Pentagon expands military benefits for same-sex couples

WASHINGTON — The Pentagon has agreed to expand benefits for gay and lesbian couples serving in the military, but officials continued to withhold equal access to base housing, healthcare and educational services.

Leon E. Panetta, the outgoing secretary of Defense, signed an order Monday that permits same-sex partners and their dependents to use numerous family-oriented facilities and services on U.S. military bases, including recreation areas, counseling programs, school buses, child care and shopping exchanges.

The order grants same-sex couples the right for the first time to request assignment to the same post or duty station if both serve in the military. It also allows partners to receive pay and other benefits if one is taken prisoner or is missing in action.

The move comes less than a month after President Obama used his second inaugural address to embrace equal rights for gay and lesbian Americans. Three days later, Panetta and Gen. Martin Dempsey, chairman of the Joint Chiefs, announced they were lifting the ban on female soldiers and Marines serving in most ground combat units.

The changes stop far short of full equalization of benefits for same-sex couples in the military.

The Defense of Marriage Act, passed by Congress in 1996, effectively barred same-sex couples in the military from the most generous federal benefits, including free or reduced-cost medical services, and tuition assistance. The law defines marriage as the legal union between a man and a woman.

The Supreme Court has scheduled oral arguments next month in a case that challenges the law as unconstitutional.

But Pentagon officials cited additional obstacles to guaranteeing same-sex couples equal access to base housing as other married couples. They said the issue remained under review.

Speaking at a news briefing, Defense officials said they worried that heterosexual couples and their families might be denied housing on some bases if same-sex couples were allowed to apply.

"One of the concerns was, 'I'm married and now I'm going to be bumped by this person who is not married,'" said one official, citing a military housing shortage. The officials spoke to reporters on condition they not be identified.

Panetta's order also does not allow a same-sex partner to request his or her partner's burial at Arlington National Cemetery.

In addition, the spouse of a heterosexual service member being deployed overseas can seek help obtaining a visa, may have access to medical facilities and has legal immunity for some laws in foreign jurisdictions. Those benefits will not be available to same-sex couples.

Under the order, gay and lesbian service members may file a form with the Defense Department that declares they are in a "domestic partnership," defined as a "committed relationship between two adults of the same sex."

It will take several months to update computer software to permit same-sex partners to receive military identification cards, officials said, but the new benefits must be available by Oct. 1.

Officials said the cost of the expanded benefits would be negligible at a time when the Pentagon faces potentially deep budget cuts. They cited estimates that 5,600 same-sex couples are on active duty, 3,400 serve in the National Guard and Reserves, and 8,000 are retirees.

Gay rights groups applauded the latest move, but critics said the administration was circumventing the Defense of Marriage Act.

"Today, the Pentagon took a historic step forward toward righting the wrong of inequality in our armed forces, but there is still more work to be done," said Chad Griffin, president of Human Rights Campaign, a gay rights organization.

"Once again, the president is eroding our military's apolitical stance and forcing conformity onto the rest of society by pushing his liberal social agenda through the Department of Defense," said Sen. James M. Inhofe (R-Okla.), ranking member of the Senate Armed Services Committee.

Panetta, who is expected to leave the Pentagon this month, vowed when he first took the job in 2011 to study additional steps to equalize benefits. Aides said Monday he wanted to fulfill that promise before he stepped down.

His likely successor, former Nebraska Sen. Chuck Hagel, promised at his confirmation hearing last month to pursue expanded benefits for gay and lesbian service members.

The Senate Armed Services Committee was expected to vote Tuesday to recommend Hagel be confirmed, but several Republican senators planned to delay a vote on his confirmation.

david.cloud@latimes.com

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'Identity Thief' grabs $34.6M to debut at No. 1

LOS ANGELES (AP) — Jason Bateman and Melissa McCarthy's "Identity Thief" has made off with the weekend box-office title with a $34.6 million debut.

The top 20 movies at U.S. and Canadian theaters Friday through Sunday, followed by distribution studio, gross, number of theater locations, average receipts per location, total gross and number of weeks in release, as compiled Monday by Hollywood.com are:

1. "Identity Thief," Universal, $34,551,025, 3,141 locations, $11,000 average, $34,551,025, one week.

2. "Warm Bodies," Lionsgate, $11,356,090, 3,009 locations, $3,774 average, $36,481,172, two weeks.

3. "Side Effects," Open Road Films, $9,303,145, 2,605 locations, $3,571 average, $9,303,145, one week.

