Husband and wife behind 'The Bible' miniseries

NEW YORK (AP) — Mark Burnett was taken aback by the scale of what his wife, actress Roma Downey, had in mind when she suggested over tea one morning four years ago that they make a television miniseries based on the Bible.

"Momentarily, I think he thought I'd lost my mind," Downey recalled. "He went out on his bicycle and he prayed on it and he came back and said, 'You know what, I think it's a good idea. I think we should do it together.' We shook hands and haven't looked back."

The series debuts on History Sunday at 8 p.m. EST, the first of five two-hour chunks that will air each weekend. The finale airs on Easter Sunday.

Different stories in the Bible have been Hollywood fodder for years. Burnett, the prolific producer behind "Survivor" and "The Voice," said no one had tried to tie it all together and use modern computer graphics to bring images like Moses parting the Red Sea to life on screen.

Instead of being all-encompassing, they tried to concentrate on stories in depth and on characters who would emotionally engage the audience. The first episode illustrates the wisdom of that approach: it flounders at the start with a discussion about the world's creation but becomes more gripping when the emphasis turns to the lives of Abraham and Moses.

Burnett said he believes there's a growing "Biblical illiteracy" among young people.

"It's like saying you never heard of Macbeth or King Lear," he said. "In school, you have to know a certain amount of Shakespeare, but no Bible. So there's got to be a way to look at it from a pure literature point of view. If it wasn't for the Bible, arguably Shakespeare wouldn't have written those stories."

Downey, the former star of "Touched By an Angel," said she wanted to be part of something that would glorify God.

After pitching their idea to several networks, Burnett and Downey found a fit with Nancy Dubuc, History's president and general manager. She likes the challenge of ideas that seem unwieldy. History made the 2010 miniseries "America the Story of Us," which was a big hit, and 2012's "Mankind the Story of All of Us," which wasn't. Last spring's miniseries on the Hatfields and McCoys was an eye-opening success.

Burnett and Downey have been building anticipation for "The Bible" by previewing it at churches and for religious leaders. Rick Warren, Joel Osteen and Cardinal Donald Wuerl, archbishop of Washington, have all endorsed the work.

"The faith community is going to sample it, unquestionably," Dubuc said. "Whether they stay or go remains with the TV gods. Our job has been to present this as an epic tale of adventure."

History's own campaign is not targeting a religious audience, emphasizing some of the dramatic scenes to suggest that audiences won't be preached to. The screening that Downey and Burnett have sweated the most was when their teenage children showed it to some friends.

"We knew that we could make it heartfelt," Downey said. "We knew we could make it faithful. But we wanted to be sure that we could make it cool."

Downey spent nearly half of 2012 in Morocco supervising filming, beginning in the cold of February and ending in the blistering heat of July. "We wanted it to be gritty and authentic," she said. "We didn't want it to look like somebody had just stepped out of the dry cleaners."

Her husband flew back and forth to the United States, where he would work on his other programs. Downey said she initially had no intention of appearing onscreen, but stepped in when they had trouble casting an actress for an older Mary, mother of Jesus.

Except for Downey, few of the actors involved are well known in the United States. Portuguese TV star Diogo Morgado portrays Jesus Christ, and many of the other lead actors are based in Britain.

The television airing of "The Bible" on History is only the beginning for this project. Lifetime will air a repeat each week after a new episode appears on History. It will air internationally, and a DVD package will go on sale this spring. The series' scripts are bound together into a book. Producers will make a theatrical release movie of a portion of the story, and are looking at showing it in stadiums this fall. Burnett and Downey have also reached a deal to make parts of the film available as part of a religious education curriculum for churches.

"More people will watch this than any of our other series combined over the next three decades," Burnett said.

Even better, their marriage survived the grueling process intact — even stronger, Downey said.

"Nobody has taken on the broad vision from Genesis to Revelation, and I think we probably realized at midpoint why no one had done it before," she said. "It was maddeningly complicated and extraordinarily hard work. We approached it humbly, but we were exhilarated by it."

___

EDITOR'S NOTE — David Bauder can be reached at dbauder(at)ap.org or on Twitter (at)dbauder.

Read More..

The New Old Age Blog: Why Can’t I Live With People Like Me?

“Aging in place” is the mantra of long-term care. Whether looking at reams of survey data, talking to friends or wishing on a star, who among us wouldn’t rather spend the final years — golden or less so — at home, surrounded by our cherished possessions, in our own bed, no cranky old coot as a roommate, no institutional smells or sounds, no lukewarm meals on a schedule of someone else’s making?

That works best, experts tell us, in dense cities, where we can hail a cab at curbside, call the superintendent when something breaks and have our food delivered from Fresh Direct or countless takeout restaurants. We’d have neighbors in the apartment above us, below us, just on the other side of the wall. Hearing their toilets flush and their children ride tricycles on uncarpeted floors is a small inconvenience compared to the security of knowing they are so close by in an emergency.

Urban planners, mindful that most Americans live in sprawling, car-reliant suburbs, are designing more elder-friendly, walkable communities, far from “real” cities. Houses and apartments are built around village greens, with pockets of commerce instead of distant strip malls. Some have community centers for congregate meals and activities; others share gardens, where people can get their hands in the warm spring dirt long after they can push a lawn mower.

All of this is a step in the right direction, despite the Potemkin-village look of so many of them. But it doesn’t take into account those who are too infirm to stay at home, even in cities or more manageable suburban environments. Some are alone, others with a loving spouse who by comparison is “well” but may not be for long, given the rigors of care-taking. It doesn’t take into account people who can’t afford a home health aide, who don’t qualify for a visiting nurse, who have no adult children to help them or whose children live far away.

But by now, aging in place, unrealistic for some, scary or unsafe for others and potentially very isolating, has become so entrenched as the right way to live out one’s life that not being able to pull it off seems a failure, yet another defeat at a time when defeats are all too plentiful. Are we making people feel guilty if they can’t stay at home, or don’t want to? Are we discouraging an array of other solutions by investing so much, program-wise and emotionally, in this sine qua non?

