Ex-Bell officials defend themselves as honorable public servants









Less than three years ago, they were handcuffed and taken away in a case alleged to be so extensive that the district attorney called it "corruption on steroids."


But on Monday, two of the six former Bell council members accused of misappropriating money from the small, mostly immigrant town took to the witness stand and defended themselves as honorable public servants who earned their near-$100,000 salaries by working long hours behind the scenes.


During her three days on the stand, Teresa Jacobo said she responded to constituents who called her cell and home phone at all hours. She put in time at the city's food bank, organized breast cancer awareness marches, sometimes paid for hotel rooms for the homeless and was a staunch advocate for education.





"I was working very hard to improve the lives of the citizens of Bell," she said. "I was bringing in programs and working with them to build leadership and good families, strong families."


Jacobo, 60, said she didn't question the appropriateness of her salary, which made her one of the highest-paid part-time council members in the state.


Former Councilman George Mirabal said he too worked a long, irregular schedule when it came to city affairs.


"I keep hearing time frames over and over again, but there's no clock when you're working on the council," he said Monday. "You're working on the circumstances that are facing you. If a family calls … you don't say, '4 o'clock, work's over.' "


Mirabal, 65, said he often reached out to low-income residents who didn't make it to council meetings, attended workshops to learn how to improve civic affairs and once even made a trip to a San Diego high school to research opening a similar tech charter school in Bell.


"Do you believe you gave everything you could to the citizens of Bell?" asked his attorney, Alex Kessel.


"I'd give more," Mirabal replied.


Both Mirabal and Jacobo testified that not only did they perceive their salaries to be reasonable, but they believed them to be lawful because they were drawn up by the city manager and voted on in open session with the city attorney present.


Mirabal, who once served as Bell's city clerk, even went so far as to say that he was still a firm supporter of the city charter that passed in 2005, viewing it as Bell's "constitution." In a taped interview with authorities, one of Mirabal's council colleagues — Victor Bello — said the city manager told him the charter cleared the way for higher council salaries.


Prosecutors have depicted the defendants as salary gluttons who put their city on a path toward bankruptcy. Mirabal and Jacobo, along with Bello, Luis Artiga, George Cole and Oscar Hernandez, are accused of drawing those paychecks from boards that seldom met and did little work. All face potential prison terms if convicted.


Prosecutors have cited the city's Solid Waste and Recycling Authority as a phantom committee, created only as a device for increasing the council's pay. But defense attorneys said the authority had a very real function, even in a city that contracted with an outside trash company.


Jacobo testified that she understood the introduction of that authority to be merely a legal process and that its purpose was to discuss how Bell might start its own city-run trash service.


A former contract manager for Consolidated Disposal Service testified that Bell officials had been unhappy with the response time to bulky item pickups, terminating their contract about 2005, but that it took about six years to finalize because of an agreement that automatically renewed every year.


Deputy Dist. Atty. Edward Miller questioned Mirabal about the day shortly after his 2010 arrest that he voluntarily told prosecutors that no work was done on authorities outside of meetings.


Mirabal said that if he had made such a statement, it was incorrect. He said he couldn't remember what was said back then and "might have heed and hawed."


"So it's easy to remember now?" Miller asked.


"Yes, actually."


"More than two years after charges have been filed, it's easier for you to remember now that you did work outside of the meetings for the Public Finance Authority?"


"Yes, sir."


Miller later asked Mirabal to explain a paragraph included on City Council agendas that began with the phrase, "City Council members are like you."


After some clarification of the question, Mirabal answered: "That everybody is equal and that if they look into themselves, they would see us."


corina.knoll@latimes.com





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Report Faults Priorities in Breast Cancer Research


Too little of the money the federal government spends on breast cancer research goes toward finding environmental causes of the disease and ways to prevent it, according to a new report from a group of scientists, government officials and patient advocates established by Congress to examine the research.


