In elf ears and wizard hats, 'Hobbit' fans rejoice

WELLINGTON, New Zealand (AP) — Wearing elf ears and wizard hats, sitting atop their dad's shoulders or peering from balconies, tens of thousands of New Zealanders watched their favorite "Hobbit" actors walk the red carpet Wednesday at the film trilogy's hometown premiere.

An Air New Zealand plane freshly painted with "Hobbit" characters flew low over Wellington's Embassy Theatre, eliciting roars of approval from the crowd.

Sam Rashidmardani, 12, said he came to see Gollum actor Andy Serkis walk the red carpet — and he wasn't disappointed.

"It was amazing," Rashidmardani said of the evening, adding his Gollum impression: "My precious."

British actor Martin Freeman, who brings comedic timing to the lead role of Bilbo Baggins, said he thought director Peter Jackson had done a fantastic job on "The Hobbit: An Unexpected Journey."

"He's done it again," Freeman said in an interview on the red carpet. "If it's possible, it's probably even better than 'The Lord of the Rings.' I think he's surpassed it."

While it is unusual for a city so far from Hollywood to host the premiere of a hoped-for blockbuster, Jackson's filming of his lauded 'LOTR' trilogy and now "The Hobbit" in New Zealand has helped create a film industry here. The film will open in theaters around the world next month.

One of the talking points of the film is the choice by Jackson to shoot it using 48 frames per second instead of the traditional 24 in hopes of improving the picture quality.

Some say the images come out too clear and look so realistic that they take away from the magic of the film medium. Jackson likens it to advancing from vinyl records to CDs.

"I really think 48 frames is pretty terrific and I'm looking forward to seeing the reaction," Jackson said on the red carpet. "It's been talked about for so long, but finally the film is being released and people can decide for themselves."

Jackson said it was strange working on the project so intimately for two years and then having it suddenly taken away as the world got to see the movie.

"It spins your head a little bit," he said.

Aidan Turner, who plays the dwarf Kili in the movie, said his character is reckless and thinks he's charming.

"I don't get to play real people it seems, I only get to play supernatural ones," he said. "So playing a dwarf didn't seem that weird, actually.

Perhaps the most well-known celebrities to walk the carpet were Cate Blanchett and Elijah Wood, who reprise their roles in the LOTR in the "Hobbit."

"Mostly I came here to see everyone. I like them all," said fan Aysu Shahin, 16, adding that Wood was her favorite. She said she wanted to see the movie "as soon as possible. I'm excited for it."

At a news conference earlier in the day, Jackson said many younger people are happy to watch movies on their iPads.

"We just have to make the cinema-going experience more magical and more spectacular to get people coming back to the movies again," he said.

Jackson said only about 1,000 of the 25,000 theaters that will show the film worldwide are equipped to show 48 frames, so most people will see it in the more traditional format. The movie has also been shot in 3D.

A handful of animal rights protesters held signs at the premiere.

The protest by the group People for the Ethical Treatment of Animals comes after several animal wranglers said three horses and up to two dozen other animals had died during the making of the movies because they were housed at an unsafe farm.

Jackson's spokesman earlier acknowledged two horses had died preventable deaths at the farms but said the production company worked quickly to improve stables and other facilities and that claims of mistreatment were unfounded.

"No mistreatment, no abuse. Absolutely none," Jackson said at the news conference.

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The New Old Age Blog: Doctor's Orders? Another Test

It is no longer news that Americans, and older Americans in particular, get more routine screening tests than they need, more than are useful. Prostate tests for men over 75, annual Pap smears for women over 65 and colonoscopies for anyone over 75 — all are overused, large-scale studies have shown.

Now it appears that many older patients are also subjected to too-frequent use of the other kind of testing, diagnostic tests.

The difference, in brief: Screening tests are performed on people who are asymptomatic, who aren’t complaining of a health problem, as a way to detect incipient disease. We have heard for years that it is best to “catch it early” — “it” frequently being cancer — and though that turns out to be only sometimes true, we and our doctors often ignore medical guidelines and ongoing campaigns to limit and target screening tests.

