DealBook Column: Relationship Science Plans Database of Names and Connections

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Locals believe bobcat trappers are crossing the line in Joshua Tree

JOSHUA TREE — Annica Kreuter's backyard on the edge of Joshua Tree National Park has been a perfect place to chronicle the adventures of eight bobcats.

Over the last decade she has watched a young bobcat chased up a tree by a coyote; an alpha male surveying the landscape from the hood of her car; a kitten sauntering into the yard as she gardens; a matron sniffing the back of Kreuter's neck as she napped on a hammock.

Lately, seven of the eight have vanished. "At sunrise, I hear the one that is still here crying for his family," Kreuter said.

She and others in this high desert community of about 8,000 say bobcats have been disappearing lately, killed for the value of their pelts by trappers who often trespass on private property. The trappers come armed with wire cages, squirt bottles of potent scent and bobcat lures: battery-powered vibrating pet toys festooned with feathers to resemble dying birds.

Hunting and trapping bobcats is legal during hunting season outside of the national park boundaries. But to the locals, that makes little difference. "The very idea of trapping in a place where bobcats are so well-known they have nicknames — Big Gray, Leroy, Tomboy — is disturbing and heartbreaking," Kreuter said.

As one of the top predators of a 720,000-acre park visited by 1.4 million people each year, the bobcat's presence — or absence — has a cascade of consequences, making it a governing force of the ecosystem and the local ecotourism economy. An adult bobcat stands about 15 inches high and can cover 25 to 30 miles of territory in a day. Using razor-sharp claws and powerful legs, it preys on rabbits and makes a significant contribution to rodent control.

Critics believe the trappers are after bobcats that routinely crisscross the invisible park boundary lines.

"This is really, really bad," said astronomer and conservationist Tom O'Key, who was the first to discover a trap. "These guys are carpetbaggers coming onto private land to slaughter bobcats with no regard for a tight-knit community that cares deeply about the national park and its wildlife."

O'Key alerted the community after finding a trap chained to a jojoba bush and camouflaged with broken branches and leaves on his property north of the park. He notified the San Bernardino County Sheriff's Department and the Hi-Desert Star newspaper.

Bobcats are being targeted for the value of their pelts in top-dollar markets such as China, Russia and Greece. A premium pelt of heavily spotted white belly fur can earn a trapper more than $600, according to Nathan Brock, who skinned 10 bobcats that he captured in the Joshua Tree area during the hunting season that ended Jan. 31.

Brock, 38, an active-duty Marine stationed at nearby Twentynine Palms Marine Corps Base, acknowledged that one of his traps was set on private property and not on federal Bureau of Land Management grounds, where trapping is legal. The region is a patchwork of private property and BLM land.

"I feel horrible about that," Brock said. "It's my fault for not making sure."

The manufacturer of Brock's trap, Mercer Lawing of Barstow, said critics miss the point. "We love those animals more than the people who are complaining about us trapping them do," Lawing said. "Nathan and I harvest adult male cats and turn loose adult females and kittens."

The national park has taken a neutral position on the issue, given that its jurisdictional reach extends only as far as its boundaries.

However, park biologist Michael Vamstad said, "Residents have every right to be upset. The fact that there is no limit on bobcats that can be legally taken during hunting season doesn't jibe along the edges of a national park. It's a relic regulation."

Conservationists are calling for a "no-trapping" buffer zone in the area because bobcats travel along a web of interconnected wildlife corridors stretching from the national park to the Marine base about 10 miles to the north.

"The law has to change if it's legal for a handful of people to line the boundary of a national park with traps to catch bobcats, then send their pelts to China for profit," said Brendan Cummings, public lands director for the Center for Biological Diversity. "We are not going to let this happen again."

Equally pointed words came from Nancy Karl, executive director of the Mojave Desert Land Trust, a nonprofit dedicated to preserving safe passage for wildlife between protected areas. "We are watching and paying close attention — and we are going to change things," Karl said. "Those trappers would be best advised to move it."

louis.sahagun@latimes.com

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Actor Steven Seagal trains Arizona posse on school security

FOUNTAIN HILLS, Arizona (Reuters) – Action film star Steven Seagal, who racks up big body counts in his on-screen battles with bad guys, took on a new role on Saturday, training posse volunteers for controversial Arizona Sheriff Joe Arpaio in how to use guns to protect schools in shooting incidents.

