Concerns About A.D.H.D. Practices and Amphetamine Addiction

Before his addiction, Richard Fee was a popular college class president and aspiring medical student. "You keep giving Adderall to my son, you're going to kill him," said Rick Fee, Richard's father, to one of his son's doctors.

VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.

Andrea Mohin/The New York Times

MENTAL HEALTH CLINIC Dominion Psychiatric Associates in Virginia Beach, where Richard Fee was treated by Dr. Waldo M. Ellison. After observing Richard and hearing his complaints about concentration, Dr. Ellison diagnosed attention deficit hyperactivity disorder and prescribed the stimulant Adderall.

It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”

It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.

The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.

Medications like Adderall can markedly improve the lives of children and others with the disorder. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.

Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.

Very few people who misuse stimulants devolve into psychotic or suicidal addicts. But even one of Richard’s own physicians, Dr. Charles Parker, characterized his case as a virtual textbook for ways that A.D.H.D. practices can fail patients, particularly young adults. “We have a significant travesty being done in this country with how the diagnosis is being made and the meds are being administered,” said Dr. Parker, a psychiatrist in Virginia Beach. “I think it’s an abnegation of trust. The public needs to say this is totally unacceptable and walk out.”

Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.

“Any step along the way, someone could have helped him — they were just handing out drugs,” said Richard’s father. Emphasizing that he had no intention of bringing legal action against any of the doctors involved, Mr. Fee said: “People have to know that kids are out there getting these drugs and getting addicted to them. And doctors are helping them do it.”

“...when he was in elementary school he fidgeted, daydreamed and got A’s. he has been an A-B student until mid college when he became scattered and he wandered while reading He never had to study. Presently without medication, his mind thinks most of the time, he procrastinated, he multitasks not finishing in a timely manner.”

Dr. Waldo M. Ellison

Richard Fee initial evaluation

Feb. 5, 2010

Richard began acting strangely soon after moving back home in late 2009, his parents said. He stayed up for days at a time, went from gregarious to grumpy and back, and scrawled compulsively in notebooks. His father, while trying to add Richard to his health insurance policy, learned that he was taking Vyvanse for A.D.H.D.

Richard explained to him that he had been having trouble concentrating while studying for medical school entrance exams the previous year and that he had seen a doctor and received a diagnosis. His father reacted with surprise. Richard had never shown any A.D.H.D. symptoms his entire life, from nursery school through high school, when he was awarded a full academic scholarship to Greensboro College in North Carolina. Mr. Fee also expressed concerns about the safety of his son’s taking daily amphetamines for a condition he might not have.

“The doctor wouldn’t give me anything that’s bad for me,” Mr. Fee recalled his son saying that day. “I’m not buying it on the street corner.”

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Lady Malcolm Douglas-Hamilton Dies at 103; Aided Britain in War

Wide World Photos

Lady Malcolm Douglas-Hamilton, then Natalie Latham, in 1941. She started Bundles for Britain.

In 1939, Lady Malcolm Douglas-Hamilton, who died on Jan. 14 at 103, had neither that title nor that name. She was Natalie Latham, a fixture of Manhattan society whose beauty drew notice in Vogue magazine. She had achieved a dollop of fame when she and her two young daughters, nicknamed Mimi and Bubbles, appeared together in matching swimwear in a Life magazine photo spread, having captivated a photographer at a beach club one day.

Mrs. Latham, deft with a needle and thread, had made the outfits herself.

At the time, England had declared war on Germany, whose navy was attacking British ships. It was then, already twice divorced at 30, that Mrs. Latham paused to take stock of her life. A former debutante, she had family wealth, a Revolutionary War pedigree and an Upper East Side address. She was busy enough, organizing charity balls, herding two rambunctious children about town and making her own clothes. Like most Americans, she did not want the United States to join the war, but she felt private citizens ought to help somehow.

“I had never had time to think before,” she said in an interview with The New Yorker in 1941. “I began to think of Britain.”

It was a turning point in a life of privilege that led to one of the 20th century’s most inspired relief efforts. Nearly two years before the United States entered World War II, Mrs. Latham started Bundles for Britain, an organization that initially consisted of a few New York women knitting socks and caps for British sailors. It would grow to embrace 1.5 million volunteers in 1,900 branches in every state in the union and begin shipping to Britain not only hundreds of thousands of knitted items but also ambulances, X-ray machines and children’s cots — all labeled “From your American friends.”

Manhattan society matrons pitched in, along with sheepherders in Oregon, apple growers in Michigan and Indian blanket makers in Oklahoma. South Carolinians raised money with a watermelon-eating contest. Women everywhere baked cakes and took in laundry to buy yarn.

Letters of thanks poured in (“Dear Bundles,” most said), so Mrs. Latham sought help in replying to them, recruiting eight women, all former debutantes, at the Stork Club, one of her favorite haunts. For help on the English end, she enlisted Janet Murrow, wife of the legendary CBS reporter Edward R. Murrow, whose live radio broadcasts from London brought the war home to Americans; Louise Carnegie, wife of the industrialist Andrew Carnegie; and Clementine Churchill, wife of the prime minister. (Mrs. Churchill sent wish lists back to New York.)

Joan Crawford asked her fans to forgo giving her holiday presents and contribute instead to Bundles. For a raffle, Queen Elizabeth the Queen Mother, mother of the current queen, donated a bejeweled cigarette case in red (rubies), white (diamonds) and blue (sapphires), as well as a piece of shrapnel from the bomb that had hit Buckingham Palace.

“It’s like a fairy tale,” Mrs. Latham told The New Yorker. “I just go around pinching myself, it’s so thrilling.”

It was also exhausting: she sometimes collapsed at her desk with fatigue. King George VI made her an honorary Commander of the British Empire, the first non-British woman to be so honored.

She died at a nursing home in Andover, N.J., her family said. After living for many years on the Upper East Side, she had retired to Stillwater, N.J.

Bundles for Britain, which continued through the war, was but one milestone in the life of Lady Malcolm Douglas-Hamilton. At the request of the White House, she created a spinoff group, Bundles for America, to aid Americans in need during the war; one project involved scavenging junkyards for upholstery to make into clothing.

In 1947 she founded and became president of Common Cause (not to be confused with the liberal government watchdog group started in 1970), a moderate anti-Communist organization whose leaders included the historian Arthur M. Schlesinger Jr. She formed a group to aid Haiti; another to stem erosion of the nation’s morals; and still another to encourage good taste. (That group built the House of Good Taste at the 1964 World’s Fair in New York.)

In the mid-1940s she worked for The New York Times Company as a liaison to women’s groups.

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Nebraska Lieutenant Governor Sheehy resigns over phone scandal

(Reuters) – Nebraska Lieutenant Governor Rick Sheehy, the leading candidate to replace the current governor in the next election, resigned on Saturday after a newspaper investigation raised questions about improper cell phone calls made to women.

The Omaha World-Herald investigation found that the 53-year-old Republican made about 2,000 late-night calls to four women, other than his wife, on his state-issued cell phone over four years. The newspaper plans to publish results of the investigation on Sunday.

Colleen Sheehy, his wife of 28 years, filed for divorce in July 2012, according to the newspaper.

Governor Dave Heineman announced the resignation of Sheehy, a rising star in state politics, at a news conference. The governor said he was “deeply disappointed” and that Sheehy had done good work, but “trust was broken.”

“Public officials are rightly held to a higher standard,” Heineman said at the news conference, provided on the Omaha World-Herald website.

Heineman will leave office in 2015 and Sheehy had announced that he would run for governor. He was considered a leading candidate. Heineman selected Sheehy as lieutenant governor in 2005 after moving into the governor’s office to replace Mike Johanns, who was tapped as U.S. agriculture secretary.

Heineman and Sheehy were elected to their first full term in 2006 and re-elected to a second term in 2010.

(Reporting by Mary Wisniewski; editing by Gunna Dickson)

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Peterson double winner of AP NFL awards

NEW ORLEANS (AP) — Adrian Peterson called it a blessing in disguise.

Strange way to describe career-threatening major knee surgery.

The Minnesota Vikings' star came back better than ever, just missing Eric Dickerson's longstanding rushing record and closing out the season with two of the top NFL awards from The Associated Press: Most Valuable Player and Offensive Player of the Year.

As sort of an added bonus, he beat Peyton Manning for both of them Saturday night.

