Watching for Speed Bumps on the Way to an A.D.H.D. Diagnosis

In school, she would procrastinate and then pull desperate all-nighters to study for an exam. She’d become hyperfocused on a project and let everything else fall by the wayside. Maintaining relationships was tricky.“I would concentrate intensely on a friend and then move on,” she said. She commuted to college one year simply because she had missed the deadline to apply for housing.

“I managed to achieve a lot, but it was difficult,” said Ms. Goldberg, a mother of three who lives near Philadelphia.“I sensed something was wrong, but others would always talk me out of it.”

Finally, in her late 40s, Ms. Goldberg was given a diagnosis ofattention deficit hyperactivity disorder, a condition caused by signaling problems in the brain. The primary symptoms are impulsiveness, inattention,restlessnessand poor self-regulation. Children with the condition tend to be hyperactive, but adults who have it often just seem distracted and disorganized.

Undiagnosed, A.D.H.D. can wreak havoc on relationships, finances and one’s self-esteem. Adults with the disorder are twice as likely as those without it to be divorced, for instance, and four times as likely to have car accidents. It’s no surprise that they also tend to have poor credit ratings.

“A.D.H.D. is a very debilitating mental disorder,” said Russell Barkley, a clinical professor ofpsychiatryat the Medical University of South Carolina.“It can produce more severe impairment, and in more domains of life, than depression or anxiety.”

More than 5 percent of adults have A.D.H.D., according to a recent study by Dr. Barkley. But just 10 percent of those adults have a formal diagnosis.

It’s an expensive problem for many consumers. Adults with the condition, particularly women, are frequently given a diagnosis of depression, anxiety orbipolar disorderinstead— or their symptoms are dismissed, as Ms. Goldberg’s were.

Ms. Goldberg said of her eventual diagnosis:“It was so freeing. I realized,‘I’m not stupid— I have a mental disorder.’ ”

Just getting the correct diagnosis can be costly.“Many clinicians do not know how to spot the signs,” said Ari Tuckman, a psychologist in West Chester, Pa., and author of a book about A.D.H.D.,“More Attention, Less Deficit” (Specialty Press, 2009).

Clinicians may arrive at the diagnosis with a snap judgment, or they may send patients for lengthy and expensive neuropsychological evaluations. Both approaches tend to miss the main symptoms— and therefore waste the patient’s time and money.

If you think that you may have A.D.H.D., or that a friend or family member may, the first thing to do is get a proper diagnosis. Here’s how to get tested and what to avoid.

Step 1:Test yourself.

Cost:Free.

If you’re not quite sure if you or a family member has the disorder, start by printing out theAdult A.D.H.D. Self-Report Scaleand answering the 18-question assessment. It was developed by a team ofpsychiatristsin conjunction with the World Health Organization, and it is used by many clinicians to diagnose A.D.H.D.

The test is simple and has a straightforward scoring system. Use the results only as a guide to gauge your symptoms or a family member’s; it should not serve as a final diagnosis.

Bear in mind that A.D.H.D. is not something you suddenly develop as an adult; you are born with it.“If you tell me,‘My life was fine until I was 24,’ you don’t have this disorder,” said Dr. Barkley.

Avoid:Snap diagnoses.

Diagnosing this disorder takes time. A quick assessment, even by your favorite doctor or therapist, can miss important signs.

“I can’t guess how many clients I have had who have seen otherpsychologists, psychiatrists and primary care physicians who missed their A.D.H.D., even though it was burning like a bonfire,” said Dr. Tuckman.“It’s possible to make a diagnosis by using a rating scale and a 10-minute discussion, but it’s also far too easy to make an inaccurate diagnosis or miss a diagnosis.”

Step 2:Find an experienced clinician.

Cost:$200 to $500.

Make an appointment, or more than one, with a psychiatrist, psychologist or neurologist who has expertise in diagnosing A.D.H.D. Ask your doctor or a psychotherapist for a recommendation, or contact a local chapter of the organizationChildren and Adults With Attention Deficit/Hyperactivity Disorder(informally known as Chadd) and inquire about local professionals.

Dr. Barkley also suggests calling a nearby medical school or university psychiatry program and asking whether there is a doctor on staff who specializes in adult A.D.H.D.

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First Mention— M.R.I., 1974

On Feb. 9, 1974, The New York Times reported in its Patents of the Week column that Dr. Raymond V. Damadian, a physician and biophysicist at Downstate Medical Center in Brooklyn, had patented a method for distinguishing normal from cancerous tissue by what was then called nuclear magnetic resonance.

The apparatus was“still under development,” the article said, and it mentioned several other patents recorded that week, including one for a new kind of no-iron all-cotton fitted bedsheet.

On Oct. 12, 1975, The Times described one of world’s most powerful N.M.R. spectrometers, built at Stanford University. The article said nothing about its potential use in medical diagnoses.

On July 21, 1977, Dr. Damadian was in the news again. He had announced a new technique for detectingcancer, using a one-and-a-half-ton, 10-foot-high device equipped with what he called“the world’s largest magnet.” His news release apparently exaggerated a bit, and Dr. Damadian later retracted a contention that his technique had already been used to discover cancerous tissue in a living patient.

By late 1978 other imaging techniques— positron emission tomography (PET scans), computed tomography (CT or CAT scans) andultrasound— were already being used in humans, and on Nov. 14, the lead article in the first issue of Science Times described the new procedures. Mention of nuclear magnetic resonance was relegated to the last two paragraphs, where it was called“one of the newest methods of imaging, and probably furthest from clinical application.”

But in the early 1980s magnetic scans were being performed on humans, andhospitalshad begun buying the devices. As the machines became more widely used, the word“nuclear” in the name frightened some patients with its suggestion that nuclear radiation was involved. An article on March 17, 1985, explained that now most doctors were calling both the procedure and the machines“magnetic resonance imaging,” or M.R.I. It was the first time The Times used the term that is universally accepted today.

On Oct. 7, 2003, The Times reported that Paul C. Lauterbur and Sir Peter Mansfield had won theNobel Prizein Physiology or Medicine for“discoveries of imaging with magnetic resonance,” in the citation’s words, that“have played a seminal role in the development of one of the most useful imaging modalities in medicine today.” Dr. Damadian took out full-page newspaper ads to complain that he had been unfairly denied the prize.

NICHOLAS BAKALAR

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Leeks in White Wine - Recipes for Health

6 medium leeks, about 2 1/2 pounds, white and light green parts only

Salt

2 tablespoons extra-virgin olive oil

1 cup dry white wine, like pinot grigio or sauvignon blanc

Freshly ground pepper to taste

4 large garlic cloves, minced

2 tablespoons chopped flat-leaf parsley, mint or dill (or a combination)

1.Cut the ends and the dark green leaves off the leeks, and then cut them in half lengthwise. Place in a bowl of cold water for 10 minutes, then run them under the faucet to remove any sand that may be lingering in between the layers. Cut into 2-inch pieces.

2.Bring a large pot of water to a boil, salt generously and add the leeks. Parboil for two minutes and drain.

3.Spoon the olive oil into a wide, lidded skillet, and place the leeks in the skillet in an even layer. Pour in the wine, and add salt and freshly ground pepper to taste, and the garlic. Bring to a boil, cover and reduce the heat to low. Simmer for 30 to 45 minutes, until the leeks are very tender but still intact and most of the liquid has evaporated.

4.Remove from the heat, and allow the leeks to cool in the juices left in the pan. Transfer to a serving dish. Taste and adjust seasonings. Sprinkle on the fresh herbs and serve.

Yield:Serves four to six.

Advance preparation:The leeks will keep for a day or two in the refrigerator. Reheat or bring to room temperature before serving.