The report, “Breast Cancer and the Environment — Prioritizing Prevention,” published on Tuesday, focuses on environmental factors, which it defines broadly to include behaviors, like alcohol intake and exercise; exposures to chemicals like pesticides, industrial pollutants, consumer products and drugs; radiation; and social and socioeconomic factors.


The 270-page report notes that scientists have long known that genetic and environmental factors contribute individually and also interact with one another to affect breast cancer risk. Studies of women who have moved from Japan to the United States, for instance, show that their breast cancer risk increases to match that of American women. Their genetics have not changed, so something in the environment must be having an effect. But what? Not much is known about exactly what the environmental factors are or how they affect the breast.


“We know things like radiation might cause breast cancer, but we don’t know much that we can say specifically causes breast cancer in terms of chemicals,” said Michael Gould, a professor of oncology at the University of Wisconsin, Madison, and a co-chairman of the 23-member committee that prepared the report.


At the two federal agencies that spend the most on breast cancer, only about 10 percent of the research in recent years involved environment and prevention. From 2008 to 2010, the National Institutes of Health spent $357 million on environmental and prevention-related research in breast cancer, about 16 percent of all the financing for the disease. From 2006 to 2010, the Department of Defense spent $52.2 million on prevention-oriented research, about 8.6 percent of the money devoted to breast cancer. Those proportions were too low, the group said, though it declined to say what the level should be.


“We’re hedging on that on purpose,” Dr. Gould said. “It wasn’t the role of the committee to suggest how much.”


He added, “We’re saying: ‘We’re not getting the job done. We don’t have the money to get the job done.’ The government will have to figure out what we need.”


Jeanne Rizzo, another member of the committee and a member of the Breast Cancer Fund, an advocacy group, said there was an urgent need to study and regulate chemical exposures and inform the public about potential risks. “We’re extending life with breast cancer, making it a chronic disease, but we’re not preventing it,” she said.


“We have to look at early life exposures, in utero, childhood, puberty, pregnancy and lactation,” Ms. Rizzo said. “Those are the periods when you get set up for breast cancer. How does a pregnant woman protect her child? How do we create policy so that she doesn’t have to be a toxicologist when she goes shopping?”


Michele Forman, a co-chairwoman of the committee and an epidemiologist and professor of nutritional sciences at the University of Texas, Austin, said the group found that breast cancer research at various government agencies was not well coordinated and that it was difficult to determine whether there was duplication of efforts.


She said that it was essential to study how environmental exposures at different times of life affected breast-cancer risk, and that certain animals were good models for human breast cancer and should be used more.


The report is the result of the Breast Cancer and Environmental Research Act, which was passed in 2008 and required the secretary of health and human services to create a committee to study breast cancer research. A third of the members were scientists, a third were from government and a third were from advocacy groups. The advocates, Dr. Forman said, brought a sense of urgency to the group


“People who are not survivors need to have that urgency there,” she said.


Pointing to the vaccine now being offered to girls to prevent cervical cancer, Dr. Forman said, “I look forward to the day when we have an early preventive strategy for breast cancer.”


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DealBook Column: Relationship Science Plans Database of Names and Connections

It sounds like a Rolodex for the 1 percent: two million deal makers, power brokers and business executives — not only their names, but in many cases the names of their spouses and children and associates, their political donations, their charity work and more — all at a banker’s fingertips.

Such is the promise of a new company called Relationship Science.

Never heard of it? Until recently, neither had I. But a few months ago, whispers began that this young company was assembling a vast trove of information about big names in corporate America. What really piqued my interest was that bankrolling this start-up were some Wall Street heavyweights, including Henry R. Kravis, Ronald O. Perelman, Kenneth G. Langone, Joseph R. Perella, Stanley F. Druckenmiller and Andrew Tisch.

It turns out that over the last two years, with a staff of more than 800 people, mostly in India, Relationship Science has been quietly building what it hopes will be the ultimate business Who’s Who. If it succeeds, it could radically change the way Wall Street does business.

