2 Palestinians Shot in Clashes With Israeli Settlers





JERUSALEM (AP) — Clashes erupted Saturday in the West Bank, with Jewish settlers shooting two Palestinian demonstrators in the northern village of Kusra, an Israeli military official and Palestinian residents said.




The unrest reflected mounting friction in the West Bank, where Palestinians have faced off against Israeli troops in recent weeks in a series of large demonstrations protesting Israel’s control of the territory in general and in solidarity with four prisoners on hunger strikes in Israeli jails.


Also on Saturday, a Palestinian prisoner died in an Israeli jail, an event that is likely to intensify tensions in the area.


In the West Bank skirmish, Helmi Abdul-Aziz, 24, was shot in the stomach by Jewish settlers, Palestinian demonstrators said. They said settlers also shot Mustafa Hilal, 14, in the foot.


An Israeli military official confirmed that two Palestinians had been shot, apparently by settlers, since the Israeli military forces there were not using live ammunition.


Villagers said the clashes began when a group of Jewish settlers encroached on their village lands and fired guns. They said settlers chased a Palestinian farmer and his family off land, prompting the farmer to call on other villagers to confront the settlers, and men on both sides hurled rocks at one another.


In an Israeli jail on Saturday, Arafat Shalish Shahin Jaradat, a Palestinian prisoner, died apparently of a heart attack, according to an Israeli prison services spokeswoman, Sivan Weizman. She said that Mr. Jaradat had not been on a hunger strike.


Israel’s domestic intelligence agency, the Shin Bet, said that Mr. Jaradat, 30, was arrested last week after he was involved in a rock-throwing attack that injured an Israeli citizen. Mr. Jaradat admitted to the charge, as well to another West Bank rock-throwing episode last year, the Shin Bet said.


A Shin Bet spokesman said that Mr. Jaradat had not been beaten during an interrogation.


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Breaking Dawn - Part 2 Sweeps the Razzies









02/23/2013 at 10:00 PM EST







Taylor Lautner and Mackenzie Foy, in Breaking Dawn – Part 2


Andrew Cooper, SMPSP/Summit


Who's misérable now?

The Twilight Saga: Breaking Dawn – Part 2, Adam Sandler and Rihanna are among the "winners" of the 33rd annual Golden Raspberry Awards – the Razzies – which are not so much handed out as they are thrown at those who are voted as perpetrating Hollywood's worst achievements of the year.

Breaking Dawn – Part 2, the fifth and final installment in Stephenie Meyer's vampire saga, was recognized in seven categories, including worst picture.

The flick's Kristen Stewart was also cited as worst actress; Taylor Lautner, worst supporting actor; Lautner and 12-year-old Mackenzie Foy, worst screen couple; the entire cast, including Robert Pattinson, worst screen ensemble, and Bill Condon, worst director.

In addition, the film, which since opening last November has taken in more than $828 million at the box office, was named worst sequel.

Sandler, who last year monopolized the Razzies – and set a record by winning in 10 categories with the "comedy" Jack & Jill – this year got only two awards: for worst actor of the year and worst screenplay, both for That's My Boy.

Unlike the Oscars, which keep voting tallies a secret and will be handed out Sunday night during a very glamorous event, founder and Head RAZZberry John Wilson announced Razzie recipients Saturday night in the utilitarian Continental Breakfast Room of the Holiday Inn Express Hollywood Walk of Fame hotel, near (and yet so far from) the Dolby Theatre, home of the Academy Awards.

Wilson revealed to the press that although Rihanna, as worst supporting actress in the movie Battleship, won her Razzie by a landslide, worst screenwriter Sandler only beat the authors of Breaking Dawn by a single vote.

It's close shaves like that that really make or break the Razzies.

Breaking Dawn – Part 2 Sweeps the Razzies| Oscars 2013, The Razzies 2013, Movies, Battleship, That's My Boy, News Franchises, Individual Class, Adam Sandler, Kristen Stewart, Rihanna, Robert Pattinson

Adam Sandler, in That's My Boy, and Rihanna, in Battleship

Columbia; Universal

The 85th annual Academy Awards will air live on ABC starting at 7 p.m. ET/4 p.m. PT on Sunday, Feb. 24, from the Dolby Theatre in Hollywood.
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FDA approves new targeted breast cancer drug


WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.


The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.


Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.


"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."


Cobleigh helped conduct the key studies of the drug at the Chicago facility.


The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.


The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.


Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.


FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.


Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.


FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer


Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.


Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.


Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.


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Oyster farm fight has many interested parties









POINT REYES NATIONAL SEASHORE — To hear Kevin Lunny tell it, he's just a little guy, draining his life's savings to stand up to a heartless federal agency bent on closing down his family's oyster farm here.


It's a compelling tale, a years-long soap opera replete with allegations of scientific misconduct and government overreach. Tea party activists have taken up his cause, citing it as an example of government quashing free enterprise and environmentalism run amok. Lunny also has the support of powerhouse conservative law firms representing him pro bono, and Cause of Action, a Washington, D.C.-based government watchdog group with ties to the conservative Koch brothers.


Others, however, don't buy his story. They say Lunny and some of his supporters have distorted what is a very simple case: The owners of the oyster farm north of San Francisco agreed 40 years ago to shut down in 2012, and Lunny is trying to break the contract.





"This thing has been hijacked by people with different agendas and manufactured narratives," said Tom Strickland, former assistant secretary of the Interior. "When someone suggests that this is 'the government versus the little guy,' I think the question should be looked at in reverse. Who is looking out for the interest of individual Americans, who is looking out for the interests of taxpayers?"


In 2005, the Lunny family bought the oyster farm in Drakes Estero, which includes the tidal area where explorer Sir Francis Drake is believed to have made landfall 430 years ago. With the purchase, the family signed on to an existing 40-year agreement with the National Park Service stating that the business would cease operations last fall and the area would convert to marine wilderness, as Congress intended.


From the beginning, Lunny made clear to the Park Service that he was interested in staying on, but Interior's solicitor ruled the agency had no legal basis to allow that.


The often-ugly debate reached a crescendo three months ago when Interior Secretary Ken Salazar elected not to extend Lunny's permit to operate in Point Reyes National Seashore. The operation is scheduled to be removed next month, clearing the way for Drakes Estero, a dramatic coastal sweep of five bays in Marin County, to become the first marine wilderness in the Lower 48 states.


Lunny filed a lawsuit to force the government to extend his lease, but it failed in federal court. He said he is appealing to the 9th Circuit Court of Appeals in San Francisco.


"To my mind, the issue really centers on the original deal," said Lynn Scarlett, an assistant secretary of the Interior under George W. Bush. "When this area was designated as a national park unit, the Congress and all those who were engaged struck a deal. A deal's a deal."


Lunny casts the debate in different terms. He says that the government is being unfair and that his protracted fight to stay has devastated his family. U.S. Sen. Dianne Feinstein (D-Calif.), who wrote two bills to help Lunny continue operating in the park, wrote Salazar to say that because of the oyster farm's impending closure, Lunny's family is "facing financial ruin."


The family does have other sources of income. They run a cattle ranch on federal land and own a paving and construction business. Lunny's legal fight is being waged by lawyers working for free, five of whom joined him at his last court appearance. He is soliciting online donations via the Farm-to-Consumer Legal Defense Fund and has a shellfish industry lobbyist on his payroll as a consultant.


Records obtained under the Freedom of Information Act show that the federal government has extended generous subsidies to the Lunny family for decades. The extended family has leased more than 1,100 acres, where it raises cattle within the park. The grazing rate Lunny and other ranchers pay is about one-third the amount ranchers are charged on adjacent private land.


