The New Old Age Blog: New Help for Hoarders

There were times, Sandra Stark remembers, when she couldn’t use her kitchen or sit on her sofa. Her collections — figurines, vases, paperweights — had overtaken every closet, drawer and surface. Stacks of clothing and old magazines added to the clutter.

Her daughters came in and threw everything away — to Ms. Stark’s horror — but a year later her home was again barely navigable. “I couldn’t throw out my garbage,” she said. “I put it in plastic bags, but I couldn’t take it out.”

A drop-in support group sponsored by the Mental Health Association of San Francisco helped her begin to control her hoarding behavior, and she has made considerable headway. “My bedroom is still a work in progress,” said Ms. Stark, 67. “But I can cook again.”

She has become a trained peer responder who works with others with this disorder. Many of the Mental Health Association’s clients are older adults: A woman in her 70s occupies one small room because the rest of her spacious house — leaking and mildewed — is filled with stuff she can’t discard. An 87-year-old, a compulsive thrift-store shopper, faces eviction because the city health department says she has created a safety hazard. “I’ll say, ‘Of these dozen black leather coats, pick two,’” Ms. Stark said, mapping her strategy to help keep the woman in her home.

Researchers are not sure if hoarding intensifies with age, but the problems it creates certainly do. “The older you get, the more stuff you’ve been able to accumulate,” said Randy Frost, co-author of the book “Stuff” and a Smith College psychologist. “And older people are less physically able to deal with it.” They are more prone to falls as they try to maneuver between piles of possessions and in a crisis, emergency crews may have trouble even entering their dwellings.

When I last wrote about hoarding almost three years ago (uncorking a wave of readers’ lamentation), I couldn’t offer much in the way of help except to steer people to the OCD Foundation. Though hoarding may not be a form of obsessive-compulsive disorder, its site remains useful.

At the time, experts knew what didn’t solve the problem, namely psychoactive drugs or “dumpster therapy,” in which well-meaning friends or family toss hoarders’ possessions, in a temporary fix that doesn’t change their behavior. But researchers were only starting to figure out what did work.

“This is an area in which there haven’t been a lot of answers,” said Eduardo Vega, executive director of the Mental Health Association of San Francisco. Now, “there’s a lot more hope and good will.”

Across the country, for example, cities, counties and states have formed about 80 hoarding task forces so that housing and health departments, senior service agencies, law enforcement and emergency units can coordinate their responses.

On the mental health front, the revised Diagnostic and Statistical Manual V is scheduled for publication in the spring, and many expect it will recognize hoarding as a distinct disorder with diagnostic criteria and a numeric code. That will make psychologists and other professionals more aware of the problem and, Mr. Vega said, “it will be easier to get insurers and providers to pay for treatment.”

Increasingly, there is treatment. Researchers have published studies showing that cognitive behavioral therapy can help, by encouraging people to reevaluate their attachment to possessions and supporting their decisions to start discarding.

Among patients in therapy groups, Dr. Frost has shown, 70 to 80 percent showed some improvement, he said. “That doesn’t mean they’re freed of symptoms, but their lives are improved and the behavior significantly reduced.”

Questions remain; several published studies use small samples that are heavily comprised of females, though hoarding may be more common among men. It is not clear, Dr. Frost said, whether cognitive therapy is as effective among older adults. And it is easier to find an individual therapist or a group in major cities than elsewhere. (Here’s a locator.)

But Dr. Frost and his co-authors have published a workbook called “Buried in Treasures,” along with a free facilitator’s guide, that allows people with hoarding disorders to form their own 15-session action workshops, led by peers rather than professionals. That approach, too, has brought measurable improvement (when used in groups, not individually), a study shows. “Here’s a way people can start working on this on their own,” Dr. Frost said.

Diagnostic criteria, treatment centers, workbooks, published research — all this is more than mental health professionals could offer years back. Still, compulsive hoarding remains a stubborn problem, a safety risk for older people and a heartache for their families.

“It’s really difficult for adult children,” who worry about their parents, but can’t induce them to change, Dr. Frost said. “There may be a history of animosity. Many report they grew up feeling their hoarding parents cared more about their possessions than about them.” The children, young or grown, could probably use a support group, too.

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

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Groupon CEO Mason offers to step down

Groupon Inc Chief Executive Andrew Mason, under fire for a plunging share price and tapering growth, declared on Wednesday he would fire himself if he ever thought he was the wrong man for the job.

