Beta Blockers May Calm Nerves, Keeping Them Banned by PGA and L.P.G.A.

Greg Norman, winner of 91 tournaments worldwide, remembers a time when panic attacks on the elite golf circuit were often alleviated with the illicit use of a common heart and blood pressure medicine, the beta blocker.

“In my day, lots of guys were on beta blockers,” Norman, 57, said in an interview at the P.G.A. Championship in August. “It wasn’t openly acknowledged, but it was obvious to the rest of us. A guy’s personality would change. In practice rounds or friendly matches, we’d see the real guy under stress. Then in competition, he was like a different, calmer person. Those guys were trying to take the nerves out of the game. But nerves are very much a part of the game.”

Norman was far from the only one with the tacit understanding that beta blockers, also prescribed for stage fright, were part of big-time golf. So in 2008, when the PGA and L.P.G.A. Tours were establishing their antidoping programs, beta blockers were included on the banned substance lists.

The little pill that inadvertently, or not so inadvertently, soothes the jitters and helps settle the bets in a recreational weekend match — nearly one in three Americans have high blood pressure, so it might be resolving a lot of $5 wagers — is strictly policed when the PGA Tour paydays top $1 million.

The permissibility of beta blockers in golf’s top level has come into focus anew this week. Charlie Beljan won a PGA Tour event Sunday, two days after being hospitalized with a panic attack. Beljan, who said that this week he was going to consult doctors near his home in Arizona, might be treated with medication to prevent future panic attacks. But in competition, he will not be allowed to take certain medications, like beta blockers, without applying for a therapeutic use exemption, which requires a review by an independent panel of doctors.

Dr. Nicole Danforth, a psychiatrist, the medical director of Massachusetts General Hospital’s sports psychology program and a former professional golfer, said, “I think beta blockers could treat the yips, and I think the tours think so, too, or they wouldn’t ban them.”

Beta blockers are prohibited in many sports other than golf, including Olympic sports. The PGA Tour took its lead from the United States Anti-Doping Agency and the World Anti-Doping Agency in adding beta blockers to its list.

“One of the many pharmacological uses of beta blockers is the steadying of hand tremors,” said Andy Levinson, the executive director of the PGA Tour’s antidoping program. “Anything requiring fine motor skills could be affected, something necessary in sports like archery or golf.”

At the 2008 Beijing Olympics, Kim Jong-su of North Korea had to return the silver medal he won in the 50-meter pistol event and the bronze he won in the 10-meter air pistol event after testing positive for propranolol, a beta blocker.

For millions of Americans who take beta blockers, enhancing athletic performance is far from the purpose. Beta blockers are heart medicines meant to control blood pressure, slow the heartbeat and treat a variety of other heart conditions. That they might help calm nerves in a pressure situation is almost an accidental side effect.

“It so happens that the response to an anxiety-producing situation is also driven by the sympathetic nervous system that the beta blocker is trying to control for the good of the patient’s heart,” said Dr. Binoy K. Singh, the associate chief of cardiology at Lenox Hill Hospital in New York.

But Singh said he knew of no long-term, randomized clinical trials measuring beta blockers’ effectiveness in resolving anxiety or improving performance in pressure situations, even if he has had patients tell him they have noticed a calmness in those settings.

There is, in fact, no universal agreement on whether beta blockers help or hurt in some athletic situations.

“Some level of anxiety is good for performance,” said Richard Ginsburg, a sports psychologist at the Harvard Medical School and Massachusetts General Hospital. “It keeps you on your game. A beta blocker can take away some edge, mellow you too much.”

Danforth, who twice played in the United States Women’s Open, agreed, though she added that beta blockers, purely from a golf perspective, had been likened to the stabilizing advantage some find using a long putter.

There are medical concerns for those who acquire beta blockers without a prescription, perhaps through the plethora of Web sites selling the drugs. Singh said there was a serious risk for people using beta blockers without a genuine, long-term medical need for them.

