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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DC Comics Turns the Occupy Movement Into a Superhero Title

Eighteen months after the phrase first entered the collective public consciousness, the plight of the 99 percent is coming to mainstream superhero comics — via a new series from the second biggest publisher in the American comic industry, which just happens to be a subsidiary of a multi-national corporation that makes around $12 billion a year. Irony, anybody?

In May, DC Comics will launch two new series taking place in their mainstream superhero universe that offer different insights into the class struggle in a world filled with superheroes, alien races and inexplicable events. The Green Team, written by Tiny Titans and Superman Family Adventures creators Art Baltazar and Franco, with art by Ig Guara, revives an obscure 1975 concept about teenage rich kids who try to make the world a better place with their outrageous wealth. In an interview promoting the series, Franco promised that it would address questions like “Can money make you happy?” and “If you had unlimited wealth, could you use that to make the lives of people better?”

Obviously, this is one of the more fanciful series DC will be publishing.

But while DC is promoting The Green Team series as the adventures of the “1%,” its companion title, The Movement, is teased as a chance for us to “Meet the 99%… They were the super-powered disenfranchised — now they’re the voice of the people!”

“It’s a book about power,” explained The Movement writer Gail Simone. “Who owns it, who uses it, who suffers from its abuse. As we increasingly move to an age where information is currency, you get these situations where a single viral video can cost a previously unassailable corporation billions, or can upset the power balance of entire governments. And because the sources of that information are so dispersed and nameless, it’s nearly impossible to shut it all down.”

“The thing I find fascinating and a little bit worrisome is, what happens when a hacktivist group whose politics you find completely repulsive has this same kind of power and influence,” she elaborated in an interview at Big Shiny Robot. “What if a racist or homophobic group rises up and organizes in the same manner?”

While the concept is ambitious, the idea that a comic capable of living up to the book’s populist inspiration could come from DC Entertainment still strikes some as unlikely. Matt Pizzolo, the editor of the Occupy Comics anthology, told Wired that “though DC Comics did help launch Alan Moore and David Lloyd’s seminal anarchist epic V For Vendetta over two decades ago, it’s unlikely they would do so today. Between dismantling Vertigo and frankensteining Watchmen, the past year has demonstrated DC isn’t a safe place for bold creators who want to tell the kinds of stories that would inspire things like Occupy, rather than just cash in on them.”

Still, Simone says that the use of the iconography and language of a real-world populist movement is deliberate, promising that the book will reflect today’s decentralized political world and offer ”a slice of rarity that we’re unlikely to see in most superhero books.”

This wouldn’t the first time that DC has attempted to offer pre-packaged populist rebellion, of course; in addition to the aforementioned publication of the anti-establishment V For Vendetta, the company’s Vertigo imprint also published Grant Morrison’s The Invisibles, a series centering around an international organization struggling against forces of authority and repression that included anti-corporate themes.

Only time will tell whether The Movement will live up to the subversive examples of these earlier books, or just end up a well-intentioned piece of topical super heroics that trades on, and commodifies, a real political movement.

The Movement #1 will be available in both print and digital formats on May 1, while The Green Team #1 will be released on May 22.

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Michael Costigan Lands two-Year, First-Look Deal at Sony Pictures

LOS ANGELES (TheWrap.com) – Sony Pictures Entertainment said Tuesday that it has entered into a two-year, exclusive first-look agreement with producer Michael Costigan and his company COTA Films.

The deal reunites Costigan with Sony Pictures, where he previously worked for nine years and served as a production executive. Costigan then served as president of Ridley and Tony Scott‘s Scott Free Productions from 2005 until 2012.

Doug Belgrad, president of Columbia Pictures, and Hannah Minghella, president of production for the studio, made the announcement jointly.

“We couldn’t be more excited to be back in business with Michael,” they said in a statement. “He has a great eye for material, strong director and talent relationships and has been making interesting, original movies during his years with Scott Free. Of course he remains a great friend and we’re thrilled to be professionally reunited.”

Costigan most recently produced “Stoker,” Park Chan Wook’s English-language debut starring Mia Wasikowska, Nicole Kidman and Matthew Goode, and “The East,” starring Brit Marling, Ellen Page and Alexander Skarsgard, and directed by Spirit Award nominee Zal Batmanglij. Both films premiered last week at Sundance to positive reviews and will be released later this spring.

Costigan also produced “Out of the Furnace,” directed by Scott Cooper (“Crazy Heart”) and starring Christian Bale, Casey Affleck and Woody Harrelson.

As executive vice president of production at Sony, he acquired and developed films including “Charlie’s Angels,” “Gattaca,” “The People Versus Larry Flynt,” “Girl Interrupted” and “Bottle Rocket.”

Under the Scott Free banner, Costigan executive produced “Prometheus,” “The Counselor,” “Robin Hood,” “Body of Lies,” and “American Gangster.” He also produced Mark and Jay Duplass’ “Cyrus” and “Welcome to the Rileys.”

Before joining Scott Free, Costigan executive produced Ang Lee’s “Brokeback Mountain.”

Joining Costigan is Ben Leclair, who most recently produced the “Upstream Color,” directed by Shane Carruth, which premiered at Sundance. He previously worked as VP, production for Mike White at Ripcord, where he was a producer of “Year of the Dog” and oversaw Jared Hess’ “Gentlemen Broncos.”

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In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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U.S. Use of Mexican Battery Recyclers Is Faulted

United States companies are sending spent lead batteries to recycling plants in Mexico that do not meet American environmental standards, according to an environmental agency created under the North American Free Trade Agreement, putting Mexican communities at risk.

In a blistering report submitted this week, the agency, the Commission for Environmental Cooperation, notes that the United States does not fully follow procedures common among developed nations that treat international battery shipments as hazardous waste. It faults environmental agencies on both sides of the border for lapses in regulation and enforcement. Cross-border trade in lead batteries increased by up to 525 percent from 2004 to 2011, the report said.

The report, which has been circulating in draft form, has been forwarded to the governments of the United States, Canada and Mexico, which have 60 days to object to its publication. An estimated 20 percent of lead acid batteries from the United States now go to Mexico for recycling, according to trade statistics.