Mason, whose performance at the helm will come under scrutiny from his board of directors during a regular board meeting Thursday, said it would be "weird" if they did not. But he said he believed the board was comfortable with his strategy.

Shares in the company, once touted as innovating local business advertising t hrough the marketing of Internet discounts on everything from spa treatments to dining, surged 8 percent to $4.25 i n the afternoon.

"It would be more noteworthy if the board wasn't discussing whether I'm the right guy for the job," Mason said in an interview from a Business Insider conference in New York. "If I ever thought I wasn't the right guy for the job, I'd be the first person to fire myself."

"As the founder and creator of Groupon, as a large shareholder ... I care far more about the success of the business than I do about my role as CEO," he said.

Groupon has shed four-fifths of its value since its public trading debut as an investor favorite during last year's consumer dotcom IPO boom, and Mason himself has presided over a string of high-profile executive departures.

Wall Street has grown uneasy about the viability of its business as fever for daily deals has cooled among consumers and merchants, hurting its growth rate.

In the interview broadcast from the conference, the outspoken and sometimes-zany co-founder argued his company was going through a period of volatility but believed it was on the right path. Groupon's efforts to reduce its reliance on plain vanilla deals include bumping up its "Goods" retail business, increasing the selection of "persistent" or long-running deals, and allowing users to search for such deals on demand.

Shares in Groupon spiked after the interview and were up 8 p ercent at $4.2 6, still way below its $20 market debut price.

Groupon and rivals in the daily deals business, like Amazon.com-backed LivingSocial, were supposed to change the very nature of small-business advertising. Instead, they were forced to revamp their business models as evidence mounts that their strategy was flawed.

This month, Groupon reported another quarter of disappointing earnings, and its stock went as low as $2.60 on Nov. 12.

Europe has been a particular problem for Groupon, partly because the sovereign debt crisis has sapped demand for higher-priced deals. Groupon was also offering steeper discounts, turning off some European merchants.

International revenue, which includes Europe, grew just 3 percent to $277 million in the third quarter, while North American revenue surged 80 percent to $292 million.

Adding to its difficulties, the U.S. Securities and Exchange Commission is looking into Groupon's accounting and disclosures, areas that raised questions among some analysts during its IPO.

But Mason shrugged off speculation that the company might run into a cash crunch and go bankrupt. The company has said it had $1.2 billion in cash and equivalents with no long-term debt.

"There was a period when those stories started that I'd go to my CFO and say: 'How would that happen, walk me through what would be required for us to actually go bankrupt'," Mason said. "And it's like an end of days, apocalyptic scenario. The business would have to go into severe negative growth for something like this. The scenario is so absurd there's no evidence for it."

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Charges dropped against NIU officer

Sex assault charges against a former Northern Illinois University police officer were dropped Tuesday after new revelations of possible irregularities in the investigation surfaced, the officer’s attorney said.

The charges against Andrew Rifkin were dropped following a hearing where a campus police IT specialist testified that he was summoned around 10 p.m. on Nov. 9, by NIU Police Chief Donald Grady and was told to remove between 60 and 70 files from the chief’s computer, Rifkin attorney Bruce Brandwein said.

Earlier that day, university administration had appointed a new supervisor to oversee Grady and the department. That same day, a DeKalb County judge had ordered the NIU police to sign an affidavit confirming that all evidence in the Rifkin case had been handed over to county prosecutors, following a previous finding that the department had withheld evidence.

Grady was placed on administrative leave the following day.

Brandwein said the specialist did not know whether the files he removed pertained to the Rifkin investigation, but Brandwein said he found the timing curious.  After hearing about the removal of the files, DeKalb County State’s Atty. Clay Campbell told the judge that prosecutors would drop the charges against Rifkin, Brandwein said.

“It was incredible,” he said. “I applaud the state’s attorney for doing the right thing.”

An attempt to reach Campbell for comment was not successful Tuesday night.

Rifkin, 25, was fired from the department in October 2011 after it was alleged he sexually assaulted an NIU student. However, the NIU police’s investigation of the case came under fire this month when it was learned that the department had failed to turn over reports of witnesses who indicated that Rifkin and the student had engaged in consensual sexual activity.

