Porn stars exposed.(HIGH TECH PROBLEMS IN THE PRESS)(Brief article) - Risk Management

In March, the multi-billion-dollar pornography industry may have been the victim of a major data breach that underscores the concerns that many have regarding the health care industry's transition to digital medical records. Though the source remains uncertain, PornWikiLeaks.com posted the names, stage names and birth dates of more than 12,000 current and former adult video performers, some of whom also had the results of their HIV tests revealed. Due to the nature of the information, many have suspected that the breach occurred at AIM Medical Center, a Sherman Oaks, California, health clinic where the majority of industry workers are tested for STDs. For the clinic, which launched an investigation into the matter, this could be a serious violation of the Health Insurance Portability and Accountability Act, not to mention a reputational black eye from which it may not be able to recover. Regardless of where the info came from, the episode shows that health records are not immune to data breaches. And that is what has so many privacy advocates worried about a future in which all patient records-not just those of porn stars--are stored digitally instead of in file cabinets.

COUNTY TO PROPOSE RIVER BEAUTIFICATION.(News) - Daily News (Los Angeles, CA)

Byline: Eric Wahlgren Daily News Staff Writer

One day, cyclists may be able to hop on their bikes at the Los Angeles River's source in Canoga Park and pedal alongside the wash for 51 miles before it flows into the Pacific Ocean in Long Beach.

The riverside bike path, which is the centerpiece of the Los Angeles River Master Plan approved by the County Board of Supervisors in June, may take half a century to complete.

But flush with millions in public money raised by recent ballot measures, Los Angeles and other county cities are gearing up to beautify the mostly concrete-lined waterway, making it a recreational destination.

``We want the river to serve as a corridor that would unite communities,'' said Cynthia D'Agosta, a landscape architect, and one of the people behind a cooperative effort to implement the county's master plan. ``We have lost a river here, basically. It is encased, channelized and doesn't serve the community in the same cultural way that a river does in other communities. People will be able to engage in all sorts of recreational activities, including walking and biking.''

The Los Angeles River Master Plan presentation is scheduled for 6:30 p.m. today in the main conference room of the Sherman Oaks Hospital and Health Center, 4929 Van Nuys Blvd.

D'Agosta is among Los Angeles River advocates who will discuss possibilities for enhancements along the San Fernando Valley stretches of the waterway.

City Councilman Michael Feuer lobbied for $10 million to be set aside for river improvements in Proposition K, a ballot measure passed by voters in November for $771 in city parks and recreation projects.

Some of the proposed river enhancements in the Valley include planting native vegetation along the waterway, connecting a small stretch of bike path in Griffith Park to the Sepulveda Basin and improving flood-control sites.

``In (Feuer's) district, there is not the opportunity to acquire a lot of additional land,'' said Sharon Mayer, Feuer's chief field deputy. ``This river area is already public land. It would be an opportunity to enjoy a different atmosphere than exists now.''

Although enhancements are proposed for Sherman Oaks and Studio City, the river passes through many Valley communities where work might also be done, including Winnetka, Reseda, Encino and Toluca Lake.

Proposition A, a county parks improvement measure, also passed in November, making an additional $12 million available for river enhancements in county areas.

The Los Angeles River Master Plan is perhaps the first attempt among various cities and agencies to come up with a universal guideline for how to make the best use of the waterway, which begins at the confluence of Bell Creek and Arroyo Calabasas in Canoga Park.

The county Public Works Department, the Santa Monica Mountains Conservancy, and the cities of Los Angeles, Bell Gardens and Long Beach are among agencies and communities involved in the long-term effort.

In memoriam: Hildegard E Peplau, 1909-1999 - Journal of Child and Adolescent Psychiatric Nursing

Hildegard E. Peplau, 89, one of the world's leading nurses and known to many as the 'Nurse of the Century,' died March 17,1999, at her home in Sherman Oaks, CA. Dr. Peplau is the only nurse to serve the American Nurses Association (ANA) as Executive Director and later as President. She was also elected to serve two terms on the board of the International Council of Nurses (ICN). In 1997 she received the world of nursing's highest honor, the Christiane Reimann Prize, at the ICN Quadrennial Congress. This award is given once every 4 years for outstanding national and international contributions to nursing and health care. In 1996 the American Academy of Nursing honored Peplau as a 'Living Legend,' and in 1998 the ANA inducted her into the ANA Hall of Fame.

Dr. Peplau is universally regarded as the mother of psychiatric nursing. Her theoretical and clinical work led to the development of the distinct specialty field of psychiatric nursing. Dr. Peplau's seminal book, Interpersonal Relations in Nursing (1952), was completed in 1948. Publication was delayed for 4 years because at that time it was considered too revolutionary for a nurse to publish a book without a physician co-author. Peplau's book has been widely credited with transforming nursing from a group of skilled workers to a fully fledged profession. Since the publication of Peplau's work, interpersonal process has been universally integrated into nursing education and nursing practices throughout the United States and abroad. It has been argued that Dr. Peplau's life and work produced the greatest changes in nursing practice since Florence Nightingale.

Dr. Peplau was awarded honorary doctoral degrees from universities including Alfred, Duke, Indiana, Ohio State, Rutgers, and the University of Ulster in Ireland. She was named one of '50 Great Americans' in Who's Who in 1995 by Marquis. She was an elected fellow of the American Academy of Nurses and of Sigma Theta Tau, the national nursing honorary society.

Hilda Peplau was born September 1, 1909, in Reading, PA, the second daughter of immigrants Gustav and Ottylie Peplau, and one of six children. As a child, she witnessed the devastating flu epidemic of 1918, a personal experience that greatly influenced her understanding of the impact of illness and death on families.

Peplau began her career in nursing in 1931 as a graduate of the Pottstown, PA, School of Nursing. She then worked as a staff nurse in Pennsylvania and New York City. A summer position as nurse for the New York University summer camp led to a recommendation for Peplau to become the school nurse at Bennington College in Vermont. There she earned a bachelor's degree in interpersonal psychology in 1943. At Bennington and through field experiences at Chestnut Lodge, a private psychiatric facility, she studied psychological issues with Erich Fromm, Frieda FrommReichmann, and Harry Stack Sullivan. Peplau's life-long work was largely focused on extending Sullivan's interpersonal theory for use in nursing practice.

From 1943 to 1945 she served in the Army Nurse Corps and was assigned to the 312th Field Station Hospital in England, where the American School of Military Psychiatry was located. Here she met and worked with all the leading figures in British and American psychiatry. After the war, Peplau was at the table with many of these same men as they worked to reshape the mental health system in the United States through the passage of the National Mental Health Act of 1946.

Peplau held master's and doctoral degrees from Teachers College, Columbia University. She was also certified in psychoanalysis at the William Alanson White Institute of New York City. In the early 1950s, Peplau developed and taught the first classes for graduate psychiatric nursing students at Teachers College. Dr. Peplau was a member of the faculty of the College of Nursing at Rutgers University from 1954 to 1974. At Rutgers, Peplau created the first graduatelevel program for the preparation of clinical specialists in psychiatric nursing. She was a prolific writer and was equally well known for her presentations, speeches, and clinical training workshops. Peplau vigorously advocated that nurses should become further educated so they could provide truly therapeutic care to patients rather than the custodial care that was prevalent in the mental hospitals of that era. During the 1950s and 1960s, she conducted summer workshops for nurses throughout the United States, mostly in state psychiatric hospitals. In these seminars, she taught interpersonal concepts and interviewing techniques, as well as individual, family, and group therapy. Peplau was an advisor to the World Health Organization and was a visiting professor at universities in Africa, Latin America, Belgium, and throughout the United States. A strong advocate for graduate education and research in nursing, she served as a consultant to the U.S. Surgeon General, the U.S. Air Force, and the National Institutes of Mental Health. She participated in many government policy-making groups. After her retirement from Rutgers, she served as a visiting professor at the University of Leuven in Belgium in 1975 and 1976. There she helped establish the first graduate nursing program in Europe.

Peplau once said that the test of a good idea was whether it had staying power. Her original book from 1952 has been translated into nine languages and in 1989 was reissued in Great Britain by Macmillan. In 1989 Springer published a volume of selected works of Peplau from previously unpublished papers. Peplau's ideas have, indeed, stood the test of time. The archives of her work and life are housed at the Schlesinger Library at Harvard University.

JOEL WEISMAN - The Independent (London, England)

Physician who alerted the world to the Aids virus

Dr Joel D Weisman, a brilliant and compassionate generalpractitioner and pioneer in HIV/Aids care and research, died at hishome in Los Angeles, California on 18 July. He was 66. He had beensuffering from heart disease and was being looked after by hispartner of 17 years, the singer and actor Bill Hutton.

In 1978 in North Hollywood, Weisman had been noticing some vexingsymptoms in some patients - skin cancers that would normally afflictan older age group, and some patients with swollen lymph glands,often an indication of lymphoma, a cancer that originates in theimmune system. In 1980, after Weisman expanded his practice inSherman Oaks with Dr Eugene Rogolsky, alarm bells started to ringwhen he observed that several gay male patients of his had similarsymptoms of pneumonia, as well as serious ailments ranging frompersistent diarrhoea and fungal infections to low white blood cellcounts.

In 1981 Weisman was put in touch with the immunologist Dr MichaelGottlieb at UCLA Medical Centre, who also had a patient withsimilarly unusual symptoms. The two doctors collated theirobservations and came to the conclusion that something not seenbefore was happening. They wrote the seminal report that signalledthe official start of the Aids epidemic and which sounded an alarmwhich was heard around the world. Aids deaths in the US roseexponentially, from 618 in 1982 to almost 90,000 by the end of thedecade. By 2002, the death toll, still climbing, passed 500,000.

'I had a feeling that what this represented was the tip of theiceberg,' Weisman told the Washington Post two decades later in2001. 'My sense was that these people were sick and we had a lot ofpeople that were potentially right behind them.'

On top of these early referral cases, the journalist and authorRandy Shilts noted in his Aids chronicle And the Band Played On(1987), 'another 20 men had appeared at Weisman's office that yearwith strange abnormalities of their lymph nodes' - the verycondition that had triggered the spiral of ailments besettingWeisman and Rogolsky's original, very sick patients.