“They are a very powerful class of drugs that have enormous impact on essential bodily functions,” he said. “They are not without adverse effects.”

Beta blockers are far from the primary treatment for panic attacks. There are a variety of medications, doctors said, and there are multiple treatments that do not involve drugs. Among the most effective treatments has been cognitive behavioral therapy. Some anti-anxiety drugs, like Xanax or Valium, are not on most prohibited substance lists, including the one used by the PGA Tour.

But if a golfer on the PGA or L.P.G.A. Tours can prove a documented medical condition that requires the use of a prohibited substance, an exemption is granted. Levinson said a beta blocker exemption had been granted.

When it comes to the recreational golfing community, no doctors said they had a patient who requested a beta blocker prescription to help with the frustrations and strain of playing golf. Singh, who said he was a golfer who had played in stressful weekend matches, was asked if he had ever been tempted to take a beta blocker for the benefits it might bring to his scorecard.

“No, but I would have benefited from a better golf game,” he said.

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McDonald's U.S. chief stepping down

Jan Fields, president of McDonald's USA has stepped down, the company said Friday. 

Fields, 57, will be succeeded by Jeff Stratton, currently the company's global chief restaurant officer.

"This was a business decision," said McDonald's spokeswoman Heidi Barker.  She added that Fields and CEO Don Thompson had "some long discussions about the state of the business and the decision was made that it was time to make a change in the leadership of the U.S. business."

Fields' departure comes days after the Oak Brook-based burger giant announced its first monthly same store sales decline in nearly a decade.

The company has cited sluggish demand and increased competition for the decline. Barker emphasized that the decision was not made based on one month of sales, but looking at the total business with an eye on the future. Her departure is effective Dec. 1.

Jeff Stratton, also 57, who currently serves as the chain's global chief restaurant officer, will take over as president of the U.S. business. A 40-year McDonald's veteran, Barker said Stratton is credited with overseeing a number of critical initiatives, including the multi-billion-dollar restaurant remodeling program expected to boost same store sales around the world, and a new point-of-sale system which has increased restaurant efficiency and speed of service.

In the U.S. Stratton's team oversaw the redesign of the majority of the chain's 14,000 restaurants to make room for the McCafe program, which has added $1 billion in sales annually.

Fields stepped into the role in 2010, succeeding Don Thompson who is now the burger giant's CEO.  She previously served as chief operating officer of McDonald's USA, stepping into that role in 2006. Fields is a 35-year veteran of McDonald's who began her career with the company behind the restaurant counter. Barker said Fields remains active in a number of boards, including Ronald McDonald House Charities.

Fields plans to spend time with family and friends, "maybe in a warmer climate," Barker said.

"She has been a great leader and an inspiration for many folks here," Barker said. "But we felt it was time for a change."

eyork@tribune.com | Twitter: @emilyyork

McDonald's Corp. said Thursday it is replacing Jan Fields, president of its U.S. business.

The move comes a week after the world's largest hamburger chain reported its first monthly decline in global restaurant sales in nine years.

Fields, 57, will be succeeded by Jeff Stratton, currently the company's global chief restaurant officer.

Company spokeswoman Heidi Barker Sa Shekhem said the move was "a business decision by senior management."

"We feel that now was the right time to make a change in leadership for the U.S. business," Shekhem said. She said she did not know what Fields's future plans were.

McDonald's replaced its chief executive officer in July.

Fields has been with McDonald's for more than 35 years.

MCD data by YCharts

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Ex-Dixon comptroller pleads guilty in $53 million scam

A former longtime treasurer of Dixon pleaded guilty today to fraud in federal court in Rockford for stealing $53 million from the coffers of the small northwestern Illinois city over two decades.

Rita Crundwell will remain free on her own recognizance until her sentencing on Feb. 14.

When asked her plea to the one count of wire fraud, Crundwell responded quietly, “Guilty.”

Crundwell admitted to stealing the $53 million since 1990 and using the money to finance her championship quarter-horse business and a lavish lifestyle.