Those reports ended up in a personnel file in what the NIU police said was an oversight. But DeKalb County Judge Robin Stuckert called it an “egregious” error and ruled that the department had purposely withheld the evidence.

That prompted university officials to place Grady on leave, pending a final disciplinary action. NIU also said it plans to terminate the officer who conducted the investigation against Rifkin.

chicagobreaking@tribune.com
Twitter: @chicagobreaking

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Leads, director of Motown musical visit Hitsville

DETROIT (AP) — The stars of the upcoming Broadway musical about Motown Records have read pretty much every book about and listened to every song from that golden era of American music.

The research only took them so far, so they decided to come and see Hitsville, U.S.A., for themselves.

Brandon Victor Dixon, who portrays the label’s founder, Berry Gordy, and Valisia LeKae, who plays its signature songstress, Diana Ross, visited the Motown Museum on Tuesday, taking a lengthy tour of the two-level home that produced the soundtrack of a generation.

“I’m trying not to get emotional,” LeKae said as she methodically inspected the hundreds of mementos — posters, gold records, clothing and more — on display at the Motown Museum.

LeKae, a Broadway veteran who has appeared in “The Book of Mormon” and “Ragtime” among others, worried about losing her composure when it came time to visit Studio A, the famed space in which Gordy and his army of artists, writers, producers and engineers signed, sealed and delivered hit after hit throughout the 1960s.

And she succeeded, descending a small flight of stairs into the square, smallish room and calmly checking out the famed studio affectionately called the “Snake Pit.” LeKae marveled at an oversized black-and-white snapshot on the wall of Ross singing with a smiling Gordy looking on.

It wasn’t until later, while visiting the home’s upstairs, that LeKae’s emotions kicked in.

Standing underneath the “echo chamber,” a hole cut in the upper level’s ceiling designed to create unique sounds for the recording process, LeKae belted out the first few lines of the Supremes’ “Where Did Our Love Go.”

“Baby, baby / Baby, don’t leave me,” she wailed, before the tears began to well up and she had to stop singing.

“This is, like, amazing,” she said.

LeKae and Dixon, who earned a Tony nomination for his work in “The Color Purple” and bears more than a passing resemblance to a Motown-era Gordy, will be front and center when the show debuts this spring.

“Motown: The Musical” begins its run of preview performances March 11 ahead of the official opening on April 14 at New York’s Lunt-Fontanne Theatre.

That gives Dixon, LeKae, Gordy (who’s producing and writing the book) and director Charles Randolph-Wright four months to bring the show to the stage.

To that end, Randolph-Wright also was at Hitsville on Tuesday, seeing prospective actors during a callback session in Studio A. He’s still looking for understudies and others to play smaller parts.

It wasn’t Randolph-Wright’s first visit to Motown’s birthplace as it was for his two leads, but for the 56-year-old who proclaims that “Motown’s in my DNA,” it was no less special.

“What a joy to be a part of (the Motown) movement and what a responsibility to try and place that in the world,” Randolph-Wright said, sitting on a piano bench in Studio A. “So, I’ve been very careful about trying to do that the right way.”

And he has, working for the past three years on “Motown: The Musical,” holding a nationwide casting call and working with Gordy and the other producers to identify which of the overwhelming number of songs from the Motown catalog to include on stage.

“The show is 15 hours,” Randolph-Wright joked.

The first version had 100 songs in it, he said, and “I wanted every song.”

While he said the show’s decision-makers are still deliberating about which songs make the final cut, one thing is certain about the musical selections: A few numbers in the show will be Gordy originals, written specifically for it.

“It’s so interesting to see him go back to being a songwriter after all these years,” said Randolph-Wright, who described one Gordy-penned song as having “all the textures of what Motown is and was, but it’s new.”

As for the man playing the man, Dixon spent his Tuesday walking through the halls of the Motown Museum, taking in every word tour guide Eric Harp and the other docents offered and, as he put it, “soaking it all in.”

At one point, he kneeled down and softly touched the cushion of a red-orange couch upstairs on which Marvin Gaye would take the occasional slumber.

Dixon burst out laughing, then leaped up and continued the tour.

Asked what was so funny, he quickly responded: “Because Marvin Gaye slept on this couch!”

All three of the Hitsville visitors spoke of their great respect and admiration for Gordy and the history of Motown and how important they felt it was to do it justice on stage.

