Well: Gluten-Free for the Gluten Sensitive

Eat no wheat.

That is the core, draconian commandment of a gluten-free diet, a prohibition that excises wide swaths of American cuisine — cupcakes, pizza, bread and macaroni and cheese, to name a few things.

For the approximately one-in-a-hundred Americans who have a serious condition called celiac disease, that is an indisputably wise medical directive.


One woman’s story of going gluten-free.



Now medical experts largely agree that there is a condition related to gluten other than celiac. In 2011 a panel of celiac experts convened in Oslo and settled on a medical term for this malady: non-celiac gluten sensitivity.

What they still do not know: how many people have gluten sensitivity, what its long-term effects are, or even how to reliably identify it. Indeed, they do not really know what the illness is.

The definition is less a diagnosis than a description — someone who does not have celiac, but whose health improves on a gluten-free diet and worsens again if gluten is eaten. It could even be more than one illness.

“We have absolutely no clue at this point,” said Dr. Stefano Guandalini, medical director of the University of Chicago’s Celiac Disease Center.

Kristen Golden Testa could be one of the gluten-sensitive. Although she does not have celiac, she adopted a gluten-free diet last year. She says she has lost weight and her allergies have gone away. “It’s just so marked,” said Ms. Golden Testa, who is health program director in California for the Children’s Partnership, a national nonprofit advocacy group.

She did not consult a doctor before making the change, and she also does not know whether avoiding gluten has helped at all. “This is my speculation,” she said. She also gave up sugar at the same time and made an effort to eat more vegetables and nuts.

Many advocates of gluten-free diets warn that non-celiac gluten sensitivity is a wide, unseen epidemic undermining the health of millions of people. They believe that avoiding gluten — a composite of starch and proteins found in certain grassy grains like wheat, barley and rye — gives them added energy and alleviates chronic ills. Oats, while gluten-free, are also avoided, because they are often contaminated with gluten-containing grains.

Others see the popularity of gluten-free foods as just the latest fad, destined to fade like the Atkins diet and avoidance of carbohydrates a decade ago.

Indeed, Americans are buying billions of dollars of food labeled gluten-free each year. And celebrities like Miley Cyrus, the actress and singer, have urged fans to give up gluten. “The change in your skin, physical and mental health is amazing!” she posted on Twitter in April.

For celiac experts, the anti-gluten zeal is a dramatic turnaround; not many years ago, they were struggling to raise awareness among doctors that bread and pasta can make some people very sick. Now they are voicing caution, tamping down the wilder claims about gluten-free diets.

“It is not a healthier diet for those who don’t need it,” Dr. Guandalini said. These people “are following a fad, essentially.” He added, “And that’s my biased opinion.”

Nonetheless, Dr. Guandalini agrees that some people who do not have celiac receive a genuine health boost from a gluten-free diet. He just cannot say how many.

As with most nutrition controversies, most everyone agrees on the underlying facts. Wheat entered the human diet only about 10,000 years ago, with the advent of agriculture.

“For the previous 250,000 years, man had evolved without having this very strange protein in his gut,” Dr. Guandalini said. “And as a result, this is a really strange, different protein which the human intestine cannot fully digest. Many people did not adapt to these great environmental changes, so some adverse effects related to gluten ingestion developed around that time.”

The primary proteins in wheat gluten are glutenin and gliadin, and gliadin contains repeating patterns of amino acids that the human digestive system cannot break down. (Gluten is the only substance that contains these proteins.) People with celiac have one or two genetic mutations that somehow, when pieces of gliadin course through the gut, cause the immune system to attack the walls of the intestine in a case of mistaken identity. That, in turn, causes fingerlike structures called villi that absorb nutrients on the inside of the intestines to atrophy, and the intestines can become leaky, wreaking havoc. Symptoms, which vary widely among people with the disease, can include vomiting, chronic diarrhea or constipation and diminished growth rates in children.

The vast majority of people who have celiac do not know it. And not everyone who has the genetic mutations develops celiac.

What worries doctors is that the problem seems to be growing. After testing blood samples from a century ago, researchers discovered that the rate of celiac appears to be increasing. Why is another mystery. Some blame the wheat, as some varieties now grown contain higher levels of gluten, because gluten helps provide the springy inside and crusty outside desirable in bread. (Blame the artisanal bakers.)

There are also people who are allergic to wheat (not necessarily gluten), but until recently, most experts had thought that celiac and wheat allergy were the only problems caused by eating the grain.

For 99 out of 100 people who don’t have celiac — and those who don’t have a wheat allergy — the undigested gliadin fragments usually pass harmlessly through the gut, and the possible benefits of a gluten-free diet are nebulous, perhaps nonexistent for most. But not all.