Weisman pressed for services for people with HIV and Aids asfounding chairman of Aids Project Los Angeles in 1983. He advocatedfor research dollars as an original board member of amfAR, which wasformed in 1985, and served as its chairman from 1988 to 1992.

Described by Shilts as 'the dean of Southern California gaydoctors', Weisman was loved and respected by patients and colleaguesalike. He continued to see patients, building his partnership withRogolsky at what is now Sherman Oaks Hospital and Health Center, oneof the largest private practices in Southern California for thetreatment of Aids and HIV.

As soon as he became convinced that Aids was sexuallytransmitted, Weisman began to urge patients to change their sexualbehaviour. But during the early years of the crisis, his warningswere too often ignored. 'I couldn't even make some of my friendslisten, and they're dead now and that's disconcerting,' he told TheNew York Times in 1988. Among the casualties was his partner of 10years, Timothy Bogue, who died in 1991.

Battling the epidemic on the front lines 'made me look at issuesof death and dying in a very different way,' he said in 1988. 'Whatmakes somebody a good physician in this situation? Is it justwinning? Keeping people alive? If I looked at every death as adefeat, I would not be able to continue.' In 1997, he stepped awayfrom the front line, just as new drug cocktails were extending thelives of Aids patients.

In 2000, he moved to upstate New York, where he ran an inn withHutton. They returned to Southern California five years ago where heremained an active ambassador for Aids Project Los Angeles untilillness overtook him this year.

My wife and I got to know Joel in 1993 when he walked into TheRedfern Gallery and bought several paintings of mine for his beachhouse in Malibu. He and Bill also made a studio visit to the EastEnd of London, when, much to my dealer's annoyance, I refused topart with a painting they liked which I didn't think was goodenough.

This episode cemented a bond between us and we were asked to stayin their beautiful modernist house in Beverly Hills. For a youngishartist it was an intoxicating experience. Joel became like an uncleand over the next 15 years his passion for the theatre meant that hewould come and visit and regularly take us and our children to playsand musicals in the West End, some of which he had part funded.

In addition to Bill Hutton, Joel Weisman is survived by hisbrother Mark, his daughter Stacey Weisman-Bogue Foster, hisgranddaughter, and two nieces. He was a wonderful man.

Physicians Join With National Healthcare Leaders to Explore New Ways to Enhance Geriatric Care in America. - Cancer Weekly

More than 200 physicians and nurses gathered with national healthcare leaders in Long Beach this weekend to address a myriad of issues surrounding geriatric care in America. Topics covered ranged from such clinical areas as diabetes, dementia and prostate cancer to more process-oriented issues such as how to best transition patients through various levels of care to assure that they receive the right care at the right time in the right setting (see also Managed Care).

'Our goal through this symposium and others like it is to improve the healthcare process by providing practical, hands-on knowledge that attendees can take back to their practice and begin implementing to make a difference,' said Dan Osterweil, M.D., professor of medicine at UCLA, director of the Specialized Ambulatory Evaluation Center in Sherman Oaks, a consulting geriatrician at SCAN Health Plan, and one of the planners of the conference. 'What we try to share is another way to provide care to older individuals that is efficient, is evidence-based, and in many cases has been proven to improve quality.'

Sponsored by the not-for-profit SCAN Health Plan, this fifth annual geriatric symposium has been growing in prestige and popularity as evidenced both by its increasing attendance and by the nationally known keynote speakers at this year's event. These included, among others: John Morley, M.D., editor-in-chief of Journal of American Medical Directors Association; Betty Ferrell, Ph.D., from The City of Hope; and Joseph G. Ouslander from the Institute of Successful Aging in Boca Raton, Florida, and executive editor of the Journal of the American Geriatric Society.

'In assembling our agenda and speakers, we look for gaps that exist in continuing medical education and try to fill those with information that can directly impact performance,' says Dr. Osterweil. 'For example, it is unique for a symposium like ours to cover the management of dementia and depression, but by focusing on this we believe physicians can improve care of other co-morbidities associated with dementia and thus improve a patient's quality of life.'

This year the conference also included a special hospitalist track in recognition of hospital-based medicine as the fastest-growing specialty in healthcare. There was also a focus on discharge planning and care coordination post-hospitalization. 'It is important that we take a holistic approach and look for new solutions if we are to care for a society where in two decades one of every five American's will be 65 or older,' Dr. Osterweil said.

As a health plan dedicated exclusively to seniors and others on Medicare, SCAN's sponsorship of the symposium is part of its ongoing commitment to better understand the aging process and advocate on behalf of the needs of seniors. Earlier this year, SCAN joined with the UCLA Academic Geriatric Resource Center and the California Geriatric Education Center to sponsor the seventh annual Leadership and Management in Geriatrics conference.

For more than 30 years, SCAN Health Plan has been focusing on the unique needs of people with Medicare and today is the fourth-largest nonprofit Medicare Advantage Plan in the United States. The company currently serves 110,000 members in Los Angeles, Orange, Riverside, San Bernardino, San Diego, Ventura and Kern counties. In Arizona, SCAN offers a Medicare Advantage Plan in Maricopa County and provides long-term care services to individuals in that county who are enrolled in the state's long-term care system. Further information may be obtained at scanhealthplan.com.

Keywords: Aging, Central Nervous System Disease, Dementia, Diabetes, Managed Care, Oncology, Prostate Cancer, Prostatic Neoplasms, SCAN Health Plan.

Relief aid affects national debt - San Bernardino County Sun (San Bernardino, CA)

WASHINGTON The federal deficit may have been the last thing onCalifornia congressional leaders' minds Friday as lawmakers approved$10.5 billion in Hurricane Katrina relief aid, but analysts say thenewest burden on the national debt shows a federal unwillingness tobudget for major disasters.

'Obviously, it's going to cost a lot of money. My guess is that itwill add tens of billions of dollars to the budget, and since thereis no extra money, it's going to add to the deficit,' said RobertBixby, executive director of the Concord Coalition, a D.C.-basedgroup that advocates for the elimination of the national debt.

Members of Congress, Bixby said, 'pretend that emergencies likethis are not going to happen when they make the budget.'

President Bush has vowed the money approved Friday for HurricaneKatrina relief is just a down payment and that more will follow foremergency efforts and rebuilding.

'In terms of dollars and cents, we know it's going to be veryexpensive in terms of the federal share,' said House AppropriationsChairman Jerry Lewis, R-Redlands.

He noted that Congress spent a total of $14 billion for relief forthe four previous hurricanes that have hit the United States.

'This one, all by itself, will be much larger than that, but Idon't know yet what that means,' he said.

Regardless, lawmakers said that with the federal governmentalready spending about $330 billion more than it has, any emergencyfunds will add to the debt but it's a moral imperative to do so.

'We will spend what we have to spend,' Rep. Adam Schiff, D-Pasadena, said. But, he added, 'our overall budget picture is veryproblematic. We have deficits as far as the eye can see.'

'We're generous with our children's money rather than our own,'said Rep. Brad Sherman, D-Sherman Oaks.

Congress should bring back Clinton-era tax policies to reduce thedeficit, he said.

'But that's off the mark. Right now the focus has got to be doingeverything we can do to help the people of Louisiana andMississippi,' Sherman said.

Bixby said Congress and the White House do a disservice to thecountry's financial health when they unveil budgets that fail toinclude money everyone knows must be spent: funding for Iraq, forexample, or for long-predicted disasters.

'It's a way of making your numbers look good, and the presidentcan go out and say, 'We're cutting the deficit,'' he said, addingthat while few predicted the enormity of Hurricane Katrina, Congressshould have been prepared for a major disaster-related budgetary blowand needs to get ready for the next one.

BUDGET DEFICIT YET ANOTHER STORM VICTIM - Daily News (Los Angeles, CA)

WASHINGTON - The federal deficit may have been the last thing onCalifornia congressional leaders' minds Friday as lawmakers approved$10.5 billion in Hurricane Katrina relief aid, but analysts say thenewest burden on the national debt shows a federal unwillingness tobudget for major disasters.

'Obviously it's going to cost a lot of money. My guess is that itwill add tens of billions of dollars to the budget, and since thereis no extra money, it's going to add to the deficit,' said RobertBixby, executive director of the Concord Coalition, a D.C.-basedgroup that advocates for the elimination of the national debt.

Members of Congress, Bixby said, 'pretend that emergencies likethis are not going to happen when they make the budget.'

President Bush has vowed that the money approved Friday forHurricane Katrina relief is just a down payment, and that more willfollow for emergency efforts and rebuilding.

'In terms of dollars and cents, we know it's going to be veryexpensive in terms of the federal share,' said House AppropriationsChairman Rep. Jerry Lewis, R-Redlands.

He noted that Congress spent a total of $14 billion for relieffor the four previous hurricanes that have hit the United States.'This one, all by itself, will be much larger than that, but I don'tknow yet what that means,' he said.

Regardless, lawmakers said that with the federal governmentalready spending about $330 billion more than it has, any emergencyfunds will add to the debt - but it's a moral imperative to do so.

'We will spend what we have to spend,' Rep. Adam Schiff, D-Pasadena, said. But, he added, 'our overall budget picture is veryproblematic. We have deficits as far as the eye can see.'

'We're generous with our children's money rather than our own,'added Rep. Brad Sherman, D-Sherman Oaks, who said Congress shouldbring back Clinton-era tax policies to reduce the deficit.

'But that's off the mark. Right now the focus has got to be doingeverything we can do to help the people of Louisiana andMississippi,' Sherman said.

Bixby said Congress and the White House do a disservice to thecountry's financial health when they unveil budgets that fail toinclude money everyone knows must be spent: funding for Iraq, forexample, or for long-predicted disasters.

'It's a way of making your numbers look good, and the presidentcan go out and say, 'We're cutting the deficit,'' he said, addingthat while few predicted the enormity of Hurricane Katrina, Congressshould have been prepared for a major disaster-related budgetaryblow and needs to get ready for the next one.

'It's kind of like saying, could New Orleans have been betterprepared? Well, could the federal budget have been better prepared?'

Lisa Friedman, (202) 662-8731

BUDGET DEFICIT YET ANOTHER STORM VICTIM.(News) - Daily News (Los Angeles, CA)

Byline: Lisa Friedman Washington Bureau

WASHINGTON - The federal deficit may have been the last thing on California congressional leaders' minds Friday as lawmakers approved $10.5 billion in Hurricane Katrina relief aid, but analysts say the newest burden on the national debt shows a federal unwillingness to budget for major disasters.

