Chris Bliss Builds Monument to Bill of Rights

PHOENIX — It started as a joke about 10 years ago. Chris Bliss, a juggler and stand-up comedian of viral Internet fame, had been scanning the headlines for inspiration and discovered the controversy over a granite monument to the Ten Commandments in the rotunda of Alabama’s state judicial building.

“Instead of arguing over whether to leave up or take down these displays of the Ten Commandments,” read his ensuing comedy routine, “my suggestion is to put up displays of the Bill of Rights next to them and let people comparison shop.”

Funny or not, the idea intrigued him, so Mr. Bliss set out to search for Bill of Rights monuments, only to find there were none. He decided to try to build one, and to do it in Arizona, “a place that’s known as contentious, a backwater, even,” he said. As he spoke early Wednesday, the monument was beginning to take shape on a knoll overlooking the State Capitol, in a plaza full of other monuments and memorials honoring women, veterans and, yes, the Ten Commandments.

Before it could happen, though, Mr. Bliss, who left Phoenix for Austin, Tex., three years ago, had to figure out a way to get the Legislature to approve the monument on a slice of public land. In 2005, he was a guest on a radio show hosted by Kyrsten Sinema, then a freshman state representative, and asked if she would sponsor a bill.

“I’m a Democrat, and this is Arizona,” Ms. Sinema recalled telling him. “You need a Republican to push this legislation for you.” (Republicans have been the majority in the Legislature for at least 40 years.)

“I don’t like ‘no’s’ for answers,” Mr. Bliss said.

Ms. Sinema, who was elected to Congress last month, devised a strategy. If the legislation were to be approved, she said in an interview, it would need the support of a staunch Republican, preferably in the Senate, which is where many bills sponsored by Democrats customarily implode. She zeroed in on Karen S. Johnson, whom she described as “Tea Party before there was a Tea Party.” (Ms. Johnson, who left the Legislature in 2008, prefers the “conservative” label.)

“Hey, for heaven’s sake, how could anybody not be supportive of this?” said Ms. Johnson, who is perhaps better known for sponsoring a bill that would have allowed people bearing concealed-weapon permits to carry guns at public colleges and universities.

She had no qualms about putting her name next to Ms. Sinema, who at 28 was the Legislature’s youngest member — as well as an openly bisexual lawmaker whom “a lot of people liked to pick on,” as Ms. Sinema put it.

The bill stipulated that the project had to be paid through private donations. On Mother’s Day, Mr. Bliss raised more than $100,000 through a benefit concert here, out of $375,000 he has raised so far. (He said there is still about $10,000 to go.)

The concert brought together some big names in both comedy and civil rights. One of them, Dick Gregory, 80, had marched alongside the Rev. Dr. Martin Luther King Jr. and staged hunger strikes in the name of racial equality. Another, Tom Smothers, 75, was a star of “The Smothers Brothers Comedy Hour,” a top-rated show on CBS from 1967 to 1969 before it was canceled over the provocative tone of its political commentary, particularly on the Vietnam War.

The bill passed unanimously in the Arizona House and Senate in 2006, which is unusual for a legislative body that remains politically divided. It was an encouraging moment for Mr. Bliss, who said it “confirmed it was a mission worth committing to.” Since then, a commemorative Bill of Rights display has been unveiled outside the Poweshiek County Courthouse in Montezuma, Iowa, and another has been approved in Everett, Wash. Mr. Bliss has also begun raising money for a monument outside the Texas Supreme Court building in Austin.

The lead sculptor for the monument here, Joseph Kincannon, has carved 10 slabs of limestone, one for each amendment. They are planted outside the Capitol and will be dedicated on Saturday. Each slab is undulating and unique – the First Amendment resembles the tip of a key; the Second Amendment, a pregnant woman’s profile.

Mr. Kincannon trained at the stone yard at the Cathedral Church of St. John the Divine in Manhattan. He worked there for 27 years, carving and building its ornate south tower. He said he wanted the monument’s pieces “to have movement when they were next to each other” so they would become “inviting to the eye.”

The blocks of limestone came from a quarry near Austin, where they were milled and carved over the summer. The heaviest, at approximately 7,000 pounds, carries the imprint of the Fifth Amendment, which protects against abuse of government authority in a legal procedure. The lightest, at 2,500 pounds, offers the Third Amendment, which prohibits quartering soldiers in private homes without the homeowner’s consent.

Mr. Kincannon has read the material over and over, and from many angles. To him, the project was never about the significance behind the words, but about making them “comfortable to read,” he said.

For Mr. Bliss, however, it is all about the words’ meaning. He envisions the monument as a place for learning and reflection, “our bedrock principles broken up in 10 digestible bites,” he said.