“There’s an energy here that is palpable still,” Randolph-Wright said. “And it remains in this space. I think more than anything, the second I walked in here, it told me that I have to be honest” in telling the Motown story.

The first time he visited the museum, Randolph-Wright remembered walking into the gift shop, where he “bought everything,” including a Temptations T-shirt that read: “Live It Again.”

“I love that, because that’s what we’re doing,” he said.

___

Online:

http://www.motownthemusical.com

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The New Old Age Blog: Doctor's Orders? Another Test

It is no longer news that Americans, and older Americans in particular, get more routine screening tests than they need, more than are useful. Prostate tests for men over 75, annual Pap smears for women over 65 and colonoscopies for anyone over 75 — all are overused, large-scale studies have shown.

Now it appears that many older patients are also subjected to too-frequent use of the other kind of testing, diagnostic tests.

The difference, in brief: Screening tests are performed on people who are asymptomatic, who aren’t complaining of a health problem, as a way to detect incipient disease. We have heard for years that it is best to “catch it early” — “it” frequently being cancer — and though that turns out to be only sometimes true, we and our doctors often ignore medical guidelines and ongoing campaigns to limit and target screening tests.

Diagnostic tests, on the other hand, are meant to help doctors evaluate some symptom or problem. “You’re trying to figure out what’s wrong,” explained Gilbert Welch, a veteran researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For these tests, medical groups and task forces offer many fewer guidelines on who should get them and how often — there is not much evidence to go on — but there is general agreement that they are not intended for routine surveillance.

But a study using a random 5 percent sample of Medicare beneficiaries — nearly 750,000 of them — suggests that often, that is what’s happening.

“It begins to look like some of these tests are being routinely repeated, and it’s worrisome,” said Dr. Welch, lead author of the study just published in The Archives of Internal Medicine. “Some physicians are just doing them every year.”

He is talking about tests like echocardiography, or a sonogram of the heart. More than a quarter of the sample (28.5 percent) underwent this test between 2004 and 2006, and more than half of those patients (55 percent) had a repeat echocardiogram within three years, most commonly within a year of the first.

Other common tests were frequently repeated as well. Of patients who underwent an imaging stress test, using a treadmill or stationery bike (or receiving a drug) to make the heart work harder, nearly 44 percent had a repeat test within three years. So did about half of those undergoing pulmonary function tests and chest tomography, a CAT scan of the chest.

Cytoscopy (a procedure in which a viewing tube is inserted into the bladder) was repeated for about 41 percent of the patients, and endoscopy (a swallowed tube enters the esophagus and stomach) for more than a third.

Is this too much testing? Without evidence of how much it harms or helps patients, it is hard to say — but the researchers were startled by the extent of repetition. “It’s inconceivable that it’s all important,” Dr. Welch said. “Unfortunately, it looks like it’s important for doctors.”

The evidence for that? The study revealed big geographic differences in diagnostic testing. Looking at the country’s 50 largest metropolitan areas, it found that nearly half the sample’s patients in Miami had an echocardiogram between 2004 and 2006, and two thirds of them had another echocardiogram within three years — the highest rate in the nation.

In fact, for the six tests the study included, five were performed and repeated most often in Florida cities: Miami, Jacksonville and Orlando. “They’re heavily populated by physicians and they have a long history of being at the top of the list” of areas that do a lot of medical procedures and hospitalizations, Dr. Welch said.

But in Portland, Ore., where “the physician culture is very different,” only 17.5 percent of patients had an echocardiogram. The places most prone to testing were also the places with high rates of repeat testing. Portland, San Francisco and Sacramento had the lowest rates.

We often don’t think of tests as having a downside, but they do. “This is the way whole cascades can start that are hard to stop,” Dr. Welch said. “The more we subject ourselves, the more likely some abnormality shows up that may require more testing, some of which has unwanted consequences.”

Properly used, of course, diagnostic tests can provide crucial information for sick people. “But used without a good indication, they can stir up a hornet’s nest,” he said. And of course they cost Medicare a bundle.

An accompanying commentary, sounding distinctly exasperated, pointed out that efforts to restrain overtesting and overtreatment have continued for decades. The commentary called it “discouraging to contemplate fresh evidence by Welch et al of our failure to curb waste of health care resources.”