Anecdotally, people like Ms. Golden Testa say that gluten-free diets have improved their health. Some people with diseases like irritable bowel syndrome and arthritis also report alleviation of their symptoms, and others are grasping at gluten as a source of a host of other conditions, though there is no scientific evidence to back most of the claims. Experts have been skeptical. It does not make obvious sense, for example, that someone would lose weight on a gluten-free diet. In fact, the opposite often happens for celiac patients as their malfunctioning intestines recover.

They also worried that people could end up eating less healthfully. A gluten-free muffin generally contains less fiber than a wheat-based one and still offers the same nutritional dangers — fat and sugar. Gluten-free foods are also less likely to be fortified with vitamins.

But those views have changed. Crucial in the evolving understanding of gluten were the findings, published in 2011, in The American Journal of Gastroenterology, of an experiment in Australia. In the double-blind study, people who suffered from irritable bowel syndrome, did not have celiac and were on a gluten-free diet were given bread and muffins to eat for up to six weeks. Some of them were given gluten-free baked goods; the others got muffins and bread with gluten. Thirty-four patients completed the study. Those who ate gluten reported they felt significantly worse.

That influenced many experts to acknowledge that the disease was not just in the heads of patients. “It’s not just a placebo effect,” said Dr. Marios Hadjivassiliou, a neurologist and celiac expert at the University of Sheffield in England.

Even though there was now convincing evidence that gluten sensitivity exists, that has not helped to establish what causes gluten sensitivity. The researchers of the Australian experiment noted, “No clues to the mechanism were elucidated.”

What is known is that gluten sensitivity does not correlate with the genetic mutations of celiac, so it appears to be something distinct from celiac.

How widespread gluten sensitivity may be is another point of controversy.

Dr. Thomas O’Bryan, a chiropractor turned anti-gluten crusader, said that when he tested his patients, 30 percent of them had antibodies targeting gliadin fragments in their blood. “If a person has a choice between eating wheat or not eating wheat,” he said, “then for most people, avoiding wheat would be ideal.”

Dr. O’Bryan has given himself a diagnosis of gluten sensitivity. “I had these blood sugar abnormalities and didn’t have a handle where they were coming from,” he said. He said a blood test showed gliadin antibodies, and he started avoiding gluten. “It took me a number of years to get completely gluten-free,” he said. “I’d still have a piece of pie once in a while. And I’d notice afterwards that I didn’t feel as good the next day or for two days. Subtle, nothing major, but I’d notice that.”

But Suzy Badaracco, president of Culinary Tides, Inc., a consulting firm, said fewer people these days were citing the benefits of gluten-free diets. She said a recent survey of people who bought gluten-free foods found that 35 percent said they thought gluten-free products were generally healthier, down from 46 percent in 2010. She predicted that the use of gluten-free products would decline.

Dr. Guandalini said finding out whether you are gluten sensitive is not as simple as Dr. O’Bryan’s antibody tests, because the tests only indicate the presence of the fragments in the blood, which can occur for a variety of reasons and do not necessarily indicate a chronic illness. For diagnosing gluten sensitivity, “There is no testing of the blood that can be helpful,” he said.

He also doubts that the occurrence of gluten sensitivity is nearly as high as Dr. O’Bryan asserts. “No more than 1 percent,” Dr. Guandalini said, although he agreed that at present all numbers were speculative.

He said his research group was working to identify biological tests that could determine gluten sensitivity. Some of the results are promising, he said, but they are too preliminary to discuss. Celiac experts urge people to not do what Ms. Golden Testa did — self-diagnose. Should they actually have celiac, tests to diagnose it become unreliable if one is not eating gluten. They also recommend visiting a doctor before starting on a gluten-free diet.



This post has been revised to reflect the following correction:

Correction: February 4, 2013

An earlier version of this article misspelled the surname of Thomas O'Bryan. It is O'Bryan, not O'Brien.

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Stocks make a U-turn and rise on housing, Europe









The stock market jumped Tuesday following a surge in U.S. home prices and new signs of strength in Europe's economy.

The Dow Jones industrial average was up 104 points at 13,983 after the first hour of trading. The Standard & Poor's 500 was up 11 at 1,507. The Nasdaq composite was up 16 to 3,147.

The rise follows two days of whiplash. On Friday, the Dow gained 149 points, rising above 14,000 for the first time since 2007. On Monday, it fell 129 points, its worst sell-off of the year so far.

Tuesday's gain was driven by new data showing that U.S. home prices rose in December at the fastest pace in more than six years. CoreLogic, a real estate data provider, reported that home prices rose 8.3 percent.

In Europe, a measure of manufacturing and service businesses rose to a 10-month high January.

While the numbers suggest that the overall economy is still contracting, there is also evidence that a recovery may be taking root.

