The New Old Age Blog: Study: More to Meal Delivery Than Food

What’s a simpler idea than Meals on Wheels? Older, lower-income people who have trouble driving, cooking or shopping — or paying for food — sign up with a local agency. Each day, volunteers or paid staff come by and drop off a hot lunch. Federal and state dollars and local charities foot the bill.

At the Mobile Meals of Essex headquarters in my town in New Jersey on a recent morning, staffers were stuffing slices of whole wheat bread, pints of low-fat milk and containers of sliced peaches into paper bags. Next, they would ladle the day’s entree — West Indian curried chicken with brown rice and broccoli — onto aluminum trays.

Drivers in vans would fan out through the county, from downtown Newark through the sprawling suburbs, delivering the meals to 475 clients.

The benefit goes beyond food, of course. When his clients answer the door, often using walkers and canes, “I ask them how their morning’s going,” said a driver, Louis Belfiore, who would make 31 stops this day. “I give them their meal, I say, ‘Have a good day.’ They tell me, ‘You have a nice day, too.’”

This may represent the only face-to-face social interaction some homebound people have in the course of a day. And if they don’t come to the door, a series of phone calls ensues. “We’ve had people yell back, ‘I’m on the floor and I can’t get up.’ It doesn’t happen only in commercials,” said Gail Gonnelli, the program’s operations director.

Meals on Wheels advocates have always believed that something this fundamental – a hot meal, a greeting, another set of eyes – can help keep people in their homes longer.

But they didn’t have much evidence to point to, until a couple of Brown University health researchers crunched numbers — from Medicare, states and counties, the federal Administration on Aging and more than 16,000 nursing homes — from 2000 to 2009, publishing their findings in the journal Health Services Research.

The connection they discovered between home-delivered meals and the nursing home population will come as welcome news (though not really news) to Meals on Wheels believers: States that spent more than the average to deliver meals showed greater reductions in the proportion of nursing home residents who didn’t need to be there.

The researchers call these people “low-care” residents. Most people living in nursing homes require around-the-clock skilled care, and policymakers have been pushing to find other ways to care for those who don’t. Still, in 2010 about 12 percent of long-term nursing home patients — a proportion that varies considerably by state — didn’t need this level of care.

“They’re not fully dependent,” explained a co-author of the study, Vincent Mor. “They could be cared for in a community setting, whether that’s assisted living or with a few hours of home care.”

That’s how most older people prefer to live, which is reason enough to try to reserve nursing homes for those who can’t survive any other way. But political budget cutters should love Meals on Wheels, too. For every additional $25 a state spends on home-delivered meals each year per person over 65, the low-care nursing home population decreases by a percentage point, the researchers calculated — a great return on investment.

“We spend a lot on crazy medical interventions that don’t have as much effect as a $5 meal,” Dr. Mor concluded. With this data, “we’re able to see this relationship for the first time.”

(Co-author Kali Thomas — herself a volunteer Meals on Wheels driver in Providence, R.I. — has compiled a state by state list, posted on the Brown University LTCfocus.org Web site, showing how much states could save on Medicaid by delivering more meals.)

Sadly, though, appropriations for home-delivered meals are not increasing. The program served more than 868,000 people in 2010, the latest numbers available. But federal financing through the Older Americans Act has been flat for most of the decade, while food and gas costs — and the number of older people — have risen.

Given current budget pressures, advocates hope they can just hold the line (the “sequester” cuts to the federal budget are still looming unless Congress and the White House can reach agreement on the debt limit and a spending plan). Already, “we’ve seen millions and millions fewer meals,” said Tim Gearan, senior legislative representative at AARP. “Cuts from five-day service to three-day service. A lot more frozen food, which can be inappropriate for people who can’t operate ovens and microwaves. It’s been hard to watch.”

My urban/suburban county, Ms. Gonnelli said, maintains a waiting list: There are always about 65 seniors who qualify for Meals on Wheels, but there is no money to provide the food.

It can be a big step for an older person or his family to acknowledge that they need this kind of basic help and apply. It must be difficult, I said to Ms. Gonnelli, who has run the program for 15 years, to tell applicants she can’t help feed them.

“You have no idea,” she said.

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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DealBook: The Banker Who Put His Faith in Armstrong

When Lance Armstrong’s interview with Oprah Winfrey about his suspected use of illegal performance-enhancing drugs is broadcast on Thursday, an investment banker will most likely be watching it very carefully (and nervously): Thomas Weisel.

Mr. Weisel is a legend in finance and Silicon Valley. He was the banker behind Yahoo’s public offering and some of the biggest deals during the dot-com bubble. He famously sold the firm he ran, Montgomery Securities, for $1.2 billion in 1997. And he sold his next firm, Thomas Weisel Partners, for $300 million to Stifel Financial in 2010.

