'Identity Thief' grabs $34.6M to debut at No. 1

LOS ANGELES (AP) — Jason Bateman and Melissa McCarthy's "Identity Thief" has made off with the weekend box-office title with a $34.6 million debut.

The top 20 movies at U.S. and Canadian theaters Friday through Sunday, followed by distribution studio, gross, number of theater locations, average receipts per location, total gross and number of weeks in release, as compiled Monday by Hollywood.com are:

1. "Identity Thief," Universal, $34,551,025, 3,141 locations, $11,000 average, $34,551,025, one week.

2. "Warm Bodies," Lionsgate, $11,356,090, 3,009 locations, $3,774 average, $36,481,172, two weeks.

3. "Side Effects," Open Road Films, $9,303,145, 2,605 locations, $3,571 average, $9,303,145, one week.

4. "Silver Linings Playbook," Weinstein Co., $6,425,271, 2,809 locations, $2,287 average, $89,519,510, 13 weeks.

5. "Hansel and Gretel: Witch Hunters," Paramount, $5,753,165, 3,285 locations, $1,751 average, $43,836,018, three weeks.

6. "Mama," Universal, $4,229,665, 2,677 locations, $1,580 average, $63,951,810, four weeks.

7. "Zero Dark Thirty," Sony, $4,006,860, 2,562 locations, $1,564 average, $83,567,450, eight weeks.

8. "Argo," Warner Bros., $2,375,344, 1,405 locations, $1,691 average, $123,608,957, 18 weeks.

9. "Django Unchained," Weinstein Co., $2,303,495, 1,502 locations, $1,534 average, $154,516,627, seven weeks.

10. "Bullet to the Head," Warner Bros., $2,078,192, 2,404 locations, $864 average, $8,269,214, two weeks.

11. "Top Gun" in 3-D, Paramount, $1,965,737, 300 locations, $6,552 average, $1,965,737, one week.

12. "Lincoln," Disney, $1,873,537, 1,517 locations, $1,235 average, $173,621,006, 14 weeks.

13. "Parker," FilmDistrict, $1,867,411, 2,004 locations, $932 average, $15,848,064, three weeks.

14. "Life of Pi," Fox, $1,745,744, 924 locations, $1,889 average, $108,530,249, 12 weeks.

15. "Les Miserables," Universal, $1,555,550, 1,447 locations, $1,075 average, $143,983,705, seven weeks.

16. "The Hobbit: An Unexpected Journey," Warner Bros., $1,468,374, 1,001 locations, $1,467 average, $298,333,426, nine weeks.

17. "Parental Guidance," Fox, $1,071,766, 1,219 locations, $879 average, $74,344,256, seven weeks.

18. "Wreck-It Ralph," Disney, $1,065,817, 757 locations, $1,408 average, $184,414,532, 15 weeks.

19. "The Impossible," Summit, $957,594, 739 locations, $1,296 average, $16,668,338, eight weeks.

20. "Quartet," Weinstein Co., $940,930, 244 locations, $3,856 average, $5,000,417, five weeks.

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Online:

http://www.hollywood.com

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Universal and Focus are owned by NBC Universal, a unit of Comcast Corp.; Sony, Columbia, Sony Screen Gems and Sony Pictures Classics are units of Sony Corp.; Paramount is owned by Viacom Inc.; Disney, Pixar and Marvel are owned by The Walt Disney Co.; Miramax is owned by Filmyard Holdings LLC; 20th Century Fox and Fox Searchlight are owned by News Corp.; Warner Bros. and New Line are units of Time Warner Inc.; MGM is owned by a group of former creditors including Highland Capital, Anchorage Advisors and Carl Icahn; Lionsgate is owned by Lions Gate Entertainment Corp.; IFC is owned by AMC Networks Inc.; Rogue is owned by Relativity Media LLC.

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Well: Picking Source of Baby's Milk

When Bevil Conway and his partner brought their premature twins home from the hospital, the two fathers felt it was important to keep them on a diet of breast milk. So the new parents purchased a couple of coolers and an extra freezer, and they started scouring Web sites for mothers with extra milk to share.

