Personal Health: Getting the Right Addiction Treatment

“Treatment is not a prerequisite to surviving addiction.” This bold statement opens the treatment chapter in a helpful new book, “Now What? An Insider’s Guide to Addiction and Recovery,” by William Cope Moyers, a man who nonetheless needed “four intense treatment experiences over five years” before he broke free of alcohol and drugs.

As the son of Judith and Bill Moyers, successful parents who watched helplessly during a 15-year pursuit of oblivion through alcohol and drugs, William Moyers said his near-fatal battle with addiction demonstrates that this “illness of the mind, body and spirit” has no respect for status or opportunity.

“My parents raised me to become anything I wanted, but when it came to this chronic incurable illness, I couldn’t get on top of it by myself,” he said in an interview.

He finally emerged from his drug-induced nadir when he gave up “trying to do it my way” and instead listened to professional therapists and assumed responsibility for his behavior. For the last “18 years and four months, one day at a time,” he said, he has lived drug-free.

“Treatment is not the end, it’s the beginning,” he said. “My problem was not drinking or drugs. My problem was learning how to live life without drinking or drugs.”

Mr. Moyers acknowledges that treatment is not a magic bullet. Even after a monthlong stay at a highly reputable treatment center like Hazelden in Center City, Minn., where Mr. Moyers is a vice president of public affairs and community relations, the probability of remaining sober and clean a year later is only about 55 percent.

“Be wary of any program that claims a 100 percent success rate,” Mr. Moyers warned. “There is no such thing.”

“Treatment works to make recovery possible. But recovery is also possible without treatment,” Mr. Moyers said. “There’s no one-size-fits-all approach. What I needed and what worked for me isn’t necessarily what you or your loved one require.”

As with many smokers who must make multiple attempts to quit before finally overcoming an addiction to nicotine, people hooked on alcohol or drugs often must try and try again.

Nor does treatment have as good a chance at succeeding if it is forced upon a person who is not ready to recover. “Treatment does work, but only if the person wants it to,” Mr. Moyers said.

Routes to Success

For those who need a structured program, Mr. Moyers described what to consider to maximize the chances of overcoming addiction to alcohol or drugs.

Most important is to get a thorough assessment before deciding where to go for help. Do you or your loved one meet the criteria for substance dependence? Are there “co-occurring mental illnesses, traumatic or physical disabilities, socioeconomic influences, cultural issues, or family dynamics” that may be complicating the addiction and that can sabotage treatment success?

While most reputable treatment centers do a full assessment before admitting someone, it is important to know if the center or clinic provides the services of professionals who can address any underlying issues revealed by the assessment. For example, if needed, is a psychiatrist or other medical doctor available who could provide therapy and prescribe medication?

Is there a social worker on staff to address challenging family, occupational or other living problems? If a recovering addict goes home to the same problems that precipitated the dependence on alcohol or drugs, the chances of remaining sober or drug-free are greatly reduced.

Is there a program for family members who can participate with the addict in learning the essentials of recovery and how to prepare for the return home once treatment ends?

Finally, does the program offer aftercare and follow-up services? Addiction is now recognized to be a chronic illness that lurks indefinitely within an addict in recovery. As with other chronic ailments, like diabetes or hypertension, lasting control requires hard work and diligence. One slip need not result in a return to abuse, and a good program will help addicts who have completed treatment cope effectively with future challenges to their recovery.

How Families Can Help

“Addiction is a family illness,” Mr. Moyers wrote. Families suffer when someone they love descends into the purgatory of addiction. But contrary to the belief that families should cut off contact with addicts and allow them to reach “rock-bottom” before they can begin recovery, Mr. Moyers said that the bottom is sometimes death.

“It is a dangerous, though popular, misconception that a sick addict can only quit using and start to get well when he ‘hits bottom,’ that is, reaches a point at which he is desperate enough to willingly accept help,” Mr. Moyers wrote.

Rather, he urged families to remain engaged, to keep open the lines of communication and regularly remind the addict of their love and willingness to help if and when help is wanted. But, he added, families must also set firm boundaries — no money, no car, nothing that can be quickly converted into the substance of abuse.

Whether or not the addict ever gets well, Mr. Moyers said, “families have to take care of themselves. They can’t let the addict walk over their lives.”

