Can CEO Meg Whitman save Hewlett-Packard?

SAN FRANCISCO — Had things gone differently, Meg Whitman might today be governor of California, fighting to turn around one of the country's most financially troubled state governments.

Instead, having lost her bid for that office in November 2010, she finds herself head of Hewlett-Packard Co., struggling to fix one of the high-tech industry's most troubled giants.

Save HP or California. It's hard to say which is the tougher job.

It sometimes seems as if just about everything that could go wrong at HP has gone wrong in recent years. HP went from being a high-tech juggernaut three years earlier to a company in steep decline, a trajectory that Whitman inherited in September 2011 and so far has been able to slow, but not stop.

"It's a huge company," said Jayson Noland, an analyst at R.W. Baird & Co. "And they are not clicking at all right now."

Just when it seemed every possible shoe had dropped, HP announced in November that it had uncovered what it contended was massive accounting fraud at Autonomy, a British software company it acquired in 2011.

In turning over evidence to U.S. and British regulators, Whitman has triggered a war of words with Autonomy's brash founder and a fresh round of lawsuits from shareholders who have watched their investment continue to hit once unthinkable lows.

Even as the unfolding legal drama threatens to become a distraction, Whitman insists that she has every intention of staying at HP's helm for the next few years, which is what she believes it will take to restore this Silicon Valley icon to greatness.

"I knew this turnaround was not a one- to two-year program," Whitman said. "Even before I took this job, I knew it was a bigger undertaking."

Sitting in a conference room at HP's Palo Alto headquarters during a recent interview, Whitman seemed to wear lightly the burden of representing the hopes that better days lie ahead for the company's 331,800 employees. She managed to laugh and smile at times while also delivering detailed responses displaying a technical grasp of HP's massive product line and a staunch defense of her decisions and vision for the company.

For the moment, Whitman, 56, also seems to be remarkably comfortable sitting in a place she could have never imagined being two years ago, after the state's voters delivered an underwhelming verdict on her quest to become governor.

"It was not part of my plan," she said. "I said many times my last CEO job was going to be EBay."

Despite spending millions of dollars on her failed gubernatorial campaign, Whitman's stint as chief executive of EBay Inc. from 1998 to 2008 had left her wealthy, and there remained plenty of goodwill toward her in Silicon Valley. She seemed headed toward the role of elder stateswoman, becoming a part-time advisor at the prestigious venture firm Kleiner Perkins Caufield & Byers and joining corporate boards such as Procter & Gamble and Zipcar.

In January 2011, Whitman was asked to join the board at HP. Nine months later, the company fired Chief Executive Leo Apotheker. He had been running HP for less than 11 months following the departure of former CEO Mark Hurd, who resigned after a female contract employee accused him of sexual harassment.

Seeking a steadier hand, the board turned to Whitman.

"I thought I could make a difference," Whitman said. "But I thought about it long and hard, because it was a big commitment."

The list of problems she inherited was daunting.

Amid the CEO turmoil, HP, one of the largest makers of personal computers in the world, was forced to abandon its TouchPad tablet — developed in response to Apple Inc.'s iPad — when the device failed to catch on with consumers. HP's hardware sales suffered as customers shifted to cloud-based services. And although it had made some massive acquisitions, such as Palm and EDS, both companies experienced problems that resulted in billions of dollars in write-downs.

Then HP faced a backlash over its announcements in August 2011 that it was considering selling its PC business and that it was buying Autonomy for the steep price of $11 billion, controversies that helped lead to Apotheker's ouster a month later.

What happened after Whitman took charge at HP seemed remarkable to those who followed her gubernatorial campaign. Criticized for being aloof and remote during her run for governor, a narrative she says was untrue, Whitman was suddenly everywhere — talking on CNBC, granting numerous interviews. She appeared relaxed, personable, confident. Here, suddenly, was the real Meg Whitman that her friends and supporters insisted that California voters didn't get a chance to see during the campaign.

