Well: Exercise and the Ever-Smarter Human Brain

Anyone whose resolve to exercise in 2013 is a bit shaky might want to consider an emerging scientific view of human evolution. It suggests that we are clever today in part because a million years ago, we could outrun and outwalk most other mammals over long distances. Our brains were shaped and sharpened by movement, the idea goes, and we continue to require regular physical activity in order for our brains to function optimally.

Phys Ed

Gretchen Reynolds on the science of fitness.

The role of physical endurance in shaping humankind has intrigued anthropologists and gripped the popular imagination for some time. In 2004, the evolutionary biologists Daniel E. Lieberman of Harvard and Dennis M. Bramble of the University of Utah published a seminal article in the journal Nature titled “Endurance Running and the Evolution of Homo,” in which they posited that our bipedal ancestors survived by becoming endurance athletes, able to bring down swifter prey through sheer doggedness, jogging and plodding along behind them until the animals dropped.

Endurance produced meals, which provided energy for mating, which meant that adept early joggers passed along their genes. In this way, natural selection drove early humans to become even more athletic, Dr. Lieberman and other scientists have written, their bodies developing longer legs, shorter toes, less hair and complicated inner-ear mechanisms to maintain balance and stability during upright ambulation. Movement shaped the human body.

But simultaneously, in a development that until recently many scientists viewed as unrelated, humans were becoming smarter. Their brains were increasing rapidly in size.

Today, humans have a brain that is about three times larger than would be expected, anthropologists say, given our species’ body size in comparison with that of other mammals.

To explain those outsized brains, evolutionary scientists have pointed to such occurrences as meat eating and, perhaps most determinatively, our early ancestors’ need for social interaction. Early humans had to plan and execute hunts as a group, which required complicated thinking patterns and, it’s been thought, rewarded the social and brainy with evolutionary success. According to that hypothesis, the evolution of the brain was driven by the need to think.

But now some scientists are suggesting that physical activity also played a critical role in making our brains larger.

To reach that conclusion, anthropologists began by looking at existing data about brain size and endurance capacity in a variety of mammals, including dogs, guinea pigs, foxes, mice, wolves, rats, civet cats, antelope, mongooses, goats, sheep and elands. They found a notable pattern. Species like dogs and rats that had a high innate endurance capacity, which presumably had evolved over millenniums, also had large brain volumes relative to their body size.

The researchers also looked at recent experiments in which mice and rats were systematically bred to be marathon runners. Lab animals that willingly put in the most miles on running wheels were interbred, resulting in the creation of a line of lab animals that excelled at running.

Interestingly, after multiple generations, these animals began to develop innately high levels of substances that promote tissue growth and health, including a protein called brain-derived neurotrophic factor, or BDNF. These substances are important for endurance performance. They also are known to drive brain growth.

What all of this means, says David A. Raichlen, an anthropologist at the University of Arizona and an author of a new article about the evolution of human brains appearing in the January issue of Proceedings of the Royal Society Biology, is that physical activity may have helped to make early humans smarter.

“We think that what happened” in our early hunter-gatherer ancestors, he says, is that the more athletic and active survived and, as with the lab mice, passed along physiological characteristics that improved their endurance, including elevated levels of BDNF. Eventually, these early athletes had enough BDNF coursing through their bodies that some could migrate from the muscles to the brain, where it nudged the growth of brain tissue.

Those particular early humans then applied their growing ability to think and reason toward better tracking prey, becoming the best-fed and most successful from an evolutionary standpoint. Being in motion made them smarter, and being smarter now allowed them to move more efficiently.

And out of all of this came, eventually, an ability to understand higher math and invent iPads. But that was some time later.

The broad point of this new notion is that if physical activity helped to mold the structure of our brains, then it most likely remains essential to brain health today, says John D. Polk, an associate professor of anthropology at the University of Illinois at Urbana-Champaign, and co-author, with Dr. Raichlen, of the new article.

And there is scientific support for that idea. Recent studies have shown, he says, that “regular exercise, even walking,” leads to more robust mental abilities, “beginning in childhood and continuing into old age.”

