rent. Often, part of the rent came out of the marketing budget — a practice that brokers say is fast disappearing.
Rents began escalating rapidly a few years ago, after the stores on the Madison Avenue side of the General Motors Building, at Fifth Avenue on 58th and 59th Streets, were expanded and began commanding annual rent of more than $1,000 a square foot, said Benjamin Fox, the president of Winick Realty Group, a New York retail brokerage.
In 2007, fancy jewelers clustered on the avenue, especially between 61st and 64th Streets. They were able to afford higher rents because their costly merchandise could fit into smaller spaces and more revenue could be squeezed out of every inch. Rents skyrocketed to $1,250 a foot or even more. (Even so, Fifth Avenue between 49th and 59th Streets is now ranked as the world’s costliest shopping strip, with asking rents as high as $2,000 a foot. Its luxury tenants share the avenue, however, with shopping-mall clothing chains like Diesel and Abercrombie & Fitch.)
Retailers typically expect their rent to equal about one-tenth of their sales volume. “In a prime location like Madison Avenue, most retailers will change that to 25 percent,” said Joel Isaacs, the president of Isaacs & Company, a retail brokerage. Even under that formula, a tenant paying $1.25 million for 1,000 square feet would need to have nearly $5 million in annual sales.
Today, however, asking rents on Madison and elsewhere are dropping by as much as one-third, brokers say. And many landlords will offer more concessions than before, like additional months of free rent. “If you’re a good retailer and you’ve got a good product, the landlord wants you,” said Faith Hope Consolo, the chairwoman of the retail group at Prudential Douglas Elliman. “The word ‘no’ no longer exists.”
Taking advantage of the softening market, Lalique, which sells crystal goods, gave up its two-level store near 63rd Street — now occupied by the watchmaker Mauboussin — and is moving into smaller quarters five blocks to the south, with lower rent than it would have paid six months ago, Ms. Consolo said.
The astronomical rise in rents did not cause all the impending vacancies on Madison. Some tenants, like the jeweler Graff, have moved to larger quarters nearby. (Hublot, a Swiss watchmaker, recently came close to leasing Graff’s former store but got cold feet and withdrew, said Robert C. Fink, director of leasing for the landlord, the Winter Organization.)
William Friedland, the Gold Coast’s largest property owner, is emptying out a building that houses the restaurant La Goulue and several stores in order to redevelop it.
Frederic L. Barbatelli, a co-owner of E. Braun, said he was moving to be closer to D. Porthault and other Park Avenue purveyors of luxury home goods. But Ms. Consolo, who is offering a Mini Cooper to the broker who snags a lease for E. Braun’s Madison Avenue space, between 63rd and 64th Streets, said the store had been driven out by high rents.
Mr. Victor of Lansco said that lower rents would be good for Madison Avenue. “The market reached a crazy level,” he said. “A lot of people who wanted to look at Madison Avenue couldn’t make it pencil out. This may be a reality check. It will still be high-end, but it will be a healthier Madison Avenue.”
Tuesday, February 03, 2009
February 3, 2009
Really?
The Claim: Sitting in a Sauna Can Relieve Cold Symptoms
By ANAHAD O’CONNOR
THE FACTS
Scientists recently confirmed the age-old notion that hot liquids can relieve some cold and flu symptoms. But what about a dose of heat on a much larger scale — say, in a sauna?
With temperatures of 176 Fahrenheit or greater, saunas have been recommended for arthritis, asthma and chronic fatigue, among other things, since they were used by nomads in Finland centuries ago. Some reputed benefits have not been examined, but there is evidence that saunas may speed recovery from colds and reduce their occurrence.
Some researchers suspect sauna heat reduces symptoms because it improves drainage, while others speculate that the high temperatures help weaken cold and flu viruses. Why this might prevent sickness in the first place, however, is unclear. But research suggests an effect.
In one study by Austrian researchers, for example, a group of 50 adults were split into two groups and tracked for six months. One group was instructed to use saunas regularly; the other group abstained. At the end of the study the sauna group had contracted fewer colds.