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Legislators want Army Corps to explain habitat removal decision

Two state senators on Thursday called on the U.S. Army Corps of Engineers to explain its decision to plow under 43 acres of lush wildlife habitat at the Sepulveda Basin without prior notice or coordination with community leaders and environmentalists.

Sens. Kevin de Leon (D-Los Angeles) and Fran Pavley (D-Agoura Hills) asked for details about what led to the agency's declaration in August that its "vegetation management plan" for the area did not require an environmental impact report because it would not significantly disturb wildlife and habitat.

On Dec. 10, Army Corps bulldozers, mowers and mulching machines stripped nearly all the greenery from the swath of Los Angeles River flood plain just west of Interstate 405 and north of Burbank Boulevard, wiping out habitat for mammals, reptiles and hundreds of species of birds.

"When a clunky federal bureaucracy doesn't collaborate with state and local officials and community leaders, you create a real mess, which is what we have right now at the Sepulveda Basin," De Leon said in an interview.

He noted that although the corps is not subject to state environmental laws, protections from the federal National Environmental Policy Act may apply.

"If the Army Corps doesn't cooperate, the next step is to engage members of Congress to exercise their powers, or have the state attorney general notify the U.S. district attorney's office," De Leon said.

Pavley, whose district includes the Sepulveda Basin, said she wants to know the extent of damage caused to trails, markers and signs funded with "state and local park monies" and installed and maintained "by thousands of hours of volunteer work."

Army Corps of Engineers District Cmdr. Col. Mark Toy was unavailable for comment. But corps spokesman Jay Field said the agency will cooperate fully with the senators.

The area existed as a wildlife preserve adjacent to the Sepulveda Dam for more than three decades. In 2010, it was reclassified as a corps "vegetation management area" with a new five-year mission of replacing trees and shrubs with native grasses as part of an effort to improve access for corps staffers, increase public safety and discourage crime, lewd activity, drug abuse and homeless camps.

Environmental groups led by the San Fernando Valley Audubon Society interpreted the plan to suggest the agency would avoid removal of native willow and cotton groves, elderberries, coyote brush and mule fat. Much of that vegetation was planted decades ago under a corps program to create the wildlife preserve.

Kris Ohlenkamp, conservation chairman of the San Fernando Valley Audubon Society, said the corps' management plan was vague. "But this much is clear: What the corps actually did to that land is not represented anywhere in the plan."

Army Corps Deputy District Cmdr. Alexander Deraney has said his agency's actions were "more or less in line with the plan." He said the corps wanted to preserve the native vegetation but discovered that "the native brush was so grown into non-native brush that it would be impossible to separate them."

The corps has ceased operations on the property pending consultations and meetings with environmental and community groups.

louis.sahagun@latimes.com

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Missing dog mystery is on Mass. author's mind

BROOKLINE, Mass. (AP) — There's a new mystery on Dennis Lehane's mind, but the story isn't something the best-selling author can control from behind a keyboard.

The plot kicked off Christmas Eve, when the crime novelist's rescue beagle Tessa escaped from his yard after an outdoor gate latch didn't lock all the way.

Since then, Lehane's family has launched an all-out search. They've posted fliers, organized foot searches and used social media to try to bring Tessa back to their home in Brookline, Mass., near Boston.

The 47-year-old author of books including "Mystic River" and "Gone, Baby, Gone" is offering a monetary reward and has said he'll name a character in his next book after whoever finds Tessa.

Lehane said Thursday outside his home that he's surprised by the media attention the story has attracted, and thinks it has something to do with the character offer.

But he said as word of the missing dog spread, his family has heard from people across the country on a "Finding Tessa" Facebook page. They even got an offer of help from a dog psychic in San Francisco.

"No dog since Lassie ever got this attention ... the flip side of the comedy is, who wouldn't do this for their dog?" he said.

The doggie dilemma comes as Lehane faces a Friday deadline for finishing a movie script based on his short story "Animal Rescue," timing he said may be "sadistic irony." The movie is scheduled to begin shooting in March in New York City.

The author said he's been spending about four hours a day searching for the tri-colored female beagle after he finishes writing, and his wife has dedicated about 10 hours a day to the effort.