The Lunnys' lease includes a three-bedroom house, a second residence and a bunkhouse, all owned by the federal government but leased by the family. Lunny pays $2,200 a month for the 1,100 acres and the buildings — about what renters nearby pay to lease a single-family house on a small plot of private land.


The Park Service, under political pressure to help Lunny, recently spent $50,000 to replace the roofs on two of the family's leased buildings. Other federal seashore tenants are required to pay for their own home maintenance.


The Park Service, however, has made mistakes in the case that have given ammunition to the Lunnys' supporters. In 2007, a seashore scientist wrote a flawed report that suggested Lunny's farm harmed harbor seals.


The Park Service acknowledged the errors and retracted the study, but the episode gave credibility to claims that the park was using "junk science" to force Lunny out.


At Feinstein's urging, the Park Service commissioned outside reviews of its ongoing study of Drakes Estero. The effort to resolve the scientific debate has morphed into a multimillion-dollar morass of scientific studies and investigations by Interior's inspector general, the National Academy of Sciences and the Marine Mammal Commission, paid for by taxpayers.


The results: In some instances the Park Service conclusions overreached, in some instances they were correct, and most of the time it was impossible to determine the accuracy of any claim without more study.


Apart from his trouble with the park, Lunny has a history of not complying with California Coastal Commission orders. For six years, Lunny's farm has failed to acquire the appropriate state permits to operate in a coastal zone.


The Coastal Commission earlier this month issued its second cease-and-desist order to the farm. "I find that this is one of the most egregious, egregious violations that I have seen," Commissioner Esther Sanchez said in a hearing.


Now that Drakes Bay Oyster Co.'s closure looms, the farm's plight has become a cause for groups with disparate agendas. Some represent the interests of the shellfish industry, which seeks to operate in protected waters up and down the coast. Some favor more commercial activities in national parks, and others espouse virulently anti-government views.


Lunny's supporters are threatening to stage protests and even blockade the road if authorities are required to escort Lunny and his staff from the seashore.


Lunny, a genial and quiet man, said he doesn't want to be associated with "right-wing land rights and anti-government groups."


"This has spun out of control like none of us would ever have imagined," Lunny said. "Some of these groups came out of the woodwork" after Salazar decided against extending the lease. "All of a sudden we have some new friends."


julie.cart@latimes.com





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IHT Rendezvous: IHT Quick Read: Feb. 23

NEWS Since the days of the Medici family in Florence, the banking house of Monte dei Paschi has rained wealth on the people of Siena, Italy. For 541 years, it has endured war, plague and panic, and it stands today as the world’s oldest operating bank. But inside the stately offices of Monte dei Paschi di Siena, a thoroughly modern fiasco has done what the centuries could not. Monte dei Paschi, founded in 1472, has been brought to its knees by 21st-century finance. Jack Ewing and Gaia Pianigiani report from Siena.

Despite growing confidence that Europe is managing its debt crisis and is poised to embark on a recovery, fresh developments on Friday indicated that the region continues to struggle to stimulate growth while cutting spending to pare deficits. James Kanter reports from Brussels.

Alcatel-Lucent, the struggling French telecommunications equipment maker, on Friday hired a former Vodafone and France Télécom executive, Michel Combes, to lead the company through what might be a major downsizing. Mr. Combes, 51, will take over for Ben Verwaayen, who had failed in four years to bring the equipment maker, created by the 2006 merger of Alcatel of France and Lucent Technologies of New Jersey, to sustained profit. Kevin J. O’Brien reports from Berlin.

Another big food producer was ensnared in the scandal over horse meat in beef products Friday when the company that owns the Iglo and Birds Eye brands withdrew a dozen types of prepared meals from stores in four European countries. The Iglo Foods Group, the parent company, said it took the action after a chili con carne dish, produced by a Belgian company called Frigilunch and on sale in Belgium, was found to contain about 2 percent horse meat. Stephen Castle reports from London.

A deadly attack by militants on an Algerian natural gas plant last month has dealt a major setback to a group of North African countries whose prospects as oil and gas producers were already cloudy. Both oil and natural gas production have been in decline in Algeria, the region’s biggest gas producer, since the mid-2000s. In Libya, the rebellion that ousted Col. Muammar el-Qaddafi and its chaotic aftermath have disrupted oil and gas exploration. In Egypt, rising domestic consumption, encouraged by government policies, has cut into exports. Stanley Reed reports from London.

ARTS The director David Lynch has released a musical album, exhibited his artwork, designed a nightclub and worked tirelessly for T.M. What he has not been doing is making movies. Claire Hoffman reports from Los Angeles.

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Courtney Lopez: Gia Thinks Our Dog Is Having a Baby




Celebrity Baby Blog





02/22/2013 at 01:00 PM ET



Courtney Lopez: Gia Thinks Dog Having Baby
Denise Truscello/Wireimage


Mario Lopez is a man of his word.


Following a December wedding, the EXTRA host declared he and wife Courtney would get to work expanding their family immediately — and he wasn’t kidding.


In January, the couple discovered they were indeed expecting.


“Mario and I are so excited to add to our family! I found out a month ago and surprised Mario with the good news at breakfast,” Courtney tells PEOPLE.


But the proud parents aren’t the only ones gearing up for a new addition. Big sister Gia Francesca, 2, already has babies on the brain.


“Gia kind of understands that there is a baby in my belly,” Courtney notes. “She also told me our dog Julio has a baby in his belly — so who knows!”

Despite a bumpy start — “I had a rough couple of weeks when I first found out,” she shares — the mom-to-be is feeling better and already sporting quite the blossoming belly. “I am showing so much faster this time around,” she says.


And with warmer weather on the way, Courtney will be swathing her bump in floor-length frocks — but plans on forgoing a few fashion ensembles from her past.


“I love being pregnant in the summer! I live in maxi dresses,” she says. “Looking back at my first pregnancy, there are certain things that I wore and I have no idea why. I looked horrible and I won’t do that again!”


Originally from Pittsburgh, the expectant mama is thrilled to have settled down with her growing family on the West Coast. Her only wish? That her children will one day enjoy a winter wonderland.


“I don’t miss the East Coast at all — especially the humidity,” she explains. “The one thing I do want my children to experience from an early age is snow. There is nothing like being a kid playing in the snow.”


– Anya Leon


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FDA approves new targeted breast cancer drug


WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.


The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.


Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.


"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."


Cobleigh helped conduct the key studies of the drug at the Chicago facility.


The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.


The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.


Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.


FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.


Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.


FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer


Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.


Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.


Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.


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California lawmaker Rubio leaves Legislature for Chevron job









SACRAMENTO — State Sen. Michael J. Rubio, who was leading the Legislature's effort to make California's environmental laws more business-friendly, abruptly resigned from office Friday to accept a government-affairs job with Chevron Corp.


Rubio, a Democrat from Shafter, in the Central Valley, was chairman of the Senate Environmental Quality Committee and introduced bills during his two years in office that related to the oil industry in his district.


The state Fair Political Practices Commission will conduct a routine review of Rubio's move to make sure it involves no violation of the conflict-of-interest rules in California's Political Reform Act.





"We will look to see if there is something to indicate that the act was violated and, if so, we will take a look at it," said the commission's chief of enforcement, Gary Winuk.


Rubio said in an interview that he has complied with state law, and he declined to discuss the terms of his employment. He said he quit the Legislature because he had tired of the 300-mile drive from his district to the Capitol and has a special-needs daughter who requires attention.


"My family comes first," he said.