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WebMD to cut 14 percent of workforce to reduce expenses

(Reuters) – Health information website WebMD Health Corp said it will cut around 250 jobs, or 14 percent of its workforce, to reduce costs.

The company, which had about 1700 employees according to Thomson Reuters data, said it would take a charge of about $ 6 million to $ 8 million in the fourth quarter, primarily on severance and other restructuring-related costs.

WebMD, which is a popular and long-trusted destination for checking health and disease related information, has lost its sheen for investors in recent times as it struggled to convert its growing user base into a steady revenue stream.

The company named a former Pfizer Inc executive Cavan Redmond as CEO earlier this year, entrusting the industry veteran with the task of reviving the website’s flagging business.

Its previous CEO, Wayne Gattinella, resigned after the company took itself off the auction block in January.

WebMD also said on Tuesday that it plans to streamline its operations and focus resources on increasing user engagement, customer satisfaction and innovation, and expects these efforts to reduce annualized operating expenses by about $ 45 million.

While most of the job cuts will be effective at the end of the year, other cost saving actions will be implemented in the first quarter of 2013, the company said in a statement.

The company reported a third-quarter loss in November, compared with a profit in the year-ago quarter, and said revenue fell 13 percent.

WebMD’s shares, which have lost nearly 40 percent of their value over the past six months, were down about 2 percent in premarket trade. They closed at $ 13.85 on Monday on the Nasdaq.

(Reporting by Esha Dey in Bangalore; Editing by Roshni Menon)

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Luke Bryan cleans up at ACAs with 9 awards

Luke Bryan didn't want the American Country Awards to end.

He cleaned up during the fan-voted show, earning nine awards, including artist and album of the year. His smash hit "I Don't Want This Night To End" was named single and music video of the year.

Miranda Lambert took home the second most guitar trophies with three. Jason Aldean was named touring artist of the year. Carrie Underwood won female artist of the year, and a tearful Lauren Alaina won new artist of the year.

Bryan, Aldean, Keith Urban, Lady Antebellum and Trace Adkins with Lynyrd Skynrd were among the high-energy performances.

The third annual ACAs were held at Mandalay Bay in Las Vegas Monday night.

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Online: http://www.theACAs.com

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Follow http://www.twitter.com/AP_Country for the latest country music news from The Associated Press.

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Mind: A Compromise on Defining and Diagnosing Mental Disorders

They plotted a revolution, fell to debating among themselves, and in the end overturned very little except their own expectations.

But the effort itself was a valuable guide for anyone who has received a psychiatric diagnosis, or anyone who might get one.

This month, the American Psychiatric Association announced that its board of trustees had approved the fifth edition of the association’s influential diagnostic manual — the so-called bible of mental disorders — ending more than five years of sometimes acrimonious, and often very public, controversy.

The committee of doctors appointed by the psychiatric association had attempted to execute a paradigm shift, changing how mental disorders are conceived and posting its proposals online for the public to comment. And comment it did: Patient advocacy groups sounded off, objecting to proposed changes in the definitions of depression and Asperger syndrome, among other diagnoses. Outside academic researchers did, too. A few committee members quit in protest.

The final text, which won’t be fully available until publication this spring, has already gotten predictably mixed reviews. “Given the challenges in a field where objective lines are hard to draw, they did a solid job,” said Dr. Michael First, a psychiatrist at Columbia who edited a previous version of the manual and was a consultant on this one.

Others disagreed. “This is the saddest moment in my 45-year career of practicing, studying and teaching psychiatry,” wrote Dr. Allen Frances, the chairman of a previous committee who has been one of the most vocal critics, in a blog post about the new manual, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM5.

Yet many experts inside and outside the process said the final document was not radically different from the previous version, and its lessons more mundane than the rhetoric implied. The status quo is hard to budge, for one. And when changes do happen, they are not necessarily the ones that were intended.

The new manual does extend the reach of psychiatry in some areas, as many critics feared it might. Hoarding is now a mental disorder (previously it was considered a symptom of obsessive-compulsive behavior). “Premenstrual dysphoric disorder,” a severe form of premenstrual syndrome, is also new (it was previously in the appendix).

And binge-eating disorder (also formerly in the appendix), a kind of severe, highly distressing gluttony, is now a full-blown diagnosis. This one by itself could tag millions of people considered healthy, if often overindulgent, with a psychiatric label, some experts said.

But the deeper story is one of compromise. It is most evident in how the committee handled three of the thorniest diagnoses in psychiatry: autism, depression and pediatric bipolar disorder.

The group working on depression declared early on that it wanted to eliminate the so-called bereavement exclusion, which stated that grieving the loss of a loved one should not be considered a clinical disorder, though it shares many of the same outward signs. Grief has always been a normal reaction to death, not a kind of depression.

Advocacy and support groups, such as those representing people who have lost a child, objected furiously to the idea that the bereaved might be given a diagnosis of depression.