But it is Mr. Weisel’s extracurricular activity that connects him to the news of the moment: he was Mr. Armstrong’s biggest financial backer and the single individual most responsible for the money machine that propelled Mr. Armstrong’s career.

Depending on what Mr. Armstrong says in the interview about his purported doping, Mr. Weisel, who was a co-owner of the United States Postal Service Pro Cycling Team through a cycling management firm that he helped found called Tailwind Sports, could be subject along with his partners to lawsuits from corporate sponsors seeking millions of dollars. Already, there is a False Claims Act case contending that Mr. Armstrong and the team defrauded the Postal Service.

Perhaps more anxiety-producing is what Mr. Weisel may have known, or should have known, about a team that for years ran “the most sophisticated, professionalized and successful doping program that sport has ever seen,” according to the United States Anti-Doping Agency.

Its report last year did not name Mr. Weisel, but did say that Mr. Armstrong was assisted by a “small army of enablers, including doping doctors, drug smugglers, and others within and outside the sport and on his team.”

Mr. Armstrong is expected to admit to doping in an effort to persuade officials to lift his lifetime ban from Olympic sports. To do so, however, he would probably need to lay out in explicit detail how the program worked and implicate those who were part of it. Late Monday, The New York Times reported that Mr. Armstrong had confessed in the interview with Ms. Winfrey that he used performance-enhancing drugs. The Times also reported that he was in discussions with the Justice Department to possibly testify in a federal whistle-blower case against several team officials and owners, including Mr. Weisel.

Mr. Weisel is currently not talking. When I called Mr. Weisel seeking a comment, his assistant told me: “He’s not commenting. And he’s not returning any calls.”

For a glimpse of the way Mr. Weisel thinks about performance-enhancing drugs in cycling, here’s what he had to say about the matter four years ago: “Handle the problem below the surface and keep the image of the sport clean,” he told The Wall Street Journal. “In the U.S. sports — baseball, basketball, football — most fans couldn’t care less.”

For Mr. Weisel, the team and Mr. Armstrong were an all-consuming passion. He would go every year to the Tour de France and at times travel in the team’s pacer car, occasionally yelling instructions to Mr. Armstrong over the radio system. He rode the team’s bus, ate meals with them and ultimately celebrated each year’s victory. On the wall of his office in San Francisco, he displayed Mr. Armstrong’s yellow jerseys.

Always the consummate banker, Mr. Weisel even tried to help Mr. Armstrong raise funds to buy the Tour de France itself. (The effort never went anywhere.)

Mr. Weisel’s name has occasionally come up in connection with accusations of doping on the team.

The wife of the famed cyclist Greg LeMond, Kathy, reportedly testified under oath in a deposition in 2006 that she had been told by one of Mr. Armstrong’s mechanics that Mr. Weisel, along with Nike, paid $500,000 though a Swiss bank account to the honorary president of the International Cycling Union to silence a drug test Mr. Armstrong purportedly failed in 1999.

Nike has vehemently denied the contention. So far, Mr. Weisel has not commented publicly.

When Floyd Landis, one of Mr. Armstrong’s former teammates, tested positive in 2006, he denied using performance-enhancing drugs under pressure from Mr. Armstrong. Soon after, Mr. Weisel set up the Floyd Fairness Fund with some of Tailwind’s co-owners to help pay his legal bills. Mr. Landis later confessed to doping in 2010.

Mr. Weisel, a longtime athlete who was a champion speed skater as a teenager, became a cycling enthusiast in the 1980s and took up racing himself. Sports dominated his life: he often said that he liked to hire athletes to work for him at the bank because of their competitive instincts. He was also the chairman of the United States Ski Team Foundation. In 1987, while still working as a banker, he started Montgomery Sports, to begin his first cycling team. In the early 1990s the team was called Subaru-Montgomery; it later became Montgomery-Bell (Bell Sports was a client that he took public) and then was renamed for the Postal Service. (Yahoo, another client, was also a sponsor of the team.)

According to a biography of Mr. Weisel, “Capital Instincts: Life as an Entrepreneur, Financier and Athlete,” he invested more than $5 million in the early teams and lost money on the investment. Mr. Armstrong was one of Mr. Weisel’s early riders for the Subaru-Montgomery team. He later left the team to join the Motorola team. After his bout with cancer, Mr. Armstrong joined what was the Postal Service team in 1998.

Tyler Hamilton, another former teammate of Mr. Armstrong, told “60 Minutes” that the team was pushing performance-enhancing drugs on its cyclists long before Mr. Armstrong battled cancer and then in 1998 rejoined the team.

“I remember seeing some of the stronger guys in the team getting handed these white lunch bags,” Mr. Hamilton said on “60 Minutes” about when he joined the team in 1995. “So finally I, you know, started puttin’ two and two together and you know, basically there were doping products in those white lunch bags.”