Arpaio, who styles himself as “America’s Toughest Sheriff,” enlisted Seagal to train his Maricopa County posse members at a school in Fountain Hills, a suburb northeast of Phoenix, with children used as stand-ins for scared students.

Seagal, a burly martial arts expert turned actor, guided 48 volunteers through various aspects of responding to a shooting, including room-to-room searches, and critiqued their work.

“I am here to try to teach the posse firearms and martial arts to try to help them learn how to respond quicker and help protect our children,” Seagal said.

Arpaio, whose tough stances on crime and illegal immigration have made him a national figure, has dispatched the volunteer posse to patrol schools in response to the shooting rampage that killed 20 children and six adults at a Connecticut school in December.

Those killings touched off a renewed debate over gun violence in the United States. President Barack Obama proposed a sweeping package of gun-control measures, including a ban on assault weapons.

The National Rifle Association, which opposes the gun-control proposal, has advocated placing armed security guards in schools.

Arpaio’s volunteers, some trained and qualified to carry the same guns as deputies, can intervene if there is an imminent threat to life. To add realism to the training event, guns firing non-lethal rounds that leave a color mark were used.

“It’s important to help protect our children and our schools and we need to do that with whatever means we have,” said Rick Velotta, a posse member and retired General Electric manager who attended the training.

About a dozen people protested the event.

“No gun should ever be in a school,” said protester Cynthia Wharton, a Fountain Hills resident.

Arpaio’s 3,450-strong posse of unpaid men and women has for years helped the sheriff target drunken drivers and illegal immigrants, and chase down fathers who are behind on child support.

Last year, Arpaio sent posse members to Hawaii to investigate the authenticity of Obama’s birth certificate at the request of local Tea Party activists, a key Arpaio constituency.

A sometime resident of the Phoenix Valley and member of Arpaio’s posse, Seagal, 60, starred in big-budget films in the 1980s and early 1990s, earning a reputation as an action star in movies like “Above the Law” and “Under Siege.”

He more recently played a corrupt Mexican drug lord in the 2010 film “Machete.”

Seagal also has been sworn in as a sheriff’s deputy in a Texas county along the border with Mexico and appeared in a reality TV show detailing his work as a reserve deputy in New Orleans.

(Reporting by Aron Ranen; Writing by Tim Gaynor and Dan Whitcomb; Editing by David Bailey and Eric Beech)

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Well: Getting the Right Addiction Treatment

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

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

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

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

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

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

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

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

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

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

Routes to Success

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

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

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

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

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

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

How Families Can Help

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

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

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

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

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

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

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

Resource Network

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

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

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

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

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

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

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

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Media Decoder Blog: NPR Campaign Seeks the Quirky Listener

Are you a sky diving algebra teacher? A Sudoku-playing barista? NPR has a new ad campaign aimed at you.

The pilot campaign, in four cities, is intended to bring new listeners to local public radio stations, and in turn NPR’s national programs, by matching a show to even the quirkiest interests.

The three-month campaign, financed with a $750,000 grant from the Ford Foundation and developed by Baltimore agency Planit, includes billboards, as well as television spots, social media outreach and rail, print and digital ads aimed at adults 25 to 54, with at least some college education. Ads point to a Web site, interestingradio.com, where visitors can take a poll, discover shows and click through to a live stream from a local station.

The ads will run in the Dallas/Fort Worth, San Diego, Indianapolis and Orlando, Fla., markets, chosen because they offer geographic diversity, as well as stations that are strong and growing, said Emma Carrasco, who joined NPR two months ago as chief marketing officer, a new position.

The campaign comes as listenership for “Morning Edition” and “All Things Considered” — NPR’s two top programs and the radio news programs that reach the most people nationwide each week — declined from spring 2011 to spring 2012, the last period for which national ratings are available.

Year-to-year, the cumulative weekday audience for “Morning Edition” declined 5 percent to 12.3 million listeners a week, from 13 million, NPR officials said, citing Arbitron ratings figures, while “All Things Considered” was off 4 percent, to 11.8 million weekly listeners, compared with 12.3 million in spring 2011.

Preliminary fall 2012 estimates showed year-to-year audience increases for those two shows, NPR said, but the figures were for major markets only.

Local public radio stations have undertaken similar efforts in recent years. WQXR’s modest 2011 “Obeythoven” campaign used TV spots to get audiences thinking about New York City classical music radio in a new way. Chicago’s WBEZ this month began a cheeky campaign called “2032 Membership Drive” encouraging audiences to procreate and raise a new generation of listeners.