That’s a big if, of course. There are plenty of other databases out there. And there’s always Google. Normally I wouldn’t write about a technology company, but I kept hearing chatter about it from people on Wall Street.

Then I got a glimpse of this new system. Forget six degrees of Kevin Bacon. This is six degrees of Henry Kravis.

Here’s how it works: Let’s say a banker wants to get in touch with Mr. Kravis, the private equity deal maker, but doesn’t know him personally. The banker can type Mr. Kravis’s name into a Relationship Science search bar, and the system will scan personal contacts for people the banker knows who also know Mr. Kravis, or perhaps secondary or tertiary connections.

The system shows how the searcher is connected — perhaps a friend, or a friend of a friend, is on a charitable board — and also grades the quality of those connections by identifying them as “strong,” “average” or “weak.” You will be surprised at the many ways the database finds connections.

The major innovation is that, unlike Facebook or LinkedIn, it doesn’t matter if people have signed up for the service. Many business leaders aren’t on Facebook or LinkedIn, but Relationship Science doesn’t rely on user-generated content. It just scrapes the Web.

Relationship Science is the brainchild of Neal Goldman, a co-founder of CapitalIQ, a financial database service that is used by many Wall Street firms. Mr. Goldman sold CapitalIQ, which has 4,200 clients worldwide, to McGraw-Hill in 2004 for more than $200 million. That may explain why he was able to easily round up about $60 million in funds for Relationship Science from many boldface names in finance. He raised the first $6 million in three days.

“I knew there had to be a better way,” Mr. Goldman said about the way people search out others. Most people use Google to learn about people and ask friends and colleagues if they or someone they know can provide an introduction.

Relationship Science essentially does this automatically. It will even show you every connection you have to a specific company or organization.

“We live in a service economy,” Mr. Goldman said. “Building relationships is the most important part for selling and growing.”

Kenneth Langone, a financier and co-founder in Home Depot, said that when he saw a demonstration of the system he nearly fell off his chair. He used an unprintable four-letter word.

“My life is all about networking,” said Mr. Langone, who was so enthusiastic he became an investor and recently joined the board of Relationship Science. “How many times do I say, ‘How do I get to this guy?’ It is scary how much it helps.”

Mr. Goldman’s version of networking isn’t for everyone. His company charges $3,000 a year for a person to have access to the site. (That might sound expensive, but by Wall Street standards, it’s not.)

Price aside, the possibility that this system could lead to a deal or to a new wealth management client means it just might pay for itself.

“If you get one extra deal, the price is irrelevant,” Mr. Goldman said.

Apparently, his sales pitch is working. Already, some big financial firms have signed up for the service, which is still in a test phase. Investment bankers, wealth managers, private equity and venture capital investors have been trying to arrange meetings to see it, egged on, no doubt, by many of Mr. Goldman’s well-heeled investors. Even some development offices of charities have taken an interest.

The system I had a peek at was still a bit buggy. In some cases, it was missing information; in other cases the information was outdated. In still other instances, the program missed connections. For example, it didn’t seem to notice that Lloyd C. Blankfein, the chief executive of Goldman Sachs, should obviously know a certain senior partner at Goldman.

But the promise is there, if the initial kinks are worked out. I discovered I had paths I never knew existed to certain people or companies. (Mr. Goldman should market his product to reporters, too.)

One of the most vexing and perhaps unusual choices Mr. Goldman seems to have made with Relationship Science is to omit what would be truly valuable information: phone numbers and e-mail addresses.

Mr. Goldman explained the decision. “This isn’t about spamming people.” He said supplying phone numbers wouldn’t offer any value because people don’t like being cold-called, which he said was the antithesis of the purpose of his database.

Ultimately, he said, as valuable as the technology can be in discovering the path to a relationship, an artful introduction is what really counts.

“We bring the science,” he said. “You bring the art.”

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Locals believe bobcat trappers are crossing the line in Joshua Tree









JOSHUA TREE — Annica Kreuter's backyard on the edge of Joshua Tree National Park has been a perfect place to chronicle the adventures of eight bobcats.