Of course, the hypothesis that jogging after prey helped to drive human brain evolution is just a hypothesis, Dr. Raichlen says, and almost unprovable.

But it is compelling, says Harvard’s Dr. Lieberman, who has worked with the authors of the new article. “I fundamentally agree that there is a deep evolutionary basis for the relationship between a healthy body and a healthy mind,” he says, a relationship that makes the term “jogging your memory” more literal than most of us might have expected and provides a powerful incentive to be active in 2013.

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Airlines' plans for 2013 up in the air









Airfares will be on the rise in 2013, and those niggling airline fees will metamorphose into optional bundles of services.


Meanwhile, onboard amenities, such as Internet access, entertainment options and refreshed interiors, will abound among U.S. carriers, but tight seating in coach probably won't improve.


And 2013 might be the year you'll finally be able to keep your smartphone, iPad or Kindle turned on during takeoffs and landings.





Those are some of the predictions airline industry experts foresee in the new year. Here's the lowdown on fares, fees and flight experience for 2013.


Higher fares forecast


Airlines pushed through six fare increases in 2012. Expect a similar number in the new year, said Rick Seaney, co-founder of FareCompare.com.


"I wouldn't be surprised to see airfares rise like they did this year, between 3 and 6 percent domestically," Seaney said. That's because airlines will succeed in properly balancing supply and demand by trimming the number of seats they offer to match "decent, but bordering on tepid, demand."


Fares are typically driven by four main factors: competition, most of all, then supply, demand and oil prices. "If you look at those drivers, they are, for the most part, on the airlines' side, which gives them pricing power," Seaney said.


That doesn't mean there won't be good airfare deals on some flights on some routes. And consumers will still see lower prices during off-peak days, such as Tuesday, Wednesday and Saturday departures and off-peak seasons, such as late January and early February. Like this year, summertime fares probably will stay relatively high, he said.


Airline mergers can also affect fares, and a huge one could take place early in 2013. American Airlines and US Airways are in talks about combining.


The general consensus among consumer advocates is that airline mergers aren't good for passengers.


"Any time you have two big airlines merging, that means consumers have less choice and competition is reduced, which only translates to higher prices," said Charlie Leocha, director of the Consumer Travel Alliance.


However, a bit of new evidence bucks that conventional wisdom. Despite four mega-mergers in the U.S. airline industry during the past seven years, fares have not increased significantly, just 1.8 percent per year, according to a December report from professional services firm PwC. In fact, average domestic fares decreased 1 percent from 2004 to 2011 when inflation is factored in, the report found.


Fliers know full well, however, that the fare isn't all that counts nowadays. There are those fees.


Fees get a makeover


The most noticeable trend in recent years with airline fees is that there are more of them: fees for checked bags, aisle seats, onboard meals, among many others. 


"What we hear is that people pay their fare and get to the airport and feel they're constantly being nickeled-and-dimed to death for things that used to be included," said Kate Hanni, founder of FlyersRights.org. 


The top five U.S. carriers alone generated more than $12 billion in fees in 2011, with even more expected through 2012, according to the PwC report.


What consumers call fees, airlines call "unbundling" — making a la carte choices from services that used to be included in the fare.


A likely trend for 2013 might be called "rebundling," airlines packaging a few now-optional services and charging for a tier of service.





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Expectations low for White House 'fiscal cliff' meeting










WASHINGTON (Reuters) - President Barack Obama and congressional leaders were to meet on Friday for the first time since November with no sign of progress in resolving their differences over the federal budget and low expectations for a "fiscal cliff" deal before January 1.

Instead, members of Congress are increasingly looking at the period immediately after the December 31 deadline to come up with a retroactive fix to avoid the steep tax hikes and sharp spending cuts that economists have said could plunge the country into another recession.






With taxes on all Americans set to rise when rates established under former President George W. Bush expire on December 31, lawmakers would be able to come back in January and take a more politically palatable vote to cut some of the tax rates.

U.S. stocks fell on Friday, with the Dow Jones industrial average dropping 0.48 percent as investors fretted about the lack of certainty.