"My career could have easily been over, just like that," the sensational running back said. "Oh man. The things I've been through throughout my lifetime has made me mentally tough.

" I'm kind of speechless. This is amazing, " he said in accepting his awards, along with five others at the "2nd Annual NFL Honors" show on CBS saluting the NFL's best players, performances and plays from the 2012 season. The awards are based on balloting from a nationwide panel of 50 media members who regularly cover the NFL.

Manning's own sensational recovery, from four neck surgeries, earned him Comeback Player honors.

"This injury was unlike any other," said the only four-time league MVP. "There really was no bar or standard, there were no notes to copy. We were coming up with a rehab plan as we went."

Before sitting out 2011, Manning had never missed a start in his first 13 seasons with Indianapolis. But he was released by the Colts last winter because of his neck issues, signed with Denver and guided the Broncos to the AFC's best record, 13-3.

"Certainly you have double variables of coming off injury, not playing for over year and joining a new team. That certainly added a lot to my plate, so it was hard to really know what to expect," Manning said. "I can't tell you how grateful and thankful I am. I can't tell you how happy I am to be playing the game of football we all love so much."

Also honored were:

—Washington's Robert Griffin III, who beat out a strong crop of quarterbacks for the top offensive rookie award.

— Houston end J.J. Watt, who took Defensive Player of the Year, getting 49 of 50 votes.

— Bruce Arians, the first interim coach to win Coach of the Year after leading Indianapolis to a 9-3 record while head man Chuck Pagano was being treated for leukemia. Arians became Arizona's head coach last month.

—Carolina linebacker Luke Kuechly, the league's leader in tackles with 164, who won the top defensive rookie award.

Peterson returned better than ever from the left knee surgery, rushing for 2,097 yards, 9 short of breaking Dickerson's record. He also sparked the Vikings' turnaround from 3-13 to 10-6 and a wild-card playoff berth.

He received 30 1-2 votes to 19 1-2 for Manning.

"I played my heart out, every opportunity I had," Peterson said. "The result of that is not what I wanted, which is being in the Super Bowl game. But I have a couple of good pieces of hardware to bring back and (put) in my statue area. So it feels good."

Was the knee injury the toughest thing he'd ever overcome?

"Losing my brother at 7, seeing him get hit by a car right in front of me, that was the toughest," he said. "But as far as injuries, yes."

New England QB Tom Brady was the last winner of MVP and Offensive Player in 2010.

"Trying to get two or three like Peyton, trying to get to your level," Peterson said of his first MVP award. "But I won't be there to accept it because I'll be winning with my coach, the most important award, the team award, the Super Bowl."

Dickerson predicted Peterson could get back to 2,000 yards.

"I hope he does have a chance to do it again," Dickerson said, adding with a laugh, "but do I want him to break it? No, I do not."

Wearing a burgundy and gold tie in honor of his Redskins, Griffin said his goal is to be ready for the season opener.

"It's truly a blessing to be up there — to be able to stand, first and foremost," said Griffin, who underwent knee surgery last month. He added that next season "you'll see a better Robert Griffin."

Arians moved up from offensive coordinator and helped Indianapolis make the playoffs at 10-6, making him an easy winner in the balloting.

"It's hard to put into words the feelings of this past year," he said. "This was kind of the cherry on the top, whipped cream and everything else you put on top."

Watt swatted the competition as Denver's Von Miller got the only other vote in the most lopsided balloting of all the awards.

"It sets the bar for me," Watt said. He led the NFL with 20 1-2 sacks and also blocked an astounding 16 passes. "I want to go out and do even better. I want to do even bigger things."

___

Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL

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Iceland, Prosecutor of Bankers, Sees Meager Returns

Ilvy Njiokiktjien for The New York Times

"Greed is not a crime. But the question is: where does greed lead?" said Olafur Hauksson, a special prosecutor in Reykjavik.

REYKJAVIK, Iceland — As chief of police in a tiny fishing town for 11 years, Olafur Hauksson developed what he thought was a basic understanding of the criminal mind. The typical lawbreaker, he said, recalling his many encounters with small-time criminals, “clearly knows that he crossed the line” and generally sees “the difference between right and wrong.”

Today, the burly, 48-year-old former policeman is struggling with a very different sort of suspect. Reassigned to Reykjavik, the Icelandic capital, to lead what has become one of the world’s most sweeping investigation into the bankers whose actions contributed to the global financial crisis in 2008, Mr. Hauksson now faces suspects who “are not aware of when they crossed the line” and “defend their actions every step of the way.”

With the global economy still struggling to recover from the financial maelstrom five years ago, governments around the world have been criticized for largely failing to punish the bankers who were responsible for the calamity. But even here in Iceland, a country of just 320,000 that has gone after financiers with far more vigor than the United States and other countries hit by the crisis, obtaining criminal convictions has proved devilishly difficult.

Public hostility toward bankers is so strong in Iceland that “it is easier to say you are dealing drugs than to say you’re a banker,” said Thorvaldur Sigurjonsson, the former head of trading for Kaupthing, a once high-flying bank that crumbled. He has been called in for questioning by Mr. Hauksson’s office but has not been charged with any wrongdoing.

Yet, in the four years since the Icelandic Parliament passed a law ordering the appointment of an unnamed special prosecutor to investigate those blamed for the country’s spectacular meltdown in 2008, only a handful of bankers have been convicted.

Ministers in a left-leaning coalition government elected after the crash agree that the wheels of justice have ground slowly, but they call for patience, explaining that the process must follow the law, not vengeful passions.

“We are not going after people just to satisfy public anger,” said Steingrimur J. Sigfusson, Iceland’s minister of industry, a former finance minister and leader of the Left-Green Movement that is part of the governing coalition.

Hordur Torfa, a popular singer-songwriter who helped organize protests that forced the previous conservative government to resign, acknowledged that “people are getting impatient” but said they needed to accept that “this is not the French Revolution. I don’t believe in taking bankers out and hanging them or shooting them.”

Others are less patient. “The whole process is far too slow,” said Thorarinn Einarsson, a left-wing activist. “It only shows that ‘banksters’ can get away with doing whatever they want.”

Mr. Hauksson, the special prosecutor, said he was frustrated by the slow pace but thought it vital that his office scrupulously follow legal procedure. “Revenge is not something we want as our main driver in this process. Our work must be proper today and be seen as proper in the future,” he said.

Part of the difficulty in prosecuting bankers, he said, is that the law is often unclear on what constitutes a criminal offense in high finance. “Greed is not a crime,” he noted. “But the question is: where does greed lead?”

Mr. Hauksson said it was often easy to show that bankers violated their own internal rules for lending and other activities, but “as in all cases involving theft or fraud, the most difficult thing is proving intent.”

And there are the bankers themselves. Those who have been brought in for questioning often bristle at being asked to account for their actions. “They are not used to being questioned. These people are not used to finding themselves in this situation,” Mr. Hauksson said. They also hire expensive lawyers.

The special prosecutor’s office initially had only five staff members but now has more than 100 investigators, lawyers and financial experts, and it has relocated to a big new office. It has opened about 100 cases, with more than 120 people now under investigation for possible crimes relating to an Icelandic financial sector that grew so big it dwarfed the rest of the economy.

To help ease Mr. Hauksson’s task, legislators amended the law to allow investigators easy access to confidential bank information, something that previously required a court order.

Parliament also voted to put the country’s prime minister at the time of the banking debacle on trial for negligence before a special tribunal. (A proposal to try his cabinet failed.) Mr. Hauksson was not involved in the case against the former leader, Geir H. Haarde, who last year was found guilty of failing to keep ministers properly informed about the 2008 crisis but was acquitted on more serious charges that could have resulted in a prison sentence.

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Ferrol Sams, Doctor Turned Novelist, Dies at 90

Ferrol Sams, a country doctor who started writing fiction in his late 50s and went on to win critical praise and a devoted readership for his humorous and perceptive novels and stories that drew on his medical practice and his rural Southern roots, died on Tuesday at his home in Lafayette, Ga. He was 90.

The cause, said his son Ferrol Sams III, also a doctor, was that he was “slap wore out.”

“He lived a full life,” his son said. “He didn’t leave anything in the tank.”