One of Rubio's bills would have clarified state codes to allow the practice of re-injecting natural gas as part of oil drilling. The 2011 measure, which stalled in a committee, was backed by the Western States Petroleum Assn., a group whose members include Chevron Corp.


In November, Rubio was among a group of legislators who went on a trip to Brazil that was paid for by the California Foundation on the Environment and the Economy, a nonprofit bankrolled by Chevron, PG&E and other firms. Sponsors sent representatives to accompany the lawmakers as they studied Brazil's low-carbon fuel standards and other issues.


In spearheading the push for streamlined environmental laws, Rubio worked closely with the Silicon Valley Leadership Group, whose members include Chevron Energy Solutions.


It is common for lawmakers to move into high-level jobs or consulting arrangements with interests that sought their help in shaping state policy. Rubio's announcement renewed complaints about the practice from watchdog groups.


Jamie Court, president of the advocacy group Consumer Watchdog, said the revolving door between the public and private sector always raises questions of whether politicians spend their time in office "auditioning for a well-paying job for the companies they are supposed to regulate."


Rubio's departure creates a third vacancy in the 40-person Senate that will temporarily put its Democrats' numbers below the supermajority they won in November.


Two Democrats had previously left for Congress, and special elections are being held in coming weeks for their seats. Both are widely expected to remain in Democratic hands, because the party has a comfortable registration advantage in those districts.


A special election will be called to fill Rubio's seat.


patrick.mcgreevy@latimes.com





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IHT Rendezvous: North Korea Widens Access to Internet, but Just for Visitors

HONG KONG — North Korea will finally allow people to search the Internet from their mobile devices and laptops within the country’s borders. But if you’re a North Korean, you’re out of luck — only foreigners will be given the privilege.

Cracking the door open ever so slightly to wider Internet use, the government has allowed a company called Koryolink to give foreigners access to 3G mobile Internet service by March 1, The Associated Press reported.

The decision, made public Friday, comes just a month after Google’s chairman, Eric E. Schmidt, visited Pyongyang and prodded officials on allowing Internet access, noting how easy it would be to set up through Koryolink’s expanding 3G network. Presumably, his appeal was directed at giving North Koreans such capability.

“As the world becomes increasingly connected, their decision to be virtually isolated is very much going to affect their physical world, their economic growth and so forth,” Mr. Schmidt told reporters after arriving at Beijing International Airport following his visit to North Korea. “We made that alternative very, very clear.”

Foreigners were only recently given access to cellphones while traveling in the country. Previously, they had to surrender their phones with customs agents.

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American Idol: Sudden-Death Round Begins for Men















02/21/2013 at 11:00 PM EST







From left: Randy Jackson, Mariah Carey, Ryan Seacrest, Nicki Minaj and Keith Urban


George Holz/FOX


On Wednesday, 10 women sang for five spots on American Idol's live shows. On Thursday, it was the remaining guys' turn.

The judges have their own euphemisms when they don't like a performance – it's usually easy to read between the lines: If they compliment a singer on his shoes, he won't advance. On Thursday, Nicki Minaj actually told a contestant, "Kudos to you for being really freshly, nicely groomed." They might as well have had a stagehand pull him offstage with an oversized vaudeville hook.

After several weeks of good behavior by the judges, Thursday's episode showed a spark of life when Nicki – who was wearing her very best Jan Brady wig – began rolling her eyes whenever Randy Jackson spoke. At one point, Ryan Seacrest even tried to get them to kiss and make up. There was talk about lipstick, and Mariah Carey did her best to look at anything other than the awkward air kiss that followed.

But the theatrics did not eclipsed some solid singers – and a few performances that just weren't good enough for the competition.

The Good: Curtis Finch Jr. wowed judges with his version of Luther Vandross's "Superstar." It was oversung. But there was no denying Finch's vocal talent. Charlie Askew's rendition of Elton John's "Rocketman" was interesting and well-suited to his voice. And Devin Velez pleased the crowd when he infused Spanish lyrics into Beyoncé's "Listen." The three of them advanced easily.

The Okay: Elijah Liu chose Bruno Mars's "Talking to the Moon," a song that felt current and new. Paul Jolley sang Keith Urban's "Tonight I'm Gonna Cry." Generally, it's a risky move to sing a song made popular by one of the judges, but Jolley's performance was pleasant, if a little shaky. Both advanced, although the judges were split on their assessment of Jolley.

The Others: Johnny Keiser, Kevin Harris, Chris Watson and Jimmy Smith sang unspectacular versions of various songs that everyone knows. Each of them had a decent voice, but none of their performances were all that unique, and none of them advanced. On the other side of the spectrum, J'DA performed an over-the-top rendition of Adele's "Rumor Has It." It wasn't enough for him to advance, but his performance – at one point he collapsed on the floor but continued singing – was by far the most memorable of the night.

There are ten contestants – five men and five women – who have made it to the next round. Next week, the remaining 20 contestants will complete for the remaining 10 spots – and all will hope the judges don't compliment what they're wearing.

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APNewsBreak: Govs to hear Oregon health care plan


SALEM, Ore. (AP) — Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.


The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.


Kitzhaber says his goal is to win over a handful of other governors from each party.


"I think the politics have been dialed down a couple of notches, and now people are willing to sit down and talk about how we can solve the problem" of rising health care costs, Kitzhaber told The Associated Press in a recent interview.


Kitzhaber introduced the plan in 2011 in the face of a severe state budget deficit, and he's been talking for two years about expanding the initiative beyond his state. Now, it seems he's found people ready to listen.


Hospital executives from Alabama visited Oregon last month to learn about the effort. And the U.S. Department of Health and Human Services announced Thursday that it's giving Oregon a $45 million grant to help spread the changes beyond the Medicaid population and share information with other states, making it one of only six states to earn a State Innovation Model grant.


Kitzhaber will address his counterparts at a meeting of the National Governors Association. His talk isn't scheduled on the official agenda, but a spokeswoman confirmed that Kitzhaber is expected to present.


"The governors love what they call stealing from one another — taking the good ideas and the successes of their colleagues and trying to figure out how to apply that in their home state," said Matt Salo, director of the National Association of Medicaid Directors.


There's been "huge interest" among other states in Oregon's health overhaul, Salo said, not because the concepts are brand new, but because the state managed to avoid pitfalls that often block health system changes.


Kitzhaber persuaded state lawmakers to redesign the system of delivering and paying for health care under Medicaid, creating incentives for providers to coordinate patient care and prevent avoidable emergency room visits. He has long complained that the current financial incentives encourage volume over quality, driving costs up without making people healthier.


Obama, in his State of the Union address this month, suggested that changes such as Oregon's could be part of a long-term strategy to lower the federal debt by reigning in the growing cost of federally funded health care.


"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive," Obama said.


The Obama administration has invested in the program, putting up $1.9 billion to keep Oregon's Medicaid program afloat over the next five years while providers make the transition to new business models and incorporate new staff and technology.


In exchange, though, the state has agreed to lower per-capita health care cost inflation by 2 percentage points without affecting quality.


The Medicaid system is unique in each state, and Kitzhaber isn't suggesting that other states should adopt Oregon's specific approach, said Mike Bonetto, Kitzhaber's health care policy adviser. Rather, he wants governors to buy into the broad concept that the delivery system and payment models need to change.


That's not a new theory. But Oregon has shown that under the right circumstances massive changes to deeply entrenched business models can gain wide support.


What Oregon can't yet show is proof the idea is working — that it's lowering costs without squeezing on the quality or availability of care. The state is just finishing compiling baseline data that will be used as a basis of comparison.