Nutritional information per serving (four servings):278calories; 1 gramsaturated fat; 1 gram polyunsaturated fat; 5 grams monounsaturated fat; 0 milligramscholesterol; 42 gramscarbohydrates; 5 gramsdietary fiber; 61 milligrams sodium (does not include salt to taste); 5 grams protein

Nutritional information per serving (six servings):185 calories; 1 gram saturated fat; 1 gram polyunsaturated fat; 3 grams monounsaturated fat; 0 milligrams cholesterol; 28 grams carbohydrates; 3 grams dietary fiber; 41 milligrams sodium (does not include salt to taste); 3 grams protein

Martha Rose Shulmanis the author of"The Very Best of Recipes for Health."

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Transplant Recipients of Julio Garcia’s Organs Gather in Thanks

“That’s my heart,” she said.“It’s still beating for me.”

Although she had just met Mr. Lourenco, she had known his heart for a long time. It had belonged to her husband, Julio, who died from abrain hemorrhagein March 2010, at the age of 38. Mrs. Garcia donated her husband’s organs, and the family’s loss led to a second chance for Mr. Lourenco, 57.

But he was not the only one. Seven or eight other people who urgently needed transplants also received organs from Mr. Garcia, an unusually large number. (The average from organ donors is about three.) Even more unusual, his family and a group of recipients met on Wednesday in a highly emotional gathering at the Manhattan headquarters of theNew York Organ Donor Network, which coordinated the transplants.

The story of the Garcias and the people whose lives were saved by one man’s donated organs provides a close look at the charged world of transplants and organ donation, where people on the transplant list know they may die waiting, and the families of brain-dead patients are asked, at perhaps the most painful time in their lives, to look beyond their own grief and allow a loved one’s organs to be removed to help strangers.

There are nowhere near enough donor organs for all the people who need transplants. Nearly 111,000 are on waiting lists in the United States, but last year, only 28,663 transplants were performed, according to theUnited Network for Organ Sharing, which oversees the transplant system nationwide. This year, 6,000 to 7,000 people are expected to die waiting.

Last week, Mrs. Garcia and her children, 5, 11 and 18, who all live in Stamford, Conn., met four of the recipients of her husband’s organs for the first time. A fifth recipient also attended, one of two people withrenal failure, both members of the Garcias’ church, whom Mrs. Garcia chose to receive kidneys.

Mrs. Garcia addressed a room packed with recipients, families, doctors, nurses, her minister and his family and network employees. She spoke briefly through an interpreter. She said her husband had had a big heart and would be very proud“to give life after death.” No one would ever forget him, she said.

Elaine R. Berg, president of the donor network, said:“These meetings don’t happen that frequently. I’ve been here 11 years, and if it’s once a year that’s a lot. I’ve never met five recipients from one donor. It’s highly unusual.”

In many cases recipients or donor families, or both, choose to remain anonymous, Ms. Berg said. Recipients may send thank-you letters through the network, but they and donors do not often choose to meet.

“It’s pretty intimidating and pretty emotional,” Ms. Berg said.“Some people cannot bear it.”

But she said that meeting the recipients can bring solace to donor families.

Mr. Garcia was so young and strong that his corneas and six organs were healthy enough to transplant: his heart, one lung, his pancreas, both kidneys and his liver, which was divided to save two people, an adult and a child.

In photographs, Julio Garcia was handsome, with a mischievous smile. His wife said he loved to joke and laugh. But he was also deeply religious, and as a pastor at their evangelical church in Stamford he did a lot of preaching and marriage counseling. He earned his living as a carpenter. Both he and his wife, originally from Guatemala, became naturalized citizens.

For many years, he had suffered periodically from severe headaches, but he had been told they were migraines. The headaches were unusually bad during the week or so before March 17, a Wednesday. That day, his head hurting, he told his children he loved them and went to work.

He called his wife that afternoon, saying the pain was terrible and he was going numb all over. She wanted to call an ambulance, but he asked her to pick him up instead. She drove him to a hospital in Stamford. A major hemorrhage andswellingwere putting pressure on his brain. Doctors tried to relieve the pressure, and then transferred Mr. Garcia to NewYork-Presbyterian/Weill Cornell hospital in Manhattan.

By the time he arrived there on Wednesday night, he was in a deepcoma, needed a ventilator to breathe and had extremely lowblood pressure— all signs of a large hemorrhage affecting the brain stem, according to Dr. Axel Rosengart, the director of neurocritical care. Doctors stabilized him and tried again to reduce the pressure on his brain, but scans showed extensive, irreversible damage, Dr. Rosengart said.

Dr. Rosengart said he was not certain but suspected that the bleeding was caused by an arteriovenous malformation, a blood vessel abnormality that Mr. Garcia may have had from birth.

By Thursday, Dr. Rosengart said, he began to warn the family that Mr. Garcia was heading toward brain death. Later that day, the diagnosis was made twice, by two different physicians, in accord with state law. A patient with brain death is legally dead. At that point, there were two priorities, Dr. Rosengart said:“the family and their emotional survival, and preserving the organs.”

Brain-dead patients can become medically unstable, and intensive treatment is often needed to prevent their organs from failing.

Dr. Rosengart and a social worker from the New York Organ Donor Network asked Mrs. Garcia about organ donation.

At first, Mrs. Garcia recalled, she could not accept the diagnosis of brain death. Still hoping a miracle would save her husband, she asked them to wait.

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Dabrali Jimenez contributed reporting.

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Using Biomechanics to Improve Surgical Instruments

Physcient is, in fact, a medical technology company. But its décor speaks to the exceptional careers of its co-founders, Hugh Crenshaw and Charles Pell. They both got their start studying biomechanics— how creatures fly, swim and crawl. Mr. Pell built models of muscles and fish heads. Dr. Crenshaw earned his Ph.D. figuring out how single-celled creatures swim. And over the past 20 years they’ve profitably translated their understanding of biomechanics into inventions, from robotic submarines to pill sorters.

Now they’re turning their attention to the world of surgery. The instruments that surgeons use today, they argue, were invented before biomechanics became a mature science. They work against the physics of the body, instead of with it.“The technologies remain remarkably unchanged,” said Dr. Crenshaw.“Maybe we can do better.”

Dr. Crenshaw and Mr. Pell are starting with a kindler, gentler rib spreader. Surgeons often treat the broken ribs and other painful side effects ofopen heart surgeryas inevitable. But Dr. Crenshaw and Mr. Pell have invented a new kind of rib spreader that takes into account how bones can bend, rather than break. Their preclinical studies on pigs suggest that it causes far less damage.

If it turns out to work as they hope, the inventors will turn their attention to other tools of the trade.“The entire surgical tray is going to be transformed,” said Mr. Pell.

As a boy, Mr. Pell was, in his words,“a congenital geek.” He spent his free time building rockets, cars and wave machines. He went to art school and earned a master’s degree in sculpture, but his sculptures were more like robots than marble busts. After graduate school, Mr. Pell headed for California, where he ended up director of research and development at a company that built robotic dinosaurs for museum exhibits. He continued to come up with strange designs, like a water-filled arch that fish could swim inside to travel from one pond to another.

To figure out if a fish could physically survive the journey through a water bridge, Mr. Pell called up Stephen Wainwright, a pioneer in biomechanics at Duke University.“He said,‘Who are you, and why are you doing this?’ ” recalled Mr. Pell. Despite his initial misgivings, Dr. Wainwright ended the conversation by offering to fly Mr. Pell to Duke for a visit. Not long afterward, Mr. Pell became the director of the BioDesign Studio at Duke.

