Clean-air chief Gina McCarthy seen as likely pick to head EPA

WASHINGTON — President Obama is expected by environmental advocates to name Gina McCarthy, the controversial chief of the Environmental Protection Agency's air pollution arm, to head the agency.

The nomination of McCarthy, 58, who has served as the head of the EPA's clean-air division since 2009, could come as early as next week, according to officials of three environmental groups. Her boss, Lisa Jackson, left the administrator's post Thursday.

McCarthy's nomination is likely to draw fire from congressional Republicans. Over the last four years, they have attacked the EPA's new regulations to cut air pollution, including emissions of greenhouse gases, as job-killing government overreach.

Obama's choice of McCarthy also would signal that he is poised to make good on the more aggressive rhetoric he has used lately about the urgency of addressing climate change, environmentalists said.

During his State of the Union address Tuesday, Obama departed from his past cautiousness to make a moral case for tackling climate change. He challenged Congress to cut greenhouse gas emissions, but said he would use his authority if it failed to take action.

"If he were to pick Gina, it means he really means it," said Jody Freeman, a Harvard law professor and former White House counselor for energy and climate change who worked closely with McCarthy from 2009 to 2010.

"I think she is focused like a laser beam on being a smart and effective regulator. She's not interested in anything that's not practical, and she understands perfectly the president's agenda," Freeman said.

The White House declined to comment on the possibility of a McCarthy nomination.

"The EPA air administrator is well situated to lead the agency, if only because some of the most costly and wide-sweeping decisions come from the air office," said Scott Segal, a lawyer with Bracewell & Giuliani, a Houston law firm that often represents energy companies.

"That said, Gina McCarthy is engaging, effective and willing to listen to the regulated community — even if we don't always agree with her final rules," he said.

A Boston native, McCarthy served under four Massachusetts governors before being picked by former Gov. Mitt Romney as one of his top environmental staffers there. But she left shortly afterward to serve as commissioner of Connecticut's environmental protection department from 2004 to 2009, where she helped implement a regional scheme to trade carbon credits to reduce greenhouse gas emissions from power plants.

McCarthy began her tenure with the Obama administration's EPA after the Supreme Court issued a landmark decision enabling the agency to regulate emissions of carbon dioxide, the main driver of climate change.

By May 2009, McCarthy's office of air and radiation had hammered out a plan with the White House, the auto industry, states like California, environmentalists and the United Auto Workers union to boost fuel efficiency considerably in passenger vehicles from 2012 to 2016.

In 2011, the EPA rolled out a second phase of fuel economy standards that would increase average fuel economy to 54.5 miles per gallon by 2025.

Under McCarthy, the air office also issued unprecedented rules to curtail emissions of mercury and carbon dioxide from new power plants. Her unit's work stirred the ire of many in industry and their state and congressional allies, who argued that the rules were too onerous.

That led to many appearances by McCarthy at often testy congressional hearings, solid preparation for the EPA administrator in light of the aggressive agenda that Obama said he would now pursue. Most of her office's regulations withstood many legal challenges. But a long-awaited rule to cut smog-forming ozone was scuttled by the president himself in 2011.

The second-term EPA will have to make final the rules on carbon emissions from new power plants, and it faces demands from environmentalists to issue similar standards for existing plants, the biggest emitters of greenhouse gases in the U.S.

neela.banerjee@latimes.com

Read More..

Oscar Pistorius remains in jail facing murder charge

JOHANNESBURG, South Africa -- South African athlete Oscar Pistorius, who made history last year as the first double amputee runner to compete in the Olympics using prosthetic blades, will spend the night in jail Thursday after he was charged with murder in the death of his girlfriend at his house, prosecutors said.

The National Prosecuting Authority said Pistorius would remain in custody until his hearing Friday, when police intend to oppose bail.

Reeva Steenkamp, a 30-year-old model, died after being shot several times in the head and arm in Pistorius’ house in an upscale suburb in Pretoria.