Diagnostic tests, on the other hand, are meant to help doctors evaluate some symptom or problem. “You’re trying to figure out what’s wrong,” explained Gilbert Welch, a veteran researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For these tests, medical groups and task forces offer many fewer guidelines on who should get them and how often — there is not much evidence to go on — but there is general agreement that they are not intended for routine surveillance.

But a study using a random 5 percent sample of Medicare beneficiaries — nearly 750,000 of them — suggests that often, that is what’s happening.

“It begins to look like some of these tests are being routinely repeated, and it’s worrisome,” said Dr. Welch, lead author of the study just published in The Archives of Internal Medicine. “Some physicians are just doing them every year.”

He is talking about tests like echocardiography, or a sonogram of the heart. More than a quarter of the sample (28.5 percent) underwent this test between 2004 and 2006, and more than half of those patients (55 percent) had a repeat echocardiogram within three years, most commonly within a year of the first.

Other common tests were frequently repeated as well. Of patients who underwent an imaging stress test, using a treadmill or stationery bike (or receiving a drug) to make the heart work harder, nearly 44 percent had a repeat test within three years. So did about half of those undergoing pulmonary function tests and chest tomography, a CAT scan of the chest.

Cytoscopy (a procedure in which a viewing tube is inserted into the bladder) was repeated for about 41 percent of the patients, and endoscopy (a swallowed tube enters the esophagus and stomach) for more than a third.

Is this too much testing? Without evidence of how much it harms or helps patients, it is hard to say — but the researchers were startled by the extent of repetition. “It’s inconceivable that it’s all important,” Dr. Welch said. “Unfortunately, it looks like it’s important for doctors.”

The evidence for that? The study revealed big geographic differences in diagnostic testing. Looking at the country’s 50 largest metropolitan areas, it found that nearly half the sample’s patients in Miami had an echocardiogram between 2004 and 2006, and two thirds of them had another echocardiogram within three years — the highest rate in the nation.

In fact, for the six tests the study included, five were performed and repeated most often in Florida cities: Miami, Jacksonville and Orlando. “They’re heavily populated by physicians and they have a long history of being at the top of the list” of areas that do a lot of medical procedures and hospitalizations, Dr. Welch said.

But in Portland, Ore., where “the physician culture is very different,” only 17.5 percent of patients had an echocardiogram. The places most prone to testing were also the places with high rates of repeat testing. Portland, San Francisco and Sacramento had the lowest rates.

We often don’t think of tests as having a downside, but they do. “This is the way whole cascades can start that are hard to stop,” Dr. Welch said. “The more we subject ourselves, the more likely some abnormality shows up that may require more testing, some of which has unwanted consequences.”

Properly used, of course, diagnostic tests can provide crucial information for sick people. “But used without a good indication, they can stir up a hornet’s nest,” he said. And of course they cost Medicare a bundle.

An accompanying commentary, sounding distinctly exasperated, pointed out that efforts to restrain overtesting and overtreatment have continued for decades. The commentary called it “discouraging to contemplate fresh evidence by Welch et al of our failure to curb waste of health care resources.”

It is hard for laypeople to know when tests make sense, but clearly we need to keep track of those we and our family members have. That way, if the cardiologist suggests another echocardiogram, we can at least ask a few pointed questions:

“My father just had one six months ago. Is it necessary to have another so soon? What information do you hope to gain that you didn’t have last time? Will the results change the way we manage his condition?”

Questions are always a good idea. Especially in Florida.

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

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Stocks decline as investors wait on 'cliff'

Stocks declined for a third day on Wall Street as investors waited for signs of progress on the “fiscal cliff.”

The Dow Jones industrial average fell 105 points to 12,772 just after 10 a.m. in New York. The Standard and Poor's 500 was down 13 points to 1,386. The Nasdaq Composite was off 29 points at 2,938.