``Obviously it's going to cost a lot of money. My guess is that it will add tens of billions of dollars to the budget, and since there is no extra money, it's going to add to the deficit,'' said Robert Bixby, executive director of the Concord Coalition, a D.C.-based group that advocates for the elimination of the national debt.

Members of Congress, Bixby said, ``pretend that emergencies like this are not going to happen when they make the budget.''

President Bush has vowed that the money approved Friday for Hurricane Katrina relief is just a down payment, and that more will follow for emergency efforts and rebuilding.

``In terms of dollars and cents, we know it's going to be very expensive in terms of the federal share,'' said House Appropriations Chairman Rep. Jerry Lewis, R-Redlands.

He noted that Congress spent a total of $14 billion for relief for the four previous hurricanes that have hit the United States. ``This one, all by itself, will be much larger than that, but I don't know yet what that means,'' he said.

Regardless, lawmakers said that with the federal government already spending about $330 billion more than it has, any emergency funds will add to the debt - but it's a moral imperative to do so.

``We will spend what we have to spend,'' Rep. Adam Schiff, D-Pasadena, said. But, he added, ``our overall budget picture is very problematic. We have deficits as far as the eye can see.''

``We're generous with our children's money rather than our own,'' added Rep. Brad Sherman, D-Sherman Oaks, who said Congress should bring back Clinton-era tax policies to reduce the deficit.

``But that's off the mark. Right now the focus has got to be doing everything we can do to help the people of Louisiana and Mississippi,'' Sherman said.

Bixby said Congress and the White House do a disservice to the country's financial health when they unveil budgets that fail to include money everyone knows must be spent: funding for Iraq, for example, or for long-predicted disasters.

``It's a way of making your numbers look good, and the president can go out and say, 'We're cutting the deficit,''' he said, adding that while few predicted the enormity of Hurricane Katrina, Congress should have been prepared for a major disaster-related budgetary blow and needs to get ready for the next one.

``It's kind of like saying, could New Orleans have been better prepared? Well, could the federal budget have been better prepared?''

Lisa Friedman, (202) 662-8731

Katrina hits budget deficit, too - Press-Telegram

WASHINGTON The federal deficit may have been the last thing onCalifornia congressional leaders' minds Friday as lawmakers approved$10.5 billion in Hurricane Katrina relief aid, but analysts say thenewest burden on the national debt shows a federal unwillingness tobudget for major disasters.

'Obviously it's going to cost a lot of money. My guess is that itwill add tens of billions of dollars to the budget, and since thereis no extra money, it's going to add to the deficit,' said RobertBixby, executive director of the Concord Coalition, a D.C.-basedgroup that advocates for the elimination of the national debt.

Members of Congress, Bixby said, 'pretend that emergencies likethis are not going to happen when they make the budget.'

President Bush has vowed that the money approved Friday forHurricane Katrina relief is just a down payment, and that more willfollow for emergency efforts and rebuilding.

'In terms of dollars and cents, we know it's going to be veryexpensive in terms of the federal share,' House AppropriationsChairman Rep. Jerry Lewis, R- Redlands, said.

He noted that Congress spent a total of $14 billion for relief forthe four previous hurricanes that have hit the United States. 'Thisone, all by itself, will be much larger than that, but I don't knowyet what that means,' he said.

Regardless, lawmakers said that with the federal governmentalready spending about $330 billion more than it has, any emergencyfunds will add to the debt but it's a moral imperative to do so.

'We will spend what we have to spend,' Rep. Adam Schiff, D-Pasadena, said. But, he added, 'our overall budget picture is veryproblematic. We have deficits as far as the eye can see.'

'We're generous with our children's money rather than our own,'added Rep. Brad Sherman, D-Sherman Oaks, who said Congress shouldbring back Clinton- era tax policies to reduce the deficit.

'But that's off the mark. Right now the focus has got to be doingeverything we can do to help the people of Louisiana andMississippi,' Sherman said.

Bixby said Congress and the White House do a disservice to thecountry's financial health when they unveil budgets that fail toinclude money everyone knows must be spent: funding for Iraq, forexample, or for long-predicted disasters.

'It's a way of making your numbers look good, and the presidentcan go out and say, 'We're cutting the deficit,' he said, adding thatwhile few predicted the enormity of Hurricane Katrina, Congressshould have been prepared for a major disaster-related budgetary blowand needs to get ready for the next one.

BABY BOOMERS TRY TO USE THEIR HEADS.(News) - Daily News (Los Angeles, CA)

Byline: DANA BARTHOLOMEW Staff Writer

Feng shui master Judy Famiglietti did yoga, practiced Pilates, sought Reiki massage and meditated 15 minutes a day.

But the svelte baby boomer from Sherman Oaks wasn't content to be just fit and calm. Fuzzy thinking meant she needed mental workouts, too.

``I used to forget lists at the grocery store,'' Famiglietti said during a Brain Gym 101 session conducted by Barbara Schwartz at Equilibrium in Encino.

``In my family, we're really obsessed with being fit, mentally and physically. Perfection is high on the list ... and I have sharpened my mental abilities.''

It's no longer enough for middle-age Angelenos to tone their bodies, Botox their brows and toss out the trans fats in their quest for vitality.

Across the nation, those born in the 20 years after World War II are popularizing everything from ``brain-healthy'' foods to virtual brain gyms in an effort to retain their cognitive edge and stave off dementia.

``We're baby boomers, and we don't want it to happen to us,'' said Sheryle Bolton, chief executive officer of Quixit Inc., of Oakland, whose HappyNeuron.com launched last fall.

``We started the fitness craze. We've learned a lot about nutrition. And now it's time to learn about mental exercise.''

Nintendo's Brain Age video game, for instance, offers math-and-word challenges, while California-based Web sites such as MyBrainTrainer.com and HappyNeuron.com supply cranial calisthenics to a generation that hatched the fitness and nutrition movements.

AARP and other 50-plus advocates offer brain health tips, while the Alzheimer's Association conducts Maintain Your Brain workshops for such corporations as Lockheed Martin and Apple Computer.

Brain health has even become the darling of health insurers.

MetLife offers a 61-page booklet called ``Love Your Brain,'' while Humana plans to offer brain fitness software to millions of graying clients.

With Americans now living longer and the first wave of the 78 million baby boomers approaching 60, many hope such noggin-builders will ward off memory problems.

``The difficult fact to face is that baby boomers are getting older at the same time,'' said Barbara Goen, spokeswoman for the Alzheimer's Association of California Southland.

``It is going to have a catastrophic effect if we don't make some progress in solving the problem of Alzheimer's disease.''

Millions affected

The degenerative brain disease affects an estimated 4.5 million Americans -- more than double the number in 1980 -- including one in 10 persons older than 65 and nearly half of those older than 85.

Research has shown that an estimated 40 percent of those 65 and older have some level of age-associated memory loss.

Without a cure, up to 16 million Americans are expected to suffer from Alzheimer's by mid-century, according to the Alzheimer's Association.

For overall brain health, AARP and health experts recommend regular exercise, staying mentally active and eating a balanced diet rich in antioxidants and omega-3 fatty acids.

To determine whether brain exercise can actually ward off flabby minds, dozens of studies are in the works. However, there already is growing evidence that it does.

Previous studies have shown that animals kept in cages full of toys had better memories and more brain cells than those housed in more mundane environments.

And research has long shown that mental exercise in people can improve test scores while crossword puzzles and reading can keep the mind sharp.

A new study suggests that brain exercise strengthens the ability of seniors to think more clearly and to perform everyday tasks needed to live independently.

Healthy seniors with only 10 hours of classes to improve their reasoning reported significantly less trouble with cooking, shopping and other routine activities.

The study, published Dec. 20 in the Journal of the American Medical Association, showed that cognitive training still brought benefits five years later.

``There is mounting evidence that cognitive exercise may protect our brains,'' said Dr. Gary W. Small, a professor of geriatric psychiatry and director of the UCLA Center on Aging and the Memory & Aging Research Center.

``We know specific exercises in certain brain functions definitely have an effect. The question is, if you do your mental aerobics, will brain exercise stave off Alzheimer's?

``There is softer evidence that it does.''

Small, whose five-week Senior Memory Training courses at UCLA Center on Aging have drawn baby boomers to teaching sites across Los Angeles, has licensed it in a half-dozen states.

He has also designed Brain Games, a handheld computer game scheduled to be released this month by Mattel.

Last year, Small led a UCLA study that found people could improve brain function and efficiency with only two weeks of memory exercises, along with healthy eating, physical fitness and stress reduction.

The study, published in the June issue of the American Journal of Geriatric Psychiatry, centered on ages 35 to 69.

``There is definitely something to this,'' Small said. ``We found that in a matter of two weeks, we cannot only improve memory performance, but improve mental efficiency as seen on brain scans.''

Entrepreneurs have pursued the boomer brain market with proven success.

In the past year, MyBrainTrainer.com has more than doubled its membership to 7,000 clients, company officials said.

``It's the Nautilus machine for the mind,'' said Bruce Friedman, the Web site's founder. ``It's the ignition for your cognition.

``I definitely believe that more and more boomers are going to be taking these kind of preventative steps to ward off, or attempt to ward off, dementia.''

Rod Evans, a 57-year-old author and philosophy professor, is an unlikely candidate for more mental stimulation.

He teaches classes at Old Dominion University in Virginia and has written 14 books, including ``The Gilded Tongue,'' a dictionary of ``meretricious words guaranteed to impress your friends.'' He rifles through flash cards daily to improve his word skills. And he plays Boggle, a Scrabble-like game for the brainy.

Keeping fit

To keep fit, he also exercises and lifts weights throughout the week.

But when Evans discovered MyBrainTrainer.com two years ago, he found himself mentally working out up to three times a day online.

``I feel energized,'' said Evans, of Norfolk, Va., whose family has no known history of dementia. ``It helps me wake up. It makes me feel good.

``I want to reduce the possibility, or at the very least, to delay senility.''

For the past 20 years, Schwartz has conducted Brain Gym sessions at her Encino home. Founded by Brain Gym International in Ventura, the technique aims to improve the mind through 26 exercises.

During a recent session, Schwartz went through a litany of exercises with Famiglietti, who once stumbled at remembering peoples' names. She signed up in August for Brain Gym sessions that cost $125 and up.