Dr. Sams grew up on a farm in the rural Piedmont area of Georgia, seven mud-road miles from the nearest town. He was a boy during the Depression; books meant escape and discovery. He read “Robinson Crusoe,” then Mark Twain and Charles Dickens. One of his English professors at Mercer University, in Macon, suggested he consider a career in writing, but he chose another route to examining the human condition: medical school.

When he was 58 — after he had served in World War II, started a medical practice with his wife, raised his four children and stopped devoting so much of his mornings to preparing lessons for Sunday school at the Methodist church — he began writing “Run With the Horsemen,” a novel based on his youth. It was published in 1982.

“In the beginning was the land,” the book begins. “Shortly thereafter was the father.”

In The New York Times Book Review, the novelist Robert Miner wrote, “Mr. Sams’s approach to his hero’s experiences is nicely signaled in these two opening sentences.”

He added: “I couldn’t help associating the gentility, good-humored common sense and pace of this novel with my image of a country doctor spinning yarns. The writing is elegant, reflective and amused. Mr. Sams is a storyteller sure of his audience, in no particular hurry, and gifted with perfect timing.”

Dr. Sams modeled the lead character in “Run With the Horsemen,” Porter Osborne Jr., on himself, and featured him in two more novels, “The Whisper of the River” and “When All the World Was Young,” which followed him into World War II.

Dr. Sams also wrote thinly disguised stories about his life as a physician. In “Epiphany,” he captures the friendship that develops between a literary-minded doctor frustrated by bureaucracy and a patient angry over past racism and injustice.

Ferrol Sams Jr. was born Sept. 26, 1922, in Woolsey, Ga. He received a bachelor’s degree from Mercer in 1942 and his medical degree from Emory University in 1949. In his addition to his namesake, survivors include his wife, Dr. Helen Fletcher Sams; his sons Jim and Fletcher; a daughter, Ellen Nichol; eight grandchildren; and nine great-grandchildren.

Some critics tired of what they called the “folksiness” in Dr. Sams’s books. But he did not write for the critics, he said. In an interview with the Georgia Writers Hall of Fame, Dr. Sams was asked what audience he wrote for. Himself, he said.

“If you lose your sense of awe, or if you lose your sense of the ridiculous, you’ve fallen into a terrible pit,” he added. “The only thing that’s worse is never to have had either.”

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BlackBerry chooses more traditional route to drum up buzz over Super Bowl ad

TORONTO – After a week of massive hype for its new smartphones, BlackBerry has decided to remain secretive about its Super Bowl commercial in an effort to squeeze every bit of juice out of the pricey advertising campaign.

The Waterloo, Ont.-based company, formerly known as Research In Motion (TSX:RIM), released a single frame of the 30-second TV spot on Friday, without any explanation of what it was, or what it meant.

The move goes against the trend of unleashing Super Bowl ads on the Internet ahead of the big game in an effort to generate extra hype.

This year, smartphone competitor Samsung chose to release its commercial starring comedians Seth Rogan and Paul Rudd on Thursday. Other major companies like Mercedes and Coke have also put their ads online.

Recent statistics have shown that advertisers gain more traction from their Super Bowl TV spots if they’re released online before the event, which takes place on Sunday.

Last year, the Super Bowl ads uploaded to YouTube before the game were viewed 600 per cent more times, an average of 9.1 million views, compared to the ones that were put online after the game, according to the streaming video service owned by Google.

Going against the trend, the BlackBerry maker will keep smartphone users guessing about what their advertisement is about and who it might feature. Certainly the company’s publicity team carefully chose which frame to release as its sneak preview.

The frame shows an early 1980s Honda Accord is parked alongside a meter. Behind it, there’s a colourful explosion of powder in front of stairs leading up to apartment No. 437.

The clues would suggest harkening back to the birth of the IBM personal computer, introduced to the market in 1981 using the coding 437 as its original character set, or more simply, the appearance of its font on screen.

It may be a clue because BlackBerry chief executive Thorsten Heins has touted the launch of the new smartphones this week as a new era in mobile computing because the devices have nearly the same amount of processing power as a personal computer.

All of that won’t be proven true or false until the game on Sunday evening where the BlackBerry ad will air sometime after the third quarter, the company said.

The Super Bowl is the most-watched television event of the year, drawing 111.3 million U.S. viewers in 2012.

In Canada, last year’s broadcast drew a record 8.1 million viewers.

The event is also the most expensive event for advertisers, costing an average of $ 3.4 million for a 30-second spot on NBC last year, according to ratings firm Nielsen.

This year, estimates for how much CBS is charging for a 30-second spot vary wildly from between $ 3.6 million to $ 4 million. CTV declined to say how much it charges for Canadian airtime.

Also slated in the Super Bowl commercial lineup are advertisements from the Bank of Montreal (TSX:BMO), with different versions airing on both sides of the border.

In the U.S., the company has purchased airtime in the midwest where its banks have a strong presence under the BMO Harris Bank brand. In the commercial, dubbed “Dream Home,” a young couple ponders the possibilities of buying a home, before they’re surprised when a real estate agent throws up a “For Sale” sign right in front of them.

BMO has also bought airtime in Canada, though it will be showing a commercial that has already aired during prime time.

Last year, a Harris-Decima Canadian Press poll found that more Canadians planned to watch the Super Bowl ads than the football game itself.

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NFL's Goodell aims to share blame on player safety

NEW ORLEANS (AP) — NFL Commissioner Roger Goodell wants to share the blame.

"Safety," he said at his annual Super Bowl news conference, "is all of our responsibilities."

Not surprisingly, given that thousands of former players are suing the league about its handling of concussions, the topics of player health and improved safety dominated Goodell's 45-minute session Friday. And he often sounded like someone seeking to point out that players or others are at fault for some of the sport's problems — and need to help fix them.

"I'll stand up. I'll be accountable. It's part of my responsibility. I'll do everything," Goodell said. "But the players have to do it. The coaches have to do it. Our officials have to do it. Our medical professionals have to do it."

Injuries from hits to the head or to the knees, Goodell noted, can result from improper tackling techniques used by players and taught by coaches. The NFL Players Association needs to allow testing for human growth hormone to go forward so it can finally start next season, which Goodell hopes will happen. He said prices for Super Bowl tickets have soared in part because fans re-sell them above face value.

And asked what he most rues about the New Orleans Saints bounty investigation — a particularly sensitive issue around these parts, of course — Goodell replied: "My biggest regret is that we aren't all recognizing that this is a collective responsibility to get (bounties) out of the game, to make the game safer. Clearly the team, the NFL, the coaching staffs, executives and players, we all share that responsibility. That's what I regret, that I wasn't able to make that point clearly enough with the union."

He addressed other subjects, such as a "new generation of the Rooney Rule" after none of 15 recently open coach or general manager jobs went to a minority candidate, meaning "we didn't have the outcomes we wanted"; using next year's Super Bowl in New Jersey as a test for future cold-weather, outdoor championship games; and saying he welcomed President Barack Obama's recent comments expressing concern about football's violence because "we want to make sure that people understand what we're doing to make our game safer."

Also:

— New Orleans will not get back the second-round draft pick Goodell stripped in his bounty ruling;

— Goodell would not give a time frame for when the NFL could hold a game in Mexico;

— next season's games in London — 49ers-Jaguars and Steelers-Vikings — are sellouts.

Goodell mentioned some upcoming changes, including the plan to add independent neurologists to sidelines to help with concussion care during games — something players have asked for and the league opposed until now.

"The No. 1 issue is: Take the head out of the game," Goodell said. "I think we've seen in the last several decades that players are using their head more than they had when you go back several decades."

He said one tool the league can use to cut down on helmet-to-helmet hits is suspending players who keep doing it.

"We're going to have to continue to see discipline escalate, particularly on repeat offenders," Goodell said. "We're going to have to take them off the field. Suspension gets through to them."

The league will add "expanded physicals at the end of each season ... to review players from a physical, mental and life skills standpoint so that we can support them in a more comprehensive fashion," Goodell said.

With question after question about less-than-light matters, one reporter drew a chuckle from Goodell by asking how he's been treated this week in a city filled with supporters of the Saints who are angry about the way the club was punished for the bounty system the NFL said existed from 2009-11.

"My picture, as you point out, is in every restaurant. I had a float in the Mardi Gras parade. We got a voodoo doll," Goodell said.