“There needs to be better coordination between government agencies and better cross-border tracking,” said Evan Lloyd, who was the agency’s executive director until late last year and oversaw the yearlong study.

The report highlighted a number of shortcomings: Customs data on the number of batteries crossing the border did not mesh with counts by the United States Environmental Protection Agency. Though the E.P.A. requires notice of batteries leaving the United States, there was no effort to make sure that they had arrived at qualified recyclers in Mexico. The data that battery companies sent to the E.P.A. about exports consisted of “piles of paper,” Mr. Lloyd said, and it was never amassed into an electronic database that would be “useful to regulators.”

Almost all lead acid batteries used in the United States are recycled to extract the lead for reuse because lead is a dangerous pollutant and because it is a valuable commodity. Lead batteries are used in vehicles, cellphone towers and wind turbines.

Since 2008, new United States limits on lead pollution have made domestic recycling complicated and costly. That has helped propel the recycling trade to Mexico, both legally and illegally, environmental groups say, because that country has less stringent limits for lead pollution, and far less vigorous enforcement.

“There’s a pretty consistent pattern suggesting that exports are the direct result of U.S. emissions standards,” said Perry Gottesfeld, executive director of Occupational Knowledge International, which has led the campaign against lead poisoning internationally. Mr. Gottesfeld noted that a Mexican plant owned by a major American recycler, Johnson Controls Inc., puts out more than 30 times as much lead emissions as its newest plant in the United States.

“What Mexico needs to do is to get its recycling up to U.S. standards, and the U.S. needs to do a much better job of tracking batteries overseas,” he said. In an e-mail, Johnson Controls, based in Milwaukee, said it was “modernizing and reinvesting” in the Mexican facility, acquired in 2005, “to reduce its environmental footprint.”

The report was initiated in response to a report by Occupational Knowledge International and Fronteras Comunes, a Mexican environmental group, as well as to an investigative article in The New York Times, Mr. Lloyd said. Soil collected by The Times in a school playground near a recycling plant outside Mexico City was found to have lead levels five times those allowed in the United States.

Lead poisoning causes high blood pressure, kidney damage and abdominal pain in adults, and serious developmental delays and behavioral problems in young children. When batteries are broken for recycling, the lead is released as dust and, during melting, as lead-laced emissions.

In the United States, recyclers operate in highly mechanized, tightly sealed plants, with smokestack scrubbers and extensive monitors to detect lead release. Plants in Mexico vary greatly in safety standards, and in some, the recycling process is little more than men with hammers smashing batteries and melting down their contents in furnaces.

In recent months, there have been new efforts to curb the flow of batteries south of the border, though many battery makers have fought that. In response to a draft of the report released late last year, Battery Council International, an industry group, said it opposed “the creation of additional burdensome certification programs.”

Last year, the United States General Services Administration, which is responsible for federal vehicles, asked ASTM International, an independent standards agency, to explore a voluntary standard for battery recycling.

But that effort came to naught after the proposal was voted down at an open meeting attended by representatives from industry, government and environmental groups in December. Of the 103 people at the meeting, 49 worked for Johnson Controls.

This article has been revised to reflect the following correction:

Correction: February 9, 2013

An earlier version of this article misstated part of the name of an American recycler cited by Perry Gottesfeld, executive director of Occupational Knowledge International, as the owner of a Mexican plant that puts out more than 30 times as much lead emissions as the company’s newest plant in the United States. The American recycling company is Johnson Controls Inc., not Johnson Controls International.

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Big Bear locked down amid manhunt

The bustling winter resort of Big Bear took on the appearance of a ghost town Thursday as surveillance aircraft buzzed overhead and police in tactical gear and carrying rifles patrolled mountain roads in convoys of SUVs, while others stood guard along major intersections.

Even before authorities had confirmed that the torched pickup truck discovered on a quiet forest road belonged to suspected gunman Christopher Dorner, 33, officials had ordered an emergency lockdown of local businesses, homes and the town's popular ski resorts. Parents were told to pick up their children from school, as rolling yellow buses might pose a target to an unpredictable fugitive on the run.

By nightfall, many residents had barricaded their doors as they prepared for a long, anxious evening.

PHOTOS: A tense manhunt amid tragic deaths

"We're all just stressed," said Andrea Burtons as she stocked up on provisions at a convenience store. "I have to go pick up my brother and get him home where we're safe."

Police ordered the lockdown about 9:30 a.m. as authorities throughout Southern California launched an immense manhunt for the former lawman, who is accused of killing three people as part of a long-standing grudge against the LAPD. Dorner is believed to have penned a long, angry manifesto on Facebook saying that he was unfairly fired from the force and was now seeking vengeance.

Forest lands surrounding Big Bear Lake are cross-hatched with fire roads and trails leading in all directions, and the snow-capped mountains can provide both cover and extreme challenges to a fugitive on foot. It was unclear whether Dorner was prepared for such rugged terrain.

Footprints were found leading from Dorner's burned pickup truck into the snow off Forest Road 2N10 and Club View Drive in Big Bear Lake.

San Bernardino County Sheriff John McMahon said that although authorities had deployed 125 officers for tracking and door-to-door searches, officers had to be mindful that the suspect may have set a trap.

"Certainly. There's always that concern and we're extremely careful and we're worried about this individual," McMahon said. "We're taking every precaution we can."

PHOTOS: A fugitive's life on Facebook

Big Bear has roughly 400 homes, but authorities guessed that only 40% are occupied year-round.

The search will probably play out with the backdrop of a winter storm that is expected to hit the area after midnight.

Up to 6 inches of snow could blanket local mountains, the National Weather Service said.

FULL COVERAGE: Sweeping manhunt for rampaging ex-cop

Gusts up to 50 mph could hit the region, said National Weather Service meteorologist Mark Moede, creating a wind-chill factor of 15 to 20 degrees.

Extra patrols were brought in to check vehicles coming and going from Big Bear, McMahon said, but no vehicles had been reported stolen.

"He could be anywhere at this point," McMahon said. When asked if the burned truck was a possible diversion, McMahon replied: "Anything's possible."

Dorner had no known connection to the area, authorities said.