Regular readers of The New Old Age know that I am single, childless and terrified of falling off a ladder while replacing a light bulb, breaking a hip and lying on the floor, unattended, until my dog wails so loudly a neighbor comes by to complain. A MedicAlert pendant is not something that appeals to me at 65, but even if I give in to that, say at 75, I’m not sure my life will be richer for digging my heels in and insisting home is where I should be.

So I spend a lot of time thinking about the alternatives. I know enough to distinguish between naturally-occurring-retirement communities, or NORCs (some of which work better than others); age-restricted housing complexes (with no services); assisted living (which works fine when you don’t really need it and not so fine when you do); and continuing care retirement communities (which require big upfront payments and extensive due diligence to be sure the place doesn’t go belly up after you get there).

What I find so unappealing about all these choices is that each means growing old among people with whom I share no history. In these congregate settings, for the most part, people are guaranteed only two things in common: age and infirmity. Which brings us to what is known in the trade as “affinity” or “niche” communities,” long studied by Andrew J. Carle at the College of Health and Human Services at George Mason University in Fairfax, Va.

Mr. Carle, who trains future administrators of senior housing complexes, was a media darling a few years back, before the recession, with the first baby boomers approaching 65 and niche communities that included services for the elderly — not merely warm-weather developments adjacent to golf courses — expected to explode. In newspaper interviews as recently as 2011, Mr. Carle said there were “about 100 of them in existence or on the drawing board,” not counting the large number of military old-age communities.

Mr. Carle still believes that better economic times, when they come, will reinvigorate this sector of senior housing, after the failure of some in the planning stages and others in operation. In an e-mail exchange, Mr. Carle said there were now about 70 in operation, with perhaps 50 of those that he has defined as University Based Retirement Communities, adjacent to campuses and popular with alumni, as well as non-alumni, who enjoy proximity to the intellectual and athletic activities. Among the most popular are those near Dartmouth, Oberlin, the University of Alabama, Penn State, Notre Dame, Stanford and Cornell.

At the height of the “affinity” boom, L.G.B.T.-assisted living communities and nursing homes were all the rage, seen as a solution to the shoddy treatment that those of different sexual orientations in the pre-Stonewall generation experienced in generic facilities. A few failed, most never got built and, by all accounts, the only one to survive is the pricy Rainbow Vision community in Sante Fe, N.M.

A handful of nudist elder communities, and ones for old hippies, also fell by the wayside, perhaps too free-spirited for the task. According to Mr. Carle, despite the odds, at least one group of RV enthusiasts has added an assisted-living component to what began as collections of transient elderly, looking only for a parking spot and necessary water and power hook-ups for their trailers. Native Americans have made a go of an assisted-living community in Montana, and Asians have done the same in Northern California.

But professional affinity communities, which I find most appealing, are few and far between.

The storied Motion Picture & Television Country House and Hospital, a sliding-scale institution in the San Fernando Valley since 1940, survived near-closure in 2009 as a result of litigation, activism by the Screen Actors Guild and the local chapter of the Teamsters, and news media pressure. Among film legends who died there — along with cameramen, back-lot security guards and extras — were Mary Astor, Joel McCrea, Yvonne De Carlo and Stepin Fetchit.

New York State’s volunteer firefighters are all welcome to a refurbished facility in the Catskill region that offers far more in the way of care and activities, including a state-of-the-art gym, than when I visited there five years ago. At that time, the residents amused themselves by activating the fire alarm to summon the local hook and ladder company, which didn’t mind a bit.

Then there is Nalcrest, the retirement home for unionized letter carriers. Even as post offices nationwide are preparing to eliminate Saturday service, and snail mail becomes an artifact, the National Association of Letter Carriers holds monthly fees around the $500 mark, is located in central Florida so its members no longer have to brave rain and sleet to complete their appointed rounds, and bans dogs, the bane of their existence.

So why not aged journalists? We surely have war stories to embroider as we rock on the porch. Perhaps a mimeograph machine to produce an old-fashioned, dead-tree newspaper, which some of us will miss once it has given way to Web sites like this one. Pneumatic tubes, one colleague suggested, to whisk our belongings upstairs when we can no longer carry them. Other colleagues wondered about welcoming both editors and reporters. How can these two groups, which some consider natural adversaries, complain about each others’ tin ears or missed deadlines if we’re not segregated?

I disagree. The joy of this profession is its collaboration. We did the impossible day after day when young. We belong together when old.

---

Read More..

SpaceX launches to space station, but experiences problem in orbit

On an overcast morning, SpaceX's Falcon 9 rocket launched from Space Launch Complex 40 at Cape Canaveral Air Force Station and sped through the clouds Friday on its way to the International Space Station.

However, about 12 minutes into the NASA resupply mission, after the rocket had lifted its Dragon capsule packed with more than 1,200 pounds of cargo into orbit, there was an anomaly in the spacecraft.

"It appears that although it reached Earth orbit, Dragon is experiencing some type of problem right now," John Insprucker, Falcon 9 product director, told viewers on SpaceX's live webcast. "We'll have to learn the nature of what happened."

PHOTOS: A 'new era': Private-sector space mission

The live webcast was then shut down.

Elon Musk, SpaceX founder and chief executive, took to Twitter to describe the problem: "Issue with Dragon thruster pods. System inhibiting three of four from initializing. About to command inhibit override."

The company later issued a statement about the thrusters, which are crucial to the spacecraft successfully reaching the space station:

"One thruster pod is running. Two are preferred to take the next step which is to deploy the solar arrays. We are working to bring up the other two in order to plan the next series of burns to get to station."

The Hawthorne company's craft blasted off at 7:10 a.m. PST. The plan was that Dragon would reach and attach to the space station on Saturday, but it's unclear how the thruster issue will affect that.

There is a news conference slated for later in the day, when more information may be available.

SpaceX, formally known as Space Exploration Technologies Corp., has already performed successful NASA resupply missions to the space station. There was one official mission in October, and a demonstration mission took place in May.