Given how widespread the doping now appears to have been on the Postal Service team based on testimony of 11 teammates, and charges against the team’s director and several of its doctors, you wonder how much due diligence its founding banker did on the most prominent deal of his career.

A version of this article appeared in print on 01/15/2013, on page B1 of the NewYork edition with the headline: The Banker Who Put Much Faith In Armstrong.

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French Say They ‘Blocked’ Rebel Advance in Mali

PARIS — The French defense ministry said on Monday that a town in central Mali had fallen to Islamist rebels from the north, hours after Foreign Minister Laurent Fabius said his country’s dramatic intervention there had succeeded in blocking a rebel advance that could have had “appalling consequences.”

At the same time, an Islamist leader in Mali said France had “opened the gates of hell” for all its citizens by intervening, reinforcing concerns that the far-flung military operation in Africa could inspire vengeance in mainland France.

French forces, Mr. Fabius said in a radio interview late Sunday, were now “taking care” of rear bases used by Islamists who took control of much of the north of the country last year after a military coup in the capital, Bamako. The duration of the French operation was “a question of weeks,” Mr. Fabius said, unlike the American-led military campaign in Afghanistan.

But within hours, reports began to emerge of a rebel counterattack in the small town of Diabaly — the first indication that the insurgents had regrouped after a wave of French airstrikes. The fighting in the town pitted rebels against government forces.

Reuters quoted residents and Malian military officials as saying that Islamists counterattacked after the insurgents infiltrated overnight across a river in small groups. The French defense minister, Jean-Yves Le Drian, said the rebels "took Diabaly after fierce fighting and resistance from the Malian Army that couldn’t hold them back.”

The setback for government forces seemed to embolden the rebels who had already struck a defiant postured on Monday.

Oumar Ould Hamaha, an insurgent leader, said the French intervention had “opened the gates of hell for all the French.”

He taunted French forces to launch a ground offensive, saying French warplanes had bombed from high altitude. “Let them come down onto the ground, if they are men,” he said. “We will greet them with open arms.”

France, he told Europe 1 radio, “has fallen into a trap which is much more dangerous than Iraq, Afghanistan or Somalia. And that is only the beginning.”

The French intervention began on Friday and continued over the weekend. French airstrikes appeared to have halted an Islamist rebel advance, as West African nations authorized what they said would be a faster deployment of troops in support of the weak government.

French aircraft dropped bombs and fired rockets from helicopter gunships and jet fighters after the Islamists, who already control the north of Mali, pressed southward and overran the village of Konna, which had been the de facto line of government control.

The French struck two columns of Islamist fighters, the French Defense Ministry said. The first was in and around Konna, driving out the rebels from the village, and the second was across a river, heading south toward the southern Mali town of Ségou, north of Bamako.

On Sunday evening, French jets attacked the northern town of Gao, an insurgent stronghold.

Abdheramane Oumarou, a local counselor in Gao reached late Sunday after a day of French airstrikes, said: “We are in the best of all possible worlds. The planes have been circling Gao since five this morning. All the of the sites they targeted, they hit. The airport. The warehouses, they destroyed them. These were all sites occupied by the Islamists, and they have been totally destroyed.”

“The Islamists are in hiding. There were many dead,” he said. For the first time since the insurgents overran the town last year, “the population of Gao will sleep soundly, and will even snore.”

Despite concerns that supporting France could provoke terrorist reprisals on its soil, Britain announced late on Saturday that it would help to transport foreign troops and equipment to Mali, though would not send its own soldiers to fight. Two British military transport planes were expected to head for Mali on Monday with equipment including French armored vehicles from a base in Normandy, the British Defense Ministry said.

“There is a very dangerous Islamist regime allied to Al Qaeda in control of the north of that country,” Prime Minister David Cameron said on Monday. “It was threatening the south of that country and we should support the action that the French have taken.”

“So we were first out of the blocks, as it were, to say to the French, ‘We’ll help you, we’ll work with you and we’ll share what intelligence we have with you and try to help you with what you are doing,’” Mr. Cameron told the BBC in a radio interview.

Foreign Minister Fabius said the military effort had three goals: to “block the advance of the terrorists, which is done,” to restore Mali’s territorial integrity “which will take more time,” and to secure the implementation of United Nations Security Council resolutions on the Mali crisis.

“If France had not intervened,” he said, the rebels “could have reached Bamako, with appalling consequences” not only for the Malian population but also for the 6,000 French and other Western citizens living in the capital of the former French colony.

Mr. Le Drian, the defense minister, said Sunday that the rebels could have reached Bamako in “three or four days” if France had not intervened.

"We will strengthen our operation depending on the situation," he said on a political talk show.

France now has more than 400 troops in Bamako, mainly to ensure the safety of French citizens and to send a signal to the Islamists, out of a total of 550 troops in Mali. The others, including some special forces, are in the town of Mopti in the south. It has also deployed Rafale jet fighters to attack rebel positions.

