Suit over hiring of Jackson doctor to go to trial


LOS ANGELES (AP) — A judge has dismissed all but one count in a civil lawsuit by Michael Jackson's mother against concert giant AEG Live, which hired a doctor who was convicted of involuntary manslaughter in the singer's death.


Superior Court Judge Yvette Palazuelos' ruling Thursday means that Katherine Jackson will have a trial on her claim that AEG negligently hired and supervised former cardiologist Conrad Murray. The ruling dismisses claims that AEG could be held liable for Murray's conduct and breached its duty to properly care for the pop superstar.


AEG Live was promoting a series of comeback concerts by Michael Jackson in London titled "This Is It." Jackson died in June 2009 while in final preparations for the shows after Murray administered a lethal dose of the anesthetic propofol in the singer's bedroom.


Katherine Jackson's attorney Kevin Boyle was not immediately available for comment but argued at a hearing Monday that AEG controlled Murray's actions and failed to properly investigate him before agreeing to pay him to work as the singer's physician.


He cited Murray's debt problems as a red flag that AEG should have spotted and contends the company created a serious conflict between his responsibility to Jackson and his own financial well-being.


Jackson died at age 50 before a contract that would have paid Murray $150,000 a month was finalized.


AEG attorney Marvin Putnam has said Murray was not employed by the promoter and he expects the company to win at trial. He said Katherine Jackson's lawyers will be unable to prove that AEG should have foreseen that Murray was a danger to the "Thriller" singer.


A trial is scheduled to begin April 2.


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Anthony McCartney can be reached at http://twitter.com/mccartneyAP .


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Well: A Rainbow of Root Vegetables

This week’s Recipes for Health is as much a treat for the eyes as the palate. Colorful root vegetables from bright orange carrots and red scallions to purple and yellow potatoes and pale green leeks will add color and flavor to your table.

Since root vegetables and tubers keep well and can be cooked up into something delicious even after they have begun to go limp in the refrigerator, this week’s Recipes for Health should be useful. Root vegetables, tubers (potatoes and sweet potatoes, which are called yams by most vendors – I mean the ones with dark orange flesh), winter squash and cabbages are the only local vegetables available during the winter months in colder regions, so these recipes will be timely for many readers.

Roasting is a good place to begin with most root vegetables. They sweeten as they caramelize in a hot oven. I roasted baby carrots and thick red scallions (they may have been baby onions; I didn’t get the information from the farmer, I just bought them because they were lush and pretty) together and seasoned them with fresh thyme leaves, then sprinkled them with chopped toasted hazelnuts. I also roasted a medley of potatoes, including sweet potatoes, after tossing them with olive oil and sage, and got a wonderful range of colors, textures and tastes ranging from sweet to savory.

Sweet winter vegetables also pair well with spicy seasonings. I like to combine sweet potatoes and chipotle peppers, and this time in a hearty lentil stew that we enjoyed all week.

Here are five colorful and delicious dishes made with root vegetables.

Spicy Lentil and Sweet Potato Stew With Chipotles: The combination of sweet potatoes and spicy chipotles with savory lentils is a winner.


Roasted Carrots and Scallions With Thyme and Hazelnuts: Toasted hazelnuts add a crunchy texture and nutty finish to this dish.


Carrot Wraps: A vegetarian sandwich that satisfies like a full meal.


Rainbow Potato Roast: A multicolored mix that can be vegan, or not.


Leek Quiche: A lighter version of a Flemish classic.


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Dow rises 35 points but stops short of record again









The Dow Jones industrial average is within striking distance of a new record.


Still.


In what has become a near-daily ritual, the world's best-known stock index inched closer to an all-time high Friday but stopped short once again.





The Dow climbed 35 points to rise for the second straight week. That marked a fresh five-year high and the third-best close of all time.


But whether it's the budget stalemate in Washington or the typical jitters that precede such milestones, the blue chips couldn't push into new high ground.


The Dow ended at 14,089.66 — just 75 points, or roughly 0.5%, from its peak close of 14,164.53 on Oct. 9, 2007.


Since climbing above 14,000 on Feb. 1, the index has largely meandered sideways, unable to muster the additional 165 points needed for the record.


Many experts think that will happen eventually, given the generally upbeat spirits among U.S. investors and consumers.


