A delicate new balancing act in senior healthcare

When Claire Gordon arrived at Cedars-Sinai Medical Center, nurses knew she needed extra attention.

She was 96, had heart disease and a history of falls. Now she had pneumonia and the flu. A team of Cedars specialists converged on her case to ensure that a bad situation did not turn worse and that she didn't end up with a lengthy, costly hospital stay.

Frail seniors like Gordon account for a disproportionate share of healthcare expenditures because they are frequently hospitalized and often land in intensive care units or are readmitted soon after being released. Now the federal health reform law is driving sweeping changes in how hospitals treat a rapidly growing number of elderly patients.

The U.S. population is aging quickly: People older than 65 are expected to make up nearly 20% of it by 2030. Linda P. Fried, dean of the Columbia University Mailman School of Public Health, said now is the time to train professionals and test efforts to improve care and lower healthcare costs for elderly patients.

"It's incredibly important that we prepare for being in a society where there are a lot of older people," she said. "We have to do this type of experiment right now."

At Cedars-Sinai, where more than half the patients in the medical and surgical wards are 65 or older, one such effort is dubbed the "frailty project." Within 24 hours, nurses assess elderly patients for their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.

The Cedars project stands out nationally because medical professionals are working together to identify high-risk patients at the front end of their hospitalizations to prevent problems at the back end, said Herb Schultz, regional director of the U.S. Department of Health and Human Services.

"For seniors, it is better care, it is high-quality care and it is peace of mind," he said.

The effort and others like it also have the potential to reduce healthcare costs by cutting preventable medical errors and readmissions, Schultz said. The federal law penalizes hospitals for both.

Gordon, an articulate woman with brightly painted fingernails and a sense of humor, arrived at Cedars-Sinai by ambulance on a Monday.

Soon, nurse Jacquelyn Maxton was at her bedside asking a series of questions to check for problems with sleep, diet and confusion. The answers led to Gordon's designation as a frail patient. The next day, the project team huddled down the hall and addressed her risks one by one. Medical staff would treat the flu and pneumonia while at the same time addressing underlying health issues that could extend Gordon's stay and slow her recovery, both in the hospital and after going home.

To reduce the chance of falls, nurses placed a yellow band on her wrist that read "fall risk" and ensured that she didn't get up on her own. To prevent bed sores, they got her up and moving as often as possible. To cut down on confusion, they reminded Gordon frequently where she was and made sure she got uninterrupted sleep. Medical staff also stopped a few unnecessary medications that Gordon had been prescribed before her admission, including a heavy narcotic and a sleeping pill.

"It is really a holistic approach to the patient, not just to the disease that they are in here for," said Glenn D. Braunstein, the hospital's vice president for clinical innovation.

Previously, nurse Ivy Dimalanta said, she and her colleagues provided similar care but on a much more random basis. Under the project, the care has become standardized.

The healthcare system has not been well designed to address the needs of seniors who may have had a lifetime of health problems, said Mary Naylor, gerontology professor at the University of Pennsylvania School of Nursing. As a result, patients sometimes fall through the cracks and return to hospitals again and again.

"That is not good for them and that is not good for society to be using resources in that way," Naylor said.

Using data from related projects, Cedars began a pilot program in 2011 and expanded it last summer. The research is continuing but early results suggest that the interventions are leading to fewer seniors being admitted to the intensive care unit and to shorter hospital stays, said Jeff Borenstein, researcher and lead clinician on the frailty project. "It definitely seems to be going in the right direction," he said.

The hospital is now working with Naylor and the University of Pennsylvania to design a program to help the patients once they go home.

"People who are frail are very vulnerable when they leave the hospital," said Harriet Udin Aronow, a researcher at Cedars. "We want to promote them being safe at home and continuing to recover."

In Gordon's case, she lives alone with the help of her children and a caregiver. The hospital didn't want her experiencing complications that would lengthen the stay, but they also didn't want to discharge her before she was ready. Under the health reform law, hospitals face penalties if patients come back too soon after being released.

Patients and their families often are unaware of the additional attention. Sitting in a chair in front of a vase of pink flowers, Gordon said she knew she would have to do her part to get out of the hospital quickly. "You have to move," she said. "I know you get bed sores if you stay in bed."

Gordon said she was comfortable at the hospital but she wanted to go back to her house as quickly as she could. "There's no place like home," she said.

Two days later, that's where she was.

anna.gorman@latimes.com

Read More..

Beyonce, Jay-Z, Rihanna hang at Roc Nation brunch

LOS ANGELES (AP) — Jay-Z and Beyonce sat tightly with Solange. Kelly Rowland embraced Beyonce with a huge hug. And Rihanna spilled some of her drink laughing with Rowland.

Music's top stars attended the annual pre-Grammy Roc Nation and Nokia brunch Saturday at the Soho House.

Grammy nominee Miguel, Timbaland, Jill Scott and Kylie Mingoue also attended the exclusive event.

Jay-Z is one of six acts nominated for six awards at Sunday's Grammys. Rihanna is up for three trophies, and Beyonce is nominated for one award.

The crowd Saturday was full of members of music industry, who mingled with performers like The-Dream, Jordin Sparks, Melanie Fiona, Diane Warren, Christina Milian, MC Lyte and Santigold.

Read More..

For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

Read More..

Boeing 787 Dreamliner takes test flight to assess batteries

SEATTLE — Aerospace giant Boeing Co. sent a 787 Dreamliner passenger jet on a test flight Saturday, the first since the new airliner was grounded three weeks ago because of a battery fire.

The aircraft took off from Boeing Field in Seattle and spent more than two hours flying back and forth over the inland Columbia Plateau. It landed at Boeing Field shortly before 3 p.m. Pacific Time. According to flight-tracking website FlightAware, the aircraft flew 1,131 miles, slightly more than the 919 planned.

The Federal Aviation Administration granted permission for test flights Thursday.

The 787 is the first commercial airliner to rely heavily on lithium-ion batteries, the same kind used in cellphones. Each plane has two of the 63-pound blue power bricks, one near the front to provide power to the cockpit if the engines stop and one near the back to start up the auxiliary power unit, which is essentially a backup generator.

On Jan. 7, a battery on a plane that had recently landed in Boston short-circuited and caught fire. Nine days later, a battery on an All Nippon Airways plane started smoking, leading to an emergency landing in Japan.

Boeing said Saturday's flight was to assess the in-flight performance of the batteries. Data would be used to support continuing investigations of the recent incidents.

Read More..

Big Bear locked down amid manhunt

The bustling winter resort of Big Bear took on the appearance of a ghost town Thursday as surveillance aircraft buzzed overhead and police in tactical gear and carrying rifles patrolled mountain roads in convoys of SUVs, while others stood guard along major intersections.

Even before authorities had confirmed that the torched pickup truck discovered on a quiet forest road belonged to suspected gunman Christopher Dorner, 33, officials had ordered an emergency lockdown of local businesses, homes and the town's popular ski resorts. Parents were told to pick up their children from school, as rolling yellow buses might pose a target to an unpredictable fugitive on the run.

By nightfall, many residents had barricaded their doors as they prepared for a long, anxious evening.

