Recipes for Health: Spinach and Turkey Salad — Recipes for Health

Andrew Scrivani for The New York Times

Turkey or chicken transforms this classic spinach salad (minus the bacon) into a light main dish, welcome after Thanksgiving and before the rest of the holiday season feasting begins.

2 cups (12 ounces) shredded cooked turkey, chicken breast or chicken breast tenders

1 6-ounce bag baby spinach

6 white or cremini mushrooms, thinly sliced

1 cup cooked wild rice

2 tablespoons chopped walnuts

1 to 2 hard boiled eggs (to taste), finely chopped (optional)

2 tablespoons chopped chives

1 to 2 tablespoons chopped fresh herbs such as parsley, tarragon or marjoram

For the dressing:

2 tablespoons fresh lemon juice

1 tablespoon red wine vinegar, tarragon vinegar or sherry vinegar

1 teaspoon Dijon mustard

Salt and freshly ground pepper

1 small garlic clove, pureed

1/3 cup extra virgin olive oil

2 tablespoons plain low-fat yogurt

1. Combine all of the salad ingredients in a large salad bowl. Whisk together the lemon juice, vinegar, Dijon mustard, salt, pepper, garlic, olive oil and yogurt. Toss with the salad just before serving.

Yield: Serves 4 as a main dish

Advance preparation: The salad can be assembled and the dressing mixed several hours before serving. Refrigerate and toss together when ready to serve.

Variation: Add 1 ripe but firm persimmon, peeled, cored and sliced, to the mixture.

Nutritional information per serving: 375 calories; 25 grams fat; 4 grams saturated fat; 5 grams polyunsaturated fat; 15 grams monounsaturated fat; 53 milligrams cholesterol; 14 grams carbohydrates; 2 grams dietary fiber; 119 milligrams sodium (does not include salt to taste); 26 grams protein

Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”

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Grim recovery forecast for U.S., global economies

WASHINGTON — In a grim new forecast, a leading international economic group sharply cut its outlook for U.S. and global growth next year and warned that the debt crisis in Europe and fiscal policy risks in America could plunge the world back into recession.

As it stands now, the industrialized world is looking at a muted and uneven recovery over the next two years, according to the Organization for Economic Cooperation and Development.

The Paris-based OECD projected gross domestic product across its 34 member nations — which include the U.S., Japan and the 17-nation Eurozone — to grow a sluggish 1.4% next year. That is down from 2.2% that the group had forecasted six months earlier.

Growth prospects in the U.S. also were slashed for next year. Experts at the OECD now see inflation-adjusted GDP, the broadest measure of economic activity, rising 2% next year in the U.S., roughly equivalent to this year and down from its earlier forecast of an increase of 2.6%.

The new projections are all the more sobering in that they are based on assumptions that Europe's debt crisis won't get much worse and that the U.S. won't go over the so-called fiscal cliff — a combination of more than $500 billion in automatic tax hikes and federal spending cuts slated to begin at the start of next year.

Quiz: How much do you know about the 'fiscal cliff'?

"If key adverse risks cannot be averted, and especially if the Eurozone crisis were to intensify significantly, the likely outcome would be considerably weaker, potentially plunging the global economy into deep recession and deflation, with large additional rises in unemployment," the OECD said.

The report, released Tuesday, is on the pessimistic side.

Although economists widely agree on the recession risks in the event that the U.S. isn't able to solve the fiscal impasse, a number of experts now say that the U.S. and global economies could see considerably stronger growth next year if Washington can reach agreement on tax and spending policies that avoid a big fiscal contraction in 2013.

"The economy in the U.S. is really poised to grow," said Bernard Baumohl, chief global economist at the Economic Outlook Group, noting that GDP growth in the U.S. could surge to a solid 3.5% or higher next year if the budget issues are resolved.

The latest forecast from the Federal Reserve, compiled in mid-September, sees U.S. GDP increasing 2.5% to 3% next year.