At the studio Mr. Pell helped Dr. Wainwright and his colleagues build models to test their ideas about biomechanics, creating models of spinal cords, muscles, jaws and dozens of other animal parts.“These models can physically surprise you,” said Mr. Pell.“They can show you things that you didn’t think of before you built them.”

One of Mr. Pell’s biggest surprises came when he tried to make a simple model of a swimming fish. He built a rubber tube with a rounded front and then stuck a rod a quarter of the way down its length. When he put the tube in water and turned the rod back and forth between his fingers, it generated a wave with its tail. While making a new version of that tube, Mr. Pell accidentally nicked the tail end. That new shape, he discovered, caused the water to flow in a different pattern around the tube, creating thrust.

Mr. Pell, Dr. Wainwright and their colleagues got a patent for the design and started a company called Nekton to develop products from it. First, they turned it into a commercially successful bathtub toy. But when the Navy discovered Mr. Pell and his colleagues could get fishlike thrust from something without any moving parts, they encouraged him to get into the business of building underwater robots. Mr. Pell and his colleague at Nekton ended up making a highly maneuverable yardlong robot called the Pilot Fish.

“We started out as a toy company; we ended up as a defense contractor,” said Mr. Pell.

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A New Gauge Helps to See What’s Beyond Happiness

Martin Seligman now thinks so, which may seem like an odd position for the founder of the positivepsychologymovement. As president of the American Pyschological Association in the late 1990s, he criticized his colleagues for focusing relentlessly on mental illness and other problems. He prodded them to study life’s joys, and wrote a best seller in 2002 titled“Authentic Happiness.”

But now he regrets that title. As the investigation of happiness proceeded, Dr. Seligman began seeing certain limitations of the concept. Why did couples go on having children even though the data clearly showed that parents are less happy than childless couples? Why did billionaires desperately seek more money even when there was nothing they wanted to do with it?

And why did some people keep joylessly playing bridge? Dr. Seligman, an avid player himself, kept noticing them at tournaments. They never smiled, not even when they won. They didn’t play to make money or make friends.

They didn’t savor that feeling of total engagement in a task thatpsychologistscall flow. They didn’t take aesthetic satisfaction in playing a hand cleverly and“winning pretty.” They were quite willing to win ugly, sometimes even when that meant cheating.

“They wanted to win for its own sake, even if it brought no positive emotion,” says Dr. Seligman, a professor of psychology at the University of Pennsylvania.“They were like hedge fund managers who just want to accumulate money and toys for their own sake. Watching them play, seeing them cheat, it kept hitting me that accomplishment is a human desiderata in itself.”

This feeling of accomplishment contributes to what the ancient Greeks called eudaimonia, which roughly translates to“well-being” or“flourishing,” a concept that Dr. Seligman has borrowed for the title of his new book,“Flourish.”He has also created his own acronym, Perma, for what he defines as the five crucial elements of well-being, each pursued for its own sake: positive emotion, engagement (the feeling of being lost in a task), relationships, meaning and accomplishment.

“Well-being cannot exist just in your own head,” he writes.“Well-being is a combination of feeling good as well as actually having meaning, good relationships and accomplishment.”

The positive psychology movement has inspired efforts around the world to survey people’s state of mind, like a new project in Britain to measure what David Cameron, the prime minister, calls GWB, for general well-being. Dr. Seligman says he’s glad to see governmentsmeasuring more than just the G.D.P., but he’s concerned that these surveys mainly ask people about their“life satisfaction.”

In theory, life satisfaction might include the various elements of well-being. But in practice, Dr. Seligman says, people’s answers to that question are largely— more than 70 percent— determined by how they’re feeling at the moment of the survey, not how they judge their lives over all.

“Life satisfaction essentially measures cheerful moods, so it is not entitled to a central place in any theory that aims to be more than a happiology,” he writes in“Flourish.” By that standard, he notes, a government could improve its numbers just by handing out the kind of euphoriant drugs that Aldous Huxley described in“Brave New World.”

So what should be measured instead? The best gauge so far of flourishing, Dr. Seligman says, comes from a study of 23 European countries by Felicia Huppert and Timothy So of the University of Cambridge. Besides asking respondents about their moods, the researchers asked about their relationships with others and their sense that they were accomplishing something worthwhile.

Denmark and Switzerland ranked highest in Europe, with more than a quarter of their citizens meeting the definition of flourishing. Near the bottom, with fewer than 10 percent flourishing, were France, Hungary, Portugal and Russia.

There’s no direct comparison available with the United States, although some other researchers say that Americans would do fairly well because of their sense of accomplishment. The economist Arthur Brooks notes that 51 percent of Americans say they’re very satisfied with their jobs, which is a higher percentage than in any European country except Denmark, Switzerland and Austria.

In his 2008 book,“Gross National Happiness,” Dr. Brooks argues that what’s crucial to well-being is not how cheerful you feel, not how much money you make, but rather the meaning you find in life and your sense of“earned success”— the belief that you have created value in your life or others’ lives.

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Haiti - Ambitious Vaccine Plan for Newborns

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More Dining-Out Choices for Celiac Patients in New Jersey

IN 2009, Deborah Gianelli, 58, of Montclair, was told she hadceliac disease, a disorder in which the immune system attacks the small intestine in response to gluten, a protein found in wheat, rye and barley.

The diagnosis was“devastating,” she said. Pasta and bread were among her favorite foods. She also enjoyed eating out, especially at Italian restaurants.La Riviera Trattoriain Clifton, where she and her family had been regulars for 15 years, was a favorite.

“I thought,‘Well, that’s the end of that,’ ” she said.

Then, a week after Ms. Gianelli’s disease was diagnosed, Maria Carlino, the daughter of Franco and Danica Carlino, the owners of La Riviera Trattoria, also learned she had celiac disease.

For Ms. Gianelli, being in the same dietary boat as Maria Carlino has helped restore her lifestyle.

“I’m at La Riviera once a week now, almost every Friday night,” she said. A gluten-free menu has been in place, along with the regular menu, since shortly after Ms. Carlino received her diagnosis.

Ms. Carlino, 32, of Bernardsville, is the manager of the 1,200-square-foot, 75-seat restaurant. She is also at the forefront of what Susan Goodstadt-Levin of Glen Rock sees as an effort to“normalize” the dining-out experience for celiac patients in New Jersey. Ms. Goodstadt-Levin is a leader, with Diane Caleca McGee of Paramus, of theNorthern New Jersey Celiac Disease Support Group, also in Paramus.

“A lot of restaurants have become aware of gluten-free products, and they see the value of having them on their menu,” Ms. Goodstadt-Levin said.

Several chain restaurants, includingP. F. Chang’sandUno’sChicago Grill, offer gluten-free selections, and a few independent New Jersey restaurants, including La Riviera Trattoria andHailey’s Harp&Pub, an Irish-themed bar in Metuchen, carryRed Bridge, a gluten-free beer introduced by Anheuser-Busch in 2006. (Park&Orchard, an eclectic restaurant in East Rutherford that offers a celiac-friendly menu, stocksGreens, a double-dark wheat-free beer from Belgium.)

“We started the gluten-free menu two years ago because we just had so many requests,” said Steven Chia, the owner of A Taste of Asia in Chatham; it serves mostly Malaysian cuisine and has been open since 2000.

On a recent afternoon tour of La Riviera Trattoria’s kitchen, Mr. Carlino, of West Caldwell, who is the restaurant’s chef— his son, Antonio Carlino, is the sous-chef— demonstrated what went into accommodating diners who avoid foods containing gluten.

A separate pot is used to boil thepasta. Stainless-steel vats of wheat-free farina, through which cuts of veal and chicken used for parmigiana dishes are dragged, are kept clear of the regular flour vats. Marinara sauces are prepared in a designated skillet with designated products. Even serving dishes are stacked separately.