"The bottom line is stocks are headed higher," said John Bollinger, head of Bollinger Capital Management in Manhattan Beach. "It's going to be volatile and hard going. It won't be easy money, but it will be money."


The Standard & Poor's 500 index is further away from a new high — about 3% — largely because of the continuing travails of Apple Inc. After a 2.5% drop to $430.47 on Friday, the technology behemoth has sunk 39% from its mid-September peak above $700.


Investors are encouraged that stocks have risen in the face of the budget showdown in Washington. The $85 billion in automatic spending cuts, known as sequestration, began taking effect Friday after federal lawmakers could not reach agreement on a plan to avert them.


The Dow might have achieved a new high already if not for the economic uncertainty brought about by the budget clash, said A.C. Moore, chief investment strategist for Dunvegan Associates Inc. in Santa Barbara.


"There's an undercurrent of positive worldwide economic developments that continues to buoy stock prices," Moore said.


Some experts think stocks have risen because of sequestration rather than in spite of it. Their logic is that investors cheer anything out of Washington, albeit unwieldy and scattershot, if it reduces budget deficits.


"Is it possible that the market actually likes the idea of sequestration?" Bollinger said. "It's the only way it sees that any of this is going to get cut."


Consumer confidence surged in February as the improving job market offset concerns about higher taxes and looming federal spending cuts.


The monthly consumer sentiment index from Thomson Reuters and the University of Michigan rose 5.1% last month from January. The new reading of 77.6 also was up 3.1% from a year earlier.


"Consumer confidence continued to improve in February due to expected gains in employment," said Richard Curtin, the survey's chief economist. "These expected job gains have partially offset concerns about higher payroll taxes and the impending reduction in federal spending."


Although the unemployment rate ticked up to 7.9% in January, the economy added 157,000 jobs and figures for the last three months of 2012 were revised sharply upward. Weekly jobless claims have been trending down.


Meanwhile, consumers spent slightly more in January than in the previous month even as their income plummeted by the largest amount in 20 years because of the "fiscal cliff," the Commerce Department said Friday.


People boosted their spending by saving less money as they sought to offset tax increases that took effect. The personal saving rate in January was 2.4%, down from 6.4% in December, the lowest monthly level since late 2007.


The U.S. economic data offset downbeat news from Europe, where joblessness hit a new high.


The Eurozone's jobless rate went up in January to 11.9%, from 11.8% in December, as the region continued to grapple with recession and government cutbacks.


walter.hamilton@latimes.com


jim.puzzanghera@latimes.com


Staff writer Don Lee contributed to this report.





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Jury in Bell corruption trial may be deadlocked









A court spokeswoman said Thursday the jury in the Bell corruption case appears to be deadlocked.

“The jurors may be at an impasse,” said Patricia Kelly, a spokeswoman for L.A. County Superior Court.


Jurors sent a note to the judge Thursday morning, and all the attorneys in the case were called in.








Six former Bell City Council members are accused of stealing public money by paying themselves extraordinary salaries in one of Los Angeles County’s poorest cities.


Luis Artiga, Victor Bello, George Cole, Oscar Hernandez, Teresa Jacobo and George Mirabal are accused of misappropriation of public funds, felony counts that could bring prison terms.


They were arrested in September 2010 and have been free on bail.


The nearly $100,000 salaries drawn by most of the former elected officials are part of a much larger municipal corruption case in the southeast Los Angeles County city in which prosecutors allege that money from the city’s modest general fund flowed freely to top officials.


The three defendants who testified painted a picture of a city as a place led by a controlling, manipulative administrator who handed out enormous salaries, loaned city money and padded future pensions. Robert Rizzo, the former adminstrator, and ex-assistant city manager Angela Spaccia are also awaiting trial.


The four-week trial of the former council members turned on extremes.


Deputy Dist. Atty. Edward Miller said the council members were little more than common thieves who were consumed with fattening their paychecks at the expense of the city’s largely immigrant, working-poor residents.


Miller said the accused represented the “one-percenters" of Bell who had “apparently forgotten who they are and where they live."


Defense attorneys said the former city leaders -- one a pastor, another a mom-and-pop grocery store owner, another a funeral director -- were dedicated public servants who put in long hours and tirelessly responded to the needs of their constituents.