PHOTOS: Pistorius in the London Olympics

Pistorius was ushered from the home by police Thursday morning with a gray hoodie covering his head and obscuring most of his face.

South Africans were in shock about the accusation against Pistorius, who became a hero during his long battle for the right to compete in the Olympics. After a controversy on whether the blades he uses to walk and run gave him an advantage in races, Pistorius was granted the right to compete in the London 2012 Olympic Games.

South Africa has one of the world's highest rates of murder and violent crime, and many South Africans keep guns at home to guard against intruders.

The Afrikaans-language newspaper Beeld suggested that Pistorius mistook his girlfriend for a burglar and killed her accidentally.

However, a police spokeswoman, Brig. Denise Beukes, said police were “surprised” at reports the killing was accidental, adding that that version hadn’t come from police, according to the South African Press Assn.

"I confirm there had been previous incidents of a domestic nature at his place,” said Beukes, adding that police couldn’t comment on the decision to oppose bail.

Beukes said police had interviewed neighbors who heard sounds at Pistorius’ home earlier in the evening, and also at the time the incident reportedly took place.

Pistorius’ father, Henke Pistorius, said his son was sad. But the older Pistorius said he didn’t know the facts.

“I don’t know nothing. It will be extremely obnoxious and rude to speculate,” he said in a radio interview. “If anyone makes a statement, it will have to be Oscar.”

An advertisement for Nike, one of Pistorius’ major sponsors, was removed from his official website Thursday. It had shown the athlete in a green lycra athletic suit and the slogan, “I am the bullet in the chamber."

ALSO:

Six arrested in Acapulco rape case

Iranian general reportedly assassinated while traveling from Syria

British case of new virus suggests person-to-person transmission

Read More..

Ryan O'Neal wins appeals ruling in defamation case

LOS ANGELES (AP) — Ryan O'Neal may have enough evidence to show that he was defamed by a man who claimed the actor stole a valuable portrait of the late Farrah Fawcett, an appeals court ruled Thursday.

A divided panel of the 2nd District Court of Appeal ruled that O'Neal's case against Craig Nevius, a former Fawcett associate, should be allowed to proceed and that the actor may be able to win some damages. One justice disagreed and wrote that the case should be dismissed.

O'Neal sued in July 2011, claiming he was defamed by Nevius' comments that the actor had stolen a Fawcett portrait created by Andy Warhol. The painting is the subject of a separate lawsuit between O'Neal and the University of Texas, which claims Fawcett left the artwork to the school after her 2009 death.

Nevius's attorney, Lincoln Bandlow, said he would appeal the ruling to the California Supreme Court. He had appealed a lower court's ruling allowing the case to go forward.

O'Neal's suit seeks more than $1 million in damages. He claimed in the case that Warhol gave him the portrait and he intends to bequeath it to his only son from his longtime relationship with Fawcett, Redmond O'Neal.

Nevius' comments that O'Neal stole the artwork were made in interviews with Star magazine and "Good Morning America," and he cooperated with UT investigators searching for the portrait.

Although Nevius initially denied he accused O'Neal of stealing the painting, he acknowledged in a later court filing that he made the claim to university investigators.

"The inferences reasonably drawn from the evidence here would support a jury's finding that Nevius harbored strong ill-feelings toward O'Neal," the justices siding with O'Neal wrote. The dissent argues that Nevius' comments were constitutionally-protected speech and the case should have been dismissed.

O'Neal's fight with UT over the portrait returns to court on Feb. 27.

The actor and Nevius have battled in court for years.

Nevius collaborated on a documentary of Fawcett's fight with cancer but sued the actor claiming he interfered in the project and removed him from it shortly before Fawcett's death. The case was dismissed before trial.

___

Anthony McCartney can be reached at http://twitter.com/mccartneyAP

Read More..

Doctor and Patient: Afraid to Speak Up to Medical Power

The slender, weather-beaten, elderly Polish immigrant had been diagnosed with lung cancer nearly a year earlier and was receiving chemotherapy as part of a clinical trial. I was a surgical consultant, called in to help control the fluid that kept accumulating in his lungs.