They adopted the 4-year-old beagle not long ago from a Florida rescue agency. Before that, Tessa was a stray in Georgia.

With the help of Twitter and Facebook accounts, Lehane and his wife organized two search efforts Thursday in sections of Brookline and Boston, where they suspect Tessa could be. In the beginning, there were three sightings within about two miles of their home not long after a house sitter reported that the dog was loose.

But the trail went cold for days after a sighting near a McDonald's restaurant. Tessa wasn't wearing tags, but does have a microchip.

"Every dog expert we talk to is strongly suggesting that she's in somebody's house," Lehane said. "That's why we keep saturating the area with pictures. Because somebody could have her and just not know."

Missing dog posters dotted the family's Coolidge Corner neighborhood Thursday, including in the front windows at Durty Harry's dog grooming shop where Tessa is a client. Shop owner Michelle Fournier said interest in the search took off even before people knew Tessa had a famous owner.

"This is about a dog and her family. This is about a community who loves dogs," she said.

Lehane said Thursday that Tessa is so sweet that she'd taken to spooning the family's puppy before her disappearance. He said if someone knows where Tessa is, he only cares about a happy ending, not about solving the mystery of where she's been.

"It's a no-questions-asked issue," the author said. "... Bring the dog to a shelter or call me and I will pick up the dog."

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Scant Proof Is Found to Back Up Claims by Energy Drinks

Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.

Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.

The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.

“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.

Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.

Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.

As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.

Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.

“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”

A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.

In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.

Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.

Consider the case of taurine, an additive used in most energy products.

On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.

But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.

Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.

Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.

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Retail sales rise 4.5% in December; merchants say discounts hurt

Wary holiday shoppers forced retailers to heavily discount items during December, ultimately handing merchants decent sales but raising worries about consumer spending in the new year.

After wooing bargain hunters in December by cutting prices, major retailers such as Macy's Inc., Target Corp. and J.C. Penney Co. lowered their profit expectations for the fourth quarter, warning that steep markdowns may eat into year-end results.

Along Colorado Boulevard in Old Town Pasadena, shoppers said they controlled their budgets during the holidays and planned to take a break from spending in the new year.

"We budgeted $600 for all our family and friends, and we stuck with that," said Wendy Estrada, 33, of Pasadena. "It wasn't the right time to go over the top."

However, Estrada, an admissions officer for a culinary school, had just picked up a $65 pair of tan heels for herself, part of a post-Christmas splurge using gift cards she'd received. But after those are used up, "I'm done until Valentine's Day," she said.

In December, many shoppers were weary of spending during Black Friday sales after Thanksgiving and were focused instead on the "fiscal cliff" debate and the school shooting tragedy in Newtown, Conn., analysts said. As a result, many merchants slashed prices in a last-ditch effort to entice people through their doors.

"The surge in sales we saw was driven by a spike in promotions by retailers, which really helped salvage sales at the back end from the Saturday before Christmas up through New Year's," Ken Perkins of Retail Metrics Inc. said. "A lot of consumers were looking for value."

Major chain stores posted an overall 4.5% sales increase in December compared with the same month a year earlier, beating analysts' expectations of a 3.3% rise. according to Thomson Reuters' tally of 17 retailers.

Top performers were a mixture of high- and low-end stores. Costco Wholesale Corp. led the way with a 9% bump, while upscale department store chain Nordstrom Inc. reported an 8.6% jump. Off-price retailers Ross Stores Inc. and TJX Cos. both said sales rose 6%.

Other retailers did not fare as well. Struggling teen clothier Wet Seal Inc. said sales fell 9.7%, while action-sports retailer Zumiez Inc. reported a 1% slump. Target said sales were flat.

Results were based on sales at stores open at least a year, known as same-store sales and considered an important measure of a retailer's health because it excludes the effect of store openings and closings.

Analysts noted that some retailers sacrificed profit by aggressively marking down merchandise to draw people into stores. Strong sales did not always translate into a blockbuster holiday season.

