Domino's hopes customers flock to 'pizza theater'

A pair of mustachioed pizza makers in blue aprons — visible from behind a glass display at a new Domino's store in Seattle — tossed dough into the air as a handful of corporate executives looked on.

Domino's calls the concept "pizza theater" because customers now can come in and watch their orders being made.

The new look is part of a four-year effort to freshen the pizza chain's image and boost its growing ranks of carryout customers.

The open-kitchen format includes seating for a dozen or so people, a chalkboard where customers can leave comments, and a refrigerated section for grab-and-go items such as salads and milk.

"This is the way we always made our pizzas. A lot of people just had no idea," said Domino's Chief Executive Patrick Doyle, who was in Seattle last week to see the new store. "It was sort of one of those lightning-bolt moments where we said, 'Gee, maybe we should show them.' "

Founded in 1960, Domino's long has been known for inexpensive pizza delivered to your doorstep. Its 30-minute guarantee helped make it the world's largest pizza-delivery company in the 1980s (though it later had to drop the pledge amid charges that it led to reckless driving).

Today, the Ann Arbor, Mich., company holds a 22% share of the U.S. pizza-delivery market and ranks No. 2 overall among U.S. pizza chains.

More than two-thirds of U.S. consumers buy carryout pizza at least once a month, making carryout the most popular pizza format, according to research firm Technomic Inc. Nearly half of all pizza orders are for carryout, while a third are for delivery and a fifth are for eat-in.

Experts say that if a Domino's store is nearby, many consumers prefer to pick up their orders and save a few dollars that otherwise would go to a delivery fee and tip.

Domino's jumped on the trend last year when it began offering a weekday pickup promotion of a large three-topping pizza for $7.99. It also redesigned its logo, dropping the word "pizza" to reflect a larger menu, including sandwiches, pasta and chocolate "lava" cakes.

Doyle said the plan is to redo the greater Seattle area's 74 franchised locations by midyear, which would make Seattle the first market to be completely overhauled.

Doyle said Domino's also is setting out to hire 800 new full-time and part-time employees in that area — something he attributed to new store openings, as well as solid sales growth.

Domino's has about 4,500 U.S. franchised stores, as well as 390 company-owned stores. Its U.S. sales at stores open at least a year rose 3.3% in the third quarter, and its stock has been trading at the upper end of a 52-week range of $28.17 to $47.91. Its shares rose 8 cents Monday to $46.81.

Pizza Hut is the largest U.S. pizza chain, with an 18% market share, followed by Domino's, at 11%, and Papa John's, at 7%, according to Technomic.

In late 2009, Domino's rolled out a new recipe promising a garlic-seasoned crust, bolder tomato sauce and tastier cheese. The new store format builds on that push to be more transparent, Doyle said.

"Consumers want to see what they're eating," he said. "We've always been known as delivery experts, but a third or more of our orders now are for carryout. We're proud of these pizzas, and we want people to see it."

Seattle resident James Johnson, 28, a longtime Domino's customer, said he welcomes the changes. Johnson stopped by the revamped Domino's on his way home from work last week to pick up dinner.

"You can watch the pizza being made from beginning to end," he said. "It's kind of cool to see, depending on whether you're engaged and not on your cellphone."

Martinez writes for the Seattle Times.

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Locals believe bobcat trappers are crossing the line in Joshua Tree

JOSHUA TREE — Annica Kreuter's backyard on the edge of Joshua Tree National Park has been a perfect place to chronicle the adventures of eight bobcats.

Over the last decade she has watched a young bobcat chased up a tree by a coyote; an alpha male surveying the landscape from the hood of her car; a kitten sauntering into the yard as she gardens; a matron sniffing the back of Kreuter's neck as she napped on a hammock.

Lately, seven of the eight have vanished. "At sunrise, I hear the one that is still here crying for his family," Kreuter said.

She and others in this high desert community of about 8,000 say bobcats have been disappearing lately, killed for the value of their pelts by trappers who often trespass on private property. The trappers come armed with wire cages, squirt bottles of potent scent and bobcat lures: battery-powered vibrating pet toys festooned with feathers to resemble dying birds.

Hunting and trapping bobcats is legal during hunting season outside of the national park boundaries. But to the locals, that makes little difference. "The very idea of trapping in a place where bobcats are so well-known they have nicknames — Big Gray, Leroy, Tomboy — is disturbing and heartbreaking," Kreuter said.

As one of the top predators of a 720,000-acre park visited by 1.4 million people each year, the bobcat's presence — or absence — has a cascade of consequences, making it a governing force of the ecosystem and the local ecotourism economy. An adult bobcat stands about 15 inches high and can cover 25 to 30 miles of territory in a day. Using razor-sharp claws and powerful legs, it preys on rabbits and makes a significant contribution to rodent control.