They found a physician who was moving away; she gave them a stash of frozen milk she had pumped but never needed. They stopped by a fire station in Lexington, Mass., to retrieve milk from a firefighter’s wife. They picked up 100 ounces from a woman whose husband wanted his freezer back before hunting season, and they made regular visits to a woman in Maine who became a close friend and produced startling, prodigious amounts of milk.

And all of it was free.

“It was amazing, absolutely amazing,” said Dr. Conway, 38, a neuroscientist and artist in Cambridge, Mass. “We managed to feed the twins continuously without any formula for 14 months.”

Wet nursing has moved into the Internet age. Where once new parents desperate for breast milk recruited a local mother or, more recently, turned to milk banks or made do with formula, now they rely on informal networks of donors, mostly strangers, hosted on Web sites like Eats on Feets and Human Milk 4 Human Babies.

But some physicians and public health experts fear that in their quest to provide infants with the benefits of breast milk, new parents may inadvertently be exposing their babies to potential harm.

Breast milk confers enormous health benefits. It’s considered the ideal nutrition for infants, and it contains antibodies and other protective immune factors that appear to reduce colds, ear and gastrointesintal infections, asthma and eczema, as well as diabetes and even leukemia, according to the American Academy of Pediatrics. Neonatal intensive care units insist on breast milk for the smallest babies because it drastically improves their prospects.

But it is also a bodily fluid that can harbor harmful bacteria and viruses, including H.I.V., and H.I.V.-positive mothers can transmit the virus to their babies through their milk.

Established human milk banks carefully screen donors, test them for diseases and pasteurize the breast milk they provide. But there is a huge demand for milk — in 2012 the banks dispensed 2.5 million ounces of milk, up from 2.1 million ounces in 2011 — and the banks must prioritize the smallest and sickest babies.

And the prices are steep. Breast milk can cost up to $5.50 an ounce, more than the cost of formula. A 3-month-old can drink anywhere from 20 to 40 ounces a day or more.

As a result, many new parents are turning to the Web, despite the Food and Drug Administration’s recommendation against feeding babies breast milk acquired directly from individuals or online.

“You don’t know what you’re getting on the Internet,” said Dr. Susan Landers, a neonatologist in Austin, Tex., one of several experts who in 2010 urged the Food and Drug Administration to step in and start regulating human milk banks. (The F.D.A. declined.)

Dr. Landers noted that even if donor mothers have tested negative for viruses and bacteria, they may drink alcohol, smoke marijuana or use medicine that can be passed on through breast milk.

When researchers reviewed the blood tests of 1,091 potential milk donors who had approached one milk bank over a recent six-year period, they found that 3.3 percent tested positive for a virus or bacterium on screening tests (some may have been false positives). Six were infected with syphilis, 17 with hepatitis B and three with hepatitis C. Six tested positive for human T-cell lymphotropic viruses (HTLV-1 and HTLV-2), and four were H.I.V.-positive.

Officials with milk banks also worry that informal milk sharing is robbing them of potential donors and could curtail the supply to premature babies. “Their lives can depend on receiving human milk,” said Kim Updegrove of the Human Milk Banking Association of North America. “And we don’t have enough. We are constantly cutting back on requests from hospitals.”

But many parents don’t even want pasteurized milk of the sort banks provide, because the heating process destroys some of the very substances — some of the milk’s immunoglobulin A, for example — that they are seeking in breast milk.

“We use it straight up,” Dr. Conway said. “We want all the antibodies.” He noted that the donors he encountered were always willing to provide their medical records and were always nursing their own babies.

So what’s a parent-to-be to do?

Pregnant women who want to breast-feed should plan for it, making sure their hospitals’ policies facilitate breast-feeding and allow a baby and mother to share a room. Pacifiers should be avoided.

If a baby is born prematurely and can’t nurse, breast milk should be pumped 10 to 12 times a day to establish a supply.

Parents who use donor milk from informal channels should ask about the health histories of the donors and for recent blood tests and medical records.