Macy's, which reported a 4.1% jump in sales, lowered its fourth-quarter earnings guidance and separately announced that it planned to close six underperforming stores nationwide, including one on Paseo Colorado in Pasadena.

Macy's Chief Executive Terry J. Lundgren said December growth "was somewhat less than we had expected."

"It came amid significant head winds from uncertain economic news and the lingering effects of Hurricane Sandy," he said in a statement Thursday.

Kevin Mansell, chief executive of Kohl's Corp., described sales in December as "lower than planned." The chain saw a 3.4% jump.

"Sales came in late in the holiday shopping season and, as a result, were at deeper discounts than planned," he said, adding that more markdowns were planned to clear out inventory before spring.

The mixed showing during the crucial holiday season indicates that shoppers have not completely shaken off worries about the economy, industry watchers say. The last-minute maneuvering over the looming "fiscal cliff" convinced some consumers that they should hold on to their dollars.

"If even Target can't get positive sales, that shows you it's a pretty tough environment," said Britt Beemer, a retail expert at America's Research Group. "When it's all said and done, it was a pretty lackluster holiday and it was a nail-biter."

Merchants are now settling into the usual post-holiday lull, with many lowering prices even further to clear inventory and prepare for the next spike in consumer spending, typically before Easter.

Going forward, industry watchers predict that 2013 will be much like last year — a time of slow growth as the economy gradually mends and shoppers find a more stable footing with their personal finances.

For retailers, the fight will continue for more discerning and picky shoppers, said Michael Brown, a partner in the retail practice at consulting firm A.T. Kearney.

"We are not seeing a period of aggressive growth where that tide is lifting all retailers," he said. "It's going to be a highly competitive environment where retailers have got to work hard to get consumers into stores."

Browsing in Old Town Pasadena, shopper Teresa Overing, 50, was feeling confident that the economy was back on track. Overing, a Pasadena human resources manager, said there was nothing in particular brightening her outlook, just a general feeling that things are finally turning around.

"In spite of all the news, I'm more optimistic," she said. "Maybe it's the new year and the nice weather."

shan.li@latimes.com

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Bieber urges crackdown on paparazzi after photographer's death

Justin Bieber and his collection of exotic cars have been tantalizing targets for celebrity photographers ever since the young singer got his driver's license.

A video captured the paparazzi chasing Bieber through Westside traffic in November. When Bieber's white Ferrari stops at an intersection, the video shows the singer turning to one of the photographers and asking: "How do your parents feel about what you do?"

A few months earlier, he was at the wheel of his Fisker sports car when a California Highway Patrol officer pulled him over for driving at high speeds while trying to outrun a paparazzo.

This pursuit for the perfect shot took a fatal turn Tuesday when a photographer was hit by an SUV on Sepulveda Boulevard after taking photos of Bieber's Ferrari. And the singer now finds himself at the center of the familiar debate about free speech and the aggressive tactics of the paparazzi.

Since Princess Diana's fatal accident in Paris in 1997 while being pursued by photographers, California politicians have tried crafting laws that curb paparazzi behavior. But some of those laws are rarely used, and attorneys have challenged the constitutionality of others.

On Wednesday, Bieber went on the offensive, calling on lawmakers to crack down.

"Hopefully this tragedy will finally inspire meaningful legislation and whatever other necessary steps to protect the lives and safety of celebrities, police officers, innocent public bystanders and the photographers themselves," he said in a statement.

It remained unclear if any legislators would take up his call. But Bieber did get some support from another paparazzi target, singer Miley Cyrus.

She wrote on Twitter that she hoped the accident "brings on some changes in '13 Paparazzi are dangerous!"

Last year, a Los Angeles County Superior Court judge threw out charges related to a first-of-its-kind anti-paparazzi law in a case involving Bieber being chased on the 101 Freeway by photographer Paul Raef. Passed in 2010, the law created punishments for paparazzi who drove dangerously to obtain images.

But the judge said the law violated 1st Amendment protections by overreaching and potentially affecting such people as wedding photographers or photographers speeding to a location where a celebrity was present.