PHOTOS: A tense manhunt amid tragic deaths

"We're all just stressed," said Andrea Burtons as she stocked up on provisions at a convenience store. "I have to go pick up my brother and get him home where we're safe."

Police ordered the lockdown about 9:30 a.m. as authorities throughout Southern California launched an immense manhunt for the former lawman, who is accused of killing three people as part of a long-standing grudge against the LAPD. Dorner is believed to have penned a long, angry manifesto on Facebook saying that he was unfairly fired from the force and was now seeking vengeance.

Forest lands surrounding Big Bear Lake are cross-hatched with fire roads and trails leading in all directions, and the snow-capped mountains can provide both cover and extreme challenges to a fugitive on foot. It was unclear whether Dorner was prepared for such rugged terrain.

Footprints were found leading from Dorner's burned pickup truck into the snow off Forest Road 2N10 and Club View Drive in Big Bear Lake.

San Bernardino County Sheriff John McMahon said that although authorities had deployed 125 officers for tracking and door-to-door searches, officers had to be mindful that the suspect may have set a trap.

"Certainly. There's always that concern and we're extremely careful and we're worried about this individual," McMahon said. "We're taking every precaution we can."

PHOTOS: A fugitive's life on Facebook

Big Bear has roughly 400 homes, but authorities guessed that only 40% are occupied year-round.

The search will probably play out with the backdrop of a winter storm that is expected to hit the area after midnight.

Up to 6 inches of snow could blanket local mountains, the National Weather Service said.

FULL COVERAGE: Sweeping manhunt for rampaging ex-cop

Gusts up to 50 mph could hit the region, said National Weather Service meteorologist Mark Moede, creating a wind-chill factor of 15 to 20 degrees.

Extra patrols were brought in to check vehicles coming and going from Big Bear, McMahon said, but no vehicles had been reported stolen.

"He could be anywhere at this point," McMahon said. When asked if the burned truck was a possible diversion, McMahon replied: "Anything's possible."

Dorner had no known connection to the area, authorities said.

Craig and Christine Winnegar, of Murrieta, found themselves caught up in the lockdown by accident. Craig brought his wife to Big Bear as a surprise to celebrate their 28th wedding anniversary. Their prearranged dinner was canceled when restaurant owners closed their doors out of fear.

Read More..

NBC pulls 'Do No Harm' after 2 low-rated episodes

LOS ANGELES (AP) — NBC is pulling the drama series "Do No Harm" after two low-rated episodes.

The show is a take on the story of Dr. Jekyll and Mr. Hyde, and stars Steven Pasquale of "Rescue Me." He plays a respected neurosurgeon who turns into a dangerous alter ego each night. Other cast members include Alana De La Garza and Phylicia Rashad.

"Do No Harm" started with a historically small audience for a major network debut and then dropped further in its second Thursday airing.

NBC will replace "Do No Harm" with reruns of "Law & Order: Special Victims Unit" for the next two weeks.

Read More..

Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His brown eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.

Friday Feb. 8 4:13 p.m. | Updated Thanks for all your responses. You can read about the winner at “Think Like a Doctor: A Confused and Terrified Patient Solved.”

---

Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

Correction: The patient’s eyes were brown, not blue.

Read More..

U.S. trade picture brightens at end of 2012

WASHINGTON — The U.S. trade picture brightened at the close of last year as exports rose at a solid pace and imports of oil and other goods shrank in December, dropping the monthly trade deficit sharply and probably lifting fourth-quarter economic growth.

The trade data Friday from the Commerce Department could be another sign of strengthening global growth. Chinese exports have surged in the last two months, and some major European nations also have seen a recent pickup in trade.

For all of last year, the U.S. trade deficit fell 3.5% to $540.4 billion, reversing two straight years of double-digit increases.

After the release of the December trade numbers, which showed that the deficit narrowed to $38.5 billion from $48.6 billion in November, some leading analysts said it appeared that U.S. economic output in the fourth quarter was a little above zero instead of the negative 0.1% annual rate reported in the government's initial estimate last week.

Obama administration officials said U.S. exports of goods and services reached a record high of $2.2 trillion last year. That was led by strong gains in automotive and capital goods, such as passenger jets and telecommunications equipment. But imports also rose to a record high of $2.74 trillion last year.

Significantly, American shipments of fuel oil hit an all-time high last year, reflecting greater domestic production of crude and natural gas. That means there was a little less reliance on foreign oil, which along with consumer goods made abroad has been the primary reason for America's perennially large trade deficit.

The U.S. goods trade shortfall with members of the Organization of the Petroleum Exporting Countries fell to $98.9 billion last year from $126.9 billion in 2011.

"I think that has a huge potential to help us get to more balanced trade," said Edward Gerwin Jr., a senior fellow at the centrist Democratic think tank Third Way, referring to greater energy independence.

Still, President Obama will need a lot of help if he is to fulfill his pledge of doubling exports in five years.

After sizzling growth in 2010 and 2011, the value of U.S. exports of goods and services rose just 4.4% last year, Commerce Department figures show. That leaves the president less than halfway to his goal with two years to go and some stumbling blocks for U.S. exporters, including weakening currencies in nations like Japan and still-weak demand in key markets such as Europe.

Obama announced his goal in his 2010 State of the Union address. Exports surged 17% that year and then jumped 14% more in 2011, putting the administration well on pace to hit its target. But those huge gains were in good part a kind of bungee-like swing up after a steep fall in trade during the recession.

Some trade experts viewed the goal as farfetched, although the U.S. previously doubled exports in the five years between 1976 and 1981.

Other analysts said it was not enough just to grow exports if imports increased as fast or faster, which would leave the trade deficit flat or rising.

Rising imports can signal growing domestic demand, and some imports are components for products that are made in the U.S. and exported. But an increase in deficits is generally seen as a drag on domestic economic output and job growth.

Dan Ikenson, a trade expert at the Cato Institute, a libertarian think tank, wasn't critical of the likelihood of Obama falling short of his goal of reaching $3.16 billion in exports in 2014.

"At least we're moving in the right direction; that's fine," he said, noting that U.S. exports depend largely on what happens in other economies that are mostly out of the president's hands.

The U.S. trade deficit of goods and services hit a peak of $753.3 billion in 2006, and it fell to $379.2 billion in 2009 when the economy was still in recession, according to Commerce Department figures.

Among major trading partners, the U.S. trade shortfall with China reached a new high of $315 billion last year, up from $295.4 billion in 2011. America's trade gap with Europe also widened, to $125.9 billion from $119.7 billion the previous year.

don.lee@latimes.com

Read More..

FBI searches Las Vegas home of fugitive

Federal and local authorities served a search warrant at the Las Vegas home of an ex-police officer sought in connection with a series of shootings in Southern California, but said the suspect was not located.

FBI spokeswoman Laura Eimiller confirmed agents and Las Vegas police searched the home Thursday as part of the ongoing investigation into Christopher Jordan Dorner, 33, but did not elaborate as to what was recovered. The surrounding neighborhood was cleared as a precaution, she said.

No one was home at the time, Eimiller said.