Dr. Landers suggested new parents also consider flash-heating donor milk, a technique that can inactivate H.I.V. and destroy bacteria while retaining much of the milk’s nutritional and antimicrobial properties and important antibodies.

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American-US Airways merger talks reportedly close to completion

Merger talks between the parent company of American Airlines and US Airways continued Monday, with sources suggesting an announcement could be made later this week.

The union of Fort Worth-based American and Phoenix-based US Airways would create the nation's largest airline, with a mainline fleet of nearly 1,000 planes.

The boards of the two airlines are expected to meet in the next few days to vote on the proposed merger, sources have told Reuters News.

According to the sources, US Airways Chief Executive Doug Parker would become CEO, while AMR Corp.' chief Tom Horton would serve as non-executive chairman of the board until next year.

In 2011, American Airlines became the latest of several major carriers in the last decade to file for bankruptcy. US Airways, a smaller but more profitable carrier, has publicly advocated a merger with American to better compete against larger carriers such as Delta and United.

Sources have told Reuters and other news outlets that a merger between the two is in the works, pending negotiations to appoint a new board and management. Also delaying a final decision has been a decision on how to split the value of the new carrier among creditors and shareholders of the existing airlines.

Analysts have estimated that the two companies could generate up to $1 billion in savings and added revenue by combining forces.

"In our view, we have held that an eventual merger between American and US Airways was in the best long-term interest of both carriers," Jeff Kauffman, an analyst at Sterne Agee, said in a report Monday.

ALSO:

American Airlines unveils new look for its planes

American, US Airways may merge to form giant airline

American Airlines plans to sell London town house for $23 million

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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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Winners of the 2013 British Academy Film Awards

LONDON (AP) — Winners of the 2013 British Academy Film Awards, presented Sunday:

Film — "Argo"

British Film — "Skyfall"

Director — Ben Affleck, "Argo"

Actor — Daniel Day-Lewis, "Lincoln."

Actress — Emmanuelle Riva, "Amour"

Supporting Actor — Christoph Waltz, "Django Unchained"

Supporting Actress — Anne Hathaway, "Les Miserables"

Rising Star — Juno Temple

British Debut — Bart Layton and Dimitri Doganis, "The Imposter"

Original Screenplay — Quentin Tarantino, "Django Unchained"

Adapted Screenplay — David O. Russell, "Silver Linings Playbook"

Film Not in the English Language — "Amour"

Music — Thomas Newman, "Skyfall"

Cinematography — "Life of Pi"

Editing — "Argo"

Production Design — Eve Stewart, Anna Lynch-Robinson, "Les Miserables"

Costume Design — "Anna Karenina"

Sound — "Les Miserables"

Visual Effects — "Life of Pi"

Makeup and Hair — "Les Miserables"

Animated Feature — "Brave"

Short Film — "Swimmer"

Short Animation — "The Making of Longbird"

Documentary — "Searching for Sugar Man"

Outstanding British Contribution to Cinema — Tessa Ross

Academy Fellowship — Alan Parker

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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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Fee increases are making FHA mortgages more expensive

WASHINGTON — If you want to buy a house with minimal cash by using an FHA-insured mortgage, here's some sobering news: Because of an ongoing series of fee increases and underwriting tweaks, those mortgages are getting steadily more expensive and may not work for you.

The Federal Housing Administration is the largest source of low-down-payment mortgage money in the country. Its minimum down is just 3.5%, compared with 5% to 20% or more from conventional, non-government sources. For decades, FHA financing has made homeownership possible for first-time buyers with modest incomes and credit history blemishes.

But in the wake of losses tied to bad loans insured during the housing bust years, the FHA has been raising its loan insurance fees and backing more loans to applicants with higher credit scores. With the latest increases, things have gotten to the point where some lenders wonder whether the agency is trying to move away from its traditional customers.

Dennis C. Smith, broker and co-owner of Stratis Financial Corp. in Huntington Beach, is blunt: "I think FHA is putting itself out of business with the moves they've made in the past couple of years."

Although they wouldn't agree with that assessment, the FHA's top officials readily admit that their priority is not increasing market share but protecting the agency's multibillion-dollar insurance fund reserves and cutting losses.