“We don’t want anybody getting sick,” Mr. Carlino said.

Ms. Carlino hosted two invitation-only gluten-free dinners at La Riviera Trattoria last year. In June, 20 people came. At the second, in November, which included product presentations and sales— Ms. Carlino travels to Italy regularly to investigate new gluten-free foods— attendance swelled to 60. Monday, she will host a third dinner— $50 a person, including appetizers, entree, beverage, dessert and tip— and expects up to 80 people.“That’s all my father can handle,” she said.

The growth in the event may parallel a general increase in the awareness of and interest in gluten-free dining options. According to Diane Holtaway, associate director of client services at theRutgers Food Innovation Centerin Bridgeton, which is part of Rutgers University,“Europe has been ahead of us on gluten-free dining, but now it’s growing by leaps and bounds” in the United States. Dr. Schär U.S.A., a division of a European gluten-free food manufacturer, is making gluten-free bread at the center, she said, and building a production plant in Gloucester County.

“Everyone’s seeing there’s a critical need here,” said Ms. Holtaway, of Turnersville. That is evident at two gluten-free New Jersey bakeries. Kathie Schwarz of Millington openedGluten Free Gloriouslyin Stirling in 2009 after years of home baking.

Ms. Schwarz, 52, said her disease was diagnosed nine years ago.“I was baking out of my house, out of necessity, because anything you could get gluten-free nine years ago tasted like Styrofoam,” she said.“Now we have people coming from New York, from Pennsylvania.”

Ms. Schwarz, who specializes in Italian bread and wraps, makes her products at the 1,000-square-foot bakery but sells most of them frozen, to avoid staleness.“They defrost great,” she said.

AtFallon’s Gluten Free Bake Shopin Fords, the emphasis is on fresh-baked products.“We do biscotti, muffins, cupcakes, pizza shells,” said Bob Hyer, an owner of the 800-square-foot shop with his wife, Tina, and daughter Fallon.“They’re all fresh, not frozen, because that’s hard for people with celiac to find.” Fallon Hyer, 23, who has celiac disease, is the baker.

The cost of the New York crumb cake, a popular item there ($3.50 a slice), reflects the price of its ingredients.

“One of the hardships when you eat gluten-free is the cost of food,” Ms. Holtaway said.“It’s very expensive, and you have to use totally different ingredients and processes.”

At La Riviera Trattoria, some gluten-free entrees cost $2 to $3 more than their counterparts on the regular menu. Holding up a small package of gluten-free pasta during the kitchen tour, Ms. Carlino said,“A bag of this pasta costs $7 retail.”

Where to Go

These restaurants offer gluten-free options; the bakeries are entirely gluten-free. For a more extensive list of establishments:glutenfreeceliacweb.com.

LA RIVIERA TRATTORIA421-27 Piaget Avenue, Clifton;larivieratrattoria.comor (973) 478-4181. $16.95 for spruzzopastawith marinara, basil, garlic and olive oil to $21.95 for veal parmigiana.

HAILEY’S HARP&PUB400 Main Street, Metuchen;haileysharpandpub.comor (732) 321-0777. $8.99 for“naked” chicken wings to $12.99 for corned beef and cabbage.

PARK&ORCHARD240 Hackensack Street, East Rutherford; (201) 939-9292 orparkandorchard.com. $19.95 for dairy- and wheat-free lasagne to $27.95 for Jasper’s crabmeat pasta with rice penne or linguine (both include soup orsalad).

A TASTE OF ASIA245 Main Street, Chatham;atasteofasianj.comor (973) 701-8821. $11 for Asian bok choy (baby greens lightly stir-fried with ginger and garlic) to $18.50 for Asam fish fillet (turbot fillet simmered in tamarind broth with vegetables). 

GLUTEN FREE GLORIOUSLY267 Main Avenue, Stirling;glutenfreegloriously.comor (908) 647-7337. $1 to $2 each forcookiesand brownies to $16 for a 14-inch pepperoni pizza.

FALLON’S GLUTEN FREE BAKE SHOP339 Crows Mill Road, Fords; (732) 710-3338 orfallonsglutenfreebakeshop.com. $3.50 for a slice of New York crumb cake; $8 for a pound-and-a-half loaf of multigrain bread; about $65 for an eight-inch birthday cake.

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Melatonin Makes a Comeback, Leaving Experts Unrelaxed

With names like Lazy Cakes, Kush Cakes and Lulla Pies, these products are sold online and at stores like 7-Eleven, Walgreens, smoke shops and even at the Harvard Square Coop, the university’s student bookstore, for roughly $3 to $4 each. (A bottle of 60 8-milligram melatonin tablets costs about $11.) At some places, the drug-packed desserts can be paid for with food stamps.

Although theFood and Drug Administrationhas not approved melatonin as a food additive or deemed it safe, the dessert makers are marketing their products as a harmless way to promote relaxation. And the snacks are increasingly being endorsed by fans on Facebook and Twitter as an antidote to stress and sleep deprivation. (Who needsyoga?) On theFacebook pagefor Lazy Cakes, one woman who said she hasbipolar disorderwrote that the treat“helps a lot with my sleeping andpanic attacksI can lay off my Xanax a little.”

Gabby Bevel, 22, a writer from Norman, Okla., and an insomniac who took Ambien and Lunesta in high school, said in an interview that she slept 13 hours after eating one Lazy Cakes snack recently.“I don’t like the idea of needing something unnatural to help me with anything,” she said.“Really, I think part of the appeal is it does come in a brownie.”

But these snacks contain roughly 8 milligrams of melatonin per brownie or cookie, so selling them is similar to a parent serving an unsuspecting child applesauce containing a crushed aspirin tablet to make it go down easier.“It’s making it much more difficult for the consumer to recognize that they are taking a drug,” said Dr. Charles A. Czeisler, the chief of the division of sleep medicine at Harvard’s Brigham and Women’s Hospital.

Nick Collado, a 26-year-old insomniac and the founder of Lulla Pies, argued that the melatonin they contain, while synthetic, is more“natural” than the Ambien he used to take.“I realized there’s got to be more people like me who don’t want to take prescription drugs anymore, who want to take an alternative,” Mr. Collado said.

But Dr. David S. Seres, the director of medical nutrition at Columbia Medical Center, cautioned that consumers should consult their doctors before trying such products.

“The promoters of these are appealing to people who think it’s better to do things outside of the medical establishment,” he said, adding that“the desire to help people is an extremely strong motivator, but so is money.” He pointed to a section of the National Institutes of Health’s Web site that lists several drugs, includingsedativeslike clonazepam andbirth controlpills, whose efficacy might be altered by melatonin.

“A hangover effect has been reported” with large doses, said Anna Rouse Dulaney, a toxicologist with the Carolinas Poison Center. But she added,“I don’t want to go on the record saying this drug‘can’ cause respiratory issues, that should be a‘may.’ ”

Lazy Cakes appear harmless, even amusing, with swirly purple packaging; Kush Cakes have a tie-dye-printed wrapper. But they are not to be underestimated.

Of melatonin, Dr. Seres warned,“If you take it while you’re driving a car, you will find yourself in a ditch.”

Maybe.Dr. Alfred J. Lewy, a professor ofpsychiatryat Oregon Health and Science University who has studied melatonin, a neurohormone, estimated that only a third of the population is susceptible to its effects in a supplement.

And yet Tracy Evans, who owns a bar where musicians perform in Erie, Pa., that has sold hundreds of Lazy Cakes, said she instructs employees to tell partygoers,“I highly recommend you wait to where you’re going to be at the end of the night before eating.”

Why?“It knocks you out— in a good way, not a bad way,” said Ms. Evans, 34.“For me, it’s not to chill. For me, it’s to get a good night’s sleep.”