``Feel complete?,'' asked Schwartz, in a room redolent of sweet aromatherapy oils.

``Yeah, I feel much better,'' said the feng shui consultant whose 80-year-old mother can still whip the most challenging crossword and Soduku puzzles.

``I'm hoping the DNA will kick in, that the gene pool will stay on my side and that I can preserve what I have with the exercises that I'm doing.''

The New York Times News Service contributed to this report.

dana.bartholomew(at)dailynews.com

(818) 713-3730

On the Net: For more information on brain health, go to http://www.alzla.org; www.aarp.org; www.aging.ucla.edu.; www.mybraintrainer.com; www.happy-neuron.com; www.braingym.org; and www.equilibriumhealing.com.

CAPTION(S):

2 photos

Photo:

(1 -- color) Dr. Gary W. Small, a UCLA geriatric psychiatry professor, holds Brain Games, computer brain exercises he developed.

(2) Brain Gym instructor Barbara Schwartz, top, helps client Judy Famiglietti release emotional stress and sharpen the mind during a session at Schwartz's home in Encino.

NURSING HOME METHODS PROTESTED - Daily News (Los Angeles, CA)

An advocacy group for nursing home patients picketed the ShermanOaks headquarters of a statewide nursing home chain Tuesday morning,protesting what they said was inadequate treatment of its elderlyresidents.

California Advocates for Nursing Home Reform a nonprofit SanFrancisco-based group, said that between 1993 and 1994 nursing homesrun by Golden State Health Centers Inc. accrued $300,750 in finesfrom the state for various deficiencies, including neglect ofpatients.

Officials at Golden State, which runs 10 area convalescentfacilities and 15 statewide, did not dispute that fines were leviedbut said the allegations of mistreatment are misguided.

'The majority of citations occurred in two of our 15 nursinghomes which we acquired over the last three years,' said Sol Goldner,Golden State's vice president and chief financial officer, referringto facilities in San Diego and Bakersfield.

'They were troubled facilities, in bad shape, and you cannotexpect things to get better overnight,' Goldner said. 'We have putmillions of dollars into those facilities and they are now in fullcompliance with all regulations.'

Seventeen protesters circled the sidewalk in front of theVentura Boulevard office building, beating drums and chanting 'shameon Golden State' and 'high profits, lousy care.'

'The numbers don't lie,' said Kim Kelley, special projectscoordinator for the advocacy group, citing 73 citations against thechain by the state in 1993 and 1994.

'This is not acceptable,' Kelley said. 'If you look at thestatistics these people are among the worst in the state.'

Inside, company officials explained that health departmentofficials carefully monitor the quality of care at convalescenthospitals and extreme violations would result in the closing offacilities.

'The nursing home industry is the most highly regulated segmentof health care,' Goldner said. 'Every complaint is investigated.'

A Los Angeles County Health Services Department official whooversees area nursing homes under contract with the state said thatGolden State's citations are not egregious.

MENDING MATTERS OF THE HEART FOR WOMEN, CARDIAC PROBLEMS CAN BE HIDDEN OR MISDIAGNOSED.(U) - Daily News (Los Angeles, CA)

Byline: Diana McKeon Charkalis Lifestyle Editor

Lori Kupetz looks younger than her 40 years, especially when she hula-hoops in front of her Sherman Oaks home with daughters Sophie, 9, and Zoe, 7. No one would ever guess that earlier this year, this thin vegetarian who doesn't smoke underwent a triple bypass.

``I just don't fit the bill of someone who would have heart surgery,'' says Kupetz, who is now out to spread the word about cardiovascular disease from a female perspective. ``But heart disease kills women more than anything else. It's not just a man's disease.''

And sadly, for many women, it often goes unnoticed.

``It's very tragic, but unfortunately two-thirds of women will actually die of heart disease and not know they have a problem,'' says Dr. Lisa Matzer, medical director of Glendale Adventist Medical Center's Outpatient Cardiac Services Program.

Doctors and researchers say this is partly because heart disease affects men and women differently.

``The symptoms women present are a lot different than the symptoms we typically see in men,'' says Matzer. She says the most common for women include weakness, fatigue, shortness of breath with exercise and just not feeling right.

In addition, tests that work for men aren't always as effective for women.

``Making the diagnosis of heart disease can be difficult,'' Matzer says. ``The angiogram is the gold standard for men, so we assume it's the gold standard for women. But it only works for one-third of women. We know that two-thirds of women (with heart problems) will go in and be given a clean bill of health.''

For Kupetz, too, getting the right diagnosis proved elusive.

Her story began in February 2005. One day while hiking with a friend, she found herself doubled over with chest pains. After two more similar episodes, she called her internist. In light of her family history of heart attacks combined with her own high cholesterol level, he recommended she see a cardiologist.

`` `Doctor, I'm having the pains right now,'' ' Kupetz said in the cardiologist's office, while taking a standard stress test on a treadmill.

But he couldn't see any abnormalities, so he diagnosed her chest pains as non-cardiac-related and sent her to a gastroenterologist. The pattern continued.

Nearly one year, four doctors and seven major tests later, Kupetz didn't have answers. And she was still getting chest pains from everyday activities like dancing with her kids or bringing in groceries. She had stopped exercising. One doctor suggested she take antidepressants.

Matzer hears this a lot. ``You go into my waiting room and ask who has a Valium and they all raise their hands because they've been told they have a psychological problem. But it's not all in their head. It's all in their heart.''

Kupetz finally found answers when she called Dr. C. Noel Bairey Merz, medical director of the Women's Health Program, Preventive and Rehabilitative Cardiac Center, at Cedars-Sinai Medical Center in Los Angeles.

Confident that Kupetz did indeed have a heart problem after hearing her story, Bairey Merz ordered an echocardiac stress test and an adenosine cardiac stress MRI. Both showed that Kupetz's heart was not responding as it should.

A subsequent angiogram found three arteries with major blockages. After an attempt at angioplasty, Kupetz had triple-bypass surgery in March. Through it all, her family, especially Daniel, her husband of 12 years, was by her side. Kupetz credits Bairey Merz with saving her life, but the doctor says Kupetz deserves praise, too.

``Lori was a positive advocate for herself. She didn't stop pursuing it or ignore her symptoms. Doctors can only do so much. They need active partners in the process.''

Bairey Merz continues to keep track of her patient's health and Kupetz does her part by maintaining a regimen of statin drugs, beta blockers, aspirin and prescribed doses of fish oil.

Kupetz's pain, triggered by insufficient blood flow to her heart, is finally gone. The only visible sign now is a scar on her collarbone. Recently while she was getting dressed, her daughter protested when she tried to hide it with a high collar.

``Every scar has a story,'' her daughter told her. ``And you should be proud of yours.''

Diana McKeon Charkalis, (818) 713-3760

diana.charkalis@dailynews.com

Women, ask your doctor

When visiting the doctor, sometimes women's heart health problems may be overlooked. Asking physicians specific questions can help get a useful discussion started. Here's a list to bring to your next office visit:

What is my risk for heart disease?

What is my blood pressure? What does it mean for me and what do I need to do about it?

What are my cholesterol numbers? (These include total cholesterol, LDL, HDL, and triglycerides, a type of fat found in the blood and food). What do they mean for me and what do I need to do about them?

What is my ``body mass index'' and waist measurement? Do they mean that I need to lose weight for my health?

What is my blood sugar level, and does it mean I'm at risk for diabetes? If so, what do I need to do about it?

What other screening tests for heart disease do I need?

What can you do to help me quit smoking?

How much physical activity do I need to help protect my heart?

What is a heart-healthy eating plan for me?

How can I tell if I may be having a heart attack? If I think I'm having one, what should I do?

-- NIH/National Heart, Lung and Blood Institute

CAPTION(S):

4 photos, box

Photo:

(1 -- cover -- color) ROUND AND ROUND

Challenges of diagnosing heart disease in women

(2) Lori Kupetz of Sherman Oaks has no problem playing with her children, Sophie, 9, left, and Zoe, 7, after undergoing triple-bypass surgery earlier this year at the age of 39. For months before her operation, doctors did not see her problem as heart-related.

(3) Spending time being active with daughters Sophie, left, and Zoe, right, is high on Kupetz's list since bypass surgery increased blood flow to her heart and stopped the regular chest pains that led her to curtail any strenuous activity.

(4) Kupetz saw four doctors and had seven major medical tests before her heart disease was diagnosed. Before then, physicians attributed her symptoms to, among other things, gastroenterological problems and depression.

Box:

BABY BOOMERS TRY TO USE THEIR HEADS - Daily News (Los Angeles, CA)

Feng shui master Judy Famiglietti did yoga, practiced Pilates,sought Reiki massage and meditated 15 minutes a day.

But the svelte baby boomer from Sherman Oaks wasn't content to bejust fit and calm. Fuzzy thinking meant she needed mental workouts,too.

'I used to forget lists at the grocery store,' Famiglietti saidduring a Brain Gym 101 session conducted by Barbara Schwartz atEquilibrium in Encino.

'In my family, we're really obsessed with being fit, mentally andphysically. Perfection is high on the list ... and I have sharpenedmy mental abilities.'

It's no longer enough for middle-age Angelenos to tone theirbodies, Botox their brows and toss out the trans fats in their questfor vitality.

Across the nation, those born in the 20 years after World War IIare popularizing everything from 'brain-healthy' foods to virtualbrain gyms in an effort to retain their cognitive edge and stave offdementia.

'We're baby boomers, and we don't want it to happen to us,' saidSheryle Bolton, chief executive officer of Quixit Inc., of Oakland,whose HappyNeuron.com launched last fall.

'We started the fitness craze. We've learned a lot aboutnutrition. And now it's time to learn about mental exercise.'

Nintendo's Brain Age video game, for instance, offers math-and-word challenges, while California-based Web sites such asMyBrainTrainer.com and HappyNeuron.com supply cranial calisthenicsto a generation that hatched the fitness and nutrition movements.

AARP and other 50-plus advocates offer brain health tips, whilethe Alzheimer's Association conducts Maintain Your Brain workshopsfor such corporations as Lockheed Martin and Apple Computer.

Brain health has even become the darling of health insurers.

MetLife offers a 61-page booklet called 'Love Your Brain,' whileHumana plans to offer brain fitness software to millions of grayingclients.