Both of those missions also had problems.

In May, a problem with the Dragon's onboard sensors pushed back its capture by the station by about two hours later than planned.

In October, one of the nine engines on the massive Falcon 9 rocket experienced a problem and shut down shortly after launch. Because of the glitch, a satellite that the rocket was carrying didn't reach proper orbit, but the NASA resupply mission went on as planned and the Dragon capsule connected with the space station.

ALSO:

Southland aerospace firms brace for defense cuts

United Airlines pulls Boeing 787 out of service until June 5

United Arab Emirates reaches deal to buy unarmed Predator drones

Read More..

DNA science points to better treatment for acne

Ancient Egyptians were vexed by it, using sulfur to dry it out. Shakespeare wrote of its "bubukles, and whelks, and knobs, and flames o' fire."

Today, acne plagues us still. Doctors can cure some cancers and transplant vital organs like hearts, but they still have trouble getting rid of the pimples and splotches that plague 85% of us at some time in our lives — usually, when we're teenagers and particularly sensitive about they way we look.

But new research hints that there's hope for zapping zits in the future, thanks to advances in genetic research.

Using state-of-the-art DNA sequencing techniques to evaluate the bacteria lurking in the pores of 101 study volunteers' noses, scientists discovered a particular strain of Propionibacterium acnes bacteria that may be able to defend against other versions of P. acnes that pack a bigger breakout-causing punch.

As best as dermatologists can tell, zits occur when bacteria that reside in human skin, including P. acnes, feed on oils in the pores and prompt an immune response that results in red, sometimes pus-filled bumps. But the study subjects who had the newly discovered bacterial strain weren't suffering from whiteheads or blackheads, according to a report published Thursday in the Journal of Investigative Dermatology.

Someday, the realization that "not all P. acnes are created equal" might help dermatologists devise treatments that more precisely target bad strains while allowing beneficial ones to thrive, said Dr. Noah Craft, a dermatologist at the Los Angeles Biomedical Research Institute who conducted the study with colleagues from UCLA and Washington University in St. Louis.

Doctors might prescribe probiotic creams that deliver "good" P. acnes to the face the same way a daily serving of yogurt helps restore healthy bacteria in the digestive tract.

"There are healthy strains that we need on our skin," Craft said. "The idea that you'd use a nuclear bomb to kill everything — what we're currently doing with antibiotics and other treatments — just doesn't make sense."

The research is part of a broad effort backed by the National Institutes of Health to characterize the so-called human microbiome: the trillions of microbes that live in and on our bodies and evolve along with us, sometimes causing illness and often promoting good health.

Most of the microbiome attention so far has gone to studying species in the gut, said study leader Huiying Li, an assistant professor of molecular and medical pharmacology at UCLA's Geffen School of Medicine. But the NIH's Human Microbiome Project, which funds her research, also looks at microbial communities in the nasal passages, the mouth, the urogenital tract and the skin.

Li said she became interested in studying acne because the skin microbiome seemed particularly understudied.

The research team recruited 101 patients in their teens and 20s from dermatology clinics in Southern California. Among them, 49 had acne and 52 had "normal skin" and were not experiencing breakouts but had come to the clinics for other problems.

Doctors used adhesive pore strips to remove skin bacteria from patients' noses. The researchers then collected the waxy plugs — a combination of bacteria, oils, dead skin cells and other stuff — and used DNA to figure out which bacteria were present.

They found that the P. acnes species accounted for about 90% of the bacteria in pores, in both healthy patients and acne sufferers. Digging a little deeper into the DNA, they found that two particular strains appeared in about 20% of acne sufferers, while a third strain was found only in acne-free patients.

"Dogs are dogs, but a Chihuahua isn't a Great Dane," Craft said. "People with acne had pit bulls on their skin. Healthy people had poodles."

The team then sequenced the complete genomes — about 2.6 million base pairs apiece — of 66 of the P. acnes specimens to explore in more depth how the good and bad strains differed.

The two notable bad strains had genes, probably picked up from other bacteria or viruses, that are thought to change the shape of a microbe to make it more virulent. The researchers hypothesized that the foreign DNA, perhaps by sticking more effectively to human host tissues, may help trigger an inflammatory response in the skin: acne.

The good strain, on the other hand, contained an element known to work like an immune system in bacteria, Li said. Perhaps it allows this P. acne to fight off intruders and prevent pimples from forming.

Li said the researchers did not know why some people had the bad P. acnes strains and others did not, and whether genetics or environment played a bigger role.

Dr. Vincent Young, who conducts microbiome research at the University of Michigan Medical School but wasn't involved in the acne project, said advances in sequencing technology and analysis made the new study possible. In the past, he said, scientists wouldn't have tried to sequence dozens of genomes in a single species.

"They'd say, why waste the money?" he said. "Now you can do this in a couple of days."

Li and Craft — neither of whom suffered bad acne as teens — plan to keep up the work.

More research is needed to come up with super-targeted anti-microbial therapies, or to develop a probiotic cream for acne sufferers.

Craft continues collecting samples from patients' pores. He hopes to study whether twins share the same microbial profiles, how acne severity is reflected in bacteria populations, and how things change in a single patient over the course of a treatment regimen.

One of the study volunteers, 19-year-old UC Santa Cruz student Brandon Pritzker, said he would have loved to have treated his acne without affecting the rest of his body. When he took Accutane, he suffered back pain and mood shifts.

Now off the drug, Pritzker said he is at peace with his pimples. "I still have breakouts, but I figure I'm 19, that's the way it's going to be," he said.

But, he added, "it hindered my confidence at the time. Kids with clear skin are probably a little happier."

eryn.brown@latimes.com

Read More..

Donald Trump returns to the 'Apprentice' boardroom

NEW YORK (AP) — There is something Donald Trump says he doesn't know.

Trump has welcomed a reporter to his 26th-floor corner office in Trump Tower to talk about "All-Star Celebrity Apprentice." And here in person, this one-of-a-kind TV star, billionaire businessman, ubiquitous brand mogul and media maestro strikes a softer pose than he has typically practiced in his decades on public display.