“This was just astonishing, that they would eliminate the exclusion, and a distortion of the research on the subject,” said Jerome Wakefield, a professor of social work and psychiatry at New York University, who did not work on the manual.

In the end the committee cut a deal. It eliminated the grief exclusion but added a note in the text, reminding doctors that any significant loss — of a job, a relationship, a home — could cause depressive symptoms and should be carefully investigated.

“It’s like they took it all back,” Dr. Wakefield said. “I don’t like the way it was done — in a footnote — but it’s there.”

The debate over autism was even more furious, and it resulted in a similar rapprochement.

From the outset, the committee intended to tighten the definition of autism and simplify it, eliminating related labels like Asperger syndrome and “pervasive developmental disorder not otherwise specified,” or PDD-NOS. The rate of diagnosis of such conditions has exploded over the past decade, in part due to the vagueness of the definitions, and the committee wanted to draw clearer boundaries.

It proposed a single “autism spectrum disorder” category, with stricter requirements.

Some outside researchers raised concerns. In January one of them, Dr. Fred Volkmar of the Yale School of Medicine, who had quit the committee in protest, presented research suggesting that 45 percent or more of people who currently had an autism or related diagnosis would not have one under the proposed revision.

Autism groups reacted immediately, fearing that the change in the diagnosis would deny services to children and families who need them.

The committee countered with its own study, suggesting that the new definition would exclude about 10 percent of people currently with a diagnosis. And again, the experts took a half step back.

The new, streamlined definition was approved, but with language that took into account a person’s diagnostic history. “It’s explicit that anyone who’s had an Asperger’s or autism or PDD-NOS diagnosis before is now included,” said Catherine Lord, a committee member who worked on the new definition and who is director of the Center for Autism and the Developing Brain in New York. “Essentially everyone gets in.”

Pediatric bipolar disorder posed a different challenge.

In the 1990s and 2000s, psychiatrists began giving aggressive, explosive children a diagnosis of bipolar disorder in increasing numbers. The trend appalled many patient advocates and doctors.

Bipolar disorder, which is characterized by episodes of depression and mania, had previously been an adult problem; now the diagnosis is given to children as young as 2 — along with powerful psychiatric drugs and tranquilizers that also cause rapid weight gain. The committee wanted to stop the trend in its tracks, said experts who were involved.

Most of the children treated for bipolar disorder did not have it, recent research found. The committee settled on an alternative label: “disruptive mood dysregulation disorder,” or D.M.D.D., which describes extreme hostility and outbursts beyond normal tantrums.

“They essentially wanted to have some place for these kids, and D.M.D.D. was all they had in their kit,” said Dr. Gabrielle Carlson, a child psychiatrist at Stony Brook University Medical Center, who provided some outside consultation. “These are mostly kids who have A.D.H.D. or what we would call oppositional defiant disorder, but with this explosive feature. They need help; you can’t wait forever. The question was what to call it, without pretending we know enough to saddle them with a lifelong diagnosis” like bipolar disorder.

D.M.D.D. has its own problems, as many experts were quick to point out. It could be a symptom of an underlying condition, as Dr. Carlson argues. It could “medicalize” frequent temper tantrums. It’s brand new, and no one knows how it will play out in practice.

But it is now in the book — because it was the best solution available, experts inside and outside of the revision process said.

From beginning to end, many experts said, the process of defining psychiatric diagnoses is very much like finding the right one for an individual: it’s a process of negotiation, in many cases.

“That’s one of the take-aways from all this, and I think it’s a good one,” Dr. Carlson said. “A diagnosis is a hypothesis. It’s a start, and you have to start somewhere. But that’s all it is.”

One of the committee’s most ambitious proposals was perhaps the least noticed: a commitment to update the book continually, when there’s good reason to, rather than once every decade or so in a giant heave. That was approved without much fanfare.

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Moroccans Fear That Flickers of Democracy Are Fading

TANGIER, Morocco — Until recently, politics in Morocco involved red carpets and speeches in high Arabic that the average citizen could not understand. But on a campaign swing this fall through a working-class area of this port city, Prime Minister Abdelilah Benkirane stood on a makeshift podium in a muddy vacant lot.

He spoke without notes, kissed babies passed forward by the crowd and promised, as he has done all along, to fight corruption and return the government to the people.

“We will get stronger with the help of God and accomplish what we wanted,” he told the crowd, which roared its approval.

But more and more Moroccans are questioning his ability to do that, wondering whether Morocco’s version of the Arab Spring brought anything more than cosmetic changes to this impoverished country, which has been one of America’s most stable and staunch allies in a region marked by turmoil.

A year ago, it seemed Moroccans were giddy with the sense that they had found a gentle, negotiated answer to the popular uprisings in the streets. The country’s king, Mohammed VI, 49, defused angry protesters by volunteering to share his power. Within months, Morocco had a new Constitution.