It is hard for laypeople to know when tests make sense, but clearly we need to keep track of those we and our family members have. That way, if the cardiologist suggests another echocardiogram, we can at least ask a few pointed questions:

“My father just had one six months ago. Is it necessary to have another so soon? What information do you hope to gain that you didn’t have last time? Will the results change the way we manage his condition?”

Questions are always a good idea. Especially in Florida.

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

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Grim recovery forecast for U.S., global economies

WASHINGTON — In a grim new forecast, a leading international economic group sharply cut its outlook for U.S. and global growth next year and warned that the debt crisis in Europe and fiscal policy risks in America could plunge the world back into recession.

As it stands now, the industrialized world is looking at a muted and uneven recovery over the next two years, according to the Organization for Economic Cooperation and Development.

The Paris-based OECD projected gross domestic product across its 34 member nations — which include the U.S., Japan and the 17-nation Eurozone — to grow a sluggish 1.4% next year. That is down from 2.2% that the group had forecasted six months earlier.

Growth prospects in the U.S. also were slashed for next year. Experts at the OECD now see inflation-adjusted GDP, the broadest measure of economic activity, rising 2% next year in the U.S., roughly equivalent to this year and down from its earlier forecast of an increase of 2.6%.

The new projections are all the more sobering in that they are based on assumptions that Europe's debt crisis won't get much worse and that the U.S. won't go over the so-called fiscal cliff — a combination of more than $500 billion in automatic tax hikes and federal spending cuts slated to begin at the start of next year.

Quiz: How much do you know about the 'fiscal cliff'?

"If key adverse risks cannot be averted, and especially if the Eurozone crisis were to intensify significantly, the likely outcome would be considerably weaker, potentially plunging the global economy into deep recession and deflation, with large additional rises in unemployment," the OECD said.

The report, released Tuesday, is on the pessimistic side.

Although economists widely agree on the recession risks in the event that the U.S. isn't able to solve the fiscal impasse, a number of experts now say that the U.S. and global economies could see considerably stronger growth next year if Washington can reach agreement on tax and spending policies that avoid a big fiscal contraction in 2013.

"The economy in the U.S. is really poised to grow," said Bernard Baumohl, chief global economist at the Economic Outlook Group, noting that GDP growth in the U.S. could surge to a solid 3.5% or higher next year if the budget issues are resolved.

The latest forecast from the Federal Reserve, compiled in mid-September, sees U.S. GDP increasing 2.5% to 3% next year.

Baumohl's reasons for greater optimism include a recovering housing market, improving job growth and healthier personal finances, all of which should help drive stronger consumer spending.

Total consumer debt, which has fallen for four years, dropped by $74 billion to $11.31 trillion in the third quarter from the previous quarter, and it is now down $1.37 trillion from the peak in September 2008, according to a report Tuesday from the New York Fed.

Reflecting these trends, the Conference Board said Tuesday that its latest survey showed consumer confidence at its highest level since early 2008, results similar to a survey by the University of Michigan.

American business sentiments, however, have been more cautious of late, and many companies have held back on making investments in recent months. But banks are generally in good shape, and big companies are sitting on mountains of cash and are expected to ramp up investments once the fiscal and tax pictures become clearer.

The OECD report nodded to these factors, but noted that the global recovery slowed markedly over the last year amid faltering confidence and weakening world trade, in part because of problems in the Eurozone, which contributed to an unexpectedly strong slowdown in developing countries such as China.

The 17-nation Eurozone will probably remain in recession well into next year, the OECD said.

Meanwhile, Japan, the world's third-largest economy, has fallen back into a downturn after a growth spurt last year aided by massive reconstruction spending following the earthquake and tsunami in March 2011. The Japanese economy is expected to move at a lumbering pace over the next two years.

The outlook for China, Brazil and India — three of the biggest developing economies, none of which is a member of the OECD — looks comparatively brighter:  Growth will probably accelerate next year and in 2014, with China, the world's second-largest economy, again leading the pack.

The OECD forecast sees China's GDP expanding 8.5% next year and nearly 9% in 2014 after slowing this year to about 7.5%.

Although far from immune from the troubles in the U.S. and Europe, which still account for much of the global demand for goods, China and other major emerging economies have more wherewithal to boost growth than their more-indebted developed counterparts by ramping up government spending and lowering interest rates.