Relaxed behind a broad desk whose mirror sheen is mostly hidden by stacks of paper that suggest work is actually done there, Trump is pleasant, even chummy, with a my-time-is-your-time easiness greeting his guest.

He even contradicts his status as a legendary know-it-all with this surprising admission: There's a corner of the universe he doesn't understand.

The ratings woes of NBC, which airs his show, are on Trump's mind at the moment, and as he hastens to voice confidence in the network's powers-that-be ("They will absolutely get it right"), he marvels at the mysteries of the entertainment world.

"If I buy a great piece of real estate and do the right building, I'm really gonna have a success," he says. "It may be MORE successful or LESS successful, but you can sort of predict how it's gonna do. But show business is like trial and error! It's amazing!"

He loves to recall the iffy prospects for "The Apprentice" when it debuted in January 2004. With show biz, he declares, "You NEVER know what's gonna happen."

Except, of course, when you do.

"I do have an instinct," he confides. "Oftentimes, I'll see shows go on and I'll say, 'That show will never make it,' and I'm always right. And I understand talent. Does anybody ask me? No. But if they did, I would be doing them a big service. I know what people want."

So maybe he does know it all. In any case, lots of people wanted "The Apprentice." In its first season, it averaged nearly 21 million viewers each week.

And it gave Trump a signature TV platform that clinched his image as corporate royalty. He presided in a mood-lit stagecraft boardroom where celebrity subjects addressed him as "Mr. Trump" and shrank at that dismissive flick of his wrist and dreaded catchphrase, "You're fired."

The two-hour premiere of "All-Star Celebrity Apprentice" (Sunday at 9 p.m. EST) starts by rallying its 14 veteran contenders in the even more evocative setting of the 2,000-year-old Egyptian Temple of Dendur at the Metropolitan Museum of Art.

There, grandly, Trump receives such returning players as Gary Busey, Stephen Baldwin, LaToya Jackson and reality mean queen Omarosa.

Soon, teammates are chosen by team leaders Bret Michaels and Trace Adkins. Their first assignment: concoct a winning recipe for meatballs, then sell more of them than the rival team.

This is the 13th edition of the "Apprentice" franchise, which has now slipped to less than one-third its original viewership, according to Nielsen Co. figures. But even an audience matching last season's 6.26 million viewers would be pleasant news for NBC, which has recently fallen to fifth place in prime time, behind even Spanish-language Univision.

"I could probably do another show when I don't enjoy 'The Apprentice' anymore," says the 66-year-old Trump, mulling his TV future. "I have been asked by virtually every network on television to do a show for them. But there's something to sticking with what you have: This is a good formula. It works."

Years before "The Apprentice," Trump had hit on a winning formula for himself: Supercharge his business success with relentless self-promotion, putting a human face — his! — on the capitalist system, and embedding his persona in a feedback loop of performance and fame.

Since then, he has ruled as America's larger-than-life tycoon and its patron saint of material success. Which raises the question: Does he play a souped-up version of himself for his audience as Donald Trump, a character bigger and broader than its real-life inspiration?

He laughs, flashing something like a you-got-me smile.

"Perhaps," he replies. "Not consciously. But perhaps I do. Perhaps I do."

It began as early as 1987, when his first book, "Trump: The Art of the Deal," became a huge best-seller.

And even without a regular showcase, he was no stranger to TV. For instance, in the span of just 10 days in May 1997, Trump not only was seen on his "Miss Universe Pageant" telecast on CBS, but also made sitcom cameo appearances as himself on NBC's "Suddenly Susan" and ABC's "Drew Carey Show."

Meanwhile, as a frequent talk-show guest then (as now), he publicized his projects and pushed his brand.

"I'll be on that show for 20 or 30 or 60 minutes, and it costs me nothing," he notes. "When you have an opportunity for promotion, take it! It's free."

No one has ever accused Trump of hiding his light under a bushel. But his promotional drive (or naked craving for attention) has taken him to extremes that conventional wisdom warns against: saying and doing things that might hurt your bottom line.

Item: Trump's noisy, even race-baiting challenge to President Barack Obama to prove his American citizenship. This crusade has earned Trump the title from one editorialist as "birther blowhard."

For an industrialist and entertainer, where's the profit in voicing political views that could tick off a segment of your market or your audience?

"It's a great question, and a hard question to answer, because you happen to be right," Trump begins. "The fact is, some people love me, and some people the-opposite-of-love me, because of what I do and because of what I say. But I'm a very truthful person. By speaking out, it's probably not a good thing for me personally, but I feel I have an obligation to do it."

But isn't he being divisive with some of his pronouncements?

"I think 'divisive' would be a fair word in some cases, not in all cases," he replies. "But I think 'truthful' is another word."

The publicity he got from his political activism reached a fever pitch during his months-long, media-blitzed flirtation with running for president that seemed conveniently to dovetail with the Spring 2011 season of his TV show.

That May, he announced he would not run. For some, it was the final scene of nothing more than political theatrics.

"They weren't," Trump says quietly. "I was very seriously considering running. It was a race that the Republicans should have won. I made a mistake in not running, because I think I would have won."

He says he has no designs on this year's race for mayor of New York. But his politicizing continues apace. In his Twitter feed, with 2 million followers, he continues to bash China and rant about Washington. He phones in to Fox News Channel's "Fox & Friends" each Monday morning to vent his spleen.

"I believe in speaking my mind," he says, "and I don't mind controversy, as you probably noticed. I think sometimes controversy is a good thing, not a bad thing."

Last summer saw the opening in Aberdeen, Scotland, of Trump International Golf Links after a bitter, yearslong fight waged by environmentalists and local residents against government leaders and, of course, Trump.

A man for whom it seems no publicity is bad publicity, Trump insists the controversy helped the project.

"If there wasn't controversy surrounding it, I don't think anybody would even know it exists," he says, laying out the alternative: "I could take an ad: 'Golf course opening.'"

Trump even seems to profit from the harsh attention focused on his hair.

