“Good Day to Die Hard” takes $10 million in Asian box office






LOS ANGELES (TheWrap.com) – “Good Day to Die Hard” is off and running overseas. The Bruce Willis action film took in more than $ 10 million in its debut in seven Asian markets for Fox.


Django Unchained” was the top international moneymaker for the fourth consecutive week, adding $ 18.7 million from 66 markets. Quentin Tarantino‘s slave saga has now brought in $ 187 million overseas.






“Good Day to Die Hard” opens Thursday in North America. The leading market was Korea, where it made $ 4.2 million. It broke a Fox record in Indonesia with $ 1.4 million and was the biggest of the franchise openings in Hong Kong with $ 1.2 million.


Fox is counting on big things from “Good Day to Die Hard.” Starting with the original film in 1988, which made $ 148 million worldwide, each successive movie has made more money at the global box office.


The last one, “Live Free Or Die Hard,” made $ 383 million in 2007. In all, the “Die Hard” franchise has taken in $ 1.13 billion.


Fox also opened “Lincoln” in seven new markets, contributing to the DreamWorks’ historical drama’s roughly $ 10 million weekend overseas, in which it played in 51 territories. Australia was the top new market with $ 1.8 million for “Lincoln,” which has brought in $ 47.6 million from foreign markets overall.


“Les Miserables,” like “Lincoln” and “Django” a Best Picture Oscar nominee, also brought in roughly $ 10 million over the weekend, from 46 markets. The musical’s international gross now stands at $ 215 million.


Paramount’s 3D action fantasy “Hansel and Gretel: Witch Hunters” added $ 11.6 million from 46 regions and has now brought in $ 84 million at the foreign box office.


Disney’s video game-inspired animated film “Wreck-it Ralph” raised its overall international total to $ 207 million by adding another $ 11.7 million from 66 foreign markets.


Movies News Headlines – Yahoo! News





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Well: Getting the Right Addiction Treatment

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

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

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

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

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

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

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

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

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

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

Routes to Success

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

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

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

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

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

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

How Families Can Help

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

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

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

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

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

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

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

Resource Network

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

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

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

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

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

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


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

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Euro’s Strength on Agenda for Finance Ministers


BRUSSELS — Concern over the euro came to the fore on Monday ahead of a meeting of finance ministers of the countries using the currency. But this time, with the union’s recession continuing, the topic was the strength of the euro rather than its many weaknesses.


As confidence has grown that the European Union will be able to manage its sovereign debt crisis, the euro has made significant gains against the dollar and other foreign currencies. That is making it more expensive for Europe’s trading partners to buy its exports and could hamper growth.


On Monday, France, which traditionally favors market intervention, renewed its calls for remedial steps, like establishing a target level for the euro’s value.


Exchange rates need “to reflect the economic fundamentals of our economies of the euro zone,” Pierre Moscovici, the French finance minister, said ahead of the regular monthly meeting of so-called Eurogroup ministers. “Exchange rates should not become subjected to moods or speculation.”


Mr. Moscovici said he would make the case for coordinated action to keep a lid on the value of the euro in order to present the plan, possibly at a meeting of finance ministers and central bankers of the Group of 20 nations to be held in Moscow at the end of the week.


The euro was trading at $1.339 on Monday after falling to the low $1.20s in 2012.


But some ministers suggested intervention would be wrongheaded.


“This is mainly decided by the market,” Maria Fekter, the Austrian finance minister, said in response to a question on the euro strength as she arrived at the meeting. “I find an artificial weakening unnecessary.”


The French position is also likely to irritate Germany, where officials suggested last week that intervention on exchange rate markets was a poor way to improve competitiveness.


The strong euro means some European exports, like cars and wine, become more expensive abroad, putting European producers at a disadvantage against foreign competitors. But there are also positive effects. Imports, particularly oil, become less expensive for Europeans, which helps stimulate the economy.


Mario Draghi, the president of the European Central Bank, warned last week that the strength of the euro could weigh on the ability of Europe to pull out of its economic doldrums. Those comments sent the euro down sharply against the dollar and yen.


Jeroen Dijsselbloem, the president of the Eurogroup who oversees the agenda for the monthly meetings, said that the strength of the euro could be one of the main subjects discussed on Monday evening. But he also said the meeting was likely to be a short one in order to allow ministers to attend a farewell dinner for Jean Claude Juncker, the prime minister of Luxembourg who stepped down last month as president of the Eurogroup.


How to handle a bailout for Cyprus was also likely to be discussed by ministers on Monday evening.


Among the potentially explosive issues is whether to force depositors in Cyprus, including wealthy Russians, to take losses on their holdings to help reduce the burden of recapitalizing and restructuring Cypriot banks.


But Vassos Shiarly, the Cypriot finance minister, bluntly rejected that scenario on Monday.