The L.A. city attorney's office is now appealing that decision.

Raef's attorney, Dmitry Gorin, said new anti-paparazzi laws are unnecessary.

"There are plenty of other laws on the books to deal with these issues. There is always a rush to create a new paparazzi law every time something happens," he said. "Any new law on the paparazzi is going to run smack into the 1st Amendment. Truth is, most conduct is covered by existing laws. A lot of this is done for publicity."

Coroner's officials have not identified the photographer because they have not reached the next of kin. However, his girlfriend, Frances Merto, and another photographer identified him as Chris Guerra.

The incident took place on Sepulveda Boulevard near Getty Center Drive shortly before 6 p.m. Tuesday. A friend of Bieber was driving the sports car when it was pulled over on the 405 Freeway by the California Highway Patrol. The photographer arrived near the scene on Sepulveda, left his car and crossed the street to take photos. Sources familiar with the investigation said the CHP told him to leave the area. As he was returning to his vehicle, he was hit by the SUV.

Law enforcement sources said Wednesday that it was unlikely charges would be filed against the driver of the SUV that hit the photographer.

Veteran paparazzo Frank Griffin took issue with the criticism being directed at the photographer as well as other paparazzi.

"What's the difference between our guy who got killed under those circumstances and the war photographer who steps on a land mine in Afghanistan and blows himself to pieces because he wanted the photograph on the other side of road?" said Griffin, who co-owns the photo agency Griffin-Bauer.

"The only difference is the subject matter. One is a celebrity and the other is a battle. Both young men have left behind mothers and fathers grieving and there's no greater sadness in this world than parents who have to bury their children."

Others, however, said the death focuses attention on the safety issues involving paparazzi

"The paparazzi are increasingly reckless and dangerous. The greater the demand, the greater the incentive to do whatever it takes to get the image," said Blair Berk, a Los Angeles attorney who has represented numerous celebrities. "The issue here isn't vanity and nuisance, it's safety."

richard.winton@latimes.com

andrew.blankstein@latimes.com

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Microsoft acquires start-up id8: source

SAN FRANCISCO (Reuters) – Microsoft Corp bought start-up id8 Group R2 Studios Inc as it looks to expand further in technology focused on the home and entertainment, a person familiar with the situation said on Wednesday.

id8 Group R2 Studios was started in 2011 by Silicon Valley entrepreneur and investor Blake Krikorian. It recently launched a Google Android application to allow users to control home heating and lighting systems from smartphones.

Krikorian’s Sling Media – which was sold to EchoStar Communications in 2007 – made the “Slingbox” for watching TV on computers.

Krikorian will join Microsoft with a small team, according to the Wall Street Journal, which reported the acquisition earlier on Wednesday. Microsoft also purchased some patents owned by the start-up related to controlling electronic devices, the newspaper added.

Krikorian and a Microsoft spokesman declined to comment.

Krikorian resigned from Amazon.com Inc’s board in late December after about a year and a half as a director at the company, the Internet’s largest retailer.

(Reporting By Alistair Barr; Editing by Steve Orlofsky)

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'Lincoln,' 'Les Miz,' 'Argo' earn producers honors

LOS ANGELES (AP) — The Civil War saga "Lincoln," the musical "Les Miserables" and the Osama bin Laden thriller "Zero Dark Thirty" are among the nominees announced Wednesday for the top honor from the Producers Guild of America.

Other best-picture contenders are the Iran hostage-crisis thriller "Argo"; the low-budget critical favorite "Beasts of the Southern Wild"; the slave-turned-bounty-hunter saga "Django Unchained"; the shipwreck story "Life of Pi"; the first-love tale "Moonrise Kingdom"; the lost-souls romance "Silver Linings Playbook"; and the James Bond adventure "Skyfall."

Walt Disney dominated the guild's animation category with three of the five nominees: "Brave," ''Frankenweenie" and "Wreck-It Ralph." The other nominees are Focus Features' "ParaNorman" and Paramount's "Rise of the Guardians."