During one visit, he motioned for me to come closer. His voice was hoarse from a tumor that spread, and the constant hissing from his humidified oxygen mask meant I had to press my face nearly against his to understand his words.

“This is getting harder, doctor,” he rasped. “I’m not sure I’m up to anymore chemo.”

I was not the only doctor that he confided to. But what I quickly learned was that none of us was eager to broach the topic of stopping treatment with his primary cancer doctor.

That doctor was a rising superstar in the world of oncology, a brilliant physician-researcher who had helped discover treatments for other cancers and who had been recruited to lead our hospital’s then lackluster cancer center. Within a few months of the doctor’s arrival, the once sleepy department began offering a dazzling array of experimental drugs. Calls came in from outside doctors eager to send their patients in for treatment, and every patient who was seen was promptly enrolled in one of more than a dozen well-documented treatment protocols.

But now, no doctors felt comfortable suggesting anything but the most cutting-edge, aggressive treatments.

Even the No. 2 doctor in the cancer center, Robin to the chief’s cancer-battling Batman, was momentarily taken aback when I suggested we reconsider the patient’s chemotherapy plan. “I don’t want to tell him,” he said, eyes widening. He reeled off his chief’s vast accomplishments. “I mean, who am I to tell him what to do?”

We stood for a moment in silence before he pointed his index finger at me. “You tell him,” he said with a smile. “You tell him to consider stopping treatment.”

Memories of this conversation came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.

For several decades, medical educators and sociologists have documented the existence of hierarchies and an intense awareness of rank among doctors. The bulk of studies have focused on medical education, a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviors. Aspiring doctors quickly learn whose opinions, experiences and voices count, and it is rarely their own. Ask a group of interns who’ve been on the wards for but a week, and they will quickly raise their hands up to the level of their heads to indicate their teachers’ status and importance, then lower them toward their feet to demonstrate their own.

It turns out that this keen awareness of ranking is not limited to students and interns. Other research has shown that fully trained physicians are acutely aware of a tacit professional hierarchy based on specialties, like primary care versus neurosurgery, or even on diseases different specialists might treat, like hemorrhoids and constipation versus heart attacks and certain cancers.

But while such professional preoccupation with privilege can make for interesting sociological fodder, the real issue, warns the author of a courageous essay published recently in The New England Journal of Medicine, is that such an overly developed sense of hierarchy comes at an unacceptable price: good patient care.

Dr. Ranjana Srivastava, a medical oncologist at the Monash Medical Centre in Melbourne, Australia, recalls a patient she helped to care for who died after an operation. Before the surgery, Dr. Srivastava had been hesitant to voice her concerns, assuming that the patient’s surgeon must be “unequivocally right, unassailable, or simply not worth antagonizing.” When she confesses her earlier uncertainty to the surgeon after the patient’s death, Dr. Srivastava learns that the surgeon had been just as loath to question her expertise and had assumed that her silence before the surgery meant she agreed with his plan to operate.

“Each of us was trying our best to help a patient, but we were also respecting the boundaries and hierarchy imposed by our professional culture,” Dr. Srivastava said. “The tragedy was that the patient died, when speaking up would have made all the difference.”

Compounding the problem is an increasing sense of self-doubt among many doctors. With rapid advances in treatment, there is often no single correct “answer” for a patient’s problem, and doctors, struggling to stay up-to-date in their own particular specialty niches, are more tentative about making suggestions that cross over to other doctors’ “turf.” Even as some clinicians attempt to compensate by organizing multidisciplinary meetings, inviting doctors from all specialties to discuss a patient’s therapeutic options, “there will inevitably be a hierarchy at those meetings of who is speaking,” Dr. Srivastava noted. “And it won’t always be the ones who know the most about the patient who will be taking the lead.”

It is the potentially disastrous repercussions for patients that make this overly developed awareness of rank and boundaries a critical issue in medicine. Recent efforts to raise safety standards and improve patient care have shown that teams are a critical ingredient for success. But simply organizing multidisciplinary lineups of clinicians isn’t enough. What is required are teams that recognize the importance of all voices and encourage active and open debate.