One factor driving the Obama administration's interest in Oregon's success is the president's health care overhaul. Under the Affordable Care Act, millions more Americans will join the Medicaid rolls after Jan. 1, and the health care system will have to be able to absorb the influx of patients in a logistically and financially sustainable way.


The federal government will pay 100 percent of the costs for those additional patients in the first three years before scaling back to 90 percent in 2020 and beyond.


"There are a lot of governors who are facing the same challenges we're facing in Oregon," Kitzhaber said. "They recognize that the cost of health care is something they're going to have to get their arms around."


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Garcetti and Greuel in duel for funds









Wendy Greuel and Eric Garcetti remain locked in a tight fundraising battle, with the front-runners in Los Angeles' mayoral contest each raising just under a half-million dollars in recent weeks and both showing ample cash reserves to wage a vigorous effort in the closing days of the primary campaign, according to disclosure reports filed with the City Ethics Commission on Thursday.


Greuel has a razor-blade edge — the city controller raised $473,582 and spent more than $1.7 million in the latest reporting period between Jan. 20 and Feb. 16. She enters the final days before the March 5 contest with nearly $1.7 million cash on hand, according to the reports.


Noting that nearly three-quarters of her recent contributions came from first-time donors and more than half were from contributors who gave $250 and under, Greuel said the figures signified the momentum behind her campaign.





"It's amazing that so many Angelenos from every corner of the city are coming together to join our grassroots campaign," Greuel said in a statement. "In this election, we can fight together to change our city. We can build a stronger economy that creates jobs, a seamless public transportation system and better schools. We can crack down on waste in government so Angelenos can get the services they deserve. Today's report shows that people across L.A. are joining together to make this vision a reality."


Greuel's main rival, City Councilman Garcetti, raised $452,819 and spent nearly $2.5 million during the same time frame, ending the filing period with $1.5 million cash on hand, according to campaign filings. He noted that with more than 10,000 donors, he leads the field in grassroots support.


"I'm proud that our campaign's momentum is growing every day as more people learn about my plans to create jobs and solve problems for L.A. residents," Garcetti said in a statement. "You can see our grassroots strength through our fundraising, our energized volunteer corps and our thriving online network."


Overall, fundraising by the mayoral candidates has topped $11 million. Greuel and Garcetti are saturating the television and radio airwaves and have started attacking one another in voters' mailboxes. They have been fairly even in their fundraising efforts for many months, allowing them both to run a robust advertising campaign. But while Garcetti spent more during the filing period, Greuel has a steep advantage in outside efforts on her behalf. Of the $1.7 million spent by independent committees, more than $1.2 million has been spent to boost her bid, largely by labor.


Voters typically only see the candidates' ads and mailers, or clips of them on the nightly news. Under the radar, the candidates are spending significant time raising the kind of money it takes to campaign in a city as sprawling as Los Angeles. On Wednesday night, Garcetti held a fundraiser at the Petersen Automotive Museum with some of the city's hottest chefs — turning out a young and stylish crowd who sampled craft beers and delicacies such as braised and crispy pork with salted oats, house mostarda and toasted broccoli. On the same night, Greuel held a fundraiser with U.S. Sen. Barbara Boxer (D-Calif.) at the Beverly Hills manse of billionaire media mogul Haim Saban. But unlike Garcetti, her campaign did not allow the media to attend.


Greuel's ads have highlighted her efforts as controller to root out "waste, fraud and abuse" — claims her opponents say she has exaggerated. On Thursday, Garcetti launched two new 15-second ads featuring his endorsement by the Los Angeles Times. Those followed two introductory spots in English and Spanish. The councilman is spending more than $600,000 this week airing ads, according to a Democratic media consultant who is not working for any candidate. Greuel and the efforts on her behalf, which are not allowed to legally coordinate with her campaign, spent about $1.3 million in the same period, according to the media consultant.


Councilwoman Jan Perry, who has been waging a blistering mail campaign against Greuel, continues to lag behind. She raised nearly $68,000 in the filing period, and spent nearly $809,000, leaving her with less than a half-million dollars for the remainder of the race. Emanuel Pleitez, the former technology executive who has never held elected office, reported raising nearly $20,000 and spending nearly $194,000 during the period, leaving him with nearly $146,000 cash on hand.


Kevin James, the sole Republican in the race, has been the beneficiary of nearly $500,000 in outside spending. He has had difficulties raising money, but his campaign has claimed that the numbers were improving. They did not file a disclosure report by press time, but his campaign manager said James had raised $52,000 and had spent $181,000 during the filing period, leaving the former entertainment attorney with about $25,000 cash on hand.


seema.mehta@latimes.com


maeve.reston@latimes.com


Times staff writer Maloy Moore contributed to this report.





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IHT Rendezvous: What of the Ringleaders, Chinese Ask About Cultural Revolution Case

BEIJING — It’s reminiscent, perhaps, of the trials of people accused of Nazi-era crimes, a John Demjanjuk, or a Samuel K.: in China this week, a man was tried for murdering a doctor during the Cultural Revolution, the China News Service reported.

A rare episode of justice for a neglected era? Judging by a discussion on China’s biggest microblog, Sina Weibo, ordinary people don’t necessarily see it just that way; rather, some are angry that a little guy, and not the masterminds of the violence, is being punished. What about the “ringleaders,” chief among them Mao Zedong, they are saying, often obliquely?

According to the report, which was widely disseminated online via news aggregators and other sites, the defendant at the rare trial this week, in Ruian in Zhejiang province, was a 80-plus-year-old man identified only as Mr. Qiu. He strangled a Mr. Hong with a rope in 1967, on the orders of a civilian militia, which suspected Mr. Hong of spying for a rival militia, the report said. Mr. Qiu had been on the run for decades and was arrested last July.

(For an English-language account, see this article in the South China Morning Post, which may be behind a paywall.)

After the killing Mr. Qiu cut off Mr. Hong’s lower legs with a shovel “to make it easier to bury him,” and then he buried him, the report said.

Violence was common during the era: yesterday, I examined this painful time in a Letter from China and Rendezvous post about Ping Fu, the businesswoman who wrote a controversial memoir.

As I wrote in my Letter, to this day, the state tightly controls discussion about the era – when many got away with, literally, murder.

“Have the main culprits who started the Cultural Revolution been punished?” asked a person with the handle Sansu dage, who added an angry red face to the posting.

“Actually, the biggest criminals of the Cultural Revolution have not been held responsible,” wrote a person with the handle Keji huangdan menwei chuangxin. “To pursue an ordinary criminal, decades later, is absurd.”

A_Jing wrote: “There should be mandatory courses in universities to talk clearly about the crimes against humanity during the Cultural Revolution!”

Wrote another: “All the cases from the Cultural Revolution should be tried.”

That’s extremely unlikely. A few key players were tried beginning in 1980, when Jiang Qing, Mao Zedong’s wife, and other members of the Gang of Four received lengthy sentences.

Yet, “I was Chairman Mao’s dog,” Ms. Jiang said in her defense. “Whomever he told me to bite, I bit.”

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American Idol: Women Face Sudden-Death Round






American Idol










02/20/2013 at 11:00 PM EST







Mariah Carey


Mario Anzuoni/Reuters/Landov


American Idol threw yet another new twist at its 40 remaining contestants: a sudden-death round.

"One song, one chance, no mercy," Ryan Seacrest said as the first group of 10 female contestants gathered in Las Vegas to try to finally sing their way – in front of a boisterous studio audience – through to the "America votes" phase of the competition.

Five women moved on, five went home.