Craig and Christine Winnegar, of Murrieta, found themselves caught up in the lockdown by accident. Craig brought his wife to Big Bear as a surprise to celebrate their 28th wedding anniversary. Their prearranged dinner was canceled when restaurant owners closed their doors out of fear.

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Sandboxr's Animation Interface Offers Completely Customizable 3-D Printed Figurines

Walt Disney invented feature animation by painting on plastic cels, Pixar reinvented the artform with computer graphics, and now Sandboxr is bringing animation to life with 3-D printers.

Animation fans, using Sandboxr’s web-based software via laptop or tablet, can digitally pose character models, change their scale, give them accessories, create scenes, and then 3-D print their custom-built result for less than the cost of a movie ticket.

3-D printed figurines already exist — MyRobotNation and FigurePrints offer similar services, allowing gamers to print models from World of Warcraft and Minecraft. But the interfaces for those sites have limited character flexibility, usually just a set of predefined poses and options. “Services like that are the tip of the iceberg,” says founder Berk Frei. “We’re trying to be the rest of the iceberg.”

What makes Sandboxr unique is how users experience some of the creative flexibility a professional animator does. All of the Sandboxr models are “rigged” — each model has a skeleton that a customer can pose like a doll, then print a souvenir of the experience. And, unlike the animators at movie studios, Sandboxr customers don’t have to learn complicated modeling software. The company has built an engine that lets people experiment with character poses using sliders to create sophisticated, animated poses, simply.

Frei is also passionate about taking the grunt work out of the process. “When I’m getting something ready for 3-D printing it’s not an easy process,” he says. “The printers choke on models with holes, multiple meshes, all these things that look visually impressive. Shelling models to reduce waste materials and adding drain holes takes a lot of time, but we’ve automated all of that. You’re going to save a lot of time using Sandboxr to post-process models.”

These automated features will do a lot to keep costs competitive with services like Shapeways. According to Frei, a 3.5-inch figure will cost approximately $20 to $25 and a 2.5-inch model will cost around $12, but final pricing is still to be determined.

To ensure that there are plenty of options for customers, the platform will be open to 3-D artists. Independent animators and toy designers will be able to post their characters and let fans interact with them in new and exciting ways. Frei says they’re also getting an “overwhelming” response from established videogame companies. “Game companies are excited for us to exist. They’ve made a game and the content already exists. We use the same model files and textures as they do to build the game so it’s an easy transition. Ultimately, we provide a store front that doesn’t cost anything to create and an infinite amount of inventory.”

The response has been so potent, Frei is looking into purchasing 40 ZCorp 3-D printers to keep up with initial demand. “We’ve decided we’re going to get capital equipment and build out our infrastructure, which is a bigger risk, but also gives us the ability to provide lower cost prints.”

For now, the site is in private beta, a Kickstarter campaign is imminent, but for those in the Salt Lake City area, the first Sandboxer project is on view at The Leonardo, a contemporary science museum.

Beyond the lively product, Sandboxr marks an important change in the industry. Most first-generation companies focused on 3-D printing were founded by engineers and focused on developing new, better hardware.

Frei and Sandboxr represent a new wave where designers are driving the technology in new directions increasingly through software. “Working with 3-D printing companies wasn’t that cool of an experience,” he says. “You’re just dropping your file off.”

Frei was introduced to 3-D printing while working as a CG animator in an arts-focused coworking space. He immediately understood the implications of the technology and had a vast library of digital content that could be printed. He also saw a huge problem. “You need to be a sophisticated designer to do anything cool with a 3-D printer,” says Frei. “My idea was to bridge the gap between an everyday person and 3-D printers.”

After evaluating systems from all the major manufacturers Frei found them lacking. He immediately got to work pitching investors on his software concept and recruited a team of engineers and 3-D artists to build the service. ”First and foremost I was thinking what a designer toy artist could do with Sandboxr,” says Frei. “Artists can collaborate with their fans.”

Frei also sees a big future for the product beyond games.

“We’re 3-D artists and game designers, but we built the system with customization in mind so that it can be interacted with in interesting ways,” he says. “I’ll be surprised what they’ll use it for — maybe cool jewelry, wedding cake toppers, who knows. I just want people to feel like they can be Tony Stark from Iron Man. They can design something in their computer and build it.”

All images: Courtesy of Sandboxr

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The New Old Age: The Executor's Assistant

I’m serving as executor for my father’s estate, a role few of us are prepared for until we’re playing it, so I was grateful when the mail brought “The American Bar Association Guide to Wills and Estates” — the fourth edition of a handbook the A.B.A. began publishing in 1995.

This is a legal universe, I’m learning, in which every step — even with a small, simple estate that owes no taxes and includes no real estate or trusts — turns out to be at least 30 percent more complicated than expected.

If my dad had been wealthy or owned a business, or if we faced a challenge to his will, I would have turned the whole matter over to an estate lawyer by now. But even then, it would be helpful to know what the lawyer was talking about. The A.B.A. guide would help.

Written with surprising clarity (hey, they’re lawyers), it maps out all kinds of questions and decisions to consider and explains the many ways to leave property to one’s heirs. Updated from the third edition in 2009, the guide not only talks taxes and trusts, but also offers counsel for same-sex couples and unconventional families.

If you want to permit your second husband to live in the family home until he dies, but then guarantee that the house reverts to the children of your first marriage, the guide tells you how a “life estate” works. It explains what is taxable and what isn’t, and discusses how to choose executors and trustees. It lists lots of resources and concludes with an estate-planning checklist.

In general, the A.B.A. intends its guide for the person trying to put his or her affairs in order, more than for family members trying to figure out how to proceed after someone has died. But many of us will play both these parts at some point (and if you are already an executor, or have been, please tell us how that has gone, and mention your state). We’ll need this information.

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

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Wall Street Edges Ahead

Stocks opened slightly higher on Wall Street on Friday after a trio of positive economic data points, but gains were expected to be modest.

The Standard & Poor’s 500-stock index added 0.2 percent in early trading, the Dow Jones industrial average rose 0.2 percent and the Nasdaq composite index jumped 0.4 percent.

Data showed that Chinese exports grew more than expected in January, while imports climbed 28.8 percent, highlighting robust domestic demand. German data showed a 2012 trade surplus that was the nation’s second highest in more than 60 years, an indication of the underlying strength of Europe’s biggest economy.

