South L.A. frustrated by delays in building new King hospital









Earlier this year, Joane Austin rushed her elderly mother to the emergency room for fear she was having a heart attack.


Austin normally would have made the short trip to Martin Luther King Jr./Drew Medical Center, the landmark hospital in South Los Angeles. But King/Drew has been closed for five years, so Austin drove several miles to the emergency room at Centinela Hospital Medical Center in Inglewood.


"I prayed all the lights would stay green," she said. "It was scary."





Once they arrived, doctors determined that Austin's mother needed emergency surgery to remove scar tissue around her intestines.


For years, King/Drew provided emergency, trauma and inpatient care to residents from throughout South Los Angeles. After a series of medical errors resulted in patient deaths, Los Angeles County closed it in 2007. County officials promised the community a better, safer new medical center in a few years.


But the opening has been repeatedly delayed, and the community is still waiting. Originally, officials hoped to have the new facility ready by 2010. Then it was pushed to 2012. Now, officials say they plan to have construction completed next year and the hospital opening its doors in 2014.


Without a nearby hospital, patients have had to travel to such places as Bellflower, Inglewood and Long Beach for emergency room and inpatient care.


Several local hospitals — California Hospital Medical Center, L.A. County/USC Medical Center and Harbor-UCLA Medical Center — received an influx of former King patients after the closure. The closest hospital, St. Francis Medical Center in Lynwood, reported an increase of 20% to 30% in emergency room visits since King/Drew closed, though other factors also may have contributed to the rise.


Getting to other hospitals has presented a challenge for many in the low-income neighborhood, said William Hobson, president and chief executive of the Watts Healthcare Corp. "Just the fact that it is a long way away may discourage them from going," he said.


The closure of King/Drew, which was born out of the Watts riots and opened in 1972, created a healthcare gap in a community where rates of chronic disease are high and vast swaths of the population lack insurance, said David Carlisle, president of the adjacent Charles R. Drew University of Medicine and Science. South Los Angeles has a shortage of doctors, inpatient beds and outpatient services, according to both experts and research.


Despite King/Drew's many medical lapses, which earned it the nickname "Killer King," many in the community remained fiercely loyal to the hospital and the services it provided.


Studies examining the impact of King/Drew's closure found that it led to delays in care for elderly blacks and Latinos and a dramatic increase in patient admissions at other trauma centers. Physicians throughout the county also reported more overcrowding in other emergency rooms and said they saw sicker patients who didn't know where to go or couldn't afford transportation elsewhere.


"It is fearful to think about how many lives may have been saved had this thing been opened by now," said Lark Galloway-Gilliam, executive director of the advocacy group Community Health Councils. "It shouldn't take five years to build a facility."


Patrick Wooten, 49, went to St. Francis when he had a dislocated kneecap a few years ago. Wooten, who is uninsured, said he received good care at the private hospital but then got a $3,200 bill. Wooten said he is frustrated that the new King hospital still hasn't opened and won't until 2014. "What you do until then, God only knows," he said. "Hopefully we can wait it out."


Last year, Sandira Gonzalez, 29, took her 5-year-old son to the Martin Luther King urgent care center when he had a fever. But when the center closed for the night, her son had to be taken by ambulance to Harbor-UCLA near Torrance, where he was treated for an infection.


Community members and advocates said they are disappointed by the long wait, caused by a combination of bureaucratic delays and the complexity of the project. But when it does open, they said, they are hopeful that it will be a better, and safer, hospital.


The county is building the hospital and will help support it financially but will not be responsible for day-to-day operations. Instead, an independent, nonprofit organization will run the facility, to be known as Martin Luther King Jr. Community Hospital, and the University of California will help staff it and ensure the quality of patient care. Construction is progressing, but the grand opening may still be nearly two years away.


"It will be a significantly different kind of institution, with the right kind of accountability," said Robert K. Ross, president and chief executive of the California Endowment. "Now we just need the institution to open up on budget and on time."