Jacobo testified that Rizzo informed her she could quit her job as a real estate agent and receive a full-time salary as a council member. She said she asked City Attorney Edward Lee if that was possible and he nodded his head.


"I thought I was doing a very good job to be able to earn that, yes," Jacobo said.


Cole said Rizzo was so intimidating that the former councilman voted for a 12% annual pay raise out of fear the city programs he established would be gutted by Rizzo in retaliation if he opposed the pay hikes.


The defense argued that the prosecution failed to prove criminal negligence -- that their clients knew what they were doing was wrong or that a reasonable person would know it was wrong.


The attorney for Hernandez, the city’s mayor at the time of the arrests, said his client had only a grade-school education, was known more for his heart than his intellect and was, perhaps, not overly “scholarly.”


Prosecutors argued that the council members pushed up their salaries by serving on city boards that rarely met and, in one case, existed only as a means for paying them even more money.


Jurors were also left to deal with the question of whether council members were protected by a City Charter that was approved in a special election that drew fewer than 400 voters.


Defense attorneys say the charter allowed council members to be paid for serving on the authorities.


But the prosecutor argued that the charter -- a quasi-constitution for a city -- set salaries at what councils in similar-sized cities were receiving under state law: $8,076 a year. Because council members automatically serve on boards and commissions, the district attorney said the total compensation for all of each council member's work was included in that figure.





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'Girls Gone Wild' files for bankruptcy over debts


LOS ANGELES (AP) — The company behind the "Girls Gone Wild" video empire has filed for bankruptcy in a move it says is an effort to restructure its legal affairs after several disputed court judgments.


GGW Brands LLC and several subsidiaries filed for Chapter 11 bankruptcy on Wednesday in Los Angeles, listing more than $16 million in disputed claims.


The largest claim is $10.3 million that Wynn Resorts Limited is seeking from the company for judgments entered against "Girls Gone Wild" founder Joe Francis over a gambling debt and statements he has made about the casino and its founder, Steve Wynn.


The figure does not include a $19 million judgment Wynn won against Francis in a slander trial last year. The case, which centered on Francis' claims that Wynn threatened to kill him over the gambling debt, is being appealed.


Francis no longer GGW Brands, which has made a fortune selling videos and magazines of young women flashing their breasts. Subsidiary companies GGW Magazine and GGW Events have also filed for bankruptcy. Bankruptcy proceedings generally halt efforts to collect judgments in other courts.


"Girls Gone Wild remains strong as a company and strong financially," the company said in a statement, likening itself to other businesses such as American Airlines and General Motors that have filed for bankruptcy to restructure. "The only reason Girls Gone Wild has elected to file for this reorganization is to re-structure its frivolous and burdensome legal affairs."


The second largest claim listed in the proceedings is a nearly $5.8 million judgment a St. Louis woman won against Francis last year in a Missouri court. Tamara Favazza sued after she learned she had been featured on a "Girls Gone Wild" DVD over an incident when she was a 20-year-old college student and someone lifted her tank top at a bar and flashed a camera.


Francis and his company, Mantra Films, are seeking to have the judgment overturned in federal court.


The bankruptcy filing also lists unspecified legal fees in the Wynn and Favazza cases.


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Doctor and Patient: Why Failing Med Students Don’t Get Failing Grades

Tall and dark-haired, the third-year medical student always seemed to be the first to arrive at the hospital and the last to leave, her white coat perpetually weighed down by the books and notes she jammed into the pockets. She appeared totally absorbed by her work, even exhausted at times, and said little to anyone around her.

Except when she got frustrated.

I first noticed her when I overheard her quarreling with a nurse. A few months later I heard her accuse another student of sabotaging her work. And then one morning, I saw her storm off the wards after a senior doctor corrected a presentation she had just given. “The patient never told me that!” she cried. The nurses and I stood agape as we watched her stamp her foot and walk away.

“Why don’t you just fail her?” one of the nurses asked the doctor.

“I can’t,” she sighed, explaining that the student did extremely well on all her tests and worked harder than almost anyone in her class. “The problem,” she said, “is that we have no multiple choice exams when it comes to things like clinical intuition, communication skills and bedside manner.”