Mr. Benkirane’s moderate Islamist party, the Justice and Development Party, won a plurality in parliamentary elections in November. Western governments heaped praise on the election process, satisfied that this strategically important country, just 12 miles south of Spain and atop a changing and uncertain continent, was settling in to a new more democratic order. (This week Secretary of State Hillary Rodham Clinton is scheduled to visit Morocco for a meeting of the Friends of Syria.)

But these days, many here are questioning whether the king and his entourage really gave up anything at all. Telquel, perhaps the country’s most influential magazine, ran a cover story this fall saying that the palace had gradually taken back its concessions: the king’s shadow cabinet was interfering at will and was even sending its own emissaries to the United States and Brussels when Moroccan interests needed tending to. Mr. Benkirane, the magazine pointed out, had publicly admitted that the king’s advisers sometimes met with government officials without consulting him.

Some also point to a quiet clamping down on political activists. In October, the United Nations said there was evidence of a recent spike in reports of torture in Morocco. About 70 protesters associated with the pro-democracy February 20 Movement are still in prison. In May, a popular rapper was sentenced to a year in jail for a song about police corruption. And six political activists testified at a hearing in September that they had been physically — and sexually — abused after being arrested for protesting in July.

In other countries rocked by Arab Spring uprisings, tensions today are being felt largely over the role of Islam in government. These issues have come up in Morocco, too. But here, the larger tensions appear to be over the power of the old guard. Many Moroccans will not criticize the king, instead focusing on the network of power and privilege that surrounds him and the corruption that they believe sucks any hope of prosperity from this country.

The problems Morocco faces are enormous. The country has invested heavily in infrastructure: superhighways are everywhere and there are plans for a high-speed train, too. But 40 percent of the population cannot read or write. Forbes has estimated the king’s fortune to be more than $2 billion. But the average income here is low, roughly half of what it was in Tunisia, where the Arab Spring first took off.

Mr. Benkirane took office showing a flare for the dramatic. He quickly slashed ministerial salaries and perquisites, and he refused to move to the prime minister’s mansion. He also took on Morocco’s notorious cronyism. To widespread amazement, his government published the names of those who had been given lucrative bus licenses. Since then, however, his efforts have foundered.

Some critics say the prime minister has been outmaneuvered at every turn. Once last spring, Mr. Benkirane seemed to lash out at the king and his entourage, suggesting that protesters could easily return to the streets. But soon after, he said the remarks had been misunderstood.

Aida Alami contributed reporting.

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Hug It Out: Public Charter and District Schools Given $25 Million to Get Along

If you need a loan, ask Bill and Melinda Gates. Or better yet, ask one of the seven cities that are splitting a new $ 25 million grant courtesy of the couple’s philanthropic foundation.

The funds are going to promote cross collaboration between charter and district schools, which have previously operated in a strict and contentious independence from one another.

The foundation announced the award this week, and the cities benefiting are Boston, Denver, Hartford (CT), New Orleans, New York City, Philadelphia and Spring Branch (TX).

How did they get so lucky? They’re among a group of 16 communities that signed the Gates-sponsored “District-Charter Collaboration Compacts” pledging for an open-source collaboration between public charter and district public schools.

Communication between these two models is unusual to say the least; they’ve had a long and illustrious history of battling each other over tax dollars, students and even building space.

But when charter schools first opened 20 years ago, their original purpose was to create an experimental educational space which would then share its best methods with public district schools. Instead, the two grew into rivals and critics of each are vehemently opposed to the other.

Among the complaints, charter schools are seen as selfishly siphoning off the most motivated students from the district while upholding a rich-poor educational divide and failing to live up to the promise of a better education. Others say its district schools that are the issue for their unionized teacher complacency and a consistent inability to keep a large margin of students from falling through the cracks.

In truth, neither system is a slam-dunk, and both are experiencing closures nationwide due to underperformance.

The goal of the District-Charter Collaboration Compacts is to restore the original relationship of the two camps, effectively establishing a regular protocol of sharing their best practices, innovations and resources.

Don Shalvey, the deputy director at teh Gates Foundation told The New York Times, “It took Microsoft and Apple 10 years to learn to talk. So it’s not surprising that it took a little bit longer for charters and other public schools. It’s pretty clear there is more common ground than battleground.”

But what will this grand collaboration yield? If all goes according to plan, students from both camps will benefit from new teacher effectiveness practices, college-ready tools and supports, and innovative instructional delivery systems.

According to the Gates Foundation, only one-third of students meet the criteria of college ready by the time they graduate. And most of the kids who don’t are often minority students from lower income areas. By creating collaborative aims with charter and district, kids from all over can have access to a wider swath of teaching frameworks and curriculums. 