Kentucky high school junior Jenny Beth Willis, whose rendition of a Trisha Yearwood song earned mixed reviews from the judges, was the first up. Although Keith Urban appreciated her "effortless confidence," Nicki Minaj said her performance lacked excitement (a comment that elicited the first audience boos of the season). Final result: It was the end of the road for Willis.

Tenna Torres, 28, – who attended Mariah Carey's camp for kids as a youngster – took the stage next and impressed the judges with her take on the Natasha Bedingfield's "Soulmate." But she lost style points with Minaj, who didn't like one particular aspect of her look. "Lose the hair," said Minaj, who felt the contestant's coif aged her. Final result: She made it through to the Top 20.

The three most powerful performances of the night all made it to the next round: Nashville's Kree Harrison, who despite taking a decidedly plain-Jane approach to styling, wowed the judges with her version of Patty Griffin's "Up to the Mountain." "You sang the hell out of that song," said Carey.

Angela Miller, 18, of Massachusetts, belted out Jessie J's hit "Nobody's Perfect." But she pretty much was.

And Amber Holcomb, an assistant teacher from Texas, closed the show with a rousing (and well received) rendition of "My Funny Valentine."

For the final spot of the night, it came down to Anchorage, Alaska, resident Adriana Latonio, 17, who tackled Aretha Franklin's "Ain't No Way," and Shubha Vedula, a Michigan high school senior who sang Lady Gaga's "Born This Way."

Although the judges saw potential in both contestants, they ultimately picked Lantonio's powerhouse vocals in a final emotional moment.

Thursday will bring out the guys. The first round of 10 will take the stage to try to make the top 20 – but once again, five will go home.

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Doc groups issue list of overused tests, therapies


WASHINGTON (AP) — Don't be afraid to question your doctor and ask, "Do I really need that?"


That's the advice from leading medical groups who came up dozens of tests and treatments that physicians too often prescribe when they shouldn't.


No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.


Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.


Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.


These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.


Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."


The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.


Last year, the coalition listed 45 overused tests and treatments. It included some of the best known examples, such as too much imaging for back pain and repeating colonoscopies too frequently.


This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.


Some other examples:


—Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.


—Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.


—Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.


—And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.


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Bulgari shows off Liz Taylor's gems









It isn't easy sometimes to be an ordinary person in Los Angeles, so near to and yet so far from the city's glamorous events.


You hear about the grand Oscar parties, but you will never be invited. The award ceremony may be taking place minutes from where you live, but you watch it at home, on TV, in your sweat pants — and you might as well be in Dubuque.


Rodeo Drive too can make you feel like a scrap on the cutting room floor. As you stroll the wide and immaculate sidewalks of Beverly Hills' iconic shopping street, you pass by boutiques you'd feel self-conscious walking into. In the windows are baubles and trinkets you could never in three lifetimes afford.





Which is why it is rather nice to be invited to make a private appointment at the house of Bulgari, the fine Italian jeweler that opened its doors in 1884.


Elizabeth Taylor loved Bulgari jewels. Richard Burton, whose torrid affair with her began during the filming of "Cleopatra" in Rome, accompanied her often to the flagship shop on the Via Condotti. He liked to joke that the name Bulgari was all the Italian she knew.


So it is fitting that starting Oscar week, the jeweler is celebrating the Oscar-winning star with an exhibit of eight of her most treasured Bulgari pieces.


They are heavy on diamonds and emeralds — of rare size, gleam and value.


And Bulgari knows their value well.


After Taylor's death, it reacquired some of the gems at a Christie's auction. One piece, an emerald-and-diamond brooch that also can be worn as a pendant, sold for $6,578,500 — breaking records both for sales price of an emerald and for emerald price per carat ($280,000).


That brooch, whose centerpiece is an octagonal step-cut emerald weighing 23.44 carats, was Burton's engagement present to Taylor. He followed it upon their marriage (his second, her fifth) with a matching necklace whose 16 Colombian emeralds weigh in at 60.5 carats. Bulgari bought the necklace back too, for $6,130,500.


They are in the exhibit, along with Burton's engagement ring to Taylor and a delicate brooch — given to her by husband No. 4, Eddie Fisher — whose emerald and diamond flowers were set en tremblant so that they gently fluttered as Taylor moved.


The jewels are not for sale.


On Tuesday night, actress Julianne Moore wore the Burton necklace, with pendant attached, at a gala for Bulgari's top clients. At the dinner hour, guests were escorted along a lavender-colored carpet to a nearby rooftop that had been transformed into a Roman terrace.


Those honored guests, of course, got private viewings of Taylor's jewels.


But so did Amanda Perry, a healer from West Hollywood who arrived the next morning for one of the first appointments available to the public.


Someone had emailed news of the collection to the 35-year-old Taylor fan. She walked in off the street Tuesday, when the exhibit was open only to press — and Sabina Pelli, Bulgari's glamorous executive vice president, fresh from Rome, was taking sips of San Pellegrino brought to her on a silver tray between back-to-back interviews that started at 5 a.m.


The camera crews were long gone when Perry came back Wednesday. She had the exhibit, and handsome sales associate Timothy Morzenti of Milan, entirely to herself.


In a black suit, still wearing on his left hand the black glove he dons to handle fine jewels, Morzenti whisked Perry off via a private elevator to the exhibit on the second floor. The jewels stood in vitrines mounted high off the ground. Behind them were photos and a slide show of Taylor, bejeweled.


"Which piece would you like to see first?" Morzenti asked her as a security guard stood by. "I personally love the emerald ring."


Then he proceeded at leisure to explain Bulgari-signature sugar-loaf cuts and trombino ring settings, while tossing in occasional Taylor stories.





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India Ink: A Personal Nightmare of Assault in India

In a hotel in southern India, in the midst of a dreamless sleep, I awoke inside a nightmare. I heard someone screaming. I’m not sure how much time passed before I realized that it was my scream.

I had traveled to India on behalf of a U.S.-based organization to film a documentary about political street theatre and how art is used as a tool for social change. It was the continuation of field research that I had begun as a William J. Fulbright Scholar. As a second-generation American born to parents who emigrated from India, I felt a sense of pride that I could use my role as a filmmaker to serve as a cultural ambassador between the two largest democracies in the world.

But I found myself awake in this nightmare, with a man violently gripping my mouth shut, attempting to rape me. I was biting and kicking, using every ounce of my energy to fight for my life. My mouth was badly bleeding and in the struggle we fell to the floor. He continued to violently grab my face, and said, “Shalini, don’t shout.” He knew my name. I recognized him as the hotel waiter who served my dinner that night.

I continued to scream and fight incessantly, until finally he relented. He picked up his lungi and said, “I’ll leave. Don’t tell the manager.” Then he ran out and shut the door. Did he really think he could try and rape me in my sleep, without protest and that I wouldn’t tell? Yes. He did. He counted on the fact that he lived in a culture that blamed the victim — that the stigma associated with sexual assault would force a woman to keep quiet. And although I had escaped the worst-case scenario, and prevented a rape, the nightmare was far from over.

In the days that followed, bruised and battered, with excruciating body pain, I managed to shuttle to and from government hospitals to be examined and police stations to file reports. I was well acquainted with India’s bureaucratic process, and in spite of my injuries, I wanted to make sure I had filled out all the paperwork correctly to obtain “justice.”

For several weeks, I tried to get a response from several American and Indian bureaucracies, but they all responded the same way: by doing nothing. Despite my formal complaints, in which I detailed the attack in full, these institutions offered no assistance – not even a single follow up call. I was devastated. I traveled to India on part of an American organization, and received no mental, physical or emotional support. As someone who has committed my life to artistic expression and social justice, I have never felt so voiceless.