Over the last decade she has watched a young bobcat chased up a tree by a coyote; an alpha male surveying the landscape from the hood of her car; a kitten sauntering into the yard as she gardens; a matron sniffing the back of Kreuter's neck as she napped on a hammock.


Lately, seven of the eight have vanished. "At sunrise, I hear the one that is still here crying for his family," Kreuter said.





She and others in this high desert community of about 8,000 say bobcats have been disappearing lately, killed for the value of their pelts by trappers who often trespass on private property. The trappers come armed with wire cages, squirt bottles of potent scent and bobcat lures: battery-powered vibrating pet toys festooned with feathers to resemble dying birds.


Hunting and trapping bobcats is legal during hunting season outside of the national park boundaries. But to the locals, that makes little difference. "The very idea of trapping in a place where bobcats are so well-known they have nicknames — Big Gray, Leroy, Tomboy — is disturbing and heartbreaking," Kreuter said.


As one of the top predators of a 720,000-acre park visited by 1.4 million people each year, the bobcat's presence — or absence — has a cascade of consequences, making it a governing force of the ecosystem and the local ecotourism economy. An adult bobcat stands about 15 inches high and can cover 25 to 30 miles of territory in a day. Using razor-sharp claws and powerful legs, it preys on rabbits and makes a significant contribution to rodent control.


Critics believe the trappers are after bobcats that routinely crisscross the invisible park boundary lines.


"This is really, really bad," said astronomer and conservationist Tom O'Key, who was the first to discover a trap. "These guys are carpetbaggers coming onto private land to slaughter bobcats with no regard for a tight-knit community that cares deeply about the national park and its wildlife."


O'Key alerted the community after finding a trap chained to a jojoba bush and camouflaged with broken branches and leaves on his property north of the park. He notified the San Bernardino County Sheriff's Department and the Hi-Desert Star newspaper.


Bobcats are being targeted for the value of their pelts in top-dollar markets such as China, Russia and Greece. A premium pelt of heavily spotted white belly fur can earn a trapper more than $600, according to Nathan Brock, who skinned 10 bobcats that he captured in the Joshua Tree area during the hunting season that ended Jan. 31.


Brock, 38, an active-duty Marine stationed at nearby Twentynine Palms Marine Corps Base, acknowledged that one of his traps was set on private property and not on federal Bureau of Land Management grounds, where trapping is legal. The region is a patchwork of private property and BLM land.


"I feel horrible about that," Brock said. "It's my fault for not making sure."


The manufacturer of Brock's trap, Mercer Lawing of Barstow, said critics miss the point. "We love those animals more than the people who are complaining about us trapping them do," Lawing said. "Nathan and I harvest adult male cats and turn loose adult females and kittens."


The national park has taken a neutral position on the issue, given that its jurisdictional reach extends only as far as its boundaries.


However, park biologist Michael Vamstad said, "Residents have every right to be upset. The fact that there is no limit on bobcats that can be legally taken during hunting season doesn't jibe along the edges of a national park. It's a relic regulation."


Conservationists are calling for a "no-trapping" buffer zone in the area because bobcats travel along a web of interconnected wildlife corridors stretching from the national park to the Marine base about 10 miles to the north.


"The law has to change if it's legal for a handful of people to line the boundary of a national park with traps to catch bobcats, then send their pelts to China for profit," said Brendan Cummings, public lands director for the Center for Biological Diversity. "We are not going to let this happen again."


Equally pointed words came from Nancy Karl, executive director of the Mojave Desert Land Trust, a nonprofit dedicated to preserving safe passage for wildlife between protected areas. "We are watching and paying close attention — and we are going to change things," Karl said. "Those trappers would be best advised to move it."


louis.sahagun@latimes.com





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Actor Steven Seagal trains Arizona posse on school security






FOUNTAIN HILLS, Arizona (Reuters) – Action film star Steven Seagal, who racks up big body counts in his on-screen battles with bad guys, took on a new role on Saturday, training posse volunteers for controversial Arizona Sheriff Joe Arpaio in how to use guns to protect schools in shooting incidents.