Los Angeles County Supervisor Mark Ridley-Thomas said it takes time to create a state-of-the-art hospital — and a whole medical complex — that could become a model for others around the nation. "A lot of eyes are on this," he said. "We want to do this well and we want to do it right.... Nothing else is acceptable."


The nonprofit's board recognizes how critical the facility is to the area, said board President Manny Abascal. "Every day this hospital is not open, people are suffering," he said. At the same time, he added, the board is committed to ensuring that the new hospital is a high-quality institution. "If you open it … and there are some of the same problems you had before, then it's going to be devastating," he said.





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General Assembly Grants Palestine Upgraded Status in U.N.


Damon Winter/The New York Times


The Palestinian Authority president, Mahmoud Abbas, center, was congratulated by Turkey’s foreign minister, Ahmet Davutoglu. More Photos »







UNITED NATIONS — More than 130 countries voted on Thursday to upgrade Palestine to a nonmember observer state of the United Nations, a triumph for Palestinian diplomacy and a sharp rebuke to the United States and Israel.




But the vote, at least for now, did little to bring either the Palestinians or the Israelis closer to the goal they claim to seek: two states living side by side, or increased Palestinian unity. Israel and the militant group Hamas both responded critically to the day’s events, though for different reasons.


The new status will give the Palestinians more tools to challenge Israel in international legal forums for its occupation activities in the West Bank, including settlement-building, and it helped bolster the Palestinian Authority, weakened after eight days of battle between its rival Hamas and Israel.


But even as a small but determined crowd of 2,000 celebrated in central Ramallah in the West Bank, waving flags and dancing, there was an underlying sense of concerned resignation.


“I hope this is good,” said Munir Shafie, 36, an electrical engineer who was there. “But how are we going to benefit?”


Still, the General Assembly vote — 138 countries in favor, 9 opposed and 41 abstaining — showed impressive backing for the Palestinians at a difficult time. It was taken on the 65th anniversary of the vote to divide the former British mandate of Palestine into two states, one Jewish and one Arab, a vote Israel considers the international seal of approval for its birth.


The past two years of Arab uprisings have marginalized the Palestinian cause to some extent as nations that focused their political aspirations on the Palestinian struggle have turned inward. The vote on Thursday, coming so soon after the Gaza fighting, put the Palestinians again — if briefly, perhaps — at the center of international discussion.


“The question is, where do we go from here and what does it mean?” Salam Fayyad, the Palestinian prime minister, who was in New York for the vote, said in an interview. “The sooner the tough rhetoric of this can subside and the more this is viewed as a logical consequence of many years of failure to move the process forward, the better.” He said nothing would change without deep American involvement.


President Mahmoud Abbas of the Palestinian Authority, speaking to the assembly’s member nations, said, “The General Assembly is called upon today to issue a birth certificate of the reality of the state of Palestine,” and he condemned what he called Israeli racism and colonialism. His remarks seemed aimed in part at Israel and in part at Hamas. But both quickly attacked him for the parts they found offensive.


“The world watched a defamatory and venomous speech that was full of mendacious propaganda against the Israel Defense Forces and the citizens of Israel,” Prime Minister Benjamin Netanyahu of Israel responded. “Someone who wants peace does not talk in such a manner.”


While Hamas had officially backed the United Nations bid of Mr. Abbas, it quickly criticized his speech because the group does not recognize Israel.


“There are controversial issues in the points that Abbas raised, and Hamas has the right to preserve its position over them,” said Salah al-Bardaweel, a spokesman for Hamas in Gaza, on Thursday.


“We do not recognize Israel, nor the partition of Palestine, and Israel has no right in Palestine,” he added. “Getting our membership in the U.N. bodies is our natural right, but without giving up any inch of Palestine’s soil.”


Israel’s ambassador to the United Nations, Ron Prosor, spoke after Mr. Abbas and said he was concerned that the Palestinian Authority failed to recognize Israel for what it is.