Along with honors from other Hollywood professional groups such as actors, directors and writers guilds, the producer prizes help sort out contenders for the Academy Awards. Those nominations come out Jan. 10.

The guild, an association of Hollywood producers, hands out its 24th annual prizes Jan. 26. The big winner often goes on to claim the best-picture honor at the Oscars, which follow on Feb. 24.

Previously announced nominees by the Producers Guild for best documentary are "A People Uncounted," ''The Gatekeepers," ''The Island President," ''The Other Dream Team" and "Searching for Sugar Man."

Other nominees:

— TV drama series: "Breaking Bad," ''Downton Abbey," ''Game of Thrones," ''Homeland," ''Mad Men."

— TV comedy series: "30 Rock," ''The Big Bang Theory," ''Curb Your Enthusiasm," ''Louie," ''Modern Family."

— Long-form television: "American Horror Story," ''The Dust Bowl," ''Game Change," ''Hatfields & McCoys," ''Sherlock."

— Non-fiction television: "American Masters," ''Anthony Bourdain: No Reservations," ''Deadliest Catch," ''Inside the Actors Studio," ''Shark Tank."

— Live entertainment and talk television: "The Colbert Report," ''Jimmy Kimmel Live," ''Late Night with Jimmy Fallon," ''Real Time with Bill Maher," ''Saturday Night Live."

— Competition television: "The Amazing Race," ''Dancing with the Stars," ''Project Runway," ''Top Chef," ''The Voice."

— Sports program: "24/7," ''Catching Hell," ''The Fight with Jim Lampley," ''On Freddie Roach," ''Real Sports with Bryant Gumbel."

— Children's program: "Good Luck Charlie," ''iCarly," ''Phineas and Ferb," ''Sesame Street," ''The Weight of the Nation for Kids: The Great Cafeteria Takeover."

___

Online:

http://www.producersguild.org

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The New Old Age Blog: On the Way to Hospice, Surprising Hurdles

I’ve often wondered why more families don’t call hospice when a loved one has a terminal disease — and why people who do call wait so long, often until death is just days away.

Even though more than 40 percent of American deaths now involve hospice care, many families still are trying to shoulder the burden on their own rather than turning to a proven source of help and knowledge. I’ve surmised that the reason is families’ or patients’ unwillingness to acknowledge the prospect of death, or physicians’ inability to say the h-word and refer dying patients to hospice care.

But maybe there’s another reason. A study in the journal Health Affairs recently pointed out that hospices themselves may be turning away patients because of certain restrictive enrollment policies. It’s possible, too, that physicians who know of these policies aren’t referring patients whom the doctors fear wouldn’t qualify.

Surprisingly, this randomized national survey of almost 600 hospice programs represents the first broad inquiry into enrollment practices, though it’s been nearly 30 years since hospice became a Medicare benefit.

Nearly 80 percent of hospice programs, the study found, reported having at least one policy that could restrict access. “It represents a barrier to people who want hospice care but can’t receive it,” said lead author Melissa Aldridge Carlson, a geriatrics and palliative care researcher at the Mount Sinai School of Medicine.

What kind of barriers are we talking about? More than 60 percent of hospices won’t accept a patient on chemotherapy, and more than half won’t take someone relying on intravenous nutrition. Many won’t enroll patients receiving palliative radiation or blood transfusions; a few say no to tube feeding.

This made more sense a couple of decades ago, when Medicare developed the regulations requiring patients to forgo curative treatments when they entered hospice. Hospice patients must have a terminal disease, likely to cause death within six months, so such treatments were presumed futile.

But medicine evolves. Now, Dr. Aldridge Carlson pointed out, the distinction between curative and palliative treatments has grown blurry. “It’s increasingly an artificial dichotomy,” she said. “That’s not the reality for most patients today with end-stage disease.”

Chemotherapy, for instance, is often used to shrink tumors that cause pain; radiation can prevent nausea and vomiting for patients with bowel obstructions. Though neither will cure a terminal cancer, as palliative treatments they can improve quality of life. Blood transfusions can help anemic cancer patients feel better, too, at least for a while.