Medical educators have long understood that good doctoring, like ducks, elephants and obscenity, is easy to recognize but difficult to quantify. And nowhere is the need to catalog those qualities more explicit, and charged, than in the third year of medical school, when students leave the lecture halls and begin to work with patients and other clinicians in specialty-based courses referred to as “clerkships.” In these clerkships, students are evaluated by senior doctors and ranked on their nascent doctoring skills, with the highest-ranking students going on to the most competitive training programs and jobs.

A student’s performance at this early stage, the traditional thinking went, would be predictive of how good a doctor she or he would eventually become.

But in the mid-1990s, a group of researchers decided to examine grading criteria and asked directors of internal medicine clerkship courses across the country how accurate and consistent they believed their grading to be. Nearly half of the course directors believed that some form of grade inflation existed, even within their own courses. Many said they had increasing difficulty distinguishing students who could not achieve a “minimum standard,” whatever that might be. And over 40 percent admitted they had passed students who should have failed their course.

The study inspired a series of reforms aimed at improving how medical educators evaluated students at this critical juncture in their education. Some schools began instituting nifty mnemonics like RIME, or Reporter-Interpreter-Manager-Educator, for assessing progressive levels of student performance; others began to call regular meetings to discuss grades; still others compiled detailed evaluation forms that left little to the subjective imagination.

Now a new study published last month in the journal Teaching and Learning in Medicine looks at the effects of these many efforts on the grading process. And while the good news is that the rate of grade inflation in medical schools is slower than in colleges and universities, the not-so-good news is that little has changed. A majority of clerkship directors still believe that grade inflation is an issue even within their own courses; and over a third believe that students have passed their course who probably should have failed.

“Grades don’t have a lot of meaning,” said Dr. Sara B. Fazio, lead author of the paper and an associate professor of medicine at Harvard Medical School who leads the internal medicine clerkship at the Beth Israel Deaconess Medical Center in Boston. “‘Satisfactory’ is like the kiss of death.”

About a quarter of the course directors surveyed believed that grade inflation occurred because senior doctors were loath to deal with students who could become angry, upset or even turn litigious over grades. Some confessed to feeling pressure to help students get into more selective internships and training programs.

But for many of these educators, the real issue was not flunking the flagrantly unprofessional student, but rather evaluating and helping the student who only needed a little extra help in transitioning from classroom problem sets to real world patients. Most faculty received little or no training or support in evaluating students, few came from institutions that had remediation programs to which they could direct students, and all worked under grading systems that were subjective and not standardized.

Despite the disheartening findings, Dr. Fazio and her co-investigators believe that several continuing initiatives may address the evaluation issues. For example, residency training programs across the country will soon be assessing all doctors-in-training with a national standards list, a series of defined skills, or “competencies,” in areas like interpersonal communication, professional behavior and specialty-specific procedures. Over the next few years, medical schools will likely be adopting a similar system for medical students, creating a national standard for all institutions.

“There have to be unified, transparent and objective criteria,” Dr. Fazio said. “Everyone should know what it means when we talk about educating and training ‘good doctors.’”

“We will all be patients one day,” she added. “We have to think about what kind of doctors we want to have now and in the future.”

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Student loan delinquency rate is increasing









More people borrowing for education are failing to pay off their loans.


Almost a third of student-loan borrowers in repayment were delinquent at the end of last year, up from about a quarter in 2008 and 20% in 2004, according to a report on household debt and credit released Thursday by the Federal Reserve Bank of New York.


The amount of educational debt, which includes federally backed and private loans taken out by students and parents, has almost tripled in the last eight years to $966 billion, the bank said. With costs to attend college continuing to outpace the inflation rate, more borrowers are struggling to pay. That makes it harder for people, especially those ages 25 to 30, to secure other types of credit, including home mortgages.








"Student loan debt is the only kind of household debt that continued to rise during the Great Recession and has now the second-largest balance after mortgage debt," wrote Donghoon Lee, an economist at the New York Fed. "With delinquent student debt, mortgage origination is very difficult."


The New York Fed report is based on a sample of data provided by the credit bureau Equifax Inc. and examines borrowers' current debt. It doesn't measure how much was taken out at origination.


About 44% of student loan borrowers aren't repaying their loans because of deferments, forbearance or continued schooling.