Stocks declined Tuesday after Senate Majority Leader Harry Reid said he was frustrated by the lack of progress in budget talks. About $671 billion of tax increases and spending cuts will come into effect Jan. 1 if no deal is reached. Economists say the measures could eventually push the U.S. back into recession.

Concern that the U.S. will go over the “cliff” has weighed on stocks since the Nov. 6 elections returned a divided government to power with President Barack Obama returning to the White House and Republicans retaining control of the House.

In economic news Wednesday, U.S. sales of new homes dipped 0.3 percent in October though remain up 20.4 percent for the year, according to a government report. Stable home prices suggest the housing market is steadily recovering.

Investors will also look will also look to the Federal Reserve for indications about the strength of the economy. A Fed snapshot of business conditions around the nation, covering October through mid-November, will be published at 2 p.m.

The yield on the 10-year Treasury note fell 3 basis points to 1.61 percent.

Stocks making big moves:

— Chipmaker Analog Devices fell $1.03 to $39.09 after it said sales fell 3 percent in the third quarter due to weak economic conditions and global uncertainty.

— Costco, the wholesale club operator, gained $4.45 to $100.90 after the company said that it would pay a special dividend of $7 a share next month, in addition to the regular quarterly dividend it pays shareholders.

— Green Mountain Coffee Roasters surged $7.04 to $36.04 after the beleaguered coffee company reported fourth-quarter results and guidance that far exceeded the market's expectations.

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Former baseball union head Miller dead at 95

Marvin Miller, the union leader who created free agency for baseball players and revolutionized professional sports with multimillion dollar contracts, died Tuesday. He was 95.

Miller died at his home in Manhattan at 5:30 a.m., said his daughter Susan Miller. He had been diagnosed with liver cancer in August.

In his 16 years as executive director of the Major League Players Association, starting in 1966, Miller fought owners on many fronts, winning free agency for the players in December 1975. He may best be remembered, however, as the man who made the word "strike" stand for something other than a pitched ball.

Miller, who retired and became a consultant to the union in 1982, led the first walkout in the game's history 10 years earlier. On April 5, 1972, signs posted at major league parks simply said "No Game Today." The strike, which lasted 13 days, was to be followed by a walkout during spring training in 1976 and a midseason job action that darkened the stadiums for seven weeks in 1981.

Miller's ascension to the top echelon among sports labor leaders was by no means free from controversy among those he would represent. Players from the Los Angeles Dodgers, Atlanta Braves, California Angels and San Francisco Giants opposed his appointment as successor to Milwaukee Circuit Court Judge Robert Cannon, who had counseled them on a part-time but unpaid basis.

Miller overcame the opposition, however, due in part to his demeanor.

"Some of the player representatives were leery about picking a union man," Hall of Fame pitcher and U.S. Senator Jim Bunning, a member of the screening committee that recommended Miller, recalled in a 1974 interview. "But he was very articulate ... not the cigar-chewing type some of the guys expected."

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Audra McDonald new 'Live From Lincoln Center' host

LOS ANGELES (AP) — Broadway superstar Audra McDonald is adding a new chapter to her long history with Lincoln Center.

The singer-actress is the new host of "Live From Lincoln Center," PBS said Tuesday.

McDonald will emcee seven broadcasts from December through spring 2013, starting Dec. 13 with "The Richard Tucker Opera Gala" and Dec. 31 with the New York Philharmonic's New Year's Eve gala.

"It's a great honor. I'm thrilled that they came to me and trusted me to do it," said McDonald, 42, whose five Tony Awards include a trophy this year for "The Gershwins' Porgy and Bess."

Her memories of the Lincoln Center performing arts complex in Manhattan run deep.

"I remember watching Beverly Sills broadcasting from the Met (the center's Metropolitan Opera House) on my PBS channel at my home in Fresno," McDonald said, adding that she was amazed at the venue's size and "inspired by the music."