Critics believe the trappers are after bobcats that routinely crisscross the invisible park boundary lines.

"This is really, really bad," said astronomer and conservationist Tom O'Key, who was the first to discover a trap. "These guys are carpetbaggers coming onto private land to slaughter bobcats with no regard for a tight-knit community that cares deeply about the national park and its wildlife."

O'Key alerted the community after finding a trap chained to a jojoba bush and camouflaged with broken branches and leaves on his property north of the park. He notified the San Bernardino County Sheriff's Department and the Hi-Desert Star newspaper.

Bobcats are being targeted for the value of their pelts in top-dollar markets such as China, Russia and Greece. A premium pelt of heavily spotted white belly fur can earn a trapper more than $600, according to Nathan Brock, who skinned 10 bobcats that he captured in the Joshua Tree area during the hunting season that ended Jan. 31.

Brock, 38, an active-duty Marine stationed at nearby Twentynine Palms Marine Corps Base, acknowledged that one of his traps was set on private property and not on federal Bureau of Land Management grounds, where trapping is legal. The region is a patchwork of private property and BLM land.

"I feel horrible about that," Brock said. "It's my fault for not making sure."

The manufacturer of Brock's trap, Mercer Lawing of Barstow, said critics miss the point. "We love those animals more than the people who are complaining about us trapping them do," Lawing said. "Nathan and I harvest adult male cats and turn loose adult females and kittens."

The national park has taken a neutral position on the issue, given that its jurisdictional reach extends only as far as its boundaries.

However, park biologist Michael Vamstad said, "Residents have every right to be upset. The fact that there is no limit on bobcats that can be legally taken during hunting season doesn't jibe along the edges of a national park. It's a relic regulation."

Conservationists are calling for a "no-trapping" buffer zone in the area because bobcats travel along a web of interconnected wildlife corridors stretching from the national park to the Marine base about 10 miles to the north.

"The law has to change if it's legal for a handful of people to line the boundary of a national park with traps to catch bobcats, then send their pelts to China for profit," said Brendan Cummings, public lands director for the Center for Biological Diversity. "We are not going to let this happen again."

Equally pointed words came from Nancy Karl, executive director of the Mojave Desert Land Trust, a nonprofit dedicated to preserving safe passage for wildlife between protected areas. "We are watching and paying close attention — and we are going to change things," Karl said. "Those trappers would be best advised to move it."

louis.sahagun@latimes.com

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Producers: 'Chicago' cast to join Oscar performers

LOS ANGELES (AP) — Academy Awards producers Craig Zadan and Neil Meron have run out of rehearsal space. Dressing rooms, too.

The award-winning production duo is planning the most performance-filled Oscar show ever. They promise a "wow moment" in each of its 13 acts, so the show demands a more dynamic stage and more dressing rooms and rehearsal time than previous Oscar productions.

"I don't think any Oscars have been as performance-based," Meron said.

It's no surprise, given the pair's hit-filled history: They produced 2003's best picture, "Chicago," and count TV's "Smash" and the recent Broadway revival of "How to Succeed in Business Without Really Trying" among their credits.

Running out of space for their Oscar production's A-list roster of performers — including Barbra Streisand, Adele and Norah Jones — is what Zadan calls a "great problem."

"When you do an Oscar show, you don't have a dressing room problem. The presenters don't get dressing rooms. And how many people perform on the Oscars, like one or two?" he said. "We have a staggering amount of performers, and each of them needs a dressing room... We're measuring the magnitude of how big the show is by the fact that we don't have (enough) dressing rooms."

Just added to the list of stars who may need spots? The cast of "Chicago."

The producers announced Monday that Renee Zellweger, Catherine Zeta-Jones, Queen Latifah and Richard Gere will reunite on the stage where "Chicago" won its Oscar 10 years ago.

"In a night of celebration of the music of the movies, we find it very appropriate," Meron said.

So will the musical cast sing?

"We can't talk about what they're going to do!" Zadan said.

Here's what they will talk about:

— Expect a dynamic, screen-filled set to accommodate the movie-focused numbers: "We're using a lot of cutting-edge technology with new LED screens of different sizes, shapes and configurations... It's kind of thrilling what we're doing with screens," Zadan said. "There will be, too, the regular screen that you have to use each year... but then we have all kinds of other screens that we're using in the show that are completely unique and different and allow us to do stuff with cinema, so it's not a concert thing where somebody comes out and sings a song. It's all integrated into movies."

— Look for a lot of host Seth MacFarlane: "He's going to be very present as a host, as a host should," Meron said.

— And expect to hear him show off his chops: "Seth will sing. He's got a great voice," Zadan said.

"Seth really does understand and have great reverence for the music of the movies," Meron added. "He loves it."