Baumohl's reasons for greater optimism include a recovering housing market, improving job growth and healthier personal finances, all of which should help drive stronger consumer spending.

Total consumer debt, which has fallen for four years, dropped by $74 billion to $11.31 trillion in the third quarter from the previous quarter, and it is now down $1.37 trillion from the peak in September 2008, according to a report Tuesday from the New York Fed.

Reflecting these trends, the Conference Board said Tuesday that its latest survey showed consumer confidence at its highest level since early 2008, results similar to a survey by the University of Michigan.

American business sentiments, however, have been more cautious of late, and many companies have held back on making investments in recent months. But banks are generally in good shape, and big companies are sitting on mountains of cash and are expected to ramp up investments once the fiscal and tax pictures become clearer.

The OECD report nodded to these factors, but noted that the global recovery slowed markedly over the last year amid faltering confidence and weakening world trade, in part because of problems in the Eurozone, which contributed to an unexpectedly strong slowdown in developing countries such as China.

The 17-nation Eurozone will probably remain in recession well into next year, the OECD said.

Meanwhile, Japan, the world's third-largest economy, has fallen back into a downturn after a growth spurt last year aided by massive reconstruction spending following the earthquake and tsunami in March 2011. The Japanese economy is expected to move at a lumbering pace over the next two years.

The outlook for China, Brazil and India — three of the biggest developing economies, none of which is a member of the OECD — looks comparatively brighter:  Growth will probably accelerate next year and in 2014, with China, the world's second-largest economy, again leading the pack.

The OECD forecast sees China's GDP expanding 8.5% next year and nearly 9% in 2014 after slowing this year to about 7.5%.

Although far from immune from the troubles in the U.S. and Europe, which still account for much of the global demand for goods, China and other major emerging economies have more wherewithal to boost growth than their more-indebted developed counterparts by ramping up government spending and lowering interest rates.

The report notes that spending cuts throughout OECD member countries have taken a toll on economic growth, particularly in the Eurozone, where GDP growth for next year was slashed to -0.1% from a positive rate of 0.9%.

Many developed countries are now struggling with financial and economic challenges related to an aging population, large public debts and high unemployment.

Assuming Europe's debt crisis stabilizes, the Eurozone is forecast to recover in 2014. For OECD countries overall, GDP growth is projected to pick up in 2014 to 2.3%.

The U.S. economy is expected to outperform most other OECD nations in 2014, with its GDP stepping up to a more sturdy growth of 2.8%. That compares with the Fed's forecast of 3% to 3.8% growth in 2014.

Either way, U.S. economic growth isn't likely to come close to keeping up with the rapid advance of developing countries, notably China.

Last year, the U.S. accounted for 23% of the global economy, with the Eurozone and China tied for second, each with a 17% share each.

But by 2030, the OECD estimates, China's share of the global economy will rise to 28%, while the U.S. will slip to No. 2 with 18% of world GDP, and the Eurozone's share will fall to 12%.

don.lee@latimes.com

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Gunfire at gang funeral: 'It s broad daylight,' says stunned neighbor

Rev. Corey Brooks talks about shooting after a funeral in Chicago on Monday, November 26, 2012. (Scott Strazzante, Chicago Tribune)

Shots rang out, causing panic and chaos as hundreds of mourners were leaving a Catholic church on the South Side following funeral services Monday for a slain reputed gang member.

As people scattered for exits, a woman knocked Deborah Echols-Moore, 59, to the floor and fell atop her. Her shoes were thrown off her feet. When she stood back up, she fled barefoot out a door.

“When I came outside, you still can hear shooting. Boom! Boom! Boom! I still ran…people was running behind me,” the longtime CTA employee said not long after the 12:30 p.m. shooting. “You didn’t know which way to go or what to do. All I knew to do was run for my life.”

Chicago police said one man was killed, another critically injured in the bloodshed at St. Columbanus Church. Police identified both as Gangster Disciples members and convicted felons, illustrating once again the high risks of gang membership in a year in which rising homicides have brought Chicago unwanted national attention.