With Americans now living longer and the first wave of the 78million baby boomers approaching 60, many hope such noggin-builderswill ward off memory problems.

'The difficult fact to face is that baby boomers are gettingolder at the same time,' said Barbara Goen, spokeswoman for theAlzheimer's Association of California Southland.

'It is going to have a catastrophic effect if we don't make someprogress in solving the problem of Alzheimer's disease.'

Millions affected

The degenerative brain disease affects an estimated 4.5 millionAmericans -- more than double the number in 1980 -- including one in10 persons older than 65 and nearly half of those older than 85.

Research has shown that an estimated 40 percent of those 65 andolder have some level of age-associated memory loss.

Without a cure, up to 16 million Americans are expected to sufferfrom Alzheimer's by mid-century, according to the Alzheimer'sAssociation.

For overall brain health, AARP and health experts recommendregular exercise, staying mentally active and eating a balanced dietrich in antioxidants and omega-3 fatty acids.

To determine whether brain exercise can actually ward off flabbyminds, dozens of studies are in the works. However, there already isgrowing evidence that it does.

Previous studies have shown that animals kept in cages full oftoys had better memories and more brain cells than those housed inmore mundane environments.

And research has long shown that mental exercise in people canimprove test scores while crossword puzzles and reading can keep themind sharp.

A new study suggests that brain exercise strengthens the abilityof seniors to think more clearly and to perform everyday tasksneeded to live independently.

Healthy seniors with only 10 hours of classes to improve theirreasoning reported significantly less trouble with cooking, shoppingand other routine activities.

The study, published Dec. 20 in the Journal of the AmericanMedical Association, showed that cognitive training still broughtbenefits five years later.

'There is mounting evidence that cognitive exercise may protectour brains,' said Dr. Gary W. Small, a professor of geriatricpsychiatry and director of the UCLA Center on Aging and the Memory &Aging Research Center.

'We know specific exercises in certain brain functions definitelyhave an effect. The question is, if you do your mental aerobics,will brain exercise stave off Alzheimer's?

'There is softer evidence that it does.'

Small, whose five-week Senior Memory Training courses at UCLACenter on Aging have drawn baby boomers to teaching sites across LosAngeles, has licensed it in a half-dozen states.

He has also designed Brain Games, a handheld computer gamescheduled to be released this month by Mattel.

Last year, Small led a UCLA study that found people could improvebrain function and efficiency with only two weeks of memoryexercises, along with healthy eating, physical fitness and stressreduction.

The study, published in the June issue of the American Journal ofGeriatric Psychiatry, centered on ages 35 to 69.

'There is definitely something to this,' Small said. 'We foundthat in a matter of two weeks, we cannot only improve memoryperformance, but improve mental efficiency as seen on brain scans.'

Entrepreneurs have pursued the boomer brain market with provensuccess.

In the past year, MyBrainTrainer.com has more than doubled itsmembership to 7,000 clients, company officials said.

'It's the Nautilus machine for the mind,' said Bruce Friedman,the Web site's founder. 'It's the ignition for your cognition.

'I definitely believe that more and more boomers are going to betaking these kind of preventative steps to ward off, or attempt toward off, dementia.'

Rod Evans, a 57-year-old author and philosophy professor, is anunlikely candidate for more mental stimulation.

He teaches classes at Old Dominion University in Virginia and haswritten 14 books, including 'The Gilded Tongue,' a dictionary of'meretricious words guaranteed to impress your friends.' He riflesthrough flash cards daily to improve his word skills. And he playsBoggle, a Scrabble-like game for the brainy.

Keeping fit

To keep fit, he also exercises and lifts weights throughout theweek.

But when Evans discovered MyBrainTrainer.com two years ago, hefound himself mentally working out up to three times a day online.

'I feel energized,' said Evans, of Norfolk, Va., whose family hasno known history of dementia. 'It helps me wake up. It makes me feelgood.

'I want to reduce the possibility, or at the very least, to delaysenility.'

For the past 20 years, Schwartz has conducted Brain Gym sessionsat her Encino home. Founded by Brain Gym International in Ventura,the technique aims to improve the mind through 26 exercises.

During a recent session, Schwartz went through a litany ofexercises with Famiglietti, who once stumbled at rememberingpeoples' names. She signed up in August for Brain Gym sessions thatcost $125 and up.

'Feel complete?,' asked Schwartz, in a room redolent of sweetaromatherapy oils.

'Yeah, I feel much better,' said the feng shui consultant whose80-year-old mother can still whip the most challenging crossword andSoduku puzzles.

'I'm hoping the DNA will kick in, that the gene pool will stay onmy side and that I can preserve what I have with the exercises thatI'm doing.'

The New York Times News Service contributed to this report.

dana.bartholomew(at)dailynews.com

(818) 713-3730

MENDING MATTERS OF THE HEART FOR WOMEN, CARDIAC PROBLEMS CAN BE HIDDEN OR MISDIAGNOSED - Daily News (Los Angeles, CA)

Lori Kupetz looks younger than her 40 years, especially when shehula-hoops in front of her Sherman Oaks home with daughters Sophie,9, and Zoe, 7. No one would ever guess that earlier this year, thisthin vegetarian who doesn't smoke underwent a triple bypass.

'I just don't fit the bill of someone who would have heartsurgery,' says Kupetz, who is now out to spread the word aboutcardiovascular disease from a female perspective. 'But heart diseasekills women more than anything else. It's not just a man's disease.'

And sadly, for many women, it often goes unnoticed.

'It's very tragic, but unfortunately two-thirds of women willactually die of heart disease and not know they have a problem,'says Dr. Lisa Matzer, medical director of Glendale Adventist MedicalCenter's Outpatient Cardiac Services Program.

Doctors and researchers say this is partly because heart diseaseaffects men and women differently.

'The symptoms women present are a lot different than the symptomswe typically see in men,' says Matzer. She says the most common forwomen include weakness, fatigue, shortness of breath with exerciseand just not feeling right.

In addition, tests that work for men aren't always as effectivefor women.

'Making the diagnosis of heart disease can be difficult,' Matzersays. 'The angiogram is the gold standard for men, so we assume it'sthe gold standard for women. But it only works for one-third ofwomen. We know that two-thirds of women (with heart problems) willgo in and be given a clean bill of health.'

For Kupetz, too, getting the right diagnosis proved elusive.

Her story began in February 2005. One day while hiking with afriend, she found herself doubled over with chest pains. After twomore similar episodes, she called her internist. In light of herfamily history of heart attacks combined with her own highcholesterol level, he recommended she see a cardiologist.

' 'Doctor, I'm having the pains right now,' ' Kupetz said in thecardiologist's office, while taking a standard stress test on atreadmill.

But he couldn't see any abnormalities, so he diagnosed her chestpains as non-cardiac-related and sent her to a gastroenterologist.The pattern continued.

Nearly one year, four doctors and seven major tests later, Kupetzdidn't have answers. And she was still getting chest pains fromeveryday activities like dancing with her kids or bringing ingroceries. She had stopped exercising. One doctor suggested she takeantidepressants.

Matzer hears this a lot. 'You go into my waiting room and ask whohas a Valium and they all raise their hands because they've beentold they have a psychological problem. But it's not all in theirhead. It's all in their heart.'

Kupetz finally found answers when she called Dr. C. Noel BaireyMerz, medical director of the Women's Health Program, Preventive andRehabilitative Cardiac Center, at Cedars-Sinai Medical Center in LosAngeles.

Confident that Kupetz did indeed have a heart problem afterhearing her story, Bairey Merz ordered an echocardiac stress testand an adenosine cardiac stress MRI. Both showed that Kupetz's heartwas not responding as it should.

A subsequent angiogram found three arteries with major blockages.After an attempt at angioplasty, Kupetz had triple-bypass surgery inMarch. Through it all, her family, especially Daniel, her husband of12 years, was by her side. Kupetz credits Bairey Merz with savingher life, but the doctor says Kupetz deserves praise, too.

'Lori was a positive advocate for herself. She didn't stoppursuing it or ignore her symptoms. Doctors can only do so much.They need active partners in the process.'

Bairey Merz continues to keep track of her patient's health andKupetz does her part by maintaining a regimen of statin drugs, betablockers, aspirin and prescribed doses of fish oil.

Kupetz's pain, triggered by insufficient blood flow to her heart,is finally gone. The only visible sign now is a scar on hercollarbone. Recently while she was getting dressed, her daughterprotested when she tried to hide it with a high collar.

'Every scar has a story,' her daughter told her. 'And you shouldbe proud of yours.'

Diana McKeon Charkalis, (818) 713-3760

diana.charkalis@dailynews.com

Women, ask your doctor

When visiting the doctor, sometimes women's heart health problemsmay be overlooked. Asking physicians specific questions can help geta useful discussion started. Here's a list to bring to your nextoffice visit:

What is my risk for heart disease?

What is my blood pressure? What does it mean for me and what do Ineed to do about it?

What are my cholesterol numbers? (These include totalcholesterol, LDL, HDL, and triglycerides, a type of fat found in theblood and food). What do they mean for me and what do I need to doabout them?

What is my 'body mass index' and waist measurement? Do they meanthat I need to lose weight for my health?

What is my blood sugar level, and does it mean I'm at risk fordiabetes? If so, what do I need to do about it?

What other screening tests for heart disease do I need?

What can you do to help me quit smoking?

How much physical activity do I need to help protect my heart?

What is a heart-healthy eating plan for me?

How can I tell if I may be having a heart attack? If I think I'mhaving one, what should I do?

Mandatory condom use urged for porn actors.(News) - Daily News (Los Angeles, CA)

Byline: Susan Abram Staff Writer

HEALTH: AIDS/HIV foundation says laws need to be enforced.

Advocates for those with AIDS and HIV called on the Los Angeles County Health Department on Thursday to force condom use on production sets in the adult entertainment industry.

'We're calling on the county to shut down porn sets that do not use condoms,' said Michael Weinstein, president of AIDS Healthcare Foundation.

Weinstein said, under California Health & Safety Code, health officials have a right to regulate film sets if they believe an infectious or communicable disease is present.

'It's not an issue of right,' Weinstein said. 'What takes place in a private setting is different than in a commercial setting.'

County officials said they had no comment Thursday.