“Three months ago, Israel’s prime minister stood in this very hall and extended his hand in peace to President Abbas,” Mr. Prosor said. “He reiterated that his goal was to create a solution of two states for two peoples, where a demilitarized Palestinian state will recognize Israel as a Jewish state.


“That’s right. Two states for two peoples. In fact, President Abbas, I did not hear you use the phrase ‘two states for two peoples’ this afternoon. In fact, I have never heard you say the phrase ‘two states for two peoples’ because the Palestinian leadership has never recognized that Israel is the nation-state of the Jewish people.”


The Israelis also say that the fact that Mr. Abbas is not welcome in Gaza, the Palestinian coastal enclave run by Hamas, from which he was ejected five years ago, shows that there is no viable Palestinian leadership living up to its obligations now.


Jennifer Steinhauer contributed reporting from Washington, Isabel Kershner from Jerusalem, and Khaled Abu Aker from Ramallah, West Bank.



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Apple overcomes last hurdle, iPhone 5 cleared for sale in China as Android continues to dominate












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The X Factor Announces Top 6






The X Factor










11/29/2012 at 09:40 PM EST







From left; Demi Lovato, Britney Spears and Simon Cowell


FOX


Mario Lopez called the first elimination on Thursday's The X Factor a "bit of a shocker."

And so was the second.

The top eight contestants sang No. 1 hits Wednesday in an emotional night. Keep reading to find out which two performers were sent packing – and who's in season 2's top six ...

Paige Thomas was the first to go – which is shocking because she toned down her over-the-top performing style to sing Rick Astley's "Never Gonna Give You Up" like a like a "legitimate pop star," according to Simon Cowell.

That left Demi Lovato with just one singer on her team: CeCe Frey, who was told (by Cowell) to "pack her bags" Wednesday after her performance of "Lady Marmalade."

But L.A. Reid's contestant Vino Alan and Team Britney's Diamond White were in the bottom two and had to sing for survival. He performed "Trouble" and she sang Beyoncé's "I Was Here."

L.A. voted to send home Diamond; Britney returned the favor and voted to send home Vino. Demi voted Vino out as well. That left Simon ... and he fell in line with the female panelists, voting to get rid of Vino. Either one would have been a shock but Vino had been ranked third last week.

Here's how the top six rank this week:
1. Carly Rose Sonenclar
2. Tate Stevens
3. Emblem3
4. Fifth Harmony
5. CeCe Frey
6. Diamond White

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Clinton releases road map for AIDS-free generation

WASHINGTON (AP) — In an ambitious road map for slashing the global spread of AIDS, the Obama administration says treating people sooner and more rapid expansion of other proven tools could help even the hardest-hit countries begin turning the tide of the epidemic over the next three to five years.

"An AIDS-free generation is not just a rallying cry — it is a goal that is within our reach," Secretary of State Hillary Rodham Clinton, who ordered the blueprint, said in the report.

"Make no mistake about it, HIV may well be with us into the future but the disease that it causes need not be," she said at the State Department Thursday.

President Barack Obama echoed that promise.

"We stand at a tipping point in the fight against HIV/AIDS, and working together, we can realize our historic opportunity to bring that fight to an end," Obama said in a proclamation to mark World AIDS Day on Saturday.

Some 34 million people worldwide are living with HIV, and despite a decline in new infections over the last decade, 2.5 million people were infected last year.

Given those staggering figures, what does an AIDS-free generation mean? That virtually no babies are born infected, young people have a much lower risk than today of becoming infected, and that people who already have HIV would receive life-saving treatment.

That last step is key: Treating people early in their infection, before they get sick, not only helps them survive but also dramatically cuts the chances that they'll infect others. Yet only about 8 million HIV patients in developing countries are getting treatment. The United Nations aims to have 15 million treated by 2015.

Other important steps include: Treating more pregnant women, and keeping them on treatment after their babies are born; increasing male circumcision to lower men's risk of heterosexual infection; increasing access to both male and female condoms; and more HIV testing.

The world spent $16.8 billion fighting AIDS in poor countries last year. The U.S. government is the leading donor, spending about $5.6 billion.