But he added that he can "appreciate the passion" of the fans and, actually, "couldn't feel more welcome here."

___

Follow Howard Fendrich on Twitter at http://twitter.com/HowardFendrich

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Media Decoder Blog: In Wake of Restructuring, NBC News President Quits

8:30 p.m. | Updated

The longest-serving president of any of the three network news divisions, Steve Capus of NBC News, stepped down from his position on Friday, six months after Comcast restructured its news units in a way that diminished his authority.

Pat Fili-Krushel, chairwoman of the NBCUniversal News Group, said in a brief telephone interview on Friday that she would “cast a wide net” while searching for a successor to Mr. Capus. In the interim, the leaders of the news division will report directly to her.

Ms. Fili-Krushel became Mr. Capus’s boss last July when Steve Burke, the chief executive of NBCUniversal, consolidated all of NBC’s news units — NBC News, the cable news channels MSNBC and CNBC, and its stake in the Weather Channel — under a new umbrella, the NBCUniversal News Group. Mr. Burke asked Ms. Fili-Krushel, one of his most trusted lieutenants, to run it, while keeping Mr. Capus and the heads of the other units in place.

Ms. Fili-Krushel worked early in her career at HBO and Lifetime. A veteran of the Walt Disney Company, where she helped program ABC, and  Time Warner, where she was an administrator, she is by her own admission not a journalist.  But now she is, by default, the highest-ranking woman in the American television news industry — not just at the moment, but in the history of the medium. The heads of the news divisions at ABC and CBS are men, as are the heads of the Fox News Channel, CNN, and Bloomberg.

Ms. Fili-Krushel has kept a low public profile, but has been a forceful presence behind the scenes, recently moving from her office on the 51st floor of 30 Rockefeller Center, near Mr. Burke’s, to a new one on the third floor, where NBC News is based. On Friday, she said she had spent her first six months “learning, listening and getting to know the players here.” She called the News Group an “unbelievably strong organization.”

Though Mr. Capus’s exit saddened many at NBC News on Friday, it came as little surprise. He had previously reported directly to Mr. Burke, but after the restructuring he reported to Ms. Fili-Krushel, and he made no secret of his unhappiness with the change. His contract had a clause that allowed him to leave in the event that he no longer reported to Mr. Burke, according to two people with direct knowledge of the arrangement at NBC, and he decided to exercise that right after months of contemplation. The people insisted on anonymity because they were not authorized by the network to speak publicly.

Mr. Capus told Ms. Fili-Krushel of his intent to leave last Friday. It is likely that he would have left sooner, but a series of major news stories kept him busy late last year — including Hurricane Sandy, the presidential election and the school shooting in Newtown, Conn. Mr. Capus also oversaw the network’s response to the kidnapping of Richard Engel and an NBC News crew in Syria last month.

“It has been a privilege to have spent two decades here, but it is now time to head in a new direction,” he wrote in an e-mail to staff members on Friday afternoon.

Mr. Capus guided NBC through a revolutionary time in news-gathering and distribution. He maintained the news division’s profitability, managed tensions between NBC News and its increasingly liberal cable channel MSNBC, and fostered new business ventures like an in-house production company and an annual education summit. Last year, he unwound an old deal with Microsoft to give the news division complete control over its Web site, now named NBCNews.com, for the first time.

Ms. Fili-Krushel wrote in a separate e-mail to staff members that “NBC News is America’s leading source of television news and Steve has been a big part of that success.”

NBC News is the producer of the most popular evening newscast in the country. But its single biggest source of profits, the morning show “Today,” fell to second place last year, behind ABC’s “Good Morning America,” for the first time since the 1990s. The decline caused widespread anxiety inside the news division and speculation that Mr. Capus would be relieved of his duties.

Inside NBC, both Mr. Capus and the executive producer of “Today,” Jim Bell, received much of the blame for the botched removal of Ann Curry from “Today” last June, which worsened the show’s already tenuous position in the ratings. Ms. Fili-Krushel was put in charge just a few weeks later.

Mr. Bell was replaced at “Today” last fall and is now the executive producer for NBC Olympics. Savannah Guthrie is now the co-host of “Today,” and Ms. Curry is a national and international correspondent for the network, but is rarely seen. Mr. Capus’s exit was seen by some at the network as the last shoe that had to drop.

In his e-mail to staff members, Mr. Capus called it an “extremely difficult decision to walk away,” noting that he started at NBC as a producer 20 years ago this month. He did not make any mention of what he would do next. “Journalism is, indeed, a noble calling, and I have much I hope to accomplish in the next phase of my career,” he wrote.

“Today” continues to lose to ABC’s “Good Morning America” among total viewers, but lately it has won a few weeks in the 25- to 54-year-old demographic that advertisers covet.

“NBC Nightly News” has more successfully fended off ABC’s “World News,” despite an aggressive push by ABC. Mr. Capus said, “NBC News has grown in all key metrics — from ratings and reputation to profitability.”

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Insurance Industry Report Faults High Fees for Out-of-Network Care

Michael Nagle for The New York Times

Angel Gonzalez, 36, faced huge bills after emergency gallbladder surgery, despite having good insurance coverage. “I was on the hook for more than I made in a year.”

Just over a year ago, Angel Gonzalez, 36, awoke with searing chest pain at 2 a.m. A friend drove him to the closest emergency room.

Though he was living on $18,000 a year as a graduate student, Mr. Gonzalez had good insurance and the hospital, St. Charles in Port Jefferson, N.Y., was in his network. But the surgeon who came in to remove Mr. Gonzalez’s gallbladder that Sunday night was not.

He billed Mr. Gonzalez $30,000, and an assistant billed an additional $30,000. Mr. Gonzalez’s policy covered out-of-network providers, but at a rate it considered appropriate: $2,000. “I was on the hook for more than I made in a year,” Mr. Gonzalez said.

A health insurance industry report to be released on Friday highlights the exorbitant fees charged by some doctors to out-of-network patients like Mr. Gonzalez. The report, by America’s Health Insurance Plans, or AHIP, contrasts some of the highest bills charged by non-network providers in 30 states with Medicare rates for the same services. Some of the charges, the insurers assert, are 30, 40 or nearly 100 times greater than Medicare rates.

Insurers hope to spotlight a vexing problem that they say the Affordable Care Act does little to address. “When you’re out of network, it’s a blank check,” said Karen Ignagni, president and chief executive of AHIP. “The consumer is vulnerable to ‘anything goes.’ ”

“Unless we deal with cost, we won’t have affordability,” she added. “And unless we have affordability, we won’t have people participating” under the Affordable Care Act.

Among the fees on the report’s list are a $6,205 outpatient office visit to a doctor in Massachusetts for which Medicare would have paid $152; a $12,000 bill for examining a tissue specimen in New York for which Medicare would have paid $128; and a $48,983 surgeon’s fee for a total hip replacement in New Jersey that Medicare would have reimbursed at $1,543. Many of the highest billers were in New York, Texas, Florida and New Jersey.

Elisabeth R. Benjamin, co-founder of the Health Care for All New York coalition, who is often at odds with the insurance industry, said that “is one area we totally agree on.” She continued, “Out-of-network billing is just out of control.”

Even when out-of-network fees are compared with average commercial insurance reimbursements, which are usually greater than Medicare, she said, “It’s pretty outrageous.”

Doctors say the report is skewed because it focuses on a few dozen cases of overcharging that are not representative of their billing. In response to the insurers’ report, the American Medical Association noted on Thursday that a recent analysis found that doctors’ services account for just 16 percent of health care costs.

“There are outliers in every profession, in every business,” said Dr. Andrew Y. Kleinman, a plastic surgeon who is vice president of the Medical Society of the State of New York.

Dr. Kleinman also noted that insurers had effectively shifted the costs of out-of-network care onto patients by changing reimbursement formulas. Instead of the rates commercial insurers usually pay doctors, insurers increasingly are basing their out-of-network payments on Medicare rates, usually far lower.

A growing number of high-end, flexible health plans offer policies that cover outside providers at, for example, 140 percent of Medicare. “They’re selling you an insurance product you can’t use,” Dr. Kleinman said. “You’re buying an insurance policy where the out-of-network benefit is worthless.”

The industry’s own report suggests that using Medicare rates as a benchmark will lead to patients’ picking up much more of the cost for out-of-network care, whether they carefully select a specialist or, as in the case of Mr. Gonzalez and many others, have no choice in the matter.