As a high school student, she had the chance to visit the center and recalled thinking, "This is where I want to be some day."

That wish was fulfilled when she moved to New York to attend The Juilliard School, which has its campus there.

Stepping in as host of the PBS series "feels like it's my way of thanking Lincoln Center," she said.

"We can't imagine a more perfect match," said Elizabeth Scott, the center's executive in charge of the TV series. McDonald's passion for the performing arts is "infectious," Scott added.

McDonald, who starred in "Private Practice" as Dr. Naomi Bennett, has performed on the long-running PBS showcase several times, including programs with Elvis Costello, Patti Lupone and the New York Philharmonic.

She will be working especially hard New Year's Eve when she hosts and performs in the holiday program, "One Singular Sensation: Celebrating Marvin Hamlisch" (check local listings for time).

"We'll see if I fall down by the end of the evening, or by the middle," she said, lightly. What she'll sing is a secret for now, but McDonald said it's among Hamlisch's most famous pieces.

The composer, who died in August at age 68, created more than 40 film scores and won a Tony and the Pulitzer for Broadway's "A Chorus Line."

"Live From Lincoln Center" is in its 37th broadcast season. In recent years, artists and actors including Yo-Yo Ma and Alec Baldwin have filled the host's job that previously saw long tenures by famed opera singer Sills and TV personality Hugh Downs.

___

Online:

http://www.pbs.org

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Clearing the Fog Around Personality Disorders

For years they have lived as orphans and outliers, a colony of misfit characters on their own island: the bizarre one and the needy one, the untrusting and the crooked, the grandiose and the cowardly.

Their customs and rituals are as captivating as any tribe’s, and at least as mystifying. Every mental anthropologist who has visited their world seems to walk away with a different story, a new model to explain those strange behaviors.

This weekend the Board of Trustees of the American Psychiatric Association will vote on whether to adopt a new diagnostic system for some of the most serious, and striking, syndromes in medicine: personality disorders.

Personality disorders occupy a troublesome niche in psychiatry. The 10 recognized syndromes are fairly well represented on the self-help shelves of bookstores and include such well-known types as narcissistic personality disorder, avoidant personality disorder, as well as dependent and histrionic personalities.

But when full-blown, the disorders are difficult to characterize and treat, and doctors seldom do careful evaluations, missing or downplaying behavior patterns that underlie problems like depression and anxiety in millions of people.

The new proposal — part of the psychiatric association’s effort of many years to update its influential diagnostic manual — is intended to clarify these diagnoses and better integrate them into clinical practice, to extend and improve treatment. But the effort has run into so much opposition that it will probably be relegated to the back of the manual, if it’s allowed in at all.

Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force updating the manual, would not speculate on which way the vote might go: “All I can say is that personality disorders were one of the first things we tackled, but that doesn’t make it the easiest.”

The entire exercise has forced psychiatrists to confront one of the field’s most elementary, yet still unresolved, questions: What, exactly, is a personality problem?

Habits of Thought

It wasn’t supposed to be this difficult.

Personality problems aren’t exactly new or hidden. They play out in Greek mythology, from Narcissus to the sadistic Ares. They percolate through biblical stories of madmen, compulsives and charismatics. They are writ large across the 20th century, with its rogues’ gallery of vainglorious, murderous dictators.

Yet it turns out that producing precise, lasting definitions of extreme behavior patterns is exhausting work. It took more than a decade of observing patients before the German psychiatrist Emil Kraepelin could draw a clear line between psychotic disorders, like schizophrenia, and mood problems, like depression or bipolar disorder.

Likewise, Freud spent years formulating his theories on the origins of neurotic syndromes. And Freudian analysts were largely the ones who, in the early decades of the last century, described people with the sort of “confounded identities” that are now considered personality disorders.

Their problems were not periodic symptoms, like moodiness or panic attacks, but issues rooted in longstanding habits of thought and feeling — in who they were.