A French analyst, who is briefed on the situation but declined to be identified by name, said France believed the United States would deliver on promises of in-flight refueling the air campaign, logistical support and reconnaissance.

The analyst said the dilemma facing French forces is now whether to maintain a United Nations schedule for West African and Malian troops to seek to recapture the north in the fall after seasonal rains, “which given the current dynamic seems hard to imagine” or to “speed things up and try to clear the north in the next eight weeks” before the rainy season.

That could extend the duration of the French intervention, the analyst said.

Steven Erlanger reported from Paris, Adam Nossiter from Bamako, Mali, and Alan Cowell from London.

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Gadgetwise Blog: Q&A: Finding Help With Apps

I like the convenience of downloading iOS apps, but where do I go if I need help or tech support with a program for iPhone or iPad?

Some apps include basic help guides and support information under its settings or tools menu. Apple has links to online manuals for its own iWork for iOS software in the Help option under the Tools menu. Tapping the toolbar question-mark icon in the company’s iMovie, iPhoto or GarageBand software activates the built-in help guides for those apps; the company also has an iOS Apps Support page online .

Not every iOS app has such extensive documentation, but in many cases, you can find technical support and help guides on the app developer’s own Web site. On either the iTunes desktop version or the iOS app for Apple’s recently redesigned App Store, search for the program you need help with.

On the app’s information page, click the Ratings and Reviews tab. Under the Customer Reviews section, you should see an App Support button. Click or tap App Support to go to the developer’s Web site, where you can find more information and hopefully get help. The quality of the technical support may vary based on the developer.

For those using Google’s Android software, checking an app’s page in the Google Play Store is also one place to look for help. Check the Overview tab on the app’s page for links to the developer’s Web site and a tech-support e-mail address. Google has a general help guide for using the Google Play store here.

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Susan Nolen-Hoeksema, Psychologist Who Studied Depression in Women, Dies at 53

Susan Nolen-Hoeksema, a psychologist and writer whose work helped explain why women are twice as prone to depression as men and why such low moods can be so hard to shake, died on Jan. 2 in New Haven. She was 53.

Andrew Sacks

Susan Nolen-Hoeksema at the University of Michigan in 2003. Dr. Nolen-Hoeksema's research showed that women were more prone to ruminate, or dwell on the sources of problems rather than solutions, more than men.

Her death followed heart surgery to correct a congenitally weak valve, said her husband, Richard Nolen-Hoeksema.

Dr. Nolen-Hoeksema, a professor at Yale University, began studying depression in the 1980s, a time of great excitement in psychiatry and psychology. New drugs like Prozac were entering the market; novel talking therapies were proving effective, too, particularly cognitive behavior therapy, in which people learn to defuse upsetting thoughts by questioning their basis.

Her studies, first in children and later in adults, exposed one of the most deceptively upsetting of these patterns: rumination, the natural instinct to dwell on the sources of problems rather than their possible solutions. Women were more prone to ruminate than men, the studies found, and in a landmark 1987 paper she argued that this difference accounted for the two-to-one ratio of depressed women to depressed men.

She later linked rumination to a variety of mood and behavior problems, including anxiety, eating disorders and substance abuse.

“The way I think she’d put it is that, when bad things happen, women brood — they’re cerebral, which can feed into the depression,” said Martin Seligman, a professor of psychology at the University of Pennsylvania, who oversaw her doctoral work. “Men are more inclined to act, to do something, plan, beat someone up, play basketball.”

Dr. Seligman added, “She was the leading figure in sex differences in depression of her generation.”

Dr. Nolen-Hoeksema wrote several books about her research for general readers, including “Women Who Think Too Much: How to Break Free of Overthinking and Reclaim Your Life.” These books described why rumination could be so corrosive — it is deeply distracting; it tends to highlight negative memories — and how such thoughts could be alleviated.

Susan Kay Nolen was born on May 22, 1959, in Springfield, Ill., to John and Catherine Nolen. Her father ran a construction business, where her mother was the office manager; Susan was the eldest of three children.

She entered Illinois State University before transferring to Yale. She graduated summa cum laude in 1982 with a degree in psychology.

After earning a Ph.D. in psychology at the University of Pennsylvania, she joined the faculty at Stanford. She later moved to the University of Michigan, before returning to Yale in 2004.

Along the way she published scores of studies and a popular textbook. In 2003 she became the editor of the Annual Review of Clinical Psychology, an influential journal.

Dr. Nolen-Hoeksema moved smoothly between academic work and articles and books for the general reader.

“I think part of what allowed her to move so easily between those two worlds was that she was an extremely clear thinker, and an extremely clear writer,” said Marcia K. Johnson, a psychology professor and colleague at Yale.