Arpaio, who styles himself as “America’s Toughest Sheriff,” enlisted Seagal to train his Maricopa County posse members at a school in Fountain Hills, a suburb northeast of Phoenix, with children used as stand-ins for scared students.






Seagal, a burly martial arts expert turned actor, guided 48 volunteers through various aspects of responding to a shooting, including room-to-room searches, and critiqued their work.


“I am here to try to teach the posse firearms and martial arts to try to help them learn how to respond quicker and help protect our children,” Seagal said.


Arpaio, whose tough stances on crime and illegal immigration have made him a national figure, has dispatched the volunteer posse to patrol schools in response to the shooting rampage that killed 20 children and six adults at a Connecticut school in December.


Those killings touched off a renewed debate over gun violence in the United States. President Barack Obama proposed a sweeping package of gun-control measures, including a ban on assault weapons.


The National Rifle Association, which opposes the gun-control proposal, has advocated placing armed security guards in schools.


Arpaio’s volunteers, some trained and qualified to carry the same guns as deputies, can intervene if there is an imminent threat to life. To add realism to the training event, guns firing non-lethal rounds that leave a color mark were used.


“It’s important to help protect our children and our schools and we need to do that with whatever means we have,” said Rick Velotta, a posse member and retired General Electric manager who attended the training.


About a dozen people protested the event.


“No gun should ever be in a school,” said protester Cynthia Wharton, a Fountain Hills resident.


Arpaio’s 3,450-strong posse of unpaid men and women has for years helped the sheriff target drunken drivers and illegal immigrants, and chase down fathers who are behind on child support.


Last year, Arpaio sent posse members to Hawaii to investigate the authenticity of Obama’s birth certificate at the request of local Tea Party activists, a key Arpaio constituency.


A sometime resident of the Phoenix Valley and member of Arpaio’s posse, Seagal, 60, starred in big-budget films in the 1980s and early 1990s, earning a reputation as an action star in movies like “Above the Law” and “Under Siege.”


He more recently played a corrupt Mexican drug lord in the 2010 film “Machete.”


Seagal also has been sworn in as a sheriff’s deputy in a Texas county along the border with Mexico and appeared in a reality TV show detailing his work as a reserve deputy in New Orleans.


(Reporting by Aron Ranen; Writing by Tim Gaynor and Dan Whitcomb; Editing by David Bailey and Eric Beech)


Celebrity News Headlines – Yahoo! News





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Well: Getting the Right Addiction Treatment

“Treatment is not a prerequisite to surviving addiction.” This bold statement opens the treatment chapter in a helpful new book, “Now What? An Insider’s Guide to Addiction and Recovery,” by William Cope Moyers, a man who nonetheless needed “four intense treatment experiences over five years” before he broke free of alcohol and drugs.

As the son of Judith and Bill Moyers, successful parents who watched helplessly during a 15-year pursuit of oblivion through alcohol and drugs, William Moyers said his near-fatal battle with addiction demonstrates that this “illness of the mind, body and spirit” has no respect for status or opportunity.

“My parents raised me to become anything I wanted, but when it came to this chronic incurable illness, I couldn’t get on top of it by myself,” he said in an interview.

He finally emerged from his drug-induced nadir when he gave up “trying to do it my way” and instead listened to professional therapists and assumed responsibility for his behavior. For the last “18 years and four months, one day at a time,” he said, he has lived drug-free.

“Treatment is not the end, it’s the beginning,” he said. “My problem was not drinking or drugs. My problem was learning how to live life without drinking or drugs.”

Mr. Moyers acknowledges that treatment is not a magic bullet. Even after a monthlong stay at a highly reputable treatment center like Hazelden in Center City, Minn., where Mr. Moyers is a vice president of public affairs and community relations, the probability of remaining sober and clean a year later is only about 55 percent.