Had Mr. Gonzalez been 65 or older, Medicare would have paid only $958 for the surgery. The average commercial price is $12,292, according to FAIR Health, an independent nonprofit group that tracks information on health care costs.

But Mr. Gonzalez’s health plan, United Healthcare, determined the fee should be $1,273, of which the company paid $838. Mr. Gonzalez filed appeals, which were rejected. He then contacted Community Health Advocates at the Community Service Society of New York for help, and the group’s caseworkers negotiated with the surgeon on his behalf.

After months of wrangling, the surgeon agreed to accept a significantly reduced payment: $340.

Consumer advocates and health insurance executives are calling for greater transparency in health care pricing, including upfront disclosure of prices of medical procedures and services.

“The health care industry can give you an estimate, just like any other industry,” said Carrie H. Colla, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice, noting that the Dartmouth-Hitchcock Medical Center has a patient price estimator online.  

“It’s just not current practice right now,” Dr. Colla said. “Sometimes a doctor won’t even know. The patient really has to push for it.”

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Fireworks Explosion on Chinese Highway Kills 26

BEIJING (AP) — A truck carrying fireworks ahead of Chinese New Year celebrations exploded and destroyed part of an elevated highway Friday in central China, killing at least 26 people as it sent vehicles plummeting 30 meters (about 100 feet) to the ground, state media said.

The huge blast destroyed an 80-meter (80-yard) stretch of highway outside the city of Sanmenxia in Henan province, and was powerful enough to shatter windows of a nearby truck stop.

Emergency crews closed the highway at the accident site, said China National Radio, which reported the death toll of 26. The Xinhua News Agency reported four deaths but said search and rescue efforts were continuing. At least 15 people were injured and sent to nearby hospitals, the Henan Commercial Newspaper reported.

Photos posted on the popular news site Sina.com by Chinese netizens showed a stretch of elevated highway gone, with a truck perched precariously at the broken edge. Other photos showed wrecked trucks below and blackened chunks of scattered debris, including collapsed sections of highway, wrecked trucks and cargo containers.

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BSkyB to offer sports channels online for daily fee

LONDON (Reuters) – BSkyB will offer its popular sports channels online for a daily fee, seeking new customers to offset slowing growth at its core pay-TV service amid sluggish consumer spending.

Sky, Britain’s dominant pay-TV group which provides fixed-line telephony, TV and broadband to 10.7 million households, has adapted its strategy during the economic downturn after years of chasing new subscribers to its core TV offering.

The group added 25,000 subscribers to its pay-TV service in the three months to the end of December, well down on the more than 100,000 users it used to routinely add each quarter.

In response, it has focused on selling more products such as high definition TV and broadband to existing customers, and moving online to reach those not willing to sign up to a monthly contract. The approach has enabled the group to consistently post strong financial results and pay higher dividends.

“Although we expect the consumer environment in 2013 to remain challenging, we have a strong set of plans for the year ahead,” Chief Executive Jeremy Darroch said on Thursday.

Darroch said the group would offer its sports channels, which show everything from Premier League soccer to Formula One motor racing and cricket, on its new online service called Now TV in the next few months.

Viewers, who do not need to sign up to a contract, will be able to pay 9.99 pounds to watch all six Sky Sports channels for 24 hours. It has already shown movies via the online offering to 25,000 customers since its launch last year.

The new internet drive will help BSkyB compete with existing online services such as Lovefilm and with BT Vision, which has won the right to show its own sports content, but it is also having to bet that its existing customers will not downgrade to the cheaper online offering to save money.

CUSTOMER LOYALTY

The group’s performance in the first half of the year showed that, despite the pressures on consumer spending, customer loyalty had remained relatively solid, with subscribers spending on average 568 pounds a year, up 24 pounds on the year before.

“Net additions were slightly below our estimates reflecting the tough consumer environment,” analysts at Numis said. “(But) encouragingly, take up of new products continues to increase, driving customer satisfaction and loyalty.”

Those customers taking all three main services – TV, broadband and telephony – accounted for 33 percent of the user base, up 4 percentage points year on year.

The rise in customers helped the group to post first-half operating profit up 8 percent to 647 million pounds ($ 1 billion) against a forecast of 632 million pounds. Cost control helped the group pay an interim dividend up 20 percent to 11 pence.

“We believe the BSkyB investment case has evolved over the past year or so, with the challenging consumer environment making the addition of new households to the (pay-TV) service more difficult,” Numis said.

“The group has rightly prioritized the increased penetration of multiple products, notably HD and broadband, which drive average revenue per user and reduce churn over the medium/long term. We are supportive of investment in products such as Now TV which offer an attractive risk/return in our view.”

Shares in BSkyB were up 1 percent to 819 pence in mid-morning trade, following a 21 percent rise in the last 12 months, and valuing the group at 13.2 billion pounds.

(Reporting by Kate Holton; Editing by Rhys Jones and Mark Potter)

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SUPER BOWL WATCH: Beyonce, avocados, practice

NEW ORLEANS (AP) — Around Super Bowl XLVII and its host city with journalists from The Associated Press bringing the flavor and details of everything surrounding the game:

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GRIDIRON TO LEMONADE STAND

Donald Driver didn't waste much time finding a new job.

The Green Bay Packers all-time leading receiver announced his retirement Thursday morning, then helped kids from Junior Achievement sell lemonade at a pop-up stand in the Super Bowl media center.

Not only did Driver help behind the counter, he loaded up four carrying cases and he and his three new friends set out to find customers. Their cases were empty when they returned.

"All the money they've raised will stay here in New Orleans," Driver said. "What they're starting to do is learn how to run their own business, become entrepreneurs by themselves.

"I'm just here to raise as much money so maybe they can open up their own lemonade stand the next couple of years.

— Nancy Armour — http://twitter.com/nrarmour

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JUDGE FOR YOURSELF: BEYONCE

Wondering about Beyonce and her response inauguration lip syncing flap?

Judge for yourself — here's her full rendition of the national anthem during a press conference Thursday: http://www.youtube.com/watch?v=8p2MTKCLNsY

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QUICKQUOTE: JERSEYS AND DRUGS

Authorities say buying a cheap imitation NFL jersey may be more harmful than you think.

Kevin Abar, assistant special agent in charge of Homeland Security Investigations in New Mexico, said there's evidence that Mexican drug cartels are getting involved in the counterfeit NFL black market trade because they can make quick money.

"A lot of folks may think that there's nothing wrong with buying a knockoff Denver Broncos jersey, but in reality, the money is being used to fund the drug war in Mexico," Abar said.

— Michael Kunzelman — http://twitter.com/Kunzelman75

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STAT OF THE DAY: 158M AVOCADOS

AP Food Editor J.M. Hirsch has the stat of the day today: Americans are expected to consume 158 million avocados around the Super Bowl.

That's 79 million pounds of green goodness — up from 8 million pounds at the turn of the century.

So has the guacamole improved that much? Not really, it's just outstanding marketing and other factors.

— J.M. Hirsch — http://twitter.com/JM_Hirsch

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YUP, WE HEARD YOU, BEYONCE

Beyonce belted out the national anthem — for real — and America clearly heard.

Shortly after the singer's press conference on Thursday where she admitted singing to a backup track during President Barack Obama's inauguration, "National Anthem" became a trending topic in the United States on Twitter.

Millions of fans clearly approved of her impromptu performance, now reassured that her pipes are still fine.

— Oskar Garcia — http://twitter.com/oskargarcia .

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NO TAPE NEEDED

Beyonce's version of the national anthem was worth the wait.

The superstar singer, roundly criticized for lip syncing "The Star-Spangled Banner" at the inauguration 10 days ago, walked into Thursday's news conference for the Super Bowl halftime show and asked the ballroom filled with several hundred people to stand. She then belted out a spine-tingling version of the anthem, leaving no doubts about the power of her voice. Many in the room applauded when she finished.

"Thank you guys so much. Any questions?" Beyonce said, drawing laughs.

Beyonce admitted she sang along with a pre-recorded track at the inauguration, saying she hadn't had time to rehearse with the orchestra. This was too big of an occasion to have it be anything less than perfect, she said.

"I did not feel comfortable taking a risk," she said. "This was about the president and the inauguration and I wanted to make my country proud."