As part of her guilty plea, she also admitted she engaged in illegal money laundering.

Under federal sentencing guidelines, prosecutors believe Crundwell faces up to 19 ½ years in prison, while Crundwell’s lawyers contend she faces no more than 15 ½ years.

Federal prosecutors had sought to have Crundwell taken into custody.

In arguing to keep her free pending sentencing, her attorney, Paul Gaziano said, “She’s worked hard with the government.”

But the 25-page plea agreement gave no indication that Crundwell was officially cooperating with federal authorities.

Crundwell still faces 60 fraud counts in Lee County criminal court. Gaziano said he did not know how those charges would be handled in light of Crundwell’s guilty plea on the lone federal count.

Since her arrest in April, Crundwell has agreed to the sale of her assets so that some of the lost money can be repaid to Dixon, bext known as the boyhood home of President Ronald Reagan.

So far, about $7.4 million has been raised by auctioning off about 400 quarter horses, a luxury motor home  and other equipment. Additional auctions are planned.

After court, Gaziano said that, with her guilty plea, Crundwell is “saving the government the burden and the expense of a lengthy trial.”

“Rita since the day of her arrest has worked with the government to accomplish the sale of her assets including her beloved horses all with the goal of hoping to recoup the losses for the city of Dixon,” Gaziano added as he wrapped his arm around Crundwell outside the courthouse. “I think the people of the city of Dixon ought to know that.”

Gaziano wouldn't take questions from a throng of reporters, and Crundwell had nothing to say before entering a black truck and being driven off.

Crundwell served as comptroller of Dixon since 1983, handling all of its finances. To conceal the scheme, Crundwell told other city officials that budgetary shortfalls were due to late payments of tax revenue from the state.

Dixon’s mayor reported Crundwell to law enforcement authorities in the fall of 2011 after another city employee filled in for Crundwell during an extended unpaid vacation and discovered a secret account she had been using to funnel the money.

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Facebook stock up as lock-up expires on largest block of shares

SAN FRANCISCO (Reuters) – Shares of Facebook Inc jumped 10 percent in early trading on Wednesday, even as the biggest block of shares held by insiders became eligible for sale for the first time since the social media company’s disappointing debut in May.

In heavy morning trading, Facebook gained $ 2.02 to $ 21.89.

“While the lock-up is expiring, there is nothing requiring anybody to sell,” said Tim Ghriskey, chief investment officer at Solaris Group in Bedford Hills, New York. “Given the low price, these long-term holders are deciding to hold the stock and that is lifting it here as the fear of the expiration subsides.”

Roughly 800 million Facebook shares could begin trading on Wednesday after restrictions on insider selling were lifted on the biggest block of shares since the May initial public offering.

The lock-up expiration greatly expanded the 921 million-share “float” available for trading on the market until now.

Facebook, the world’s No. 1 online social network, became the only U.S. company to debut with a market value of more than $ 100 billion. But its value has dropped nearly 50 percent since the IPO on concerns about its long-term money-making prospects.

Insider trading lock-up provisions started to expire in August, and the rolling expirations have added to the pressure on Facebook’s stock.

Pivotal Research Group analyst Brian Wieser said he didn’t expect Facebook insiders to sell all of their shares as the lock-ups expired.

“I would expect heavy volumes over the next few weeks, but not undigestible volumes,” said Wieser. By his estimates, roughly 486 million of the nearly 800 million newly freed Facebook shares will be sold.

There is some evidence that the heavy interest in shorting the stock was dissipating, given the poor performance since it first sold shares in May.

According to Markit’s Data Explorers, about 28 percent of the shares available for short-selling were being borrowed for that purpose, down from a high of more than 80 percent in early August.

Similarly, SunGard’s Astec Analytics, which also tracks interest in shorting, noted in a comment on Tuesday that the cost of borrowing Facebook shares is down more than 50 percent since the beginning of the month.

“Everything would seem to indicate the market is losing its appetite to short Facebook,” wrote Karl Loomes, market analyst at Astec.