But some in the market were resigned to Washington going beyond the New Year's Day deadline, as long as a serious agreement on deficit reduction comes out of the talks in early January.

"Regardless of whether the government resolves the issues now, any deal can easily be retroactive. We're not as concerned with January 1 as the market seems to be," said Richard Weiss, a Mountain View, California-based senior money manager at American Century Investments.

The new factor in the mix was involvement by Republican Senate Minority Leader Mitch McConnell of Kentucky, who held conversations with Obama this week and said he expected a new proposal from the president that he would consider.

The White House spent much of Thursday stifling expectations for any new offer from Obama, beyond the limited fallback plan he outlined in vague terms on December 21, which would protect what he described as "middle class Americans" from the tax hikes, extend unemployment insurance and lay the "groundwork for further work" on deficit reduction and tax reform.

The major sticking point on taxes is Republican opposition to hikes on anyone, particularly in the absence of heavy cuts in spending for so-called entitlement programs such as Medicare and Medicaid, the government-run health programs for senior citizens and the poor.

Democrats in Congress want to keep lower tax rates for most Americans but raise them on those earning above $250,000 a year.

"The wealthy have got to kick in," Senator Debbie Stabenow, a Michigan Democrat, said Friday on CNN. "The tough part is in the House, where they have taken this very extreme position" of "protecting the wealthy at all costs," she said.

"It's feeling very much to me like an optical meeting than a substantive meeting," said Republican Senator Bob Corker of Tennessee, noting that it was not a sign of urgency to set a meeting for mid-afternoon with a deadline just days away.

"Any time you announce a meeting publicly in Washington, it's usually for political theater purposes," Senator Lindsey Graham, a South Carolina Republican, said on Thursday on Fox News.

"When the president calls congressional leaders to the White House, it's all political theater or they've got a deal. My bet is all political theater," said Graham, adding that he did not believe an agreement could be reached before the deadline.

(Editing by Alistair Bell and Vicki Allen)

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Apple still said to account for 87% of North American tablet traffic as Kindle Fire, Nexus 7 gain






Apple’s (AAPL) share of the global tablet market is in decline now that low-cost Android slates are proliferating, but the iPad still appears to be the most used tablet by a huge margin. Ad firm Chitika regularly monitors tablet traffic in the United States and Canada and in its latest report, Apple’s iPad was responsible for almost 90% of all tablet traffic across the company’s massive network.


[More from BGR: Samsung looks to address its biggest weakness in 2013]






Using a sample of tens of millions of impressions served to tablets between December 8th and December 14th this year, Chitika determined that various iPad models collectively accounted for 87% of tablet traffic in North America. That figure is down a point from the prior month but still represents a commanding lead in the space.


[More from BGR: New purported BlackBerry Z10 specs emerge: 1.5GHz processor, 2GB RAM, 8MP camera]


The next closest device line, Amazon’s (AMZN) Kindle Fire tablet family, had a 4.25% share of tablet traffic during that period, up from 3.57% in November. Samsung’s (005930) Galaxy tablets made up 2.65% of traffic, up from 2.36%, and Google’s (GOOG) Nexus 7 and Nexus 10 tablets combined to account for 1.06% of tablet traffic in early December.


“Despite these gains by some of the bigger players in the tablet marketplace, there has been a negligible impact to Apple’s dominant usage share,” Chitika wrote in a post on its blog.


This article was originally published by BGR


Gadgets News Headlines – Yahoo! News





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Singer Travis pleads not guilty to assault






SAN ANTONIO (Reuters) – Country singer Randy Travis pleaded not guilty to misdemeanor assault in a municipal courtroom in the Dallas suburb of Plano on Friday, his lawyer said.


Lawyer Peter A. Schulte told Reuters his client is “absolutely not guilty of this crime.”






Police say Travis assaulted a man in a church parking lot in Plano in August while attempting to intervene in a disagreement between a woman he was with and the woman’s estranged husband.


“He was actually being a good Samaritan at the time, stepping in to save two women from being assaulted,” Schulte said. He said the woman Travis was with and his daughter were being harassed by two men.