GDs alone make up more than a quarter of the city’s approximately 470 homicide victims. About 60 percent of this year’s homicide victims were gang members, according to department statistics.

Police were still investigating who was responsible for the shooting, but investigators said the neighborhood has long been rife with conflict between GDs and rival Black Disciples.

Illustrating the sudden, often unpredictable nature of the violence, police Superintendent Garry McCarthy just a couple of hours earlier was touting the department’s crime-fighting strategies in tamping down the city’s rate of violence since earlier in the year when homicides soared. Through Sunday, homicides have risen more than 19 percent over the same period a year earlier, department records show.

There were five fewer homicides during the first 25 days of November compared to the same period in 2011, according to department statistics. But shootings during the first 25 days of this month have risen sharply by 45 percent.

From November 1 through Sunday there were 161 shootings compared to 111 during the same period in 2011, department statistics show.

Rev. Corey Brooks, a well-known South Side pastor who officiated at Monday’s services for James Holman, 32, said a church would have been off-limits for gangbangers at one time.

“Now we are living at a day and time where these younger criminals have no regard for life or for street rules,” he said.

Holman, identified by police as a gang member, was gunned down last week at an apartment building in the Washington Park neighborhood.

The shooting took place just outside St. Columbanus, the same church where gangster Al Capone’s wife and mother attended mass daily more than half a century ago.

A Cook County Medical Examiner's spokesman identified one of the two victims as Sherman Miller, 21, and said he was pronounced dead at Stroger Hospital. A 26-year-old man was shot in the back and listed as in “extremely critical condition,” a hospital spokesman said.

Miller, who is also identified in court records as William Miller, was on parole for being in possession of a stolen vehicle and escaping from police custody, according to the Illinois Department of Corrections Web site.

The surviving victim has a 2004 felony weapons conviction in his criminal background, court records show.

Police said two guns were recovered, one down the block from the church at East 71st Street and South Prairie Avenue and another on one of the victims.

About a dozen bullet casings littered the steps outside the church where yellow evidence markers were placed. Beat cops blocked off traffic with their squad cars and sealed off the church’s entrance with yellow and red tape. As evidence technicians took photos of the crime scene, detectives went door-to-door to nearby homes scouring for witnesses.

April Smith, 30, said she looked out a second-floor window of her home when she heard her car alarm sound off and noticed a man wearing a black hooded sweatshirt and blue jeans walking toward the church entrance on 71st Street. She then heard about a dozen gunshots and saw two passersby crouch for protection.

Moments later, the same man in the sweatshirt ran back onto Prairie and fled south, said Smith. Mourners then frantically exited the church.

“To know that something like that happened right across the street...it’s terrible,” Smith, who has lived at her home for seven years, said in disbelief. “It’s broad daylight.”

Brooks, who is pastor of New Beginnings Church of Chicago in the Woodlawn neighborhood and is considering a run for former U.S. Rep. Jesse Jackson Jr.’s vacant congressional seat, said about 500 people attended the funeral, including about 50 children. The church was so crowded that people were standing in the back.

Brooks had finished the eulogy and Holman’s family and close friends had gone out the front door of the church when shots rang out.

“That's when all the gunfire broke out and it was just crazy,” Brooks said. “People were hollering and screaming and kids running everywhere.”

Charles Childs, a co-owner of the A.A. Rayner and Sons Funeral Home across the street from the church, held an uneventful visitation for Holman on Sunday. On Monday he said he saw the gunman firing his weapon as he came down the front steps outside the church.

“No place is safe,” he said. “It’s just despicable.”

Tribune reporter Naomi Nix contributed to this story.

jgorner@tribune.com
lford@tribune.com
csadovi@tribune.com

Twitter: @ChicagoBreaking

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HTC confirms 5-inch ‘Deluxe’ smartphone won’t launch in Europe

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Halle Berry’s ex claims he was victim in Thanksgiving brawl

LOS ANGELES (Reuters) – Halle Berry‘s ex-boyfriend Gabriel Aubry on Monday won a restraining order against the actress’s current lover, as the two men fought in the Los Angeles courts over who started their Thanksgiving Day brawl.