Weinstein's call for action was in response to last week's news that a woman who works in the adult entertainment industry tested positive for HIV. Health workers at the Sherman Oaks-based Adult Industry Medical Healthcare Foundation, where she is a client, said the case was an isolated one and is significantly different from the HIV scare that jolted the industry five years ago.

Those who work and support the industry say self-regulation, such as the 30-day testing for HIV and other sexually transmitted diseases, works better than government regulation, which could force production to move to other states.

'It's been five years since there was a positive (test result) in our industry. It was caught immediately, showing it does work,' said Diane Duke, executive director for the Canoga Park-based Free Speech Coalition. She said condom use on sets should remain optional.

The AIDS Healthcare Foundation and the Los Angeles County Commission on HIV both want legislation that would require condom use on production sets.

Officials with the state Division of Occupational Safety and Health said employers are required to establish an effective control plan to limit exposure to bloodborne pathogens including semen and other fluids. The code does not require condom use.

Six code citations have been issued against adult film production companies in the Valley since 2004, said Erika Monterroza, spokeswoman for the Department of Industrial Relations, which oversees Cal-OSHA.

susan.abram@dailynews.com

EDITORIAL TAKING AIM PERMANENT CLOSURE OF PORN ACTORS CLINIC WOULD BE BAD FOR THE PUBLIC ; Permanent closure of porn actors clinic would be bad for the public - Daily News (Los Angeles, CA)

STRAIGHT society has a hard time dealing with the porn industry.On the one hand, it doesn't want to legitimize the business or theadult film actors in any way. On the other hand, it wants theindustry and workers to conform to strict - and restrictive - rulesand standards.

And, if there were another hand, on it would be the millions ofcustomers who keep adult movies in high demand and the source of oneof the San Fernando Valley's most profitable enterprises.

This societal schizophrenia is exhibited in the hopefullytemporary closure earlier this month of one of the industry's mostimportant health centers - AIM, or the Adult Industry MedicalHealthcare Foundation. The Sherman Oaks-based clinic is the mainscreener of sexually transmitted diseases for adult film workers. Italso acts as an advocate for an industry that others consideruntouchable.

Citing what sounds like extremely minor paperwork violations,state public health officials ordered AIM to close on Dec. 9, theday after an adult film star announced publicly that he was treatedpoorly at the clinic after he tested positive for HIV in October anddidn't get treatment as fast as he could.

In fact, it appears just ammunition in the long-standing feudbetween Los Angeles County Public Health officials and AIDSactivists and AIM and its co-founder Sharon Mitchell over the issueof condoms in adult films. State law requires that adult film starsuse condoms, but many performers eschew them. While AIM suppliesfree condoms, it focuses on testing performers as opposed toenforcing condom rules.

Mitchell, a former porn star herself, sees the closure as aconspiracy. But there's been nothing secret about how she and AIMhave been targeted. After AIM was shut down, for example, MichaelWeinstein, the executive director for AIDS Healthcare Foundation, aprovider of medical treatment for AIDS and HIV patients, made itclear his goal is getting the adult film industry shut down if itdoesn't use condoms.

While his concern about the spread of AIDS and HIV is admirable,he's misguided if he thinks persecuting AIM or adult film actorswill make the public safer. It's likely to have the opposite effect.

AIM provides important support for adult film stars. AIM testsabout 1,500 clients a month. And some have said that if AIM didn'tdo these screenings, they probably wouldn't happen. In fact, losingcenters like AIM will likely force adult film production undergroundor to other states, endangering workers and public health evenfurther.

Mandatory condom use urged for porn actors - Daily News (Los Angeles, CA)

HEALTH: AIDS/HIV foundation says laws need to be enforced.

Advocates for those with AIDS and HIV called on the Los AngelesCounty Health Department on Thursday to force condom use onproduction sets in the adult entertainment industry.

'We're calling on the county to shut down porn sets that do notuse condoms,' said Michael Weinstein, president of AIDS HealthcareFoundation.

Weinstein said, under California Health & Safety Code, healthofficials have a right to regulate film sets if they believe aninfectious or communicable disease is present.

'It's not an issue of right,' Weinstein said. 'What takes placein a private setting is different than in a commercial setting.'

County officials said they had no comment Thursday.

Weinstein's call for action was in response to last week's newsthat a woman who works in the adult entertainment industry testedpositive for HIV. Health workers at the Sherman Oaks-based AdultIndustry Medical Healthcare Foundation, where she is a client, saidthe case was an isolated one and is significantly different from theHIV scare that jolted the industry five years ago.

Those who work and support the industry say self-regulation, suchas the 30-day testing for HIV and other sexually transmitteddiseases, works better than government regulation, which could forceproduction to move to other states.

'It's been five years since there was a positive (test result) inour industry. It was caught immediately, showing it does work,' saidDiane Duke, executive director for the Canoga Park-based Free SpeechCoalition. She said condom use on sets should remain optional.

The AIDS Healthcare Foundation and the Los Angeles CountyCommission on HIV both want legislation that would require condomuse on production sets.

Officials with the state Division of Occupational Safety andHealth said employers are required to establish an effective controlplan to limit exposure to bloodborne pathogens including semen andother fluids. The code does not require condom use.

Six code citations have been issued against adult film productioncompanies in the Valley since 2004, said Erika Monterroza,spokeswoman for the Department of Industrial Relations, whichoversees Cal-OSHA.

susan.abram@dailynews.com

IN YOUR 40S? GET A MAMMOGRAM : ACTIVISTS PRAISE GOVERNMENT DECISION TO SUPPORT BREAST-CANCER SCREENING.(L.A. LIFE)(Statistical Data Included) - Daily News (Los Angeles, CA)

Byline: Jenifer Hanrahan Daily News Staff Writer

Almost 50 years ago, a gal named Terese Lasser had her breast removed. A painful mastectomy shaved her chest muscles down to her ribs. The missing flesh threw off her balance.

Before the days of reconstructive surgery, Lasser did the only thing she could do, recalled her friend, Helene Brown.

``She went into the department store to get a bra to stuff with something,'' said Brown, an honorary lifetime member of the America Cancer Society's National Board of Directors. ``And they kicked her out. They said, `We don't allow people like you to try on underwear.' ''

When Brown began promoting women's health issues 47 years ago as a volunteer for the Cancer Society, her job was to spread the word about Pap smears and self-breast examination.

In those days, the only breast cancer screening available to most women was feeling a lump.

Oh, how times have changed.

Last week, the federal government came out in favor of mammograms every one or two years for women in their 40s.

``It's marvelous, absolutely marvelous,'' said Brown, a longtime Sherman Oaks resident. ``Women will make decisions for themselves, but they need guidance.''

Health-care victory

The announcement by the National Cancer Advisory Board on the controversial mammogram debate was a significant victory for the grass-roots campaign to improve women's health care in the United States through legislation, gender-specific research, increased funding and improved standards of care.

Across the country, women in the breast-cancer prevention movement started support groups and outreach programs to encourage women to get regular exams. They even took their message on the road with the Wall of Hope, a traveling photo exhibit celebrating breast cancer survivors, and adopted the pink ribbon, a variation on the red AIDS ribbon, as a symbol to increase awareness.

``For a long time, it had been a subject that people didn't discuss,'' Brown said. ``It turned out that a lot of women not only wanted to talk but wanted to do something.''

The move by the cancer advisory board, which advises the National Cancer Institute, is expected to put pressure on the insurance industry to pay for mammograms. The Cancer Institute's decisions are used by health insurance companies to set benefits and by doctors to determine appropriate care.

``This is a big deal,'' said Linda Hirsh, a member of the Los Angeles Breast Cancer Alliance, a group that lobbies for improved health care for women. ``Before, women were left in a bind.''

A helping hand

Kay Powell, founder of Los Angeles-based Sisters Breast Cancer Survivor Network, a group that provides information and support for minority women who have been diagnosed with breast cancer, said she believes the decision will make it easier for low-income women to have mammograms.

``So many times, I hear the excuse that they don't have the money,'' Powell said. ``We're going to go out and spread the word and let the ladies know money won't stop them.''

For women at high risk of breast cancer, the recommendation advises seeking expert medical advice about mammograms before age 40. High risk factors include a family history of breast cancer and delaying pregnancy until after age 30.

For decades, women have gotten conflicting information about whether to have a mammogram. In 1977, the National Cancer Institute and the American Cancer Society issued the first guidelines, recommending that women 40 to 49 have mammograms only if they or their mothers or sisters had breast cancer.

In 1980, the Cancer Society recommended a one-time mammogram for women 35 to 40 to establish a base line for future measurements, with women younger than 50 consulting their doctors to decide whether to have one.

In 1983, the Cancer Society told women from 40 to 49 to have mammograms every one to two years.

Muddling matters furt`her, the National Cancer Institute in 1993 said there was insufficient evidence to justify mammograms for women in their 40s.

Calling for clarification

So when a panel of experts assembled by the National Cancer Institute convened in January to hear two days of evidence from specialists and researchers, women's health advocates were hoping for clarification.

Instead, the panel said each woman should ``decide for herself.''

The debate over mammograms for younger women revolves around the high number of false alarms and questions about whether the mammograms save lives.

Mammograms are far from a foolproof method of detecting the cancer, especially in younger women, because their breast tissue is more dense. Mammograms miss about one-fourth of invasive breast cancer in women in their 40s, compared to one-tenth of such cancers in women 50 and older.

Because of this, mammograms for women younger than 40 are not a ``panacea,'' said Dr. Mitzi Crockover, director of the Iris Cantor-UCLA Women's Health Center. ``Mammograms are not going to catch all the cancers in 40-year-olds. What we need are better ways of screening.''

About 1.5 percent of American women will get breast cancer between age 40 and 49.

An important procedure

Almost all health professionals agree that women past 50 should get annual mammograms that can spot tumors before they spread to other organs and can reduce breast cancer deaths by 30 percent. Most also agree that mammograms are generally unnecessary for women in their 30s.

Traditionally, governmental and medical advisory bodies' decisions to recommend screening for disease are based only on scientific evidence and cost-effectiveness. In other words, will testing people for the disease save enough lives to make economic sense?

The breast cancer issue, and questions of women's health in general, have moved beyond the scientific world and into the political realm.

More than any other disease, American women fear breast cancer, said Dr. Debra `Judelson, president of the American Medical Women's Association, a group of women doctors and medical students that was formed in 1915 when the American Medical Association was closed to women.