The charge against Travis carries a maximum $ 500 fine and no jail time. The case is set for trial March 11.


The altercation occurred during a bad stretch for the 53-year-old Grammy winner. Earlier in August, Travis was arrested on suspicion of drunken driving after he was found lying naked near his wrecked car along a north Texas highway. He also was accused of threatening to shoot and kill the troopers investigating the case, according to a police report.


The North Carolina-born country singer, known for hits such as “Forever and Ever, Amen,” also was arrested in February for drunken driving while sitting in his car in the parking lot of another north Texas church.


Schulte said Travis has been doing well since the two August incidents. He said his client was upbeat as he left the courtroom Friday.


“He turned and wished everybody who was there a merry Christmas and a happy and healthy New Year,” he said.


(Editing by Corrie MacLaggan and Bill Trott)


Music News Headlines – Yahoo! News





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Surgery Returns to NYU Langone Medical Center


Chang W. Lee/The New York Times


Senator Charles E. Schumer spoke at a news conference Thursday about the reopening of NYU Langone Medical Center.







NYU Langone Medical Center opened its doors to surgical patients on Thursday, almost two months after Hurricane Sandy overflowed the banks of the East River and forced the evacuation of hundreds of patients.




While the medical center had been treating many outpatients, it had farmed out surgery to other hospitals, which created scheduling problems that forced many patients to have their operations on nights and weekends, when staffing is traditionally low. Some patients and doctors had to postpone not just elective but also necessary operations for lack of space at other hospitals.


The medical center’s Tisch Hospital, its major hospital for inpatient services, between 30th and 34th Streets on First Avenue, had been closed since the hurricane knocked out power and forced the evacuation of more than 300 patients, some on sleds brought down darkened flights of stairs.


“I think it’s a little bit of a miracle on 34th Street that this happened so quickly,” Senator Charles E. Schumer of New York said Thursday.


Mr. Schumer credited the medical center’s leadership and esprit de corps, and also a tour of the damaged hospital on Nov. 9 by the administrator of the Federal Emergency Management Agency, W. Craig Fugate, whom he and others escorted through watery basement hallways.


“Every time I talk to Fugate there are a lot of questions, but one is, ‘How are you doing at NYU?’ ” the senator said.


The reopening of Tisch to surgery patients and associated services, like intensive care, some types of radiology and recovery room anesthesia, was part of a phased restoration that will continue. Besides providing an essential service, surgery is among the more lucrative of hospital services.


The hospital’s emergency department is expected to delay its reopening for about 11 months, in part to accommodate an expansion in capacity to 65,000 patient visits a year, from 43,000, said Dr. Andrew W. Brotman, its senior vice president and vice dean for clinical affairs and strategy.


In the meantime, NYU Langone is setting up an urgent care center with 31 bays and an observation unit, which will be able to treat some emergency patients. It will initially not accept ambulances, but might be able to later, Dr. Brotman said. Nearby Bellevue Hospital Center, which was also evacuated, opened its emergency department to noncritical injuries on Monday.


Labor and delivery, the cancer floor, epilepsy treatment and pediatrics and neurology beyond surgery are expected to open in mid-January, Langone officials said. While some radiology equipment, which was in the basement, has been restored, other equipment — including a Gamma Knife, a device using radiation to treat brain tumors — is not back.


The flooded basement is still being worked on, and electrical gear has temporarily been moved upstairs. Mr. Schumer, a Democrat, said that a $60 billion bill to pay for hurricane losses and recovery in New York and New Jersey was nearing a vote, and that he was optimistic it would pass in the Senate with bipartisan support. But the measure’s fate in the Republican-controlled House is far less certain.


The bill includes $1.2 billion for damage and lost revenue at NYU Langone, including some money from the National Institutes of Health to restore research projects. It would also cover Long Beach Medical Center in Nassau County, Bellevue, Coney Island Hospital and the Veterans Affairs hospital in Manhattan.