4. "Silver Linings Playbook," Weinstein Co., $6,425,271, 2,809 locations, $2,287 average, $89,519,510, 13 weeks.

5. "Hansel and Gretel: Witch Hunters," Paramount, $5,753,165, 3,285 locations, $1,751 average, $43,836,018, three weeks.

6. "Mama," Universal, $4,229,665, 2,677 locations, $1,580 average, $63,951,810, four weeks.

7. "Zero Dark Thirty," Sony, $4,006,860, 2,562 locations, $1,564 average, $83,567,450, eight weeks.

8. "Argo," Warner Bros., $2,375,344, 1,405 locations, $1,691 average, $123,608,957, 18 weeks.

9. "Django Unchained," Weinstein Co., $2,303,495, 1,502 locations, $1,534 average, $154,516,627, seven weeks.

10. "Bullet to the Head," Warner Bros., $2,078,192, 2,404 locations, $864 average, $8,269,214, two weeks.

11. "Top Gun" in 3-D, Paramount, $1,965,737, 300 locations, $6,552 average, $1,965,737, one week.

12. "Lincoln," Disney, $1,873,537, 1,517 locations, $1,235 average, $173,621,006, 14 weeks.

13. "Parker," FilmDistrict, $1,867,411, 2,004 locations, $932 average, $15,848,064, three weeks.

14. "Life of Pi," Fox, $1,745,744, 924 locations, $1,889 average, $108,530,249, 12 weeks.

15. "Les Miserables," Universal, $1,555,550, 1,447 locations, $1,075 average, $143,983,705, seven weeks.

16. "The Hobbit: An Unexpected Journey," Warner Bros., $1,468,374, 1,001 locations, $1,467 average, $298,333,426, nine weeks.

17. "Parental Guidance," Fox, $1,071,766, 1,219 locations, $879 average, $74,344,256, seven weeks.

18. "Wreck-It Ralph," Disney, $1,065,817, 757 locations, $1,408 average, $184,414,532, 15 weeks.

19. "The Impossible," Summit, $957,594, 739 locations, $1,296 average, $16,668,338, eight weeks.

20. "Quartet," Weinstein Co., $940,930, 244 locations, $3,856 average, $5,000,417, five weeks.

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Online:

http://www.hollywood.com

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Universal and Focus are owned by NBC Universal, a unit of Comcast Corp.; Sony, Columbia, Sony Screen Gems and Sony Pictures Classics are units of Sony Corp.; Paramount is owned by Viacom Inc.; Disney, Pixar and Marvel are owned by The Walt Disney Co.; Miramax is owned by Filmyard Holdings LLC; 20th Century Fox and Fox Searchlight are owned by News Corp.; Warner Bros. and New Line are units of Time Warner Inc.; MGM is owned by a group of former creditors including Highland Capital, Anchorage Advisors and Carl Icahn; Lionsgate is owned by Lions Gate Entertainment Corp.; IFC is owned by AMC Networks Inc.; Rogue is owned by Relativity Media LLC.

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Health Testing on Mice Is Found Misleading in Some Cases

Evan McGlinn for The New York Times

Dr. H. Shaw Warren is one of the authors of a new study that questions the use of laboratory mice as models for all human diseases.

For decades, mice have been the species of choice in the study of human diseases. But now, researchers report evidence that the mouse model has been totally misleading for at least three major killers — sepsis, burns and trauma. As a result, years and billions of dollars have been wasted following false leads, they say.

The study’s findings do not mean that mice are useless models for all human diseases. But, its authors said, they do raise troubling questions about diseases like the ones in the study that involve the immune system, including cancer and heart disease.

“Our article raises at least the possibility that a parallel situation may be present,” said Dr. H. Shaw Warren, a sepsis researcher at Massachusetts General Hospital and a lead author of the new study.

The paper, published Monday in Proceedings of the National Academy of Sciences, helps explain why every one of nearly 150 drugs tested at a huge expense in patients with sepsis has failed. The drug tests all were based on studies in mice. And mice, it turns out, can have something that looks like sepsis in humans, but is very different from the condition in humans.

Medical experts not associated with the study said that the findings should change the course of research worldwide for a deadly and frustrating condition. Sepsis, a potentially deadly reaction that occurs as the body tries to fight an infection, afflicts 750,000 patients a year in the United States, kills one-fourth to one-half of them, and costs the nation $17 billion a year. It is the leading cause of death in intensive-care units.