Several members of Facebook’s senior management have sold millions of dollars worth of shares in recent weeks through pre-arranged stock trading plans as lock-up restrictions expired.

Chief Operating Officer Sheryl Sandberg has sold roughly 530 million shares this month, netting just over $ 11 million, though she still owns roughly 20 million vested shares in Facebook.

In August, Facebook board member Peter Thiel sold roughly $ 400 million worth of Facebook stock, the majority of his stake, when an earlier phase of lock-up restrictions expired.

Facebook’s 28-year-old chief executive, Mark Zuckerberg, has committed to not sell any shares before September 2013.

(Reporting by Alexei Oreskovic; Editing by Jeffrey Benkoe)

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Actor Channing Tatum dubbed People’s sexiest man alive

NEW YORK (Reuters) – Actor Channing Tatum, who set female hearts fluttering in the summer movie hit “Magic Mike”, was named the sexiest man alive by People magazine on Wednesday.

“My first thought was, ‘Y’all are messing with me,” Tatum told the magazine after hearing the news.

The 32-year-old actor, who is married to actress Jenna Dewan-Tatum, is training to play an Olympic athlete in his upcoming film, “Foxcatcher”.

The couple, who have been married since 2009, are ready to start a family, according to People.

“The first number that pops into my head is three, but I just want one to be healthy and then we’ll see where we go after that,” he told the magazine.

Tatum joins a long list of Hollywood heartthrobs who also have also received the “sexiest man” title from the magazine including Brad Pitt, Johnny Depp, Ryan Reynolds, George Clooney and Matt Damon.

(Reporting by Patricia Reaney; Editing by Maureen Bavdek)

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Drug Compounders Get Help on Capitol Hill

WASHINGTON — Despite two decades of dire health warnings and threats of federal intervention, the specialty drugmakers at the center of the nation’s deadly meningitis outbreak have repeatedly staved off tougher federal oversight with the help of powerful allies in Congress.

Over the years, industry friends like Tom DeLay, the former House Republican leader from Texas, have come to its defense. Even Senator Edward M. Kennedy, regarded as the strongest health care advocate in Congress in recent times, dropped efforts to impose new safeguards.

But the pharmacists known as compounders are now facing their biggest regulatory threat as they confront questions on Wednesday and Thursday at Congressional hearings on the deadly outbreak. The question is whether Congress will move to oversee the niche industry more aggressively.

“A lot of the blame for the meningitis situation lies at Congress’s door,” said Larry D. Sasich, a research pharmacist who has written about compounders’ safety record. For specially mixed drugs that fall into a gray area of federal law, he said, “the protections for your cat or dog are stronger than for your wife and children.”

By Washington standards, the industry’s financial clout is not terribly large. The main trade group, the International Academy of Compounding Pharmacists, has spent $1.1 million on lobbying in the past decade, while major players in the business have given at least $300,000 to candidates since 2008, according to data from the Center for Responsive Politics, a research group in Washington.

But by positioning itself as a more affordable, community-based alternative to huge drug manufacturers, compounders have attracted broad support from politicians. They have become popular among proponents of hormone therapy to slow aging and advocates for the autistic, who often distrust the traditional pharmaceutical industry, and rely on compounders’ tailor-made blends.

If history is a guide, it often takes a disaster to get real change in the law.

In 1938, Congress passed the Food, Drug and Cosmetic Act after a drug company mixed an antibiotic with a toxic solvent and more than 100 people were killed, many of them children. In 1962, it amended that act to effectively create the modern drug approval system after thalidomide, a German drug intended to treat morning sickness in pregnant women, caused severe birth defects in Europe, said Kevin Outterson, an associate professor of law at Boston University.

Experts say the magnitude of the current crisis, in which more than 400 people have been sickened with meningitis and 32 have died, may finally spur action. This week’s hearings are expected to include testimony from the head of the Food and Drug Administration and the head of the Massachusetts pharmacy that produced the tainted drug.