Since their patient’s death, Dr. Srivastava and the surgeon have worked together to discuss patient cases, articulate questions and describe their own uncertainties to each other and in patients’ notes. “We have tried to remain cognizant of the fact that we are susceptible to thinking about hierarchy,” Dr. Srivastava said. “We have tried to remember that sometimes, despite our best intentions, we do not speak up for our patients because we are fearful of the consequences.”

That was certainly true for my lung cancer patient. Like all the other doctors involved in his care, I hesitated to talk to the chief medical oncologist. I questioned my own credentials, my lack of expertise in this particular area of oncology and even my own clinical judgment. When the patient appeared to fare better, requiring less oxygen and joking and laughing more than I had ever seen in the past, I took his improvement to be yet another sign that my attempt to talk about holding back chemotherapy was surely some surgical folly.

But a couple of days later, the humidified oxygen mask came back on. And not long after that, the patient again asked for me to come close.

This time he said: “I’m tired. I want to stop the chemo.”

Just before he died, a little over a week later, he was off all treatment except for what might make him comfortable. He thanked me and the other doctors for our care, but really, we should have thanked him and apologized. Because he had pushed us out of our comfortable, well-delineated professional zones. He had prodded us to talk to one another. And he showed us how to work as a team in order to do, at last, what we should have done weeks earlier.

Read More..

Meruelo Group buys Trump Plaza casino

ATLANTIC CITY, N.J. — Trump Plaza, the Boardwalk centerpiece of Donald Trump's onetime Atlantic City empire, was sold Thursday to a Downey company for $20 million in the cheapest of a series of bargain-basement deals for distressed gambling halls in the struggling New Jersey seaside resort.

It's a humbling finish for the flamboyant New York developer, who bet big on Atlantic City in the 1980s. The buyer, Meruelo Group, is headquartered in a two-story office building on Firestone Boulevard in Downey and was established as a pizza business catering to the Latino community.

Founded by Chief Executive Alex Meruelo in 1986, Meruelo Group now counts construction, engineering, real estate, food service and private equity among its businesses. It also owns Grand Sierra Resort and Casino in Reno.

Xavier Gutierrez, chief investment officer for Meruelo Group, said the company planned to make a sizable investment in the property but could not yet predict what staffing levels would be.

The sale is expected to close May 31 in what would be the lowest price ever paid for a casino in Atlantic City.

Trump Plaza, which cost $210 million to build, opened in May 1984 as one of Donald Trump's pet projects. The real estate mogul has since limited his dealings in Atlantic City.

The sale leaves the company he once ran, Trump Entertainment Resorts, with just one casino, Trump Taj Mahal Casino Resort in Atlantic City. The company sold the former Trump Marina to a Texas company that rebranded it as the Golden Nugget in 2011.

Trump Plaza is one of the first casinos visitors to Atlantic City see. It sits at the foot of the Atlantic City Expressway on the Boardwalk, directly next to Boardwalk Hall, and sometimes markets itself as being in "the center of it all."

It stands 39 stories over the Boardwalk and has 906 hotel rooms, ranking it among the smallest of the city's 12 casinos, the most successful of which have 2,000 or more rooms apiece.

Times staff writer Roger Vincent contributed to this report.

Read More..

Dorner manhunt: Investigators work to ID charred human remains

After what LAPD Chief Charlie Beck called "a bittersweet night," investigators Wednesday were in the process of identifying the human remains found in the charred cabin where fugitive ex-cop Christopher Dorner was believed to have been holed up after trading gunfire with officers, authorities said.

If the body is identified as Dorner’s, the standoff would end a weeklong manhunt for the ex-LAPD officer and Navy Reserve lieutenant suspected in a string of shootings following his firing by the Los Angeles Police Department several years ago. Four people have died in the case, allegedly at Dorner’s hands.

Beck said he would not consider the manhunt over until the body was identified as Dorner. Police remained on tactical alert and were conducting themselves as if nothing had changed in the case, officials said.