The market has risen more or less steadily in the new year. Lance Roberts, chief economist at Streettalk Advisors in Houston, Texas, said that's related more to the Federal Reserve's commitment to keep money cheap than to companies' performance. If earnings are beating estimates, he said, it's largely because expectations were so low.

“If you lower the hurdles enough, companies can get over them,” Roberts said.

The fact that small, individual investors are starting to return to stocks, as they have in recent weeks, is another sign that the market is due for a correction, Roberts and other analysts have said.

McGraw-Hill Cos., parent of the Standard & Poor's ratings agency, fell more than 4 percent, down $2.40 to $47.90, after the federal government sued S&P. The government said that S&P knowingly misled investors about the quality of the mortgage-backed securities it was rating. That followed a 14 percent decline at McGraw-Hill on Monday, after reports about the lawsuit first leaked.

Yum Brands, parent of KFC, Pizza Hut and Taco Bell, fell nearly 6 percent, down $3.66 to $60.28. The company warned late Monday that 2013 profits could decline as it continues to reel from a controversy over its chicken suppliers in China.

Dell, the struggling computer giant, rose 12 cents to $13.39 after the company announced a $24.4 billion buyout deal led by founder Michael Dell that will take the company private at $13.65 a share.

Cereal maker Kellogg was up nearly 2 percent, jumping $1.05 to $59.15, after reporting fourth-quarter results. It reported a fourth-quarter loss on a pension-related charge, but its underlying earnings rose, helped partly by its recent purchase of Pringles chips.

Zynga, the maker of online games like FarmVille, jumped more than 7percent, up 20 cents to $2.76. The company will report quarterly earnings this afternoon.

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Suspected child molester left L.A. archdiocese for L.A. schools









A former priest and suspected child molester left employment with the Los Angeles archdiocese to work for the L.A. Unified School District, officials confirmed Sunday.


The former clergyman, Joseph Pina, did not work with children in his school district job, L.A. schools Supt. John Deasy said. He added that, as a result of the disclosures, Pina would no longer be employed by the nation's second-largest school system.


Over the weekend, Deasy was unable to pull together Pina's full employment history, but said the district already was looking into the matter of Pina's hiring.





"I find it troubling," he said of the disclosures about Pina. "And I also want to understand what knowledge that we had of any background problems when hiring him, and I don't yet know that."


L.A. Unified itself has come under fire in the last year for its handling of employees accused of sexual misconduct.


Pina, 66, was laid off from his full-time district job last year, but returned to work episodically to organize events. One event he may have helped organize was a ribbon-cutting Saturday for a new education facility. School district officials over the weekend, however, could not confirm that. Pina did not attend the event, and the district could not confirm payment for any help he may have provided.


Pina's name emerged in documents released by the archdiocese to comply with a court order. His case was one of many in which church officials failed to take action to protect child victims and in which first consideration was given to helping the offending priests rather than their victims, according to the documentation.


A just-released, internal 1993 psychological evaluation states that Pina "remains a serious risk for acting out." The evaluation recounts how Pina was attracted to a victim, an eighth-grade girl, when he saw her in a costume.


"She dressed as Snow White ... I had a crush on Snow White, so I started to open myself up to her," he told the psychologist. "I felt like I fell in love with her. I got sexually involved with her, but never intercourse. She was about 17 when we got involved sexually, and it continued until she was about 19."


In a report sent to a top Mahony aide, the psychologist expressed concern the abuse was never reported to authorities.


Pina's evaluation also includes a recommendation "to take appropriate measures and precautions to insure that he is not in a setting where he can victimize others." Pina continued to work as a pastor as late as March 1998.


School district officials could not verify Pina's hiring date over the weekend, but he took a job with L.A. Unified as the school system was carrying out the nation's largest school construction program. His job involved community outreach, building support for school projects, while also finding out communities' concerns and trying to address them, officials said. Such work was crucial to the program, because even though communities wanted new schools, their locations and other elements could prove controversial. Such projects frequently involved tearing down homes or businesses, environmental cleanups, and the blocking of streets and other disruptions.


"His duties were to rally community support and elicit community comments regarding schools in a neighborhood," district spokesman Tom Waldman said.


Pina's work did bring him into contact with families, frequently at public meetings organized to hear and address their concerns.


Projects that Pina worked on included a new elementary school in Porter Ranch and a high school serving the west San Fernando Valley, Waldman said. The high school, in particular, generated substantial public debate as a district team and a local charter school competed aggressively for control of the site.


The $19.5-billion building program is winding down, and, as a result, many jobs attached to it have come to an end. Pina's was among them.


The dedication he may have helped organize Saturday was for the Richard N. Slawson Southeast Occupational Center in Bell. Participants told KCET-TV, which first reported Pina's school employment, that he had assisted with community outreach on that project. The adult education and career technical education facility has 29 classrooms as well as health-career labs and child care for students. The school opened in August 2012.