Why, then, would hospices not accept dying people using these treatments? First, these are expensive to provide. The national average Medicare reimbursement for hospice care is just $140 a day, the study notes, and it’s not adjusted to reflect the cost of more complicated regimens. Besides, hospices worry about running afoul of Medicare regulations and being denied even that inadequate reimbursement.

This probably explains why the researchers found that smaller hospices were more likely than large ones to say no to patients receiving such treatments. “If you’re a small hospice caring for someone with many medical issues and the reimbursement doesn’t even cover the care – and then Medicare comes to take it back – that’s a big hit,” Dr. Aldridge Carlson said. Larger organizations with more patients and bigger budgets can better absorb the costs.

One bright note, though, is that almost 30 percent of the hospices studied offer some kind of open access enrollment without insisting on those prohibitions. Much more common in nonprofit hospices (a pity, because the real growth is in for-profit ones), open access usually means enrolling people who don’t yet meet the Medicare criteria, then converting them to Medicare patients as they become eligible.

At Gilchrist Hospice Care in Baltimore, for instance, patients still using chemotherapy, radiation, transfusions and several other treatments can enter what it calls “expanded care,” sometimes also known as “concurrent care.” (At Gilchrist, however, such patients still must meet the six-month hospice eligibility requirement.)

“If you say, ‘You can’t get blood transfusions any more,’ people say, ‘Why would I go with your program?’” said Regina Bodnar, Gilchrist’s clinical director. The hospice’s concurrent program “is not so either/or.”

People who enter hospice care with palliative treatments usually decide to forgo them anyway when they become less effective or more burdensome, Ms. Bodnar said, but “this allows people to make the transition over time.” As the largest hospice program in Maryland, a nonprofit with generous donors, Gilchrist can afford this more flexible, but expensive, approach.

Could it be the future of hospice? That would require Medicare to make some changes in eligibility and reimbursement practices — a shift that might bolster Medicare’s solvency, too.

“Hospice saves money because it keeps people out of the hospital,” Dr. Aldridge Carlson said. Even more expensive outpatient treatments, like palliative radiation, are less costly than days spent in intensive care. Adjusting policies to allow more patients into hospice might bring costs down.

But as important, it could make the call to hospice a slightly less terrifying prospect and provide more families with the help they need at the end of life. “We need to take down the barriers to hospice care,” Ms. Bodnar said, “and this is one way to do it.”

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

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World's 100 richest people got $241 billion richer in 2012

The richest people on the planet got even richer in 2012, adding $241 billion to their collective net worth, according to the Bloomberg Billionaires Index, a daily ranking of the world's 100 wealthiest individuals.

The aggregate net worth of the world's top 100 stood at $1.9 trillion at the market close Dec. 31, according to the index. Of the people who appeared on the final ranking of 2012, only 16 registered a net loss for the 12-month period.

"Last year was a great one for the world's billionaires," said John Catsimatidis, the billionaire owner of Red Apple Group Inc., in an email written poolside on his BlackBerry in the Bahamas. "In 2013, they will continue looking for investments around the world — and not necessarily in U.S. — that will give them an advantage."

Amancio Ortega, the Spaniard who founded retailer Inditex, was the year's biggest gainer. The 76-year-old tycoon's fortune increased to $57.5 billion, a gain of $22.2 billion, according to the index, as shares of the retailer that operates the Zara clothing chain rose 66.7%.

"It's an amazing company that has done great, and the gains are quite justified given its performance," said Christodoulos Chaviaras, an analyst at Barclays in London who's had an "equalweight" rating on Inditex for about a year. "Can they repeat that? It will be harder. A lot of the positive news is already reflected in the share price."

Global stocks soared in 2012. The MSCI World Index gained 13.2% during the year to close at 1338.50 on Dec. 31. The Standard & Poor's 500 index rose 13.4% to close at 1426.19.

European stocks surged in the second half of the year. The Stoxx Europe 600 index is up 19.6% since June 4, advancing as the European Central Bank introduced bond-buying programs, S&P upgraded Greece's debt and German business confidence rose more than forecast. The benchmark gauge's 14.4% advance for the year was the best annual return since 2009.