“This was found particularly during the last three months of the study period, when the incidence was roughly halved compared to controls,” the scientists wrote.
Other studies have found similar results. But doctors caution that saunas can be hazardous to those with heart or circulatory problems.
THE BOTTOM LINE
There is evidence sauna use might reduce or prevent cold symptoms.
Really?
The Claim: Sitting in a Sauna Can Relieve Cold Symptoms
By ANAHAD O’CONNOR
THE FACTS
Scientists recently confirmed the age-old notion that hot liquids can relieve some cold and flu symptoms. But what about a dose of heat on a much larger scale — say, in a sauna?
With temperatures of 176 Fahrenheit or greater, saunas have been recommended for arthritis, asthma and chronic fatigue, among other things, since they were used by nomads in Finland centuries ago. Some reputed benefits have not been examined, but there is evidence that saunas may speed recovery from colds and reduce their occurrence.
Some researchers suspect sauna heat reduces symptoms because it improves drainage, while others speculate that the high temperatures help weaken cold and flu viruses. Why this might prevent sickness in the first place, however, is unclear. But research suggests an effect.
In one study by Austrian researchers, for example, a group of 50 adults were split into two groups and tracked for six months. One group was instructed to use saunas regularly; the other group abstained. At the end of the study the sauna group had contracted fewer colds.
“This was found particularly during the last three months of the study period, when the incidence was roughly halved compared to controls,” the scientists wrote.
Other studies have found similar results. But doctors caution that saunas can be hazardous to those with heart or circulatory problems.
THE BOTTOM LINE
There is evidence sauna use might reduce or prevent cold symptoms.
February 3, 2009
Well
Telling Food Allergies From False Alarms
By TARA PARKER-POPE
For Ingelisa Keeling, a Houston mother of three children with multiple allergies, mealtime was a struggle. Nuts, eggs, wheat, beef, peas and rice were all off limits — banned by the children’s allergist.
But recently, Mrs. Keeling learned that her family’s diet need not be so restrictive. Although her children do have real allergies — to peanuts, milk and eggs, among other foods — extensive testing at a major allergy center showed that they were not in fact allergic to many of the foods they had been avoiding. Her 2-year-old son, who had been living on a diet primarily of potatoes, fruit and hypoallergenic formula, has resumed eating wheat, bananas, beef, peas, rice and corn.
“His diet had become so, so restricted that nutrition had become a real concern,” said Mrs. Keeling, who traveled to specialists at National Jewish Health in Denver last summer for answers about her children’s diet and eczema problems. Among other findings, she learned that neither of her younger children was really allergic to wheat.
“That’s the big one,” she said. “Wheat is in everything, so it makes life a whole lot easier.”
Doctors say that misdiagnosed food allergies appear to be on the rise, and countless families are needlessly avoiding certain foods and spending hundreds of dollars on costly nonallergenic supplements. In extreme cases, misdiagnosed allergies have put children at risk for malnutrition.
And avoiding food in the mistaken fear of allergy may be making the overall problem worse — by making children more sensitive to certain foods when they finally do eat them.
More than 11 million Americans, including 3 million children, are estimated to have food allergies, most commonly to milk, eggs, peanuts and soy. The prevalence among children has risen 18 percent in the past decade, according to the Centers for Disease Control and Prevention. While the increase appears to be real, so does the increase in misdiagnosis.
The culprit appears to be the widespread use of simple blood tests for antibodies that could signal a reaction to food. The tests have emerged as a quick, convenient alternative to uncomfortable skin testing and time-consuming “food challenge” tests, which measure a child’s reaction to eating certain foods under a doctor’s supervision.
While the blood tests can help doctors identify potentially risky foods, they aren’t always reliable. A 2007 issue of The Annals of Asthma, Allergy & Immunology reported on research at Johns Hopkins Children’s Center, finding that blood allergy tests could both under- and overestimate the body’s immune response. A 2003 report in Pediatrics said a positive result on a blood allergy test correlated with a real-world food allergy in fewer than half the cases.