“Be wary of any program that claims a 100 percent success rate,” Mr. Moyers warned. “There is no such thing.”

“Treatment works to make recovery possible. But recovery is also possible without treatment,” Mr. Moyers said. “There’s no one-size-fits-all approach. What I needed and what worked for me isn’t necessarily what you or your loved one require.”

As with many smokers who must make multiple attempts to quit before finally overcoming an addiction to nicotine, people hooked on alcohol or drugs often must try and try again.

Nor does treatment have as good a chance at succeeding if it is forced upon a person who is not ready to recover. “Treatment does work, but only if the person wants it to,” Mr. Moyers said.

Routes to Success

For those who need a structured program, Mr. Moyers described what to consider to maximize the chances of overcoming addiction to alcohol or drugs.

Most important is to get a thorough assessment before deciding where to go for help. Do you or your loved one meet the criteria for substance dependence? Are there “co-occurring mental illnesses, traumatic or physical disabilities, socioeconomic influences, cultural issues, or family dynamics” that may be complicating the addiction and that can sabotage treatment success?

While most reputable treatment centers do a full assessment before admitting someone, it is important to know if the center or clinic provides the services of professionals who can address any underlying issues revealed by the assessment. For example, if needed, is a psychiatrist or other medical doctor available who could provide therapy and prescribe medication?

Is there a social worker on staff to address challenging family, occupational or other living problems? If a recovering addict goes home to the same problems that precipitated the dependence on alcohol or drugs, the chances of remaining sober or drug-free are greatly reduced.

Is there a program for family members who can participate with the addict in learning the essentials of recovery and how to prepare for the return home once treatment ends?

Finally, does the program offer aftercare and follow-up services? Addiction is now recognized to be a chronic illness that lurks indefinitely within an addict in recovery. As with other chronic ailments, like diabetes or hypertension, lasting control requires hard work and diligence. One slip need not result in a return to abuse, and a good program will help addicts who have completed treatment cope effectively with future challenges to their recovery.

How Families Can Help

“Addiction is a family illness,” Mr. Moyers wrote. Families suffer when someone they love descends into the purgatory of addiction. But contrary to the belief that families should cut off contact with addicts and allow them to reach “rock-bottom” before they can begin recovery, Mr. Moyers said that the bottom is sometimes death.

“It is a dangerous, though popular, misconception that a sick addict can only quit using and start to get well when he ‘hits bottom,’ that is, reaches a point at which he is desperate enough to willingly accept help,” Mr. Moyers wrote.

Rather, he urged families to remain engaged, to keep open the lines of communication and regularly remind the addict of their love and willingness to help if and when help is wanted. But, he added, families must also set firm boundaries — no money, no car, nothing that can be quickly converted into the substance of abuse.

Whether or not the addict ever gets well, Mr. Moyers said, “families have to take care of themselves. They can’t let the addict walk over their lives.”

Sometimes families or friends of an addict decide to do an intervention, confronting the addict with what they see happening and urging the person to seek help, often providing possible therapeutic contacts.

“An intervention can be the key that interrupts the process and enables the addict to recognize the extent of their illness and the need to take responsibility for their behavior,”Mr. Moyers said.

But for an intervention to work, Mr. Moyers said, “the sick person should not be belittled or demeaned.” He also cautioned families to “avoid threats.” He noted that the mind of “the desperate, fearful addict” is subsumed by drugs and alcohol that strip it of logic, empathy and understanding. It “can’t process your threat any better than it can a tearful, emotional plea.”

Resource Network

Mr. Moyer’s book lists nearly two dozen sources of help for addicts and their families. Among them:

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

Substance Abuse and Mental Health Services Administration treatment finder www.samhsa.gov/treatment/;

Al-Anon Family Groups www.Al-anon.alateen.org;

Nar-Anon Family Groups www.nar-anon.org;

Co-Dependents Anonymous World Fellowship www.coda.org.


This is the second of two articles on addiction treatment. The first can be found here.