“I would say that the bail-in of depositors is a grossly exaggerated possibility,” Mr. Shiarly said. “We will not accept it under any circumstances.”


No agreement with the Cypriot government in Nicosia is expected until after the departure of President Demetris Christofias, a Communist, who will not be running in elections scheduled for later this month.


International creditors want to wait to negotiate a rescue program with the winner, who is likely to be Nicos Anastasiades of the Democratic Rally, a center-right party.


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Ambitious makeover planned for old housing project









Denise Penegar puts a little extra effort into the teenage girls, the ones who've dropped out of high school to care for their firstborns.


Don't be afraid, the outreach worker tells them. Come down to the housing project's community center, get your GED and some job skills. Change your life.


"I was one of those girls," said Penegar, now 51 and still living in Jordan Downs, the Watts housing project where she was born.





Sometimes, she imagines how different her life might have been if someone had knocked on her door when she was 17, caring for her first baby. What would it have meant just to have "someone who is here who can help pick me up"?


Penegar is on the front lines of a bold social experiment underway at Jordan Downs, a project notorious to outsiders for its poverty, blight and violence but seen by many longtime residents, for all its problems, as a close-knit community worth preserving.


In the last year, the Housing Authority of the City of Los Angeles has begun an effort to transform Jordan that could cost more than $600 million. The plan is to turn the complex of 700 aging units into a mixed-income community of up to 1,400 apartments and condominiums, with shops and restaurants and fancy touches such as native plant gardens. The city hopes to draw in hundreds of more-affluent residents willing to pay market rate to live side by side with the city's poorest.


Spurred by changes in federal funding and policy, such "mixed use" developments have sprung up in place of infamous housing projects all over the country. But experts say Jordan is taking an approach that has not been tried on this scale.


Typically, public housing residents are moved out ahead of the bulldozers, scattered to search for new shelter. In Los Angeles, the housing authority has promised that any of the 2,300 Jordan residents "in good standing" can stay in their old units until the day they move into new ones. The project is to be built in phases, beginning with units on 21 acres of adjacent land purchased by the authority in 2008 for $31 million.


To ease the transition, the city has dispatched "community coaches" like Penegar, along with teachers, social workers, therapists — even police officers whose charge is not to make arrests but to coach youth football and triathlon teams.


In essence, officials intend to raze the buildings, not the community — and radically change its character.


It will be an enormous challenge, with success likely to be measured in tiny increments.


Only 47% of adults at Jordan reported any wages to the housing authority last year. As in many urban projects, poverty and social ills have multiplied through the generations, leaving some residents unfamiliar with opportunities and expectations beyond the neighborhood. Some rarely leave the area.


Before inviting in new neighbors with expectations of safety and comfort, the housing authority has begun flooding Jordan Downs with social services. Many of the programs are focused on women, because more than 60% of Jordan Downs' tenants live in households headed by single mothers. But men are targeted too — for job training and lessons in parenting, for instance.


By December, 10 months into the effort, more than 450 families had been surveyed by intake workers and 280 signed up for intensive services.


"Most people would say it's ambitious, but I think it's essential," said Kathryn Icenhower, executive director of Shields for Families, the South Los Angeles nonprofit that is running many of the new programs under a more than $1-million annual contract with the housing authority.


It is unknown, however, how effective the social services will be, how easy it will be to draw in wealthier residents and how many millions of dollars the federal government — a major source of funding — will provide.


Already, the housing authority has picked a development team — the for-profit Michaels Organization and the nonprofit Bridge Housing, both with respectable track records in other cities. But with financing still uncertain, it is unclear exactly how many units will be built or how much various occupants would pay.


Ultimately, a working family could pay hundreds of dollars more in rent than unemployed tenants next door for a nearly identical unit. Officials say they do not expect Watts to draw the same kind of high-income residents as the former Cabrini Green project in Chicago, which sat on prime real estate near downtown. But Jordan is in a convenient location, near the intersection of the 105 and 110 Freeways; and in a high-rent city like Los Angeles, even the steepest rates at Jordan are likely to seem a bargain.


Despite the onslaught of social services and some palpable changes — including a 53% plunge in the violent crime rate at Jordan last year — financial risks abound.


Later this spring, the authority plans to put in an application for $30 million from the federal government's Choice Neighborhoods Program as seed money. Without it, the project could be delayed.





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Wired Science Space Photo of the Day: Wings of the Seagull Nebula


This image shows the intricate structure of part of the Seagull Nebula, known more formally as IC 2177. These wisps of gas and dust are known as Sharpless 2-296 (officially Sh 2-296) and form part of the “wings” of the celestial bird. This region of the sky is a fascinating muddle of intriguing astronomical objects — a mix of dark and glowing red clouds, weaving amongst bright stars. This new view was captured by the Wide Field Imager on the MPG/ESO 2.2-metre telescope at ESO’s La Silla Observatory in Chile.