“This is a game changer,” said Dr. Mitchell Fink, a sepsis expert at the University of California, Los Angeles, of the new study.

“It’s amazing,” said Dr. Richard Wenzel, a former chairman at the department of internal medicine at Virginia Commonwealth University and a former editor of The New England Journal of Medicine. “They are absolutely right on.”

Potentially deadly immune responses occur when a person’s immune system overreacts to what it perceives as danger signals, including toxic molecules from bacteria, viruses, fungi, or proteins released from cells damaged by trauma or burns, said Dr. Clifford S. Deutschman, who directs sepsis research at the University of Pennsylvania and was not part of the study.

The ramped-up immune system releases its own proteins in such overwhelming amounts that capillaries begin to leak. The leak becomes excessive, and serum seeps out of the tiny blood vessels. Blood pressure falls, and vital organs do not get enough blood. Despite efforts, doctors and nurses in an intensive-care unit or an emergency room may be unable to keep up with the leaks, stop the infection or halt the tissue damage. Vital organs eventually fail.

The new study, which took 10 years and involved 39 researchers from across the country, began by studying white blood cells from hundreds of patients with severe burns, trauma or sepsis to see what genes were being used by white blood cells when responding to these danger signals.

The researchers found some interesting patterns and accumulated a large, rigorously collected data set that should help move the field forward, said Ronald W. Davis, a genomics expert at Stanford University and a lead author of the new paper. Some patterns seemed to predict who would survive and who would end up in intensive care, clinging to life and, often, dying.

The group had tried to publish its findings in several papers. One objection, Dr. Davis said, was that the researchers had not shown the same gene response had happened in mice.

“They were so used to doing mouse studies that they thought that was how you validate things,” he said. “They are so ingrained in trying to cure mice that they forget we are trying to cure humans.”

“That started us thinking,” he continued. “Is it the same in the mouse or not?”

The group decided to look, expecting to find some similarities. But when the data were analyzed, there were none at all.

“We were kind of blown away,” Dr. Davis said.

The drug failures became clear. For example, often in mice, a gene would be used, while in humans, the comparable gene would be suppressed. A drug that worked in mice by disabling that gene could make the response even more deadly in humans.

Even more surprising, Dr. Warren said, was that different conditions in mice — burns, trauma, sepsis — did not fit the same pattern. Each condition used different groups of genes. In humans, though, similar genes were used in all three conditions. That means, Dr. Warren said, that if researchers can find a drug that works for one of those conditions in people, it might work for all three.

This article has been revised to reflect the following correction:

Correction: February 11, 2013

An earlier version of this article misstated the position of Dr. Richard Wenzel. He is a former chairman of the department of internal medicine at Virginia Commonwealth University. He is not currently the chairman.

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TV commercial actors feeling pinched as they pitch products

In a nearly 30-year television career, Frank Crim has appeared in more than 150 commercials, pitching Honda SUVs, Jack in the Box hamburgers, Allstate insurance, and Capital One credit cards.

The Oklahoma City native has played a plumber, a trash collector, a chef, a cab driver and a demon.

But lately Crim is having to book more jobs to make the same money he did a decade ago.

"I still don't make enough money to buy a house," said Crim, who makes about $60,000 a year and shares an apartment in the San Fernando Valley. "I'm not asking for the moon, just enough to make a livable wage."

PHOTOS: Celebrities by The Times

Even as the advertising industry rebounds in the wake of the Great Recession — commercial production reached a record level in Los Angeles last year — middle-class actors hired to pitch products for Ford or Budweiser are having a tougher time making ends meet.

They're being pinched by a variety of forces. Celebrities are taking spots once occupied by lesser-known actors. Lucrative network television residuals — the fees that actors get when their work is rerun — have eroded as advertisers shift spending to cable television shows like "Mad Men" and "Breaking Bad" that pay lower rates.

Many actors feel overexposed and underpaid too when their TV commercials go viral on the Internet.

Those are among the issues confronting negotiators for SAG-AFTRA as they meet in New York this week to begin bargaining on a new three-year contract with advertising agencies. The current contract, which covers about $1 billion in annual earnings for commercial actors, expires March 31.

The negotiation is being closely watched: It is the first since the Screen Actors Guild merged a year ago with its smaller sister union, the American Federation of Television and Radio Artists. SAG-AFTRA leaders face pressure to make good on their vow that a combined union would have more leverage in negotiations to extract improved pay and benefits for their more than 165,000 members, many of whom rely on commercial and voice-over jobs to supplement income from television and film work.