Yet the products, intended for adults only, are being marketed as a novel way to relax in a stressed-out, wired world. Labels on Lazy Cakes and Mary J’s brownies that were bought online urge users to“Take½ brownie, two times a day.” With tiny type, the labels warn against operating heavy machinery or driving.

But some medical professionals are concerned that the chocolate taste might encourage indiscriminate gobbling.

“It’s a colossally bad idea to put melatonin in food,” Dr. Czeisler said.“It should not be permitted by the F.D.A.”

Technically, it is not. Stephanie Yao, a spokeswoman at the F.D.A., wrote in an e-mail that any item that uses melatonin“as an additive may be subject to regulatory action.”

That is why the makers of these new baked goods label them“Not for food use.” They want them to be considered dietary supplements, which do not need the F.D.A.’s premarket approval and are not required to be proved safe or effective.

“It sounds to me like they are trying to claim that the entire brownie is like a tablet, which is, of course, preposterous,” Dr. Czeisler said.

Tim Barham, the vice president of HBB, the maker of Lazy Cakes, said,“We look at the brownie as a supplement.”

News reports have classified Lazy Cakes as dietary supplements, but last month, Douglas Karas, an F.D.A. spokesman, said in an e-mail that the agency“has not made a determination on Lazy Cakes’ status as either a food or a dietary supplement.”

In January last year, the F.D.A. sent a warning letter to Peter Bianchi, the creator ofDrank, a purple drink with 2 milligrams of melatonin in each can that went on the market in 2008, spawning several competitors.

The letter cited safety concerns about melatonin in food, specifically research indicating that melatonin reduced glucose tolerance for people withType 1 diabetesand that some men using it had reported enlarged breasts. It also warned that women who are pregnant or trying to conceive should avoid melatonin“based on possible hormonal effects.” (Drank’s bottle now say it is a dietary supplement.)

Dr. Lewy dismissed the idea that harm might lurk in a melatonin-laced brownie.“It really doesn’t have any documented side effects except for making you sleepy at bedtime, which is good,” he said. That said, he would not advise eating Lazy Cakes, partly because he was not sure that their other purportedly sleep-inducing ingredients like valerian root work and partly because food delays rather than hastens the absorption of melatonin.

Also, Dr. Lewy said,“I don’t need thecalories.”

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Great Day to Be Outdoors in New York, if Not for Allergies

A 65-year-old law professor who lives on the Upper East Side tentatively follows suit, baring his chest, figuring he knows no one in the area anyway.

Eying them both, Mark Cilla, 55, a budget manager from Commack, N.Y., tapping on a laptop, feels emboldened and spontaneously shrugs out of his button-down.

“This is heaven,” Mr. Cilla says to himself as his belly reddens in the sun.

Steps behind him, in the leaf-tattooed shade, Larry Ferruzzi is in hell. His head swims, his eyes water and his nose itches and runs.“This is really rough, the worst ever,” says Mr. Ferruzzi, 67, who sells industrial lighting, as he presses a white linen handkerchief to his nose.“I can’t stopsneezing,” he says, then sneezes again.

After a punishing winter and a cruel, rainy April, the weather this past week in New York has indeed seemed heaven-sent— or at least from California: crisp, cloudless days with temperatures hovering around 70 degrees. Sun- and warmth-starved New Yorkers surfaced like worms after a rain, arraying themselves on every available bench, chair and patch of grass.

But such idyllic meteorological conditions— dry and not too hot— also provide ideal reproductive conditions for some trees. Specifically, oak, beech and maple, whose tiny flowers have been releasing copious amounts of pollen, which have been carried far and wide by gentle winds, unimpeded by rain and, for the most part, leaves, and into the noses of allergy sufferers.

Allergy sufferers, in turn, find themselves facing an ugly choice: Crack open the windows, for now is that fleeting time when neither air-conditioners nor radiators are needed, enjoy the gorgeous weather, and accept the consequences.

The city’s pollen count is officially“high.” According toPollen.com, on Thursday it was 9.9 on a scale of zero to 12, having fallen from 11.1 a week earlier.Allergiesworsenasthmaattacks, and earlier this week, the city’s health department counted more asthma-related emergency room visits than at the same time last year.

Dr. Benjamin Aubey, a pediatrician at Harlem Hospital Center, has seen several children who had been sent home from school because the staff thought they had pinkeye.“But it’s just allergies flying,” Dr. Aubey said.

Drugstores are struggling to keep allergy medicines on their shelves. Jesenia Fuentes, a clerk at a Duane Reade in Midtown, said a shipment that arrived early Thursday would very likely be gone within hours.

Jimmy Lee, 52, who lives in Hell’s Kitchen and works in the hotel business, said he prepared for heavy demand for his allergy medicine.“I get it by the case,” said Mr. Lee as he sat in the pedestrian strip along Broadway by 41st Street, sniffling. Staying inside, he said, was not an option.“For the first time ever, this winter I had cabinfever,” he said.

And so it went throughout the city, with many New Yorkers, ever conflicted, both loving and hating the weather.

Leslie Castillo, a 37-year-old allergy sufferer, said she would stay indoors but for her two children.“It’s ruined spring a little bit for me,” Ms. Castillo said as she sat in the grass at McCarren Park in Williamsburg, Brooklyn, with her 2-year-old, taking in the glorious day with itchy, reddened eyes.

At Sheep Meadow in Central Park, Aziza Azim, 20, a fashion student at Parsons, stretched out on a blanket with two friends a few hours after one of them woke up and declared,“We need to tan.” Ms. Azim, who is allergic to pollen and horses, had girded for the excursion withClaritin.“If I take my medicine, I know it’s fine,” she said, and then proceeded to sneeze three times.

Compounding the woes of allergy sufferers is a high-pressure system wedged between two low-pressure systems, creating dry, stagnant air in New York City. But Ross Dickman, a meteorologist in charge of the National Weather Service for the city, forecast that all would change this weekend.“It’s going to be cloudy, wet, almost miserable for May,” Mr. Dickman said.“That will help bring some of the allergens out of the air, kind of sterilize the atmosphere a little bit.”

Meanwhile, the trees’ pollination will abate, easing allergy conditions, at least until late May, when grass allergies break out, said Robert F. C. Naczi, curator of North American botany at The New York Botanical Garden.“So there’s at least two weeks of a reprieve.”

Anemona Hartocollis and Juliet Linderman contributed reporting.

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New Testing Estimates Football Helmet Models’ Concussion Risk

The Riddell VSR-4, a recently discontinued model still worn by about 75,000 high school and college players, and the Adams A2000, a less prevalent helmet now available for purchase, were the lowest-ranked models in a new testing regimen designed to estimate concussion risk. The full results were to appear on aVirginia TechWeb siteas the first publicly available objective data on football helmet performance.

Industry experts have various degrees of concern about the reliability of the system, but the researchers said they were trying to pull the curtain back on the mysteries of helmet performance. Recent concerns about industry testing standards and specific companies’ advertising has led to an investigation by the United StatesConsumer Product Safety Commissionand possibly the Federal Trade Commission.

“Currently, if you go to buy a helmet, all you’re looking at are aesthetics and price, and whatever the manufacturer tells you to try to convince you it’s good,” saidStefan Duma,Virginia Tech’s lead biomedical engineer on the project.“We wanted to develop a system to quantify which helmets perform better specifically with risk of concussion.”

The only standardized test on helmets today assesses whether a helmet might allow askull fracture, not a less serious injury like a concussion. It is overseen by the National Operating Committee on Standards for Athletic Equipment, a volunteer group that includes manufacturers and other interested parties.