PHOTOS: Manhunt for ex-LAPD officer

Several law enforcement agencies are involved in the ongoing manhunt for Dorner and alerts have been issued all across California and in Nevada, warning Dorner was considered "armed and extremely dangerous." Dorner was believed to be carrying multiple weapons, including an assault rifle.

In California, a SWAT team clad in military fatigues spent Thursday afternoon combing the mountain community of Big Bear after Dorner's burned-out truck was found on a forest road. Authorities were going door-to-door and checking all vehicles coming and going from the mountain.

Dorner, who was fired from the LAPD in 2009, is suspected of shooting three police officers, one of whom died, in Riverside County early Thursday.

PHOTOS: Manhunt for ex-LAPD officer

He also is suspected of killing a couple who were found shot in a car in Orange County earlier this week. One of the victims was the daughter of a former LAPD captain named in a lengthy online manifesto that law enforcement officials attributed to Dorner.

The Los Angeles Police Department had dispatched units across the region to protect at least 40 officers and others named in the document, which threatened "unconventional and asymmetrial warfare" against police.

Dorner received awards for his expertise with a rifle and pistol, according to military records obtained by The Times. He received an Iraq Campaign Medal and was a member of a mobile inshore undersea warfare unit.

Riverside Police Chief Sergio Diaz, calling the attack on his officers a "cowardly ambush," said Dorner is suspected of opening fire with a rifle about 1:30 a.m. Thursday as he pulled up to two police officers waiting at a traffic light.

The attack was carried out about 20 minutes after Dorner wounded an LAPD officer in a shooting in nearby Corona, police said.

Early Thursday, two women delivering the Los Angeles Times in Torrance were shot by Los Angeles police who were headed to the home of a police captain named in the manifesto.

The women, shot in the 19500 block of Redbeam Avenue, were taken to area hospitals, Torrance Police Lt. Devin Chase said. One suffered a minor wound, and the other was struck twice and listed in stable condition, LAPD Chief Charlie Beck told reporters.

"Tragically," Beck said, "we believe this is a case of mistaken identity."

Read More..

APNewsBreak: Tyler to testify on HI celeb privacy

HONOLULU (AP) — Aerosmith frontman Steven Tyler plans to attend a legislative hearing in Hawaii on Friday on a bill that bears his name and would limit people's freedom to take photos and video of celebrities.

A publicist for the former "American Idol" judge told The Associated Press on Thursday that Tyler has submitted written testimony supporting the proposal, which would allow celebrities to collect damages from people who photograph them in an offensive way during their private lives.

Hawaii's Senate Judiciary Committee plans to consider the so-called Steven Tyler Act on Friday morning, the first time lawmakers will discuss the bill publicly.

Sen. Kalani English, from Maui, says he introduced the bill at Tyler's request. Tyler owns a multimillion-dollar home in Maui. More than two-thirds of the state's senators have co-sponsored the bill.

English says the bill will spur celebrity tourism to the islands, boosting Hawaii's economy.

Opponents say the bill could be unconstitutional.

Laurie Temple, an attorney at the American Civil Liberties Union, said Thursday the bill would punish freedoms of expression protected by the First Amendment.

She said lawmakers should support better enforcement of current stalking laws rather than passing new legislation.

The bill would open up photographers, videographers and distributors to civil lawsuits if they take, sell or disseminate photos or videos of celebrities during private or family moments "in a manner that is offensive to a reasonable person."

The bill doesn't specify whether public places, like Hawaii's beaches, would be exempt. The bill says it would apply to people who take photos from boats or anywhere else within ocean waters.

English says the bill is not intended to limit beach photos. But he says Tyler has had paparazzi hide in his bushes to take photos of him inside his house.

Photos of vacationing stars in swimsuits have long been a fixture in tabloids and celebrity magazines.

The state's largest newspaper, the Honolulu Star-Advertiser, published an editorial Thursday that called lawmakers who support the bill "star-struck."

The newspaper said the bill might not affect only journalists.

"It could also make lawbreakers out of anyone taking photographs in public places, be it an ordinary photojournalist or someone with a camera phone," the editorial said.

___

Anita Hofschneider can be reached at http://twitter.com/ahofschneider .

Read More..

Daniel Doctoroff Enlists Bloomberg in A.L.S. Research

Nicole Bengiveno/The New York Times

Daniel L. Doctoroff, second from right, chief executive of Bloomberg L.P., at Columbia University’s Motor Neuron Center.

Daniel L. Doctoroff watched in pain as his father developed a limp one day, was found to have Lou Gehrig’s disease, and died within two years. Then an uncle also developed symptoms of the same disease, and died soon after.

Now Mr. Doctoroff, like many other relatives of Lou Gehrig’s disease victims, worries that he or his children may someday develop the illness.

But unlike many, he is in a position to try to do something about it. At a time when scientists are making rapid gains in the genetic roots of many diseases, Mr. Doctoroff, a former deputy mayor and private equity investor, is working with Mayor Michael R. Bloomberg and a private equity director, David M. Rubenstein, to put together a $25 million package of donations to support research to try to cure this rare and usually fatal degenerative neurological illness.

“This is a devastating disease,” Mr. Doctoroff said in an interview this week in the glass high-rise on the Upper East Side that houses Bloomberg L.P., the mayor’s media and financial information company, where Mr. Doctoroff is now chief executive. “Up to now, there’s been basically no hope. I have the resources, and I think it’s my obligation to do that.”

The gift is part of a wave of investment based on the booming field of genomic analysis. The money will go to a project called Target A.L.S., a consortium of at least 18 laboratories, including ones at Columbia and at Johns Hopkins, the mayor’s alma mater, working to find biological “targets,” like gene mutations, and the biochemical changes they cause in the spinal cord, that could be used to test potential drug therapies for the disease, formally known as amyotrophic lateral sclerosis.

It comes on top of a previous $15 million gift by Mr. Doctoroff, Bloomberg Philanthropies and other donors. By comparison, the National Institutes of Health, the single largest source of research financing for the disease, expects to give $44 million in 2013.

This is not Mr. Bloomberg’s first time supporting charitable causes that are dear to his close associates. The mayor quietly gave at least $1 million to put the name of his top deputy mayor, Patricia E. Harris, on a new academic center at her alma mater, Franklin & Marshall College in Lancaster, Pa.

Mr. Doctoroff said the conversation about A.L.S. in which he got Mr. Bloomberg involved “lasted about five seconds.” He declined to say what share of the money each of the three donors was giving.

Mr. Rubenstein, a founder of the Carlyle Group, said Wednesday that he had long been fascinated with A.L.S. because of its association with Gehrig, the baseball player who died of it. He wondered why more than 70 years later so little progress had been made in treating it.

He said he jumped at the chance to join in because he thought that A.L.S. research was underfinanced owing to the rarity of the disease, and that even a small amount of money could make a big difference.

In the Bloomberg administration, where he was deputy mayor for economic development and rebuilding from 2002 to 2008, Mr. Doctoroff was best known for his dogged — and ultimately dashed — attempt to bring the 2012 Olympics to New York City. (London got the Games.) Now that he has left City Hall, he no longer rides his bike to work — he says the 2.6-mile route from the Upper West Side to his office is too short — but he sometimes runs.