Pina "was slated for some additional temporary work when the issue came to our attention last week and that work was canceled," Deasy said.


It may have been Pina who first alerted district officials that his name appeared in disclosed documents, Deasy said. Pina called a senior administrator in the facilities division. So far, no untoward issues have emerged regarding Pina's work for L.A. Unified.


howard.blume@latimes.com





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The Future of BlackBerry 10 Sales Looks Hazy






Early sales figures from abroad suggest high demand for one of BlackBerry‘s two big comeback phones… in the struggling Canadian company’s strongest market. As the U.S. market remains on standby for sales and even ads, reports from both analysts and suppliers suggest sold-out new models in the United Kingdom, the first and only place the BlackBerry Z10 is available yet. “We believe Carphone Warehouse is seeing widespread sell-outs, while O2, Vodafone, Orange and EE are seeing robust demand,” Jefferies analyst Peter Misek writes. “We estimate sell-in to be at least several hundred thousand units,” he added. It’s not that these sales aren’t deserved — the gadget reviewers loved the touchscreen Z10, for the most part, and the full-keyboard Q10 model that also works with the new BlackBerry 10 OS isn’t on sale anywhere yet. But if any place would like a touchscreen BlackBerry, it would be the UK. Because the British may not have abandoned the smartphone keyboard, but they fell out of love it with a lot more slowly than Americans did  — BlackBerry held on to 12 percent of its market share there last year, compared to the 2 percent in the U.S. Unfortunately for the company formerly known as Research in Motion, the earliest signs suggest the Z10 may not change that lack of enthusiasm in the states.


RELATED: Everything You Need to Know About BlackBerry 10






The lack of stateside BlackBerry enthusiasm starts with American wireless carriers. U.S. customers can’t even buy the Z10 until sometime in March — we’ll be the last country to get it in this initial wave. The delay stems from a Federal Communications Commission approval process that will take weeks. While that might sound like a regulatory technicality, it may also reflect a lack of excitement to get the phone out there. None of the cellphone companies have started taking pre-sale orders, and all but one failed to provide an executive quote playing up the new BlackBerry, as PC Mag’s Sascha Segan pointed out. Sprint won’t even sell the Z10, opting to push out the more traditional Q10 and its signature keyboard when that phone starts to hit carriers in April. 


RELATED: Blackberry’s New OS Met With Resounding ‘Meh’


The Z10 sales delay could work in BlackBerry’s favor in one peculiar way — it should give consumers enough time to forget about the very weird, very desperate product unveiling. Still, two months is also enough time for initial hype to wear off, as other, newer phones get more and more attention — the much anticipated Samsung Galaxy SIV will supposedly come out around March as well. To keep Americans excited, BlackBerry has spent hundreds of millions on an ad campaign in the U.S., reports The Wall Street Journal. But the company’s new Super Bowl ad, which focused on all the things the new BlackBerry can’t do, has techies baffled:


RELATED: Look How Desperate the BlackBerry 10 Unveiling Event Actually Was


RELATED: RIM Says Sorry to Customers with Free Apps


“It’s just hard to see how you can introduce a new product without covering a single feature,” wrote The Verge’s T.C. Sotteck of the new spot. Lucky for BlackBerry, the ad was a one-time Super Sunday move. Its “Keep Moving” campaign, which focuses on what the phone can do, will debut today. The 60-second preview sampled over at The Verge sounds like it does a better job selling Z10′s features. “[The ad] featured a side-scrolling view of people moving through different variations on work and play: a nod to the company’s enterprise-focused heritage,” Sottech writes.


Gadgets News Headlines – Yahoo! News





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Following Super Bowl, Beyonce announces world tour


NEW YORK (AP) — Beyonce was just warming up at the Super Bowl: The singer has announced a world tour.


"The Mrs. Carter Show World Tour" will kick off April 15 in Belgrade, Serbia. The European leg of the tour will wrap up May 29 in Stockholm, Sweden.


The tour's North American stint starts June 28 in Los Angeles and ends Aug. 3 in Brooklyn, N.Y., at the Barclays Center.


It was also announced Monday that a second wave of the tour is planned for Latin America, Australia and Asia later this year.


Beyonce was the halftime performer at Sunday night's Super Bowl, where the Baltimore Ravens defeated the San Francisco 49ers. She performed a 13-minute set that included hits "Crazy in Love," ''Single Ladies (Put a Ring on It)" and a Destiny's Child reunion.


___


Online:


http://www.beyonceonline.com/us/home


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The New Old Age Blog: Therapy Plateau No Longer Ends Coverage

Ellen Gorman, 72, a New York psychotherapist, can’t walk very far and gets around the city mainly by taxi, “which is really expensive,” she said. Twice since 2008 her physical therapy was discontinued because she wasn’t progressing. But after a knee replacement last year, she is getting physical therapy again, exercising with her therapist and building up her endurance by walking in the hallway of her Manhattan apartment building.