And U.S. data showed that the trade deficit shrank in December to $38.5 billion, its narrowest in nearly three years, indicating the economy did better in the fourth quarter than initially estimated.

The S.&P. 500 has risen for five straight weeks and is up 5.8 percent for the year. Its advance was helped by legislators in Washington averting a series of automatic spending cuts and tax increases earlier in the year, as well as better-than-expected corporate earnings and data that pointed to modest economic improvement but no immediate change in the Federal Reserve’s stimulus plans.

But the index, hovering near five-year highs, has stalled in recent days as investors await strong trading incentives to drive it further..

“The market has made a big run, a lot of this was anticipated and so now investors are saying, ‘Now what? What do we do for an encore?'” said Terry Morris, senior equity manager for National Penn Investors Trust Company in Reading, Pa. “It has made a big run and it is deserving of rest — in fact, it would probably be healthy if we had a little bit of a pullback.”

McDonald’s said that January sales at established hamburger restaurants around the world fell 1.9 percent, a steeper decline than analysts expected. Shares edged down 0.5 percent.

LinkedIn jumped 10.6 percent after announcing both blow-out quarterly profit and a bullish forecast for the new year that exceeded Wall Street’s already lofty expectations.

According to Thomson Reuters data through Thursday morning, of 317 companies in the S.&P. 500 that have reported earnings, 69 percent have exceeded analysts’ expectations, above a 62 percent average since 1994 and a 65 percent average over the past four quarters.

Fourth-quarter earnings for S.&P. 500 companies grew 5 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

On Thursday, comments about the strength of the euro by the European Central Bank president, Mario Draghi, renewed concern about the euro zone economy and sent global equities lower. On Friday, European stock markets were mostly higher in afternoon trading, while the euro traded around $1.3394.

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Manhunt underway for ex-LAPD officer suspected of shooting 3 cops

A manhunt involving multiple law enforcement agencies was underway early Thursday after three police officers were shot -- one fatally -- in Riverside County. Authorities believe that the suspect is a former Los Angeles police officer already wanted in connection with two Orange County slayings.

The suspect, Christopher Jordan Dorner, 33, wrote an online manifesto threatening to harm police officials and their families, authorities said, and he is considered "armed and extremely dangerous."

The California Highway Patrol issued a "blue alert" for nine Southern California counties. Officials said Dorner is believed to be driving a 2005 blue or gray Nissan Titan, with California license plate 8D83987 or 7X09131. Police said they believe he may be switching between the two license plates. Dorner is described as a black male, 33 years old, 6 feet tall, weighing 270 pounds with black hair and brown eyes. His last known address is in La Palma.

Members of the public were warned to stay away from him if they spot him, and to call 911 immediately.

The first shooting occurred about 1:30 a.m. in Corona, where two Los Angeles Police Department officers were on "protection detail" for someone mentioned in the suspect's manifesto, officials said. One officer suffered a grazing head wound during a shootout and Dorner fled the scene, police said.

A short time later, two Riverside officers were involved in a shooting with a suspect at the corner of Magnolia Avenue and Arlington Avenue in Riverside, according to Riverside Police Officer Bryan Galbreath.

Sources told The Times that the officers were in a patrol unit and ambushed by the suspect.

One police officer was killed, the other seriously wounded, Galbreath said.

He said said there were no other officers who witnessed the shooting, and that it's only a possibility that Dorner was involved.

Irvine police on Wednesday night named Dorner as the suspect in the double slaying in the parking lot of an upscale Irvine apartment complex Sunday. Law enforcement sources said police have placed security at the homes of LAPD officials named in the manifesto and believe that Dorner has numerous weapons.

In the online postings on his Facebook page, Dorner specifically named the father of Monica Quan, the Cal State Fullerton assistant basketball coach who was found dead Sunday, along with her fiance, Keith Lawrence.

Randy Quan, a retired LAPD captain, was involved in the review process that ultimately led to Dorner’s dismissal.

A former U.S. Navy reservist, Dorner was fired in 2009 for allegedly making false statements about his training officer.

Dorner said in his online postings that being a police officer had been his life’s ambition since he served in the Police Explorers program. Now that had been taken away from him, he said, and he suffered from severe depression and was filled with rage over the people who forced him from his job.

Dorner complained that Randy Quan and others did not fairly represent him at the review hearing.

“Your lack of ethics and conspiring to wrong a just individual are over. Suppressing the truth will leave to deadly consequences for you and your family. There will be an element of surprise where you work, live, eat, and sleep,” he wrote, referring to Quan and several others.

“I never had the opportunity to have a family of my own, I'm terminating yours,” he added.

The online postings indicated that Quan served as Dorner’s representative in the review hearing. Of Quan, Dorner wrote: “He doesn't work for you, your interest, or your name. He works for the department, period. His job is to protect the department from civil lawsuits being filed and their best interest which is the almighty dollar. His loyalty is to the department, not his client.”

In the document, he threatens violence against other police officers: “The violence of action will be high. ... I will bring unconventional and asymmetrical warfare to those in LAPD uniform whether on or off duty.”

In his postings, Dorner seemed to allude to the Irvine slaying.

“I know most of you who personally know me are in disbelief to hear from media reports that I am suspected of committing such horrendous murders and have taken drastic and shocking actions in the last couple of days,” he wrote.

“Unfortunately,” he added, “this is a necessary evil that I do not enjoy but must partake and complete for substantial change to occur within the LAPD and reclaim my name.”

Quan, 28, and Lawrence, 27, had recently become engaged and moved into the condominium complex near Concordia University, where they had played basketball and received their degrees, authorities said. Lawrence worked as a campus officer at USC.

Dorner’s LAPD case began when he lodged a complaint against his field training officer, Sgt. Teresa Evans. He accused her of kicking a suspect named Christopher Gettler. An LAPD Board of Rights found that the complaint was false and terminated his employment for making false statements. He appealed the action.

He testified that he graduated from the Police Academy in February 2006 and left for a 13-month military deployment in November 2006.

“This is my last resort,” he wrote online. “The LAPD has suppressed the truth and it has now led to deadly consequences.”