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Wall Street heads for longest losing streak in three months










NEW YORK (Reuters) - Stocks fell on Friday, putting the S&P 500 on track for a fifth straight decline, as President Barack Obama and top congressional leaders were set to make a last-ditch attempt to steer the country away from severe fiscal austerity next year.

Obama and lawmakers from both political parties will meet at the White House on Friday afternoon for talks in an effort to agree on a solution before a New Year's deadline to keep large tax hikes and spending cuts from taking effect. Economists say that combination of automatic higher taxes and lower government spending - known as the "fiscal cliff" - could push the U.S. economy into a recession.

Trading was volatile and stocks rebounded from their session lows after unconfirmed reports that President Obama was about to offer a new plan to Republicans.

But investors' pessimism about achieving anything more than a stop-gap deal by the deadline was reflected in the benchmark S&P 500's drop of 1.3 percent so far this week. The broad index was on pace for its worst weekly performance since mid-November.

A five-day decline would be the S&P 500's longest losing streak in three months.

"There's a pretty good chance that we won't have something in hand by year-end," said Jonathan Golub, chief U.S. equity strategist at UBS, in New York. "It should be pretty obvious that that is now the majority case."

Golub, however, said investors were still counting on a deal that would avoid most of the tax hikes and spending cuts next year even if it does come after the deadline.

"It is widely believed that we're going to get a deal," he said. "We are not going to go over the cliff to the extent that we have a huge economic contraction."

With time running short, members of Congress may attempt to pass a retroactive fix to neutralize tax increases and spending cuts soon after the automatic fiscal policies come into effect on January 1.

The Dow Jones industrial average fell 65.65 points, or 0.50 percent, to 13,030.66. The Standard & Poor's 500 Index dropped 6.03 points, or 0.43 percent, to 1,412.07. The Nasdaq Composite Index slipped 7.29 points, or 0.24 percent, to 2,978.62.

"It doesn't matter which side wins, but at this point, nobody wants to play a game where there aren't rules," said Joe Costigan, director of equity research at Bryn Mawr Trust, in Bryn Mawr, Pennsylvania.

"So everybody is talking about what the prospects are for changes in the rules. But at the end of the day, nothing is happening."

Highlighting Wall Street's sensitivity to developments in Washington, stocks tumbled slightly more than 1 percent on Thursday after Senate Majority Leader Harry Reid warned that a deal was unlikely before the deadline. But late in the day, the three major U.S. stock indexes rebounded and ended down just 0.1 percent after the U.S. House of Representatives said it would hold an unusual Sunday session to work on a fiscal solution.

With many investors away for the holiday-shortened week, volume is expected to remain light and that could exacerbate the stock market's swings.

Positive economic data failed to alter the market's downtrend.

The National Association of Realtors said contracts to buy previously owned U.S. homes rose in November to their highest level in 2-1/2 years, while a report from the Institute for Supply Management-Chicago showed business activity in the U.S. Midwest expanded in December.

Barnes & Noble Inc shares rose 6.2 percent to $15.24 after the top U.S. bookstore chain said British publisher Pearson Plc had agreed to make a strategic investment in its Nook Media subsidiary. But Barnes & Noble also said its Nook business will not meet its previous projection for fiscal year 2013.

Shares of magicJack VocalTec Ltd jumped 8.5 percent to $17.67 after the company, which provides VoIP or voice over Internet protocol services, forecast more than $39 million in GAAP revenue and over 70 cents per share in operating income for the fourth quarter. The company also said it has appointed Gerald Vento as president and CEO, effective January 1.

The U.S.-listed shares of Canadian drugmaker Aeterna Zentaris Inc surged 16.1 percent to $2.52 after the company said it had reached an agreement with the U.S. Food and Drug Administration on a special protocol assessment by the FDA for a Phase 3 registration trial in endometrial cancer with AEZS-108 treatment.

(Reporting by Edward Krudy; Editing by Jan Paschal)

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Snow in Chicago nothing like storm out East













Snowy ride


A bicyclist fights the snow heading north on Halsted Street, north of Roosevelt Avenue in Chicago.
(Chris Walker, Chicago Tribune / December 27, 2012)


























































As the Northeast gets battered by a powerful winter storm, Chicago is getting hit by a gentler weather system that could coat parts of the area with an inch or more of snow by Friday.