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Media Decoder Blog: NPR Campaign Seeks the Quirky Listener

Are you a sky diving algebra teacher? A Sudoku-playing barista? NPR has a new ad campaign aimed at you.

The pilot campaign, in four cities, is intended to bring new listeners to local public radio stations, and in turn NPR’s national programs, by matching a show to even the quirkiest interests.

The three-month campaign, financed with a $750,000 grant from the Ford Foundation and developed by Baltimore agency Planit, includes billboards, as well as television spots, social media outreach and rail, print and digital ads aimed at adults 25 to 54, with at least some college education. Ads point to a Web site, interestingradio.com, where visitors can take a poll, discover shows and click through to a live stream from a local station.

The ads will run in the Dallas/Fort Worth, San Diego, Indianapolis and Orlando, Fla., markets, chosen because they offer geographic diversity, as well as stations that are strong and growing, said Emma Carrasco, who joined NPR two months ago as chief marketing officer, a new position.

The campaign comes as listenership for “Morning Edition” and “All Things Considered” — NPR’s two top programs and the radio news programs that reach the most people nationwide each week — declined from spring 2011 to spring 2012, the last period for which national ratings are available.

Year-to-year, the cumulative weekday audience for “Morning Edition” declined 5 percent to 12.3 million listeners a week, from 13 million, NPR officials said, citing Arbitron ratings figures, while “All Things Considered” was off 4 percent, to 11.8 million weekly listeners, compared with 12.3 million in spring 2011.

Preliminary fall 2012 estimates showed year-to-year audience increases for those two shows, NPR said, but the figures were for major markets only.

Local public radio stations have undertaken similar efforts in recent years. WQXR’s modest 2011 “Obeythoven” campaign used TV spots to get audiences thinking about New York City classical music radio in a new way. Chicago’s WBEZ this month began a cheeky campaign called “2032 Membership Drive” encouraging audiences to procreate and raise a new generation of listeners.

If NPR’s new ads are deemed successful, NPR will seek additional funds to expand them to more markets, Ms. Carrasco said.

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





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




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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


“No, I didn’t compare you.”


“Then what did you say?”


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Boeing 787 Completes Test Flight





A Boeing 787 test plane flew for more than two hours on Saturday to gather information about the problems with the batteries that led to a worldwide grounding of the new jets more than three weeks ago.




The flight was the first since the Federal Aviation Administration gave Boeing permission on Thursday to conduct in-flight tests. Federal investigators and the company are trying to determine what caused one of the new lithium-ion batteries to catch fire and how to fix the problems.


The plane took off from Boeing Field in Seattle heading mostly east and then looped around to the south before flying back past the airport to the west. It covered about 900 miles and landed at 2:51 p.m. Pacific time.


Marc R. Birtel, a Boeing spokesman, said the flight was conducted to monitor the performance of the plane’s batteries. He said the crew, which included 13 pilots and test personnel, said the flight was uneventful.


He said special equipment let the crew check status messages involving the batteries and their chargers, as well as data about battery temperature and voltage.


FlightAware, an aviation data provider, said the jet reached 36,000 feet. Its speed ranged from 435 to 626 miles per hour.


All 50 of the 787s delivered so far were grounded after a battery on one of the jets caught fire at a Boston airport on Jan. 7 and another made an emergency landing in Japan with smoke coming from the battery.


The new 787s are the most technically advanced commercial airplanes, and Boeing has a lot riding on their success. Half of the planes’ structural parts are made of lightweight carbon composites to save fuel.


Boeing also decided to switch from conventional nickel cadmium batteries to the lighter lithium-ion ones. But they are more volatile, and federal investigators said Thursday that Boeing had underestimated the risks.


The F.A.A. has set strict operating conditions on the test flights. The flights are expected to resume early this week, Mr. Birtel said.


Battery experts have said it could take weeks for Boeing to fix the problems.


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A delicate new balancing act in senior healthcare









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


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


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





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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


Two days later, that's where she was.


anna.gorman@latimes.com





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