Related Stories on TakePart:

• Public Dollars for Private Schools? Voices from the Voucher Debate

• School Vouchers: The Debate Heats Up Across the U.S.

• Howard Fuller: One of the Most Powerful Educators in America

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A Bay Area native, Andri Antoniades previously worked as a fashion industry journalist and medical writer.  In addition to reporting the weekend news on TakePart, she volunteers as a webeditor for locally-based nonprofits and works as a freelance feature writer for TimeOutLA.com. Email Andri | @andritweets | TakePart.com

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Singer feared dead in Mexican plane crash

MONTERREY, Mexico (AP) — Mexico's music world mourned Jenni Rivera, the U.S.-born singer presumed killed in a plane crash whose soulful voice and openness about her personal troubles had made her a Mexican-American superstar.

Authorities have not confirmed her death, but Rivera's relatives in the U.S. say they have few doubts that she was on the Learjet 25 that disintegrated on impact Sunday in rugged territory in Nuevo Leon state in northern Mexico.

"My son Lupillo told me that effectively it was Jenni's plane that crashed and that everyone on board died," her father, Pedro Rivera, told dozens of reporters gathered in front of his Los Angeles-area home. "I believe my daughter's body is unrecognizable."

He said that his son would fly to Monterrey Monday.

Messages of condolence poured in from fellow musicians and celebrities.

Mexican songstress and actress Lucero wrote on her Twitter account: "What terrible news! Rest in peace ... My deepest condolences for her family and friends." Rivera's colleague on the Mexican show "The Voice of Mexico," pop star Paulina Rubio, said on her Twitter account: "My friend! Why? There is no consolation. God, please help me!"

Born in Long Beach, California, Rivera was at the peak of her career as perhaps the most successful female singer in grupero, a male-dominated regional style influenced by the norteno, cumbia and ranchero styles.

A 43-year-old mother of five children and grandmother of two, the woman known as the "Diva de la Banda" was known for her frank talk about her struggles to give a good life to her children despite a series of setbacks.

She was recently divorced from her third husband, was once detained at a Mexico City airport with tens of thousands of dollars in cash, and she publicly apologized after her brother assaulted a drunken fan who verbally attacked her in 2011.

Her openness about her personal troubles endeared her to millions in the U.S. and Mexico.

"I am the same as the public, as my fans," she told The Associated Press in an interview last March.

Rivera sold 15 million records, and recently won two Billboard Mexican Music Awards: Female Artist of the Year and Banda Album of the Year for "Joyas prestadas: Banda." She was nominated for Latin Grammys in 2002, 2008 and 2011.

Transportation and Communications Minister Gerardo Ruiz Esparza said "everything points toward" the wreckage belonging to the plane carrying Rivera and six other people to Toluca, outside Mexico City, from Monterrey, where the singer had just given a concert.

"There is nothing recognizable, neither material nor human" in the wreckage found in the state of Nuevo Leon, Ruiz Esparza said. The impact was so powerful that the remains of the plane "are scattered over an area of 250 to 300 meters. It is almost unrecognizable."

A mangled California driver's license with Rivera's name and picture was found in the crash site debris.

No cause was given for the plane's crash, but its wreckage was found near the town of Iturbide in Mexico's Sierra Madre Oriental, where the terrain is very rough.

The Learjet 25, number N345MC, took off from Monterrey at 3:30 a.m. local time and was reported missing about 10 minutes later. It was registered to Starwood Management of Las Vegas, Nevada, according to FAA records. It was built in 1969 and had a current registration through 2015.

Also believed aboard the plane were her publicist, Arturo Rivera, her lawyer, makeup artist and the flight crew.

Though drug trafficking was the theme of some of her songs, she was not considered a singer of "narco corridos," or ballads glorifying drug lords like other groups, such as Los Tigres del Norte. She was better known for singing about her troubles in love and disdain for men.

Her parents were Mexicans who had migrated to the United States. Two of her five brothers, Lupillo and Juan Rivera, are also well-known singers of grupero music.

She studied business administration and formally debuted on the music scene in 1995 with the release of her album "Chacalosa". Due to its success, she recorded two more independent albums, "We Are Rivera" and "Farewell to Selena," a tribute album to slain singer Selena that helped expand her following.

At the end of the 1990s, Rivera was signed by Sony Music and released two more albums. But widespread success came for her when she joined Fonovisa and released her 2005 album titled "Partier, Rebellious and Daring."

Besides being a singer, she is also a businesswoman and actress, appearing in the indie film Filly Brown, which was shown at the Sundance Film Festival, as the incarcerated mother of Filly Brown.

She was filming the third season of "I love Jenni," which followed her as she shared special moments with her children and as she toured through Mexico and the United States. She also has the reality shows: "Jenni Rivera Presents: Chiquis and Raq-C" and her daughter's "Chiquis 'n Control."