If NPR’s new ads are deemed successful, NPR will seek additional funds to expand them to more markets, Ms. Carrasco said.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“No, I didn’t compare you.”

“Then what did you say?”

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Boeing 787 Completes Test Flight

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

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

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

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

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

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

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

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

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

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

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

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A delicate new balancing act in senior healthcare

When Claire Gordon arrived at Cedars-Sinai Medical Center, nurses knew she needed extra attention.

She was 96, had heart disease and a history of falls. Now she had pneumonia and the flu. A team of Cedars specialists converged on her case to ensure that a bad situation did not turn worse and that she didn't end up with a lengthy, costly hospital stay.

Frail seniors like Gordon account for a disproportionate share of healthcare expenditures because they are frequently hospitalized and often land in intensive care units or are readmitted soon after being released. Now the federal health reform law is driving sweeping changes in how hospitals treat a rapidly growing number of elderly patients.

The U.S. population is aging quickly: People older than 65 are expected to make up nearly 20% of it by 2030. Linda P. Fried, dean of the Columbia University Mailman School of Public Health, said now is the time to train professionals and test efforts to improve care and lower healthcare costs for elderly patients.

"It's incredibly important that we prepare for being in a society where there are a lot of older people," she said. "We have to do this type of experiment right now."

At Cedars-Sinai, where more than half the patients in the medical and surgical wards are 65 or older, one such effort is dubbed the "frailty project." Within 24 hours, nurses assess elderly patients for their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.

The Cedars project stands out nationally because medical professionals are working together to identify high-risk patients at the front end of their hospitalizations to prevent problems at the back end, said Herb Schultz, regional director of the U.S. Department of Health and Human Services.

"For seniors, it is better care, it is high-quality care and it is peace of mind," he said.

The effort and others like it also have the potential to reduce healthcare costs by cutting preventable medical errors and readmissions, Schultz said. The federal law penalizes hospitals for both.

Gordon, an articulate woman with brightly painted fingernails and a sense of humor, arrived at Cedars-Sinai by ambulance on a Monday.

Soon, nurse Jacquelyn Maxton was at her bedside asking a series of questions to check for problems with sleep, diet and confusion. The answers led to Gordon's designation as a frail patient. The next day, the project team huddled down the hall and addressed her risks one by one. Medical staff would treat the flu and pneumonia while at the same time addressing underlying health issues that could extend Gordon's stay and slow her recovery, both in the hospital and after going home.

To reduce the chance of falls, nurses placed a yellow band on her wrist that read "fall risk" and ensured that she didn't get up on her own. To prevent bed sores, they got her up and moving as often as possible. To cut down on confusion, they reminded Gordon frequently where she was and made sure she got uninterrupted sleep. Medical staff also stopped a few unnecessary medications that Gordon had been prescribed before her admission, including a heavy narcotic and a sleeping pill.

"It is really a holistic approach to the patient, not just to the disease that they are in here for," said Glenn D. Braunstein, the hospital's vice president for clinical innovation.

Previously, nurse Ivy Dimalanta said, she and her colleagues provided similar care but on a much more random basis. Under the project, the care has become standardized.

The healthcare system has not been well designed to address the needs of seniors who may have had a lifetime of health problems, said Mary Naylor, gerontology professor at the University of Pennsylvania School of Nursing. As a result, patients sometimes fall through the cracks and return to hospitals again and again.

"That is not good for them and that is not good for society to be using resources in that way," Naylor said.

Using data from related projects, Cedars began a pilot program in 2011 and expanded it last summer. The research is continuing but early results suggest that the interventions are leading to fewer seniors being admitted to the intensive care unit and to shorter hospital stays, said Jeff Borenstein, researcher and lead clinician on the frailty project. "It definitely seems to be going in the right direction," he said.

The hospital is now working with Naylor and the University of Pennsylvania to design a program to help the patients once they go home.

"People who are frail are very vulnerable when they leave the hospital," said Harriet Udin Aronow, a researcher at Cedars. "We want to promote them being safe at home and continuing to recover."

In Gordon's case, she lives alone with the help of her children and a caregiver. The hospital didn't want her experiencing complications that would lengthen the stay, but they also didn't want to discharge her before she was ready. Under the health reform law, hospitals face penalties if patients come back too soon after being released.