Dr. Nolen-Hoeksema lived in Bethany, Conn. In addition to her husband, a science writer, she is survived by a son, Michael; her brothers, Jeff and Steve; and her father, John.

“Over the past four decades women have experienced unprecedented growth in independence and opportunities,” Dr. Nolen-Hoeksema wrote in 2003, adding, “We have many reasons to be happy and confident.”

“Yet when there is any pause in our daily activities,” she continued, “many of us are flooded with worries, thoughts and emotions that swirl out of control, sucking our emotions and energy down, down, down. We are suffering from an epidemic of overthinking.”

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Susan Nolen-Hoeksema, Psychologist Who Studied Depression in Women, Dies at 53

Susan Nolen-Hoeksema, a psychologist and writer whose work helped explain why women are twice as prone to depression as men and why such low moods can be so hard to shake, died on Jan. 2 in New Haven. She was 53.

Andrew Sacks

Susan Nolen-Hoeksema at the University of Michigan in 2003. Dr. Nolen-Hoeksema's research showed that women were more prone to ruminate, or dwell on the sources of problems rather than solutions, more than men.

Her death followed heart surgery to correct a congenitally weak valve, said her husband, Richard Nolen-Hoeksema.

Dr. Nolen-Hoeksema, a professor at Yale University, began studying depression in the 1980s, a time of great excitement in psychiatry and psychology. New drugs like Prozac were entering the market; novel talking therapies were proving effective, too, particularly cognitive behavior therapy, in which people learn to defuse upsetting thoughts by questioning their basis.

Her studies, first in children and later in adults, exposed one of the most deceptively upsetting of these patterns: rumination, the natural instinct to dwell on the sources of problems rather than their possible solutions. Women were more prone to ruminate than men, the studies found, and in a landmark 1987 paper she argued that this difference accounted for the two-to-one ratio of depressed women to depressed men.

She later linked rumination to a variety of mood and behavior problems, including anxiety, eating disorders and substance abuse.

“The way I think she’d put it is that, when bad things happen, women brood — they’re cerebral, which can feed into the depression,” said Martin Seligman, a professor of psychology at the University of Pennsylvania, who oversaw her doctoral work. “Men are more inclined to act, to do something, plan, beat someone up, play basketball.”

Dr. Seligman added, “She was the leading figure in sex differences in depression of her generation.”

Dr. Nolen-Hoeksema wrote several books about her research for general readers, including “Women Who Think Too Much: How to Break Free of Overthinking and Reclaim Your Life.” These books described why rumination could be so corrosive — it is deeply distracting; it tends to highlight negative memories — and how such thoughts could be alleviated.

Susan Kay Nolen was born on May 22, 1959, in Springfield, Ill., to John and Catherine Nolen. Her father ran a construction business, where her mother was the office manager; Susan was the eldest of three children.

She entered Illinois State University before transferring to Yale. She graduated summa cum laude in 1982 with a degree in psychology.

After earning a Ph.D. in psychology at the University of Pennsylvania, she joined the faculty at Stanford. She later moved to the University of Michigan, before returning to Yale in 2004.

Along the way she published scores of studies and a popular textbook. In 2003 she became the editor of the Annual Review of Clinical Psychology, an influential journal.

Dr. Nolen-Hoeksema moved smoothly between academic work and articles and books for the general reader.

“I think part of what allowed her to move so easily between those two worlds was that she was an extremely clear thinker, and an extremely clear writer,” said Marcia K. Johnson, a psychology professor and colleague at Yale.

Dr. Nolen-Hoeksema lived in Bethany, Conn. In addition to her husband, a science writer, she is survived by a son, Michael; her brothers, Jeff and Steve; and her father, John.

“Over the past four decades women have experienced unprecedented growth in independence and opportunities,” Dr. Nolen-Hoeksema wrote in 2003, adding, “We have many reasons to be happy and confident.”

“Yet when there is any pause in our daily activities,” she continued, “many of us are flooded with worries, thoughts and emotions that swirl out of control, sucking our emotions and energy down, down, down. We are suffering from an epidemic of overthinking.”

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DealBook: Swatch to Buy Watch and Jewelry Business of Harry Winston

The Swatch Group agreed on Monday to acquire the watch and jewelery business of Harry Winston, which plans to shift its focus to its diamond mining activities.

Swatch, the world’s largest watch maker, will pay $750 million in cash for Harry Winston. It will also assume about $250 million of debt. The Harry Winston Diamond Corporation will be renamed Dominion Diamond after the takeover.

For Swatch, the takeover adds a prominent brand regularly worn by Hollywood actresses to its already vast portfolio. Swatch owns not only its colorful plastic Swatch watches but also upscale names Blancpain and Omega. Swatch also controls the bulk of the sector’s watch movement production after buying several makers of components.