Dorner said it was the LAPD’s fault that he lost his law enforcement and Navy careers, as well as his relationships with family and close friends. Dorner wrote that he began his law enforcement career in February 2005 and that it ended in January 2009. His Navy career began in April 2002 and ended this month.

“I lost everything,” he said, “because the LAPD took my name and knew I was innocent.”

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The UFO Is Fake in Animator's YouTube Prank — But So Is Everything Else

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Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His brown eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.

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Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

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DealBook: K.K.R. Profit Rises 22% on Investment Gains

Improving markets lifted the fortunes of Kohlberg Kravis Roberts in the fourth quarter, as the investment firm reported a 22 percent rise in profit.

K.K.R. said on Thursday that it earned $347.7 million for the quarter, as all of its businesses showed strong gains. For the year, the firm reported earning $2.1 billion.

The fourth-quarter profit, reported as economic net income and which includes unrealized gains from investments, comes out to 48 cents a share. That is more than double the 20-cents-a-share average of analyst estimates compiled by Capital IQ.

Private equity firms have benefited from an improvement in the markets, which have bolstered the value of their own holdings. Last week, the Blackstone Group reported a 43 percent increase in fourth-quarter earnings.

K.K.R. said the value of its investments rose 4 percent for the quarter and 24 percent for the year.

The strongest performers among the firm’s investments included Alliance Boots, a British pharmacy chain; HCA, the giant hospital operator that went public last year; and the Nielsen Company, the media measurement company.

The improved market conditions also make selling portfolio companies a more attractive prospect, letting the firms harvest tangible returns from their investments. That was reflected in K.K.R.’s results, as it reported a nearly fourfold increase in distributable earnings for the quarter, to $546.3 million. That metric tracks how much a firm actually pays to its limited partners.

And K.K.R.’s assets under management rose 13.9 percent from the third quarter, to $75.5 billion.

The firm’s co-founders and co-chairmen, Henry R. Kravis and George R. Roberts, said in a statement that the growth of their private equity portfolio outpaced the Standard & Poor’s 500-stock index by about 7 percent last year.

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R.I.P., Barney: How 'Barney Cam' made George W. Bush's dog a Web star

"Mr. Orr, this is the White House operator."

As a White House spokesman, I received phone calls like this all the time. But this was the first time the president's secretary had ordered me to report to the Oval Office immediately. Before 7 a.m. on a Saturday.

It was December 2003. Iraq was all over the news. We were closing in on the capture of Saddam Hussein. But — and the nation should be thankful — this wasn't my domain.

President George W. Bush had another reason for calling for me now.

Barney Cam.

How it happened

Whenever I'm asked to speak about my tenure in the White House, the conversation always shifts to Barney, the Scottish terrier whom the president regarded as the son he never had.

After Barney died Friday at age 12, I found myself thinking about how he became an Internet sensation.

In 2002, the White House was still closed to the public after the attacks of Sept. 11. I ran the White House website, and we wanted to use the Internet to better connect with citizens.

Our first attempt to bring people in to the White House — virtually — was a big hit. Millions of viewers went to our site to see President Bush give a personal video tour of the Oval Office.

During a brainstorming session, my deputy, Jane Cook, mentioned that the theme for the White House Christmas was "All Creatures Great and Small" — a tribute to presidential pets.

People liked our videos. People loved Barney. Why not strap a video camera to the first dog's head, chase him through the White House so viewers can see the Christmas decorations from his vantage point, and stream it over the Internet?

I decided to pitch the idea at the morning communications meeting in the West Wing, where a couple of dozen communication staffers gather to plan the day.

When Dan Bartlett, counselor to the president, asked me what was on my agenda, I swallowed hard and then said, "As you know, Dan, White House tours are still closed due to terrorist concerns. And the theme for this year's Christmas at the White House is 'All Creatures Great and Small.'

"So it's only logical that we have a Barney Cam, Dan, which is where we strap a video camera on Barney's head and have him run through the White House looking at decorations while Christmas music is playing in the background."

I smiled.

Dan looked at me as though I'd grown another head.

After about 10 seconds of dead silence, Press Secretary Ari Fleischer chimed in: "That. Is. Awesome."

His validation was all it took.

"Brilliant!"

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Amazon Launches Its Own Currency to Make It Easier to Spend on the Kindle

Following in the footsteps of Microsoft and Nintendo, Amazon has announced its own virtual currency for game, app, and in-app purchases, called Amazon Coins, on the Kindle Fire HD. The e-commerce giant is billing it as a way for developers to make more money by making it easier for shoppers to buy apps and games.

Android and iOS app developer Zak Tanjeloff agrees that Amazon Coins could put more cash in developer’s bank accounts. ”Any time you reduce the friction in buying an app or an in-app purchase, developers see better sales,” he says. It could also open the door for more in-app promos, where consumers can win coins and use them for future in-app purchases, which would help developers earn even more money, Tanjeloff says.

One Amazon Coin equals one U.S. penny, meaning a 99 cent game will cost 99 coins, a $1.99 app costs 199 coins, and so on. By converting coins to pennies instead of dollars, Amazon is giving developers the flexibility to sell in-app purchases for less than a dollar if they choose. It also means that mentally converting your Amazon Coin balance to real dollars won’t be too hard, a problem that’s plagued Microsoft Points and Nintendo Points.

With Amazon already accepting two forms of payment for Kindle purchases (credit/debit cards and gift cards), it begs the question: why another Amazon specific currency? One answer is that virtual currency takes the sting out of a purchase, it’s not real money after all, thus encouraging us to buy more. Perhaps more to the point, and the audience, the virtual coins also make it easy for kids to buy games and apps on the Kindle Fire without badgering their parents for real money – at least not until the coins run out.

It’s well-documented that we spend more money with credit cards than we do with cash, because instead of forking over a $100 bill, you’re merely swiping a card and not watching the money fly from your wallet. Likewise, it’s easy to forget you’re spending real money when you pay with virtual currency, because you’re thinking in terms of coins or points, not cash. Since you’ve already pre-paid for your Amazon Coins, several small purchases hardly feel like a drain on your bank account, at least until it’s time to reload your balance. “Using virtual currency takes the user one level away from actual dollars, which can lure them to spend more,” says Tanjeloff. “It’s like when you get chips at a casino, it’s easy to forget that you’re playing with real money.” In the long run, that could help developers boost their app sales and rake in more cash (they get 70 percent of every Amazon Appstore purchase), if shoppers are more willing to dole out Amazon Coins instead of dollars.