The report notes that spending cuts throughout OECD member countries have taken a toll on economic growth, particularly in the Eurozone, where GDP growth for next year was slashed to -0.1% from a positive rate of 0.9%.

Many developed countries are now struggling with financial and economic challenges related to an aging population, large public debts and high unemployment.

Assuming Europe's debt crisis stabilizes, the Eurozone is forecast to recover in 2014. For OECD countries overall, GDP growth is projected to pick up in 2014 to 2.3%.

The U.S. economy is expected to outperform most other OECD nations in 2014, with its GDP stepping up to a more sturdy growth of 2.8%. That compares with the Fed's forecast of 3% to 3.8% growth in 2014.

Either way, U.S. economic growth isn't likely to come close to keeping up with the rapid advance of developing countries, notably China.

Last year, the U.S. accounted for 23% of the global economy, with the Eurozone and China tied for second, each with a 17% share each.

But by 2030, the OECD estimates, China's share of the global economy will rise to 28%, while the U.S. will slip to No. 2 with 18% of world GDP, and the Eurozone's share will fall to 12%.

don.lee@latimes.com

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Gunfire at gang funeral: 'It s broad daylight,' says stunned neighbor

Rev. Corey Brooks talks about shooting after a funeral in Chicago on Monday, November 26, 2012. (Scott Strazzante, Chicago Tribune)

Shots rang out, causing panic and chaos as hundreds of mourners were leaving a Catholic church on the South Side following funeral services Monday for a slain reputed gang member.

As people scattered for exits, a woman knocked Deborah Echols-Moore, 59, to the floor and fell atop her. Her shoes were thrown off her feet. When she stood back up, she fled barefoot out a door.

“When I came outside, you still can hear shooting. Boom! Boom! Boom! I still ran…people was running behind me,” the longtime CTA employee said not long after the 12:30 p.m. shooting. “You didn’t know which way to go or what to do. All I knew to do was run for my life.”

Chicago police said one man was killed, another critically injured in the bloodshed at St. Columbanus Church. Police identified both as Gangster Disciples members and convicted felons, illustrating once again the high risks of gang membership in a year in which rising homicides have brought Chicago unwanted national attention.

GDs alone make up more than a quarter of the city’s approximately 470 homicide victims. About 60 percent of this year’s homicide victims were gang members, according to department statistics.

Police were still investigating who was responsible for the shooting, but investigators said the neighborhood has long been rife with conflict between GDs and rival Black Disciples.

Illustrating the sudden, often unpredictable nature of the violence, police Superintendent Garry McCarthy just a couple of hours earlier was touting the department’s crime-fighting strategies in tamping down the city’s rate of violence since earlier in the year when homicides soared. Through Sunday, homicides have risen more than 19 percent over the same period a year earlier, department records show.

There were five fewer homicides during the first 25 days of November compared to the same period in 2011, according to department statistics. But shootings during the first 25 days of this month have risen sharply by 45 percent.

From November 1 through Sunday there were 161 shootings compared to 111 during the same period in 2011, department statistics show.

Rev. Corey Brooks, a well-known South Side pastor who officiated at Monday’s services for James Holman, 32, said a church would have been off-limits for gangbangers at one time.

“Now we are living at a day and time where these younger criminals have no regard for life or for street rules,” he said.

Holman, identified by police as a gang member, was gunned down last week at an apartment building in the Washington Park neighborhood.

The shooting took place just outside St. Columbanus, the same church where gangster Al Capone’s wife and mother attended mass daily more than half a century ago.

A Cook County Medical Examiner's spokesman identified one of the two victims as Sherman Miller, 21, and said he was pronounced dead at Stroger Hospital. A 26-year-old man was shot in the back and listed as in “extremely critical condition,” a hospital spokesman said.

Miller, who is also identified in court records as William Miller, was on parole for being in possession of a stolen vehicle and escaping from police custody, according to the Illinois Department of Corrections Web site.

The surviving victim has a 2004 felony weapons conviction in his criminal background, court records show.

Police said two guns were recovered, one down the block from the church at East 71st Street and South Prairie Avenue and another on one of the victims.

About a dozen bullet casings littered the steps outside the church where yellow evidence markers were placed. Beat cops blocked off traffic with their squad cars and sealed off the church’s entrance with yellow and red tape. As evidence technicians took photos of the crime scene, detectives went door-to-door to nearby homes scouring for witnesses.