Image: ESO [high-resolution]


Caption: ESO

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All eyes on Frank Ocean as Grammy Awards approach






LOS ANGELES (AP) — Everybody’s thinkin’ about Frank Ocean.


Ocean is a cause celebre and the man with the momentum as Sunday’s Grammy Awards approach. One of six top nominees with six nominations apiece, the 25-year-old R&B singer turned cultural talking point will have the music world’s attention.






It remains to be seen if it will be the “Thinkin Bout You” singer’s night, but there’s no question he’s dominated the discussion so far. Already a budding star with a gift for building buzz as well as crafting songs, Ocean was swept up by something more profound when he told fans his first love was a man last fall as he prepared to release his major-label debut, “channel ORANGE.”


It was a bold move and one that could have submarined his career before it really even got started. Instead, everyone from Beyonce to the often-homophobic R&B and rap communities showed public support. It was a remarkable moment.


“It speaks to the advancements of our culture,” renowned producer Rick Rubin said. “It feels like the culture’s moving forward and he’s a representative of the new acceptance in the world for different ideas, which just broadens (our experience), makes the world a better place.”


Ocean is up for major awards best new artist, album of the year and record of the year when the show airs live on CBS at 8 p.m. EST from the Staples Center, sharing top-nominee billing with fun., Dan Auerbach of The Black Keys, Mumford & Sons, Jay-Z and Kanye West.


Don’t hand Ocean those trophies just yet, though. R&B and hip-hop performers (Ocean is part of the Odd Future collective) have had a spotty history at the Grammys recently when it comes to major awards.


Only one R&B act has won album of the year this century, and it’s hard to even call him just an R&B act given his legend, artistic scope and material: Ray Charles for his “Genius & Friends,” an all-star collaboration that was honored posthumously.


Also limiting Ocean‘s chances for a clean sweep are his fellow top nominees. Most are riding waves of their own.


Fun. became just the second act to sweep nominations in all four major categories with a debut album, equaling Christopher Cross‘ 1981 feat. Like Cross’ “Sailing,” the New York-based pop-rock band has ridden along on the crest of an inescapable song: “We Are Young,” featuring Janelle Monae.


Cross won five Grammys, sweeping the major awards. Fun. likely will have a much harder time piling up that number of victories because of the buzz surrounding the group’s competitors. It’s not just Ocean who has people talking.


London-based folk-rockers Mumford & Sons had one of the top-selling albums of the year with “Babel” and already has a history with The Recording Academy’s thousands of voters, having been nominated for major awards the year prior. Also, The Black Keys have a winning track record at the Grammys.


And don’t count out West and Jay-Z, who were shut out of the major categories but remain very much in voters’ minds.


Jack White’s “Blunderbuss” competes with fun.’s “Some Nights,” Ocean‘s “channel ORANGE,” Mumford’s “Babel” and The Keys’ “El Camino” for the night’s top award, album of the year.


Gotye’s “Somebody That I Used To Know,” featuring Kimbra, Taylor Swift’s “We Are Never Ever Getting Back Together” and Kelly Clarkson‘s “Stronger (What Doesn’t Kill You)” join the fun., Ocean and Black Keys entries in record of the year.


Fun. and Clarkson also are nominated for song of the year along with Ed Sheeran’s “The A Team,” Carly Rae Jepsen’s “Call Me Maybe” and Miguel’s “Adorn.”


And rounding out the major categories, fun., Ocean, Alabama Shakes, Hunter Hayes and The Lumineers are up for best new artist.


Those major nominees figure prominently on the 3 1/2-hour telecast, broadcast live on CBS at 8 p.m. EST.


Swift will kick things off with a show-opening performance. Fun. and Ocean will take the stage. Others scheduled to perform include Justin Timberlake, Carrie Underwood, Clarkson, White and Juanes.


There will be no shortage of mashups the Grammys have become famous for, either. Elton John, Mavis Staples, Mumford, Brittany Howard, T Bone Burnett and Zac Brown are saluting the late Levon Helm, who won the Americana Grammy last year a few months before his death. The Keys will join Dr. John and the Preservation Hall Jazz Band on stage. Sting, Rihanna and Bruno Mars will perform together. Other team-ups include Miranda Lambert and Dierks Bentley, and Alicia Keys and Maroon 5.


___


Online:


http://grammy.com


___


Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott.


Entertainment News Headlines – Yahoo! News





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





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




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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


“No, I didn’t compare you.”


“Then what did you say?”


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Boeing 787 Completes Test Flight





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




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


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


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


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


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


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


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


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


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


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


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A delicate new balancing act in senior healthcare









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


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


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





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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


Two days later, that's where she was.


anna.gorman@latimes.com





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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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