“Before this, I was getting weaker and weaker, and I just kept caving in,” she said.

Because of an action by Congress and a recent court settlement, Medicare probably won’t cut off Ms. Gorman’s physical therapy again should her progress level off — as long as her doctor says it is medically necessary.

Congress continued for another year a little-known process that allows exceptions to what Medicare pays for physical, occupational and speech therapy. The Medicare limits before the exceptions are $1,900 for physical and speech therapy this year, and $1,900 for occupational therapy.

In addition, the settlement of a class-action lawsuit last month now means that Medicare is prohibited from denying patients coverage for skilled nursing care, home health services or outpatient therapy because they had reached a “plateau,” and their conditions were not improving. That will allow people with Medicare who have chronic health problems and disabilities to get the therapy and other skilled care that they need for as long as they need it, if they meet other coverage criteria.

The settlement is expected to affect thousands, and possibly millions, of Medicare beneficiaries with chronic health problems like Parkinson’s or Alzheimer’s disease, stroke, multiple sclerosis and spinal cord injuries. It could also help families, as well as the overburdened Medicare budget, delay costly nursing home care by enabling seniors to live longer in their own homes.

“Under this settlement, Medicare policy will be clarified to ensure that claims from providers are reimbursed consistently and appropriately and not denied solely based on a rule-of-thumb determination that a beneficiary’s condition is not improving,” said Fabien Levy, a spokesman for the U. S. Department of Health and Human Services, which includes the Medicare program.

The lawsuit was filed by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of four Medicare patients and five national organizations, including the National Multiple Sclerosis Society, Parkinson’s Action Network and the Alzheimer’s Association. A tentative settlement had been reached in October and on Jan. 24 a federal judge in Vermont approved the deal.

For seniors getting skilled services at home under a doctor’s order, the settlement means Medicare’s home health coverage has no time limit, Margaret Murphy told lawyers attending the annual meeting of the National Academy of Elder Law Attorneys in Washington, D. C., shortly after the then-tentative settlement was announced.

The coverage “can go on for years and years, if your doctor orders it,” said Ms. Murphy, the center’s associate director, who added that patients must be homebound (though not bedbound) and need intermittent care — every couple of days or weeks – that can only be provided by a physical therapist, nurse or other trained health care professional. When physical therapy is provided as part of Medicare’s home health benefit, the therapy dollar limits may not apply.

The settlement ensures that nursing home residents will also get coverage for skilled care regardless of improvement, but does not change the duration, which is still limited to up to 100 days per “benefit period.” That begins when a patient is admitted as an inpatient to a hospital or a nursing home for skilled care and ends after 60 days without skilled care. The agreement preserves the requirement that they must also have spent at least three days as inpatients in a hospital.

Federal officials say the settlement is not a change in Medicare coverage rules, but that statement may surprise many beneficiaries and providers.

“If someone isn’t making progress, I say, ‘Listen, I’m sorry but Medicare’s not going to cover this so you can come in for a few more sessions but then I have to let you go,’ ” said Greg Babiec, a physical therapist and one of the owners of Evolve, a private therapy practice with offices in Manhattan and Brooklyn. He had not heard about the settlement.

Beneficiaries also often lose Medicare coverage for outpatient therapy because they hit the payment limit. But under the exceptions process Congress continued for another year, the health care provider can put an additional code on the claim that indicates further treatment above the $1,900 limit is medically necessary. When treatment costs reach $3,700, the provider can submit medical documentation to support a request for another exception to cover 20 more sessions. (A Medicare fact sheet provides some additional details, but has not been updated for 2013.)

In 2011, nearly five million seniors received therapy services at a cost of $5.7 billion, and about one out of every four received an exception to the then-$1,870 limit, according to the Medicare Payment Advisory Commission, an independent government agency that advises Congress.

Just a few hours before the settlement was approved, Rachel DeGolia learned that her 87-year-old father in Chicago was going to have to stop therapy because he stopped showing improvement — again.

“Every time he stops going to physical therapy, he starts to backslide in terms of his balance, his strength and his mobility,” said Ms. DeGolia, executive director of the Universal Health Care Action Network, a national advocacy group in Cleveland. His physical therapist did not know Medicare will cover therapy to prevent her father’s condition from getting worse.

Under the settlement, Medicare officials have until next January to straighten things out by notifying health care providers. Beneficiaries are not among those to be contacted, and so far the federal officials have not issued a formal statement on the settlement.