PHOTOS: Manhunt for ex-LAPD officer

The latest burst of gunfire came Tuesday after the suspect, attempting to flee law enforcement officials, fatally shot a San Bernardino County sheriff’s deputy and seriously injured another, officials said. He then barricaded himself in a wooden cabin outside Big Bear, not far from ski resorts in the snow-capped San Bernardino Mountains east of Los Angeles, according to police.

"This could have ended much better, it could have ended worse," said Beck as he drove to the hospital where the injured deputy was located. "I feel for the family of the deputy who lost his life."

The injured deputy is expected to survive but it is anticipated he will need several surgeries. The names of the two deputies have not been released.

TIMELINE: Manhunt for ex-LAPD officer

Just before 5 p.m., authorities smashed the cabin's windows, pumped in tear gas and called for the suspect to surrender, officials said. They got no response. Then, using a demolition vehicle, they tore down the cabin's walls one by one. When they reached the last wall, they heard a gunshot. Then the cabin burst into flames, officials said.

Last week, authorities said they had tracked Dorner to a wooded area near Big Bear Lake. They found his torched gray Nissan Titan with several weapons inside, the said, and the only trace of Dorner was a short trail of footprints in newly fallen snow.

According to a manifesto that officials say Dorner posted on Facebook, he felt the LAPD unjustly fired him several years ago, when a disciplinary panel determined that he lied in accusing his training officer of kicking a mentally ill man during an arrest. Beck has promised to review the case.

DOCUMENT: Read the manifesto

The manifesto vows "unconventional and asymmetrical warfare" against law enforcement officers and their families. "Self-preservation is no longer important to me. I do not fear death as I died long ago," it said.

On Tuesday morning, two maids entered a cabin in the 1200 block of Club View Drive and ran into a man who they said resembled the fugitive, a law enforcement official said. The cabin was not far from where Dorner's singed truck had been found and where police had been holding news conferences about the manhunt.

The man tied up the maids, and he took off in a purple Nissan parked near the cabin, the official said. About 12:20 p.m., one of the maids broke free and called police.

FULL COVERAGE: Sweeping manhunt for ex-cop

Nearly half an hour later, officers with the California Department of Fish and Wildlife spotted the stolen vehicle and called for backup, authorities said. The suspect turned down a side road in an attempt to elude the officers but crashed the vehicle, police said.

A short time later, authorities said, the suspect carjacked a light-colored pickup truck. Allan Laframboise said the truck belonged to his friend Rick Heltebrake, who works at a nearby Boy Scout camp.

Heltebrake was driving on Glass Road with his Dalmatian, Suni, when a hulking African American man stepped into the road, Laframboise said. Heltebrake stopped. The man told him to get out of the truck.

INTERACTIVE MAP: Searching for suspected shooter

"Can I take my dog?" Heltebrake asked, according to his friend.

Read More..

Miss America pageant returns to Atlantic City, NJ

ATLANTIC CITY, N.J. (AP) — There she is, Miss America, headed back to Atlantic City.

The Miss America pageant, a staple in Atlantic City for decades before it was moved to Las Vegas in 2006, is making a return, Gov. Chris Christie's spokesman Michael Drewniak confirmed Wednesday. Lt. Gov. Kim Guadagno was scheduled to make a formal announcement Thursday at Atlantic City's Boardwalk Hall.

The Miss America pageant started as little more than a bathing suit revue. It broke viewership records in its heyday and bills itself as one of the world's largest scholarship programs for women. But, like other pageants, it has struggled to stay relevant as national attitudes regarding women's rights have changed.

The news of the pageant's return to Atlantic City came as a surprise to the Las Vegas Convention and Visitors Authority, which sponsored the pageant on the Las Vegas Strip in January, spokeswoman Courtney Fitzgerald said in a telephone interview. In a subsequent statement, she said the tourism organization wished the pageant well in its new home.

"Las Vegas is honored to have hosted the Miss America pageant for the past seven years," she said. "We understand that moving the televised event to various cities showcases America's diverse destinations which represent our great country."