— And about those "wow moments?" Among them will be a celebration of the James Bond film franchise, a tribute to movie musicals, Streisand, Adele, a "special appearance" by Daniel Radcliffe, Charlize Theron, Channing Tatum and Joseph Gordon-Levitt, and maybe something from the cast of "Chicago."

"We think seeing the cast of 'The Avengers' is pretty wow," Meron said.

Better book them a dressing room.

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Contact Sandy Cohen at www.twitter.com/APSandy.

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Well: 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.

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

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Dozens of airline fees rose or changed in 2012, study finds

Airline travel fees — including charges to check a bag and to board early — have become so prevalent that travelers almost need an advanced degree in mathematics to calculate overall trip costs.

Last year at least 36 airline fees increased, and 16 others were redefined, bundled or unbundled with other services, according to a recent study by the consumer travel website Travelnerd.

One bright spot in the Travelnerd study of 14 U.S. airlines is that most fee increases were only $5 to $10 each.

In one case an airline had a big fee reduction. The study found that United Airlines reduced its fee for checking an overweight bag to $100 from $200 for bags 50 to 70 pounds and to $200 from $400 for bags 71 to 100 pounds.

"Travelers really have to be extra cautious when booking a flight," said Alicia Jao, vice president of travel media at Travelnerd, who predicts travelers will see even more fees in 2013. "U.S. carriers are becoming creative at charging consumers extra fees."

But some airlines seem to charge fees arbitrarily, said Perach Mazol, a Los Angeles resident who recently flew to Florida with friends from Romania to take a cruise.

On her flight from L.A. to Fort Lauderdale, Fla., on Spirit Airlines, she said the Florida airline did not charge for the carry-on bags she and her friends were carrying, but the carrier asked for $50 each to carry the same bags on the flight back. (Spirit is one of only two airlines in the U.S. that charge passengers for carry-on luggage.)

"I don't understand why they charged us on one flight and they don't on the other," Mazol said. "It's confusing."

A spokeswoman for Spirit said the airline tries to enforce its policies consistently.

"Maybe she got lucky one way and didn't have to pay," Spirit spokeswoman Misty Pinson said.

United offering satellite-based Wi-Fi

United Airlines was one of the last major airlines to offer onboard wireless Internet. But the Chicago carrier is trying to make up for its tardiness.

United offers Wi-Fi in about 3% of its fleet of about 700 planes, one of the lowest rates of any major carrier in the nation, according to a recent study.

But United recently became the first U.S.-based international carrier to offer satellite-based Wi-Fi Internet for passengers traveling on long-haul overseas flights.

The carrier has installed satellite-based Wi-Fi on nearly a dozen planes, with plans to expand the service to more than 300 planes, or about 43% of the fleet, by the end of the year.

"With this new service, we continue to build the airline that customers want to fly," said Jim Compton, vice chairman and chief revenue officer at United.

Satellite-based Wi-Fi is typically as fast as ground-based Wi-Fi, experts say, but the advantage is that it can give passengers Internet access when flying over areas where cellular towers don't exist — such as the Pacific or Atlantic oceans.

But, of course, there is a price to pay for the service.

United is charging $3.99 to $14.99 for standard speed, depending on the duration of the flight, and $5.99 to $19.99 for faster speeds.

United is not the only airline to offer satellite-based Wi-Fi. Southwest Airlines, the nation's largest domestic carrier, offers it through Westlake Village-based Row 44.

Delta to raise fee to access lounges

Airline fees are rising not only for onboard services but for amenities at the airport too.

Delta Air Lines, which has invested more than $20 million in its airport lounges over the last two years, announced that it would raise the cost for annual membership to access its lounges across the country by $50, starting March 1.

The increase means that an annual membership will range from $350 to $450, depending on membership level. (The more miles passengers fly on Delta the less they pay for membership.)

Among the investments Delta has made is the addition of a new luxury bar that opened recently at Delta's lounge at Los Angeles International Airport. Instead of helping themselves at a self-serve bar, members can now belly up to a fully stocked bar and order a drink from a bartender.

hugo.martin@latimes.com

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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?”

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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

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Grammy nominee Frank Ocean performs at Levi event

LOS ANGELES (AP) — Frank Ocean is nominated for six awards and will perform at Sunday's Grammys, and he warmed up at an event for a few hundred people Friday night.

The R&B singer-songwriter performed a 30-minute set at the Ace Museum in Los Angeles. He was calm onstage, singing songs like "Pyramid," ''Crack Rock," ''Sierra Leone" and "Thinkin Bout You," which is nominated for record of the year at the Grammys.

The 25-year-old wore his signature headband while purple lights shined in the background. He bent on his knees as his guitarist jammed on one song.

Ocean is part of the six top acts nominated for six awards at the Grammy Awards. His debut studio album, "channel ORANGE," is nominated for album of the year. He's also up for best new artist.