Though Amazon didn’t offer any details on why it thinks consumers will adopt its virtual currency, it makes sense that the company would have kids and parents in mind. Amazon knows that more kids are getting their hands on tablets like the Kindle Fire, and parents don’t want to constantly field requests to buy a new app or pay a few dollars for in-app characters or special features. Right now, if you want to keep your kids away from your credit card on a Kindle, you can buy an Amazon gift card and load it into the Amazon App Store on the tablet.

That means the move into Amazon Coins is less about utility, and more about convenience. Instead of buying a gift card and loading it, a process that is frustratingly difficult on the Kindle Fire, but easier to do online, Amazon promises it will give shoppers a quick way to reload Amazon Coins, though didn’t elaborate on how that will work. That could make Amazon Coins enticing to parents, who could load an account with several dollars’ worth of Coins each month and let their kids spend them at will without any hassle.

The news is already spurring criticism from folks who have had unfavorable experiences with Microsoft Points and Nintendo Points, neither of which have a one to one currency conversion. Microsoft Points (MSP) – used to buy games, music, and video on the Xbox and other Microsoft devices – have a conversion rate of 80 MSP to one U.S. dollar, and 1000 Nintendo Points equals one dollar. That’s led countless gamers to complain that buying anything with MSPs or NPs makes the purchase process too complicated or confusing. Amazon penny-per-coin approach won’t suffer from that problem, but it may still be an uphill battle with people who have been burned by virtual currency.

Amazon Coins officially launch in May and Amazon will give “tens of millions of dollars’ worth of free Amazon Coins to spend on developers’ apps on Kindle Fire in the Amazon Appstore,” the company says. Developers have until April 25 to submit their app to run on the new Coins currency when it launches.

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Ipswich Journal: Paul Mason Is One-Third the Man He Used to Be

Paul Nixon Photography

Paul Mason in 2012, two years after gastric bypass surgery stripped him of the unofficial title of “the world’s fattest man.”

IPSWICH, England — Who knows what the worst moment was for Paul Mason — there were so many awful milestones, as he grew fatter and fatter — but a good bet might be when he became too vast to leave his room. To get him to the hospital for a hernia operation, the local fire department had to knock down a wall and extricate him with a forklift.

That was nearly a decade ago, when Mr. Mason weighed about 980 pounds, and the spectacle made him the object of fascinated horror, a freak-show exhibit. The British news media, which likes a superlative, appointed him “the world’s fattest man.”

Now the narrative has shifted to one of redemption and second chances. Since a gastric bypass operation in 2010, Mr. Mason, 52 years old and 6-foot-4, has lost nearly two-thirds of his body weight, putting him at about 336 pounds — still obese, but within the realm of plausibility. He is talking about starting a jewelry business.

“My meals are a lot different now than they used to be,” Mr. Mason said during a recent interview in his one-story apartment in a cheerful public housing complex here. For one thing, he no longer eats around the clock. “Food is a necessity, but now I don’t let it control my life anymore,” he said.

But the road to a new life is uphill and paved with sharp objects. When he answered the door, Mr. Mason did not walk; he glided in an electric wheelchair.

And though Mr. Mason looks perfectly normal from the chest up, horrible vestiges of his past stick to him, literally, in the form of a huge mass of loose skin choking him like a straitjacket. Folds and folds of it encircle his torso and sit on his lap, like an unwanted package someone has set there; more folds encase his legs. All told, he reckons, the excess weighs more than 100 pounds.

As he waits to see if anyone will agree to perform the complex operation to remove the skin, Mr. Mason has plenty of time to ponder how he got to where he is. He was born in Ipswich and had a childhood marked by two things, he says: the verbal and physical abuse of his father, a military policeman turned security guard; and three years of sexual abuse, starting when he was 6, by a relative in her 20s who lived in the house and shared his bed. He told no one until decades later.

After he left school, Mr. Mason took a job as a postal worker and became engaged to a woman more than 20 years older than him. “I thought it would be for life, but she just turned around one day and said, ‘No, I don’t want to see you anymore — goodbye,’ ” he said.

His father died, and he returned home to care for his arthritic mother, who was in a wheelchair. “I still had all these things going around in my head from my childhood,” he said. “Food replaced the love I didn’t get from my parents.” When he left the Royal Mail in 1986, he said, he weighed 364 pounds.

Then things spun out of control. Mr. Mason tried to eat himself into oblivion. He spent every available penny of his and his mother’s social security checks on food. He stopped paying the mortgage. The bank repossessed their house, and the council found them a smaller place to live. All the while, he ate the way a locust eats — indiscriminately, voraciously, ingesting perhaps 20,000 calories a day. First he could no longer manage the stairs; then he could no longer get out of his room. He stayed in bed, on and off, for most of the last decade.

Social service workers did everything for him, including changing his incontinence pads. A network of local convenience stores and fast-food restaurants kept the food coming nonstop — burgers, french fries, fish and chips, even about $22 worth of chocolate bars a day.

“They didn’t deliver bags of crisps,” he said of potato chips. “They delivered cartons.”

His life became a cycle: eat, doze, eat, eat, eat. “You didn’t sleep a normal sleep,” he said. “You’d be awake most of the night eating and snacking. You totally forgot about everything else. You lose all your dignity, all your self-respect. It all goes, and all you focus on is getting your next fix.”

He added, “It was quite a lonely time, really.”

He got infections a lot and was transported to the hospital — first in a laundry van, then on the back of a truck and finally on the forklift. For 18 months after a hernia operation in 2003, he lived in the hospital and in an old people’s home — where he was not allowed to leave his room — while the local government found him a house that could accommodate all the special equipment he needed.

This article has been revised to reflect the following correction:

Correction: February 6, 2013

The headline on an earlier version of this article misstated Paul Mason’s current weight relative to what he weighed nearly a decade ago. He is now about one-third of the weight he was then, not two-thirds.

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Postal Service Plans to End Saturday Delivery

Jim Wilson/The New York Times

A postal worker delivered mail in San Francisco last year.