"I get killed on my hair!" he says, with no trace of remorse. But he wants everyone to know, "It's not a wig!" Nor is it an elaborately engineered coif to hide a hairline in retreat, as many Trump-watchers imagine.

To prove it, Trump does a remarkable thing: He lifts the flaxen locks that flop above his forehead to reveal, plain as day, a normal hairline.

"I wash my hair, I comb it, I set it and I spray it," he says. "That's it. I could comb it back and I'd look OK. But I've combed it this way for my whole life. It's become almost a trademark. And I think NBC would be very unhappy if I combed it back, 'cause — you know what? — maybe I wouldn't get as high a rating."

___

Online:

www.nbc.com

___

Frazier Moore is a national television columnist for The Associated Press. He can be reached at fmoore(at)ap.org and at http://www.twitter.com/tvfrazier

Read More..

The New Old Age Blog: For the Elderly, Medical Procedures to Avoid

The Choosing Wisely campaign, an initiative by the American Board of Internal Medicine Foundation in partnership with Consumer Reports, kicked off last spring. It is an attempt to alert both doctors and patients to problematic and commonly overused medical tests, procedures and treatments.

It took an elegantly simple approach: By working through professional organizations representing medical specialties, Choosing Wisely asked doctors to identify “Five Things Physicians and Patients Should Question.”

The idea was that doctors and their patients could agree on tests and treatments that are supported by evidence, that don’t duplicate what others do, that are “truly necessary” and “free from harm” — and avoid the rest.

Among the 18 new lists released last week are recommendations from geriatricians and palliative care specialists, which may be of particular interest to New Old Age readers. I’ve previously written about a number of these warnings, but it’s helpful to have them in single, strongly worded documents.

The winners — or perhaps, losers?

Both the American Geriatrics Society and the American Academy of Hospice and Palliative Medicine agreed on one major “don’t.” Topping both lists was an admonition against feeding tubes for people with advanced dementia.

“This is not news; the data’s been out for at least 15 years,” said Sei Lee, a geriatrician at the University of California, San Francisco, and a member of the working group that narrowed more than 100 recommendations down to five. Feeding tubes don’t prevent aspiration pneumonia or prolong dementia patients’ lives, the research shows, but they do exacerbate bedsores and cause such distress that people often try to pull them out and wind up in restraints. The doctors recommended hand-feeding dementia patients instead.

The geriatricians’ list goes on to warn against the routine prescribing of antipsychotic medications for dementia patients who become aggressive or disruptive. Though drugs like Haldol, Risperdal and Zyprexa remain widely used, “all of these have been shown to increase the risk of stroke and cardiovascular death,” Dr. Lee said. They should be last resorts, after behavioral interventions.

The other questionable tests and treatments:

No. 3: Prescribing medications to achieve “tight glycemic control” (defined as below 7.5 on the A1c test) in elderly diabetics, who need to control their blood sugar, but not as strictly as younger patients.

No. 4: Turning to sleeping pills as the first choice for older people who suffer from agitation, delirium or insomnia. Xanax, Ativan, Valium, Ambien, Lunesta — “they don’t magically disappear from your body when you wake up in the morning,” Dr. Lee said. They continue to slow reaction times, resulting in falls and auto accidents. Other sleep therapies are preferable.

No. 5: Prescribing antibiotics when tests indicate a urinary tract infection, but the patient has no discomfort or other symptoms. Many older people have bacteria in their bladders but don’t suffer ill effects; repeated use of antibiotics just causes drug resistance, leaving them vulnerable to more dangerous infections. “Treat the patient, not the lab test,” Dr. Lee said.

The palliative care doctors’ Five Things list cautions against delaying palliative care, which can relieve pain and control symptoms even as patients pursue treatments for their diseases.

It also urges discussion about deactivating implantable cardioverter-defibrillators, or ICDs, in patients with irreversible diseases. “Being shocked is like being kicked in the chest by a mule,” said Eric Widera, a palliative care specialist at the San Francisco V.A. Medical Center who served on the American Academy of Hospice and Palliative Medicine working group. “As someone gets close to the end of life, these ICDs can’t prolong life and they cause a lot of pain.”

Turning the devices off — an option many patients don’t realize they have — requires simple computer reprogramming or a magnet, not the surgery that installed them in the first place.

The palliative care doctors also pointed out that patients suffering pain as cancer spreads to their bones get as much relief, the evidence shows, from a single dose of radiation than from 10 daily doses that require travel to hospitals or treatment centers.

Finally, their list warned that topical gels widely used by hospice staffs to control nausea do not work because they aren’t absorbed through the skin. “We have lots of other ways to give anti-nausea drugs,” Dr. Widera said.

You can read all the Five Things lists (more are coming later this year), and the Consumer Reports publications that do a good job of translating them, on the Choosing Wisely Web site.

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

After 2 days of big gains, stocks turn mixed

The stock market on Thursday plodded rather than soared, flicking between small ups and downs after two days of triple-digit gains.

Big-name companies reported higher quarterly earnings, and the government reported that the jobless claims are falling and that the economy did better last year than first expected. But Washington's budget battle cast a pall over the market, with spending cuts set to automatically kick in Friday and no sign that the two political parties might work out their differences beforehand.

The Dow Jones industrial average darted between small gains and losses in early trading. At midday, it was up 12 at 14,087. That tamped down some of the buzz from the last two days about when it might top its record high. The Dow hit its highest point, 14,164.53, in October 2007, before the effects of the financial crisis had manifested themselves.

The Standard & Poor's 500 was up two at 1,518. The Nasdaq composite edged up eight to 3,171.

The economic data, while enough to edge the market higher for parts of the morning, painted a picture of investors' low expectations more than one of robust growth.

The government said the U.S. economy grew at an annual rate of 0.1 percent in the last three months of 2012. That's hardly ideal, but it's better than the previous estimate. Originally, the government thought the economy had shrunk 0.1 percent in the period.

The number of Americans seeking unemployment aid also fell last week, which economists described as mildly encouraging.