Ocean performed at an event for Levi celebrating the denim brand's 140 year anniversary of its 501 jeans. He'll compete with acts like fun. and The Black Keys in major categories at the Grammys, to air live from the Staples Center on CBS.

___

Online:

http://frankocean.com/

http://grammy.com

____

Follow Mesfin Fekadu at http://www.twitter.com/MusicMesfin

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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.

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Entrepreneur Brian Lee is business partner to the stars

The gig: Lawyer-turned-serial-entrepreneur Brian Lee, 41, is pulling double duty as the chief executive of two celebrity-backed e-commerce websites: ShoeDazzle, co-founded with Kim Kardashian, and Honest Co., co-founded with Jessica Alba. The companies are headquartered in Santa Monica and offer customers monthly subscription plans in addition to typical a la carte shopping for shoes and baby products, respectively.

ShoeDazzle has more than 15 million registered users and last year posted $100 million in revenue, up 80% from 2011; it has raised $66 million from investors including venture capital firm Andreessen Horowitz. Honest Co., launched a year ago, has yet to release membership or financial numbers but has raised $27 million.

From Seoul to L.A.: Lee was born in Seoul. When he was 1, his family immigrated to Huntington Beach, where he grew up.

As an 8-year-old, Lee mapped out his trick-or-treating route on Halloween so he could collect as much candy as possible. When he got home, he separated his loot into Ziploc bags, which he sold at school for 25 cents each.

"Cost of goods: zero. Profit margins: 100%, outside of my own little labor," he said. "I probably did that for five years."

He now lives in Marina del Rey with his wife, Mira; their 4-year-old son, Davis; and their 1-year-old daughter, Madison.

Education: Bachelor's degree in business economics from UCLA in 1993, J.D. from UCLA School of Law in 1996.

Bold cold call: After practicing law for a few years, Lee came up with the idea for LegalZoom, which offers self-help legal documents such as divorce and bankruptcy forms, prenuptial agreements and wills. He wanted a high-profile name to represent the start-up, and decided to approach O.J. Simpson defense attorney Robert Shapiro.

Lee got Shapiro's number from 411 and called him at 10 p.m. "He picked up the phone and said, 'Hi, this is Robert Shapiro, how can I help you?' and I said, 'Well, my name is Brian Lee and I have a business opportunity I'd like to run by you.'... I think he heard the desperation in my voice and he said, 'You've got two minutes.'"

LegalZoom, based in Glendale, launched in 2001.

Online shoe shopping: ShoeDazzle was inspired by Lee's wife, who one day returned from a shopping spree on Robertson Boulevard with a pair of pricey designer shoes. When Lee asked her why she didn't just go to Loehmann's or DSW, she said discount chains didn't provide the type of personalized, one-on-one service that small boutiques did. Lee set out to replicate that experience online and met Kardashian through Shapiro, who is a family friend.

ShoeDazzle launched four years ago as an online subscription business, with members viewing a customized showroom of shoes based on a personal fashion quiz and choosing one new pair to receive every month for $39.95 including shipping.

Taking back the reins: In November, Lee became CEO of ShoeDazzle for a second time. He returned after the departure of Bill Strauss, who scrapped the company's subscription-based business model last year, leading to speculation that the company wasn't doing well.

In his first 100 days on the job, Lee laid off about two dozen employees and hired celebrity fashion stylist Rachel Zoe as the company's chief stylist; ShoeDazzle also began introducing one new shoe style every day. This month the company will roll out an optional $9.95-a-month VIP membership program that includes free shipping, early access to sales, discounts and an extended return policy.

Since a site relaunch in January, orders have increased 30% and repeat visits are up 12%, Lee said. The company sells as many as 250,000 pairs of shoes per month.

From shoes to babies: Lee was approached by Alba when the actress wanted to start an eco-friendly baby products line. Honest Co. sells diapers, shampoo, sunscreen and household items online that are nontoxic and made with organic ingredients.

Caffeine junkie: As the CEO of two companies, Lee arrives at Honest Co. offices by 7 a.m. every day and is there until 9:30 a.m. He then heads over to nearby ShoeDazzle, where he stays until 5 p.m. or so. Then it's back to Honest Co. until about 8 or 9 p.m.

"I drink seven Coca-Colas a day," he said. "Regular Coke, which is really bad for me."

Advice to entrepreneurs: "Believe in the idea with 100% certainty," Lee said. "But also don't be scared to change that idea and pivot very quickly. Because as an entrepreneur, nothing ever goes to plan."

For instance, Lee said that in the early days of LegalZoom, the company created do-it-yourself software programs such as Estate Planning in a Box that it hoped to sell at Staples and OfficeMax. When LegalZoom realized that Internet-based downloading was the future, it dropped those plans.

"We spent a lot of resources on it," he said, "but we weren't afraid at all to just cut it."

andrea.chang@latimes.com

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