At Bloomberg, he sits in front of a conference room with walls of hot-pink glass, while carp swim in a giant fish tank nearby. He keeps no family photos or other personal mementos on his desk, and talking about his family’s disease history does not seem easy for him.

A.L.S. is rare, with about 2 new cases diagnosed a year per 100,000 people, according to the A.L.S. Association. A vast majority of cases are “sporadic,” in people who have no family history, while only 5 to 10 percent of cases are inherited. There appear to be no racial, ethnic or socioeconomic predispositions.

There is some speculation about environmental factors, like exposure to toxic chemicals and high physical activity that athletes might endure, “but nothing firm,” said Christopher E. Henderson, a researcher at Columbia and the Target A.L.S. project’s scientific director. Some researchers suspect a link between A.L.S. and head trauma suffered by professional football players.

Mr. Doctoroff’s father, Martin, an appeals court judge in Michigan, received the diagnosis in 2000 and died in 2002. One of Martin Doctoroff’s brothers, Michael, was found to have the disease in 2009 and died in 2010.

“When my father contracted the disease and passed away, it was very easy to chalk it up to bad luck,” Mr. Doctoroff said. “When my uncle got it, it obviously had broader implications.”

Given his family history, Mr. Doctoroff estimates that there is a 50-50 chance that he has the gene, C9orf72, that could lead to A.L.S. But he has chosen not to be tested, which would have implications not just for him but for his three children. “It’s very personal, but I’m not sure that I want to know,” he said.

Even when family members develop the disease, it can occur at vastly different ages, so he could still be in suspense even after testing. “Assuming you have the gene, you don’t know when you would actually get the disease,” he said. His uncle was 71. His father was 66. He is now 54.

Sheelagh McNeill contributed reporting.

This article has been revised to reflect the following correction:

Correction: February 8, 2013

Because of an editing error, a picture caption on Thursday with an article about efforts by Daniel L. Doctoroff, a former deputy mayor of New York, to research Lou Gehrig’s disease misstated his title at Bloomberg L.P. in some editions. He is the chief executive, not the executive director.

Read More..

South Korea firm aims for the sky in L.A.

Ambitious South Korean enterprises continue to make noise on the global economic stage.

Electronics giant Samsung is giving Apple fits in markets across the globe with its hot-selling smartphones and tablets. Seoul-based Hyundai and Kia have been among the world's fastest-growing automakers in recent years. Portly singer Psy put South Korea on the pop culture map with his monster hit “Gangnam Style,” which has become the most popular video of all time on YouTube with nearly 1.3 billion views.

So it was only natural that South Korea's top airline, Korean Air, on Thursday took the wraps off its design for a dramatic, skyline-changing tower for downtown Los Angeles. The $1-billion skyscraper is to become the tallest building west of the Mississippi River — and a symbol of South Korea's status as an up-and-coming economic powerhouse.

The 73-story hotel and office building will include 900 guest rooms, double-decker elevators and an observation deck that will afford views of the Pacific Ocean. Slated to replace the old Wilshire Grand Hotel at Wilshire Boulevard at Figueroa Street, the new building will be slightly taller than the nearby U.S. Bank Tower, which has held the title of tallest building west of Chicago since 1989.

Originally planned as two smaller towers when it was announced four years ago, the Korean Air plan has morphed into a single tower that will give the Seoul company bragging rights to the highest skyscraper on the West Coast.

Experts said that's in keeping with South Korea's hard-charging business ethos. The skyscraper, currently dubbed the Wilshire Grand, is an outgrowth of a competitive corporate culture that has come to dominate the South Korean economy over the last 30 years, according to UC Riverside Ethnic Studies professor Edward Taehan Chang.

After the nation endured poverty, dictatorship and political unrest during much of the 20th century, attaining superlatives has become part of the country's fabric, Chang said. Corporations strive to dominate their industries, while younger generations take pride in the near universality of South Korea's popular culture.

“They always want to reach for No. 1 status,” Chang said. “The rapid economic growth has been about striving for the top spot.”

Korean Air is already at work dismantling the closed 1950s-era Wilshire Grand Hotel to make way for the glass-clad tower, which is expected to be completed in 2017. Korean Air has provided airline service to Los Angeles for more than 40 years and has owned the Wilshire Grand since 1989.

Korean Air is the flagship company of Hanjin Group, one of South Korea's largest conglomerates. Hanjin has interests in land, sea and air transportation as well as construction, heavy industry, finance and information services. A high-end hotel fits well with Korean Air's operations in Los Angeles: The company makes parts for airplanes, flies the planes here as the busiest Asian carrier at Los Angeles International Airport, runs travel agencies that book the tickets and operates a catering business that serves the food on the planes.

“The new Wilshire Grand is an investment that makes sense, and we are excited to continue our relationship with this great city,” Korean Air Chairman Y.H. Cho said Thursday at the offices of AC Martin Partners, the project's architect.

The sail-shaped skyscraper will light up at night and dwarf many of its neighbors. Most of the building will be devoted to a hotel, though an operator has yet to be named. Arriving guests would be whisked by high-speed elevators to the “sky lobby” on the 70th floor for check-in.

According to the plan, the 71st floor will be a restaurant. The floor above that will house window-washing gear and engineering equipment, clearing the top floor for an infinity swimming pool and observation deck.

Near street level will be about three floors of restaurants and shops, topped by 30 floors of offices for rent. Elevators will be double-decked, carrying two stacked cabs of passengers for additional capacity during peak hours.

Perched at the very top of the building will be a decorative “crown” and a mast-like spire that will have embedded LED lighting that can change colors. The display will be eye-catching and visible for miles, but it will not be used for advertising, said Christopher Martin, chief executive of AC Martin.

“It's not Coke bottles, it's art,” he said.

With the spire reaching to 1,100 feet, the Wilshire Grand would become one of the tallest structures in the country, surpassing the 1,046-foot Chrysler Building in New York, which has 77 stories.

The contemporary design of the Wilshire Grand, with its floor-to-ceiling windows, is intended to set it apart from surrounding granite-clad office towers, said architect David Martin, who is Christopher Martin's cousin.

He hopes the building, which is to include 400,000 square feet of office space, will reflect the city better than the last generation of skyscrapers does. The Wilshire Grand, for instance, will have operable windows in its guest rooms and offices.

“This is about the culture and climate of L.A.,” Martin said. “We are creating a sense of place, only it's 1,000 feet up in the air.”

AC Martin also designed the Figueroa-at-Wilshire high-rise across the street from the Wilshire Grand in 1990. The family firm was the primary architect of Los Angles City Hall in the 1920s.

Work on the new skyscraper will create 11,000 union construction jobs, Korean Air's Cho said, and employ 1,700 workers when it opens in four years. The project has obtained most development approvals from L.A. city officials.

Cho, who lives in Seoul and has a home in Newport Beach, is on the board of trustees at USC, where his children attended college and where he obtained his MBA.

“L.A. is like a second home,” Cho said.

The 936-room Wilshire Grand, built in 1952, was originally a Hotel Statler and later a Hilton. Once one of the city's best hotels, it was most recently a mid-market inn catering to conventioneers and tour groups from overseas before it closed at the end of 2011.