Swatch is paying about 23 times the estimated earnings before interest, tax, depreciation and amortization of Harry Winston, said René Weber, a watch analyst at Bank Vontobel in Zurich, who welcomed the takeover. He said that price was high but justified, considering that Swatch has ample cash reserves. The purchase of Harry Winston also comes after Swatch ended in 2011 a partnership with Tiffany, another luxury jeweler.

“It is a great fit,” Mr. Weber said, adding a strong jewelery brand which “fills the gap in the portfolio” of Swatch. Swatch shares were up 4 percent in midday trading on the Swiss stock exchange.

Swatch is a listed company, but its management and about a third of its equity remain in the hands of the family of Nicolas Hayek, who founded the company and helped revive the whole Swiss watch industry in the 1980s, in the face of stiff Japanese competition, by starting the inexpensive and highly successful Swatch plastic watch. Mr. Hayek died in 2010.

Nayla Hayek, his daughter and chairwoman of the company, said in a statement on Monday that the takeover of Harry Winston “brilliantly complements the prestige segment” of her company. “Diamonds are still a girl’s best friend,” she added, in reference to a song that mentioned Harry Winston and was made famous by Marilyn Monroe in the movie “Gentlemen Prefer Blondes.”

Robert Gannicott, chairman and chief executive of the Harry Winston Diamond Corporation, said that the sale “will leave us well equipped to realize upstream opportunities in an environment where cash has become a strategic resource while preserving and expanding our relationship with the downstream diamond business.” Last November, the company acquired another diamond mine in Canada, called Ekati, from BHP Billiton.

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Thousands of Russians Rally Against Adoption Ban

MOSCOW – Thousands of Russians marched on Sunday in condemnation of the Russian Parliament’s move to ban adoption of Russian children by American families, an event dubbed a “March Against Scoundrels,” where participants chanted, “Take your hands off children,” and carried posters showing the faces of lawmakers stamped with the word “Shame.”

Marchers flooded tree-lined boulevards for many blocks on a bitterly cold day. The police estimated the turnout for the march, which was sanctioned by city authorities, at 9,500; a group of activists who made a count told Interfax that there were about 24,000 participants.

The sight gags and clever slogans of last year’s anti-government rallies were gone Sunday, and many participants had emotional answers for why they had come to march. Many questioned the moral principles of a ban on adoptions by Americans in a country with so many children in foster care or orphanages.

“Even I can’t afford to adopt, and I’m supposedly middle class,” Yekaterina Komissarova, 31, said, adding that perhaps the issue angered her so deeply because she was the mother of two children.

Marina Lukanova, a teacher, said many of her friends had tried to adopt and found it nearly impossible. “What they found was endless bureaucracy – they fill out forms and nothing happens,” she said. “And now they have given up.”

The adoption ban has underlined a growing division in Russian society, as the government has embraced conservative rhetoric tailored to voters in the heartland, and turned away from prosperous city-dwellers who have mobilized over the Internet. State-controlled television has regaled Russians with reports of American parents who abuse or neglect Russian children, and a top official derided the marchers as “child-sellers.”

“I am especially surprised to see people gather at such a large action in support of American business — because for them, our children, Russian children, are factually, let’s put it this way, an object of trade,” said Yekaterina Lakhova, the United Russia lawmaker who sponsored the ban, in an interview with Kommersant FM radio station shortly after Sunday’s march began.

“Economically developed countries – and we do not consider ourselves a third-world country, we are in the top 20 – do not give up their children to foreign adoption as much as we do,” she said. “Excuse me, but in the past years, we have given the United States a small city with a population of up to 100,000, that is how many children we have given up to foreign adoptions.”

President Vladimir V. Putin approved the adoption ban in late December, as part of a broader law retaliating against the United States for the so-called Magnitsky Act, an effort to punish Russian officials accused of human rights violations.

Russian leaders have complained bitterly for years about light sentences handed down in cases where American adoptive parents abused or neglected children adopted from Russia, and named the ban after Dmitri Yakovlev, a toddler who died of heatstroke in Virginia in 2008 after his adoptive father left him in a parked car for nine hours.

But the decision has proven divisive in Russia, even within government circles. More than 650,000 children live in foster care or orphanages in Russia, of whom about 120,000 are eligible for adoption. Many children in orphanages are sick or disabled, and most have little hope of finding permanent homes.

“We hope that these people, who came out to express their opinion, are aware of the plans of our nation’s leaders to bring order to the adoption process, and the implementation of a range of measures aimed to improve the lives of orphans,” Dmitri S. Peskov, the Kremlin press secretary, said.

The protesters on Sunday, however, were not likely to be convinced. One woman carried a sign that read, “Stop the repressions, you’re making revolutionaries out of us.” Many said they support the Magnitsky Act, which was passed by the American Congress late last year, as a way to hold Russian officials accountable for crimes that would otherwise never be punished.