Carlos Slim, the telecommunications magnate who controls Mexico's America Movil, maintained his title as the richest person on Earth for the entire year. The 72-year-old's net worth rose $13.4 billion, or 21.6%, through Dec. 31, making him the second-biggest gainer by dollars.

Gains by Slim's industrial conglomerate, Grupo Carso, and Grupo Financiero Inbursa, his banking and insurance operation, more than offset the decline posted by America Movil, his biggest holding. The largest mobile phone operator in the Americas by subscribers fell 5.8% to close at 14.9 pesos at the end of the year.

U.S. software mogul Bill Gates, 57, ranks second on the list, trailing Slim by $12.5 billion. The Microsoft Corp. co-founder added $7 billion to his net worth as shares of the Redmond, Wash., company rose 2.9%. Microsoft stock accounts for less than 20% of the billionaire's fortune.

Warren Buffett, 82, lost his title as the world's third-richest man to Ortega on Aug. 6. The Berkshire Hathaway Inc. chairman gained $5.1 billion during the year, even after donating 22.3 million Berkshire Class B shares in July to charity. The billionaire, who has pledged to give away most of his fortune, spent much of the year pressing for higher taxes on the wealthy.

Ikea founder Ingvar Kamprad, 86, is the world's fifth-richest person with a $42.9-billion fortune. The complex ownership structure behind Ikea, the world's largest furniture retailer, became more transparent in August after Ikea's franchisor published its financial performance publicly for the first time. His net worth rose 16.6% in 2012.

Brazil's Eike Batista, 56, was the year's biggest loser by dollars, falling $10.1 billion. The commodities maven, who vowed a year ago that he'd become the world's wealthiest man by 2015, sold a 5.63% stake in his EBX Group Co. in March to Abu Dhabi's Mubadala Development Co.

As part of the deal, he pledged an unspecified additional stake in 2019 if he fails to meet a 5% annual return on the sovereign wealth fund's $2-billion investment, according to a person with knowledge of the deal. Batista now ranks 75th in the world with a net worth of $12.4 billion. On March 27, he was worth $34.5 billion and ranked 8th on the Bloomberg index.

Batista's former title as the richest Brazilian is now held by 73-year-old banker Jorge Paulo Lemann, who ranks 37th on the index with an $18.8-billion fortune. The country's second-richest person is Dirce Camargo, the matriarch behind Camargo Correa, the Sao Paulo conglomerate that has interests in cement, electricity and Havaianas flip-flops. Her net worth is $13.4 billion, according to the Bloomberg ranking.

Camargo, who doesn't appear on any other major international wealth ranking, is one of 54 billionaires the index uncovered during the year. Among the others: Hamdi Ulukaya, the 40-year-old Turkish immigrant owner of Chobani, the bestselling yogurt brand in the U.S.; South Africa's Nathan "Natie" Kirsh, 80, who amassed a $5.4-billion fortune in retail and real estate; and Elaine Marshall, 70, whose 14.6% ownership of closely held Koch Industries makes her the fourth-richest woman in America. She is worth $14.1 billion.

Koch Industries' two other shareholders, the brothers Charles and David Koch, are each worth $40.9 billion, up $7.1 billion, or 20.9%, for the year.

Oracle Corp. founder Larry Ellison rose $6.4 billion in 2012 as shares of the world's largest database company jumped 31.7%. Ellison, 68, who has more than tripled the amount of Oracle stock he has pledged against lines of credit in the last year, agreed to buy 98% of Hawaii's Lanai island. The 141-square-mile parcel with no traffic lights was purchased from billionaire David Murdock, the 89-year-old chairman of Dole Food Co., the world's largest producer of fresh fruit and vegetables.

The bulk of Ellison's fortune comes from his 23.5% stake in Oracle. He also has interests in software makers NetSuite Inc. and LeapFrog Enterprises Inc., as well as property holdings, including estates in California and Newport, R.I.

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