Releasing photos of himself with a black eye and cuts to his face, Aubry claimed that he was the victim in the November 22 punch-up with Berry’s fiancé, French actor Olivier Martinez, in the driveway of her Los Angeles house.

“I suffered numerous injuries as a result of the attack, including a fractured rib, multiple bruises on my face and a number of cuts which required stitches,” Aubry said in court papers, alleging that Martinez had threatened the day before to kill him.

“It all happened so fast and so suddenly; I did not see Mr Martinez’s actions coming and thus I was not ready for it and was not able to defend myself,” Aubry wrote.

Aubry, Martinez, and the Oscar-winning “Monster’s Ball” actress have been embroiled for months in a custody fight over Berry’s 4-year-old daughter, Nahla. Berry wants to take the daughter she had with Aubry to live with her and Martinez in France, but a Los Angeles judge denied that request earlier in November.

Aubry claimed in his request for a restraining order on Monday that Martinez told him, “You cost us $ 3 million,” while the French actor punched and kicked him on November 22.

Aubry, a Canadian model, was arrested last week for battery after the fist fight, and ordered to stay away from Berry, the child, and Martinez.

Neither man has been yet been formally charged in the case.

(Reporting by Jill Serjeant; Editing by Jackie Frank)

Celebrity News Headlines – Yahoo! News

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The New Old Age Blog: New Efforts to Close Hospitals' Revolving Doors

In the past, the only thing a patient was sure to get after a hospital stay was a bill. But as Medicare cracks down on high readmission rates, hospitals are dispatching nurses, transportation, culturally specific diet tips, free medications and even bathroom scales to patients deemed at risk of relapsing.

Robert Wood Johnson University Hospital in New Brunswick, N.J., has nurses visit high-risk patients at their home within two days of leaving the hosital. Teresa De Peralta, a nurse practitioner who runs the program, said they frequently find that patients don’t realize a drug they were prescribed in the hospital does the same thing as one they have already been taking.

“When medications are changed, they don’t want to throw things out, they think it’s a waste,” Ms. De Peralta said. “We actually go through the cupboards and painstakingly write out in big letters what they should be taking during the day.”

Many hospital officials say their efforts to keep patients healthy after discharge have been spurred by new financial penalties Medicare started imposing in October on places with too many readmissions. Increasingly, hospitals are no longer leaving to patients the responsibility for setting up follow-up appointments or filling new prescriptions.

And hospitals are not assuming that personnel in nursing homes and other facilities know how to properly care for their patients and follow the hospital discharge instructions.

Patients taking the wrong dose or mixing medicines that react badly often end up back in the hospital. A survey of 377 elderly patients at Yale-New Haven Hospital, published this year in The Journal of General Internal Medicine, discovered that 81 percent of the patients either didn’t understand what all their prescriptions were for; were prescribed the wrong drug or the wrong dose; were taken off a drug they needed, or never picked up a new prescription.

Dr. Leora Horwitz, the study’s leader, said patients who were called a week after their discharge and were asked what changes to their medication they were supposed to make “overwhelmingly” couldn’t tell them.

A big part of reducing readmissions is making sure that patients understand early warning signs that their health is deteriorating. Sun Health Care Transitions, a foundation-supported program in Sun City, Ariz., gives scales to some patients with congestive heart failure because small weight gains indicate they are retaining water, a sign that their heart isn’t pumping adequately.

“We have them keep a log,” said Jennifer Drago, a Sun Health vice president. “We want them to be looking for a two-pound daily weight gain, or five pounds over the week.”

Patients whose weight creeps up are quickly sent back to their doctor. Debra Richards, director of case management at Banner Del E. Webb Medical Center, one of the hospitals Sun Health is assisting, said, “That program has helped us quite a bit.”