April Smith, 30, said she looked out a second-floor window of her home when she heard her car alarm sound off and noticed a man wearing a black hooded sweatshirt and blue jeans walking toward the church entrance on 71st Street. She then heard about a dozen gunshots and saw two passersby crouch for protection.

Moments later, the same man in the sweatshirt ran back onto Prairie and fled south, said Smith. Mourners then frantically exited the church.

“To know that something like that happened right across the street...it’s terrible,” Smith, who has lived at her home for seven years, said in disbelief. “It’s broad daylight.”

Brooks, who is pastor of New Beginnings Church of Chicago in the Woodlawn neighborhood and is considering a run for former U.S. Rep. Jesse Jackson Jr.’s vacant congressional seat, said about 500 people attended the funeral, including about 50 children. The church was so crowded that people were standing in the back.

Brooks had finished the eulogy and Holman’s family and close friends had gone out the front door of the church when shots rang out.

“That's when all the gunfire broke out and it was just crazy,” Brooks said. “People were hollering and screaming and kids running everywhere.”

Charles Childs, a co-owner of the A.A. Rayner and Sons Funeral Home across the street from the church, held an uneventful visitation for Holman on Sunday. On Monday he said he saw the gunman firing his weapon as he came down the front steps outside the church.

“No place is safe,” he said. “It’s just despicable.”

Tribune reporter Naomi Nix contributed to this story.

jgorner@tribune.com
lford@tribune.com
csadovi@tribune.com

Twitter: @ChicagoBreaking

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India: 2 policemen suspended, magistrate transferred for arrest of 2 women over Facebook post

NEW DELHI – An Indian official says two senior policemen have been suspended for arresting two women over a Facebook post criticizing the shutdown of Mumbai for the funeral of a powerful politician.

Maharashtra state Home Minister R.R. Patil said Tuesday the policemen were suspended indefinitely and the magistrate who registered the case against the women has been transferred to another district.

Police also arrested nine men who vandalized a medical clinic run by the uncle of one of the women, Patil said.

One of the women had posted a Facebook comment complaining that Mumbai had come to a standstill after the death of rightwing leader Bal Thackeray. Her friend “liked” the post.

Their arrest last week was seen as a misuse of Internet laws and an attempt to curb freedom of expression.

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New Zealand becomes Middle Earth as Hobbit mania takes hold

WELLINGTON (Reuters) – New Zealand‘s capital city was rushing to complete its transformation into a haven for hairy feet and pointed ears on Tuesday as stars jetted in for the long-awaited world premiere of the first movie of the Hobbit trilogy.

Wellington, where director Peter Jackson and much of the post production is based, has renamed itself “the Middle of Middle Earth“, as fans held costume parties and city workers prepared to lay 500 m (550 yards) of red carpet.

A specially Hobbit-decorated Air New Zealand jet brought in cast, crew and studio officials for the premiere.

Jackson, a one-time printer at a local newspaper and a hometown hero, said he was still editing the final version of the “Hobbit, an Unexpected Journey” ahead of Wednesday’s premiere screening.

The Hobbit movies are based on J.R.R. Tolkien’s book and tell the story that leads up to his epic fantasy “The Lord of the Rings“, which Jackson made into three Oscar-winning films about 10 years ago.

It is set 60 years before “The Lord of The Rings” and was originally planned as only two movies before it was decided that there was enough material to justify a third.

New Zealand fans were getting ready to claim the best spots to see the film’s stars, including British actor Martin Freeman, who plays the Hobbit Bilbo Baggins, Hugo Weaving, Cate Blanchett, and Elijah Wood.

“It’s been a 10-year wait for these movies, New Zealand is Tolkien’s spiritual home, so there’s no way we’re going to miss out,” said office worker Alan Craig, a self-confessed Lord of the Rings “nut”.

The production has been at the centre of several controversies, including a dispute with unions in 2010 over labor contracts that resulted in the government stepping in to change employment laws, and giving Warner Brothers increased incentives to keep the production in New Zealand.

“The Hobbit did come very close to not being filmed here,” Jackson told Radio New Zealand.

He said Warners had sent scouts to Britain to look at possible locations and also matched parts of the script to shots of the Scottish Highlands and English forests.

“That was to convince us we could easily go over there and shoot the film … and I would have had to gone over there to do it but I was desperately fighting to have it stay here,” Jackson said.