Thursday's report from PEPFAR, the President's Emergency Plan for AIDS Relief, outlines how progress could continue at current spending levels — something far from certain as Congress and Obama struggle to avert looming budget cuts at year's end — or how faster progress is possible with stepped-up commitments from hard-hit countries themselves.

Clinton warned Thursday that the U.S. must continue doing its share: "In the fight against HIV/AIDS, failure to live up to our commitments isn't just disappointing, it's deadly."

The report highlighted Zambia, which already is seeing some declines in new cases of HIV. It will have to treat only about 145,000 more patients over the next four years to meet its share of the U.N. goal, a move that could prevent more than 126,000 new infections in that same time period. But if Zambia could go further and treat nearly 198,000 more people, the benefit would be even greater — 179,000 new infections prevented, the report estimates.

In contrast, if Zambia had to stick with 2011 levels of HIV prevention, new infections could level off or even rise again over the next four years, the report found.

Advocacy groups said the blueprint offers a much-needed set of practical steps to achieve an AIDS-free generation — and makes clear that maintaining momentum is crucial despite economic difficulties here and abroad.

"The blueprint lays out the stark choices we have: To stick with the baseline and see an epidemic flatline or grow, or ramp up" to continue progress, said Chris Collins of amFAR, the Foundation for AIDS Research.

His group has estimated that more than 276,000 people would miss out on HIV treatment if U.S. dollars for the global AIDS fight are part of across-the-board spending cuts set to begin in January.

Thursday's report also urges targeting the populations at highest risk, including gay men, injecting drug users and sex workers, especially in countries where stigma and discrimination has denied them access to HIV prevention services.

"We have to go where the virus is," Clinton said.

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Lottery panel votes to bring Powerball game to California









Californians griping about not getting their shot at the recent $587.5-million Powerball jackpot won't have much longer to complain.


The California Lottery Commission voted unanimously Thursday to bring the popular multi-state game to California. Tickets, which cost $2 each, will go on sale at licensed lottery merchants in April.


The vote comes a day after the game attracted wide attention for its largest jackpot ever.





"That would have been worth an investment of my dollar, but I didn't want to go all the way to Arizona to buy a ticket," said Alfred Reeves, 51, as he stood by his car outside Country Donut Shop in Long Beach. "Now I won't have to."


California is one of eight states that do not sell Powerball tickets. The others are Utah, Nevada, Alabama, Alaska, Hawaii, Mississippi and Wyoming.


Lottery officials said the game is especially popular because the prize starts at $40 million — compared with the $12-million starting point of the Mega Millions jackpot — and increases by $5 million each time the drawing doesn't produce a winner.


"There's always a bit of a frenzy out there when the jackpot gets up there," said Russ Lopez, a California Lottery Commission spokesman.


The commission believes that adding the Powerball game could add between $90 million and $120 million annually in net revenue. Lottery commission officials said at least $50 million to $100 million of that will go directly to California schools.


At Bluebird Liquor in Hawthorne, a "lucky" market that is legendary for drawing long lotto lines, customers welcomed the Powerball news.


"People here are jumping up and down. We are so excited," said employee Eduardo Duran. "Customers have been asking us about Powerball all week. We've even had a few people tell us they were headed to Arizona to buy tickets."


The process of bringing Powerball to California began last December. Lottery officials first commissioned a study to analyze the logistics of implementing the game in California before ultimately recommending that sales be offered in 2013.


To play Powerball, a participant must purchase a $2 ticket and pick five unique numbers from a field of 1 through 59, and then a Powerball number from 1 through 35. Players can win by matching three or more of the unique numbers, or by matching the Powerball number alone, or by matching the Powerball number and one or more of the five unique numbers. In all, there are nine winning combinations. Players can increase their winnings by paying for a $3 ticket.


Drawings are held twice a week.


Danny Ta, owner of Long Beach Dairy & Liquor, said he will talk to his lottery representative about selling Powerball tickets because he knows the game is in high demand.