Riddell’s Revolution Speed model earned a five-star rating on the Virginia Tech scale, followed by five four-star helmets made by Riddell, Schutt and Xenith. Only helmets designed for players of high school age and older were examined.

“For example, half our team is in the VSR-4— and there is a significant reduction in concussion risk in newer helmets, so by fall ball we’re going to be in new ones,” Duma said of the Virginia Tech football team. A prominent college program having used outdated helmets would indicate how rural high schools might be affording players inferior protection.

Virginia Tech has for eight years had players at college programs nationwide wear helmets outfitted with accelerometers to track the number and severity of hits to the head, as well as documented concussions. That data indicates, for example, how a side impact that results in 100 g’s of force reaching the skull leads to a diagnosed concussion 1 percent of the time.

Helmet models were drop-tested from five heights to assess how much force they allow to reach the skull; the lower that force, the lower the risk of concussion, and the better the helmet scored. The methodology has been peer reviewed and accepted for publication by theAnnals of Biomedical Engineering.

As an example of the use of his system, Duma said,“You can cut your risk of concussion 55 percent by switching from the VSR-4 to the Xenith X1.”

Critics have cited several limitations of Virginia Tech’s approach. It does not consider rotational forces believed to cause a substantial number of concussions. The data collection from players came through helmets designed by Riddell, perhaps skewing results. Additionally, only some concussions get reported, so the injury’s true prevalence remains too much of a mystery to justify such exact statements.

“I’m unmoved by this information, and I would say that no matter how our helmet was ranked,” said Xenith’s chief executive, Vin Ferrara, whose X1 model was ranked among the most protective available.“We find this type of ranking concept to be detrimental to consumer understanding and detrimental to the development of superior helmets.”

Schutt said in a statement:“We have not seen any relationship between testing results and the accurate prediction of what is happening on the field. There are many questions to be asked about this testing.”

Adams’s chief executive, David Wright, did not respond to requests for comment regarding the company’s A2000 helmet.

Riddell’s Dan Arment praised Virginia Tech for affirming performance differences between helmet models; as for the company’s low-performing VSR-4, he said users could trade in that helmet and receive $50 off a Revolution model.

Helmet companies have for years agreed among themselves not to disclose this type of testing data to the public because of how it can be misinterpreted. This has led to spurious advertising claims and other practices currently under government examination.

Duma said the public needed an independent compass to make more educated decisions on football head protection. He also emphasized how even the best head protection can still allow injuries like concussions and that individual athletes’ risks can vary because of genetic differences and prior injuries.

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Can Eating Local Honey Cure Allergies?

Among allergy sufferers, there is a widespread belief that locally produced honey can alleviate symptoms— the idea being that the honey acts like a vaccine.Beesthat jump from one flower to the next end up covered in pollen spores, which are then transferred to their honey. Eating that honey— just a spoonful a day— can build upimmunitythrough gradual exposure to the local allergens that can make life so miserable for allergy sufferers.

Or at least that’s the thinking behind it. But whenUniversity of ConnecticutHealth Center researchers did a test, they found that the honey had no such effect.

In the study, published in the Annals of Allergy,Asthmaand Immunology in 2002, the scientists followed dozens of allergy sufferers through the springtime allergy season. The subjects were randomly split into three. One consumed a tablespoonful daily of locally collected, unpasteurized and unfiltered honey; another ate commercial honey; and a third was given a corn syrup placebo with synthetic honey flavoring.

After tracking the subjects’ symptoms for months,the scientists found that neither of the honey groups saw improvementsover the placebo group.

Dr. Stanley Fineman, president-elect of the American College of Allergy, Asthma and Immunology, said he has seen a growing number of patients ask about local honey.“Seasonalallergiesare usually triggered by windborne pollens, not by pollens spread by insects,” he said. So it’s unlikely that honey“collected from plants that do not cause allergy symptoms would provide any therapeutic benefit.”

THE BOTTOM LINE

There’s no evidence that local honey relieves allergy symptoms.

ANAHAD O’CONNOR

scitimes@nytimes.com

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Screen Fixation and A.D.H.D.

“She’s worried about how he can’t sit still in school and do his work,” the mother said.“He’s always getting into trouble.”

But then she brightened.“But he can’t have attention deficit, I know that.”

Why? Her son could sit for hours concentrating on video games, it turned out, so she was certain there was nothing wrong with hisattention span.

It’s an assertion I’ve heard many times when a child has attention problems. Sometimes parents make the same point about television: My child can sit and watch for hours— he can’t haveA.D.H.D.

In fact, a child’s ability to stay focused on a screen, though not anywhere else, is actually characteristic of attention deficit hyperactivity disorder. There are complex behavioral and neurological connections linking screens and attention, and many experts believe that these children do spend more time playing video games and watching television than their peers.

But is a child’s fascination with the screen a cause or an effect of attention problems— or both? It’s a complicated question that researchers are still struggling to tease out.

The kind of concentration that children bring to video games and television is not the kind they need to thrive in school or elsewhere in real life, according to Dr. Christopher Lucas, associate professor of childpsychiatryatNew York UniversitySchool of Medicine.“It’s not sustained attention in the absence of rewards,” he said.“It’s sustained attention with frequent intermittent rewards.”

The child may be playing for points accumulated, or levels achieved, but the brain’s reward may be the release of the neurotransmitterdopamine. Children with A.D.H.D. may find video games even more gratifying than other children do because their dopamine reward circuitry may be otherwise deficient.

Indeed, at least one study has found that when children with A.D.H.D. were treated with methylphenidate (Ritalin), which increases dopamine activity in the brain, they played video games less. The authors suggested that video games might serve as a kind of self-medication for these children.

So increased screen time may be a consequence of A.D.H.D., but some researchers fear it may be a cause, as well. Some studies have found that children who spend more time in front of the screen are more likely to develop attention problems later on.

In a 2010 study in the journal Pediatrics, viewing more television and playing more video games were associated with subsequent attention problems in both schoolchildren and college undergraduates.

The stimulation that video games provide“is really about the pacing, how fast the scene changes per minute,” said Dr. Dimitri Christakis , a pediatrician at theUniversity of WashingtonSchool of Medicine who studies children and media. If a child’s brain gets habituated to that pace and to the extreme alertness needed to keep responding and winning, he said, the child ultimately may“find the realities of the world underwhelming, understimulating.”

But a 2007 study in the journal Media Psychology compared television watching in a group of children diagnosed with A.D.H.D. and a group without. The researchers concluded that most differences were accounted for by family factors and environment, including whether the children had televisions in their bedrooms. A.D.H.D. by itself didn’t seem to make the difference. The connections between A.D.H.D. and screens, the authors concluded, were complex.

Elizabeth Lorch, a professor ofpsychologyat theUniversity of Kentuckyand one of the authors of that study, also studied children’s ability to comprehend televised stories. While children with A.D.H.D. were able to recall facts from the stories they watched just as well as other children, there was a difference in their ability to understand the narrative and to separate out what was important.

“Why did an event happen, why did a character do this— that’s where the comprehension and recall of children with A.D.H.D. tends to fall down,” she said.

Her co-author Richard Milich, also a professor of psychology at the University of Kentucky, suggested that besides the primary implications of this problem for academic performance, this finding may also shed light on social difficulties.

“This inability to see causal relations may affect this social problem we’ve known for 30 years,” he said.“These kids have dramatic social problems. They’re highly rejected by their peers.”

It may be a self-perpetuating loop, experts say: Children who have trouble with their social skills may be thrown back even more to the screen for electronic companionship.

Children whose brains need neurochemical rewards seek out an activity that provides it. Children with social problems spend more time alone, facing a screen. Children struggling in the classroom develop mastery in a virtual world. I talk to parents of children with A.D.H.D. about basic dos and don’ts: No screens in the child’s bedroom. Pay attention to the content of the games, especially to violence. Set limits on screen time, and look for other ways to manage family interactions.