About 50,000 people work under the commercials contract.

Representatives of SAG-AFTRA and a joint policy committee of the American Assn. of Advertising Agencies and the Assn. of National Advertisers declined to comment on the upcoming talks, which begin Thursday.

But the negotiations could be contentious. In 2000 actors staged a six-month strike, mainly over how they were to be paid for commercials shown on network and cable television.

PHOTOS: Hollywood backlot moments

SAG at that time was dominated by a hard-line group. SAG-AFTRA Co-President Roberta Reardon, who is chairing the negotiating committee, and chief negotiator David White, the union's executive director, are known as moderates who eschew outward confrontations with employers.

That was evident last week when the union sounded a conciliatory tone after the board approved a package of bargaining proposals.

"While there are difficult issues to negotiate ahead, we anticipate a productive dialogue with our bargaining partners and expect a result that is positive for our members," White said.

But the advertisers policy committee has warned members to prepare for a possible strike.

"Consider rescheduling production planned for March 31, 2013, through June 2013 to dates prior to March 31, 2013, to account for any possible impasse and strike," lead negotiator Doug Wood said in a memo in December. "This is of particular concern if you are planning production for the rollout of a new campaign or a planning a celebratory production."

Although SAG-AFTRA officials have declined to publicly discuss their package of proposals, sources close to the confidential negotiations said the union is seeking annual wage increases and higher pay for commercials shown on the Internet, as well as larger health and pension contributions. It's unclear how receptive advertisers will be to the demands, having agreed to $36 million in pay increases over three years in the previous contract negotiation in 2009.

But many veteran commercial actors fear being left behind as advertising migrates to new media.

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Gen. Joseph Dunford becomes U.S. commander in Afghanistan

KABUL, Afghanistan — Gen. Joseph F. Dunford Jr. took over Sunday as the newest and probably last U.S. commander in Afghanistan, charged with ending America's longest war even as insurgents continue to challenge the U.S.-backed Afghan government.

Dunford, a four-star Marine officer, arrives as the U.S.-led NATO coalition has closed three-quarters of its 800 bases and as it watches to see whether the Afghan security forces it trained can keep the Taliban insurgency at bay.

A ceremony inside the coalition's heavily guarded compound in Kabul marked the end of the 19-month tenure of Gen. John R. Allen, whose command was marred by a rash of deadly "insider" attacks by Afghan forces against their U.S. and NATO trainers and by strained relations with Afghan President Hamid Karzai.

But in remarks tinged with emotion Sunday, Allen pointed to significant progress, including the growth of the Afghan security forces, an increase in Afghan-led military operations, a sharp reduction in civilian casualties and the withdrawal of about 35,000 U.S. troops.

"This is victory," Allen said. "This is what winning looks like, and we should not shrink from using those words."

Allen was cleared of wrongdoing last month in a Pentagon inquiry into emails he exchanged with a woman who was linked to the sex scandal that forced the resignation of CIA Director David H. Petraeus. Allen has been nominated to lead North Atlantic Treaty Organization forces in Europe.

By replacing Allen with Dunford, the respected but low-key assistant commandant of the Marine Corps, President Obama hopes to repair ties with Karzai so they can cement a long-term security deal that could see several thousand U.S. troops remain in Afghanistan beyond the withdrawal of combat forces next year.

Embracing Allen at the ceremony, Dunford stressed continuity in the mission.

"What's not changed is the will of this coalition," he said. "What's not changed is the growing capability of our Afghan partners."

Obama is expected to spell out plans for the troop withdrawal and a post-2014 U.S. military presence in Afghanistan as early as his State of the Union message Tuesday. Although White House officials have said it's possible that no U.S. troops would remain, Pentagon officials are calling for a residual force that would focus on counter-terrorism and supporting Afghan forces.

Dunford will have a key seat at the table as U.S. officials try to work out the security agreement, which will hinge on earning assurances from Afghan leaders that they won't release prisoners currently in U.S. custody and will guarantee U.S. troops immunity from prosecution in Afghan courts. The failure to reach an immunity guarantee was a main reason no U.S. troops remained in Iraq after the war ended there.

About 65,000 U.S. troops remain in Afghanistan, down from a high of 100,000. Despite flagging U.S. support for the war, military commanders contend that removing the remaining troops precipitously could cause Afghan security forces to collapse.

In his Senate confirmation hearing in November, Dunford offered no prescriptions for troop levels but cautioned against withdrawing too quickly, saying it could destabilize the region.