Delinquency rates in 2012 were highest among borrowers younger than 30 who are repaying their loans. Thirty-five percent were 90 or more days behind, compared with 21% in 2004.


The Fed also reports on the share of all borrowers who are delinquent 90 days or more, including those in deferral, forbearance or still in school. That rate is 16% for those younger than 30, up from almost 8% in 2004.


As more people attend college, the average educational loan balance and the numbers of borrowers and delinquencies are increasing. The number of student-loan borrowers was almost 39 million in 2012, up 70% from about 23 million in 2004. The average borrower's balance in 2012 was $24,700, compared with $15,308 eight years earlier.


Total student-loan debt in the fourth quarter was $966 billion, up $10 billion from the previous quarter, according to the New York Fed. The federal Consumer Financial Protection Bureau put the number at $1 trillion last year.





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Race for L.A. city controller heats up









A previously low-profile race for Los Angeles city controller has begun to heat up as opponents of City Councilman Dennis Zine accuse him of "double dipping" the city's payroll and question why he is considering lucrative tax breaks for a Warner Center developer.


Zine, who for 12 years has represented a district in the southeast San Fernando Valley, is the better known of the major candidates competing to replace outgoing Controller Wendy Greuel.


The others are Cary Brazeman, a marketing executive, and lawyer Ron Galperin. Zine has raised $766,000 for his campaign, more than double that of Galperin, the next-highest fundraiser, and has the backing of several of the city's powerful labor unions.





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He also has been endorsed by Mayor Antonio Villaraigosa and several of his council colleagues. Galperin is backed by the Service Employees International Union, one the city's largest labor groups, and Brazeman is supported by retired Rep. Diane Watson and several neighborhood council representatives.


With the primary ballot less than a week away, Brazeman and Galperin have turned up the heat on Zine, hoping to push the race beyond the March 5 vote. If no one wins more than 50% of the ballots cast, the top two vote-getters will face a runoff in the May general election.


In a recent debate, Zine's opponents criticized him for receiving a $100,000 annual pension for his 33 years with the Los Angeles Police Department and a nearly $180,000 council salary. Brazeman and Galperin called it an example of "double dipping" that should be eliminated.


That brought a forceful response from Zine, who shot back that he gives a big portion of his police pension check to charities.


"I am so tired of hearing 'double dipping,' " he said. "I worked 33 years on the streets of Los Angeles. I have given over $300,000 to nonprofits that need it.... That's what's happened with that pension."


In the same debate, Brazeman accused Zine of cozying up to a Warner Center developer by pushing for tax breaks on a project that already has been approved. The nearly 30-acre Village at Westfield Topanga project would add 1 million square feet of new shops, restaurants, office space and a hotel to a faded commercial district on Topanga Canyon Boulevard.


"The councilman proposed to give developers at Warner Center tens of millions of dollars in tax breaks even though it's a highly successful project," he said. "He wants to give it away."


City records show that less than a month after the development was approved in February 2012, Zine asked the council for a study looking at possible "economic development incentives" that could be given to Westfield in return for speeding up street and landscaping enhancements to the project's exterior.


The motion's language notes that similar tax breaks have been awarded to large projects in the Hollywood and downtown areas, and that "similar public investment in the Valley has been lacking." Westfield is paying for the $200,000 study.


Zine defended his decision before the debate audience, saying if the study finds that the city will not benefit, no tax breaks will be awarded. "If there's nothing there, then they get nothing," Zine said.


The controller serves as a public watchdog over the city's $7.3-billion annual operation, auditing the general fund, 500 special fund accounts and the performance of city departments. Those audits often produce recommendations for reducing waste, fraud and abuse.


But the mayor and the council are not obligated to adopt those recommendations, and as a result the job is part accountant, part scolder in chief. All the candidates say they will use their elective position not only to perform audits but also to turn them into action.


Their challenge during the campaign has been explaining how they will do that.


Zine, 65, says his City Hall experience has taught him how to get things done by working with his colleagues. He won't be afraid to publicly criticize department managers, he said, but thinks collaboration works better than being combative.


"You can rant and rave and people won't work with you," he said. "Or you can sit down and talk it out, and you can accomplish things."


Galperin, 49, considers himself a policy wonk who relishes digging into the details to come up with ways to become more efficient with limited dollars and to find ways to raise revenue using the city's sprawling assets. For instance, the city owns two asphalt plants that could expand production and sell some of its material to raise money to fix potholes, he said.