WASHINGTON — The Postal Service is expected to announce on Wednesday morning that it will stop delivering letters and other mail on Saturdays, but continue to handle packages, a move the financially struggling agency said would save about $2 billion annually as it looks for ways to cut cost.

The agency has long sought Congressional approval to end mail delivery on Saturdays. But Congress, which continues to work on legislation to reform the agency, has resisted. It is unclear how the agency will be able to end the six-day delivery of mail without Congressional approval.

News of the move was first reported by CBS News.

The announcement, which is expected at a Wednesday morning news conference, comes as the agency continues to lose money, mainly due to a 2006 law which requires it to pay about $5.5 billion a year into a future retiree health benefit fund. Last year, for the first time, the agency defaulted on two payments after it had reached its borrowing limit from the Treasury Department. The Postal Service also continues to see a decline in mail volume as more people shift to electronic forms of communication like e-mail and online bill paying services. Packaging is one of the few areas where the agency is seeing growth.

While many business and postal unions have generally opposed ending Saturday delivery, most Americans support the move.

A New York Times/CBS News poll last year found that about 7 in 10 Americans say they would favor the change as a way to help the post office deal with billions of dollars in debt. The Postal Service continues to suffer losses of $36 million a day and is headed for projected losses of about $21 billion a year by 2016. Last year, the Postal Service had a net loss of $15.6 billion.

The American Postal Workers Union, which represents about 220,000 workers and retirees, said the plan to end six-day delivery will add to the agency’s financial problems.

“The A.P.W.U. condemns the Postal Service’s decision to eliminate Saturday mail delivery, which will only deepen the agency’s congressionally manufactured financial crisis,” said Cliff Guffey, president of the union.

This article has been revised to reflect the following correction:

Correction: February 6, 2013

An earlier version of this article misstated the news organization that first reported the Postal Service’s plans to end Saturday service. It was CBS News, not The Associated Press.

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Friends, investigators seek answers in killing of O.C. couple

They met in college, two highly regarded basketball players who seemed to have the same winning touch on the court and off.

After blazing through high school and college with her outside shot, Monica Quan became the assistant women's basketball coach at Cal State Fullerton. Keith Lawrence, whose highlight shots are still there on his college website, became a campus officer at USC.

Now police in Irvine are scrambling for an explanation — and friends are looking for a way to express their shock — after Quan and Lawrence were found shot to death in their parked car on the top floor of a parking structure in an upscale, high-security condominium complex near UC Irvine.

The two had just announced their engagement and had recently moved into a condominium complex near Concordia University, where they played basketball and had gone on to earn their degrees.

Late Sunday, after a passerby noticed two people in the parked car, police said they found Lawrence slumped in the driver's side of his white Kia. Quan was next to him, also dead. The couple were shot multiple times, and authorities said they have tentatively ruled out the possibility of it being a murder-suicide or motivated by robbery. Nothing in the car, police said, seemed to be disturbed.

The couple's friends and family said they were shaken by the violent deaths of two people who seemed to have so much to offer.

Quan was a 2002 graduate of Walnut High School in the San Gabriel Valley, where she set school records for the most three-pointers in a season and a game. She played at Long Beach State and at Concordia, where she graduated in 2007. She went on to earn a master's degree before becoming the assistant coach at Fullerton.

Quan's father was the first Chinese American captain in the LAPD, and went on to become police chief at Cal Poly Pomona.

Quan was known for pulling students aside to offer encouragement, said Megan Richardson, a former player. Marcia Foster, the head basketball coach at Cal State Fullerton, described her assistant as a special person — "bright, passionate and empowering," she said.

Quan shared a love of basketball with her fiancee, Lawrence, whom she met at Concordia.

He too had been a standout basketball player, starting at Moorpark High, where he played point guard and shooting guard, said Tim Bednar, who coached Lawrence.

Bednar said that Lawrence, who came from a family of athletes, was talented, yet quiet and humble. After Lawrence graduated in 2003, he continued to participate in summer youth camps

When he returned for the camps, Bednar said, he was known as the "best basketball player that ever came through" the school.

"He was awesome with the kids," Bednar said. "They all wanted to be around Keith Lawrence."

Bednar heard from Lawrence when he needed a recommendation to become a police officer after graduating from the Ventura County Sheriff's Academy. In August, he was hired by USC's public safety department.

John Thomas, the executive director and chief of the department, said that Lawrence was an "honorable, compassionate and professional" member of the community.

"We are a better department and the USC campus community is a safer place as a result of his service," Thomas said in a statement.

On Monday night, Quan's friends gathered outside Walnut High School. One clutched a heart-shaped balloon, another carried a collage of her basketball playing days. Still another held a basketball.

Lawrence's friends and family put up a Facebook page. "RIP Keith Lawrence, you will be missed," it said simply. Within hours, 840 had left comments or indicated they "liked" it. Concordia put up a link to Lawrence's game-winning shot that carried the school into a post-season tournament.

Michelle Thibeault, 27, said in a Facebook message that she had known Quan for more than a decade. The two were on the same athletic teams and went to junior high and high school together. "Monica was loved by everyone," she said.

During a somber gathering at the Cal State Fullerton gymnasium Monday, Foster read a brief statement from Quan's brother Ryan.

"We just shared a moment of incredible joy on her recent engagement," he wrote, and then added: "A bright light was just put out."

nicole.santacruz@latimes.com

kate.mather@latimes.com

lauren.williams@latimes.com

Times staff writer John Canalis contributed to this report.

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Late-Night Infomercial Reviews: The Horror of the WaxVac

When you’re an insomniac freelance writer who works from home, you end up seeing a lot of infomercials, and eventually, those things will wear you down. No matter how skeptical you might start off, you will eventually get to a point where you’ll start to wonder if there actually is somebody out there with a better way to fry eggs, chop tomatoes and make milkshakes in the comfort of your own home. I mean, television’s never lied to us before, has it? That’s why I wanted to actually check out a few of these things to see if they really were the life-changing innovations they purported to be. Today’s experiment: The WaxVac.