The disease's impact on women cannot be fully measured by scientific studies or medical bills, Judelson said.

By recommending that women get mammograms if they are in their 40s, ``it says it's worthwhile to save lives,'' Judelson said. ``Even if the technique isn't perfect, we are going to the trouble and expense necessary to catch a disease in its early, treatable stages.''

Despite any evidence to the contrary, Joanne Eacrett of Woodland Hills, is more than certain that mammograms save lives.

At 47, a mammogram spotted cancer that she had removed by a mastectomy.

``I know there are many different opinions,'' said Eacrett, 55, who has been active in the Breast Cancer Alliance. ``I know that other people feel it doesn't save lives, however, I feel that I am here because of it.''

CAPTION(S):

Drawing, Photo

Drawing: PINK POWER

Women win a battle in the war against breast cancer

Bradford Mar/Daily News

Photo: ``It's marvelous, absolutely marvelous. Women will make decisions for themselves, but they need guidance,'' the American Cancer Society's Helene Brown says of the mammogram decision.

HMO FEE HIKES AHEAD INDUSTRY OFFICIALS BLAME MEDICARE.(News) - Daily News (Los Angeles, CA)

Byline: Dana Bartholomew Staff Writer

For 82-year-old Queenie Serot, life's great pleasure is treating each of her seven grandchildren to dinner and a show.

But if a $20-a-month HMO-Medicare premium proposed by Kaiser Permanente is approved this week by Uncle Sam, Serot said she might not be able to share the next Disney spectacular with her offspring.

``I have a fixed income,'' said the retired school teacher from Woodland Hills, who can amble about thanks to a pacemaker and walker supplied by Kaiser. ``It would be difficult.''

The increase, she said, is ``not acceptable.''

Serot is one of almost 554,000 Kaiser beneficiaries in California likely to be hit in 2001 with new or higher Medicare premiums. For Los Angeles, the $20 Kaiser premium is new - a result, company and industry officials say, of medical costs failing to keep pace with government Medicare reimbursement rates.

Though other counties will probably fare worse, the likely increase for Kaiser beneficiaries in Los Angeles already worries some seniors. The federal Health Care Financing Administration, which administers Medicare, is scheduled to announce the new rates Friday.

The Center for Health Care Rights, a health insurance counseling program in Los Angeles, reports numerous calls from concerned seniors.

``The primary concern is the $20 premium is unfair,'' said Aileen Harper, executive director for the Department of Aging program. ``because last year Kaiser increased its office visit copayment and pharmaceuticals copayment.

``I think people feel it's a double whammy,'' she said. ``These costs are striking for low-income seniors on fixed incomes who are not eligible for Medicaid.''

The myth is that Medicare pays for health care, said Clare Smith, executive director of California Health Care Advocates. ``Time and again, it shows it barely covers half'' when such big-ticket expenditures as long- term care are included.

Many Kaiser beneficiaries, however, said they can absorb the $240 a year.

Compared to the regular Medicare fee-for-service plan, which doesn't pay for costly drugs or confer other benefits, the choice to enroll in a health maintenance organization plan is inexpensive.

``I think Kaiser is a pretty good bargain,'' said George Honorof, 89, of Sherman Oaks, who like Serot was in line to receive care from the Kaiser Permanente Woodland Hills Medical Center on Friday.

``I've been with Kaiser and I've saved money in contrast with private physicians.''

Rising costs cited

Kaiser officials were apologetic enough about the proposed increase to notify an undisclosed number of Los Angeles beneficiaries by letter last July.

``We're in for the long haul,'' said Kaiser spokeswoman Lisa Kort, ``but unfortunately, we're seeing a rise in costs.

``The rate of (federal Medicare) reimbursement increases at a rate slower than the cost of health care, hospital utilization, pharmacy costs, new technology and recruiting and obtaining specialized doctors.''

Other insurance providers and analysts agree. But compared to HMO- Medicare increases for Northern California and other states, Los Angeles and Orange county (also at $20) are faring well.

Managed care markets in those regions are mature, with 10 HMO insurance providers and a medical infrastructure with hundreds of hospitals and thousands of doctors.

Such competition, along with the highest per patient Medicare reimbursement rate in the state - at $661 per patient per year, compared with Fresno's $438 - have kept patient costs down, analysts say.

``Los Angeles will fare the best,'' said Jack Christy, director of the California Medicare Project, a research arm of the California Health Foundation. Elsewhere, he added, ``there's going to be a lot of pain out there.''

In most counties outside Los Angeles, Medicare managed care plans will begin charging a hospital deductible of $100 per visit, with some imposing new limits on total drug purchases, he said.

Kaiser, which commands 34 percent of the Medicare managed care market in California, has proposed $30 premiums for Ventura, Riverside, San Bernardino and San Diego counties. Beneficiaries in Northern California counties may pay up to $50 a month.

A call to action

PacifiCare, the country's largest HMO, whose Secure Horizons plan covers about 200,000 seniors in Los Angeles, has proposed higher premiums as well - but not in the Los Angeles market, company officials say.

``It doesn't warrant a premium, not in our eyes yet,'' said PacifiCare Senior Vice President Kathy Feeny, who said premiums have cost PacifiCare market share. Instead, the company has proposed a minor increase in generic drug costs for Los Angeles.

This year, medical costs have risen 6 percent; drug costs 23 percent, while Uncle Sam has upped reimbursements only 2 percent. What's needed for Medicare, she said, is a massive infusion of federal dollars.

``There's a call to action here, and it's loud and clear,'' Feeny said. ``More money needs to be put into the system - and the federal government needs to hear that.''

Health Care Financing Administration officials could not be reached for comment Friday.

Help may - or may not - be on its way.

Insurance companies have called for an additional $70 billion a year for Medicare. Senate Republicans are pushing legislation that would offer up to $31 billion for temporary, immediate Medicare prescription drug assistance for lower-income senior citizens. Other pending bills call for less.

``Assuming that things stay the same - and there is no legislative intervention - the plans in Los Angeles are going to see continual increases,'' said Cecilia Echeverria, senior policy analyst for the California Medicare Project.

``If things stay the same, beneficiaries (in Los Angeles) will begin to see premiums just like the other counties'' across the state.

Report: Good nursing home care rare. - Daily News (Los Angeles, CA)

Byline: Dana Bartholomew

Aug. 9--Poor nursing homes abound while good ones are harder to find, says a survey released Tuesday that blames lax oversight of nursing care facilities.

An analysis by the nonprofit Consumer Reports listed what it considers the best and worst of the nation's 16,000 nursing homes -- including two of the best and one of the worst in the San Fernando Valley.

'It's a national disgrace that 20 years after landmark legislation was passed, nursing homes continue to provide poor care,' said Trudy Lieberman, director of the Center for Consumer Health Choices and author of the report.

'People in nursing homes are frailer and sicker than ever before.'

In 'Nursing Homes: Business as Usual,' the New York-based consumer advocate found that not-for-profit nursing homes generally provide the best care.

It also found that independent nursing homes are generally superior than those run by chains, saying that unaffiliated facilities tend to have more staff and registered nurses.

State nursing home industry officials took issue with the report, saying it used old data and unfairly lumped nursing homes with hospital nursing care or psychiatric services.

'They really have missed the mark on this one,' said Betsy Hite, spokeswoman for the California Association of Health Facilities, which represents the state's nursing homes.

Nursing home care, she added, has actually improved.

'It's so flawed, I frankly consider it an actual disservice to Consumer Reports, which many people rely on for goods and services.'

Consumer Reports based its conclusions on evaluation of recent state inspection reports for nursing homes.

The report, available online and in the September issue of Consumer Reports, ranked homes according to inspection surveys, staffing and quality indicators, listing top and bottom 10 percent of nursing homes.

The report also discusses the influence of politics on the 1987 federal nursing home reform law, with violators receiving token fines -- or no fines at all.

'We couldn't agree more,' said Mike AdvertisementGetAd('tile','box','/news_article',','www.dailynews.com',','null','null');Connors of the Pasadena office of California Advocates for Nursing Home Reform, which has sued the state for failing to investigate nursing home complaints in a timely manner.

'Poor care is business as usual for many California nursing homes.'

A representative of the state Department of Health Services, which oversees nursing homes, could not be reached for comment late Tuesday.

California contains three of the nation's worst dozen nursing homes, including Fountain Gardens Convalescent Hospital in Los Angeles, according to the report.

A Fountain Gardens administrator did not return calls.

In the San Fernando Valley, Consumer reports recommended Alameda Care Center in Burbank and Glendale Memorial Hospital and Health Center. Sherman Oaks Hospital was also recommended but closed its transitional-bed unit last year.

The magazine suggested avoiding California Healthcare & Rehab of Van Nuys, listed on a Medicare Web site with 28 deficiencies. A company official did not return calls.

Only 2 percent of for-profit nursing homes and 7.3 percent of not-for-profit homes met Consumer Reports standards for quality nursing home care.

What's needed, Lieberman said, is tough federal and state oversight and enforcement for the 1.6 million people who live in nursing homes.

'What's amazing to me is that things are really going in the wrong direction,' she said. 'The feds pull their punches ... the regulation process in the states have been swamped by politics.'

FOR MORE INFO

-- To read the full Consumer Reports survey on nursing homes, go to www.consumerreports.org/nursinghomes.

-- For Medicare nursing home comparisons, see www.medicare.gov.

-- For more on nursing home reform, go to www.canhr.org.

To see more of the Daily News, or to subscribe to the newspaper, go to http://www.dailynews.com.

Copyright (c) 2006, Daily News, Los Angeles

Distributed by McClatchy-Tribune Business

News.

BRIEFLY - Daily News (Los Angeles, CA)

Mayor nominates 5 for board posts

Los Angeles Mayor Antonio Villaraigosa announced Monday that hewas nominating a cross section of labor activists and specialists ashis appointees to the city's Civil Service Board of Commissioners.

Villaraigosa said he was seeking to appoint residents withvarious backgrounds to the panel, which oversees civil-service rulesand disciplinary matters against workers.

The five nominees, subject to City Council confirmation, areSylvia Drew Ivie, a poverty and civil-rights attorney; Yolanda Vega,director of LA Health Action; John Perez, past president of UnitedTeachers Los Angeles; Margaret Leal-Sotelo, a lifetime health policyand labor advocate; and attorney Prosy Abarquez-Delacruz.