Shady Grove Adventist Hospital in Rockville, Md., has started taking patients’ cultural backgrounds into consideration when doling out advice about maintaining their health. For example, the hospital encourages Salvadoran patients to substitute olive oils for the palm oils their cuisine traditionally calls for, to roast or bake meat instead of frying it and to use sugar substitutes when making horchata, a popular Central American drink.

When Hackensack University Medical Center sent staff members to teach caregivers how to take care of their patients, one place “didn’t even know what a low-salt diet was,” even though that’s a critical part of keeping heart failure patients from retaining fluids, said Dr. Charles Riccobono, chief quality and safety officer at the New Jersey hospital.

Aurora Health Care, a Milwaukee-based health system, now places its own nurse practitioners in several nursing homes to watch over Aurora’s discharged patients. Aurora says readmission rates of those patients have decreased, in some months by as much as half.

Dr. Eric Coleman, a Denver geriatrician whose ideas on reducing readmissions have been adopted by a number of hospitals and Medicare, said that while some hospital changes are “exciting and new,” others are “relabeling old wine in new bottles.”

“Yesterday we had ‘discharge planning’ and today we have a ‘rapid response transition team,’ and content-wise they’re doing the same thing,” Dr. Coleman said. “But it’s a nice thing to report out to the board of trustees.”

Jordan Rau is a reporter for Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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Holiday sales continue to soar on Cyber Monday

Web shopping soared on Cyber Monday, continuing a strong start to the holiday season.

Online sales were up 26.6 percent from last year by Monday evening, according to IBM Digital Analytics Benchmark, which tracks data from 500 retail sites. ComScore meanwhile, expected online sales to hit a record of about $1.5 billion by day's end.

Cyber Monday has become the biggest online shopping day in recent years as employees head back to the office but continue to cybershop for holiday gifts. The growth of smartphones and tablets has only increased that ability, an opportunity Web retailers have been eager to exploit.

This year, retailers aggressively pushed "Pre-Black Friday" promotions and flooded consumers with emails touting good deals in the days before Thanksgiving. As a result, the big shopping days of Thanksgiving, Black Friday and Cyber Monday have blurred into a sale-laden week.

Some retail analysts had worried that strong online sales growth on Thanksgiving Day and Black Friday would entice shoppers to buy earlier, threatening revenue later in the season.

"So far, that is not the case," said Jay Henderson, the strategy director for IBM Smarter Commerce. "Extending the shopping season has really just fueled additional online spending rather than cannibalizing days later in the season."

Sales across Amazon.com, the largest online retailer, had risen 52 percent from the previous year by midmorning Monday, according to ChannelAdvisor, which offers services to third-party sellers on e-commerce sites. Meanwhile, eBay sales volume increased 57 percent, the firm said.

The average online order size on Cyber Monday was $130.30. That was down from almost $200 during the whole of Cyber Monday last year, according to IBM.

But Monday's discounts on the websites of bricks -and-mortar retailers weren't necessarily as broad or as deep as consumers could find if they shopped in the days before, according to Michael Brim, founder of deal site BFAds.net. "We're not seeing across the board the lowest prices like we do on Black Friday or Thanksgiving," he said. "It's better than the average weekly sales, but it's not on the level of Black Friday … yet," he said.

Most retailers — about 97 percent — were expected to offer Cyber Monday deals this year, up from 90 percent last year, according to the National Retail Federation. That means good deals were there for the finding on sites that might not normally have sales, Brim said.

Laptops and apparel at specialty sites were popular items Monday, Brim said.

Amazon offered $30 off its 7-inch Kindle Fire tablet, which usually sells for $159. The deal was available only on Cyber Monday.

Hoffman Estates-based retailer Sears said it found that a number of its shoppers opted to buy online and pick up merchandise in the store, according to spokesman Tom Aiello, who declined to say whether online traffic increased Monday. Shoppers want "to save on shipping, or they want to touch it — and get it the same day and make sure they've got that gift in their hands," he said.