In 2009, she was detained at the Mexico City airport when she declared $20,000 in cash but was really carrying $52,167. She was taken into custody. She said it was an innocent mistake and authorities gave her the benefit of the doubt and released her.

In 2011, her brother Juan assaulted a drunken fan at a popular fair in Guanajuato. In the face of heavy criticism among her fans and on social networks, Rivera publicly apologized for the incident during a concert in Mexico City, telling her fans: "Thank you for accepting me as I am, with my virtues and defects."

On Saturday night, Rivera had given a concert before thousands of fans in Monterrey. After the concert she gave a press conference during which she spoke of her emotional state following her recent divorce from former Major League Baseball pitcher Esteban Loaiza, who played for teams including the New York Yankees and Los Angeles Dodgers.

"I can't get caught up in the negative because that destroys you. Perhaps trying to move away from my problems and focus on the positive is the best I can do. I am a woman like any other and ugly things happen to me like any other woman," she said Saturday night. "The number of times I have fallen down is the number of times I have gotten up."

Rivera had announced in October that she was divorcing Loaiza after two years of marriage.

There have been several high-profile crashes involving Learjets, known as swift, longer-distance passenger aircraft popular with corporate executives, entertainers and government officials.

A Learjet carrying pro-golfer Payne Stewart and five others crashed in northeastern South Dakota in 1999. Investigators said the plane lost cabin pressure and all on board died after losing consciousness for lack of oxygen. The aircraft flew for several hours on autopilot before running out of fuel and crashing in a corn field.

Former Blink 182 drummer Travis Barker was severely injured in a 2008 Learjet crash in South Carolina that killed four people.

That same year, a Learjet slammed into rush-hour traffic in a posh Mexico City neighborhood, killing Mexico's No. 2 government official, Interior Secretary Juan Camilo Mourino, and eight others on the plane, plus five people on the ground.

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Associated Press Writer Galia Garcia-Palafox and Olga R. Rodriguez contributed to this report from Mexico City.

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The New Old Age Blog: Training Needed for Home Care Is Lacking

“H” from Chicago, I heard you when you joined a lively discussion over hospice at home here a couple of weeks ago and asked, “where can family members get the training to do all the nursing tasks?”

In the comments section, many readers wrote in to say that caring for relatives at the end of their lives was a duty and a privilege. Others said they were unprepared for the physical and emotional burdens of doing so.

Your question stood out because of its practical character. Do caregivers have to figure out how to handle all these complicated medical issues on their own? Or is some help out there?

For an answer, I called two of the authors of “Home Alone: Family Caregivers Providing Complex Chronic Care,” put out by the United Hospital Fund and the AARP Public Policy Institute. That study recently made headlines by reporting that 46 percent of the nation’s 42 million caregivers handle medical and nursing tasks such as giving injections, caring for wounds or administering I.V.s.

Susan Reinhard, senior vice president and director of the AARP Public Policy Institute, sighed when I reached her, and said “this is a huge gap,” referring to a notable absence of available training in demanding caregiving tasks.

To the extent training exists through local agencies on aging, disease-specific organizations or social service groups, it deals mostly with so-called “activities of daily living” — helping someone bath, dress, eat, or use the bathroom — not the demands of nursing-style care, Ms. Reinhard observed.

Really, this kind of training should be the responsibility of health care providers, but doctors and nurses often give only cursory, unsatisfactory explanations of complex tasks that fall to caregivers, said Carol Levine, director of the Families and Health Care Project of the United Hospital Fund.

That leaves the burden on caregivers to be assertive and ask for help, these experts agreed. If someone is hospitalized and ready to return home, they suggest asking a nurse or another provider “show me what you are doing so I can learn how to do it,” and then asking “now, watch me do it and tell me if I am doing it wrong or right.”

Don’t give up after the first time if you feel awkward or uncomfortable. Ask to do the task again, and ask again for feedback.

No videos or written manuals, can substitute for this one-on-one, hands-on instruction. If you don’t get it to your satisfaction before a loved-one is ready to go home, don’t sign the form that says you have been given instructions on what to do, Ms. Reinhard advised. The hospital is legally obligated to ensure that discharges are safe, and this operates in your favor.

The same goes for the pharmacy: don’t sign that sheet that the pharmacist hands you indicating that you have been adequately informed about the medications you are purchasing. If you are concerned about the number of prescriptions, what they are for, their possible side effects and whether all are necessary, ask the pharmacist to sit down with you and go over all this information. Again, don’t leave until you are satisfied.

Often, caregiving tasks will change as someone with a chronic condition like Parkinson’s disease or heart failure becomes more frail. Should this happen, consider calling a home care agency and asking for a nurse to come out and teach you how to administer oxygen or help transfer someone safely from a bed to a wheelchair, Ms. Reinhard said.