“These therapists saw people coming into treatment who looked well put-together on the surface but on the couch became very disorganized, very impaired,” said Mark F. Lenzenweger, a professor of psychology at the State University of New York at Binghamton. “They had problems that were neither psychotic nor neurotic. They represented something else altogether.”

Several prototypes soon began to emerge. “A pedantic sense of order is typical of the compulsive character,” wrote the Freudian analyst Wilhelm Reich in his 1933 book, “Character Analysis,” a groundbreaking text. “In both big and small things, he lives his life according to a preconceived, irrevocable pattern.”

Others coalesced too, most recognizable as extreme forms of everyday types: the narcissist, with his fragile, grandiose self-approval; the dependent, with her smothering clinginess; the histrionic, always in the thick of some drama, desperate to be the center of attention.

In the late 1970s, Ted Millon, scientific director of the Institute for Advanced Studies in Personology and Psychopathology, pulled together the bulk of the work on personality disorders, most of it descriptive, and turned it into a set of 10 standardized types for the American Psychiatric Association’s third diagnostic manual. Published in 1980, it is a best seller among mental health workers worldwide.

These diagnostic criteria held up well for years and led to improved treatments for some people, like those with borderline personality disorder. Borderline is characterized by an extreme neediness and urges to harm oneself, often including thoughts of suicide. Many who seek help for depression also turn out to have borderline patterns, making their mood problems resistant to the usual therapies, like antidepressant drugs.

Today there are several approaches that can relieve borderline symptoms and one that, in numerous studies, has reduced hospitalizations and helped aid recovery: dialectical behavior therapy.

This progress notwithstanding, many in the field began to argue that the diagnostic catalog needed a rewrite. For one thing, some of the categories overlapped, and troubled people often got two or more personality diagnoses. “Personality Disorder-Not Otherwise Specified,” a catchall label meaning little more than “this person has problems” became the most common of the diagnoses.

It’s a murky area, and in recent years many therapists didn’t have the time or training to evaluate personality on top of everything else. The assessment interviews can last hours, and treatments for most of the disorders involve longer-term, specialized talk therapy.

Psychiatry was failing the sort of patients that no other field could possibly help, many experts said.

“The diagnoses simply weren’t being used very much, and there was a real need to make the whole system much more accessible,” Dr. Lenzenweger said.

Resisting Simplification 

It was easier said than done.

The most central, memorable, and knowable element of any person — personality — still defies any consensus.

A team of experts appointed by the psychiatric association has worked for more than five years to find some unifying system of diagnosis for personality problems.

The panel proposed a system based in part on a failure to “develop a coherent sense of self or identity.” Not good enough, some psychiatric theorists said.

Later, the experts tied elements of the disorders to distortions in basic traits.

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Stocks fail to get boost from consumer confidence

Investors took little comfort from the latest deal to deliver financial aid to Greece and increases in U.S. consumer confidence and orders for machinery and equipment.

The Dow Jones industrial average fell 54 points to 12,913 as of 10:30 a.m. Tuesday. The Standard & Poor's 500 was down five points at 1,401. The Nasdaq composite index fell eight points to 2,968 points.

ConAgra advanced after it agreed to buy Ralcorp for $5 billion, a deal that will make it the nation's biggest maker of private-label foods. Ralcorp surged $18.55 to $88.77. Corning Inc., a specialty glass maker, rose 76 cents to $12.32 after it said that North American television sales are stronger than expected in the fourth quarter, boosting demand for its products.

Investors were unmoved by two reports that suggested that outlook for the U.S. economy may be improving.

Consumer confidence rose this month to the highest level in almost five years, pushed up by steady improvement in hiring. The Conference Board's consumer confidence index rose to 73.7 in November from 73.1 in October. Both are the best readings since February 2008.

The government reported separately that U.S. companies increased their orders of machinery and equipment last month, a sign that business investment is rising. Orders for core capital goods rose 1.7 percent in October, the best showing since a 2.3 percent rise in May.