Tribune news services contributed.

crshropshire@tribune.com

Twitter @corilyns

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Pfleger points police to suspect in fatal stabbing

During an argument with his wife Wednesday, Demetrius Jackson allegedly stabbed to death a 55-year-old man who intervened, then called St. Sabina Catholic Church to pray with the Rev. Michael Pfleger.

Shortly after a Cook County judge ordered Jackson, 32, held without bond on Sunday on a charge of first-degree murder, Pfleger, reached by phone, recounted the conversation he had with Jackson on Friday, a day before he turned himself in.

"He told me the guy who he allegedly stabbed is his best friend," Pfleger said. "He said (the victim) punched him in the face. He told me he just reacted. He asked me to pray with him, and I prayed with him."

Jackson, who lives in Chicago's Roseland neighborhood, hung his head in Cook County Bond Court as a judge said he faced a murder charge in the death of William Terry of the 10300 block of South Forest Avenue.

Jackson and his wife were arguing in their home, also in the 10300 block of South Forest, Wednesday night when he allegedly grabbed a knife and threatened to kill her, prosecutors said. The wife fled to Terry's home and called 911, prosecutors said.

Before police arrived, Jackson's wife and Terry decided to walk back to Jackson's home. Still holding a knife, Jackson confronted the two outside and continued to berate his wife, authorities said. Terry stepped between them, "trying to calm" the defendant, Assistant State's Attorney Brad Dickey said. Terry fell to the ground, and Jackson leapt on top of him, stabbing him multiple times in front of several witnesses, authorities said.

"Terry was able to stagger to his home," Dickey said. Gasping for breath, he collapsed on his front porch. He was taken to Advocate Christ Medical Center in Oak Lawn shortly after 8 p.m. and pronounced dead, according to police. Other county officials said Terry lived in Riverdale.

Jackson, who appears to have no criminal record, worked with St. Sabina on the Safe Passage project, public defender Stephen Herczeg said. A Chicago Public Schools program, Safe Passage employs community members to help improve safety by standing guard along the routes children travel to schools.

When the two spoke, Pfleger encouraged Jackson to turn himself in to police.

"I told him, 'I'm not a court or a lawyer or a judge,'" Pfleger said. "I told him I wouldn't judge him. I just encouraged him to turn himself in and not run. A lot of times, people are afraid to go to the police directly. I said I would try to set it up."

When Jackson agreed, Pfleger said he called police at the Gresham District, telling them of Jackson's intentions.

As promised, Jackson showed up at a police station Friday morning and gave a video-taped confession, according to court documents.

"Thank God it worked," said Pfleger. "It's very sad. I feel bad about the man who got killed, too. It's a loss of two lives."

efmeyer@tribune.com

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Jose Luis Borau, Spanish Filmmaker, dies at 83

LOS ANGELES (TheWrap.com) – Influential Spanish filmmaker Jose Luis Borau died Friday in Madrid, the Spanish Academy of Cinematographic Arts and Sciences said. He was 83.

Borau had reportedly been suffering from throat cancer.

Though Borau, who was born in Zaragoza in 1929, only made a handful of films since his 1960 directorial debut “En el Rio,” his talents were widely respected, and he received a Goya award for Best Director in 2000 for his final film, “Leo.”

Borau was also a screenwriter and producer, and acted in some of his films. According to the Academy, his other pursuits included editing the first published biography of director-producer Samuel Bronston and short-story writing. He also “dabbled in advertising,” the Academy said.

Borau was probably best known for his 1975 drama “Furtivos” (“Poachers”), a film whose success, he later said, made him “a little sad.”

“Nobody is bitter sweet, but I’m a little sad,” the filmmaker once said. “My scale is a bit like what happened to Orson Welles, who made great films after ‘Citizen Kane,’ but just remember that title. “

Movies News Headlines – Yahoo! News

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Agency Investigates Deaths and Injuries Associated With Bed Rails

Thomas Patterson for The New York Times

Gloria Black’s mother died in her bed at a care facility.