Sometimes families or friends of an addict decide to do an intervention, confronting the addict with what they see happening and urging the person to seek help, often providing possible therapeutic contacts.

“An intervention can be the key that interrupts the process and enables the addict to recognize the extent of their illness and the need to take responsibility for their behavior,”Mr. Moyers said.

But for an intervention to work, Mr. Moyers said, “the sick person should not be belittled or demeaned.” He also cautioned families to “avoid threats.” He noted that the mind of “the desperate, fearful addict” is subsumed by drugs and alcohol that strip it of logic, empathy and understanding. It “can’t process your threat any better than it can a tearful, emotional plea.”

Resource Network

Mr. Moyer’s book lists nearly two dozen sources of help for addicts and their families. Among them:

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

Substance Abuse and Mental Health Services Administration treatment finder www.samhsa.gov/treatment/;

Al-Anon Family Groups www.Al-anon.alateen.org;

Nar-Anon Family Groups www.nar-anon.org;

Co-Dependents Anonymous World Fellowship www.coda.org.

---

This is the second of two articles on addiction treatment. The first can be found here.

Read More..

Bits Blog: Reporter's Notebook: Snapchat's Path From Stanford to the Beach

Over the weekend, I reported about the recent successes of an up-and-coming start-up, Snapchat, that lets people send messages that disappear after they are viewed. I spent two days with the founders of the company, Evan Spiegel and Bobby Murphy, in Los Angeles, interviewing them and learning about their business.

Snapchat’s headquarters are on the sunny stretch of the Venice Beach boardwalk, steps from surf and sand, in an airy beach house whose previous tenants include a medical marijuana dispensary and a Nike party house.

Their offices have a glowing, life-size replication of their app icon positioned outside the main entrance.

The company also has security detail, 24 hours a day, seven days a week, to keep anyone wandering by from trying to break into the offices.

The company also has a lot of Snapchat-themed art in its offices, including a series of prints that say “No photographs please” and a glitter portrait of their company mascot, “Ghostface Chillah.”

Snapchat does not currently generate any revenue, but its founders envision a future where the company could partner with brands or advertisers that want to show certain Snapchat users a glimpse of a new device, a preview of a new movie or a sneak peek of an upcoming line of clothing. Or, they say, they could show “exploding coupons,” an image that gives information about a deal or discount that expires after a certain amount of time.

Mr. Spiegel and Mr. Murphy met at Stanford, and eventually became roommates. Mr. Spiegel said he would often ask Mr. Murphy for help with computer science and Mr. Murphy recalled being impressed with a line of shirts that Mr. Spiegel designed for their fraternity, which set the precedent for their future business partnership.

One of Snapchat’s defining features is that it allows users to take screenshots of photos they receive, which sends a notification to the sender, alerting them that an image of their photo was taken. This, of course, means that nimble-fingered Snapchat users can make copies of photos that would otherwise disappear after a few seconds. Snapchat’s founders say that feature can also be considered akin to a “like” or a “favorite,” a signal to the sender that their image was favorably received.

Before working on Snapchat, Mr. Spiegel and Mr. Murphy collaborated on a Web product, Future Freshman, a guide for high school students who were applying to college. The product failed to gain any significant traction, however, and the founders went back to the drawing board before coming up with Snapchat.

Snapchat’s original name was Pickaboo — a riff on the kid’s game Peekaboo. But that name was taken by another photo company, and after a brainstorm session, the founders settled on Snapchat.

---

This post has been revised to reflect the following correction:

Correction: February 11, 2013

An earlier version of this post misspelled the surname of one of Snapchat's founders on some references. He is Evan Spiegel, not Siegel.

Read More..

Ambitious makeover planned for old housing project

Denise Penegar puts a little extra effort into the teenage girls, the ones who've dropped out of high school to care for their firstborns.

Don't be afraid, the outreach worker tells them. Come down to the housing project's community center, get your GED and some job skills. Change your life.

"I was one of those girls," said Penegar, now 51 and still living in Jordan Downs, the Watts housing project where she was born.

Sometimes, she imagines how different her life might have been if someone had knocked on her door when she was 17, caring for her first baby. What would it have meant just to have "someone who is here who can help pick me up"?