“We still have work to do, still a lot of headwinds to face,” said Steve Sachs, head of capital markets at ProShares in Bethesda, Md. “But long story short, we're in a better position now than we were three years ago.”

The past two days have been good for the stock market. The Dow gained a combined 291 points after reports showed that Americans are more confident and are buying more homes. Investors were also relieved by Federal Reserve Chairman Ben Bernanke's avowal that the Fed will keep trying to prop up the economy with bond purchases and other programs, although that also does signify that the Fed thinks the economy is doing poorly.

In Washington, lawmakers were preparing for another fiscal cliff. Automatic government budget cuts are set to take effect Friday, slashing spending in the defense industry and elsewhere. The cuts are happening because Democrats and Republicans haven't been able to compromise over the budget, and Thursday gave no indication that they will do so any time soon. Congressional leaders weren't scheduled to meet with President Barack Obama on the matter until Friday, after the cuts have already kicked in.

The yield on the 10-year Treasury note edged down to 1.89 percent from 1.90 percent late Wednesday.

Among companies making big moves:

—Groupon, the coupons website, plunged 21 percent after reporting late Wednesday that its quarterly loss had expanded. The stock fell $1.26 to $4.72.

—J.C. Penney fell 19 percent. Investors were unnerved by the quarterly loss the department store reported late Wednesday, which was larger than they were expecting. The stock dropped $4.10 to $17.06.

—A number of retailers and restaurants reported results Thursday morning. Wendy's, Domino's and the clothing chain Chico's were all up after reporting higher profit and revenue.

Read More..

Race for L.A. city controller heats up

A previously low-profile race for Los Angeles city controller has begun to heat up as opponents of City Councilman Dennis Zine accuse him of "double dipping" the city's payroll and question why he is considering lucrative tax breaks for a Warner Center developer.

Zine, who for 12 years has represented a district in the southeast San Fernando Valley, is the better known of the major candidates competing to replace outgoing Controller Wendy Greuel.

The others are Cary Brazeman, a marketing executive, and lawyer Ron Galperin. Zine has raised $766,000 for his campaign, more than double that of Galperin, the next-highest fundraiser, and has the backing of several of the city's powerful labor unions.

He also has been endorsed by Mayor Antonio Villaraigosa and several of his council colleagues. Galperin is backed by the Service Employees International Union, one the city's largest labor groups, and Brazeman is supported by retired Rep. Diane Watson and several neighborhood council representatives.

With the primary ballot less than a week away, Brazeman and Galperin have turned up the heat on Zine, hoping to push the race beyond the March 5 vote. If no one wins more than 50% of the ballots cast, the top two vote-getters will face a runoff in the May general election.

In a recent debate, Zine's opponents criticized him for receiving a $100,000 annual pension for his 33 years with the Los Angeles Police Department and a nearly $180,000 council salary. Brazeman and Galperin called it an example of "double dipping" that should be eliminated.

That brought a forceful response from Zine, who shot back that he gives a big portion of his police pension check to charities.

"I am so tired of hearing 'double dipping,' " he said. "I worked 33 years on the streets of Los Angeles. I have given over $300,000 to nonprofits that need it.... That's what's happened with that pension."

In the same debate, Brazeman accused Zine of cozying up to a Warner Center developer by pushing for tax breaks on a project that already has been approved. The nearly 30-acre Village at Westfield Topanga project would add 1 million square feet of new shops, restaurants, office space and a hotel to a faded commercial district on Topanga Canyon Boulevard.

"The councilman proposed to give developers at Warner Center tens of millions of dollars in tax breaks even though it's a highly successful project," he said. "He wants to give it away."

City records show that less than a month after the development was approved in February 2012, Zine asked the council for a study looking at possible "economic development incentives" that could be given to Westfield in return for speeding up street and landscaping enhancements to the project's exterior.

The motion's language notes that similar tax breaks have been awarded to large projects in the Hollywood and downtown areas, and that "similar public investment in the Valley has been lacking." Westfield is paying for the $200,000 study.

Zine defended his decision before the debate audience, saying if the study finds that the city will not benefit, no tax breaks will be awarded. "If there's nothing there, then they get nothing," Zine said.

The controller serves as a public watchdog over the city's $7.3-billion annual operation, auditing the general fund, 500 special fund accounts and the performance of city departments. Those audits often produce recommendations for reducing waste, fraud and abuse.

But the mayor and the council are not obligated to adopt those recommendations, and as a result the job is part accountant, part scolder in chief. All the candidates say they will use their elective position not only to perform audits but also to turn them into action.

Their challenge during the campaign has been explaining how they will do that.

Zine, 65, says his City Hall experience has taught him how to get things done by working with his colleagues. He won't be afraid to publicly criticize department managers, he said, but thinks collaboration works better than being combative.

"You can rant and rave and people won't work with you," he said. "Or you can sit down and talk it out, and you can accomplish things."

Galperin, 49, considers himself a policy wonk who relishes digging into the details to come up with ways to become more efficient with limited dollars and to find ways to raise revenue using the city's sprawling assets. For instance, the city owns two asphalt plants that could expand production and sell some of its material to raise money to fix potholes, he said.

He's served on two city commissions, including one that found millions of dollars in savings by detailing ways to be more efficient. Zine is positioning himself as a "tough guy for tough times," but the controller should be more than that, Galperin said.

"What we really need is some thoughtfulness and some smarts and some effectiveness," he said. "Just getting up there and saying we need to be tough is not going to accomplish what needs to be done."

Brazeman, 46, started his own marketing and public relations firm in West Los Angeles a decade ago and became active in city politics over his discontent with a development project near his home. He has pushed the council to change several initiatives over the last five years, including changes to the financing of the Farmers Field stadium proposal that will save taxpayer dollars, he said.

As controller, he would pick and choose his battles, and, Brazeman said, be "the right combination of constructive, abrasive and assertive."

catherine.saillant@latimes.com

Read More..