Stocks advanced in Europe after Greece's euro partners and the International Monetary Fund agreed to release funds the country needs to avoid imminent bankruptcy, as well as introduce a series of measures designed to reduce the country's massive debts to a more manageable level within a decade.

The Stoxx 50 index of leading European shares was up 0.4 percent to 2,542.93

The yield on the 10-year Treasury note was little changed at 1.66 percent.

Among other stocks making big moves:

— Airgas Inc., a specialty supplier of medical and industrial gases, fell $3.15 to $87.32 after disclosing that its chairman sold 1.2 million shares of the company's stock in a privately negotiated block trade.

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Sex, love, surrogacy and 'Sessions'

BERKELEY, Calif. — Cheryl Cohen Greene likes to spend weekends close to home with her husband, Bob, a former postal worker. Often, they go hiking in the Berkeley Hills that surround their neighborhood, or watch movies in the living room of their modest duplex.

At 68, Greene is trim for her age and says she'd lose 10 pounds if she didn't love food so much. She's a devoted grandmother who frequently visits with her two children and grandchildren.

No one would guess that more than 900 people have paid to have sex with her.

Greene has worked as a surrogate partner therapist for 40 years. During one-on-one sessions at her home, which doubles as an office, she uses sensual touch to guide those who struggle with sex and intimacy issues. She almost always removes her clothes. And — yes — she sleeps with her patients. In the bed, by the way, that she shares with her spouse.

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"For a long time, I didn't bring it up at cocktail parties," says Greene, who keeps hand-carved wooden statues of genitalia in the nooks and crannies of her home. A close look at her bookshelves reveals "The Guide to Getting It On" and hundreds of other sex-related titles, along with "Calorie Counting" and "The Big Book of Jewish Humor." A big Tupperware container labeled "Cheryl's Vitamins" rests on a coffee table.

"If people have an attitude about my job," she says, "I just feel sorry for them for not understanding that there's a difference between me and a prostitute."

Greene's career choice is getting newfound attention from "The Sessions," a movie based on the true story of Mark O'Brien, a journalist and poet paralyzed from the neck down. Greene, played in the film by Helen Hunt, was hired by the late O'Brien when he wanted to lose his virginity at age 38.

Not all of the attention is positive. Although some in the country's small community of sex surrogates are hopeful that "The Sessions" might inspire more people to join the profession, others say the movie does not accurately depict the career path and its therapeutic worth.

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"I would never get naked in my first session with someone like Cheryl's character does in the movie," says Shai Rotem, a 43-year-old male surrogate, who began his career in his native Israel and now practices in Los Angeles. "We have to get to know one another first and develop a safe rapport."

Greene is one of fewer than 40 practicing partner therapists in the U.S. certified by the International Professional Surrogates Assn., a governing body for the industry.

Two decades ago, there were hundreds of surrogates working in the U.S. after sex researchers William Masters and Virginia Johnson popularized the idea in their 1970 book "Human Sexual Inadequacy." With the rise of AIDS in the mid-1980s, many spouses of surrogates insisted their partners quit the profession.

"There's no law against it because the intent is not to exchange sex for money," says IPSA president Vena Blanchard. "These clients are paying tons of money to sit and talk and do breathing exercises and learn about their body. So much of the work has nothing to do with intercourse or arousal."

Greene, who speaks with a thick Boston accent, was born in Salem, Mass., grew up Catholic and converted to Judaism after marrying her first husband, Michael Cohen. She and Cohen had an open marriage, which in the 1970s wasn't unusual among their Bay Area peers. She also worked as a nude art model and walked around her home naked, even with her children in the room.

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She first considered becoming a surrogate after a friend handed her a copy of the pseudonymous "Surrogate Wife: The Story of a Masters & Johnson Sexual Therapist and the Nine Cases She Treated." The friend told her, "I think you would be good at this work."

She learned to practice conjoint therapy — where two or more people work through issues together — from two therapists who trained with Masters and Johnson. Soon, she began answering calls for the San Francisco Sex Information hotline, and discovered how much she liked helping people with their sex-related questions.