But patients don’t have to wait for their provider to get the official word, said Judith Stein, the lead attorney for the plaintiffs and executive director of the Center for Medicare Advocacy. “This isn’t a clandestine settlement,” she said.

The center’s Web site offers free “self-help” packets explaining how to challenge a denial of coverage that is based on the lack of improvement. Ms. Stein also advises beneficiaries to show a copy of the settlement — also available from the Web site — to your health care provider at your next physical therapy appointment if you are concerned about losing Medicare coverage. (If you follow this advice, let us know what happens.)

The Web site also explains how beneficiaries can request a review of their case if they received skilled nursing or therapy services in a skilled nursing facility, at home or as outpatients and were denied Medicare coverage because of a lack of progress after Jan. 18, 2011, when the lawsuit was filed.

Dean Lerner relied on the settlement last month to ensure that his brother-in-law would continue to receive Medicare physical therapy coverage.

“My brother-in-law in St. Louis suffers from Parkinson’s disease, and has for many years, and my sister is having a devil of a time helping him as his disease progresses,” said Mr. Lerner, a retired lawyer and state health official in Des Moines, who is also a Medicaid consultant.

A physical therapist teaches his brother-in-law to stand, turn and use a walker and maintain what little strength he still has. But because his condition hasn’t improved, the therapist said Medicare would not pay for additional sessions.

“But for my being an attorney, the outcome may well have been very different, and that shouldn’t be,” he said. “Why should you have to fight?”

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Senate Republicans vow to block consumer bureau chief's nomination









WASHINGTON -- Nearly all Senate Republicans have pledged to block the confirmation of Richard Cordray to head the Consumer Financial Protection Bureau, adding to the uncertainty about the agency's leadership after a recent court ruling threatening his recess appointment to the position.


"Far too much power is vested in the sole CFPB director without any meaningful checks and balances," the senators wrote to President Obama on Friday.


The letter was signed by Minority Leader Mitch McConnell (R-Ky.) and 42 of his GOP colleagues -- enough to filibuster a vote on Cordray's nomination.





Obama last month renominated Cordray, who has been serving as director since the recess appointment in early 2012.


The senators demanded changes to the bureau's structure before they would allow a vote on Cordray or any nominee to be its director.


They want the single director position to be replaced by a bipartisan board similar to those that run most other government agencies. The senators also want the bureau's funding to be part of the congressional appropriations process instead of flowing directly from the Federal Reserve.


And they want to make it easier for other banking regulators to block actions by the consumer bureau.


The demands are the same as those made by Senate Republicans in 2011 when Obama was looking to appoint the first director of the bureau, which was the centerpiece of the 2010 overhaul of financial regulations.


Because of Republican opposition, Obama used a recess appointment to install Cordray in January 2012. On the same day, Obama also made three recess appointments to the National Labor Relations Board.


The Senate was holding short, pro forma sessions during its holiday break. Obama argued that the Senate was effectively recessed, allowing him to temporarily fill vacancies. Cordray's recess appointment expires at the end of this year.


Last month, a federal appeals court ruled that Obama's NLRB appointments violated the Constitution because the Senate had not formally adjourned. The lawsuit challenging the appointments did not mention Cordray, but it is widely believed to affect his appointment.


The Obama administration is almost certain to appeal the decision to the Supreme Court.


Sen. Jerry Moran (R-Kan.), has introduced legislation to enact the changes to the bureau's structure that he and his colleagues want.


"Allowing a single unelected official to define their own jurisdiction and regulate vast segments of our economy without accountability or restraint is irresponsible regardless of political party," Moran said.


There are likely enough votes in the Democratic-controlled Senate to confirm Cordray's nomination, which only requires a majority. But there is enough Republican opposition to prevent a vote. It takes 60 senators to overcome a filibuster.


"The American people need Richard to keep standing up for them," Obama said in renominating Cordray on Jan. 24. "And there's absolutely no excuse for the Senate to wait any longer to confirm him."


Senate Banking Committee Chairman Tim Johnson (D-S.D.) said Republicans were playing politics with an important appointment.


"For more than a year, Director Cordray has been leading the Consumer Financial Protection Bureau, and under his leadership the CFPB has been widely praised for its thoughtful and balanced rule-makings and enforcement actions," Johnson said in a statement.


"The market needs certainty, and blocking Richard Cordray's nomination is a disservice to consumers and industry alike," Johnson said.


ALSO:


Court rules Obama's recess picks are illegal


Mary Jo White won't be intimidated as SEC chief, Obama says


Obama bypassing Senate to appoint Richard Cordray consumer chief





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L.A. County removing metal detectors from some hospital facilities









It was typically chaotic in the emergency room at Los Angeles County/USC Medical Center that February day in 1993. Richard May was treating patients in the triage area when a disgruntled man started ranting about the long wait. Then, without warning, the man pulled a gun and started shooting, hitting May in the head, chest and arm and seriously wounding two other doctors.


