Study Links Segregation and Lung Cancer Deaths in Blacks

African-Americans who live in highly segregated counties are considerably more likely to die from lung cancer than those in counties that are less segregated, a new study has found.

The study was the first to look at segregation as a factor in lung cancer mortality. Its authors said they could not fully explain why it worsens the odds of survival for African-Americans, but hypothesized that blacks in more segregated areas may be less likely to have health insurance or access to health care and specialty doctors. It is also possible that lower levels of education mean they are less likely to seek care early, when medical treatment could make a big difference. Racial bias in the health care system might also be a factor.

“If you want to learn about someone’s health, follow him home,” said Dr. Awori J. Hayanga, a heart and lung surgeon at the University of Pittsburgh Medical Center, who was the lead author of the study.

The study, published in JAMA Surgery on Wednesday, divided all counties in the country into three levels of segregation: high, medium and low. It found that lung cancer mortality rates, a ratio of deaths to a population, were about 20 percent higher for blacks who lived in the most segregated counties, than for blacks living in the least segregated counties.

Lung cancer is the top cause of preventable death in the United States. Blacks have the highest incidence of it and are also more likely to die from it. For every million black males, 860 will die from lung cancer, compared with 620 white males among every million white males. The rates were calculated over the period of the study, from 2003 to 2007.

The study drew on federal mortality data from that period, and segregation data from about a third of United States counties that had African-American populations large enough to measure. About 28 percent of the American population lives in counties with low segregation, 40 percent in counties with moderate segregation, and 32 percent in counties with high segregation.

The gap in outcomes persisted even after accounting for differences in smoking rates and socio-economic status, said Dr. Hayanga said.

For whites, high levels of segregation had the opposite effect, a finding that surprised the authors. Whites who lived in highly segregated counties had about 6 percent lower mortality rates from lung cancer than those who lived in the least segregated counties, though researchers pointed out that the difference was slight enough that it was not clear whether it was meaningful.

Dr. David Chang, director of outcomes research at the University of California San Diego Department of Surgery, who wrote an accompanying editorial, said he hoped that the study would focus attention on the environmental factors involved in the stark disparities in health outcomes in the United States because they lend themselves to change through policy. Medical researchers tend to focus on factors like the genetics and the behaviors of individuals that are harder to change.

“We don’t need drugs or genetic explanations to fix a lot of the health care problems we have,” he said.

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Bits Blog: Facebook Unveils a New Search Tool

8:53 p.m. | Updated

MENLO PARK, Calif. — Facebook has spent eight years nudging its users to share everything they like and everything they do. Now, the company is betting it has enough data so that people can find whatever they want on Facebook. And on Tuesday, it unveiled a new tool to help them dig for it.

The tool, which the company calls graph search, is Facebook’s most ambitious stab at overturning the Web search business ruled by its chief rival, Google. It is also an effort to elbow aside other Web services designed to unearth specific kinds of information, like LinkedIn for jobs, Match for dates and Yelp for restaurants.

Facebook has spent over a year honing graph search, said Mark Zuckerberg, the company’s co-founder and chief executive, at an event here at Facebook’s headquarters introducing the new product. He said it would enable Facebook users to search their social network for people, places, photos and things that interest them.

That might include, Mr. Zuckerberg offered, Mexican restaurants in Palo Alto that his friends have “liked” on Facebook or checked into. It might be used to find a date, dentist or job, other Facebook executives said.

“Graph search,” Mr. Zuckerberg said, “is a completely new way to get information on Facebook.”

Graph search will be immediately available to a limited number of Facebook users — in the “thousands,” Mr. Zuckerberg said — and gradually extended to the rest.

Every Internet platform company has been interested in conquering search.

But Facebook search differs from other search services because of the mountain of social data the company has collected over the years. It knows which parks your friends like to take their children to, or which pubs they like to visit, and who among their network is single and lives nearby.

The company is betting that its users are more eager to hear their friends’ recommendations for a restaurant than advice from a professional food critic or from a stranger on Yelp.

Its search tool is based on the premise that the data within Facebook is enough and that its users will have little reason to venture outside its blue walled garden. What they cannot find inside the garden, its search partner, Bing, a Microsoft product, will help them find on the Web.

For now, the Facebook tool will mine its users’ pictures, likes and check-ins, but not their status updates. Graph search, Mr. Zuckerberg explained, is aimed at answering questions based on the data contained in your social network, not serving you a list of links to other Web sites.