"I wasn't even thinking about the fact that I'd be sleeping with strangers," she says of her decision to become a surrogate. "I just liked the idea of guiding people to be more relaxed about their sexuality."

Greene sits in her bedroom as she talks, and through the window's plantation shutters, her son's home is visible. He and his family live behind Greene's residence.

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Rolling Stones storm London; New York next

LONDON (AP) — The verdict is in: The Rolling Stones are back. They may look old, but they still sound young.

That was the consensus Monday as Britain's rock critics responded to the Stones 50th anniversary bash Sunday night, the first of five shows to commemorate their half century of rhythm and blues-tinged rock. It was the band's first London performance in five years, and their own advancing years had led some to be skeptical that they could still perform at the highest level.

They were led by the seemingly ageless Mick Jagger, whose strutting style has not been dimmed, and backed by brilliant guitarists Keith Richards and Ronnie Wood and the energetic drumming of Charlie Watts, who is now past 70 but shows no sign of slowing down. There was a stunning guest appearance by former Stone Mick Taylor, who stole the show during a searing performance of "Midnight Rambler" and a brief visit from former bassist Bill Wyman.

The Daily Mail's Jan Moir said the Stones had somehow beaten the aging process: "You might imagine that they had been worn down by life, by wives, by arthritis, by scandals old and new, by drugs, but no — they seemed indestructible." She said their swampy, gritty sound remains unique after half a century.

Daily Telegraph reviewer Neil McCormick said the band exceeded all expectations. He described the weaving of the guitarists, mixed with Jagger's blues harmonica, as a wonder.

"When looking for the secret of the Stones, it is perhaps that they actually listen to each other while they play, and almost lose themselves in it, while their brilliant frontman keeps it all together," he wrote.

Ebullient fans agreed with this assessment, as did the Guardian newspaper, which gave the performance four out of five stars.

Jagger, in skin-tight black pants, a sparkly tie and a matching checked jacket and hat, took time out from singing to thank the crowd for its loyalty.

"It's amazing that we're still doing this, and it's amazing that you're still buying our records and coming to our shows," he said. "Thank you, thank you, thank you."

Lead guitarist Keith Richards, whose survival has surprised many who thought he would succumb to drugs and drink, was blunter: "We made it," he said. "I'm happy to see you. I'm happy to see anybody."

But the band's fiery music was no joke, fuelled by strong guest appearances by Taylor, and Mary J. Blige, who shook the house in a duet with Jagger on "Gimme Shelter," and Jeff Beck.

The 50th anniversary show, which will be followed by one more in London, then three in the greater New York area, lacked some of the band's customary bravado — the "world's greatest rock 'n' roll band" intro was shelved — and there were some rare nostalgic touches.

The concert began with some early Stones' numbers rarely heard in concert, including the band's cover of the Lennon-McCartney rocker "I Wanna Be Your Man" and a cover of "It's All Over Now," written by Bobby Womack and Shirley Womack.

They didn't shy away from their darker numbers, including "Paint It Black" and "Sympathy for the Devil" — Jagger started that one wearing a slightly silly black, purple-lined faux fur cape that conjured up his late '60s satanic image.

He even cracked a joke about one of the band's low points, telling the audience it was in for a treat: "We're going to play the entire "Their Satanic Majesty's Request" album now," he said, referring to one of the band's least-loved efforts, a psychedelic travesty that has been largely, mercifully, forgotten.

He didn't make good on his threat.

Jagger seemed more mellow than usual, chatting a bit about the good old days and asking if there was anyone in the crowd who had seen them in 1962, when they first took to the stage.

He said 2012 had been a terrific year for Britain and that the Stones nearly missed the boat, playing no role in the celebration of the Queen's Diamond Jubilee, the London Olympics, or the new James Bond film.

"We just got in under the wire," he said. "We feel pretty good."

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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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