Rape and sexual assault are not isolated incidents in a woman’s life. The physical wounds can heal, but the psychological and social stigma associated with rape can keep a woman from reaching her highest potential. My mother had always raised me with the idea that I could lift myself up from my bootstraps and follow my dreams. But in the years following the sexual assault, I suffered the worst depression that I had ever known. I finally sought out a free clinic for survivors. The counselor explained to me, “You have something called post-­‐traumatic stress disorder (PTSD). You have the stuff soldiers have coming home from a war.” Had I not found someone who could diagnose me with PTSD, and tell me this was a real and treatable condition, this assault may have held me back for life.

The recent gang rapes in India are a reminder to all of us that the rapists are not the only persons who are guilty. The onlookers, the institutions that turn a blind eye, and fail to implement comprehensive policies to address sexual assault are complicit in the violence. When these crimes are swept under the carpet, it perpetuates a culture of silence, a culture that blames the victim.

In the mainstream coverage of the recent gang rape in India, there is a kind of colonial mentality to view these men as savages, and to see India as a place that oppresses women. But looking at figures in the U.S., every two minutes a woman is sexually assaulted. One in four American women suffer rape or attempted rape by the time they reach college.

When I first started to share my story, I was astounded by just how many women began sharing their stories with me. It was like a common secret that we were all hiding. And I grieved not just for my own loss of innocence, but also for just how ordinary my story is, for the invisible war that is happening against women everyday. Sexual violence against women is ubiquitous. It happens to women everywhere, however educated, however empowered, across boundaries of race, class, and nationality.

We can longer wait for the death of another woman to break the silence of so many victims of sexual violence. U.S. and Indian institutions must move quickly to implement comprehensive policies regarding education, training, and support as well as clearly defined medical and legal protocol to deal with women who are sexually assaulted at home and abroad.

Healing from this traumatic event has been a journey towards deep compassion for myself, for my attacker, and for the people and institutions that betrayed me in my time of need. This story is for the courageous women who have been betrayed by the institutions they loved and served. This story is for the 40,000 women in India who are still waiting for justice for sexual assault. My case is among them. And in the silence, I can hear their scream.

Shalini Kantayya is the director of 7th Empire Media and a 2000 Fulbright Scholar.

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What's Next for Mindy McCready's Two Young Boys?















02/19/2013 at 07:00 PM EST



Mindy McCready's apparent suicide on Sunday has left her two young sons in custodial limbo.

The boys – Zander, 6, and Zayne, 10 months – had been in state custody since Feb. 7, when McCready called police to ask for help in making her father and stepmother leave her home. When police arrived, McCready appeared to be intoxicated, according to a Department of Human Services report.

In a subsequent petition, the singer's father, Tim McCready, asked the court to order her to undergo mental health and substance abuse evaluation and treatment, alleging that his daughter, who had recently lost her boyfriend, "hasn't had a bath in a week ... screams about everything ... [is] very verbally abusive to Zander."

After a judge granted the petition, the children were quickly removed and placed into foster care. Although McCready was released from treatment, the boys remained in state custody.

At the time, Zander's father, Billy McKnight, requested custody of his son. "My son needs me," he told PEOPLE on Feb. 8. "I'm married, working and successful. I'm on the right track and proud of it. I've been sober for years. I just want my son."

But McCready's mother and stepfather, Gayle and Michael Inge, also want custody of the children – and authorities seem to agree.

In a proposed order sent to Circuit Judge Lee Harrod, the Department of Human Services proposed that the Inges might be a better fit for the children, claiming that they have "a substantial relationship." The Inges had custody of Zander for much the past few years, during McCready’s rehab and jail stints.

With McCready's death, the judge will have to determine what is in the children's best interest. A custody hearing has been scheduled for April 5.

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Drug overdose deaths up for 11th consecutive year


CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.


"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.


In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.


The report appears in Tuesday's Journal of the American Medical Association.


It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.


Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.


They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.


Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.


Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.


The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.


The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.


Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.


"But at some point, people using these drugs are going to become more aware of the dangers," he said.


Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.


Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.


One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.


___


Stobbe reported from Atlanta.


___


Online:


JAMA: http://www.jama.ama-assn.org


CDC: http://www.cdc.gov


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com


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L.A. Community College District chancellor to resign









The chancellor of the Los Angeles Community College District announced Tuesday that he will resign his post, leaving behind a system grappling with poor graduation and transfer rates and daunting budget cuts.


Daniel LaVista made his announcement in a districtwide email in which he extolled the progress made in strengthening accountability and bringing better coordination to the nine-campus district but acknowledged the challenges that lie ahead.


"Even with a healthier FY14 budget proposed for the state's community colleges, there are no quick fixes," LaVista said, for increasing student success, addressing accreditation problems and completing the multibillion-dollar building program.





"The chancellor who leads this remarkable albeit challenging district must take the long view and make a long-term commitment, something I'm unable to do," he said in the email.


LaVista was not available for comment. In the memo, he said he would pursue "other opportunities that combine my professional and family interests." LaVista, 69, became chancellor in August 2010 and earns an annual salary of $370,000.


His resignation is effective June 30, giving the Board of Trustees time to recruit a new or interim chief, he said.


LaVista presided over the colleges as the state was mired in a severe budget crisis, with public higher education systems especially hard hit. California's 112 community colleges operate in a decentralized system of 72 districts governed by boards of trustees; those boards appoint chancellors.


The two-year colleges play a vital role in California's higher education system, training large segments of the state's workforce and typically sending large shares of students to four-year schools. But the system has strained under the pressure of nearly $1 billion in funding cuts and has seen enrollment drop by more than 500,000 students in recent years.


The colleges have struggled to move students more quickly toward graduation and transfer to other universities. Gov. Jerry Brown and others have offered proposals to prioritize enrollment, change funding policies and require orientation and counseling.


The Los Angeles district serves about 240,000 students each year but has lost about $100 million in state support since 2009 and has slashed more than 1,500 class sections. It received harsher scrutiny after a 2011 Times investigation uncovered poor planning, questionable spending and other flaws in a $6-billion campus rebuilding project. And two campuses — Harbor and Southwest — were placed on academic probation last year.


The chancellor initially rejected criticism of the building project, financed with bonds, calling the program "well-managed and effective," and dismissed Times articles as "one-sided" and "sensationalist." But he subsequently committed to reviewing construction practices.


LaVista steered a steady course, establishing a strong working relationship with his Board of Trustees and centralizing oversight of the building program, board President Steve Veres said.


"He fought to keep the institution focused on the mission and on a steady track and that's really critical when the money isn't there," Veres said. "He set us in a strong positive direction."


Veres said LaVista had recently undergone an annual performance review that was satisfactory and that the decision to leave was entirely his own.


"The board as a whole has a high regard for him and believes he's done a good job at the district," he said.


Brice Harris, chancellor of the California community colleges, said in a statement that under LaVista's leadership, the district "survived severe cutbacks forced on it by the recession, improved operations and accountability throughout the district and brought heightened focus on improving student success."


The board is scheduled to discuss the search for a new leader at its meeting Wednesday, Veres said.


Three of the seven board seats will be contested in the March 5 election. One incumbent, Nancy Pearlman, is running, while Tina Park and Kelly Candaele did not seek reelection. Veres said he will ask LaVista to help orient new board members before they take office July 1.