Much of the scrutiny has focused on lax oversight by state boards and the Food and Drug Administration. But public health and drug industry experts say Congress is partly to blame for failing to clearly define the F.D.A.’s authority to police the practice.

A familiar cycle has played out in Washington since the 1990s: Publicity over illnesses or deaths from compounding drugs prompts outrage. Expert witnesses warn of the dangers of an unregulated industry. Proposals to fix the system follow. Then nothing happens.

“The public is at risk, an alarming great risk,” one pharmacist warned in 2003 Senate testimony after one person died and five more fell ill from contaminated medicine in 2002 produced by a South Carolina pharmacy.

Compounding, the practice of mixing medicines for individual patients, has grown in recent decades, helping fill gaps during drug shortages and offering cheaper versions of commercial drugs. But it has also become prone to abuse, with some pharmacies becoming, in effect, mini-drug manufacturers.

While the F.D.A. has clear authority to regulate drug manufacturers, state authorities have the main jurisdiction over pharmacies. Determining which category a company falls into is difficult because compounders are not required to give the F.D.A. access to their books.

Ultimately, stronger regulation has been stymied by sharp opposition from the industry and its defenders in Congress, both Democrats and Republicans, many of whom have compounders in their districts.

In 2008, the F.D.A. challenged what it said were misleading claims by compounders that their hormone therapy for older women was safer and more natural than that of big drug makers; it was met with staunch opposition, including objections from Suzanne Somers, the celebrity anti-aging advocate. The agency eventually prevailed.

Hundreds of members of Congress have attended conferences or taken part in charitable events and letter-writing campaigns organized by the International Academy of Compounding Pharmacists. The trade group said recently that its Congressional supporters had surged in recent years and that compounding had “gone from being a little-known practice to having a strong and steady presence in Washington.”

Texas, home to many compounding pharmacies and their main trade lobbying group, has been an important base of support, producing industry allies like Mr. DeLay and Representative Joe L. Barton, a Texas Republican.

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Microsoft executive exits at a shaky time

Turns out Microsoft Corp.'s radical overhaul of its Windows operating system last month wasn't the only big change in store for the company.

The abrupt departure of Steven Sinofsky, president of Windows and Windows Live, is being called poor timing for the tech behemoth. It's also seen as a sign that longtime Chief Executive Steve Ballmer has no plans to step down anytime soon.

Sinofsky's exit, just weeks after the company rolled out the Windows 8 operating system, "doesn't necessarily reflect well on the company," said Kirk Materne, managing director at Evercore Partners.

"I think if you're Steve, having this happen right after creates a level of distraction that you don't want in the first place," he said. "It's never great when you've had this much turnover at the senior level of a company that is really trying to gain its footing in markets like tablet and mobile."

Shares of Microsoft slid 90 cents, or 3.2%, to $27.09 on Tuesday. Its stock has languished in the last decade — virtually unchanged — while shares of rival Apple Inc. have climbed more than 6,700%.

Microsoft is under pressure to impress consumers and investors with its latest offerings, which include Windows 8 and its new Surface device, a hybrid tablet-laptop that launched last month.

But both products have been met with lackluster interest. Windows 8 debuted to low investor expectations, and reviews for the revamped operating system have been mixed, with some users saying it's at times confusing to use.

The Surface, meanwhile, was buzz-worthy when it was first unveiled, but analysts seem unconvinced that it will make a dent in a market currently dominated by Apple's iPad. Although the hardware is sleek, the Surface lacks applications compared with the iPad, and its highly touted snap-on keyboard that doubles as a cover is difficult to accurately type on, reviewers have said.

The Windows 8 launch was said to be the biggest revamp of the operating system in nearly two decades. The latest update includes a new interface called the Start screen that was designed for tablets and touch-screen computers and features moving tiles similar to those on Windows Phone devices. Microsoft wants the new Start screen interface to be the future of Windows.

"The general conclusion of Win 8 is on the surface, it's a solid first start," Materne said. "It's not mind-blowing, it's not going to immediately recapture market share, but it gets them back in the ballgame to a certain degree."