In November 2006, when Clara Marshall began suffering from the effects of dementia, her family moved her into the Waterford at Fairway Village, an assisted living home in Vancouver, Wash. The facility offered round-the-clock care for Ms. Marshall, who had wandered away from home several times. Her husband Dan, 80 years old at the time, felt he could no longer care for her alone.

Thomas Patterson for The New York Times

Gloria Black, visiting her mother’s grave in Portland, Ore. She has documented hundreds of deaths associated with bed rails and said families should be informed of their possible risks.

But just five months into her stay, Ms. Marshall, 81, was found dead in her room apparently strangled after getting her neck caught in side rails used to prevent her from rolling out of bed.

After Ms. Marshall’s death, her daughter Gloria Black, who lives in Portland, Ore., began writing to the Consumer Product Safety Commission and the Food and Drug Administration. What she discovered was that both agencies had known for more than a decade about deaths from bed rails but had done little to crack down on the companies that make them. Ms. Black conducted her own research and exchanged letters with local and state officials. Finally, a letter she wrote in 2010 to the federal consumer safety commission helped prompt a review of bed rail deaths.

Ms. Black applauds the decision to study the issue. “But I wish it was done years ago,” she said. “Maybe my mother would still be alive.” Now the government is studying a problem it has known about for years.

Data compiled by the consumer agency from death certificates and hospital emergency room visits from 2003 through May 2012 shows that 150 mostly older adults died after they became trapped in bed rails. Over nearly the same time period, 36,000 mostly older adults — about 4,000 a year — were treated in emergency rooms with bed rail injuries. Officials at the F.D.A. and the commission said the data probably understated the problem since bed rails are not always listed as a cause of death by nursing homes and coroners, or as a cause of injury by emergency room doctors.

Experts who have studied the deaths say they are avoidable. While the F.D.A. issued safety warnings about the devices in 1995, it shied away from requiring manufacturers to put safety labels on them because of industry resistance and because the mood in Congress then was for less regulation. Instead only “voluntary guidelines” were adopted in 2006.

More warnings are needed, experts say, but there is a technical question over which regulator is responsible for some bed rails. Are they medical devices under the purview of the F.D.A., or are they consumer products regulated by the commission?

“This is an entirely preventable problem,” said Dr. Steven Miles, a professor at the Center for Bioethics at the University of Minnesota, who first alerted federal regulators to deaths involving bed rails in 1995. The government at the time declined to recall any bed rails and opted instead for a safety alert to nursing homes and home health care agencies.

Forcing the industry to improve designs and replace older models could have potentially cost bed rail makers and health care facilities hundreds of million of dollars, said Larry Kessler, a former F.D.A. official who headed its medical device office. “Quite frankly, none of the bed rails in use at that time would have passed the suggested design standards in the guidelines if we had made them mandatory,” he said. No analysis has been done to determine how much it would cost the manufacturers to reduce the hazards.

Bed rails are metal bars used on hospital beds and in home care to assist patients in pulling themselves up or helping them out of bed. They can also prevent people from rolling out of bed. But sometimes patients — particularly those suffering from Alzheimer’s — can get confused and trapped between a bed rail and a mattress, which can lead to serious injury or even death.

While the use of the devices by hospitals and nursing homes has declined as professional caregivers have grown aware of the dangers, experts say dozens of older adults continue to die each year as more rails are used in home care and many health care facilities continue to use older rail models.

Since those first warnings in 1995, about 550 bed rail-related deaths have occurred, a review by The New York Times of F.D.A. data, lawsuits, state nursing home inspection reports and interviews, found. Last year alone, the F.D.A. data shows, 27 people died.

As deaths continued after the F.D.A. warning, a working group put together in 1999 and made up of medical device makers, researchers, patient advocates and F.D.A. officials considered requiring bed rail makers to add warning labels.

But the F.D.A. decided against it after manufacturers resisted, citing legal issues. The agency said added cost to small manufacturers and difficulties of getting regulations through layers of government approval, were factors against tougher standards, according to a meeting log of the group in 2000 and interviews.

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