Starting April 1, the FHA's annual mortgage insurance premiums for most new loans will jump one-tenth of a percentage point (10 basis points in lending parlance). This is on top of two previous increases since 2011.

Other changes that won't take effect until June 3 include mandatory manual underwriting of applications by borrowers whose total household debt-to-income ratios exceed 43% and who have credit scores below 620, and mandatory 5% minimum down payments on FHA loans above $625,500 in high-cost areas such as California, metropolitan Washington, D.C., and others.

The FHA also announced that as of June 3 it is rescinding its popular policy of canceling mortgage insurance premium charges for borrowers whose loan balances decline to 78% of the original amount. This will require FHA customers to pay premiums for as long as they keep their loans, and is in stark contrast to the private mortgage insurance market, in which homeowners can request cancellation of premium payments once their loans hit the 78% mark.

"That stinks," said Steve Stamets, a mortgage officer with Apex Home Loans in Rockville, Md. "It's just a money grab" that will cause creditworthy borrowers to avoid FHA loans and seek out low-down-payment alternatives through Fannie Mae and Freddie Mac, using private mortgage insurance.

Already, Stamets said, FHA is the more expensive option for many borrowers who have good credit but don't want to make hefty down payments.

He estimates that with the FHA's new fees, an applicant with a 720 FICO score making a 3.5% down payment on a $250,000, fixed-rate, 30-year FHA mortgage will pay $144.66 more a month than a borrower with the same credit score on a conventional loan of the same amount with a 5% down payment and private mortgage insurance.

Even with a 680 credit score, the conventional loan is cheaper by $85 a month based on the FHA's new fee levels, Stamets said. And those monthly premium payments can be canceled at the 78% loan-to-value level, whereas the FHA will keep charging them for the life of the mortgage.

Steven R. Maizes, managing director of mortgage banking for Mortgage Capital Partners Inc. in Los Angeles, says the FHA's new fees and policies are likely to cost the agency valuable low-risk business on refinancings. Maizes recently ran a spreadsheet analysis for a client with a $460,000 FHA loan at 5%. Even with a 1.5-point rate reduction, the added fees caused the monthly payment to decrease just $97.11.

"If you couple that [small saving] with the fact that the mortgage insurance payment can never go away," he said, refinancing an existing FHA loan for a creditworthy borrower into a new FHA loan will be tough to justify.

Bottom line for you: Make sure your loan officer runs the numbers comparing FHA loans with privately insured conventional alternatives. You may not want to be saddled indefinitely with higher payments — and no right to cancel.

kenharney@earthlink.net

Distributed by Washington Post Writers Group

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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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Elton John shares Grammy stage with young rockers

LOS ANGELES (AP) — Elton John still fills stadiums worldwide on his own, but he'll share the spotlight with a dozen other musicians at Sunday's Grammy Awards.

The 65-year-old entertainer rehearsed Saturday at Staples Center alongside young Grammy nominees Mumford & Sons, Zac Brown, Ed Sheeran and Brittany Howard of Alabama Shakes.

John prepared for two performances: a rousing rendition of the Band's "The Weight" that also featured T. Bone Burnett and Mavis Staples, and a duet of Sheeran's single "The A Team."

"The fun of it for me is playing with other people," said John, wearing a navy Adidas tracksuit and his trademark red shades.

He also loves the Band's classic American sound.

"You've got a lot of British people up there playing American music, because that's what we love," he said of the Levon Helm tribute, which John dedicated to "the teachers and students of Sandy Hook Elementary School, whose songs ended too soon."

The Grammy Awards honor all kinds of music, but John said, "It should be more of a potpourri than it is."

"It's a bit ageist," he added.

"You're lucky it's ageist!" joked Grammy Awards executive producer Ken Ehrlich.

"T. Bone and I are the oldest people to play the Grammys," John said. "And we're only 30."

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AP Entertainment Writer Sandy Cohen is on Twitter at http://www.twitter.com/APSandy .

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Online:

http://www.grammy.com

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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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