The carnage, coming after a series of violent incidents, prompted a wave of safety improvements, including the installation of metal detectors at hospital entrances, bulletproof enclosures in emergency rooms and the addition of more security guards.


Now, 20 years after the attack, officials want the metal detectors removed from parts of county hospitals to make them more welcoming to patients in the newly competitive marketplace being created by the Obama administration's healthcare overhaul. The machines in the emergency rooms will remain, but the others are to be taken out by summer. The proposal comes at a time when high-profile shootings have put the nation on edge and prompted emotionally charged debates about the availability of assault weapons and the presence of armed officers in schools.





The county's director of Health Services, Mitchell Katz, says metal detectors stigmatize poor patients and visitors and give the impression that the county facilities are dangerous. Security is paramount, but metal detectors aren't the best way to ensure that, he argues. Most other urban hospitals in L.A. County do not have the machines, relying on guards to provide safety, he said.


"It is a different moment to look and ask ourselves, 'What is the best way to do security?'" Katz said.


But the proposed changes have patients, nurses and doctors worried and are drawing opposition from law enforcement and union members.


May, 67, who suffers from post-traumatic stress disorder, is among those asking administrators to reconsider. He works part-time at the county's Hudson Comprehensive Health Center south of downtown, where he says the metal detector gives patients and staff peace of mind.


"I feel angry, frustrated and resentful," he said of the proposal to remove the devices. "We wouldn't have been shot if they were there then."


Paul Kaszubowski, 64, another doctor shot in 1993, said the bullet shattered his arm and grazed his head. He still suffers problems with his arm and has occasional flashbacks. Removing the metal detectors doesn't make sense, he said. Providing compassionate and high-quality care is the best way to attract and retain patients, he said.


Beginning next year, uninsured patients will be eligible for Medi-Cal coverage and have more options outside of the county's healthcare system. That is driving safety-net hospitals to improve their customer service so they are no longer the providers of last resort.


But that push is running headlong into a record of violence at urban medical facilities, where healthcare workers are often the victims of assault. Hospitals are intrinsically high-risk places, and metal detectors can help prevent violent attacks, said Jane Lipscomb, a University of Maryland professor who has studied hospital safety.


The county's largest public hospital workers' union is trying to stop the removal of the scanners and sent a letter to Katz saying the action is a "huge decision" that could put patients and staff in harm's way.


Longtime County/USC nurse Sabrina Griffin, a union representative, vividly remembers the 1993 shooting and fears something similar could happen again if the screening equipment is removed. She particularly worries about gang retaliation spilling into the hospital after a shooting or stabbing.


"I just feel safer having the scanners," she said.


Sheriff's Department Capt. Chuck Stringham, who oversees security at the county healthcare facilities, said late Friday that the department is opposed to the wholesale removal of the metal detectors without another plan for weapons screening.


County hospitals mirror the crime and violence of surrounding communities, he said, and the scanners serve as the first line of defense — finding guns, knives, box cutters and other weapons.


The county removed the metal detector equipment from the outpatient building at County/USC in July, and no violent incidents have been reported there since doing so, according to the Sheriff's Department. By June 30, the county plans to remove 26 more machines from County/USC, Harbor-UCLA Medical Center, Olive View Medical Center and the Martin Luther King and Hudson centers.


Patients and visitors entering another County/USC facility last week emptied their pockets of cellphones, keys and wallets before stepping through the scanners. In a period of a few hours, guards confiscated two pocketknives.


Walter Johnson, 59, who had an eye appointment, said removing the machines is "crazy." "How would they know if anyone is coming in with a gun, or an AK-47, or a knife?" he said. "The minute you take these out, you are gonna give some idiot some excuse to do something."


Michelle Mendez, an ER nurse, said metal detectors are needed in the emergency room but not elsewhere. "I think [visitors] would feel more comfortable when visiting their loved ones, knowing we aren't so concerned about violence and crime and weapons," she said.


Tammy Duong, a medical resident in the psychiatric unit, said the machines can be intimidating. But she worries about what might happen without them.


"Just because it is a hospital," she said, "doesn't mean violence can't spill over."


anna.gorman@latimes.com





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Can a Robot Clean Your Windows Better Than You Can?






Home robots like the Roomba and the Neato have legions of fans, myself included. They truly make vacuuming a snap. So could a window-washing robot that costs $ 300 do the same – and is it worth the money? The Winbot is coming to market this spring; to find out if it’s worth your hard-earned dollars, I test it out.


How It Works
The Winbot uses suction (in fact, it sounds like a powerful vacuum) to hold itself onto your windows. You plug it in and give it a base charge, but in addition, you run it plugged in to a socket. The internal battery is only there in case the power goes out – so it won’t lose suction while an alarm alerts you to the power outage.