- Daily News

New toys needed for holiday drive

The Northeast Valley Health Corp. is collecting toys through Dec.7 to make the holidays brighter for needy children in the SanFernando Valley.

New, unwrapped toys for newborns to age 10 are being accepted atthe organization's corporate office, 1172 N. Maclay Ave., SanFernando, and at the following locations: Canoga Park Health Center,7107 Remmet Ave.; Valencia Health Center, 23763 Valencia Blvd;Pacoima Health Center, 12756 Van Nuys Blvd.; San Fernando HealthCenter, 1600 San Fernando Road; and Van Nuys Pediatric HealthCenter, 7138 Van Nuys Blvd.

- Daily News

Shooting victim is ID'd by police

SYLMAR - Juan Borjas, a 20-year-old resident of Canyon Country,was identified by police as the victim in a fatal shooting Fridaynight on the 1300 block of MacNeil Street.

Borjas was shot multiple times in the roadway about 7:30 p.m.,and died at Providence Holy Cross Medical Center, Mission AreaDetective Jim Freund said.

Police have found no eyewitnesses and have few leads, Freundsaid.

'It's a real whodunit,' Freund said. 'We don't know if there wasa dispute before this or anything.'

Anyone with information on the shooting is asked to call theMission Area Police Station at (818) 838-9800.

- Daily News

Man, 21, charged in carnival death

An alleged gang member was charged Monday with murder in the Nov.13 shooting death of a 14-year-old boy outside a neighborhoodcarnival in Jefferson Park.

Los Angeles Superior Court Commissioner James N. Bianco orderedJason Robert Walton, 21, held on $2 million bail pendingarraignment, which was postponed to Dec. 5 at the defense's request.

- City News Service

UCLA gets funds for nurse program

Newly approved funding will allow UCLA to restore a bachelor'sdegree program in nursing that fell under the budget ax in the mid-1990s, the university said Monday.

In voting to approve $5.2 million to fund the undergraduateprogram and a new entry-level master's in nursing - to begin in the2006-07 academic year - the University of California Board ofRegents was responding to the shortage of nurses in California.

Admissions to both new programs are expected to begin in fall2006, and plans call for UCLA to hire 22 new faculty members andfive new staff members in the next three years, officials said.

- City News Service

Suspect arrested in murder attempt

STUDIO CITY - A man suspected of attempted murder was arrestedMonday after undercover officers spotted him driving a blackMercedes-Benz, police said.

The man, whose identity was not released, was spotted in ShermanOaks. Soon afterward, officers in a patrol car ordered him to stopin the 12600 block of Ventura Boulevard in Studio City, Los AngelesPolice Officer Jason Lee said.

HOSPITALS IN AREA PASS PATIENTS' QUALITY TESTS.(News) - Daily News (Los Angeles, CA)

Byline: Dana Bartholomew Staff Writer

Patients gave satisfactory marks to many San Fernando Valley-area hospitals in a survey, released today, that rated the ``institutional bedside manner'' of California medical facilities.

The patient survey - the largest comparison of local hospitals ever made public - asked patients to rank their overnight experience in such categories as physical comfort, emotional support, coordination of care and transition to home.

Officials at about half the hospitals in the Valley region volunteered to ask patients to participate in the survey, and most received an average rating from patients, saying they would recommend their hospital.

``I think it validates what we think internally: We're a very customer- friendly hospital,'' said Rick Miller, spokesman for West Hills Hospital & Medical Center, which got top marks for care coordination and the involvement of family and friends.

The Patients' Evaluation of Performance in California or PEP-C survey, conducted by the Oakland-based California HealthCare Foundation and the California Institute for Health Systems Performance, was released today at www.calhospitals.com.

Survey analysts found that, across the state, patients gave above-average scores to 25 percent of hospitals and average scores to 57 percent, and they rated 18 percent of their hospital experiences below average.

Patients generally gave high marks for physical comfort, care coordination and respect for personal preferences. Lower marks were handed out for emotional support and information about side effects to expect when they got home.

The authors of the survey stressed that the ratings were meant to assist hospitals in improving services and were not meant to assess clinical results - or to brand hospitals as ``good'' or ``bad.''

``Patients, God love 'em, think that hospitals get the technical things right,'' said Dr. Mark Smith, president and chief executive officer of the California HealthCare Foundation.

``But what they do know from direct experience is whether their emotional needs were attended to, whether their pain was managed and whether the transition to home was explained,'' he said. ``It's a kind of institutional bedside manner, but (the survey) also says how good a job they're doing at certain tasks.''

The survey, conducted by mail by the National Research Corp., queried nearly 35,000 patients who had spent at least one night in an acute-care hospital between July and October of 2002. Of the 385 licensed hospitals - with 470 hospital sites across the state - 181 participated in the survey.

The California Healthcare Association, an industry advocate for hospitals, called the survey a harbinger of a coalition of federal and private industry patient surveys to be published beginning next month.

``There is definitely a growing sentiment that hospitals need to be more public in their evaluation of quality care,'' said Jan Emerson, spokeswoman for the association, who endorsed the PEP-C report.

In the Valley and eastern Ventura County, patients gave average marks to Glendale Adventist Medical Center, Kaiser Permanente Foundation hospitals in Panorama City and Woodland Hills, Northridge Hospital Medical Center's Roscoe Boulevard campus, West Hills Hospital & Medical Center and Los Robles Regional Medical Center.

Officials contacted at each hospital said that, even with the risk of going public, they chose to have patients participate in the survey as a positive addendum to regular in-house studies on patient satisfaction.

``Average scores - we're very pleased,'' said Kris Carroway-Bowman, spokeswoman for Los Robles. ``My feeling was: Let's use another source. Let's use the PEP-C thing. Let's see if our surveys were right. They were.''

Only Sherman Oaks Hospital and Health Center got a below-average score on overall patient satisfaction with care.

``We feel we were brave enough to confront our strengths and weaknesses,'' said Jami Feldstein, spokeswoman for Sherman Oaks Hospital, which also received below-average scores in respect for patient preferences, physical comfort and transition to home.

``We thought it was a valuable tool to perform better.''

Dana Bartholomew, (818) 713-3730

dana.bartholomew(at)dailynews.com

CAPTION(S):

photo, box

Photo:

Dr. Alan Kuban checks a patient at West Hills Hospital & Medical Center, which got some high marks in a new survey.

Michael Owen Baker/Staff Photographer

Box:

PATIENTS RATE LOCAL HOSPITALS

SOURCE: The Patients' Evaluation of Performance in California, 2003

Los Angeles-Area Hospitals Pass Patients' Quality Tests. - Knight Ridder/Tribune Business News

By Dana Bartholomew, Daily News, Los Angeles Knight Ridder/Tribune Business News

Jun. 25--Patients gave satisfactory marks to many San Fernando Valley-area hospitals in a survey, released today, that rated the 'institutional bedside manner' of California medical facilities.

The patient survey -- the largest comparison of local hospitals ever made public -- asked patients to rank their overnight experience in such categories as physical comfort, emotional support, coordination of care and transition to home.

Officials at about half the hospitals in the Valley region volunteered to ask patients to participate in the survey, and most received an average rating from patients, saying they would recommend their hospital.

'I think it validates what we think internally: We're a very customer-friendly hospital,' said Rick Miller, spokesman for West Hills Hospital & Medical Center, which got top marks for care coordination and the involvement of family and friends.

The Patients' Evaluation of Performance in California or PEP-C survey, conducted by the Oakland-based California HealthCare Foundation and the California Institute for Health Systems Performance, was released today at www.calhospitals.com.

Survey analysts found that, across the state, patients gave above-average scores to 25 percent of hospitals and average scores to 57 percent, and they rated 18 percent of their hospital experiences below average.

Patients generally gave high marks for physical comfort, care coordination and respect for personal preferences. Lower marks were handed out for emotional support and information about side effects to expect when they got home.

The authors of the survey stressed that the ratings were meant to assist hospitals in improving services and were not meant to assess clinical results -- or to brand hospitals as 'good' or 'bad.'

'Patients, God love 'em, think that hospitals get the technical things right,' said Dr. Mark Smith, president and chief executive officer of the California HealthCare Foundation.

'But what they do know from direct experience is whether their emotional needs were attended to, whether their pain was managed and whether the transition to home was explained,' he said. 'It's a kind of institutional bedside manner, but (the survey) also says how good a job they're doing at certain tasks.'

The survey, conducted by mail by the National Research Corp., ...ueried nearly 35,000 patients who had spent at least one night in an acute-care hospital between July and October of 2002. Of the 385 licensed hospitals -- with 470 hospital sites across the state -- 181 participated in the survey.

The California Healthcare Association, an industry advocate for hospitals, called the survey a harbinger of a coalition of federal and private industry patient surveys to be published beginning next month.

'There is definitely a growing sentiment that hospitals need to be more public in their evaluation of ...uality care,' said Jan Emerson, spokeswoman for the association, who endorsed the PEP-C report.

In the Valley and eastern Ventura County, patients gave average marks to Glendale Adventist Medical Center, Kaiser Permanente Foundation hospitals in Panorama City and Woodland Hills, Northridge Hospital Medical Center's Roscoe Boulevard campus, West Hills Hospital & Medical Center and Los Robles Regional Medical Center.

Officials contacted at each hospital said that, even with the risk of going public, they chose to have patients participate in the survey as a positive addendum to regular in-house studies on patient satisfaction.

'Average scores -- we're very pleased,' said Kris Carroway-Bowman, spokeswoman for Los Robles. 'My feeling was: Let's use another source. Let's use the PEP-C thing. Let's see if our surveys were right. They were.'

Only Sherman Oaks Hospital and Health Center got a below-average score on overall patient satisfaction with care.

'We feel we were brave enough to confront our strengths and weaknesses,' said Jami Feldstein, spokeswoman for Sherman Oaks Hospital, which also received below-average scores in respect for patient preferences, physical comfort and transition to home.

'We thought it was a valuable tool to perform better.'

FYI

The PEP-C survey can be viewed at www.calhospitals.org, or can be obtained free of charge by calling (888) 430-2423.

To see more of the Daily News, or to subscribe to the newspaper, go to http://www.dailynews.com.