“I truly think they have lost touch with society, and they use these laws to divert society’s anger toward ‘our enemies,’ the Americans,” said Boris Komberg, a physicist who was distributing a poem he had written.

A series of high-ranking officials openly expressed their disagreement before the ban was enacted, and figures from the art and entertainment world have recorded emotional messages of dissent and published them on the Internet. Opposition groups have hoped that outrage sparked by the adoption ban would reinvigorate a Moscow-based protest movement that has sagged in recent months, as the government began to prosecute and impose tough sentences on street activists.

A poll released in December by the Public Opinion Foundation showed that 56 percent of Russians approved of the adoption ban. A top official from United Russia, Andrei Isayev, last week described Sunday’s protest as a “March of Child-Sellers,” and tried to refocus attention on the Magnitsky Act, which he described as a “public, demonstrative humiliation of the Russian Federation.”

“All the enemies of Russian sovereignty showed themselves the ardent supporters of American adoption,” Mr. Isayev wrote on a party Web site.

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Aaron Swartz, Internet Activist, Dies at 26

Aaron Swartz, a wizardly programmer who as a teenager helped develop code that delivered ever-changing Web content to users and who later became a steadfast crusader to make that information freely available, was found dead on Friday in his New York apartment.

An uncle, Michael Wolf, said that Mr. Swartz, 26, had apparently hanged himself, and that a friend of Mr. Swartz’s had discovered the body.

At 14, Mr. Swartz helped create RSS, the nearly ubiquitous tool that allows users to subscribe to online information. He later became an Internet folk hero, pushing to make many Web files free and open to the public. But in July 2011, he was indicted on federal charges of gaining illegal access to JSTOR, a subscription-only service for distributing scientific and literary journals, and downloading 4.8 million articles and documents, nearly the entire library.

Charges in the case, including wire fraud and computer fraud, were pending at the time of Mr. Swartz’s death, carrying potential penalties of up to 35 years in prison and $1 million in fines.

“Aaron built surprising new things that changed the flow of information around the world,” said Susan Crawford, a professor at the Cardozo School of Law in New York who served in the Obama administration as a technology adviser. She called Mr. Swartz “a complicated prodigy” and said “graybeards approached him with awe.”

Mr. Wolf said he would remember his nephew, who had written in the past about battling depression and suicidal thoughts, as a young man who “looked at the world, and had a certain logic in his brain, and the world didn’t necessarily fit in with that logic, and that was sometimes difficult.”

The Tech, a newspaper of the Massachusetts Institute of Technology, reported Mr. Swartz’s death early Saturday.

Mr. Swartz led an often itinerant life that included dropping out of Stanford, forming companies and organizations, and becoming a fellow at Harvard University’s Edmond J. Safra Center for Ethics.

He formed a company that merged with Reddit, the popular news and information site. He also co-founded Demand Progress, a group that promotes online campaigns on social justice issues — including a successful effort, with other groups, to oppose a Hollywood-backed Internet piracy bill.

But he also found trouble when he took part in efforts to release information to the public that he felt should be freely available. In 2008, he took on PACER, or Public Access to Court Electronic Records, the repository for federal judicial documents.

The database charges 10 cents a page for documents; activists like Carl Malamud, the founder of public.resource.org, have long argued that such documents should be free because they are produced at public expense. Joining Mr. Malamud’s efforts to make the documents public by posting legally obtained files to the Internet for free access, Mr. Swartz wrote an elegant little program to download 20 million pages of documents from free library accounts, or roughly 20 percent of the enormous database.

The government shut down the free library program, and Mr. Malamud feared that legal trouble might follow even though he felt they had violated no laws. As he recalled in a newspaper account, “I immediately saw the potential for overreaction by the courts.” He recalled telling Mr. Swartz: “You need to talk to a lawyer. I need to talk to a lawyer.”

Mr. Swartz recalled in a 2009 interview, “I had this vision of the feds crashing down the door, taking everything away.” He said he locked the deadbolt on his door, lay down on the bed for a while and then called his mother.

The federal government investigated but did not prosecute.

In 2011, however, Mr. Swartz went beyond that, according to a federal indictment. In an effort to provide free public access to JSTOR, he broke into computer networks at M.I.T. by means that included gaining entry to a utility closet on campus and leaving a laptop that signed into the university network under a false account, federal officials said.

Mr. Swartz turned over his hard drives with 4.8 million documents, and JSTOR declined to pursue the case. But Carmen M. Ortiz, a United States attorney, pressed on, saying that “stealing is stealing, whether you use a computer command or a crowbar, and whether you take documents, data or dollars.”