She did promise to sing live Sunday, however.

"I am well-rehearsed," she said. "This was what I was born to do."

That was about all Beyonce was willing to spill, though. She wouldn't say what she'll be singing, though she did say it was "not easy" to choose a few songs from her many hits.

"All of my songs are like my children," she said.

As for that rumored Destiny's Child reunion, Beyonce wouldn't confirm it.

She didn't deny it, though, either.

"I can't really give you any details," she said. "I'm sorry."

— Nancy Armour — http://twitter.com/nrarmour

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TURF WARS

The Baltimore Ravens don't like the artificial turf at Tulane's baseball field.

So they've moved to the Saints' facility instead.

The San Francisco 49ers were already training at the Saints' complex in nearby Metairie.

The AFC champions were forced to practice in the outfield of the baseball facility Wednesday because Tulane has broken ground on a new football stadium. Coach John Harbaugh, star linebacker Ray Lewis and several other players said it was "hard on the legs."

After the Ravens approached the league about practicing on grass, the NFL arranged for them to follow the 49ers at the Saints training fields.

— Barry Wilner

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10 ADS TO WATCH

If you're a fan of Super Bowl ads, here are 10 to look out for during Sunday's game. With more than 111 million people expected to tune in, it's advertising's biggest showcase.

1. Samsung Mobile's 2-minute ad with "Knocked Up" actors Paul Rudd and Seth Rogen, directed by Jon Favreau ("Iron Man"). The company has not released details about the ad's plot other than to say that it shows Rogen and Rudd on a "quest to become the next big thing." Teaser here: http://www.youtube.com/watch?v=pzfAdmAtYIY

2. Best Buy's 30-second ad in the first quarter stars Amy Poehler, star of NBC's "Parks and Recreation," asking a Best Buy employee "lots of questions." Teaser: http://www.youtube.com/watch?v=PcmW8HCuLo8

3. Kraft enlists Tracy Morgan from NBC's "30 Rock" to introduce its new Mio Fit water enhancing drops in a 30-second ad during the third quarter. Teaser: http://www.youtube.com/user/makeitmio?feature=watch

4. Hyundai Motor Group's Kia invents a fanciful way that babies are made, blasting in from a baby planet in its "Space babies" ad for the 2014 Sorento crossover. Link: http://www.youtube.com/user/KiaMotorsAmerica?feature=watch

5. First-time advertiser Paramount Farms is touting its Wonderful Pistachios brand of nuts in a 30-second ad with Korean pop sensation Psy. The campaign: http://getcrackin.com/

6. First-time advertiser Axe shows a woman in the ocean getting rescued by a sexy lifeguard, but going for an astronaut instead. It promotes Axe's new cologne "Apollo" and its contest to send someone on the first suborbital space tour in 2014. Link: http://www.youtube.com/watch?v=QGoU3VH7He4

7. Audi's 60-second ad in the first quarter, with an ending voted on by viewers, shows a boy gaining confidence from driving his father's Audi to the prom, kissing the prom queen and getting decked by the prom king. Link: http://www.youtube.com/watch?v=ANhmS6QLd5Q

8. PepsiCo's Frito-Lay's Doritos "Crash the Super Bowl" ads are back for the seventh straight year. Two 30-second commercials made by consumers will make it on the air. Fans voted for one winner and Doritos chose the other.

9. Ford Motor Co. enlisted late-night talk show host Jimmy Fallon to choose road trip stories submitted by Twitter with the hashtag (hash)steerthescript to base its Super Bowl commercial for Lincoln. The ad features rapper Joseph "Rev Run" Simmons, Wil Wheaton, who acted in the iconic science-fiction series "Star Trek: The Next Generation."

10. The Milk Processor Education Program, known as MilkPep and popular for its "Got Milk?" print ads, is featuring actor and professional wrestler Dwayne "The Rock" Johnson in a 30-second ad in the second quarter that is directed by Peter Berg ("Friday Night Lights.")

— Mae Anderson

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BEYONCE, BUT WHO ELSE?

There's lots of hype for Beyonce's halftime performance at the Super Bowl, but she's far from the only A-list act in New Orleans this week.

The NFL has announced Jennifer Hudson is planning to sing "America the Beautiful" before the game with the chorus from Sandy Hook Elementary School in Newtown, Conn.

Just add her to the already packed list. It also includes:

— Justin Timberlake, in his first major musical performance in four years (hosting Saturday Night Live doesn't count — he hasn't been an official musical guest on the show since 2006).

— Stevie Wonder

— CeeLo Green with his old hip-hop clique, Goodie Mob.

—Rascal Flatts with Journey.

And then there's the parties. Lil Wayne is throwing a bash. Jay-Z will host another event the night before his wife, Beyonce, takes stage. Jamie Foxx and Santigold are also performing, while DJs including Diplo and Questlove from The Roots are spinning.

Not that it's ever difficult, but it's extra easy to find a party in New Orleans the next few days.

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— Stacey Plaisance

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PUTTING POLITICS ASIDE FOR NEW ORLEANS

Long working on opposite sides of the American political spectrum, James Carville and Mary Matalin are pulling in the same direction when it comes to promoting their adopted home of New Orleans as a Super Bowl host.

Carville, a longtime Democratic strategist, and Matalin, a Republican pundit, are the co-chairs of the Super Bowl host committee. They're also married.

They've been making the rounds together from one event to the next in the convention center, which houses both the NFL Experience theme park and work stations for several thousand international media.

Carville is from Louisiana and the couple married in New Orleans. Then in 2008, they decided to move here from Washington, D.C. Now living in a stately home just two blocks off of historic St. Charles Avenue, they've been among the biggest boosters of the Big Easy's recovery from Hurricane Katrina, lending their support to a variety of community projects with goals ranging from restoration of fragile coastal wetlands to education and economic development.

The pair agree that while organizing a Super Bowl doesn't cost as much as a presidential campaign, it's just as hard because it's a multiyear project with a lot of moving parts.

Carville says he's always been a sports fan so the transition was natural for him. Matalin says one obvious goal is to get New Orleans back in the regular rotation as a Super Bowl host, but the larger goal is to help the city's future by demonstrating how successfully it can host one of the biggest single events in the sports world. While New Orleans is hosting its 10th Super Bowl, the NFL championship has not been played there since 2002.

Says Carville: "If it goes the way we hope it does, it'll go beyond economic impact. It'll go beyond who won the game. It think there's something significant that's coming to a point here in the city."

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— Brett Martel — http://twitter.com/brettmartel

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ZOO VS ZOO

File this in the quirky Super Bowl wager department: Zoos in Baltimore and San Francisco are gambling with the homes of two ravens and a rhino.

Leaders of The Maryland Zoo and The San Francisco Zoological Gardens have wagered naming rights to their respective exhibits with ties to their hometown football teams.

The zoo in Baltimore is home to official Ravens mascots, Rise and Conquer. If 49ers win, it will rename the ravens' enclosure the "San Francisco 49ers exhibit."

If the Ravens win, the San Francisco zoo has agreed to re-name the enclosure of its black rhino "Boone," who is named after the 49ers offensive tackle Alex Boone, in honor of the Ravens.

The new name would last one month, starting Feb. 11.

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CATCHING THE COUNTERFEITERS

Shop wisely when looking for those Super Bowl souvenirs.

Federal officials have seized more than 163,000 counterfeit items worth more than $13.6 million over the last five months as part of Operation Red Zone, John Morton, director of U.S. Immigrations and Customs Enforcement, said. That's a "significant" increase from last year, when about $5 million worth of merchandise was seized.

"Everything from hats to jerseys to Nike shoes. My personal favorite is this counterfeit Super Bowl ring from Super Bowl XLIV," Morton said, holding up a massive gold ring. "It's actually quite heavy and a better counterfeit than most. Just goes to show you the lengths people will go in this business."

Equally troubling are websites selling counterfeit merchandise, some so sophisticated they include anti-virus logos and the seal of the Better Business Bureau — making them almost impossible to tell them apart from legitimate vendors.

Morton said federal officials have already seized domain names of 313 web sites, almost all of which originated overseas.

"Imagine what's going on when you're putting your credit card through this site. Really think about that," Morton said. "The site is being run by overseas criminals in Asia.... You can imagine what the result is, and sadly many, many of these sites come with malware and other unfortunate ornaments on the Christmas tree."