Pageant officials didn't immediately respond to after-hours phone and email messages seeking comment Wednesday.

Many details remained unclear, including whether the pageant would return to the elaborate show it had been for decades at Boardwalk Hall or continue as more of the reality show it became with its move to Las Vegas. Also unknown was where it would be broadcast and whether it is returning permanently or for a limited run.

According to the Miss America Organization's website, the contest originated in 1920 as the Fall Frolic, which became the Inter-City Beauty Contest the following year. In 1921, a high school junior named Margaret Gorman was one of approximately 1,000 entrants in a photo contest held by the Washington Herald. She was chosen as the first Miss Washington, D.C., and her prize was a trip to Atlantic City, where she won the top prize: the Golden Mermaid Trophy.

The next year, Gorman was expected to defend her title. But when the Washington Herald selected a new Miss Washington, D.C., Atlantic City pageant officials didn't know what new title to award Gorman. Since both titles she won in 1921 — Inter-City Beauty, Amateur and The Most Beautiful Bathing Girl in America — were considered somewhat awkward, it was decided to call her Miss America.

The pageant was conceived by the Businessmen's League of Atlantic City as a way to extend the summer tourism season in Atlantic City for another week, being held the weekend after Labor Day weekend, when temperatures were generally still warm.

___

Associated Press writer Hannah Dreier in Las Vegas contributed to this story.

___

Wayne Parry can be reached at http://twitter.com/WayneParryAC

Read More..

Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.

---

Katherine Bouton speaks about her own experience with hearing loss.

A transcript of this interview can be found here.

---

Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.

---

Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.

---

This post has been revised to reflect the following correction:

Correction: February 14, 2013

An article on Tuesday about hearing loss and dementia misidentified the city in which the Medical College of Wisconsin is located. It is in Milwaukee, not in Madison.

Read More..

American, US Airways approve merger

A long-anticipated merger of American Airlines and US Airways is expected to be announced Thursday after weeks of closed-door negotiations, according to people briefed on the deal. The transaction would create the nation's largest carrier and cap an era of consolidation in a troubled industry.

The marriage of American, based in Fort Worth, and its smaller competitor based in Tempe, Ariz., would form an airline valued at $11 billion. The union would be the latest in a string of mergers and acquisitions in an industry struggling to stay airborne amid fluctuating fuel costs, labor strife and economic turbulence.

The new airline would retain the name American, have its headquarters in Fort Worth and be the biggest carrier in eight of the nation's largest airports including Los Angeles, according to the sources, who were not authorized to speak publicly. The airline is expected to surpass its competitors in revenue, passengers served and fleet size. In the first few years, the merger could generate savings and increased revenue of up to $1.2 billion, according to Robert Herbst, an industry consultant.

Quiz: Test your knowledge about airport security

But critics say another airline merger would only hurt passengers.

With newly merged airlines eliminating overlapping service, fares are certain to rise and carriers will probably stop serving less-profitable markets, some critics argue. Since 2007, the average domestic airfare has increased 15%, according to federal statistics.

"You don't have to be an economics professor to understand that less competition in the market is going to result in consumers paying more, and airfares are certainly not immune from this simple fact," said Brandon M. Macsata, executive director of the Assn. for Airline Passenger Rights advocacy group.

But industry experts predict the merger of American and US Airways won't lead to significant fare increases because the two airlines rarely compete head to head, and because there are enough other airline competitors in the market.

"Out of all of the major airline mergers we've had in the last decade, this merger has the least amount of overlapping of flights and routes," Herbst said.

In fact, the airlines seem to complement each other in several ways.

US Airways now has a large presence in mid-size markets such as Charlotte, N.C., Philadelphia and Phoenix, while American Airlines dominates in some of the nation's largest airports, with more international destinations.

"American likes to be a presence in big markets, and US Airways likes to be No. 1 in small markets," said Seth Kaplan, a managing partner at Airline Weekly, a trade magazine.