Founded in 1995, JSTOR, or Journal Storage, is nonprofit, but institutions can pay tens of thousands of dollars for a subscription that bundles scholarly publications online. JSTOR says it needs the money to collect and to distribute the material and, in some cases, subsidize institutions that cannot afford it. On Wednesday, JSTOR announced that it would open its archives for 1,200 journals to free reading by the public on a limited basis.

Mr. Malamud said that while he did not approve of Mr. Swartz’s actions at M.I.T., “access to knowledge and access to justice have become all about access to money, and Aaron tried to change that. That should never have been considered a criminal activity.”

Mr. Swartz did not talk much about his impending trial, Quinn Norton, a close friend, said on Saturday, but when he did, it was clear that “it pushed him to exhaustion. It pushed him beyond.”

Recent years had been hard for Mr. Swartz, Ms. Norton said, and she characterized him “in turns tough and delicate.” He had “struggled with chronic, painful illness as well as depression,” she said, without specifying the illness, but he was still hopeful “at least about the world.”

Cory Doctorow, a science fiction author and online activist, posted a tribute to Mr. Swartz on BoingBoing.net, a blog he co-edits. In an e-mail, he called Mr. Swartz “uncompromising, principled, smart, flawed, loving, caring, and brilliant.”

 “The world was a better place with him in it,” he said.

Mr. Swartz, he noted, had a habit of turning on those closest to him: “Aaron held the world, his friends, and his mentors to an impossibly high standard — the same standard he set for himself.” Mr. Doctorow added, however, “It’s a testament to his friendship that no one ever seemed to hold it against him (except, maybe, himself).”

In a talk in 2007, Mr. Swartz described having had suicidal thoughts during a low period in his career. He also wrote about his struggle with depression, distinguishing it from sadness.

“Go outside and get some fresh air or cuddle with a loved one and you don’t feel any better, only more upset at being unable to feel the joy that everyone else seems to feel. Everything gets colored by the sadness.”

When the condition gets worse, he wrote, “you feel as if streaks of pain are running through your head, you thrash your body, you search for some escape but find none. And this is one of the more moderate forms.”

Ravi Somaiya contributed reporting.

This article has been revised to reflect the following correction:

Correction: January 12, 2013

An earlier version of this article incorrectly identified the police who arrested Mr. Swartz, and when they did so. The police were from Cambridge, Mass., not the Massachusetts Institute of Technology campus force, and the arrest occurred two years before Mr. Swartz’s suicide, but not two years to the day.

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City Room: Cuomo Declares Public Health Emergency Over Flu Outbreak

With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available.

There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported.

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Gov. Andrew M. Cuomo said in a statement.

Under the order, pharmacists will be allowed to administer flu vaccinations to patients between 6 months and 18 years old, temporarily suspending a state law that prohibits pharmacists from administering immunizations to children.

While children and older people tend to be the most likely to become seriously ill from the flu, Mr. Cuomo urged all New Yorkers to get vaccinated.

On Friday, the Centers for Disease Control and Prevention in Atlanta said that deaths from the flu had reached epidemic levels, with at least 20 children having died nationwide. Officials cautioned that deaths from pneumonia and the flu typically reach epidemic levels for a week or two every year. The severity of the outbreak will be determined by how long the death toll remains high or if it climbs higher.

There was some evidence that caseloads may be peaking, federal officials said on Friday.

In New York City, public health officials announced on Thursday that flu-related illnesses had reached epidemic levels, and they joined the chorus of authorities urging people to get vaccinated.

“It’s a bad year,” the city’s health commissioner, Dr. Thomas A. Farley, told reporters on Thursday. “We’ve got lots of flu, it’s mainly type AH3N2, which tends to be a little more severe. So we’re seeing plenty of cases of flu and plenty of people sick with flu. Our message for any people who are listening to this is it’s still not too late to get your flu shot.”

There has been a spike in the number of people going to emergency rooms over the past two weeks with flulike symptoms – including fever, fatigue and coughing – Dr. Farley said.

Mayor Michael R. Bloomberg and Mr. Cuomo made a public display of getting shots this past week.

In a briefing with reporters on Friday, officials from the C.D.C. said that this year’s vaccine was effective in 62 percent of cases.

As officials have stepped up their efforts encouraging vaccinations, there have been scattered reports of shortages. But officials said plenty of the vaccine was available.

According to the C.D.C., makers of the flu vaccine produced about 135 million doses for this year. As of early this month, 128 million doses had been distributed. While that would not be enough for every American, only 37 percent of the population get a flu shot each year.

Federal health officials said they would be happy if that number rose to 50 percent, which would mean that there would be more than enough vaccine for anyone who wanted to be immunized.

Two other diseases – norovirus and whooping cough – are also widespread this winter and are contributing to the number of people getting sick.

The flu can resemble a cold, though the symptoms come on more rapidly and are more severe.

A version of this article appeared in print on 01/13/2013, on page A21 of the NewYork edition with the headline: New York Declares Health Emergency.

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