Penegar is on the front lines of a bold social experiment underway at Jordan Downs, a project notorious to outsiders for its poverty, blight and violence but seen by many longtime residents, for all its problems, as a close-knit community worth preserving.

In the last year, the Housing Authority of the City of Los Angeles has begun an effort to transform Jordan that could cost more than $600 million. The plan is to turn the complex of 700 aging units into a mixed-income community of up to 1,400 apartments and condominiums, with shops and restaurants and fancy touches such as native plant gardens. The city hopes to draw in hundreds of more-affluent residents willing to pay market rate to live side by side with the city's poorest.

Spurred by changes in federal funding and policy, such "mixed use" developments have sprung up in place of infamous housing projects all over the country. But experts say Jordan is taking an approach that has not been tried on this scale.

Typically, public housing residents are moved out ahead of the bulldozers, scattered to search for new shelter. In Los Angeles, the housing authority has promised that any of the 2,300 Jordan residents "in good standing" can stay in their old units until the day they move into new ones. The project is to be built in phases, beginning with units on 21 acres of adjacent land purchased by the authority in 2008 for $31 million.

To ease the transition, the city has dispatched "community coaches" like Penegar, along with teachers, social workers, therapists — even police officers whose charge is not to make arrests but to coach youth football and triathlon teams.

In essence, officials intend to raze the buildings, not the community — and radically change its character.

It will be an enormous challenge, with success likely to be measured in tiny increments.

Only 47% of adults at Jordan reported any wages to the housing authority last year. As in many urban projects, poverty and social ills have multiplied through the generations, leaving some residents unfamiliar with opportunities and expectations beyond the neighborhood. Some rarely leave the area.

Before inviting in new neighbors with expectations of safety and comfort, the housing authority has begun flooding Jordan Downs with social services. Many of the programs are focused on women, because more than 60% of Jordan Downs' tenants live in households headed by single mothers. But men are targeted too — for job training and lessons in parenting, for instance.

By December, 10 months into the effort, more than 450 families had been surveyed by intake workers and 280 signed up for intensive services.

"Most people would say it's ambitious, but I think it's essential," said Kathryn Icenhower, executive director of Shields for Families, the South Los Angeles nonprofit that is running many of the new programs under a more than $1-million annual contract with the housing authority.

It is unknown, however, how effective the social services will be, how easy it will be to draw in wealthier residents and how many millions of dollars the federal government — a major source of funding — will provide.

Already, the housing authority has picked a development team — the for-profit Michaels Organization and the nonprofit Bridge Housing, both with respectable track records in other cities. But with financing still uncertain, it is unclear exactly how many units will be built or how much various occupants would pay.

Ultimately, a working family could pay hundreds of dollars more in rent than unemployed tenants next door for a nearly identical unit. Officials say they do not expect Watts to draw the same kind of high-income residents as the former Cabrini Green project in Chicago, which sat on prime real estate near downtown. But Jordan is in a convenient location, near the intersection of the 105 and 110 Freeways; and in a high-rent city like Los Angeles, even the steepest rates at Jordan are likely to seem a bargain.

Despite the onslaught of social services and some palpable changes — including a 53% plunge in the violent crime rate at Jordan last year — financial risks abound.

Later this spring, the authority plans to put in an application for $30 million from the federal government's Choice Neighborhoods Program as seed money. Without it, the project could be delayed.

Read More..

Wired Science Space Photo of the Day: Wings of the Seagull Nebula

This image shows the intricate structure of part of the Seagull Nebula, known more formally as IC 2177. These wisps of gas and dust are known as Sharpless 2-296 (officially Sh 2-296) and form part of the “wings” of the celestial bird. This region of the sky is a fascinating muddle of intriguing astronomical objects — a mix of dark and glowing red clouds, weaving amongst bright stars. This new view was captured by the Wide Field Imager on the MPG/ESO 2.2-metre telescope at ESO’s La Silla Observatory in Chile.

Image: ESO [high-resolution]

Caption: ESO

Read More..

For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

Read More..

Boeing 787 Completes Test Flight

A Boeing 787 test plane flew for more than two hours on Saturday to gather information about the problems with the batteries that led to a worldwide grounding of the new jets more than three weeks ago.

The flight was the first since the Federal Aviation Administration gave Boeing permission on Thursday to conduct in-flight tests. Federal investigators and the company are trying to determine what caused one of the new lithium-ion batteries to catch fire and how to fix the problems.