You may want to videotape the session so you can view it several times; most of us don’t pick these skills up right away and need repeat practice, Ms. Levine said.

Be as specific in your request for help as possible. Rather than complaining that you are overwhelmed, say something along the lines of, “I want to make sure I know how to clean this wound and prevent an infection” or “I need to know what texture the food should be so I can feed mom without having her choke,” Ms. Levine suggested.

Her organization has prepared comprehensive materials for caregivers called “Next Step in Care.” While the focus isn’t on nursing-style caregiving tasks, three might be useful: a self-assessment tool for family caregivers, a medication management guide, and a guide to hospice and palliative care.

Other helpful materials are few and far between. Ms. Levine’s staff identified a $24.95 American Red Cross training manual for family caregivers that has a DVD explaining the mechanics of transfers and a few other complicated tasks. Also, some videos are available for free at www.mmlearn.org, a Web site that says its mission is to provide caregivers with online training and education.

Asked about model programs, Ms. Reinhard said she knew of only one: the Schmieding Home Caregiver Training Program in Arkansas, operated by the Donald W. Reynolds Institute on Aging of the University of Arkansas for Medical Sciences. The Schmieding program trains family caregivers as well as professional caregivers who work in people’s homes or nursing homes.

On the family side, it offers eight hours of instruction in “physical needs” associated with caregiving — managing incontinence, skin care, turning someone regularly in bed, using adaptive equipment, transfers from a bed to a wheelchair, helping patients remain mobile, and more. Classes are offered at five sites and four more are planned in the next several years, said Robin McAtee, associate director of the Reynolds Institute on Aging. If people, churches or senior centers want the instruction, which is free, Schmieding nurses will take the program to them. One-on-one instruction for tasks is also available on request.

A separate eight-hour program is available for caregivers dealing with dementia, who have additional concerns.

At a Web site called Elder Stay at Home, Schmieding sells a package of materials (three DVDs and a booklet, for $99) summarizing the content of its family caregiver training program. Separately, it has begun selling its curriculum for paid caregivers, and programs in California, Hawaii and Texas are among the first buyers. The University of Arkansas for Medical Sciences also has received a $3.7 million innovation grant from the government to expand the caregiver training program more broadly and develop online training materials.

Ms. Reinhard said AARP would like to see Schmieding-style programs rolled out across the country and begin to offer structured, reliable support to caregivers now providing nursing-style care in homes with little or no assistance.

What else am I missing here? Do you know of resources or other organizations providing intensive caregiver training along the lines of what I’ve been discussing? Where would you suggest people turn for this kind of help?

Editor’s Note:

Correction: An earlier version of this post contained an incorrect spelling of the first name of the director of the Families and Health Care Project of the United Hospital Fund. She is Carol Levine, not Carole Levine.

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DealBook: Standard Chartered Agrees to Settle Iran Money Transfer Claims

The British bank Standard Chartered reached a deal with federal and state prosecutors on Monday over accusations that it had illegally funneled money for Iranian banks and corporations.

The 150-year-old bank will pay $327 million to settle claims by the Justice Department, the Manhattan district attorney’s office, the Federal Reserve Bank of New York and the Treasury Department.

“Investigations of financial institutions, businesses and individuals who violate U.S. sanctions by misusing banks in New York are vitally important to national security and the integrity of our banking system,” Cyrus R. Vance Jr., the Manhattan district attorney, said in a statement.

The agreement allows the bank to move beyond a turbulent period.

In August, the New York State Department of Financial Services, headed by Benjamin M. Lawsky, broke from regulators and moved to accuse Standard Chartered of scheming for nearly a decade to hide 60,000 transactions worth $250 billion. Standard Chartered agreed to pay $340 million over the matter a month later.

United States authorities have been cracking down on banks that flouted federal law to transfer money on behalf of sanctioned nations. Investigations into Standard Chartered began in 2009, according to several law enforcement officials.

Executives at Standard Chartered have spent months trying to work out a settlement and resolve the investigation. Lawyers for the bank, in numerous conversations with federal and state prosecutors, maintained vociferously that a large majority of the transactions with Iran were permitted under a federal law that previously allowed foreign banks to transfer money for Iranian clients to another foreign institution through their American subsidiaries.

The settlement will also help to quell tensions between the law enforcement agencies, which were riven by divisions after Mr. Lawsky moved independently against the bank.

Since January 2009, the Justice Department, Treasury and the Manhattan prosecutor have charged five foreign banks in an effort to crack down on the illegal movement of tainted money across the globe. In June, ING Bank reached a $619 million settlement to resolve claims that it had transferred billions of dollars in the United States for Cuba and Iran.