"I've had customers always asking me for the game, but I tell them California doesn't have it, only in other states," he said.


Ta said that if he does get the game for his store, he hopes to sell the winning ticket someday.


"Hopefully," he said, smiling.


wesley.lowery@latimes.com


ruben.vives@latimes.com





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U.S. Is Weighing Stronger Action in Syrian Conflict


Francisco Leong/Agence France-Presse — Getty Images


Rebels in northern Syria celebrated on Wednesday next to what was reported to be a government fighter jet.







WASHINGTON — The Obama administration, hoping that the conflict in Syria has reached a turning point, is considering deeper intervention to help push President Bashar al-Assad from power, according to government officials involved in the discussions.




While no decisions have been made, the administration is considering several alternatives, including directly providing arms to some opposition fighters.


The most urgent decision, likely to come next week, is whether NATO should deploy surface-to-air missiles in Turkey, ostensibly to protect that country from Syrian missiles that could carry chemical weapons. The State Department spokeswoman, Victoria Nuland, said Wednesday that the Patriot missile system would not be “for use beyond the Turkish border.”


But some strategists and administration officials believe that Syrian Air Force pilots might fear how else the missile batteries could be used. If so, they could be intimidated from bombing the northern Syrian border towns where the rebels control considerable territory. A NATO survey team is in Turkey, examining possible sites for the batteries.


Other, more distant options include directly providing arms to opposition fighters rather than only continuing to use other countries, especially Qatar, to do so. A riskier course would be to insert C.I.A. officers or allied intelligence services on the ground in Syria, to work more closely with opposition fighters in areas that they now largely control.


Administration officials discussed all of these steps before the presidential election. But the combination of President Obama’s re-election, which has made the White House more willing to take risks, and a series of recent tactical successes by rebel forces, one senior administration official said, “has given this debate a new urgency, and a new focus.”


The outcome of the broader debate about how heavily America should intervene in another Middle Eastern conflict remains uncertain. Mr. Obama’s record in intervening in the Arab Spring has been cautious: While he joined in what began as a humanitarian effort in Libya, he refused to put American military forces on the ground and, with the exception of a C.I.A. and diplomatic presence, ended the American role as soon as Col. Muammar el-Qaddafi was toppled.


In the case of Syria, a far more complex conflict than Libya’s, some officials continue to worry that the risks of intervention — both in American lives and in setting off a broader conflict, potentially involving Turkey — are too great to justify action. Others argue that more aggressive steps are justified in Syria by the loss in life there, the risks that its chemical weapons could get loose, and the opportunity to deal a blow to Iran’s only ally in the region. The debate now coursing through the White House, the Pentagon, the State Department and the C.I.A. resembles a similar one among America’s main allies.


“Look, let’s be frank, what we’ve done over the last 18 months hasn’t been enough,” Britain’s prime minister, David Cameron, said three weeks ago after visiting a Syrian refugee camp in Jordan. “The slaughter continues, the bloodshed is appalling, the bad effects it’s having on the region, the radicalization, but also the humanitarian crisis that is engulfing Syria. So let’s work together on really pushing what more we can do.” Mr. Cameron has discussed those options directly with Mr. Obama, White House officials say.


France and Britain have recognized a newly formed coalition of opposition groups, which the United States helped piece together. So far, Washington has not done so.


American officials and independent specialists on Syria said that the administration was reviewing its Syria policy in part to gain credibility and sway with opposition fighters, who have seized key Syrian military bases in recent weeks.


“The administration has figured out that if they don’t start doing something, the war will be over and they won’t have any influence over the combat forces on the ground,” said Jeffrey White, a former Defense Intelligence Agency intelligence officer and specialist on the Syria military. “They may have some influence with various political groups and factions, but they won’t have influence with the fighters, and the fighters will control the territory.”


Jessica Brandt contributed reporting from Cambridge, Mass.