“The only true test of whether you’re allergic to a food or not is whether you can eat it and not react to it,” said Dr. David Fleischer, an assistant professor of pediatrics at National Jewish Health. In one recent case there, doctors treated a young boy who had been given a feeding tube because blood tests indicated he was allergic to virtually every food. Food challenge testing allowed doctors to quickly reintroduce 20 foods into his diet, and they expect more to be added.
Blood tests may be unreliable because they fail to distinguish between similar proteins in different foods. A child who is allergic to peanuts, for instance, might test positive for allergies to soy, green beans, peas and kidney beans. Children with milk allergies may test positive for beef allergy.
The most important question in diagnosing food allergy is whether the child has tolerated the food in the past, Dr. Fleischer says. While some severe allergies are obvious, parents given a positive blood test result should seek advice from an experienced allergist who performs medically supervised food challenge testing.
Even when a food allergy has been confirmed, parents should have children retested, because many allergies are outgrown, particularly in the cases of milk, eggs, soy and wheat.
Doctors’ groups are also starting to acknowledge that some of their own policies may have contributed to overtesting and misdiagnoses. A committee for the American Academy of Asthma Allergy and Immunology is considering revised guidelines recommending earlier introduction of foods like eggs, peanuts and shellfish, which in the past have been delayed until age 2 or 3. A 2008 study of 10,000 British children, reported in The Journal of Allergy and Clinical Immunology, found that early exposure to peanuts lowered allergy risk.
Just as an allergy indicates oversensitivity to certain foods, it may be that doctors and parents have become oversensitive to food allergies. In an essay in The British Medical Journal in December, Dr. Nicholas A. Christakis, a professor at Harvard Medical School, argues that an “overreaction” to allergy is leading to unnecessary testing and false positives.
“If the kid has been doing fine, I would advise parents not to get allergy testing, because the results are more likely to be false positives than true positives,” Dr. Christakis said in an interview. “If they do think they need allergy testing, be extremely measured and go to reputable people.”
well@nytimes.com
Well
Telling Food Allergies From False Alarms
By TARA PARKER-POPE
For Ingelisa Keeling, a Houston mother of three children with multiple allergies, mealtime was a struggle. Nuts, eggs, wheat, beef, peas and rice were all off limits — banned by the children’s allergist.
But recently, Mrs. Keeling learned that her family’s diet need not be so restrictive. Although her children do have real allergies — to peanuts, milk and eggs, among other foods — extensive testing at a major allergy center showed that they were not in fact allergic to many of the foods they had been avoiding. Her 2-year-old son, who had been living on a diet primarily of potatoes, fruit and hypoallergenic formula, has resumed eating wheat, bananas, beef, peas, rice and corn.
“His diet had become so, so restricted that nutrition had become a real concern,” said Mrs. Keeling, who traveled to specialists at National Jewish Health in Denver last summer for answers about her children’s diet and eczema problems. Among other findings, she learned that neither of her younger children was really allergic to wheat.
“That’s the big one,” she said. “Wheat is in everything, so it makes life a whole lot easier.”
Doctors say that misdiagnosed food allergies appear to be on the rise, and countless families are needlessly avoiding certain foods and spending hundreds of dollars on costly nonallergenic supplements. In extreme cases, misdiagnosed allergies have put children at risk for malnutrition.
And avoiding food in the mistaken fear of allergy may be making the overall problem worse — by making children more sensitive to certain foods when they finally do eat them.
More than 11 million Americans, including 3 million children, are estimated to have food allergies, most commonly to milk, eggs, peanuts and soy. The prevalence among children has risen 18 percent in the past decade, according to the Centers for Disease Control and Prevention. While the increase appears to be real, so does the increase in misdiagnosis.
The culprit appears to be the widespread use of simple blood tests for antibodies that could signal a reaction to food. The tests have emerged as a quick, convenient alternative to uncomfortable skin testing and time-consuming “food challenge” tests, which measure a child’s reaction to eating certain foods under a doctor’s supervision.