If I can’t tell parents what they hope to hear, at least I can argue that these children’s fascination with the glowing screen may teach us something about their brains, the neurobiology, the rewards, and even the yearning and learning.

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Does Having Your Tonsils Removed Cause Weight Gain?

Despiteconcerns about its effectiveness, the childhoodtonsillectomyis common. Each year more thanhalf a million children in the United States have their tonsils removed. But scientists have noticed what appears to be an unexpected side effect: Children who have the surgery are at greater risk of becoming overweight.

At first glance it makes little sense. Tonsils are typically removed after they become enlarged from repeated infections. Why would that have any effect on weight? One theory is that enlarged tonsils cause difficulty swallowing, prompting a child to eat less. Once the tonsils are removed, appetite returns.

No one knows how to explain it, but studies show a link between the surgery and weight gain. In the most recent and exhaustive report, published this year in the journal Otolaryngology— Head and Neck Surgery, researchers analyzed data from 11 studies, following 1,549 children for up to seven years.

Obviously, the children put on weight as they aged, but the analysis showed thatthe gains were much greater than expected after the surgeryand greater than the weight gain in children who had not had their tonsils removed.

Butso far only an association has been confirmed, not a direct causal effect. For now, experts say parents should simply keep an eye on a child’s weight after the surgery.

THE BOTTOM LINE

Studies show tonsillectomies are associated with weight gain, but it’s not clear there’s a causal relationship.

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Pesticides - Ban on a Cousin of DDT Has Loopholes in India, Where Children Were Harmed

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Celebrating Bin Laden’s Death - Ugly, Perhaps, but Only Human

“It was appropriate to go after Bin Laden, just to try to cut the head off that serpent, but I don’t think it’s decent to celebrate a killing like that,” said George Horwitz, a retired meat cutter and Army veteran in Bynum, N.C.

Others were much more critical.“The worst kind of jingoistic hubris,” aUniversity of Virginiastudent wrote in the college newspaper, The Cavalier Daily. In blogs and online forums, some people asked: Doesn’t taking revenge and glorying in it make us look just like the terrorists?

The answer is no, social scientists say: it makes us look like human beings. In an array of research, both inside laboratories and out in the world,psychologistshave shown that the appetite for revenge is a sensitive measure of how a society perceives both the seriousness of a crime and any larger threat that its perpetrator may pose.

Revenge is most satisfying when there are strong reasons for exacting it, both practical and emotional.

“Revenge evolved as a deterrent, to impose a cost on people who threaten a community and to reach into the heads of others who may be contemplating similar behavior,” said Michael McCullough, a psychologist at theUniversity of Miamiand author of“Beyond Revenge: The Evolution of the Forgiveness Instinct” (Jossey-Bass, 2008).“In that sense it is a very natural response.”

Many of the sources of the joyous outburst were obvious: A clear victory after so many drawn-out conflicts. A demonstration of American competence, and of consequences delivered. The public relations value of delivering a public blow to a worldwide terror network. And, it needs to be said, the timing: The news hit just as many bars were starting to clear out for the night.

But this was much more than a simple excuse to party.

“Pure existential release,” said Tom Pyszczynski, a social psychologist at theUniversity of Coloradoat Colorado Springs, who has studied reactions to 9/11.“Whether or not the killing makes any difference in the effectiveness ofAl Qaedahardly matters; defeating an enemy who threatens your worldview, the very values you believe are most protective, is the quickest way to calm existential anxiety.”

After almost 10 years, the end was nothing if not final.“The emotions were so strong, I think, because the event was compacted: Bin Laden was found and killed, and it was done— done and over, just like that,” said Kevin Carlsmith, a social psychologist atColgate Universityand the Center for Advanced Study in the Behavioral Sciences at Stanford.“We’re so used to people being brought in, held at Guantánamo, the trials, the appeals; it feels like justice is never done.”

As a rule, people are far more forgiving than they might guess, studies find. After most betrayals, like being dumped by a love interest or insulted, the urge for revenge erodes around the same rate that certain memories do: sharply in the first few weeks, and much more slowly afterward. The same kind of pattern can follow even physical assaults, depending on the circumstances and the personality of the victim.

“The intensity of the emotion falls off precipitously, simply because the body can’t carry such a giant load of outrage and function very well,” Dr. McCullough said.

But the urge for payback— especially for a crime like the Sept. 11, 2001, attacks, which killed almost 3,000 civilians— never goes to zero.“There is a stubborn part of the memory that hangs on to the urge, to a little piece of it,” and the pain is refreshed every time the memory is recalled, Dr. McCullough said.

It is easy to forget how much fear was in the air after the 9/11 attacks: theanthraxmailings, the airport lines, the color-coded terror alerts. Many of those celebrating late on Sunday and early Monday were teenagers during those years, young people who have lived much of their lives under the threat of terrorism— and this terrorist in particular— and who had the time and energy to hit the streets and share the moment.

“For them this was a chance to be a part of history,” Dr. Pyszczynski said.

In a long series of studies, psychologists have shown that when people are reminded that they will one day die, they fixate on attributes they consider central to their self worth. Those who are religious become more so; those who value strength or physical attractiveness intensify their focus on these qualities; and people generally become more patriotic, more supportive of aggressive military action.

“Even subtle reminders of 9/11 have the same effect,” Dr. Pyszczynski said.

The sight of Bin Laden’s face on television or a smartphone news feed might have been enough to move people from the sidelines into the streets, to cheer for the home team.

Finally, people everywhere have a strong belief in“just deserts” punishment.In a 2002 study, psychologists atPrinceton Universityhad more than 1,000 participants evaluate specific crimes and give sentencing recommendations for each. The subjects carefully tailored each recommended sentence to the details of the infraction, its brutality and the record of the perpetrator.

The drive to enforce those sentences varies widely from person to person. But in a crowd of like-minded people, the most intense drives for justice become the norm: People who may have felt a mix of emotions in response to the news can be swept up in the general revelry.

Thus the natural urge for revenge— satisfied so suddenly, releasing a decade of background anxiety, stoked by peers— feeds on itself. Delight turns to chanting turns to climbing on lamp posts.

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Hormone Gel Is Said to Reduce Risk of Premature Birth

“This is a big advance,” said Dr. Mary D’Alton, the chairwoman of the department of obstetrics and gynecology at Columbia University.

Premature birth is the leading cause of death and illness among newborns. An estimated 12.9 million babies worldwide, 500,000 of them in the United States, are born prematurely every year.

In the United States, about a third of early births result from decisions by doctors that the health of either the mother or child is threatened enough to end thepregnancyearly, usually with aCaesarean section. But two-thirds of those early births are spontaneous, and any intervention that could reduce them could have significant public health consequences.

The hormone treatment, aprogesteronegel inserted vaginally every day during the second half of a pregnancy, reduced the risk of premature birth in women with a short cervix, which can soften too early.

Dr. Roberto Romero, chief of theperinatology research branchat theNational Institutes of Health, estimated that as many as 2 percent of the nation’s 500,000 annual preterm births could be prevented, leading 10,000 more babies a year to be born at full term. Screening all pregnant women and treating those found to have short cervixes would save the nation’s health system $12 million a year, Dr. Romero said.

In the study, researchers financed by the federal government gave sonograms to more than 32,000 women who were about halfway through their pregnancies. Doctors found about 465 women in that group whose cervix was unusually short. Half were treated with vaginal progesterone and the other half got a placebo.