Say, for example, you are searching for a grocery store in Manhattan. You would type that question into a box on your Facebook page and the results would show stores your friends liked or where they had checked in.

It remains unclear how users will react to having others mine the data they share on Facebook. Mr. Zuckerberg took pains to reassure users that what they post would be found only if they wanted it to be found. Before the new search tool is available to them, he said, users will see this message: “Please take some time to review who can see your stuff.” Facebook tweaked its privacy controls last December.

Mr. Zuckerberg said Tuesday that initially, photos posted on Instagram, which Facebook owns, would not be part of the database of photos that can be searched. Nor would he specify how soon graph search would be available to those who log in using the Facebook app on their cellphones.

The search tool is plainly designed with an eye toward profits. If done right, said Brian Blau, an analyst with Gartner, it could offer marketers a more precise signal of a Web user’s interests. “It’s going to lend itself to advertising or other revenue-generating products that better matches what people are looking for,” he said. “Advertisers are going to be able to better target what you’re interested in. It’s a much more meaningful search than keyword search.”

News of the new search tool offered a modest lift to Facebook shares, which rose 2.7 percent to a close at $30.10 Tuesday. Google remained stable, with a share price of nearly $725. Google retains two-thirds of the search market, and Facebook’s search tool by itself is not likely to affect Google’s business.

Still, introduction of graph search sharpens the divide between Facebook and Google.

“If Facebook can truly provide relevant answers based on mining data from the social graph, it has an advantage,” said Venkat N. Venkatraman, a business professor at Boston University.

Google has been scrambling for several years to collect social data and incorporate it into search results, as Web users increasingly turn to social networks to seek friends’ recommendations.

It introduced Google Plus, its Facebook rival, in 2011, and from the beginning said its main purpose was to use social information to improve and personalize all Google products, from search to maps to ads. Last year, Google began showing posts, photos, profiles and conversations from Google Plus in Google search results. A search for restaurants in Seattle, for instance, could show posts and photos shared by friends in addition to links from around the Web. Google declined to comment for this article.

The kind of personal search that Facebook is promising is rife with potential privacy hazards, which Mr. Zuckerberg acknowledged repeatedly. “The search we wanted to build is privacy aware,” he maintained. “On Facebook, most of the things people share with you isn’t public.”

The American Civil Liberties Union immediately posted a warning, reminding Facebook users to review their privacy settings. It pointed out that advertisers who, until now, could target only certain categories of people anonymously — “users under 35 who live in Texas,” for instance — could now find specific users under 35 who live in Texas, if their privacy settings allowed them to be found. It cautioned that “controlling your personal data means controlling not only who can see your information but how it can be found and what can be done with it.”

But Facebook pointed out that even though a business owner could personally search for specific personal data, a brand page could not. Detailed searching of Facebook data for the sake of sending promotional messages would violate the site’s internal policies.

The search team was led by two former Google engineers, Lars Rasmussen and Tom Stocky. As they explained in a blog post on the Facebook Engineering Department page, graph search solves a problem of Facebook’s own making: it has collected so much information.

“As people shared more and more content, we saw that we needed to give them better ways to explore and enjoy those stories and memories,” they wrote.

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L.A. City Council drops $3-billion bond measure for this year

The Los Angeles City Council scrapped plans Tuesday for placing a $3-billion bond measure on the May 21 ballot, opting instead to consider it in a future election year.

Councilmen Mitchell Englander and Joe Buscaino, who had proposed the bond, said they would spend more time communicating with the public about the proposal before trying to send it to voters. "We're going to continue working on this, obviously," said Buscaino, whose district stretches from San Pedro to Watts.

The proposal, which would have increased property taxes for 20 years, had signatures from seven of the council's 15 members only two weeks ago. But in recent days, some on the council complained there hadn’t been enough outreach to the public.

Some neighborhood activists had warned that a protracted debate over the bond measure would doom passage of a proposed half-cent sales tax hike, which is on the March 5 ballot and being promoted as a way to eliminate potholes. The sales tax, known as Proposition A, is seen as a way of erasing a $220-million budget shortfall.

The search for street repair money is being driven, in part, by a fear that major sources of funding for road work are disappearing. Money from Proposition 1B, a state measure that provided $87 million for streets over a three-year period, runs out in June. Funding from President Obama’s stimulus package was depleted in summer.