Patients and their families often are unaware of the additional attention. Sitting in a chair in front of a vase of pink flowers, Gordon said she knew she would have to do her part to get out of the hospital quickly. "You have to move," she said. "I know you get bed sores if you stay in bed."

Gordon said she was comfortable at the hospital but she wanted to go back to her house as quickly as she could. "There's no place like home," she said.

Two days later, that's where she was.

anna.gorman@latimes.com

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In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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John E. Karlin, 1918-2013: John E. Karlin, Who Led the Way to All-Digit Dialing, Dies at 94

Courtesy of Alcatel-Lucent USA

John E. Karlin, a researcher at Bell Labs, studied ways to make the telephone easier to use.

A generation ago, when the poetry of PEnnsylvania and BUtterfield was about to give way to telephone numbers in unpoetic strings, a critical question arose: Would people be able to remember all seven digits long enough to dial them?

And when, not long afterward, the dial gave way to push buttons, new questions arose: round buttons, or square? How big should they be? Most crucially, how should they be arrayed? In a circle? A rectangle? An arc?

For decades after World War II, these questions were studied by a group of social scientists and engineers in New Jersey led by one man, a Bell Labs industrial psychologist named John E. Karlin.

By all accounts a modest man despite his variegated accomplishments (he had a doctorate in mathematical psychology, was trained in electrical engineering and had been a professional violinist), Mr. Karlin, who died on Jan. 28, at 94, was virtually unknown to the general public.

But his research, along with that of his subordinates, quietly yet emphatically defined the experience of using the telephone in the mid-20th century and afterward, from ushering in all-digit dialing to casting the shape of the keypad on touch-tone phones. And that keypad, in turn, would inform the design of a spate of other everyday objects.

It is not so much that Mr. Karlin trained midcentury Americans how to use the telephone. It is, rather, that by studying the psychological capabilities and limitations of ordinary people, he trained the telephone, then a rapidly proliferating but still fairly novel technology, to assume optimal form for use by midcentury Americans.

“He was the one who introduced the notion that behavioral sciences could answer some questions about telephone design,” Ed Israelski, an engineer who worked under Mr. Karlin at Bell Labs in the 1970s, said in a telephone interview on Wednesday.

In 2013, the 50th anniversary of the introduction of the touch-tone phone, the answers to those questions remain palpable at the press of a button. The rectangular design of the keypad, the shape of its buttons and the position of the numbers — with “1-2-3” on the top row instead of the bottom, as on a calculator — all sprang from empirical research conducted or overseen by Mr. Karlin.

The legacy of that research now extends far beyond the telephone: the keypad design Mr. Karlin shepherded into being has become the international standard on objects as diverse as A.T.M.’s, gas pumps, door locks, vending machines and medical equipment.

Mr. Karlin, associated from 1945 until his retirement in 1977 with Bell Labs, headquartered in Murray Hill, N.J., was widely considered the father of human-factors engineering in American industry.

A branch of industrial psychology that combines experimentation, engineering and product design, human-factors engineering is concerned with easing the awkward, often ill-considered marriage between man and machine. In seeking to design and improve technology based on what its users are mentally capable of, the discipline is the cognitive counterpart of ergonomics.

“Human-factors studies are different from market research and other kinds of studies in that we observe people’s behavior and record it, systematically and without bias,” Mr. Israelski said. “The hallmark of human-factors studies is they involve the actual observation of people doing things.”

Among the issues Mr. Karlin examined as the head of Bell Labs’ Human Factors Engineering department — the first department of its kind at an American company — were the optimal length for a phone cord (a study that involved gentle, successful sabotage) and the means by which rotary calls could be made efficiently after the numbers were moved from inside the finger holes, where they had nestled companionably for years, to the rim outside the dial.

John Elias Karlin was born in Johannesburg on Feb. 28, 1918, and reared nearby in Germiston, where his parents owned a grocery store and tearoom.

He earned a bachelor’s degree in philosophy, psychology and music, and a master’s degree in psychology, both from the University of Cape Town. Throughout his studies he was a violinist in the Cape Town Symphony Orchestra and the Cape Town String Quartet.

Moving to the United States, Mr. Karlin earned a Ph.D. from the University of Chicago in 1942. Afterward, he became a research associate at Harvard; he also studied electrical engineering there and at the Massachusetts Institute of Technology.

At Harvard, Mr. Karlin did research for the United States military on problems in psychoacoustics that were vital to the war effort — studying the ways, for instance, in which a bomber’s engine noise might distract its crew from their duties.

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