Last week, an animal rights group said more than 20 animals, including horses, pigs and chickens, had been killed during the making of the film. Jackson has said some animals used in the film died on the farm where they were being housed, but that none had been hurt during filming.

The films are also notable for being the first filmed at 48 frames per second (fps), compared with the 24 fps that has been the industry standard since the 1920s.

The second film “The Hobbit: The Desolation of Smaug” will be released in December next year, with the third “The Hobbit: There and Back Again” due in mid-July 2014.

(Editing by Paul Tait)

Movies News Headlines – Yahoo! News

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The New Old Age Blog: New Efforts to Close Hospitals' Revolving Doors

In the past, the only thing a patient was sure to get after a hospital stay was a bill. But as Medicare cracks down on high readmission rates, hospitals are dispatching nurses, transportation, culturally specific diet tips, free medications and even bathroom scales to patients deemed at risk of relapsing.

Robert Wood Johnson University Hospital in New Brunswick, N.J., has nurses visit high-risk patients at their home within two days of leaving the hosital. Teresa De Peralta, a nurse practitioner who runs the program, said they frequently find that patients don’t realize a drug they were prescribed in the hospital does the same thing as one they have already been taking.

“When medications are changed, they don’t want to throw things out, they think it’s a waste,” Ms. De Peralta said. “We actually go through the cupboards and painstakingly write out in big letters what they should be taking during the day.”

Many hospital officials say their efforts to keep patients healthy after discharge have been spurred by new financial penalties Medicare started imposing in October on places with too many readmissions. Increasingly, hospitals are no longer leaving to patients the responsibility for setting up follow-up appointments or filling new prescriptions.

And hospitals are not assuming that personnel in nursing homes and other facilities know how to properly care for their patients and follow the hospital discharge instructions.

Patients taking the wrong dose or mixing medicines that react badly often end up back in the hospital. A survey of 377 elderly patients at Yale-New Haven Hospital, published this year in The Journal of General Internal Medicine, discovered that 81 percent of the patients either didn’t understand what all their prescriptions were for; were prescribed the wrong drug or the wrong dose; were taken off a drug they needed, or never picked up a new prescription.

Dr. Leora Horwitz, the study’s leader, said patients who were called a week after their discharge and were asked what changes to their medication they were supposed to make “overwhelmingly” couldn’t tell them.

A big part of reducing readmissions is making sure that patients understand early warning signs that their health is deteriorating. Sun Health Care Transitions, a foundation-supported program in Sun City, Ariz., gives scales to some patients with congestive heart failure because small weight gains indicate they are retaining water, a sign that their heart isn’t pumping adequately.

“We have them keep a log,” said Jennifer Drago, a Sun Health vice president. “We want them to be looking for a two-pound daily weight gain, or five pounds over the week.”

Patients whose weight creeps up are quickly sent back to their doctor. Debra Richards, director of case management at Banner Del E. Webb Medical Center, one of the hospitals Sun Health is assisting, said, “That program has helped us quite a bit.”

Shady Grove Adventist Hospital in Rockville, Md., has started taking patients’ cultural backgrounds into consideration when doling out advice about maintaining their health. For example, the hospital encourages Salvadoran patients to substitute olive oils for the palm oils their cuisine traditionally calls for, to roast or bake meat instead of frying it and to use sugar substitutes when making horchata, a popular Central American drink.

When Hackensack University Medical Center sent staff members to teach caregivers how to take care of their patients, one place “didn’t even know what a low-salt diet was,” even though that’s a critical part of keeping heart failure patients from retaining fluids, said Dr. Charles Riccobono, chief quality and safety officer at the New Jersey hospital.

Aurora Health Care, a Milwaukee-based health system, now places its own nurse practitioners in several nursing homes to watch over Aurora’s discharged patients. Aurora says readmission rates of those patients have decreased, in some months by as much as half.

Dr. Eric Coleman, a Denver geriatrician whose ideas on reducing readmissions have been adopted by a number of hospitals and Medicare, said that while some hospital changes are “exciting and new,” others are “relabeling old wine in new bottles.”

“Yesterday we had ‘discharge planning’ and today we have a ‘rapid response transition team,’ and content-wise they’re doing the same thing,” Dr. Coleman said. “But it’s a nice thing to report out to the board of trustees.”

Jordan Rau is a reporter for Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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