LaVista replaced interim Chancellor Tyree Wieder, who took over after the June 2009 departure of Chancellor Marshall Drummond. A native of upstate New York, LaVista previously served as executive director of the State Council of Higher Education for Virginia and executive director of the Illinois Board of Higher Education, as well as president of two community colleges in Illinois.


carla.rivera@latimes.com





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India Ink: Kalyan Anand, the Sadhu From Madhya Pradesh

Why do millions of Indians, sometimes entire villages, brave the crowds to attend the Kumbh Mela? India Ink interviewed some of the estimated 100 million pilgrims who traveled to this year’s Kumbh Mela at Allahabad, Uttar Pradesh, a 55-day pilgrimage during which Hindus take a holy dip in the Ganges River to wash away their sins.

Kalyan Anand, 46, a sadhu from Chitrakoot town of Madhya Pradesh was one among them. This is what he had to say.

Why did you come to the Kumbh Mela this year? Is this your first time?

I have been coming to the Kumbh for 20 years now. I have gone everywhere there is a Kumbh – Ujjain, Nashik, Haridwar and Allahabad. The purity of River Ganges never ceases to fascinate me. I come to each Kumbh to try and make myself as pure as Mother Ganges.

How have you found it so far?

This one is particularly crowded. They have significantly restricted the bathing area for the sadhus to accommodate the common folk. That is a disappointment. But otherwise, the energy in a Kumbh is always infectious.

Describe your journey to the Kumbh. Did you travel alone? How long did it take?

I travel with my ashram wherever I go.

What does religion mean to you? Do you consider yourself a religious person?

Internal cleansing – that is the basis of religion. Our ancestors strived for it. We should all too. It becomes our inherent responsibility. When everyone on this earth is conscious of his sins, imagine how pure the world will become? Just the mere knowledge will ensure you don’t err in the future.

Who do you think is going to win the 2014 election? Have you ever cast a vote?

We are people who are beyond these things. I haven’t cast a vote all my life.

(The interview was translated from Hindi.)

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Mindy McCready: Under Police Scrutiny at Time of Suicide?















02/18/2013 at 06:00 PM EST







Mindy McCready and David Wilson


Courtesy Mindy McCready


When Mindy McCready talked to police in recent weeks, her account of how her boyfriend came to be found with a fatal gunshot wound to the head concerned police, a law enforcement source tells PEOPLE.

"At first, she said she hadn't heard the gunshot because the TV was too loud. Then she said she had heard the gunshot," the source says. "So obviously there were a lot of questions, and the Sheriff was asking for clarification."

But before investigators could re-interview her, the long-troubled country singer also would die under eerily similar circumstances, her body discovered at the same Heber Springs, Ark., house just feet away from where David Wilson died.

McCready's death was blamed on what "appears to be a single self-inflicted gunshot wound," the Cleburne County Sheriff's Office said in a statement.

This differed from how the sheriff characterized Wilson's case. His cause and manner of death still have not been established by the coroner. It was McCready's publicist, and not a law enforcement official, who announced that Wilson had died of a self-inflicted gunshot wound.

After Wilson's death, McCready, 37, spoke to investigators three times, but they didn't feel as if they were through with her.

"At no point did [police] tell her she was a suspect, and she wasn't officially one," says the source. "But she knew that some of her answers didn't stand up to questioning. She was very cooperative, but she just wasn't making a lot of sense."


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Hip implants a bit more likely to fail in women


CHICAGO (AP) — Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.


The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries.


"This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.


Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration.


After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening.


"There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."


Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads — the ball-shaped part of the ball-and-socket joint in an artificial hip — are more likely to dislocate and require a surgical repair.


That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.


The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years.


"Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."


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Online:


Journal: http://www.jamainternalmed.com


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Restorer of vintage farm equipment could pull in big prize









TULARE — At this year's annual World Ag Expo there was a star exhibit: a young man and an old tractor.


Ryan Haas, 19, of Devine, Texas, a two-time national grand champion at the Delo Tractor Restoration competition, is at the top of a hotly contested field largely unknown to urbanites.


But in rural places that aren't color-coded blue versus red, but rather green versus orange — as in big green John Deere tractors, or smaller, sunny-colored Cases — tractor restoration is an obsession.





Youth participation in restoration competitions is growing especially fast in struggling agricultural areas. It's deep rooted in drought-plagued Texas and gaining momentum in California's Central Valley, where the dairy industry has been pummeled by high feed prices and low milk prices.


More than just a symbol of hanging on to a slipping heritage, the competition requires the skills needed in modern agriculture jobs: engineering, budgeting, marketing and social media. There is also the allure of big cash prizes at fairs and stock shows and the chance to make a profit selling a vehicle to a wealthy collector.


Haas' restored beauty, a 1970 Case tractor— its vintage "Desert Sunset" and "Flambeau Red" paint gleaming in the Central Valley sun — took two years of long nights and $12,000 to rebuild and restore.


His earliest memories are of being in a tractor. His father would go out to plow and use a wooden pallet on the floor of the tractor's cab as his son's playpen. Later on, his older sister drove her date to a prom in one of the family's tractors.


Haas was 10 when the drought first got so bad that his family mostly stopped planting wheat and sorghum. They parked their tractors and turned to cattle on land the family had farmed near Devine since 1872.


Both of Haas' older siblings competed in the national restoration competition. By the time they got to this last year of eligibility for the youngest sibling, all of their father's and grandfather's oldest, retired tractors had been restored.


The youngest Haas wanted to try to restore something with more complicated mechanics anyway. A family friend bought a ranch and found the abandoned Case with a diesel engine.


"My dad and my granddad both ran Case, so pretty much anything you needed to know, they knew," he said.


There is a strong possibility that father and son bear a striking resemblance, but it's hard to tell for sure with them both in straw western hats pulled low and Tony Haas adding a handlebar mustache and sunglasses. Sometimes in hours and hours of tearing apart and rebuilding, the two would bump heads over the best way to go about the work. How did they settle disputes?


"Well, ma'am, I reckon it was whoever gave up first," Ryan Haas said.


He is majoring in business administration at a local college and wants to open a diesel performance business — specializing, of course, in tractors.


The trade may have a promising future. Tractor-love is spreading, with experts pointing to the earth-churning behemoths as the next high-end collectible.


"Tractors are an up-and-coming trend. Many collectors remember riding in a tractor with their father or grandfather. But a lot of others just think they're cool," said Tabetha Salsbury of Hagerty Insurance, the world's largest insurer of collector vehicles. She is the only other two-time winner of the Delo competition.


In addition to the Delo, which is sponsored by Chevron's brand of oil and lubricants and is considered a Super Bowl of tractor restoration, there's also a tractor restoration Web series ("Tractor Fanatic," with episodes available in a two-DVD set) and Midwest tractor shows that draw thousands of fans each summer.


Dennis Rupert, a national tractor restoration judge, said this may be a moment in the sun for old tractors. But there are a couple of challenges: size and weight.


"You're restoring 20 tons. It's not like those TV shows where they're restoring a pedal car or a Coke machine," he said. "Still, there is something nostalgic that hits home. If it's Uncle John's tractor you oughta see the tears flow."


At the ag show, teenagers posed for photos in caps resembling pink cow udders, the smoky smell of Portuguese linguica drew long lines to a food court and folks hurried to a hay and forage seminar, but one farmer stood stock still in front of Haas' Case.


"This is the best tractor in the whole place," Don Adams, 62, said with a look of delight usually associated with a child opening a birthday present. "Sure brings back memories."


Haas hopes to sell his restored tractor for twice what he spent on it. But if he doesn't, he won't treat it like a museum piece.