The property is a few blocks north of Staples Center.

roger.vincent@latimes.com

Times staff writer Frank Shyong contributed to this story.

Read More..

Obama names REI chief to lead the Interior Department

President Obama nominated REI business executive Sally Jewell to lead his second-term Interior Department.

WASHINGTON – President Obama on Wednesday nominated Sally Jewell, a former oil engineer and banker and current chief executive of a national outdoor retailer, to lead the Interior Department, making an unorthodox pick for his first woman nominee to his second-term Cabinet.

The president and CEO of Recreational Equipment Inc., Jewell has no government and little public policy experience, and has spent her career far from Washington. But her resume has elements that appealed to both of the two feuding interests that consume much of the debate at the department that controls public lands: the oil and gas extraction industries seeking access to public lands, as well as environmentalists seeking to preserve them.

Jewell, 56, started her career as a petroleum engineer working in the oil fields of Oklahoma and Colorado for Mobil Oil Corp. She then moved to the corporate banking industry, and joined the REI board in 1996,  becoming chief operating officer four years later.

PHOTOS: President Obama’s past

She has been credited with expanding the Washington state-based retailer's Internet operations and contributing the membership cooperative’s resources to environmental stewardship. Jewell, an avid outdoorswoman, serves on the board of the National Parks Conservation Assn. as well as the Board of Regents of the University of Washington.

In announcing his choice, Obama cast her as someone who would seek a balance between protection and economic development of public lands. 

“She knows the link between conservation and good jobs,” Obama said in remarks at the White House. “She knows that there’s no contradiction between being good stewards of the land and our economic progress, that in fact, those two things need to go hand-in-hand. She’s shown that a company with more than $1 billion in sales can do the right thing for our planet.”

In fact, little is known about Jewell’s policy positions. And while environmental groups largely praised her nomination, Republicans and some Democrats withheld judgment.

“The livelihoods of Americans living and working in the West rely on maintaining a real balance between conservation and economic opportunity,” said Sen. Lisa Murkowski (R-Alaska), the ranking member of the Senate committee on energy and national resources.  “I look forward to hearing about the qualifications Ms. Jewell has that make her a suitable candidate to run such an important agency, and how she plans to restore balance to the Interior Department.”

PHOTOS: President Obama’s second inauguration

If confirmed, Jewell will replace Ken Salazar, who served in the post throughout the president’s first term and led a period of expansion of oil and gas drilling on public lands. Salazar plans to return to Colorado. Obama on Wednesday praised the former senator as a close friend and trusted advisor.

Salazar, he said, had “ushered in a new era of conservation of our land, our water and our wildlife.”

“He’s opened more public land and water for safe and responsible energy production – not just gas and oil, but also wind and solar – creating thousands of new jobs and nearly doubling our use of renewable energy in this country,” Obama said. 

Jewell is the first woman to be named to lead a Cabinet-level department in the second term. After naming a few white men to top jobs, Obama said the next round of nominees would include more women and be more racially diverse.

Follow Politics Now on Twitter and Facebook

Kathleen.hennessey@latimes.com

Twitter: @khennessey

Read More..

Selena Gomez works the front row at Neo show

NEW YORK (AP) — Selena Gomez sat front and center at the fashion show to preview the first collection in her collaboration with Adidas' streetwear Neo label.

But the runway at Wednesday evening's show was a next-gen catwalk: Teenager bloggers were charged with styling the outfits instead of industry professionals.

Gomez thanked them as she stood on stage at the end of the show. She was flanked by models in denim shorts, Bermudas, slouchy sweats and T-shirts that read "Pirate Love." There were a few graffiti prints sprinkled in, and some varsity jackets.

The clothes, mostly in sunny yellow, bright pink and navy, were more surf than sport, which is Adidas' normal niche.

The show was very briefly interrupted by a protester trying to hand out leaflets about sweatshops.

Read More..

Personal Health: Effective Addiction Treatment

Countless people addicted to drugs, alcohol or both have managed to get clean and stay clean with the help of organizations like Alcoholics Anonymous or the thousands of residential and outpatient clinics devoted to treating addiction.

But if you have failed one or more times to achieve lasting sobriety after rehab, perhaps after spending tens of thousands of dollars, you’re not alone. And chances are, it’s not your fault.

Of the 23.5 million teenagers and adults addicted to alcohol or drugs, only about 1 in 10 gets treatment, which too often fails to keep them drug-free. Many of these programs fail to use proven methods to deal with the factors that underlie addiction and set off relapse.

According to recent examinations of treatment programs, most are rooted in outdated methods rather than newer approaches shown in scientific studies to be more effective in helping people achieve and maintain addiction-free lives. People typically do more research when shopping for a new car than when seeking treatment for addiction.

A groundbreaking report published last year by the National Center on Addiction and Substance Abuse at Columbia University concluded that “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.” The report added, “Only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.”

The Columbia report found that most addiction treatment providers are not medical professionals and are not equipped with the knowledge, skills or credentials needed to provide the full range of evidence-based services, including medication and psychosocial therapy. The authors suggested that such insufficient care could be considered “a form of medical malpractice.”

The failings of many treatment programs — and the comprehensive therapies that have been scientifically validated but remain vastly underused — are described in an eye-opening new book, “Inside Rehab,” by Anne M. Fletcher, a science writer whose previous books include the highly acclaimed “Sober for Good.”

“There are exceptions, but of the many thousands of treatment programs out there, most use exactly the same kind of treatment you would have received in 1950, not modern scientific approaches,” A. Thomas McLellan, co-founder of the Treatment Research Institute in Philadelphia, told Ms. Fletcher.

Ms. Fletcher’s book, replete with the experiences of treated addicts, offers myriad suggestions to help patients find addiction treatments with the highest probability of success.

Often, Ms. Fletcher found, low-cost, publicly funded clinics have better-qualified therapists and better outcomes than the high-end residential centers typically used by celebrities like Britney Spears and Lindsay Lohan. Indeed, their revolving-door experiences with treatment helped prompt Ms. Fletcher’s exhaustive exploration in the first place.

In an interview, Ms. Fletcher said she wanted to inform consumers “about science-based practices that should form the basis of addiction treatment” and explode some of the myths surrounding it.

One such myth is the belief that most addicts need to go to a rehab center.

“The truth is that most people recover (1) completely on their own, (2) by attending self-help groups, and/or (3) by seeing a counselor or therapist individually,” she wrote.

Contrary to the 30-day stint typical of inpatient rehab, “people with serious substance abuse disorders commonly require care for months or even years,” she wrote. “The short-term fix mentality partially explains why so many people go back to their old habits.”

Dr. Mark Willenbring, a former director of treatment and recovery research at the National Institute for Alcohol Abuse and Alcoholism, said in an interview, “You don’t treat a chronic illness for four weeks and then send the patient to a support group. People with a chronic form of addiction need multimodal treatment that is individualized and offered continuously or intermittently for as long as they need it.”

Dr. Willenbring now practices in St. Paul, where he is creating a clinic called Alltyr “to serve as a model to demonstrate what comprehensive 21st century treatment should look like.”