Van Cliburn, American classical pianist, dies

FORT WORTH, Texas (AP) — Van Cliburn, the internationally celebrated pianist whose triumph at a 1958 Moscow competition helped thaw the Cold War and launched a spectacular career that made him the rare classical musician to enjoy rock-star status, died Wednesday after a fight with bone cancer. He was 78.

Cliburn died at his home in Fort Worth surrounded by loved ones, said his publicist and longtime friend Mary Lou Falcone.

"Van Cliburn was an international legend for over five decades, a great humanitarian and a brilliant musician whose light will continue to shine through his extraordinary legacy," Falcone said in a statement. "He will be missed by all who knew and admired him, and by countless people he never met."

Cliburn made what would be his last public appearance in September at the 50th anniversary of the prestigious piano competition named for him. Speaking to the audience in Fort Worth, he saluted the many past contestants, the orchestra and the city. "Never forget: I love you all from the bottom of my heart, forever," he said to a roaring standing ovation.

Cliburn skyrocketed to fame when he won the first International Tchaikovsky Competition in Moscow at age 23 in 1958, six months after the Soviets' launch of Sputnik embarrassed the U.S. and propelled the world into the space age. He triumphantly returned to a New York City ticker tape parade — the first ever for a classical musician — and a Time magazine cover proclaimed him "The Texan Who Conquered Russia."

But the win also proved the power of the arts, bringing unity in the midst of strong rivalry. Despite the tension between the nations, Cliburn became a hero to music-loving Soviets who clamored to see him perform and Premier Nikita Khrushchev reportedly gave the go-ahead for the judges to honor a foreigner: "Is Cliburn the best? Then give him first prize."

In the years that followed, Cliburn's popularity soared, and the young man from the small east Texas town of Kilgore sold out concerts, caused riots when spotted in public and even prompted an Elvis Presley fan club to change its name to his. His recording of the Tchaikovsky Piano Concerto No. 1 with Russian conductor Kirill Kondrashin became the first classical album to reach platinum status.

Time magazine's 1958 cover story quoted a friend as saying Cliburn could become "the first man in history to be a Horowitz, Liberace and Presley all rolled into one."

Cliburn performed for royalty, heads of state in Europe, Asia and South America, and for every U.S. president since Harry Truman.

"Since we know that classical music is timeless and everlasting, it is precisely the eternal verities inherent in classical music that remain a spiritual beacon for people all over the world," Cliburn once said.

But he also used his skill and fame to help other young musicians through the Van Cliburn International Music Competition.

Created by a group of Fort Worth teachers and citizens in 1962, the competition, held every four years, remains a pre-eminent showcase for the world's top pianists. An amateur contest was added in 1999.

"It is a forum for young artists to celebrate the great works of the piano literature and an opportunity to expose their talents to a wide-ranging international audience," Cliburn said during the 10th competition in 1997. The 14th competition is to be held in May and June.

President George W. Bush presented Cliburn with the Presidential Medal of Freedom — the nation's highest civilian honor — in 2003. In 2004, he received the Order of Friendship of the Russian Federation from Russian President Vladimir Putin.

"I still have lots of friends in Russia," Cliburn said at the time. "It's always a great pleasure to talk to older people in Russia, to hear their anecdotes."

After the death of his father in 1974, Cliburn announced he would soon retire to spend more time with his ailing mother. He stopped touring in 1978.

He told The New York Times in 2008 that among other things, touring robbed him of the chance to enjoy opera and other musical performances. "I said to myself, 'Life is too short.' I was missing so much," he said. After winning the competition, he added, "it was thrilling to be wanted. But it was pressure too."

Cliburn emerged from his sabbatical in 1987, when he played at a state dinner at the White House during the historic visit to Washington of Soviet leader Mikhail Gorbachev. Gorbachev leapt from his seat to give the pianist a bear-hug and kisses on the cheeks.

The 13th Cliburn competition, held in 2009, made history when a blind pianist from Japan, Nobuyuki Tsujii, and a teenager from China, Haochen Zhang, both won gold medals. They were the first winners from any Asian country, and Tsujii was the first blind pianist to win. And it was only the second time there were dual first place winners.

Cliburn was born Harvey Lavan Cliburn Jr. on July 12, 1934, in Shreveport, La., the son of oilman Harvey Cliburn Sr. and Rildia Bee O'Bryan Cliburn. At age 3, he began studying piano with his mother, herself an accomplished pianist who had studied with a pupil of the great 19th century Hungarian pianist Franz Liszt.

The family moved back to Kilgore, Texas, within a few years of his birth.

Cliburn won his first Texas competition when he was 12, and two years later he played in Carnegie Hall as the winner of the National Music Festival Award.

At 17, Cliburn attended the Juilliard School in New York, where fellow students marveled at his marathon practice sessions that stretched until 3 a.m. He studied under the famed Russian-born pianist Rosina Lhevinne.

Between 1952 and 1958, he won all but one competition he entered, including the G.B. Dealey Award from the Dallas Symphony, the Kosciusko Foundation Chopin Scholarship and the prestigious Leventritt. By age 20, he had played with the New York Philharmonic and the symphonies of most major cities.

Cliburn's career seemed ready to take off until his name came up for the draft. Cliburn had to cancel all shows but was eventually excused from duty due to chronic nosebleeds.

Over the next few years, Cliburn's international popularity continued as he recorded pieces ranging from Mozart to a concerto by American Edward McDowell. Still, having been trained by arguably the best Russian teachers in the world, Cliburn's heart was Russian, with the Tchaikovsky and Rachmaninoff concertos.

After 1990, Cliburn toured Japan numerous times and performed throughout the United States. He was in the midst of a 16-city U.S. tour in 1994 when his mother died at age 97.

Cliburn made his home in Fort Worth, where in 1998 he appeared at the opening of the Nancy Lee and Perry R. Bass Performance Hall, both in recital and as soloist with the Fort Worth Symphony Orchestra. He endowed scholarships at many schools, including Juilliard, which gave him an honorary doctorate, and the Moscow and Leningrad Conservatories.