The plane took off from Boeing Field in Seattle heading mostly east and then looped around to the south before flying back past the airport to the west. It covered about 900 miles and landed at 2:51 p.m. Pacific time.

Marc R. Birtel, a Boeing spokesman, said the flight was conducted to monitor the performance of the plane’s batteries. He said the crew, which included 13 pilots and test personnel, said the flight was uneventful.

He said special equipment let the crew check status messages involving the batteries and their chargers, as well as data about battery temperature and voltage.

FlightAware, an aviation data provider, said the jet reached 36,000 feet. Its speed ranged from 435 to 626 miles per hour.

All 50 of the 787s delivered so far were grounded after a battery on one of the jets caught fire at a Boston airport on Jan. 7 and another made an emergency landing in Japan with smoke coming from the battery.

The new 787s are the most technically advanced commercial airplanes, and Boeing has a lot riding on their success. Half of the planes’ structural parts are made of lightweight carbon composites to save fuel.

Boeing also decided to switch from conventional nickel cadmium batteries to the lighter lithium-ion ones. But they are more volatile, and federal investigators said Thursday that Boeing had underestimated the risks.

The F.A.A. has set strict operating conditions on the test flights. The flights are expected to resume early this week, Mr. Birtel said.

Battery experts have said it could take weeks for Boeing to fix the problems.

Read More..

A delicate new balancing act in senior healthcare

When Claire Gordon arrived at Cedars-Sinai Medical Center, nurses knew she needed extra attention.

She was 96, had heart disease and a history of falls. Now she had pneumonia and the flu. A team of Cedars specialists converged on her case to ensure that a bad situation did not turn worse and that she didn't end up with a lengthy, costly hospital stay.

Frail seniors like Gordon account for a disproportionate share of healthcare expenditures because they are frequently hospitalized and often land in intensive care units or are readmitted soon after being released. Now the federal health reform law is driving sweeping changes in how hospitals treat a rapidly growing number of elderly patients.

The U.S. population is aging quickly: People older than 65 are expected to make up nearly 20% of it by 2030. Linda P. Fried, dean of the Columbia University Mailman School of Public Health, said now is the time to train professionals and test efforts to improve care and lower healthcare costs for elderly patients.

"It's incredibly important that we prepare for being in a society where there are a lot of older people," she said. "We have to do this type of experiment right now."

At Cedars-Sinai, where more than half the patients in the medical and surgical wards are 65 or older, one such effort is dubbed the "frailty project." Within 24 hours, nurses assess elderly patients for their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.

The Cedars project stands out nationally because medical professionals are working together to identify high-risk patients at the front end of their hospitalizations to prevent problems at the back end, said Herb Schultz, regional director of the U.S. Department of Health and Human Services.

"For seniors, it is better care, it is high-quality care and it is peace of mind," he said.

The effort and others like it also have the potential to reduce healthcare costs by cutting preventable medical errors and readmissions, Schultz said. The federal law penalizes hospitals for both.

Gordon, an articulate woman with brightly painted fingernails and a sense of humor, arrived at Cedars-Sinai by ambulance on a Monday.

Soon, nurse Jacquelyn Maxton was at her bedside asking a series of questions to check for problems with sleep, diet and confusion. The answers led to Gordon's designation as a frail patient. The next day, the project team huddled down the hall and addressed her risks one by one. Medical staff would treat the flu and pneumonia while at the same time addressing underlying health issues that could extend Gordon's stay and slow her recovery, both in the hospital and after going home.

To reduce the chance of falls, nurses placed a yellow band on her wrist that read "fall risk" and ensured that she didn't get up on her own. To prevent bed sores, they got her up and moving as often as possible. To cut down on confusion, they reminded Gordon frequently where she was and made sure she got uninterrupted sleep. Medical staff also stopped a few unnecessary medications that Gordon had been prescribed before her admission, including a heavy narcotic and a sleeping pill.

"It is really a holistic approach to the patient, not just to the disease that they are in here for," said Glenn D. Braunstein, the hospital's vice president for clinical innovation.

Previously, nurse Ivy Dimalanta said, she and her colleagues provided similar care but on a much more random basis. Under the project, the care has become standardized.