U.S. officials recently estimated that a residual American force could number from 6,000 to 9,000 troops — fewer than the 15,000 senior military commanders had wanted. Experts say that Dunford will be charged with figuring out how such a force could achieve U.S. strategic aims.

"A major challenge will be identifying a mission that those troops can perform that's useful and doable with that small number," said Stephen Biddle, a defense analyst and professor at George Washington University.

Even as the war winds down, challenges remain. The insider attacks that killed 61 NATO troops in 2012 have dissipated, but only after U.S. troops scaled back joint operations with Afghan forces, hampering training efforts. By next year, Afghan forces are expected to be in the lead of all security operations, but the Taliban, though weakened, retains the ability to attack in Kabul and other strategic areas.

Experts say that Dunford, who earned the nickname "Fighting Joe" when he led a charge from Kuwait into Baghdad during the 2003 invasion of Iraq, could clash with a second-term Obama Cabinet, whose members — including Secretary of State John F. Kerry and, if he's confirmed, Chuck Hagel as Defense secretary — have not been strong supporters of a large long-term U.S. presence in Afghanistan.

"It's going to be extremely difficult for a commanding general who's not going to have many partners in the administration," said Thomas Donnelly, a military expert at the American Enterprise Institute, a conservative Washington think tank.

"It's a bit of a thankless task, for sure."

shashank.bengali@latimes.com

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Fun. takes song of the year at Grammy Awards

LOS ANGELES (AP) — You can cross one major trophy off the list for fun. at the Grammy Awards.

The pop-rockers won song of the year for their transcendent anthem, "We Are Young," featuring Janelle Monae, during Sunday night's telecast, taking the first of four major awards the group's been nominated.

"I don't know what I was thinking when I wrote the chorus to this song," lead singer Nate Ruess joked. "This is in HD, everyone can see our faces, and we are not very young."

Most of the attention has been on Frank Ocean going into the awards — he won a trophy for urban contemporary album and is up for four more trophies during the telecast. But his fellow lead nominees got an early lead on the R&B singer.

"We Are Young" helped fun. earn a starring role at these Grammys with nominations in all four major categories after the release of their first album, matched only by Christopher Cross in 1981, and six overall. The band turned in a powerful early performance of "Carry On" early in the show as a downpour on stage began mid-song and guitarist Jack Antonoff got a kiss from girlfriend Lena Dunham of "Girls" fame after winning.

Fun. may have picked up a major win, but it was The Black Keys and Skrillex who had the early lead thanks to strong runs in the pre-telecast awards show.

The Black Keys singer-guitarist Dan Auerbach took the early lead during the pre-telecast show, picking up three trophies and assisting with a fourth. Auerbach won producer of the year alone and best rock song for "Lonely Boy" and rock album for "El Camino" with his bandmate Patrick Carney, joining electronic dance music innovator Skrillex atop the early leaderboard. He was also producer for another winner, Dr. John.

A slew of artists sit one back going into the main awards show at the Staples Center, including fellow top nominees Kanye West and Jay-Z, Gotye, former best new artist winner Esperanza Spalding, jazz man Chick Corea and Christian singer-songwriter Matt Redman.

West and Jay-Z won best rap song and best rap performance for the song "... in Paris" from their "Watch the Throne" collaboration and lost a third for short form video for "No Church in The Wild," which featured Ocean. Ocean will be up for five awards later in the evening.

Other early winners included Rihanna, Beyonce, Mumford & Sons and Taylor Swift, who opened the show as the Mad Hatter. Swift dressed in white top hat, tails, shorts and tall boots during the surreal version of her hummable hit "We Are Never Ever Getting Back Together" that included a troop of mime clowns and a guy on a tricycle with a flame-thrower attached.

The singer pretended to talk to the offending boyfriend on the phone: "I'm busy opening the Grammys and we're never getting back together."

Justin Timberlake debuted new tracks "Suit & Tie" with Jay-Z and "Pusher Love" in a performance that was broadcast in retro black and white. Elton John and Ed Sheeran teamed on "The A Team" and Miguel and Wiz Kalifa teamed up on "Adorn."

Adele won the first award of the night on the main telecast, taking home best pop solo performance for "Set Fire to the Rain (Live)," in one of the night's least-surprising moments — though the singer was somewhat taken aback.

"I just wanted to be part of the night, because I loved it last year, obviously," she said of winning a record-tying six awards in 2012.

Carrie Underwood won best country solo performance for "Blown Away."