A 2011 survey found that nearly one-third of the city’s streets are in D or F condition, the worst rating possible. With the current funding available, repairing those streets will take 60 years, city officials said.

The general fund, which pays for basic services, provides less than 1% of the money allocated by the city for street maintenance and repairs. Nevertheless, city officials have managed to increase the amount it spends on road work anyway, by tapping state and federal funding and special transportation taxes.

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Justice Sonia Sotomayor writes of life’s struggles

WASHINGTON (Reuters) – In a memoir to be published on Tuesday, Sonia Sotomayor writes of the chronic disease, troubled family relationships and failed marriage that accompanied her rise from a housing project in the Bronx to a seat on America’s highest court.

The first Hispanic and the third woman to serve on the U.S. Supreme Court, the 58-year-old justice, appointed by President Barack Obama in 2009, describes the insecurities she has felt as a minority who benefited from racial remedies.

She signed on to write the sweeping, 315-page book, “My Beloved World,” early in her tenure. She received a $ 1.175 million book advance in 2010 from publisher, Alfred A. Knopf, according to financial disclosure records.

Sitting down for a rare interview in her Supreme Court chambers, Sotomayor said that after being thrust into the public limelight with her nomination to the court, she felt the need for introspection to hold onto her identity.

The court’s nine justices, appointed for life, typically decline to sit for interviews or offer any personal observations related to cases. Book tours offer rare opportunities to draw them out on issues, even if only a little.

“I began to realize that if I didn’t stop and take a breath and figure out who this Sonia was, I could be in danger of losing the best in me,” she said. She didn’t want the memoir to be a retelling of her public persona, but rather to reveal who she is as a person, she said.

The interview was part of an orchestrated media blitz to promote the book, which included appearances on Sunday night’s popular CBS News program “60 Minutes” and in People Magazine.

In the coming-of-age story, Sotomayor paints a picture of her young self as a boisterous child, once rescued by a fireman neighbor when she got her head stuck in a bucket, trying to hear what her voice sounded like.

TROUBLED FAMILY RELATIONSHIPS

She exudes the same energy when speaking on the phone or talking through the door to her assistant, often calling people “sweetie.” Her chambers are spacious, bright and elegant, decorated with modern art on the walls.

Her environs have not always been so pristine. She describes the difficulty of growing up with a father who was an alcoholic and a mother who was frequently absent. Diagnosed with diabetes at a young age, she wet the bed, fainted in church and learned to inject daily doses of insulin to regulate her blood sugar.

Her father died when Sotomayor was nine, leaving a room full of drained liquor bottles hidden under his mattress, in jacket pockets and closets. While his death sent Sotomayor’s mother into a state of grief, it was also a relief. Until then, her mother had worked long hours as a nurse to stay out of the house and avoid conflict.

At her Supreme Court nomination, Sotomayor ascribed her success to her mother. In the book, Sotomayor portrays a more complicated relationship, describing the pain caused by her mother’s absence and lack of affection. Sotomayor told Reuters that the part in the book about her relationship with her mother, who is still alive, was the most difficult to write.

The justice is open about her insecurities. At Princeton, which admitted her in 1972 under an affirmative action program, Sotomayor questioned her right to be there at times. Other students could be hostile to minorities, and the college newspaper routinely published letters bemoaning the presence of students on campus through racial remedies known as affirmative action.

It gave her the sense that vultures were “circling, ready to dive when we stumbled,” she writes.

VESTIGES OF DISCRIMINATION

The book comes out as the Supreme Court is weighing a landmark case about the role of race in college admissions. Sotomayor was careful in the Reuters interview not to discuss current cases, but said there was value to affirmative action programs.

“It’s impossible to not recognize that the vestiges of discrimination take a long time to erase,” she said. “It just doesn’t happen overnight.”

But she also called affirmative action a “double-edged sword.” She said some people still attribute her position on the court to affirmative action, based on her identity as a Latina justice.

“That’s hurtful. To have your accomplishments naysaid is not something you welcome, and not something that makes you feel good,” she said.

Sotomayor’s book is not the first literary window into a justice’s personal life. Justice Clarence Thomas described his experience with poverty, racism and affirmative action in “My Grandfather’s Son,” and retired Justice Sandra Day O’Connor wrote about her early life growing up on an Arizona cattle ranch in “Lazy B.” Sotomayor’s self-portrait is the most revealing, down to the references to the old-lady underwear a friend persuaded her to abandon.