The healthcare system has not been well designed to address the needs of seniors who may have had a lifetime of health problems, said Mary Naylor, gerontology professor at the University of Pennsylvania School of Nursing. As a result, patients sometimes fall through the cracks and return to hospitals again and again.

"That is not good for them and that is not good for society to be using resources in that way," Naylor said.

Using data from related projects, Cedars began a pilot program in 2011 and expanded it last summer. The research is continuing but early results suggest that the interventions are leading to fewer seniors being admitted to the intensive care unit and to shorter hospital stays, said Jeff Borenstein, researcher and lead clinician on the frailty project. "It definitely seems to be going in the right direction," he said.

The hospital is now working with Naylor and the University of Pennsylvania to design a program to help the patients once they go home.

"People who are frail are very vulnerable when they leave the hospital," said Harriet Udin Aronow, a researcher at Cedars. "We want to promote them being safe at home and continuing to recover."

In Gordon's case, she lives alone with the help of her children and a caregiver. The hospital didn't want her experiencing complications that would lengthen the stay, but they also didn't want to discharge her before she was ready. Under the health reform law, hospitals face penalties if patients come back too soon after being released.

Patients and their families often are unaware of the additional attention. Sitting in a chair in front of a vase of pink flowers, Gordon said she knew she would have to do her part to get out of the hospital quickly. "You have to move," she said. "I know you get bed sores if you stay in bed."

Gordon said she was comfortable at the hospital but she wanted to go back to her house as quickly as she could. "There's no place like home," she said.

Two days later, that's where she was.

anna.gorman@latimes.com

Read More..

DC Comics Turns the Occupy Movement Into a Superhero Title

Eighteen months after the phrase first entered the collective public consciousness, the plight of the 99 percent is coming to mainstream superhero comics — via a new series from the second biggest publisher in the American comic industry, which just happens to be a subsidiary of a multi-national corporation that makes around $12 billion a year. Irony, anybody?

In May, DC Comics will launch two new series taking place in their mainstream superhero universe that offer different insights into the class struggle in a world filled with superheroes, alien races and inexplicable events. The Green Team, written by Tiny Titans and Superman Family Adventures creators Art Baltazar and Franco, with art by Ig Guara, revives an obscure 1975 concept about teenage rich kids who try to make the world a better place with their outrageous wealth. In an interview promoting the series, Franco promised that it would address questions like “Can money make you happy?” and “If you had unlimited wealth, could you use that to make the lives of people better?”

Obviously, this is one of the more fanciful series DC will be publishing.

But while DC is promoting The Green Team series as the adventures of the “1%,” its companion title, The Movement, is teased as a chance for us to “Meet the 99%… They were the super-powered disenfranchised — now they’re the voice of the people!”

“It’s a book about power,” explained The Movement writer Gail Simone. “Who owns it, who uses it, who suffers from its abuse. As we increasingly move to an age where information is currency, you get these situations where a single viral video can cost a previously unassailable corporation billions, or can upset the power balance of entire governments. And because the sources of that information are so dispersed and nameless, it’s nearly impossible to shut it all down.”

“The thing I find fascinating and a little bit worrisome is, what happens when a hacktivist group whose politics you find completely repulsive has this same kind of power and influence,” she elaborated in an interview at Big Shiny Robot. “What if a racist or homophobic group rises up and organizes in the same manner?”

While the concept is ambitious, the idea that a comic capable of living up to the book’s populist inspiration could come from DC Entertainment still strikes some as unlikely. Matt Pizzolo, the editor of the Occupy Comics anthology, told Wired that “though DC Comics did help launch Alan Moore and David Lloyd’s seminal anarchist epic V For Vendetta over two decades ago, it’s unlikely they would do so today. Between dismantling Vertigo and frankensteining Watchmen, the past year has demonstrated DC isn’t a safe place for bold creators who want to tell the kinds of stories that would inspire things like Occupy, rather than just cash in on them.”

Still, Simone says that the use of the iconography and language of a real-world populist movement is deliberate, promising that the book will reflect today’s decentralized political world and offer ”a slice of rarity that we’re unlikely to see in most superhero books.”

This wouldn’t the first time that DC has attempted to offer pre-packaged populist rebellion, of course; in addition to the aforementioned publication of the anti-establishment V For Vendetta, the company’s Vertigo imprint also published Grant Morrison’s The Invisibles, a series centering around an international organization struggling against forces of authority and repression that included anti-corporate themes.