Sinofsky, a 23-year Microsoft veteran, was in charge of the Windows 8 and Surface efforts at the Redmond, Wash., company. He was a polarizing figure in the office with a tough management style and was rumored to be in line to succeed Ballmer, who has been chief executive since 2000.

In an employee memo Monday, the day Microsoft announced his departure, Sinofsky said he had decided to leave to seek "new opportunities."

"With the general availability of Windows 8/RT and Surface, I have decided it is time for me to take a step back from my responsibilities at Microsoft," he said. "I've always advocated using the break between product cycles as an opportunity to reflect and to look ahead, and that applies to me too."

Now that Sinofsky has left, analysts — some of whom speculated there had been a rift between Sinofsky and Ballmer — say they expect a new direction for the Windows division.

"Sinofsky was a highly talented operator who hit product release dates, got delivery in Windows to be more reliable, and was pivotal to successful Office and Win 7 releases," Morgan Stanley analyst Adam Holt said in a note to investors. "While he is a loss for Microsoft, Windows has entered a different phase where cultivation of developers, collaboration between product groups, integration with the mobile operating system and a focus on applications become more important."

Sinofsky will be replaced by Julie Larson-Green, who has been with the company since 1993 and oversaw program management, user interface design and research for Windows 7 and 8. She will lead all Windows software and hardware engineering.

Tami Reller, Windows chief financial officer and chief marketing officer, also will assume responsibility for the business of Windows.

There could be a bit of a learning curve in the meantime, said equity analyst Angelo Zino of S&P Capital IQ.

"We are surprised by the announcement, given Sinofsky's recent success as well as a belief by many that he could eventually have been the successor to CEO Steve Ballmer," he said. "While we are confident in the abilities of both individuals, we see the change increasing product development risk to future Windows releases."

andrea.chang@latimes.com

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Father of 3 killed in West Rogers Park hit-and-run

A 44-year-old man is dead and another man seriously injured after a hit-and-run in West Rogers Park.

Tsering Dorjee had spent the day Monday helping his brother-in-law find an apartment for his family, due here from India next month.

As it turned evening, Dorjee and Dakpa Jorden went to get food and were crossing the street in the 6400 block of North Maplewood Avenue around 6 p.m. when they were struck by a dark blue Volkswagen that kept on driving, police said.

Dorjee, 44 and the father of three small children, was taken to Saint Francis Hospital in Evanston, where he was pronounced dead at 10:27 p.m. from head injuries, according to the medical examiner's office.

Jorden suffered a broken leg and was taken to the same hospital.

“I don’t know what to do," Dorjee's wife, Kalsang Wangmo. "I don’t know what to do now.’’

"My boys are asking, 'Where’s daddy? Where's daddy?' " she said. They are 6, 3 and 1.

Wangmo said she started getting worried when her husband wasn’t home by 7 p.m.  "Normally he comes home before 6:30 p.m," she said.

Wangmo said she called his cell phone several times but got no answer. Finally, the hospital called her at 8 p.m. "They said, ‘Your husband is in critical condition, can you come now,' " Wangmo said, her voice choking with emotion.
 
She frantically called a relative to watch her boys and got to the hospital before he died. "His eyes were all swollen," Wangmo said, and he could not talk.

As she sat by her husband side, Wangmo said she thought of their children and how she would face life without him. “I don’t know, I don’t know…I have three children,’’ she said, sobbing.

She said her husband had the day off Monday and was helping her brother find an apartment. He has been living with them, and the rest of his family was coming from India to live in Chicago next month.

Dorjee worked in the Cook County Clerk's office and was the president of the Rogers Park Chamber of Commerce.

Wangmo said she and her husband are both from India and went to same high school there. She is from Bangalore, in the Indian state of Karnataka, and her husband was from Himachal in northern India.