She describes the blow of being denied a job offer at Paul, Weiss, Rifkind, Wharton & Garrison after working there as a summer associate while she was at Yale Law School. That disappointment hung over her like a cloud until she became a judge, she writes. The firm declined to comment.

She also opens up about her marriage to her high school sweetheart, Kevin Noonan, which ended with an amicable divorce. On their wedding night, she insisted that he flush down the toilet Quaaludes that were given as a gift by his friends, showing her respect for the law. She says the marriage failed, in part, because of her self-reliance, but that she is still open to finding a happy relationship.

(Editing by Howard Goller and Lisa Shumaker)

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Well: How to Go Vegan

When I first heard former President Bill Clinton talk about his vegan diet, I was inspired to make the switch myself. After all, if a man with a penchant for fast-food burgers and Southern cooking could go vegan, surely I could too.

At the grocery store, I stocked up on vegan foods, including almond milk (that was the presidential recommendation), and faux turkey and cheese to replicate my daughter’s favorite sandwich. But despite my good intentions, my cold-turkey attempt to give up, well, turkey (as well as other meats, dairy and eggs) didn’t go well. My daughter and I couldn’t stand the taste of almond milk, and the fake meat and cheese were unappealing.

Since then, I’ve spoken with numerous vegan chefs and diners who say it can be a challenge to change a lifetime of eating habits overnight. They offer the following advice for stocking your vegan pantry and finding replacements for key foods like cheese and other dairy products.

NONDAIRY MILK Taste all of them to find your favorite. Coconut and almond milks (particularly canned coconut milk) are thicker and good to use in cooking, while rice milk is thinner and is good for people who are allergic to nuts or soy. My daughter and I both prefer the taste of soy milk and use it in regular or vanilla flavor for fruit smoothies and breakfast cereal.

NONDAIRY CHEESE Cheese substitutes are available under the brand names Daiya, Tofutti and Follow Your Heart, among others, but many vegans say there’s no fake cheese that satisfies as well as the real thing. Rather than use a packaged product, vegan chefs prefer to make homemade substitutes using cashews, tofu, miso or nutritional yeast. At Candle 79, a popular New York vegan restaurant, the filling for saffron ravioli with wild mushrooms and cashew cheese is made with cashews soaked overnight and then blended with lemon juice, olive oil, water and salt.

THINK CREAMY, NOT CHEESY Creaminess and richness can often be achieved without a cheese substitute. For instance, Chloe Coscarelli, a vegan chef and the author of “Chloe’s Kitchen,” has created a pizza with caramelized onion and butternut squash that will make you forget it doesn’t have cheese; the secret is white-bean and garlic purée. She also offers a creamy, but dairy-free, avocado pesto pasta. My daughter and I have discovered we actually prefer the rich flavor of butternut squash ravioli, which can be found frozen and fresh in supermarkets, to cheese-filled ravioli.

NUTRITIONAL YEAST The name is unappetizing, but many vegan chefs swear by it: it’s a natural food with a roasted, nutty, cheeselike flavor. Ms. Coscarelli uses nutritional yeast flakes in her “best ever” baked macaroni and cheese (found in her cookbook). “I’ve served this to die-hard cheese lovers,” she told me, “and everyone agrees it is comparable, if not better.”

Susan Voisin’s Web site, Fat Free Vegan Kitchen, offers a nice primer on nutritional yeast, noting that it’s a fungus (think mushrooms!) that is grown on molasses and then harvested and dried with heat. (Baking yeast is an entirely different product.) Nutritional yeasts can be an acquired taste, she said, so start with small amounts, sprinkling on popcorn, stirring into mashed potatoes, grinding with almonds for a Parmesan substitute or combining with tofu to make an eggless omelet. It can be found in Whole Foods, in the bulk aisle of natural-foods markets or online.

BUTTER This is an easy fix. Vegan margarines like Earth Balance are made from a blend of oils and are free of trans fats. Varieties include soy-free, whipped and olive oil.

EGGS Ms. Coscarelli, who won the Food Network’s Cupcake Wars with vegan cupcakes, says vinegar and baking soda can help baked goods bind together and rise, creating a moist and fluffy cake without eggs. Cornstarch can substitute for eggs to thicken puddings and sauces. Vegan pancakes are made with a tablespoon of baking powder instead of eggs. Frittatas and omelets can be replicated with tofu.