“There will be mainly light snow that will cause some visibility reduction,’’ said Richard Castro, a meteorologist with the National Weather Service.

The snow will fall, on and off, until the early evening hours with an accumulation of only two tenths of an inch. “There could be an occasional burst of snow in the lakefront areas,’’ Castro said. More light snow is expected Friday. Temperatures will reach only into the 20s or lower 30s both days.

“Some places could possibly see over an inch,’’ Castro said. “It’s going to feel like winter.’’


A storm that swept through the South earlier this week brought snow to inland parts of the Northeast and driving rain and wind to areas along the coast Thursday.

The storm, which was blamed for nine deaths, pushed through the Upper Ohio Valley and made its way into the Northeast Wednesday night. By Thursday morning, there was anywhere from a few inches of snow to a foot in some locations







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Christmas box-office haul paces Hollywood for record year






LOS ANGELES (Reuters) – A strong Christmas-day box office performance by musical “Les Miserables” and western “Django Unchained” put Hollywood on pace to set an all-time box office record with $ 10.8 billion in annual revenue, box-office tracker Hollywood.com said on Wednesday.


Universal Pictures‘ star-studded “Les Miserables” took in a weekday Christmas record of $ 18.2 million in the United States and Canada when it opened on Tuesday, according to studio estimates of weekday ticket sales.






Quentin Tarantino‘s spaghetti western “Django Unchained,” starring Jamie Foxx and Leonardo DiCaprio, hauled nearly $ 15 million for The Weinstein Co.


Studios “are definitely on the road to a record year with $ 10.8 billion expected (up 6 percent over last year and beating the previous record of $ 10.6 billion in 2009),” Hollywood.com analyst Paul Dergarabedian told Reuters in an email, adding that the number of tickets sold should climb 6 percent from 2011 to 1.36 billion.


Dergarabedian credits a successful marketing year for studios as a chief reason for the projected box-office record, as well as spring and summer smashes “The Hunger Games” and “The Avengers” helping boost revenue.


“It was not just the fact that most of the movies delivered, it was the timing of their release dates and the marketing was obviously effective as well with social media continuing to provide an outlet for the movie-going peer group to talk about their favorite flicks,” Dergarabedian said.


“The Hobbit: An Unexpected Journey,” based on the J.R.R. Tolkein classic fantasy novel, brought in $ 11.4 million on Christmas day after ruling the box office with nearly $ 37 million in sales over the weekend.


Billy Crystal family film “Parental Guidance” debuted in fourth place with about $ 6.4 million in Christmas sales while Tom Cruise’s “Jack Reacher,” which featured author Lee Child’s character in an investigation into a sniper shooting, was fifth with some $ 5.3 million.


“The Hobbit” was distributed by Time Warner Inc’s Warner Bros. Studio. News Corp’s 20th Century Fox released “Parental Guidance” and Paramount Pictures, a unit of Viacom, released “Jack Reacher.” Universal Pictures is owned by Comcast Corp.


(Reporting by Eric Kelsey; Edited by Ronald Grover and Andrew Hay)


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New York’s Mental Health System Thrashed by Services Lost to Storm


Marcus Yam for The New York Times


Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum hospitals, at St. Luke’s-Roosevelt Hospital Center.







When a young woman in the grip of paranoid delusions threatened a neighbor with a meat cleaver one Saturday last month, the police took her by ambulance to the nearest psychiatric emergency room. Or rather, they took her to Beth Israel Medical Center, the only comprehensive psychiatric E.R. functioning in Lower Manhattan since Hurricane Sandy shrank and strained New York’s mental health resources.




The case was one of 9,548 “emotionally disturbed person” calls that the Police Department answered in November, and one of the 2,848 that resulted in transportation to a hospital, a small increase over a year earlier.