Only time will tell whether The Movement will live up to the subversive examples of these earlier books, or just end up a well-intentioned piece of topical super heroics that trades on, and commodifies, a real political movement.

The Movement #1 will be available in both print and digital formats on May 1, while The Green Team #1 will be released on May 22.

Read More..

In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

Read More..

Digital Domain: Digital Tags Help Ensure That the Price Is Right

SOME decades ago, a grocery store’s aisles were often filled with “chunk-a-chunk-a” sounds, as clerks stamped prices to the tops of cans and boxes before putting them on shelves. It was a labor-intensive operation, but it did result in a price being affixed to most every item in the store.

Randy Stross

A paper “Sale” sign accompanies an Altierre screen in a Kohl’s store.

Altierre

Digital labels from Altierre are intended to help retailers keep prices up to date.

Then bar codes and computerized cash registers arrived. In most stores, prices were posted on shelves but not on the items themselves.

I’ve always trusted that the system works well — and I’ve tapped my foot impatiently when a shopper ahead of me slowed the checkout process by closely watching the prices that came up, as if the scanner might have recorded the wrong product code. What I hadn’t realized was that there is valid reason to be vigilant. The potential problems originate on the shelves, in the form of the shelf tags, which may or may not match the current price in a store’s computer.

A typical grocery store puts 5,000 items on sale in a week and removes sale prices from another 5,000. That creates an abundance of opportunities for mismatches when workers print out the new price labels in a back room, then hunt for the proper place on the shelf to attach them.

This has left store technology in an incomplete state: mostly but not entirely computerized. The next step is to go completely paperless by putting small, battery-powered digital price tags on the shelves. Price changes can then be received wirelessly from the store’s network, ensuring that the price displayed on the shelf and the one called up at the checkout counter are the same.

Altierre, a digital tag and sensor maker based in San Jose, Calif., has raised more than $80 million from investors and spent 10 years developing the technology for digital tags and the wireless networks they require. It asserts that outfitting a store with 20,000 to 25,000 tags, each costing about $5, would produce labor savings that would pay back the investment in two to two-and-a-half years.

The tags can provide multiple screens of information. To reduce power consumption, Altierre uses black-on-gray liquid crystal displays, the same type used in digital watches and pocket calculators. The most generous thing that can be said about this type of display is that its legibility is satisfactory.

At Altierre’s headquarters, a full-size mock grocery store is set up with its tags installed on the shelves. There, I was surprised to find that the LCD’s legibility problems didn’t seem so significant: shoppers stand close to the shelves anyway. On some shelves, Altierre showed off an improved tag, at a higher price, that uses E Ink technology. Its text is noticeably crisper than that of an ordinary LCD tag.

I asked Sunit Saxena, Altierre’s chief executive, why grocery stores haven’t leapt at the chance to save themselves money by installing the tags. “They’re treading carefully because the fear is, they’ll put 30,000 of these in a store where people are used to seeing paper and it will be a drastic change,” he said. “They worry that their sales will drop.”

Digital sign technology is hardly new. In France, customers are accustomed to digital signs in grocery stores, where an LCD tag with limited display capacity has been on shelves for about 10 years, says Michel Itié, an I.T. consultant. It shows only the price and the price per weight, so it requires a separate paper tag to show an item’s name.

Many French hypermarkets, which combine grocery stores and department stores, also use the tags. Mr. Itié is working with a company that is installing Altierre’s technology for the hypermarket chain E.Leclerc, which has installed 300,000 new LCD tags in 10 stores and plans to deploy a total of two million tags by year-end.

In the United States, grocery stores still cannot justify making the investment in digital price tags, says Patrick C. Fitzpatrick, president of Atlanta Retail Consulting. “If the payback was advantageous, you’d see them everywhere.”

Stores are eager, however, to find an affordable way to reduce price-related errors. Mr. Fitzpatrick says that when grocery store managers conduct “price integrity audits” and compare price labels on the shelves with the prices in the store computer, paper labels are only 95 percent to 96 percent accurate.

Randall Stross is an author based in Silicon Valley and a professor of business at San Jose State University. E-mail: stross@nytimes.com.

Read More..