Finally, don’t try to replicate your favorite meaty foods right away. If you love a juicy hamburger, meatloaf or ham sandwich, you are not going to find a meat-free version that tastes the same. Ms. Voisin advises new vegans to start slow and eat a few vegan meals a week. Stock your pantry with lots of grains, lentils and beans and pile your plate with vegetables. To veganize a recipe, start with a dish that is mostly vegan already — like spaghetti — and use vegetables or a meat substitute for the sauce.

“Trying to recapture something and find an exact substitute is really hard,” she said. “A lot of people will try a vegetarian meatloaf right after they become vegetarian, and they hate it. But after you get away from eating meat for a while, you’ll find you start to develop other tastes, and the flavor of a lentil loaf with seasonings will taste great to you. It won’t taste like meat loaf, but you’ll appreciate it for itself.”

Ms. Voisin notes that she became a vegetarian and then vegan while living in a small town in South Carolina; she now lives in Jackson, Miss.

“If I can be a vegan in these not-quite-vegan-centric places, you can do it anywhere,” she said. “I think people who try to do it all at once overnight are more apt to fail. It’s a learning process.”

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What are your tips for vegan cooking and eating? Share your suggestions on ingredients, recipes and strategies by posting a comment below or tweeting with the hashtag #vegantips.

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The Caucus: Credit Rating Agency Warns of Downgrade if Debt Limit Is Not Raised

Fitch Ratings Ltd. warned on Tuesday that Congress’s failure to raise the federal government’s statutory borrowing limit would “very likely” prompt a downgrading of the United States Government’s credit rating, and the agency seemed to suggest that Congress should simply do away with the debt ceiling altogether.

In a pointed statement, Fitch dismissed the assurances of some Republicans that the Treasury Department would be able to use incoming tax receipts to prioritize the payment of government debt and interest, as well as vital services like military pay and Social Security. That warning echoed the Treasury’s own assessment that breaching the debt ceiling could not be managed in any way that would minimize the economic turmoil or avoid default.

“It is not assured that the Treasury would or legally could prioritize debt service over its myriad of other obligations, including Social Security payments, tax rebates and payments to contractors and employees. Arrears on such obligations would not constitute a default event from a sovereign rating perspective but very likely prompt a downgrade even as debt obligations continued to be met,” Fitch wrote.

Standard & Poor’s, a larger credit rating agency, downgraded United States debt a notch in August 2011 after the last standoff over the federal debt limit, reflecting “our view that the effectiveness, stability, and predictability of American policy making and political institutions have weakened at a time of ongoing fiscal and economic challenges to a degree more than we envisioned.”

Fitch and Moody’s Investors Service, the other major rating agency, did not follow suit, keeping the rating of United States Treasury debt at AAA. Far from serving as a unifying moment, the S.&P. downgrade divided Washington further. Republicans said the downgrade resulted from President Obama’s refusal to dramatically cut spending to get the federal deficit under control. Democrats said it was a reflection of political paralysis that stemmed from Republican intransigence.

The Fitch warning seemed to hem in Republicans further, however. Mr. Obama has repeatedly said he will not negotiate over the debt ceiling, and on Monday, he compared Republican refusal to raise it to a criminal taking a hostage. Fitch appeared to side with the president.

“In Fitch’s opinion, the debt ceiling is an ineffective and potentially dangerous mechanism for enforcing fiscal discipline. It does not prevent tax and spending decisions that will incur debt issuance in excess of the ceiling while the sanction of not raising the ceiling risks a sovereign default and renders such a threat incredible,” the agency wrote.

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An Anaheim woman demands respect for her neighborhood

Yesenia Rojas, vibrant in her purple shawl, sang with a voice so powerful it rose above the rest of the procession as they shuffled down the damp Anaheim sidewalk.

"Era mexicana. Era mexicana," they sang with a statue of Our Lady of Guadalupe hoisted high, candlelight and street lamps illuminating their way. "Madrecita de los mexicanos."

The singsong serenade lauds the patroness, the mother of all Mexicans.

On this drizzly evening, Rojas led the group down Anna Drive, where she and her family have made their home.

In a city often defined by Disneyland and elegant sports venues, this street of working-class Latino immigrants has become an avatar of a lesser-known, voiceless Anaheim, one riddled with poverty and gangs.