The easiest way to make sure fans are buying legitimate merchandise is to buy from an official vendor, Morton said. Each team has one, as does the NFL.

But the best way fans can prevent being scammed is to use common sense, Morton said. Look closely at items, and there will be signs they're fakes. If there are extra words in a website address — com.us — or misspellings, that's almost always a dead giveaway.

"We're not letting up," Morton said. "We'll have teams out the next couple of days looking for counterfeit and scam artists."

— Nancy Armour — http://twitter.com/nrarmour

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RENO: THE KAEPERNICK EFFECT

Casinos in the Biggest Little City in the World are expecting a bump in Super Bowl betting this year thanks to 49ers quarterback Colin Kaepernick, maybe enough to help Nevada set a record in wagering on the game.

Kaepernick played college football at Nevada, just down the street from casinos in Reno.

Now, most of those casinos are offering an especially large number of proposition bets on the quarterback.

Kaep-mania has run so rampant in Reno that sporting goods stores can't keep stocked in jerseys. More than 7,000 fans set what Nevada officials said was a world record when they all simultaneously kissed their arms "Kaepernicking style" during a break in last week's basketball game against San Diego State.

A Kaepernick viewing party is planned during Sunday's game at the student union.

— Scott Sonner

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NO MORE TALKING

The players can focus on football now — they're officially done talking to the media.

Ravens safety Ed Reed was the last guy at the podium on Thursday. After he finished talking with reporters, he scooped up a blue placard with his name on it.

"I'm going to give it to my mother," he said.

He said he's very glad that his interviews are done for the week.

Players had three hourlong sessions during the week, and Reed had another press availability on Monday.

The coaches for the 49ers and Ravens will speak with reporters again on Friday morning.

— Paul Newberry — http://twitter.com/pnewberry1963

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BROTHERLY ADVICE: BROOK LOPEZ

Baltimore Ravens coach John Harbaugh and San Francisco 49ers coach Jim Harbaugh are hardly the only high-profile siblings who've squared off in their arena of expertise. The AP is asking some others who can relate how they'd handle going against a family member in the Super Bowl.

Brooklyn Nets center Brook Lopez said after scoring 21 points in a loss to the Miami Heat on Wednesday night that it's a combination of joy and competitiveness.

"I know they're just going to treat it as a game. That's how I treat it whenever I play Robin," Brook Lopez said. "I know they will enjoy it as well. But if I have any experience playing against Robin growing up, I know it's going to be competitive. I know they're going to want to beat each other."

Brook's brother, Robin, plays for the New Orleans Hornets.

— Brian Mahoney — http://twitter.com/briancmahoney

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SORRY, MOM

The way Jack Harbaugh tells the story, Jackie Harbaugh was so shocked by her eldest son's decision to choose coaching over a career in law or politics, she fell face-first into a dish of mashed potatoes.

See, Jackie Harbaugh loves political science and politics. And as a political science major at Bowling Green with a high grade-point, John Harbaugh seemed headed for law school.

"Jackie was so excited about it," Jack Harbaugh said.

But both of the Harbaugh boys had been bitten by the coaching bug early. The practice fields at Iowa and Michigan were their playground, and they knew more about coaching before they got out of grade school than some veteran assistants.

"He came home one day and we're sitting around the table and we're having dinner. Jackie says, 'John, what law school will it be?' John said, 'Mom, I think I want to try coaching,' Jack Harbaugh said. "To which Jackie went facedown into the mashed potatoes. She said, 'What? Coaching? You've got to reconsider!'"

That's not exactly what happened, Jackie Harbaugh said.

"May I tell the truth? There were no mashed potatoes," she said. "When he came home and talked about (coaching) and I saw that look in his eyes, my feeling was, you have to do what you want to do. If you want to try this and see where it takes you, that would be great."

Seems like he made the right choice. After making the playoffs in each of his first four seasons, John Harbaugh has the Baltimore Ravens in the Super Bowl on Sunday, where they'll face his brother Jim's San Francisco 49ers.

— Nancy Armour — http://twitter.com/nrarmour

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EATING RIGHT

How about some home cookin' in the Big Easy — as in 150 plates of it to feed a football team? That's what Ravens wide receiver Jacoby Jones' mother, Emily, presented the Baltimore players for dinner this week at the team hotel to kick off Super Bowl prep New Orleans-style.

"Gumbo, jambalaya, potato salad, bread pudding, macaroni, the whole nine yards. She made 150 plates," Jones said. "All they kept saying is she put her foot in it. I love it."

That's a real compliment around here.

Now, Jones might give his mother a break.

"I'm going to let her be. I might buy me some crawfish or something."

And he knows all the best spots in New Orleans to get it.

— Janie McCauley — http://twitter.com/janieMcCAP

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EDITOR'S NOTE — "Super Bowl Watch" shows you the Super Bowl and the events surrounding the game through the eyes of Associated Press journalists across New Orleans and around the world. Follow them on Twitter where available with the handles listed after each item.

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DealBook: Doubt Is Cast on Firms Hired to Help Banks

Federal authorities are scrutinizing the private consultants hired by banks to clean up financial misdeeds like money laundering and foreclosure abuses, taking aim at a conflict-riddled, billion-dollar industry.

The well-connected consultants operate with scant supervision and produce mixed results, according to government documents and interviews with prosecutors and regulators. In one case, the consulting firms enabled the wrongdoing. The deficiencies, officials say, can leave consumers vulnerable and allow tainted money to flow through the financial system.

“How can you be independent if you’re hired by the entity you’re reviewing?” said Senator Jack Reed, Democrat of Rhode Island, who sits on the Senate Banking Committee.

The pitfalls were exposed last month when federal regulators halted a broad effort to help millions of homeowners in foreclosure. The regulators reached an $8.5 billion settlement with banks, scuttling a flawed foreclosure review run by eight consulting firms. In the end, borrowers hurt by shoddy practices are likely to receive less money than they deserve, regulators say.

On Thursday, Senator Elizabeth Warren, Democrat of Massachusetts, and Representative Elijah Cummings, Democrat of Maryland, announced that they would open an investigation into the foreclosure review, seeking “additional information about the scope of the harms found.”

Critics concede that regulators have little choice but to farm out certain responsibilities. The government does not have the resources to ensure that banks behave. The consultants, with a deep bench of expertise, regularly provide additional oversight and help fix abuses. The less palatable alternative, regulators say, is for banks to police themselves.

Still, consultants like Deloitte & Touche and Promontory Financial Group can add to regulators’ headaches, the government documents and interviews indicate. Some banks that work with consultants continue to run afoul of the law. At other times, consultants underestimate the extent of the misdeeds or facilitate them, preventing regulators from holding institutions accountable.

Now, regulators and lawmakers are rethinking their relationship with the consultants. Officials at the Federal Reserve, which oversees many large banks, are questioning the prudence of relying on consultants so heavily, said two people with direct knowledge of the matter.

When the Office of the Comptroller of the Currency penalized JPMorgan Chase last month for breakdowns in money-laundering controls, it imposed stricter requirements, ordering the bank to hire a consultant with “specialized experience” in money laundering and to ensure that the firm “not be subject to any conflict of interest.” In a separate action against the bank related to a $6 billion trading loss last year, the agency opted not to mandate an outside consultant at all.

While the comptroller’s office will continue requiring consultants in certain cases, some agency officials are worried about the quality of the work, as well as the consultants’ independence, according to three government officials briefed on the matter.

Since the financial crisis, regulators have increasingly relied on consultants. The comptroller’s office ordered banks to hire consultants in more than 130 enforcement actions since 2008, or nearly 15 percent of the cases.

It can be a lucrative business. In 2011, regulators mandated that 14 banks employ consultants to determine whether homeowners were wrongfully evicted. Over 14 months, the consultants collected about $2 billion in fees, according to regulators and bank officials.

Those fees amounted to more than half of what homeowners will receive under the $8.5 billion settlement that ended the review. As part of the deal, officials will disburse $3.3 billion to 3.8 million borrowers in foreclosure.

According to consultants and regulators, the broad review was plagued with inefficiencies. For example, Promontory initially instructed employees to calculate lawyers’ fees for each loan, to assess if borrowers were overcharged. Later, it scrapped the original procedure, only to reverse the policy again two weeks later, according to two reviewers who worked for Promontory.