Cook County Clerk David Orr released a statement saying Dorjee "was a much-loved member of my Vital Records staff since 1998. Tsering was an incredibly kind soul and dedicated public servant. News of his death this morning brought his coworkers to tears. Our deepest condolences go to his wife, children and family. He will be dearly missed."

The car was described as a dark blue Volkswagen Beetle with the Illinois license plate P121817. Police asked anyone with information to call 312-745-4521.

chicagobreaking@tribune.com

Twitter: @chicagobreaking

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Day-Lewis heeded inner ear to find Lincoln’s voice

LOS ANGELES (AP) — A towering figure such as Abraham Lincoln, who stood 6 feet 4 and was one of history’s master orators, must have had a booming voice to match, right? Not in Daniel Day-Lewis‘ interpretation.

Day-Lewis, who plays the 16th president in Steven Spielberg‘s epic film biography “Lincoln,” which goes into wide release this weekend, settled on a higher, softer voice, saying it’s more true to descriptions of how the man actually spoke.

“There are numerous accounts, contemporary accounts, of his speaking voice. They tend to imply that it was fairly high, in a high register, which I believe allowed him to reach greater numbers of people when he was speaking publicly,” Day-Lewis said in an interview. “Because the higher registers tend to reach farther than the lower tones, so that would have been useful to him.”

“Lincoln” is just the fifth film in the last 15 years for Day-Lewis, a two-time Academy Award winner for best actor (“My Left Foot” and “There Will Be Blood”). Much of his pickiness stems from a need to understand characters intimately enough to feel that he’s actually living out their experiences.

The soft, reedy voice of his Lincoln grew out of that preparation.

“I don’t separate vocal work, and I don’t dismember a character into its component parts and then kind of bolt it all together, and off you go,” Day-Lewis said. “I tend to try and allow things to happen slowly, over a long period of time. As I feel I’m growing into a sense of that life, if I’m lucky, I begin to hear a voice.

“And I don’t mean in a supernatural sense. I begin to hear the sound of a voice, and if I like the sound of that, I live with that for a while in my mind’s ear, whatever one might call it, my inner ear, and then I set about trying to reproduce that.”

Lincoln himself likely learned to use his voice to his advantage depending on the situation, Day-Lewis said.

“He was a supreme politician. I’ve no doubt in my mind that when you think of all the influences in his life, from his childhood in Kentucky and Indiana and a good part of his younger life in southern Illinois, that the sounds of all those regions would have come together in him somehow.

“And I feel that he probably learned how to play with his voice in public and use it in certain ways in certain places and in certain other ways in other places. Especially in the manner in which he expressed himself. I think, I’ve no doubt that he was conscious enough of his image.”

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Q & A: Weighing the Evidence

Q. My husband weighs twice as much as I do, yet we take the same dose of over-the-counter medications, as recommended on the packaging. Shouldn’t weight be a factor?

A. There is little information about using weight as a factor in adjusting doses of either prescription or over-the-counter medications, said Dr. Steven A. Kaplan, director of the Iris Cantor Men’s Health Center at NewYork-Presbyterian/Weill Cornell hospital.

“We are beginning to study different responses by weight,” he said, but he and other researchers have reached no conclusions on recommendations for therapy.

“In my own field, urology,” he added, “my opinion is that it is more likely for the recommended dose to be ineffective in a larger person rather than to be toxic in a thinner adult.”

Some prescription drugs, like chemotherapy agents, already have their dosages adjusted for weight because of their highly toxic nature. As for over-the-counter drugs, recommended doses generally tend to be weighted in favor of safety rather than efficacy, Dr. Kaplan said.

He and other doctors emphasized the importance of following package directions. For example, acetaminophen (like Tylenol) can present a life-threatening risk if the liver cannot process a high dose. If you find that the recommended dose does not work for you, Dr. Kaplan said, speak to your doctor.

C. CLAIBORNE RAY

Readers may submit questions by mail to Question, Science Times, The New York Times, 620 Eighth Avenue, New York, N.Y. 10018, or by e-mail to question@nytimes.com.

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