While the blood tests can help doctors identify potentially risky foods, they aren’t always reliable. A 2007 issue of The Annals of Asthma, Allergy & Immunology reported on research at Johns Hopkins Children’s Center, finding that blood allergy tests could both under- and overestimate the body’s immune response. A 2003 report in Pediatrics said a positive result on a blood allergy test correlated with a real-world food allergy in fewer than half the cases.
“The only true test of whether you’re allergic to a food or not is whether you can eat it and not react to it,” said Dr. David Fleischer, an assistant professor of pediatrics at National Jewish Health. In one recent case there, doctors treated a young boy who had been given a feeding tube because blood tests indicated he was allergic to virtually every food. Food challenge testing allowed doctors to quickly reintroduce 20 foods into his diet, and they expect more to be added.
Blood tests may be unreliable because they fail to distinguish between similar proteins in different foods. A child who is allergic to peanuts, for instance, might test positive for allergies to soy, green beans, peas and kidney beans. Children with milk allergies may test positive for beef allergy.
The most important question in diagnosing food allergy is whether the child has tolerated the food in the past, Dr. Fleischer says. While some severe allergies are obvious, parents given a positive blood test result should seek advice from an experienced allergist who performs medically supervised food challenge testing.
Even when a food allergy has been confirmed, parents should have children retested, because many allergies are outgrown, particularly in the cases of milk, eggs, soy and wheat.
Doctors’ groups are also starting to acknowledge that some of their own policies may have contributed to overtesting and misdiagnoses. A committee for the American Academy of Asthma Allergy and Immunology is considering revised guidelines recommending earlier introduction of foods like eggs, peanuts and shellfish, which in the past have been delayed until age 2 or 3. A 2008 study of 10,000 British children, reported in The Journal of Allergy and Clinical Immunology, found that early exposure to peanuts lowered allergy risk.
Just as an allergy indicates oversensitivity to certain foods, it may be that doctors and parents have become oversensitive to food allergies. In an essay in The British Medical Journal in December, Dr. Nicholas A. Christakis, a professor at Harvard Medical School, argues that an “overreaction” to allergy is leading to unnecessary testing and false positives.
“If the kid has been doing fine, I would advise parents not to get allergy testing, because the results are more likely to be false positives than true positives,” Dr. Christakis said in an interview. “If they do think they need allergy testing, be extremely measured and go to reputable people.”
well@nytimes.com
In Motorola Earnings, Signs of an Industry in Change
Cellphone sales are falling, manufacturers have announced thousands of layoffs and wireless carriers are finding it harder to acquire and keep customers.
It sounds like another tale of “recession bites industry,” but there are signs that this downturn is masking something more fundamental, that the cellphone industry’s best days are behind it.
A fourth-quarter earnings report on Tuesday by the telecommunications equipment manufacturer Motorola reinforced that notion. The company, which is suspending its quarterly dividend, lost $3.6 billion in the fourth quarter, compared with earnings of $100 million in the period a year ago. Sales were $7.14 billion, down 26 percent, from $9.65 billion in the fourth quarter of 2007.
Motorola sold 19.2 million cellphones in the quarter, down 53 percent from the period a year ago. It went from being the world’s second-largest maker of cellphones in 2007 to its fifth-largest.
Analysts and investors are beginning to ask whether the industry as a whole can continue growing. The challenge is both simple and daunting: how to expand when four billion of the six billion people on the planet already have phones. And even in developing countries where there are underserved markets, subscribers spend less on phones and services.
Craig Moffett, an industry analyst at Sanford C. Bernstein & Company, is one of the skeptics. “I don’t think anyone would argue that the salad days of the wireless industry are over,” he said. He added that in terms of subscriber growth in North America, “we’re awfully close to saturation.”
“It’s not correct to call this a cyclical problem,” Mr. Moffett said. “To do so suggests that after the recession, growth rates will bounce back. There’s no reason to believe that’s the case.”
To be sure, nobody is looking at the cellphone industry and making comparisons with Detroit. There is little doubt that there are tens of billions of dollars to be made selling phones and providing services, particularly those involving data.