The Pitch

The WaxVac has what is unquestionably one of the best commercials on television, to the point where I actually get excited whenever it comes on. I just love how ludicrously confrontational it is right out of the gate, wasting no time at all in setting itself up as the only sensible alternative to the barbarism of using a Q-Tip to clean your ears. That they chose to do this by having a grown man jam a cotton swab into his ear and then shriek like he is being murdered with actual knives, a scene so great that they show it twice and then have a frowny doctor examine the damage? That, my friends, is just a truly beautiful bonus feature.

They do have a point, though. Every box of cotton swabs does, in fact, carry a warning about how you’re not actually supposed to use them to clean out the inside of your ear, which is weird when you consider that this is quite literally the only thing I have ever used them for. Apparently, that’s pretty dangerous, as evidenced by their 100% scientific animation of a Q-Tip shoving its way through your eardrum. I’m one of the very few lucky ones, it seems.

Really, though, I actually went into this one hoping it would work. My own ears are crazy sensitive to moisture, and if I so much as get a stray raindrop in there, they end up aching for days. It’s the reason I almost never go swimming. Well, that and the fact that I have exactly the body you’d expect from someone who watches infomercials all night. Either way, having something that could get all that moisture out of there before it could cause any problems would be nice, and keeping my earbuds from getting any more gross than they already are wouldn’t hurt either.

Obviously, I needed a tiny vacuum cleaner designed to suck earwax directly out of my head. What
could possibly go wrong with that?

The Process

According to the ad, you can get two WaxVacs — seen above with a copy of 50 Cent: Blood on the Sand for scale — for ten bucks (plus shipping) by ordering it through their website. I’ll be honest with you, though: There was no way in hell I was going to plug my credit card number into the front page of a website selling earwax removal machines, no matter how charming their auto-playing videos may be. If you want my financial information without even the courtesy of a second webpage, then I’d better at least be seeing the hottest singles in my area naked.

Fortunately, since this was ostensibly a work-related earwax maintenance purchase, I had the option of getting Wired editor Laura Hudson to buy it for me. This, incidentally, is the only part of this entire process that I would recommend to anyone: Getting your boss to buy you things.

As it turns out, my reluctance was entirely founded. The purchase went off the rails almost immediately, as the $10 turned out to actually be $23.98 ($6.99 shipping and handling for each WaxVac), which you probably won’t notice until after you’ve been charged since it’s down at the bottom of the page — below the form you use to order the product, in a markedly smaller font size.

To make matters even more fun, Laura got a call on her cell phone the next day from the fine folks at WaxVac offering her “$100 in gas vouchers” (which she described as “almost certainly bullshit”) and then informing her that they would be shipping the WaxVacs to the wrong address (despite having my place of residence right there on the receipt) and that they couldn’t change it to the right one.

Three weeks later, they arrived.

The Product

If I were to ask you to describe the most pleasant sound you could possibly hear after you got out of the shower first thing in the morning, I’m pretty sure that we’d all agree that it would be the high-pitched whine of a vacuum cleaner motor, right? Well what if I told you that you could have this sound directly against your ear for up to five minutes? I know! It’s like a dream come true!

To be fair, the WaxVac isn’t all that loud unless you hold it right up to your ear, but since that is in fact the entire reason for it to exist, I’m pretty comfortable calling that one a design flaw. Considering that it’s not that much worse than just using a hair dryer, I’d be willing to overlook that if the machine itself actually did what it was supposed to do, but that’s not the case either.

It’s entirely possible that I have some kind of hardcore militant earwax that’s dug in there and won’t come out without the weapon of ear canal mass destruction that is the Q-Tip, but the WaxVac was not up to the task. I think the only “moisture and debris” that it was able to pull out were the bits that were dislodged from poking the nozzle around in there, which is what I would’ve been doing with a Q-Tip anyway. Except that once I was done, I would’ve just thrown the Q-tip away and gone on with my life instead of field-stripping the WaxVac and sterilizing it with rubbing alcohol.

Seriously, this thing is the pits. I gave it another shot before I sat down to start writing, and I swear to you, it actually made my ears feel worse. I’m just going to go ahead and just keep on risking having to visit a frowny doctor and explain that I sometimes jam sticks into my ear canal and then stare at them as though they have betrayed me. Hell, if this is the alternative, then I might actually prefer to go with one of those mind control ear slugs that Khan has Star Trek II.The WaxVac definitely lives up to the ad, but unfortunately, it’s only the part about how much it sucks.

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NBCU’s Bonnie Hammer to run Cable; Joe Uva to run Telemundo

LOS ANGELES (TheWrap.com) – NBC Universal‘s executive lineup underwent a shift of responsibilities on Monday, with Bonnie Hammer, NBCU‘s chairman of cable entertainment and cable studios, taking control of NBC Universal’s full cable portfolio, and executive Lauren Zalaznick being promoted to a new role, and former Univision president and CEO Joe Uva taking over NBCU’s Spanish-language network Telemundo.

Under her new expanded duties, Hammer (pictured) will oversee Bravo, Oxygen, Style, Sprout and TV One adding to her existing duties of overseeing USA Network, SyFy, E!, G4, Cloo, Chiller and other properties. The newly consolidated collection of networks will be renamed Cable Entertainment Group.

Zalaznick, who has been serving as chairman of NBC Universal Entertainment & Digital Networks and Integrated media, has been promoted to the new position of EVP NBCUniversal, where she’ll focus on “innovation, digital, monetization and emerging technology across the company,” NBC Universal CEO Steve Burke told employees in an internal email.

Uva, meanwhile, has been tapped for the newly created position of NBCU’s chairman of Hispanic Enterprises and Content, a position that will include running the company’s Spanish language networks Telemundo and mun2. Uva stepped down as president and CEO of Univsion in June 2011.

Hammer and Zalaznick will assume their new responsibilities immediately, while Uva will come aboard April 3.

Burke, who’s enacted similar restructurings for NBCU’s sports and news divisions, said that the restructuring will help streamline things while allowing for better exploitation of the company’s assets.

“Our business is more dynamic and challenging than at any point in its history,” Burke wrote in a memo to his staff. “Now, more than ever, we need to simplify our organization and take advantage of the breadth of our assets. At the same time, we need to focus more on innovation and emerging technologies. These organization changes are designed to do just that,” Burke wrote.

TV News Headlines – Yahoo! News

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