As part of the agreement announced on Monday, Standard Chartered admitted to processing more than $200 million for Iranian and Sudanese clients through its American subsidiaries. To avoid having those transactions detected by Treasury Department computer filters, Standard Chartered deliberately removed identifying information, according to the authorities.

Until 2008, foreign banks like Standard Chartered were permitted to transfer money for Iranian clients through their American branches to separate offshore institutions. These so-called U-turn transactions required banks to provide scant information about the original client to their American operations as long as they had checked for questionable activities. The Iranian loophole was closed in 2008 after American authorities suspected that Iranian banks were funneling money to support nuclear weapons development.

While the overwhelming majority of payments processed by Standard Chartered for Iran and Sudan were technically legal, they should have been disclosed, the Manhattan district attorney said on Monday.

Mr. Lawsky of the New York financial services department had based his case against Standard Chartered, in large part, on similar claims that the bank had thwarted efforts to spot sanctions violations by cloaking the identities of Iranian clients and lying to regulators.

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Changes to Agriculture Highlight Cuba’s Problems

HAVANA — Cuba’s liveliest experiment with capitalism unfolds every night in a dirt lot on the edge of the capital, where Truman-era trucks lugging fresh produce meet up with hundreds of buyers on creaking bicycle carts clutching wads of cash.

“This place, it feeds all of Havana,” said Misael Toledo, 37, who owns three small food stores in the city. “Before, you could only buy or sell in the markets of Fidel.”

The agriculture exchange, which sprang up last year after the Cuban government legalized a broader range of small businesses, is a vivid sign of both how much the country has changed, and of all the political and practical limitations that continue to hold it back.

President Raúl Castro has made agriculture priority No. 1 in his attempt to remake the country. He used his first major presidential address in 2007 to zero in on farming, describing weeds conquering fallow fields and the need to ensure that “anyone who wants can drink a glass of milk.”

No other industry has seen as much liberalization, with a steady rollout of incentives for farmers. And Mr. Castro has been explicit about his reasoning: increasing efficiency and food production to replace imports that cost Cuba hundreds of millions of dollars a year is a matter “of national security.”

Yet at this point, by most measures, the project has failed. Because of waste, poor management, policy constraints, transportation limits, theft and other problems, overall efficiency has dropped: many Cubans are actually seeing less food at private markets. That is the case despite an increase in the number of farmers and production gains for certain items. A recent study from the University of Havana showed that market prices jumped by nearly 20 percent in 2011 alone. And food imports increased to an estimated $1.7 billion last year, up from $1.4 billion in 2006.

“It’s the first instance of Cuba’s leader not being able to get done what he said he would,” said Jorge I. Domínguez, vice provost for international affairs at Harvard, who left Cuba as a boy. “The published statistical results are really very discouraging.”

A major cause: poor transportation, as trucks are in short supply, and the aging ones that exist often break down.

In 2009, hundreds of tons of tomatoes, part of a bumper crop that year, rotted because of a lack of transportation by the government agency charged with bringing food to processing centers.

“It’s worse when it rains,” said Javier González, 27, a farmer in Artemisa Province who described often seeing crops wilt and rot because they were not picked up.

Behind him were the 33 fertile, rent-free acres he had been granted as part of a program Mr. Castro introduced in 2008 to encourage rural residents to work the land. After clearing it himself and planting a variety of crops, Mr. Gonzalez said, he was doing relatively well and earned more last year than his father, who is a doctor, did.

But Cuba’s inefficiencies gnawed at him. Smart, strong, and ambitious, he had expansion plans in mind, even as in his hand he held a wrench. He was repairing a tractor part meant to be grading land. It was broken. Again.

The 1980s Soviet model tractor he bought from another farmer was as about good as it gets in Cuba. The Cuban government maintains a monopoly on selling anything new, and there simply is not enough of anything — fertilizer, or sometimes even machetes — to go around.

Government economists are aware of the problem. “If you give people land and no resources, it doesn’t matter what happens on the land,” said Joaquin Infante of the Havana-based Cuban National Association of Economists.

But Mr. Castro has refused to allow what many farmers and experts see as an obvious solution to the shortages of transportation and equipment: Let people import supplies on their own. “It’s about control,” said Philip Peters, a Cuba analyst with the Lexington Institute, a Virginia-based research group.

Other analysts agree, noting that though the agricultural reforms have gone farther than other changes — like those that allow for self-employment — they remain constrained by politics.

“The government is not ready to let go,” said Ted Henken, a Latin American studies professor at Baruch College. “They are sending the message that they want to let go, or are trying to let go, but what they have is still a mechanism of control.”

For many farmers, that explains why land leases last for 10 years with a chance to renew, not indefinitely or the 99 years offered to foreign developers. It is also why many farmers say they will not build homes on the land they lease, despite a concession this year to allow doing so.

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