When police shot and killed a 25-year-old alleged gang member who lived on Anna Drive, it stoked what had been a growing fire in the city. It was the latest in a spate of police shootings last year, which inflamed anger with law enforcement into a larger sense of resentment over ethnic and class fissures that divide Orange County's largest city.

Unrest — amplified by Occupy-connected protesters from outside the city — gripped Anaheim for days after the July shooting, followed by weeks of heated City Council meetings.

The wave of protesters demanding change has washed away, but Rojas has emerged in its wake. The 35-year-old mother of six, with short, wavy dark hair and a small frame that belies her force of will, has taken it upon herself to become the voice of Anna Drive.

Her family lives in a one-bedroom apartment just yards from where Manuel Diaz was shot that summer day. Rojas' 14-year-old daughter saw Diaz's body and has been traumatized since. Her mother can't let that go.

"I thought about leaving, and so did my husband, because of the children," she said. "But I said no. Because, first of all, we don't need to fear anyone, not even the police. The biggest thing right now is to stay on our feet and make things happen as a community. If we all leave, things won't change. They'll keep trampling us and humiliating us."

Rojas has a vision for her community that would seem bold if her wishes weren't so simple: She imagines playgrounds and community centers and political representation. But most of all, she sees respect for Anna Drive.

She balances two jobs, but she makes time for her community. She bends the ears of politicians. She organizes rallies encouraging her neighbors to register to vote and head to the polls. She plans events that she hopes will draw together a community that has grown accustomed to seeing itself as the backdrop of news cameras trying to highlight the city's ills.

And on this night, dozens gathered to pray a rosario in the tight courtyard outside her apartment, where the statue of the Virgin rested on an altar of roses and carnations.

As sirens echoed in the distance, the crowd stayed late into the night. They sang, they danced, they sipped cinnamon-spiced coffee.

And they prayed, petitioning the Virgin Mother for peace and for guidance.

"This is the community," Rojas said. "These are the people of Anna Drive."

::

Anna Drive, a collection of squat, modest apartment buildings, horseshoes off of a busy thoroughfare. On any given day, it pulses with life: children whipping down the sidewalk on scooters and skateboards, older boys tussling with one another and nanas and tatas watching it all unfold from chairs in their frontyards.

The street is clogged with cars and the vending truck that always seems to be parked along the same slice of curb, hawking snacks, produce and spices to the families who live on this stretch of tidy apartments and small, fenced-in lawns.

Rojas came to Anna Drive about a year ago, moving her family into the tight but comfortable apartment, its walls lined with family photographs. She was born in the Mexican state of Guanajuato, but she has lived much of her life in the flatlands of Anaheim. Her mother has lived in the same apartment, just a few blocks away, for decades.

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Fed Gets Chatty: Bernanke Will Answer Your Tweets

Chairmen of the Federal Reserve are expected to speak rarely and obliquely. Which is why it’s interesting to see Ben Bernanke taking Twitter questions for an hour and a half this afternoon.

In addition to answering questions that are labeled with the Twitter hashtag #fordschoolbernanke, the Fed chairman will take questions from the public in an auditorium on the University of Michigan’s Ann Arbor campus. His answers will be streamed live to the web. That’s a remarkable degree of openness for a man who had to apologize for briefly chatting with a financial reporter at a dinner event seven years ago. Needless to say, Bernanke is not a tweeter and has never answered questions on the microblogging network.

Prior to answering questions from the public, Bernanke will participate in an on-stage interview with the dean of the university’s public policy school, answering questions focused on “monetary policy, recovery from the global financial crisis, and long-term challenges facing the U.S. economy,” according to a university announcement. Questions from Twitter thus far are slightly more broad, touching on the platinum coin, inflation, Ron Paul, intergalactic capital flows, and whether the Fed chairman uses performance enhancing drugs.

The Bernanke event and livestream begin at 4 p.m. ET.

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Coroner releases new report on Natalie Wood death

LOS ANGELES (AP) — Some of the bruises found on Natalie Wood‘s body may have occurred before the actress drowned in the waters off Southern California more than 30 years ago, according to a newly released coroner’s report on one of Hollywood’s most mysterious deaths.

The case took another twist Monday when officials released a 10-page addendum to Wood’s 1981 autopsy that cites unexplained bruises and scratches on Wood’s face and arms as significant factors that led to officials changing her death certificate last year from a drowning to “drowning and other undetermined factors.”

Officials were careful about their conclusions because they lacked several pieces of evidence for their review.