The industry is pinning high hopes on a new generation of more powerful (and expensive) smartphones. AT&T activated 1.9 million iPhones in the fourth quarter, while Verizon added more than a million BlackBerry Storms.
Over all, these devices make up about 10 percent of the domestic cellphone market and are considered likely to grow in popularity, driving people to upgrade and pay for more data to do things like download songs and send text messages. In the fourth quarter, for example, AT&T’s data revenue for each subscriber rose 27 percent, to $16.30, from about $12 a year earlier.
Over the long term, the industry vigorously disputes the notion that it is anywhere near slowing down. “If there’s anything I can be extremely confident about, it’s that our customer base wants new phones,” said Denny Strigl, president and chief operating officer of Verizon, which owns 55 percent of Verizon Wireless (the Vodafone Group owns 45 percent). Verizon and its chief rival, AT&T, each reported financial returns last week that hinted at challenges to sustained high levels of growth. Verizon Wireless gained 1.4 million subscribers, but that is down from 2 million a year earlier. AT&T gained 2 million subscribers, compared with 2.7 million in the fourth quarter of 2007.
SprintNextel recently announced plans to eliminate 8,000 jobs.
Some industry analysts say they believe the lure of data and the fancier phones that provide it will not stop growth rates from falling over time.
Over all in the wireless industry, “there’s ton of money being made, but it’s not going to grow as fast as people have experienced or as quickly as they’re relying on it to in the future,” said Ed Snyder, an analyst with Charter Equity Research. “All this talk about data and other services bringing a renaissance of growth is wrong.”
One challenge for the long-term growth of smartphones is that they are expensive. The average selling price of the Apple iPhone is $600 (excluding carrier subsidies) and the BlackBerry from Research in Motion costs $370, according to Broadpoint Amtech, a research firm.
By comparison, the average selling price of phones made by Motorola and Samsung (companies with fewer smartphones in their inventory) is around $120. Analysts have little doubt that this price differential will fall over time. But that still means the cellphone industry is depending on consumers to upgrade to a significantly more expensive product in the years ahead.
Smartphones are also smart in preventing their own obsolescence. As they are more dependent on software than hardware to stay up to date, a downloaded upgrade or new application (one that mobile carriers are eager to sell) can do for some of these new phones what used to require an entirely new device.
Apple’s chief executive, Steven P. Jobs, addressed this issue in 2007 when he introduced the iPhone, praising its adaptability when compared with more hardware-based competitors at the time.
“What happens if you think of a great idea six months from now?” he asked about the other devices. “You can’t run around and add a button to these things; they’ve already shipped.”
Smartphones notwithstanding, the number of handsets sold around the world has been falling in important regions — even before the recession. In Western Europe, around 191 million mobile phones were sold in 2007, a figure that fell to 171 million in 2008 and is projected at 165 million in 2009, according to Carolina Milanesi, an analyst with the research firm, Gartner.
In the United States, people bought 176 million handsets in 2007, and 184 million in 2008. That number will probably remain flat this year, the Gartner analyst said. She said that Europe might provide some indication of where the United States was headed because, as highly populated as it is with phones, it is still slightly behind Europe.
The toll seemed to blindside handset makers in the last quarter. Motorola said last month that it sold half as many phones in the fourth quarter than it had the year earlier, and announced 3,000 job cuts from its cellphone unit.
In the fourth quarter, Nokia sold 113 million handsets, down about 15 percent from the period a year earlier. Samsung Electronics said worldwide cellphone demand might be down 10 percent in 2009.
Meanwhile, new and more numerous competitors are fighting over that demand. The industry did not have to contend with Apple until two years ago. This year may bring a resurgent Palm with its Pre smartphone, as well as Dell, which is reportedly working on its own mobile device.
“The macro environment is challenging and we believe will remain clearly so in 2009,” Olli-Pekka Kallasvuo, Nokia’s chief executive, said recently in a conference call with investors to discuss the earnings. He added that he believed Internet-centric phones and mobile services would drive a new generation of growth.
“This will drive the next wave of industry growth, and innovation will not stand still,” he said.
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