In December 2001, Cliburn was presented with the prestigious Kennedy Center Honors Medallion at the televised tribute held in Washington.

Until only recently, Cliburn practiced daily and performed limited engagements.

___

Online:

Van Cliburn Foundation: http://www.cliburn.org

Read More..

Personal Health: Too Many Pills in Pregnancy

The thalidomide disaster of the early 1960s left thousands of babies with deformed limbs because their mothers innocently took a sleeping pill thought to be safe during pregnancy,

In its well-publicized wake, countless pregnant women avoided all medications, fearing that any drug they took could jeopardize their babies’ development.

I was terrified in December 1968 when, during the first weeks of my pregnancy, I developed double pneumonia and was treated with antibiotics and codeine. Before swallowing a single dose, I called my obstetrician, who told me to take what was prescribed, “reassuring” me that if I died of pneumonia I wouldn’t have a baby at all.

In the decades that followed, pregnancy-related hazards were linked to many medicinal substances: prescription and over-the-counter drugs and herbal remedies, as well as abused drugs and even some vitamins.

Now, however, the latest findings about drug use during pregnancy have ignited new concerns among experts who monitor the effects of medications on the developing fetus and pregnancy itself.

During the last 30 years, use of prescription drugs during the first trimester of pregnancy, when fetal organs are forming, has grown by more than 60 percent.

About 90 percent of pregnant women take at least one medication, and 70 percent take at least one prescription drug, according to the Centers for Disease Control and Prevention.

Since the late 1970s, the proportion of pregnant women taking four or more medications has more than doubled.

Nearly one woman in 10 takes an herbal remedy during the first trimester.

A growing number of pregnant women, naïvely assuming safety, self-medicate with over-the-counter drugs that were once sold only by prescription.

While many commonly taken medications are considered safe for unborn babies, the Food and Drug Administration estimates that 10 percent or more of birth defects result from medications taken during pregnancy. “We seem to have forgotten as a society that drugs pose risks,” Dr. Allen A. Mitchell, professor of epidemiology and pediatrics at Boston University Schools of Public Health and Medicine, said in an interview. “Many over-the-counter drugs were grandfathered in with no studies of their possible effects during pregnancy.”

Medical progress has contributed to the rising use of medications during pregnancy, Dr. Mitchell said. Various conditions, like depression, are now recognized as diseases that warrant treatment; drugs have been developed to treat conditions for which no treatment was previously available, and some conditions, like Type 2 diabetes and hypertension, have become more prevalent.

Misled by the Web

Now a new concern has surfaced: Bypassing their doctors, more and more women are using the Internet to determine whether the medication they are taking or are about to take is safe for an unborn baby.

A study, published online last month in Pharmacoepidemiology and Drug Safety, of so-called “safe lists for medications in pregnancy” found at 25 Web sites revealed glaring inconsistencies and sometimes false reassurances or alarms based on “inadequate evidence.”

The report was prepared by Cheryl S. Broussard of the Centers for Disease Control and Prevention with co-authors from Emory, Georgia State University, the University of British Columbia and the Food and Drug Administration.

“Among medications approved for use in the U.S.A. from 2000 to 2010, over 79% had no published human data on which to assess teratogenic risk (potential to cause birth defects), and 98% had insufficient published data to characterize such risk,” the authors wrote.

But that did not stop the 25 Web sites from characterizing 245 medications as “safe” for use by pregnant women, which “might encourage use of medications during pregnancy even when they are not necessary,” the authors suggested.

Furthermore, the information found online was sometimes contradictory. “Twenty-two of the products listed as safe by one or more sites were stated not to be safe by one or more of the other sites,” the study found.

The question of timing was often ignored. A drug that could interfere with fetal organ development might be safe to take later in pregnancy. Or one (for example, ibuprofen) that is safe early in pregnancy could become a hazard later if it raises the risk of excessive bleeding or premature delivery.

Fewer than half the sites advised taking medication only when necessary, and only 13 sites encouraged pregnant women to consult their doctors before stopping or starting a medication.

Doctors, too, are often poorly informed about pregnancy-related hazards of various medications, the authors noted. One woman I know was advised to wean off an antidepressant before she became pregnant, but another was told to continue taking the same drug throughout her pregnancy.

“In many instances the best bet is for mom to stay on her medication,” said Dr. Siobhan M. Dolan, an obstetrician and geneticist at Albert Einstein College of Medicine. She said that if a woman is depressed during pregnancy, her risk of postpartum depression is greater and she may have difficulty bonding with her baby.

Dr. Dolan, who is author, with Alice Lesch Kelly, of the March of Dimes’ newest book, “Healthy Mom Healthy Baby,” emphasized the importance of weighing benefits and risks in deciding whether to take medication during pregnancy and which drugs to take.

“In anticipation of pregnancy, a woman taking more than one drug to treat her condition should try to get down to a single agent,” Dr. Dolan said in an interview. “Of the various medications available to treat a condition, is there a best choice — one least likely to cause a problem for either the baby or the mother?”

She cautioned against sharing medications prescribed for someone else and assuming that a remedy labeled “natural” or “herbal” is safe. Virtually none have been tested for safety in pregnancy.

Among medications a woman should be certain to avoid, in some cases starting three months before becoming pregnant, are isotretinoin (Accutane and others) for acne; valproic acid for seizure disorders; lithium for bipolar disorder; tetracycline for infections, and angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor antagonists for hypertension, Dr. Dolan said.

“Many medications that are not recommended during pregnancy can be replaced with low-risk alternatives,” she wrote.

Dr. Broussard, who did the “safe lists” study, said in an interview, “We’ve heard about women seeing medications on these lists and deciding on their own that it’s O.K. to take them. “Women who are pregnant or even thinking about getting pregnant should talk directly to their doctors before taking anything. They should be sure they’re taking only what’s necessary for their health condition.”

A reliable online resource for both women and their doctors, Dr. Mitchell said, are fact sheets prepared by OTIS, the Organization of Teratology Information Specialists, which are continually updated as new facts become available: http://www.otispregnancy.org.

Read More..