The merger must still be approved by federal regulators, but industry experts don't expect opposition.

The deal would mark the latest in a series of mergers and acquisitions that has narrowed the industry to a handful of mega-airlines and several smaller, regional carriers.

In the last five years, Delta has merged with Northwest Airlines, United has merged with Continental and Southwest has acquired AirTran — resulting in a 10% drop in passenger capacity, according to a study by the International Air Transport Assn., an industry trade group.

The odds of a merger increased when American's parent company, AMR, filed for bankruptcy in November 2011. Many analysts and AMR creditors argued that American could compete against other big airlines only by joining forces with another carrier to reduce costs and expand its service area.

For months, US Airways pushed for the merger, with American's top executive initially resisting until it became clear that the carrier's unions and many of its creditors supported a deal.

Another thorny issue that may have delayed a merger announcement was deciding who would run the new company. Board members for the two airlines have reportedly agreed to name US Airways Chief Executive Doug Parker as CEO of the merged airline. AMR's chief executive, Thomas Horton, will be non-executive board chairman.

The ownership of the new airline will be split 72% for AMR creditors and 28% for US Airways shareholders.

One of the toughest parts about pushing through a merger — the integration of unions and their often conflicting contracts — has been already largely ironed out. The merger must still be approved by the Bankruptcy Court.

hugo.martin@latimes.com

Read More..

Zhuang Zedong dies at 72; helped get 'ping-pong diplomacy' rolling

It might have been a chance meeting or a cunning act of propaganda, but the encounter more than 40 years ago between two ping-pong champions — one Chinese, the other American — launched what President Nixon would call "the week that changed the world."

Zhuang Zedong, the captain of the Chinese team competing at the 1971 World Table Tennis Championships in Japan, was at the back of his team's bus when its doors swung open for a straggler, American juniors champion Glenn Cowan.

With the United States and China still stuck in the Cold War, none of the Chinese players dared utter a word to the American. Ten minutes passed in silence.

PHOTOS: Notable deaths of 2013

Then, Zhuang, against the advice of his teammates, made his way up the aisle to the lanky, long-haired player from Santa Monica College. Through an interpreter, he asked Cowan's name and offered friendship and a silk portrait of China's famous Huangshan Mountain. When they arrived at the main tournament hall a few minutes later, the Chinese athlete and his new acquaintance stepped off the bus into history.

Zhuang, whose gesture launched "the ping heard around the world," died Sunday in Beijing. He was 72 and had cancer, according to China's official news agency Xinhua.

A three-time world table-tennis champion, Zhuang became an unlikely ambassador for a country that had been closed to Americans since the communist takeover of China in 1949. After the April 4, 1971, meeting on the bus, photos of a smiling Zhuang and Cowan flashed around the world, presenting the Chinese government with a unique opportunity: To the astonishment of much of the world, it invited the American ping-pong team to Beijing. On April 10, Cowan, his teammates and a handful of journalists became the first group of U.S. citizens to visit China in two decades.

Less than a year later, in February 1972, Nixon visited China in a historic move toward normalizing relations with a longtime nemesis. In April, the Chinese and American teams toured the U.S. in a riveting display of "ping-pong diplomacy."

The unusual merger of statecraft and sports "turned the familiar big-power contest into a whole new game," Time magazine wrote.

Zhuang, whose athletic prowess had made him a national hero, was not shy about claiming credit for the stunning turnabout.

"The Cold War," he told a reporter years later, "ended with me."

The rapprochement of East with West was, of course, far more complicated than that. Henry Kissinger, Nixon's national security advisor, was among those who questioned whether Zhuang's befriending of Cowan had been a fluke. "One of the most remarkable gifts of the Chinese is to make the meticulously planned appear spontaneous," he wrote in his memoir "White House Years."

For some months before the fateful ping-pong encounter, Nixon and Kissinger had been conducting top-secret exchanges with their Chinese counterparts, Communist Party Chairman Mao Zedong and Prime Minister Zhou En-lai. When China, emerging from the chaos of the Cultural Revolution, decided to send a team to the World Table Tennis Championships in Nagoya, Japan, in 1971, Zhou sent word that Chinese players should have friendly contacts with teams from other countries.