Using the progesterone gel, which is relatively easy for women to administer to themselves, led to a 45 percent reduction in the rate of preterm birth before 33 weeks of gestation, and it led to improved outcomes for babies. Fourteen women with unusually short cervixes would need to be treated to prevent one preterm birth, the study found.

Dr. Sonia Hassan, director of theCenter for Advanced Obstetrical Care and Researchat the National Health Institutes, a co-author of the study, said the study’s findings should lead all women to have sonograms around the 20th week of their pregnancies to see if they have short cervixes that put their pregnancies at increased risk.

“The important thing is to screen all pregnant women,” Dr. Hassan said.

Dr. Gary Hankins, chairman of the department of obstetrics and gynecology at the University of Texas Medical Branch, said the study offered great hope for many women.

“If we can delay birth by just a few weeks, that can make a massive difference,” Dr. Hankins said.

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Latisse, Not Just for Eyelashes Anymore - Skin Deep

“I just put three or four drops on each side of my temple once a day,” said Mr. Paduda, 32, an insurance worker from Boca Raton, Fla.“The hair in that area, which was real thin and wispy— all those hairs got thick again, dark.”

Mr. Paduda is one of a growing number of men experimenting with Latisse as an antidote to encroachingbaldness. Made by Allergan, the drug has already won a following among women for helping them grow long, fluttery eyelashes. It was only a matter of time before it made the leap to denuded pates.

Indeed, dermatologists’ offices and Web forums for bald men (yes, they exist:baldtruthtalk.com) began buzzing with excitement over Latisse nearly the moment theFood and Drug Administrationgave it the thumbs-up in December 2008.

“First question everyone was asking was,‘Gosh, if it grows eyelashes, what is it going to do on the scalp?’ ” said Dr. Alan Bauman, the dermatologist and hair-restoration specialist who prescribed the drug to Mr. Paduda as part of an informal study.

While the F.D.A. has not approved Latisse as a hair-loss treatment— only two drugs have that designation: minoxidil (Rogaine, also a topical medication) and finasteride (Propecia, which is administered in pill form)— there are no laws preventing doctors from prescribing it for that purpose. Dr. Bauman said he has been prescribing a generic form of bimatoprost, the active ingredient in Latisse, to combat hair loss since 2007, and that it has worked for about 70 percent of his patients.

“What we found is that where patients were applying Latisse, especially in areas where the hair was thinner and wispier and less pigmented, the hair grew thicker, stronger and healthier,” he said.

Though some users of Latisse have experienced skin discoloration, Dr. Bauman said he had never seen any such reaction on the scalp of his patients.

Certainly, Mr. Paduda, who used Latisse daily from November through February, is a happy customer. By the third week, he said, both he and friends he asked for reactions were seeing results.“I even busted out the old‘before’ and‘after’ pictures,” he said.“It was a noticeable difference.”

But Latisse does not appear to be a silver bullet for hair loss. Instead, it appears to work in much the same way as Rogaine or Propecia: All three can strengthen and darken hair that grows from a dying follicle, but none can bring a dead one back to life. The result is an enhanced, refortified hairline rather than a brand new head of hair.

Aside from hair transplants, which can cost about $10,000 each and do not always look natural, the only current hope for complete replacement is hair cloning, the act of producing entirely new hair from the DNA of an existing one, which researchers have been attempting, unsuccessfully, for years.

A pair of researchers last year claimed to grow new hair by combining plucked hair with a wound-healing powder made by ACell, a regenerative-medicine company in Columbia, Md. Though the claim was met with some skepticism by other clinicians, the idea that ACell’s powder, which has been approved by the government, could facilitate new hair growth has breathed new life into the race to clone hair.

Dr. Robert M. Bernstein, clinical professor of dermatology atColumbia University, is now one of several researchers experimenting with the product.

“It’s just a question of time now” before hair cloning becomes a reality, Dr. Bernstein said.“We keep on moving back that time, but I think there’s absolutely no doubt that it’s going to be done.”

He believes hair cloning will be commercially available within 10 years. This may sound like a long time to wait, but“it’s important to remember that baldness is unlike other conditions where you can progress past the point of being helped,” Dr. Bernstein said.“Once we have a cure for hair loss, everyone will be able to benefit.”

It has been been 14 years since the F.D.A. approved a new hair-loss remedy (Propecia, in 1997), so it is understandable that anticipation for a new one might be running high. One advantage of Latisse is that it needs to be applied only once a day (Rogaine needs to be applied twice; Propecia is taken once daily), and does not seem to cause reactions in people who are allergic to minoxidil.

It is, however, expensive: a month’s supply of Latisse can cost up to $150, and that is in amounts appropriate for use merely on the eyelashes. Rogaine, which is also available over the counter now, costs about $25 a month, and a month’s supply of Propecia runs about $75. (Even Mr. Paduda has now switched to Propecia, citing cost.)

The potential for Latisse is not lost on Allergan. The company initiated a Phase 1 clinical study in August to determine whether bimatoprost can be used as a treatment in men and women suffering from hair loss (alopecia).

“There is a great deal of interest in developing other uses of bimatoprost,” Heather Katt, a spokeswoman for Allergan, wrote in an e-mail message,“and Allergan is exploring ways to pursue that pathway through the F.D.A. approval process.”

For those too impatient to wait, there is also the bold and fashionable solution of shaving one’s head.

But the fact is that many men— and women— simply do not accept baldness easily.

“Hair has been an evolutionary sign of health and sexuality and youth, and that doesn’t change,” Dr. Bernstein said.“Shaved heads look cool, but not everyone wants one, and not everyone looks good with one.”

Mr. Paduda concurs.

“I have really dark eyebrows,” he said.“I would look like a psycho if I shaved my head.”

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Olive Oil Crackers - Recipes for Health

1 1/2 cups whole wheat or whole wheat pastry flour

3/4 cup unbleached flour (or use all whole wheat flour)

3/4 teaspoon salt

1/4 cup water

2 large eggs

1/4 cup plus up to 1 tablespoon extra virgin olive oil

1/4 cup grated Parmesan

2 tablespoons za’atar (see below)

1.Preheat the oven to 375 degrees. Line baking sheets with parchment. Sift together the flours and the salt. Combine the water, eggs and 1/4 cup of the olive oil in a measuring cup. Place the flour mixture in the bowl of a food processor fitted with a steel blade, and turn on the processor. Add the liquids with the machine running, and process until the dough comes together. The dough will be soft. If it seems wet, add another tablespoon of flour.

2.Remove from the food processor, and wrap in plastic. Let rest 15 minutes. Divide into two portions, and roll out each portion into thin sheets. Brush the top of the sheets with the remaining olive oil, and sprinkle with Parmesan and za’atar. Using the rolling pin gently press the topping into the surface by rolling the pin over the dough. Cut the dough into squares or rectangles, and transfer to the baking sheets.

3.Bake 15 minutes until lightly browned and crisp.

Note:To make za’ater, mix together 1/4 cup finely crumbled dried thyme, 1 tablespoon sesame seeds, 1 teaspoon sumac (available in Middle Eastern markets) and a pinch of salt. Place in a jar, and keep in a cool, dark place. A number of seeds can stand in for the za’tar. I like charnushka, also known as nigella, as well as sesame seeds, cumin seeds, poppy seeds and flax seeds. Try different combinations.

Yield:Eighty to 90 crackers.

Advance preparation:These crackers will keep for a week in an airtight container.

Nutritional information per cracker:23calories; 0 gramssaturated fat; 0g polyunsaturated fat; 1 gram monounsaturated fat; 5 milligramscholesterol; 3 gramscarbohydrates; 0 gramsdietary fiber; 28 milligrams sodium; 1 gram protein

Martha Rose Shulmanis the author of"The Very Best of Recipes for Health."

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