He's served on two city commissions, including one that found millions of dollars in savings by detailing ways to be more efficient. Zine is positioning himself as a "tough guy for tough times," but the controller should be more than that, Galperin said.


"What we really need is some thoughtfulness and some smarts and some effectiveness," he said. "Just getting up there and saying we need to be tough is not going to accomplish what needs to be done."


Brazeman, 46, started his own marketing and public relations firm in West Los Angeles a decade ago and became active in city politics over his discontent with a development project near his home. He has pushed the council to change several initiatives over the last five years, including changes to the financing of the Farmers Field stadium proposal that will save taxpayer dollars, he said.


As controller, he would pick and choose his battles, and, Brazeman said, be "the right combination of constructive, abrasive and assertive."


catherine.saillant@latimes.com





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Lawyer says Lohan committed to turning life around


LOS ANGELES (AP) — Lindsay Lohan is committed to turning her life around and wants to record public service announcements on the dangers of domestic violence, alcohol abuse and drunken driving, her attorney said Wednesday.


Mark Heller told The Associated Press that the actress' plans are independent of a criminal case that could return her to jail on charges that she lied to police about being a passenger in her car when it slammed into a dump truck in June.


The "Liz & Dick" star has been repeatedly sentenced to jail, rehab, and community service since her first pair of arrests for driving under the influence in 2007. She spent several months in court-ordered psychotherapy until a judge released her from supervised probation in March 2012.


As part of the intense psychotherapy sessions, Lohan is in the beginning stages of trying to become an inspirational speaker to young people, he said.


"I think she suddenly woke up one morning and had an epiphany and she suddenly realized and appreciated the seriousness of the events that led to her being in court," Heller said.


"She's going to try to inspire hope in people," he said. "I think it will be good for her. It certainly won't hurt others."


Heller mentioned Lohan's intent to become an inspirational speaker in a letter to prosecutors and a judge that was obtained Tuesday. He said he will meet with prosecutors on Friday to try to reach a resolution in Lohan's newest case, which includes misdemeanor charges of reckless driving and obstructing officers from performing their duties.


She has pleaded not guilty. Lohan, 26, was on probation at the time of the crash and faces up to 245 days in jail if a judge determines her conduct violated her probation in a 2011 necklace theft case.


Officers suspected alcohol might have been involved in the June accident on Pacific Coast Highway, but the actress passed sobriety tests at a hospital and she was never charged with driving under the influence.


Santa Monica police Sgt. Richard Lewis said officers did not give Lohan a field sobriety test at the accident scene because she and her assistant were injured in the crash and were taken to a nearby hospital. While officers could not rule out that Lohan might have been drinking, he noted that she did not show signs of impairment.


Celebrity web site TMZ, citing anonymous sources, reported Wednesday that a bottle of alcohol was found next to Lohan's sports car after the crash. Lewis said he could not discuss evidence in the case, but noted that the actress was not charged with drunken driving.


Heller wrote in a motion filed last week that officers found a bottle that they initially thought was urine, but might have contained wine. His filing, which seeks a delay or dismissal of charges against the actress, states that "upon information and belief" the bottle's contents were never tested.


Lohan's case returns to court on Friday, although the actress is not required to attend.


Heller is asking a judge to dismiss the case against Lohan because officers ignored the actress' request to talk to her attorney before being interviewed, court records show. He said he is prepared to defend Lohan at trial if necessary, but is hoping a deal can be worked out. He is seeking a delay in the case to have time to prepare and allow Lohan to demonstrate she is improving her life.


Threats from judges and jail sentences that are invariably cut short because of overcrowding haven't helped Lohan, Heller said. "None of it really brought closure to this predicament that led to this most recent event."


___


Anthony McCartney can be reached at http://twitter.com/mccartneyAP


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Global Health: After Measles Success, Rwanda to Get Rubella Vaccine


Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.


On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.


Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping to finance the upcoming one.


Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.


Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.


Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.


The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)


More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.


The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.


In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.


Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.


Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.


This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article misstated the source of the vaccine and some financing for the campaign. The vaccine and financing is being provided by the GAVI Alliance, not the Measles and Rubella Initiative.




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