There is a cleaning pad on the front, a squeegee in the center, and a drying pad on the back. You spray cleaning fluid on the front pad; they provide their own brand and strongly advise it over traditional cleaning fluids, which may have ammonia and which they say could damage the Winbot. Once the pads are dirty, you remove them (they affix with Velcro) and toss them in the washing machine.


The Winbot glides along the window, and when it bumps the frame, it turns itself around and edges up the window to eventually go back in the other direction, systematically cleaning in a series of horizontal lines. The higher end model also works on frameless surfaces like mirrors.


[Related: Stupid or Genius: Ten Craziest New Gadgets]


But How Well Does It Clean?
The Winbot did a good job cleaning the inside of my living room windows. It easily handled my kids fingerprints, spots, and general dirt. Outside it did an equally good job, but I did notice later that on a 5’ X 6’ window, it left two horizontal streaks the width of the window. The company says we probably had too much cleaning solution on the pad. They also suggested using the remote control to go back over any streaks and manually clear them. Overall, my hard-to-reach windows were cleaner than they’ve been in years.9673b  uyl ep104 embed Can a Robot Clean Your Windows Better Than You Can?


For really serious dirty build-up on exterior windows, the company suggests giving a preliminary spray down or wash with a rag, letting it dry and then using the Winbot; the small pads can only handle so much dirt.


Is It Worth the Money?
$ 300 gets you the base model (which we tested), and $ 400 gets one that also works on frameless windows and mirrors, and has an extra extension cord for high windows.


For ordinary interior window washing, I’m not sold. It isn’t like a robotic vacuum cleaner where you set it and forget it. You have to spray the pads, place the device on each window, and then detach it to move it to the next window. You have to wash the pads and sometimes follow behind it to get rid of a streak here or there. But for really big and hard-to-reach windows, the Winbot made a lot of sense. It did a better job than I would have done on a ladder. And if I regularly had to pay someone to reach those high windows, the Winbot would pay for itself very quickly.


[Related: Worst Ways to Clean Your TV]


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Timberlake gives Super Bowl-eve comeback concert


NEW ORLEANS (AP) — One of the most anticipated musical moments of the year so far happened in New Orleans and was connected to the Super Bowl — but it had nothing to do with Beyonce.


Instead, it was another superstar, Justin Timberlake, who had the town buzzing as he gave his first performance in nearly five years — a sizzling, hour-long concert that featured the nattily dressed entertainer with a more than 10-piece band and guest appearances by Timbaland and Jay-Z, who's prominently featured on Timberlake's comeback single, "Suit and Tie."


Timberlake hadn't released new music in years, preferring to concentrate on a blossoming acting career that included star turns in movies such as "Friends With Benefits" and the Oscar-nominated "The Social Network."


But when Timberlake took to the stage on Saturday night for DirecTV's Super Bowl-eve bash, it seemed as if he had never left. Timberlake, dressed in a black tux, betrayed no nerves or rust as he appeared with the backing band dubbed "JT & the Tennessee Kids" and dove into the night's first song, "Like I Love You," his signature falsetto in top form.


There was a bit of irony the setting of Timberlake's comeback concert because he is identified with the most infamous Super Bowl performance of them all, 2004's wardrobe malfunction featuring Janet Jackson. He spoke a little about Sunday's big game as he baited Baltimore Ravens fans against San Francisco 49ers followers.


Other than that, had little else to say, letting his music do all the talking. For the most part, his musical statement consisted a rundown of his greatest hits, including "Senorita," ''Cry Me A River," ''Summer Love" and "My Love" (the latter of which included a verse of Jay-Z and Kanye's "... In Paris").


But he did offer at least two new songs that seemed as if they could have been inspired by his recent marriage to Jessica Biel. Both were slow jams: One was called "Push Your Love Girl," while another had the refrain: "I'm in love with that girl ... don't be mad at me."


Timberlake also drew from others' music, performing a cover of INXS' "What You Need" and delivering a spot-on rendition of the Jacksons' "Shake Your Body Down To the Ground," complete with the Jacksons' trademark choreography.


The standing-room crowd — which included Paul McCartney, Sofia Vergara, John Legend and New England Patriots owner Bob Kraft — was dancing most of the night, and by the time Jay-Z came on to deliver his verse for "Suit and Tie," the party was in full throttle.


Timberlake ended the evening with "SexyBack," bringing his sexy —and more importantly his music — back for the public to enjoy.


Timberlake's comeback will reach an even larger audience next Sunday with his performance on the Grammys. His third album, "The 20/20 Experience," is out next month.


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Online:


http//www.justintimberlake.com


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Follow Nekesa Mumbi Moody on Twitter at http://www.twitter.com


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