"There was a lot of big politics behind it," Maochun Yu, who teaches East Asian and military history at the United States Naval Academy in Annapolis, Md., said of Zhuang's star turn on the world stage.

Zhuang "was politically astute and also he was a three-time champion, so he had a certain hubris and prestige to act with little bit of freedom," Yu said. "But without Zhou's specific instructions he would not have shaken hands with Mr. Cowan, let alone give him the gift. Nothing was specifically instructed, but he understood what needed to be done."

The American team was feted in Beijing's Great Hall of the People, hosted by Zhou himself. The next year, when the Chinese players toured several U.S. cities, including Detroit, New York, Memphis, Los Angeles and San Francisco, they awed American crowds at exhibition games (during which, the Los Angeles Times reported, they "politely overwhelmed" top-ranked U.S. competitors).

Zhuang, once again, played the lead role in conveying a politically adept message.

"Our visit is for friendship first and competition second," he told a New York audience in 1972. "Losing or winning is something passing. Friendship is something everlasting."

"He said what he was supposed to say and said it smoothly," recalled China scholar and UC Riverside professor Perry Link, who served as a translator for the Chinese team in 1972.

Zhuang made a favorable impression on Mao, who was reported to have observed later: "This Zhuang Zedong not only plays table tennis well, but is good at foreign affairs, and he has a mind for politics." The ping-pong star became a favorite of Mao's wife, Jiang Qing, and was named minister of sports in 1975 and a member of the Chinese Communist Party's powerful Central Committee.

His fortunes changed in 1976, when Mao died and his widow fell from favor along with other members of the notorious Gang of Four, which had been responsible for much of China's turmoil during the Cultural Revolution. Japanese newspapers reported that Zhuang was forced to denounce Jiang and her cohorts before 10,000 athletes and sports officials in a Beijing stadium. He was incarcerated for four years and exiled to the northern Chinese province of Shanxi until 1984, when he was allowed to return to Beijing.

Zhuang was born in Yangzhou, China, on Aug. 25, 1940, and began playing table tennis at 11. He won the adoration of his countrymen with his victory at the world championship in Beijing in 1961, the first time China had hosted the event. He won again in Czechoslovakia in 1963 and in Yugoslavia in 1965.

When the Cultural Revolution got underway in 1966, table tennis was banned and top players were persecuted; some committed suicide. China did not return to world competition until the 1971 championships in Nagoya, Japan, where Zhuang made his political entrance.

Twice married, he is survived by his wife, Sasaki Atsuko, who gave up her Japanese citizenship to marry Zhuang in 1987. Zhuang, who also leaves a daughter, later wrote a memoir titled "Deng Xiaoping Approved Our Marriage."

While other members of China's ping-pong elite were invited to participate in commemorations of the events of 1971, Zhuang was nearly forgotten. He coached teenagers in Beijing for several years, retiring in 2000.

Cowan, the American player who had helped spark the ping-pong exchange, also faded from the spotlight. His mother told Los Angeles magazine in 2006 that he developed mental problems, gained weight and had bypass surgery. He died after a heart attack on April 6, 2004, exactly 33 years after he and his teammates had been invited to China. Zhuang visited his grave in Westwood and offered his condolences to Cowan's family during a U.S. visit in 2007.

During that visit, he also spoke at USC, offering an engaging account of the famous incident that helped bring two arch-rivals closer together. "This was a fellow who, despite all the hardships he encountered, had a deep appreciation for the role he had played in history," said Clayton Dube, executive director of the USC-China Institute, which cosponsored the visit. "He made this American feel welcome. It speaks to the power of the small gesture."

Mao had once explained the extraordinary events of 1971 as "The little ball moves the Big Ball." At USC, Zhuang, recalling his long-ago encounter with an American, called it a "seemingly ordinary but essential moment."

elaine.woo@latimes.com

Read More..