“While some people are helped by one intensive round of treatment, the majority of addicts continue to need services,” Dr. Willenbring said. He cited the case of a 43-year-old woman “who has been in and out of rehab 42 times” because she never got the full range of medical and support services she needed.

Dr. Willenbring is especially distressed about patients who are treated for opioid addiction, then relapse in part because they are not given maintenance therapy with the drug Suboxone.

“We have some pretty good drugs to help people with addiction problems, but doctors don’t know how to use them,” he said. “The 12-step community doesn’t want to use relapse-prevention medication because they view it as a crutch.”

Before committing to a treatment program, Ms. Fletcher urges prospective clients or their families to do their homework. The first step, she said, is to get an independent assessment of the need for treatment, as well as the kind of treatment needed, by an expert who is not affiliated with the program you are considering.

Check on the credentials of the program’s personnel, who should have “at least a master’s degree,” Ms. Fletcher said. If the therapist is a physician, he or she should be certified by the American Board of Addiction Medicine.

Does the facility’s approach to treatment fit with your beliefs and values? If a 12-step program like A.A. is not right for you, don’t choose it just because it’s the best known approach.

Meet with the therapist who will treat you and ask what your treatment plan will be. “It should be more than movies, lectures or three-hour classes three times a week,” Ms. Fletcher said. “You should be treated by a licensed addiction counselor who will see you one-on-one. Treatment should be individualized. One size does not fit all.”

Find out if you will receive therapy for any underlying condition, like depression, or a social problem that could sabotage recovery. The National Institute on Drug Abuse states in its Principles of Drug Addiction Treatment, “To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems.”

Look for programs using research-validated techniques, like cognitive behavioral therapy, which helps addicts recognize what prompts them to use drugs or alcohol, and learn to redirect their thoughts and reactions away from the abused substance.

Other validated treatment methods include Community Reinforcement and Family Training, or Craft, an approach developed by Robert J. Meyers and described in his book, “Get Your Loved One Sober,” with co-author Brenda L. Wolfe. It helps addicts adopt a lifestyle more rewarding than one filled with drugs and alcohol.

This is the first of two articles on addiction treatment.

Read More..

Pitfalls seen in growth of part-time work

Although the state's unemployment rate is at its lowest level in almost four years and the number of employed Californians is growing, labor experts see a different reality: Full-time work has faded in many industries.

Nubia Calderón Barillas, 32, left a job in retail in May for a housekeeping job at the Holiday Inn LAX that promised better pay and steady work.

But nearly nine months later, the mother of three said, she rarely works more than two days a week. She has asked for more hours, she said, but to no avail, even in an industry that set a new peak employment level last year.

"It's been difficult lately," she said. "I practically didn't work all of December except for the holidays."

California employers picked up the rate of hiring during 2012 — at times at nearly twice the rate of the country as a whole. But a significant portion of those jobs are less than full time, according to federal data released last week.

The number of people involuntarily working part time nationwide has grown to 7.9 million, an 80% increase from 2006, data from the Bureau of Labor Statistics show.

That trend is particularly pronounced in the Golden State, which saw the number of involuntary part-time workers swell to 1.3 million, up 126% from 585,100 in 2006. Only four other states, Nevada and Florida among them, had higher rates of involuntary part-time workers.

Various industries are increasingly relying on part-time workers and other contingent employees, such as temporary workers, to save money, said Michael Bernick, a Milken Institute fellow who studies labor markets.

"As you have more and more costs associated with full-time workers in terms of healthcare or other costs, employers look for alternative ways to reduce costs," Bernick said. "One way is on-demand and part-time work."

The increase isn't limited to industries that typically employ part-time workers, such as leisure and hospitality. Other sectors with strong job growth, such as professional and business services, have also seen a rise in part-time workers as employers aim to keep payroll costs down, Bernick said.

Nationwide, the number of involuntary part-time workers in professional and business services, which includes white-collar occupations such as accountants and lawyers, nearly doubled to 711,000 last year from 367,000 in 2007. A sector-by-sector breakdown is unavailable for California because the sample size of the household survey that the federal data rely on is too small.

Part-time work is common in California's leisure and hospitality sector, which added almost 61,000 jobs since December 2011, accounting for more than a quarter of the state's net jobs created in that time period.

Growth of low-wage industries such as hospitality provides work opportunities for people with limited education, even if the work is only part time, said Jerry Nickelsburg, senior economist at the UCLA Anderson Forecast.

"We shouldn't look with dismay" on the rapid growth of a sector that is so dependent on part-time work, he said. "If that were the only sector we were growing, then that would be worrisome."

Tom Walsh, president of Unite Here Local 11, a union representing hospitality workers in Los Angeles and Orange counties, said in negotiations with employers, his group has pushed for workers' hours to be maximized.

Although full-time work sometimes isn't ensured, Walsh said, employers are urged to give part-time workers as many hours as possible.

"I think it's an example of certain employers being penny wise but pound foolish," he said. "They figure they can save money by having more part-time workers and having low pay. If they don't change that, folks are going to take jobs somewhere else the first chance they get."

The long-term implication of part-time work, economists said, is growing wage disparities and the risk of dampening consumer spending, a major driver of the economy. Part-time workers also are more likely to rely on state aid, such as food stamps, to make ends meet.

Kellie Flowers moved to Los Angeles late last year hoping to find work as an event coordinator or wardrobe stylist.

But full-time work has been elusive, even with a college degree.

The 30-year-old Virginia native managed to land two part-time jobs when she first relocated, one at a Manhattan Beach boutique and the other at a running store.

She earned $10 per hour at both jobs but didn't have benefits or health insurance.

"It was very hard working two jobs," she said. "You definitely don't have any spending money."

Flowers recently started a new job, selling spa packages, on commission. She sells between six to 10 a day, earning $15 for each.

"I'm going to look for other jobs that make me happier. Until then I just need to make money," she said.

Meanwhile, Barillas, the Holiday Inn housekeeper, said she hopes she'll eventually work more hours.

She and her husband are falling behind on utility bills at the one-bedroom Koreatown apartment they share with their three children. She recently applied for food stamps, a decision she said was embarrassing.

"I've always had work," she said. "I used to think people on food stamps just didn't want to work, but now I find myself with the need to ask for help."

ricardo.lopez2@latimes.com

Read More..

Child porn suspect indicted by federal grand jury

A North Hills woman whom authorities allege plied a young girl with crack cocaine and photographed her having sex with an older man was indicted Tuesday on federal charges of producing child pornography and sex trafficking.

Letha Montemayor Tucker was named Tuesday in a four-count indictment returned by a federal grand jury. If convicted of all the charges, Tucker would face a mandatory minimum federal sentence of 10 years and could get up to life in prison, authorities said.

The charges come a month after authorities sought the public's help in the investigation by releasing photographs of a man and woman depicted in a set of widely circulated child pornography photos.

Tips started pouring in immediately after the photos were released, investigators said.

Tucker, who goes by the name Butterfly, was located about 10 hours after the release of the photos and taken into custody, said Claude Arnold, special agent in charge for Homeland Security Investigations in Los Angeles, a division of U.S. Immigration and Customs Enforcement.