“From Day 1, Promontory strove to conduct its review work as thoroughly and independently as possible,” a spokesman for the firm, Christopher Winans, said in a statement. “Our overarching concern at all times was to serve the best interests of borrowers.”

Some lawmakers question whether a consultant’s regulatory connections helped it secure contracts. PricewaterhouseCoopers, which has a stable of former Securities and Exchange Commission officials, won much of the foreclosure review work, signing deals with four banks, including Citigroup. Promontory — the firm examining loans for Wells Fargo, Bank of America and PNC — was founded in 2000 by the former head of the comptroller’s office, Eugene A. Ludwig.

When the contracts were initially awarded, some housing advocates complained that consulting firms could not objectively evaluate banks with which they had pre-existing business relationships. The comptroller’s office said it vetted the firms to spot such potential conflicts, and argued that the process provided swifter relief for homeowners than if the government had hired the companies directly through a lengthy contracting process.

But concerns persisted. Deloitte, which won the contract to review JPMorgan’s loans, had previously audited Washington Mutual and Bear Stearns, two firms JPMorgan scooped up during the financial crisis. In May, the comptroller’s office replaced Allonhill, the consultant for Aurora Bank, after the firm disclosed that it had already reviewed some “of the same pool of loans” as part of an earlier contract.

“It’s clear from the foreclosure settlement that oversight over consultants was inadequate and the review process was deeply flawed,” said Representative Carolyn B. Maloney, Democrat of New York, who recently pressed regulators to detail how consultants were paid. People close to the review say consultants relied on a process that the comptroller’s office designed in 2011, under previous leadership.

“This was a very complex process,” said a spokesman for the comptroller. “Throughout the process, regulators provided continuous oversight, guidance and were available to discuss issues.” The agency also performs spot checks on the consultants.

Still, the foreclosure review highlighted broader concerns about the role consultants play.

Since the financial crisis, the comptroller’s office has issued nearly 20 enforcement actions against banks that had already hired consultants to help iron out problems, according to government documents. While consultants cannot be expected to remedy every last issue at the banks, the actions raise questions about the efficacy of their work.

When HSBC, the British bank, was sanctioned in 2003 over porous money-laundering controls, the bank turned to Deloitte to review its compliance, an official briefed on the matter said. Deloitte also worked for HSBC from 2006 to 2008, the person said, building a system to monitor money flows more effectively. But the bank ran into trouble in 2010 over similar issues, as highlighted in a recent scathing report by the Senate’s Permanent Subcommittee on Investigations.

As part of a regulatory order, HSBC again hired Deloitte, this time to assess the number of times the bank failed to report suspicious transactions. Deloitte, three officials said, generously bundled hundreds of missed transfers into a single report. That helped save the bank from some government fines.

Despite the undercounting, HSBC still paid a record $1.9 billion last year to settle accusations that it enabled drug cartels to move money through its American subsidiaries.

In a statement, a spokesman for the firm said, “Deloitte fully stands behind the quality and integrity of its work on behalf of regulatory authorities.”

Deloitte has also been suspected of helping institutions cloak illicit transfers of money to rogue nations around the globe. In August, New York’s top banking regulator, Benjamin M. Lawsky, accused Deloitte of helping the British bank Standard Chartered flout American sanctions.

The consulting firm was hired to flag suspicious transfers routed through Standard Chartered’s New York branches. Instead, it instructed bankers on how to escape regulatory scrutiny, according to state court documents.

Deloitte turned over “highly confidential information” from which the bank gleaned insight into “regulators’ concerns and strategies,” the court documents said. The firm later doctored its report to regulators, Mr. Lawsky said, deliberately removing some illegal transfers on behalf of Iranian clients. In an e-mail, a Deloitte partner admitted that a report on the transactions was a “watered-down version.”

The authorities never took legal action against Deloitte, and federal officials noted in a separate settlement agreement that Standard Chartered employees withheld critical information from the consulting firm.

Despite these concerns, regulators are turning to a familiar source to help Standard Chartered. As part of a $327 million settlement last year, the bank is required to hire “an independent consultant.”

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Well: Waiting for Alzheimer's to Begin

My gray matter might be waning. Then again, it might not be. But I swear that I can feel memories — as I’m making them — slide off a neuron and into a tangle of plaque. I steel myself for those moments to come when I won’t remember what just went into my head.

I’m not losing track of my car keys, which is pretty standard in aging minds. Nor have I ever forgotten to turn off the oven after use, common in menopausal women. I can always find my car in the parking lot, although lots of “normal” folk can’t.

Rather, I suddenly can’t remember the name of someone with whom I’ve worked for years. I cover by saying “sir” or “madam” like the Southerner I am, even though I live in Vermont and grown people here don’t use such terms. Better to think I’m quirky than losing my faculties. Sometimes I’ll send myself an e-mail to-do reminder and then, seconds later, find myself thrilled to see a new entry pop into my inbox. Oops, it’s from me. Worse yet, a massage therapist kicked me out of her practice for missing three appointments. I didn’t recall making any of them. There must another Nancy.

Am I losing track of me?

Equally worrisome are the memories increasingly coming to the fore. Magically, these random recollections manage to circumnavigate my imagined build-up of beta-amyloid en route to delivering vivid images of my father’s first steps down his path of forgetting. He was the same age I am now, which is 46.

“How old are you?” I recall him asking me back then. Some years later, he began calling me every Dec. 28 to say, “Happy birthday,” instead of on the correct date, Dec. 27. The 28th had been his grandmother’s birthday.

The chasms were small at first. Explainable. Dismissible. When he crossed the street without looking both ways, we chalked it up to his well-cultivated, absent-minded professor persona. But the chasms grew into sinkholes, and eventually quicksand. When we took him to get new pants one day, he kept trying on the same ones he wore to the store.

“I like these slacks,” he’d say, over and over again, as he repeatedly pulled his pair up and down.

My dad died of Alzheimer’s last April at age 73 — the same age at which his father succumbed to the same disease. My dad ended up choosing neurology as his profession after witnessing the very beginning of his own dad’s forgetting.

Decades later, grandfather’s atrophied brain found its way into a jar on my father’s office desk. Was it meant to be an ever-present reminder of Alzheimer’s effect? Or was it a crystal ball sent to warn of genetic fate? My father the doctor never said, nor did he ever mention, that it was his father’s gray matter floating in that pool of formaldehyde.

Using the jarred brain as a teaching tool, my dad showed my 8-year-old self the difference between frontal and temporal lobes. He also pointed out how brains with Alzheimer’s disease become smaller, and how wide grooves develop in the cerebral cortex. But only after his death — and my mother’s confession about whose brain occupied that jar — did I figure out that my father was quite literally demonstrating how this disease runs through our heads.

Has my forgetting begun?

I called my dad’s neurologist. To find out if I was in the earliest stages of Alzheimer’s, he would have to look for proteins in my blood or spinal fluid and employ expensive neuroimaging tests. If he found any indication of onset, the only option would be experimental trials.

But documented confirmation of a diseased brain would break my still hopeful heart. I’d walk around with the scarlet letter “A” etched on the inside of my forehead — obstructing how I view every situation instead of the intermittent clouding I currently experience.

“You’re still grieving your father,” the doctor said at the end of our call. “Sadness and depression affect the memory, too. Let’s wait and see.”

It certainly didn’t help matters that two people at my father’s funeral made some insensitive remarks.

“Nancy, you must be scared to death.”

“Is it hard knowing the same thing probably will happen to you?”

Maybe the real question is what to do when the forgetting begins. My dad started taking 70 supplements a day in hopes of saving his mind. He begged me to kill him if he wound up like his father. He retired from his practice and spent all day in a chair doing puzzles. He stopped making new memories in an all-out effort to preserve the ones he already had.

Maybe his approach wasn’t the answer.

Just before his death — his brain a fraction of its former self — my father managed to offer up a final lesson. I was visiting him in the memory-care center when he got a strange look on his face. I figured it was gas. But then his eyes lit up and a big grin overtook him, and he looked right at me and said, “Funny how things turn out.”

An unforgettable moment?

I can only hope.

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Nancy Stearns Bercaw is a writer in Vermont. Her book, “Brain in a Jar: A Daughter’s Journey Through Her Father’s Memory,” will be published in April 2013 by Broadstone.

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