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Facebook exec says company is reducing spam despite clogging your feed with brands you don’t like












Recent changes to Facebook’s (FB) Edgerank, the algorithm that’s responsible for displaying items on a user’s Newsfeed, have angered privacy groups who say the new policy will actually produce more spam than reducing it. According to Forbes’ Jeff Bercovici, Facebook’s VP of global marketing solutions Carol Everson said on Tuesday that the social network is reducing spam by using “Suggests Posts” – “non-connected page posts” that show a brand’s ads even if a user and their friends don’t “like” or support them. Bercovici argues that Facebook’s new approach to targeting brands at users contradicts its claims of reducing spam by doling out spam that users don’t connect with. 


As expected, Everson’s response to clogging the Newsfeed with brand ads that users don’t support was: “You may not be a fan of a brand, but maybe everyone in your network is talking about it, so we think you might be interested in it,” and she said there are “literally more than a thousand signals” that go into displaying “relevant” brand ads.












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Angus T. Jones Is Not Leaving Two and a Half Men: Source















11/28/2012 at 07:50 PM EST



The Half is back!

Ever since Angus T. Jones bashed Two and a Half Men in a now-viral video, it begged the question: Will the 19-year-old actor return to the hit show?

If he has it his way, he will.

"Angus expects to report to work after the holiday break in January," says a source close to the star. "He intends to honor his contract through the end of the season."

Jones, who called the show "filth" and urged viewers in a video interview on a religious website to stop watching, issued an apology Tuesday night, saying he has the "highest regard" for the "wonderful people" on the show.

Although Jones is not featured in an episode that tapes next week, he intends to show up on schedule after the break, the source says.

In the meantime, the source adds, "Angus is feeling positive and he is concentrating on spending some downtime with family and friends."

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Simple measures cut infections caught in hospitals

CHICAGO (AP) — Preventing surgery-linked infections is a major concern for hospitals and it turns out some simple measures can make a big difference.

A project at seven big hospitals reduced infections after colorectal surgeries by nearly one-third. It prevented an estimated 135 infections, saving almost $4 million, the Joint Commission hospital regulating group and the American College of Surgeons announced Wednesday. The two groups directed the 2 1/2-year project.

Solutions included having patients shower with special germ-fighting soap before surgery, and having surgery teams change gowns, gloves and instruments during operations to prevent spreading germs picked up during the procedures.

Some hospitals used special wound-protecting devices on surgery openings to keep intestine germs from reaching the skin.

The average rate of infections linked with colorectal operations at the seven hospitals dropped from about 16 percent of patients during a 10-month phase when hospitals started adopting changes to almost 11 percent once all the changes had been made.

Hospital stays for patients who got infections dropped from an average of 15 days to 13 days, which helped cut costs.

"The improvements translate into safer patient care," said Dr. Mark Chassin, president of the Joint Commission. "Now it's our job to spread these effective interventions to all hospitals."

Almost 2 million health care-related infections occur each year nationwide; more than 90,000 of these are fatal.

Besides wanting to keep patients healthy, hospitals have a monetary incentive to prevent these infections. Medicare cuts payments to hospitals that have lots of certain health care-related infections, and those cuts are expected to increase under the new health care law.

The project involved surgeries for cancer and other colorectal problems. Infections linked with colorectal surgery are particularly common because intestinal tract bacteria are so abundant.

To succeed at reducing infection rates requires hospitals to commit to changing habits, "to really look in the mirror and identify these things," said Dr. Clifford Ko of the American College of Surgeons.

The hospitals involved were Cedars-Sinai Medical Center in Los Angeles; Cleveland Clinic in Ohio; Mayo Clinic-Rochester Methodist Hospital in Rochester, Minn.; North Shore-Long Island Jewish Health System in Great Neck, NY; Northwestern Memorial Hospital in Chicago; OSF Saint Francis Medical Center in Peoria, Ill.; and Stanford Hospital & Clinics in Palo Alto, Calif.

___

Online:

Joint Commission: http://www.jointcommission.org

American College of Surgeons: http://www.facs.org

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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