The alleged victim, who was about 12 when the photos were taken, was found within a week of the case going public, Arnold said. She is an adult now and is cooperating with authorities, he said.

In addition to photographing the girl having sex with the man, authorities said, Tucker also committed sex acts with the alleged victim.

The photos were part of a child pornography collection known as the "Jen Series."

The 40-plus photos were first discovered by investigators in the Chicago area in 2007. Investigators said images in the series have been reported about 300 times and have been found on computers across the country.

The victim "didn't even know these images were out there," Arnold said.

"The horror of child pornography is it's for life, the victimization," Arnold said. "Once the photos are there in cyberspace, they're there forever."

The girl, identified in court records only by the initials J.M.M., lived in the same Los Angeles County residential hotel as Tucker, who worked as a prostitute, authorities said.

Around 2000 or 2001, the girl stopped attending school regularly and spent more and more time in Tucker's room, smoking crack cocaine Tucker provided, according to the indictment.

The girl was present when Tucker engaged in prostitution with clients and was usually high when this happened, authorities allege. Tucker instructed the child to take off her clothes in front of the clients, prosecutors alleged in court papers.

The faces of Tucker and the girl are "clearly visible" in the photos, according to the indictment. Tucker had an eyebrow piercing and a tattoo of a sleeping cat behind her shoulder, which made her easier to identify, authorities said.

The face of the man, however, is blacked out in the photographs. Authorities are still trying to identify the man, Arnold said.

"Obviously, we want him also to answer for his crimes," Arnold said.

Arnold said the alleged victim is "going to be dealing with this for a long time."

Now that she has been identified, she will receive a victim notification every time one of the images turns up in an investigation, he said.

Tucker is being held without bond and is scheduled to be arraigned in federal court on Feb. 13. Her attorney could not be reached for comment.

hailey.branson@latimes.com

Read More..

Fox cuts ties to commentator Dick Morris

NEW YORK (AP) — Political commentator Dick Morris' prediction of a huge landslide for Mitt Romney didn't pan out. And now he's lost his job at Fox News Channel.

Network spokeswoman Dana Klinghoffer said Tuesday that Fox wasn't renewing its contract with Morris, who was steadfast throughout the campaign in his prediction of a big Romney win over President Barack Obama. He has made few appearances on Fox since the election.

Morris had also been criticized for accepting paid advertisements on his website from candidates that he discussed on the air at Fox.

On his website, Morris said he'll be appearing on CNN's Piers Morgan show Wednesday to talk politics.

Read More..

Question Mark: Women’s Eggs Diminish With Age

Baby girls enter the world with enough of them to populate perhaps 40 small cities. A dozen or so years later, the first will make a debut of its own. And in the months and years to come, others will appear regularly, sometimes greeted with relief, other times with disappointment, perhaps most often with a touch of annoyance.

Abdullah Pope/Agence France-Presse — Getty Images

Not women's eggs, obviously.

Now, for women in the baby boom generation, they may be coming more sporadically, or not at all, signaling unmistakably that one time of life is over, and another begun. But what happened to all those eggs?

When girls are born, they have about two million eggs in their ovaries, nestled in fluid-filled cavities called follicles. That may sound like a lot, but consider that months earlier, when they were still in utero, they may have had as many as six or seven million eggs. Those eggs are still immature, and the proper name for them, by the way, is oocytes (rhymes with: nothing).

The first eggs to bite the dust were those in the fetus, which waste away. And by the time a girl reaches puberty, most of her remaining eggs have also deteriorated and been reabsorbed. If that sounds ominously like something from a “Star Trek” episode about the Borg, imagine if all those eggs had to take the customary path out of the body.

Even with the Great Egg Disappearance, girls enter puberty with many more than they will use, 300,000 or more. Each month, the body produces a hormone, FSH, which stimulates the follicles to prepare an egg for maturation and release.

With eggs backed up like bowling balls on a busy Saturday night at the lanes, the ovaries can afford to be a little wasteful, and as many as several dozen follicles are called into action. Then a single mature egg — usually, anyway — gets the tap on the shoulder and begins its travels to the uterus.

As for the maturing eggs that didn’t make the grade, there is no second chance. But they do not go out on their own. “Each month you probably lose a thousand or so,” said Dr. James T. Breeden, president of the American Congress of Obstetrics and Gynecology. “There’s just a natural death of them.”

For all the eggs a woman begins with, in the end only about 400 will go through ovulation. While men produce sperm throughout their lives, over time the number of eggs declines, and they disappear with increasing frequency the decade or so before menopause. Those that remain may decline in quality. “When you have a thousand or less within the ovaries, you’re thought to have undergone menopause,” said Dr. Mitchell Rosen, the director of the Fertility Preservation Center at the University of California, San Francisco.

It’s true that women make far more eggs than they end up using, but men should not pass judgment. “They produce millions of sperm, millions,” Dr. Rosen said. “The whole process is not the most efficient in the world.”

Questions about aging? E-mail boomerwhy@nytimes.com

Booming: Living Through the Middle Ages offers news and commentary about baby boomers, anchored by Michael Winerip. You can follow Booming via RSS here or visit nytimes.com/booming. You can reach us by e-mail at booming@nytimes.com.

This article has been revised to reflect the following correction:

Correction: February 5, 2013

An earlier version of this article incorrectly described estrogen levels at the time of ovulation. They rise, rather than fall.

Read More..

Dell founder to take PC maker private in $24.4-billion buyout

Once-mighty Dell Inc., which has struggled for years in a competitive and increasingly mobile device-driven industry, will try to transform itself as a private company in a $24.4-billion buyout led by founder Michael Dell.

Away from the scrutiny and glare of Wall Street, Dell is hoping the company will stand a better chance reinventing itself for the long term. But many of the fundamental challenges that have toppled the company from its perch as the world's biggest PC maker won't go away once it becomes privately held, analysts say.

"The PC guys really miscalculated the disruptive nature of tablets and the way they've cannibalized the PC business," said Tim Bajarin, president of industry analysis firm Creative Strategies Inc. "And the result is that all of them are really struggling with a shrinking market. That means that they have to find other ways to shore up their business."

In the coming years, analysts project, almost all growth in consumer electronics will come from tablets and smartphones while sales of PCs will decline.

Computing giants have taken different roads to adapt. Microsoft has launched the touch-based Windows 8 that works across traditional and mobile platforms. Intel is focusing on making chips. HP has announced a five-year turnaround plan to make the company a leader in business computing and cloud-based services.

Dell, now the world's third-largest PC maker, wants to pursue a strategy similar to HP's.

"Dell has made solid progress executing this strategy over the past four years," CEO Michael Dell said in a statement. "But we recognize that it will still take more time, investment and patience."

And so, after weeks of rumors, Dell confirmed the biggest leveraged buyout since the Great Recession. Under the terms of the agreement, the Round Rock, Texas, company will be acquired by Michael Dell and global technology investment firm Silver Lake, with a $2-billion investment from Microsoft Corp.

Michael Dell — who currently holds about a 16% stake in the company — said the going-private transaction would "open an exciting new chapter for Dell, our customers and team members."