Bruises on Wood’s arms, a scratch on her neck and superficial abrasions to the actress’ face may have occurred before Wood ended up in the waters off Catalina Island in November 1981, but coroner’s officials wrote they could not definitely determine when the injuries occurred.

The findings have not altered a sheriff’s department investigation into Wood’s death, which a spokesman described as ongoing.

Wood, 43, was on a yacht with her actor-husband Robert Wagner, co-star Christopher Walken and the boat captain on Thanksgiving weekend in 1981 before somehow ending up in the water. A dinghy that had been attached to the boat was found along the island’s shoreline, but investigators could not locate it to review it last year.

Investigators initially reported that it had no scratches on its hull, and Wood’s fingernails were not preserved for analysis.

Several of the original coroner’s investigators who worked on the case were re-interviewed, and officials attempted to test some items taken during the investigation into Wood’s death and an autopsy, but they could not be located.

“The location of the bruises, the multiplicity of the bruises, lack of head trauma, or facial bruising support bruising having occurred prior to entry in the water,” the report states. “Since there are unanswered questions and limited additional evidence available for evaluation, it is opined by this Medical Examiner that the manner of death should be left as undetermined,” Chief Medical Examiner Dr. Lakshmanan Sathyavagiswaran wrote in the report completed in June.

Officials also considered that Wood wasn’t wearing a life jacket and had no history of suicide attempts and didn’t leave a note as reasons to amend its report and the death certificate.

The report was released Monday after sheriff’s officials released a security hold.

Sheriff’s spokesman Steve Whitmore said the agency has known about the findings in the newly released autopsy report for several months and it does not change the status of the investigation, which remains open. He said Wagner is not considered a suspect in Wood’s death.

Wood, famed for roles in such films as “West Side Story” and “Rebel Without a Cause,” was nominated for three Academy Awards during her lifetime. Her death stunned the world and has remained one of Hollywood’s most enduring mysteries. The original detective on the case, Wagner and Walken have all said they considered her death an accident.

Conflicting versions of what happened on the yacht have contributed to the mystery of how the actress died. Wood, Wagner and Walken had all been drinking heavily in the hours before the actress disappeared.

The newly released report states there are conflicting statements about when the boat’s occupants discovered Wood was missing. The report estimates her time of death was around midnight, and she was reported missing at 1:30 a.m.

The renewed inquiry came after the boat’s captain, Dennis Davern, told “48 Hours Mystery” and the “Today” show that he heard Wagner and Wood arguing the night of her disappearance and believed Wagner was to blame for her death.

Wagner wrote in a 2008 memoir that he and Walken argued that night. He wrote that Walken went to bed and he stayed up for a while, but when he went to bed, he noticed that his wife and a dinghy attached to the yacht were missing.

___

Anthony McCartney can be reached at http://twitter.com/mccartneyAP

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Personal Best: Training Insights From Star Athletes

Of course elite athletes are naturally gifted. And of course they train hard and may have a phalanx of support staff — coaches, nutritionists, psychologists.

But they often have something else that gives them an edge: an insight, or even an epiphany, that vaults them from the middle of the pack to the podium.

I asked several star athletes about the single realization that made the difference for them. While every athlete’s tale is intensely personal, it turns out there are some common themes.

Stay Focused

Like many distance swimmers who spend endless hours in the pool, Natalie Coughlin, 30, used to daydream as she swam laps. She’d been a competitive swimmer for almost her entire life, and this was the way she — and many others — managed the boredom of practice.

But when she was in college, she realized that daydreaming was only a way to get in the miles; it was not allowing her to reach her potential. So she started to concentrate every moment of practice on what she was doing, staying focused and thinking about her technique.

“That’s when I really started improving,” she said. “The more I did it, the more success I had.”

In addition to her many victories, Ms. Coughlin won five medals in the 2008 Beijing Olympics, including a gold medal in the 100-meter backstroke.

Manage Your ‘Energy Pie’

In 1988, Steve Spence, then a 25-year-old self-coached distance runner, was admitted into the United States Long Distance Runner Olympic Development Program. It meant visiting David Martin, a physiologist at Georgia State University, several times a year for a battery of tests to measure Mr. Spence’s progress and to assess his diet.

During dinner at Dr. Martin’s favorite Chinese restaurant, he gave Mr. Spence some advice.

“There are always going to be runners who are faster than you,” he said. “There will always be runners more talented than you and runners who seem to be training harder than you. The key to beating them is to train harder and to learn how to most efficiently manage your energy pie.”