But the woman was discharged within hours, to the shock of the mental health professionals who had called the police. It took four more days, and strong protests from her psychiatrist and caseworkers, to get her admitted for two weeks of inpatient treatment, said Tony Lee, who works for Community Access, a nonprofit agency that provides supportive housing to people with mental illness, managing the Lower East Side apartment building where she lives.


Psychiatric hospital admission is always a judgment call. But in the city, according to hospital records and interviews with psychiatrists and veteran advocates of community care, the odds of securing mental health treatment in a crisis have worsened significantly since the hurricane. The storm’s surge knocked out several of the city’s largest psychiatric hospitals, disrupted outpatient services and flooded scores of coastal nursing homes and “adult homes” where many mentally ill people had found housing of last resort.


One of the most affected hospitals, Beth Israel, recorded a 69 percent spike in psychiatric emergency room cases last month, with its inpatient slots overflowing. Instead of admitting more than one out of three such cases, as it did in November 2011, it admitted only one out of four of the 691 emergency arrivals this November, records show. Capacity was so overtaxed that ambulances had to be diverted to other hospitals 15 times in the month, almost double the rate last year, in periods typically lasting for eight hours, officials said.


Dr. Richard Rosenthal, physician in chief of behavioral services for Continuum Health Partners, Beth Israel’s parent organization, said he was proud of how much Continuum’s hospitals had done to handle psychiatric overflow since storm damage shuttered Bellevue Hospital Center, the city’s flagship public hospital; NYU Langone Medical Center; and the Veterans Affairs Hospital. But these days, he said, as he walks on Amsterdam Avenue between Continuum’s Roosevelt hospital on West 59th Street and its St. Luke’s hospital on West 114th Street, he notices more mentally ill people in the streets than he has seen in years.


“When you have the most vulnerable folks, all you need is one chink in the system and you lose them,” Dr. Rosenthal said. “Whether they lost their housing, or the outpatient services they usually go to were closed and they were lost to follow-up, they have become disconnected, with predictable results.”


Similar patterns are playing out in Brooklyn, where Maimonides Medical Center has been overwhelmed with mental health emergencies from the Coney Island vicinity since Coney Island Hospital, one of the city’s largest acute care psychiatric hospitals, suspended operations, hospital officials said.


“Triage has reached a different level: You have to get sicker to get in,” said Dr. Andrew Kolodny, the chairman of psychiatry at Maimonides, citing a 56 percent increase in psychiatric emergency room visits there from Oct. 26 to Dec. 7, compared with the same period last year, and a 24 percent rise in admissions. The increase in admissions was possible only with emergency permission from the state to exceed licensed limits.


“Not only is there decreased capacity, because Bellevue and Coney Island are off line,” Dr. Kolodny added, “but there’s increased demand because the storm or the loss of their residence has been a stressor for mental illness.”


The storm battered a mental health system that still relies heavily on private nursing homes and substandard adult homes to house people with mental illness. Such institutions have a sordid history of neglect and exploitation, and the courts have repeatedly found that their overuse by the state isolated thousands of people in violation of the Americans With Disabilities Act.


Plans are under way to increase supportive housing — dwellings where mentally ill people can live relatively independently, with support services. But even before Hurricane Sandy, the expansion fell far short of demand.


The storm underscored the fragility of the system. Many disabled evacuees who were sent first to makeshift school shelters lost access to the psychiatric medications that kept their symptoms at bay, Dr. Kolodny said. Even those lucky enough to have the drugs they need are at greater risk of relapse as they experience crowded living conditions. “If they’re now sleeping in a gym with 100 people, that can tip them over the edge and start making them really paranoid,” he said.


On Staten Island, where the chief of psychiatry at Richmond University Medical Center says psychiatric resources have been stretched to the limit, clergy members report that mentally ill people transferred to a large adult home in New Brighton from one that was washed away in Far Rockaway, Queens, are now showing up at church rectories, begging for socks and underwear.


“It’s heartbreaking, because they just found us by chance,” said Margaret Moschetto, a missionary at the Church of Assumption-St. Paul in New Brighton. “They were just walking around the neighborhood. They really didn’t know where they were.”


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