"We can deliver immediate value to stockholders, while we continue the execution of our long-term strategy and focus on delivering best-in-class solutions to our customers as a private enterprise," he said.

Dell stockholders will receive $13.65 in cash for each share of Dell common stock they hold, representing a 25% premium over Dell's closing share price of $10.88 on Jan. 11, the last trading day before rumors of a possible sale began. The company currently has a $23.3-billion market value. Dell shares rose 15 cents, or 1%, to $13.42.

Dell wants to complete the transaction by the end of July. The company said it would solicit competing offers for 45 days, although analysts said they didn't expect a counteroffer to emerge.

Despite the advantages of being a private company, Dell will be saddled with huge debt as part of the deal that may make it difficult to make large acquisitions. Already, Dell had been outbid on deals by rivals such as HP.

"I think they have some real structural issues that can't be fixed by going private," said Bill Kreher, an analyst at Edward Jones, pointing to Dell's continued dependence on traditional PC sales.

Many of the industry's tech stalwarts have struggled with PC sales. IBM sold its PC business in 2004 to Lenovo. HP briefly considered exiting the business two years ago, but then quickly backed down amid controversy.

The Dell deal quickly sent waves across the personal computer industry, with some big rivals — perhaps seeking to take advantage of the turmoil that the transition may cause Dell — slamming the company and its prospects.

"Dell has a very tough road ahead," HP said in a statement. "The company faces an extended period of uncertainty and transition that will not be good for its customers."

It added: "Leveraged buyouts tend to leave existing customers and innovation at the curb. We believe Dell's customers will now be eager to explore alternatives, and HP plans to take full advantage of that opportunity."

Lenovo, meanwhile, said that it was focused on its products and customers "rather than distracting financial maneuvers and major strategic shifts."

Redmond, Wash.-based Microsoft didn't detail why it was making the investment in Dell other than to say it wanted to help support "the long-term success of the entire PC ecosystem."

With Dell a "key channel" for Microsoft products, the software giant probably wants to keep an eye on Dell as it reinvents itself, said Jayson Noland, a senior analyst at Robert W. Baird & Co.

"Microsoft is going to be there, talking in their ear," Noland said. "It's to keep the ecosystem healthy; it's to influence a key supplier relationship."

The buyout marks the start of a new chapter in what is already one of technology's most remarkable entrepreneurial stories. In 1984, when he was 19, Michael Dell started PC's Ltd. in his University of Texas at Austin dorm room with $1,000. The company would go on to become Dell.

With its hyper-efficient supply chain, Dell became a PC-selling juggernaut. In 2000, at the height of the dot-com boom, Dell was the world's largest PC maker with a market value of more than $100 billion. The founder left in 2004 when the company seemed unstoppable but returned as CEO three years later to a company that had lost its title as leading seller of PCs and was facing an accounting scandal.

The private equity buyout is Michael Dell's biggest gamble yet to revive the fortunes of the company that bears his name.

"To make this transition is not something you can do overnight," Bajarin said. "One of the things you need is time. And one of the things that Wall Street is not good at is giving you time."

andrea.chang@latimes.com

chris.obrien@latimes.com

Read More..

Scientists identify remains as those of King Richard III

LONDON -- More than 500 years after his death in battle, scientists announced Monday that they had definitively identified a skeleton unearthed in central England last summer as that of Richard III, the medieval king portrayed by William Shakespeare as a homicidal tyrant who killed his two young nephews in order to ascend the throne.

DNA from the bones, found beneath the ruins of an old church, matches that of a living descendant of the monarch's sister, researchers said.

"Rarely have the conclusions of academic research been so eagerly awaited," Richard Buckley, the lead archaeologist on the excavation, told a phalanx of reporters Monday morning. "Beyond reasonable doubt, the individual exhumed ... is indeed Richard III, the last Plantagenet king of England."

PHOTOS: Remains of King Richard III

The dramatic announcement capped a brief hunt for Richard's remains, the progress of which has been closely charted by international media and whose success has been barely short of miraculous.

Working from old maps of Leicester, about 100 miles northwest of London, archaeologists from the local university had less than a month to dig in a small municipal parking lot -- one of the few spaces not built over in the crowded city center. The team stumbled on the ruins of the medieval priory where records say Richard was buried, then found the bones a few days later last September.

"It was an extraordinary discovery that stunned all of us," Buckley said.

The nearly intact skeleton bore obvious traces of trauma to the skull and of scoliosis, a curvature of the spine that matched contemporary descriptions of Richard's appearance. The feet were missing, almost certainly the result of later disturbance, and the hands were crossed at the wrist, which suggests that they may have been tied.

Scientists at the University of Leicester, which pioneered the practice of DNA fingerprinting, were able to extract samples from the bones and compare them to a man descended from Richard III's sister Anne. The match through the maternal line was virtually perfect.

"The DNA evidence points to these being the remains of Richard III," said Turi King, the project’s geneticist.

Richard reigned from 1483 to 1485, and occupies a unique place in England's long line of colorful rulers. He was the last English king to be killed in combat, at the Battle of Bosworth Field, by his successor, Henry VII. His death ended the Plantagenet dynasty and ushered in the long era of the Tudors, including Henry VIII and Elizabeth I.

Jo Appleby, an osteologist at the university, said the skeleton belonged to an adult male in his late 20s to late 30s; Richard III was 32 when he died. The man would have stood 5-foot-8 at full height, but the curved spine would have made him appear shorter.

The skull was riddled with wounds strongly indicative of death in battle, including two blows from bladed weapons, either of which would have been fatal, Appleby said.

Richard III is one of England's most controversial monarchs, reviled by some as a bloodthirsty despot who stopped at nothing to gain power, but revered by others who insist that he has been unfairly maligned. His supporters note that the repugnant portrait of Richard in today's popular imagination is based almost entirely on accounts from the time of the usurping Tudors, especially Shakespeare's indelible characterization of him as a "deform'd, unfinish'd" man without scruples.

Fans say Richard III was an enlightened, capable ruler whose important social reforms included the presumption of innocence for defendants and the granting of bail, which remain pillars of the legal system in Britain and the U.S.

However, what happened to Richard's two nephews, who were his rivals for the throne and who were locked up in the Tower of London as young boys, never to be seen again, remains a mystery.

ALSO:

Race to unearth a royal mystery

Bones found in hunt for King Richard III's remains

Netanyahu officially asked to put together new Israeli government

Read More..

NJ Gov. Christie, Letterman laugh about fat jokes

TRENTON, N.J. (AP) — New Jersey Gov. Chris Christie and David Letterman have shared some laughs about the many fat jokes the comedian has made about the lawmaker's ample girth.

Christie has termed his plumpness "fair game" for comedians. And during his first appearance on "Late Show with David Letterman" on Monday, the outspoken Republican and potential 2016 presidential contender read two of Letterman's jokes that he said were "some of my personal favorites."

The governor also drew loud laughs when he pulled out a doughnut and started eating it while Letterman asked him if he was bothered by the digs that have been made about his weight. Christie said he wasn't, noting that he laughs at the jokes if he finds them funny.

"Late Show" airs on CBS at 11:35 p.m. Eastern time.

Read More..