The Grammy pre-telecast awards show at the Nokia Theatre had 70 trophies up for grabs, including rock, pop, rap and country categories.

Skrillex won best dance recording for "Bangarang," featuring Sirah, best dance/electronica album for "Bangarang" and best remixed recording a year after winning those same awards in his first appearance at the Grammys.

"You know what, I thought I'd get used to it, but I tripped over every word when I was up there," Skrillex said of his acceptance speeches. "I felt like I just wanted a pool of ice water and just couldn't even breathe or think. It was crazy. I think it was even crazier than last year."

Gotye won best alternative album for "Making Mirrors" and best pop/duo performance for "Somebody That I Used To Know," featuring Kimbra.

Celebrities rolled down the red carpet in the early afternoon, showing a fair amount of skin despite CBS's mandate that stars dress appropriately with butts, breasts and other sensitive areas covered adequately.

Nevertheless, Jennifer Lopez showed up on stage in a dress slit all the way to her hip.

"As you can see, I read the memo," Lopez joked.

Celebrities also felt an increased Los Angeles Police Department presence in light of a manhunt involving an alleged cop killer. Police were everywhere, including atop the hotel across from the Staples Center.

Frank Ocean remains in contention for five awards and will perform.

"It feels cool," Ocean said on the red carpet. "It's really bright, a lot of beautiful ladies walking around being fancy. I have to perform tonight so the wheels are constantly spinning. You can't really just sit in your seat and take it all in."

Three of the night's major awards are still to come. Jack White's "Blunderbuss" competes with fun.'s "Some Nights," Ocean's "channel ORANGE," Mumford's "Babel" and The Keys' "El Camino" for the night's top award, album of the year.

Gotye's "Somebody That I Used To Know," featuring Kimbra, Taylor Swift's "We Are Never Ever Getting Back Together" and Kelly Clarkson's "Stronger (What Doesn't Kill You)" join the fun., Ocean and Black Keys entries in record of the year.

And rounding out the major categories, fun., Ocean, Alabama Shakes, Hunter Hayes and The Lumineers are up for best new artist.

There was no shortage of mashups the Grammys have become famous for, either. Elton John, Mavis Staples, Mumford, Brittany Howard, T Bone Burnett and Zac Brown are saluting the late Levon Helm, who won the Americana Grammy last year a few months before his death. The Keys will join Dr. John and the Preservation Hall Jazz Band on stage. Sting, Rihanna and Bruno Mars will perform together. Other team-ups include Miranda Lambert and Dierks Bentley, and Alicia Keys and Maroon 5.

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AP writers Nekesa Mumbi Moody, Mesfin Fekadu, Sandy Cohen, Anthony McCartney and Beth Harris in Los Angeles contributed to this report.

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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?”

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Apple developing wristwatch device that runs on iOS, reports say

The cycle of speculation that Apple plans to build some kind of wristwatch or other wearable computing device kicked into high gear this weekend after a pair of reports claimed to confirm that such a device was under development. 

First, the New York Times reported that it had confirmed with multiple sources that Apple "is experimenting with wristwatch-like devices made of curved glass."

That story was followed by another report from the Wall Street Journal saying it had also confirmed that Apple "is experimenting with designs for a watch-like device that would perform some functions of a smartphone."

QUIZ: Test your Apple knowledge

There were no additional confirmed details about what such a gadget might do, what features it would specifically offer, how much it would cost, or even when it might hit the market. 

Speculation about a possible iWatch has been ebbing and flowing for several years now. In December, a Chinese blog claimed it had confirmation that such a device was under development. And this week, former Apple designer Bruce Tognazzini wrote an expansive blog post suggesting what such a device might do. 

He believed Apple was the perfect company to address the numerous design flaws, such as bulkiness and short battery life, that have made adoption of other such devices slow. 

"The first thing Apple has to do is address traditional drawbacks in smartwatch design, something they are qualified to do," he wrote. 

One other notable nugget from the New York Times story: Steve Jobs had told another reporter that he had very much wanted Apple to build a car:

"In a meeting in his office before he died, Steven P. Jobs, Apple’s co-founder and former chief executive, told John Markoff of The New York Times that if he had more energy, he would have liked to take on Detroit with an Apple car."

The idea of dueling Apple and Google cars battling it out for the future of our roadways may be the stuff nerd dreams are made of. 

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Unusual, quirky and just plain weird iPhone cases

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Follow me on Twitter @obrien.

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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

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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.

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