"I'd rather see it running than sitting," he said. "It's a tractor."


diana.marcum@latimes.com





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India Ink: Modern in Mumbai

Cecilia Morelli Parikh is still a woman on a mission. Nearly two years ago, with Julie Leymarie and Aurélie de Limelette, she opened Le Mill, a multibrand fashion and home store, in a converted warehouse in a gritty section of Mumbai, India, which brought a contemporary Western aesthetic to an affluent Indian shopper. Last November, Morelli Parikh and her co-founders (Leymarie is a former L’Oréal executive; de Limelette has designed numerous displays for Hermès) rolled out a second store, this one in the city’s decidedly fancier Breach Candy area. Morelli Parikh describes the first store’s location as the equivalent of New York’s “meatpacking district, 30 years ago,” while the new store’s surroundings are “the Upper East Side.”

At 1,900 square feet, the second Le Mill is much smaller than the 15,000-square-foot flagship store (which, as of next month, will carry only home products, including the store’s own furniture and tabletop lines, designed by de Limelette, as well as European brands like Carl Hansen & Son, Gervasoni and Gubi). In contrast to the flagship’s industrial look — the name Le Mill refers to the building’s early life as a rice mill — the new store is “more polished,” Morelli Parikh says. The entry floor is painted in a gray and white abstract geometric pattern; the cashier’s desk is a shipping container painted glossy white. It’s the perfect backdrop for the store’s sharply focused fashion offerings — from contemporary labels like 3.1 Phillip Lim, Alexander Wang, Erdem and the Row — as well as jewelry by Mawi, En Inde, Shourouk and Tom Binns, among others, and gift items and tableware.

This spare but sensual look — in design as well as fashion — is what Morelli Parikh and her co-founders want to bring to the Indian luxury goods market, which still lags well behind that of, say, China. It wasn’t that long ago that Indian women began to abandon traditional dress for Western fashion, and even then they often chose flashy over fashion-forward. Add India’s high import duties and the fact that affluent Indians, who travel frequently, prefer to shop in London, Dubai and New York, and the women behind Le Mill had their work cut out for them.

But none of this fazes the American-born, London-raised Morelli Parikh, who, after working at Bergdorf Goodman, married Rohan Parikh — who runs the real estate and construction branch of his family’s shipping company, Apurva Natvar Parikh Group, or A.N.P.G. — and settled in Mumbai two years ago. She noticed a lack of multibrand stores, and realized that while many Western fashion and home products are made in India, with its traditions of craftsmanship, those goods — and their contemporary aesthetic — were generally not available there. So she, Leymarie and de Limelette set about “bringing that heritage into the 21st century,” away from heavy and ornate toward a lighter, more modern take on tradition.

It is no surprise that the apartment that Morelli Parikh and her husband share, in an Art Deco building on Marine Road (which has one of the largest concentration of Art Deco buildings in the world), embodies her “more natural, raw, delicate” outlook. The 2,400-square-foot space’s monochromatic restraint is leavened by contemporary Indian artworks and luxurious touches like the master bedroom’s inlaid marble floor. The furnishings are a mix of de Limelette’s understated pieces for Le Mill, Western classics like a Carl Hansen & Son lounge chair and contemporary works like dining chairs by BDDW in New York (available by special order at Le Mill). The look is comfortable and stylish, but modern.

And that is exactly the direction that Morelli Parikh is taking with Le Mill’s second store. Now that younger, less mainstream designers have proven to be successful, Le Mill has introduced fashion from what Morelli Parikh calls “even edgier” labels like Peter Pilotto and Mary Katrantzou. Still, Morelli Parikh explains that there’s a market for more classic clothing, so this month Joseph will join the store’s designer roster. But its biggest move to date will be the addition of Azzedine Alaïa in March. Morelli Parikh explains that the designer already has a following among the store’s core customers, about 50 women who represent a good 60 percent of Le Mill’s ready-to-wear business. “Alaïa is sexy, but it’s so chic,” she says.

Le Mill is forging ahead with plans to open stores in other prosperous Indian cities, like Delhi and Bangalore, and an e-commerce site will make its debut next month: “There is lots of wealth in third- and fourth-tier cities where there are no shops,” Morelli Parikh says. Being a tastemaker in a brave new world is “incredibly challenging,” she adds, “but really fun.”

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Downton Abbey's Season 3 Finale: Shocking, Says PEOPLE's TV Critic






Downton Abbey










02/17/2013 at 10:00 PM EST







Downton Abbey season 3 cast


Carnival Film & Television/PBS


Downton Abbey's third season finale on PBS's Masterpiece was, to say the least, a spoiler's paradise. The episode, which saw the Granthams and servants going on holiday in the Scottish Highlands, started on a joyful note – Lady Mary was pregnant! – and ended with a shock that would have knocked the hat off Lady Violet wobbling head.

SPOLIER ALERT: Major plot points to be revealed immediately.

Cousin Matthew (Dan Stevens) died in a car accident. He was driving back to Downton, so happy he was practically whistling, just after Lady Mary (Michelle Dockery) had given birth to their son – the male Downton heir everyone has been so obsessed with since Season 1.

Many viewers probably saw this coming: For one thing, Stevens had said he was thinking of decamping before season 4 started shooting. And after the finale had its premiere broadcast in Britain in December, he blabbed all about it, including for an interview posted online by The New York Times.

Even so, the death was almost sadistically abrupt and arbitrary, especially after the soft tenderness and growing love between Mary and Matthew in recent episodes. Now we saw dead poor Matthew dumped on the cold mossy ground, eyes wide open.

You can never be sure Downton writer-creator Julian Fellowes won't pull some shameless stunt to kick-start a story – in season 2 Matthew, paralyzed during the war, suddenly leaped out of his wheelchair – but he seemed to want us to be sure that Matthew was 100% gone. I wouldn't have been surprised if the car backed over the corpse.

So ended a terribly sad season of Downton.

We already suffered the loss in childbirth of Lady Sybil (Jessica Brown Findlay). Her deathbed scene was unflinching and deeply moving as she gasped for breath and called for help. Her poor mother (Elizabeth McGovern) sobbed in despair, and the doctors couldn't agree on what to do.

Millions of viewers cried, too, and sighed for a long time afterward. Those who didn't are probably evil.

That scene was the heart of the season: Sybil was so beautiful and kind and gracious and spirited, and so different from her fractious sisters. It was if one were to discover a rare, transcendent soul among the Kardashians. Her death robbed the show of a lovely presence, and also brought out the best moments yet from McGovern and Maggie Smith, as Lady Violet.

It never ceases to annoy me, to be honest, that Lady Violet's feeble witticisms are treated as if they were Oscar Wilde one-liners on loan, like Harry Winston jewels. If you want real witticisms, try any contemporary American sitcom, including FX's Archer.

But this season, as Violet grieved, we saw how much depth Smith can invest in a single moment. At one point in the finale, she looked up as dinner was announced, and in her enormous eyes you saw a woman who wished she could just chuck the whole damn thing and dwell on her memories.

I wish I could say I will miss Matthew, but all in all an unattached Lady Mary is better than a married one. She was never sexier than in the first season, when she sneaked off to bed with velvety, sensual Mr. Pamuk, who unfortunately kicked the bucket while they made love.

Mary is a wonderful creation – the show's most original, complex character – capable of bouncing from romance to sorrow to sarcasm. You could say her love for Matthew transformed her, but it also had the potential to dull her.

Matthew was blandly handsome and good and patient and full of improving notions, but not terribly exciting. He was like a Bachelor from a much earlier period.

There isn't much else to say about the finale. Fellowes worked through a number of plots with his usual tangy glibness. The performances were all delightful, tart, full of emotion, humor and regret.

For now, we can look forward to Lady Mary at her most beautiful, because most woeful, in season 4.

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