Energy pie? All the things that take time and energy — a job, hobbies, family, friends, and of course athletic training. “There is only so much room in the pie,” said Mr. Spence.

Dr. Martin’s advice was “a lecture on limiting distractions,” he added. “If I wanted to get to the next level, to be competitive on the world scene, I had to make running a priority.” So he quit graduate school and made running his profession. “I realized this is what I am doing for my job.”

It paid off. He came in third in the 1991 marathon world championships in Tokyo. He made the 2004 Olympic marathon team, coming in 12th in the race. Now he is head cross-country coach and assistant track coach at Shippensburg College in Pennsylvania. And he tells his teams to manage their energy pies.

Structure Your Training

Meredith Kessler was a natural athlete. In high school, she played field hockey and lacrosse. She was on the track team and the swimming team. She went to Syracuse University on a field hockey scholarship.

Then she began racing in Ironman triathlons, which require athletes to swim 2.4 miles, cycle 112 miles and then run a marathon (26.2 miles). Ms. Kessler loved it, but she was not winning any races. The former sports star was now in the middle of the pack.

But she also was working 60 hours a week at a San Francisco investment bank and trying to spend time with her husband and friends. Finally, six years ago, she asked Matt Dixon, a coach, if he could make her a better triathlete.

One thing that turned out to be crucial was to understand the principles of training. When she was coaching herself, Ms. Kessler did whatever she felt like, with no particular plan in mind. Mr. Dixon taught her that every workout has a purpose. One might focus on endurance, another on speed. And others, just as important, are for recovery.

“I had not won an Ironman until he put me on that structure,” said Ms. Kessler, 34. “That’s when I started winning.”

Another crucial change was to quit her job so she could devote herself to training. It took several years — she left banking only in April 2011 — but it made a huge difference. Now a professional athlete, with sponsors, she has won four Ironman championships and three 70.3 kilometer championships.

Ms. Kessler’s parents were mystified when she quit her job. She reminded them that they had always told her that it did not matter if she won. What mattered was that she did her best. She left the bank, she said, “to do my best.”

Take Risks

Helen Goodroad began competing as a figure skater when she was in fourth grade. Her dream was to be in the Olympics. She was athletic and graceful, but she did not really look like a figure skater. Ms. Goodroad grew to be 5 feet 11 inches.

“I was probably twice the size of any competitor,” she said. “I had to have custom-made skates starting when I was 10 years old.”

One day, when Helen was 17, a coach asked her to try a workout on an ergometer, a rowing machine. She was a natural — her power was phenomenal.

“He told me, ‘You could get a rowing scholarship to any school. You could go to the Olympics,’ ” said Ms. Goodroad. But that would mean giving up her dream, abandoning the sport she had devoted her life to and plunging into the unknown.

She decided to take the chance.

It was hard and she was terrified, but she got a rowing scholarship to Brown. In 1993, Ms. Goodroad was invited to train with the junior national team. Three years later, she made the under-23 national team, which won a world championship. (She rowed under her maiden name, Betancourt.)

It is so easy to stay in your comfort zone, Ms. Goodroad said. “But then you can get stale. You don’t go anywhere.” Leaving skating, leaving what she knew and loved, “helped me see that, ‘Wow, I could do a whole lot more than I ever thought I could.’ ”

Until this academic year, when she had a baby, Ms. Goodroad, who is 37, was a rowing coach at Princeton. She still runs to stay fit and plans to return to coaching.

The Other Guy Is Hurting Too

In 2006, when Brian Sell was racing in the United States Half Marathon Championships in Houston, he had a realization.

“I was neck-and-neck with two or three other guys with two miles to go,” he said. He started to doubt himself. What was he doing, struggling to keep up with men whose race times were better than his?

Suddenly, it came to him: Those other guys must be hurting as much as he was, or else they would not be staying with him — they would be pulling away.

“I made up my mind then to hang on, no matter what happened or how I was feeling,” said Mr. Sell. “Sure enough, in about half a mile, one guy dropped out and then another. I went on to win by 15 seconds or so, and every race since then, if a withering surge was thrown in, I made every effort to hang on to the guy surging.”

Mr. Sell made the 2008 Olympic marathon team and competed in the Beijing Olympics, where he came in 22nd. Now 33 years old, he is working as a scientist at Lancaster Laboratories in Pennsylvania.

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