Grammy-winning bassist injured in Swiss bus crash

GENEVA (AP) — Grammy-winning jazz bassist Marcus Miller and several members of his band were injured when their bus overturned Sunday on a busy highway in Switzerland, killing the driver, police said.

The German-registered private bus tipped over as it drove into a bend on the A2 highway in central Switzerland and came to a rest on its side, police in the canton (state) of Uri said. The bus was carrying 13 people — two drivers and 11 members of the Marcus Miller Band, including Miller.

Over his career, the bassist has worked with jazz greats such as Miles Davis, Dizzy Gillespie and Wayne Shorter, according to his website. He won two Grammys, his first coming in 1991 for Best Rhythm & Blues Song (“Power of Love”) along with Luther Vandross and Teddy Vann, and the second came in 2001 for Best Contemporary Jazz Album (“M2″).

The band was on its way from Monte Carlo to the Dutch town of Hengelo, the next stop on the American band’s tour, where it was due to perform Monday.

The driver who was at the wheel at the time of the accident sustained fatal injuries. Police spokesman Karl Egli said the 12 passengers were injured and taken to hospitals, but none had life-threatening injuries.

Miller was discharged from the hospital later Sunday, as were fellow band members Alex Han and Kris Bowers, but some other band and crew members were being kept in hospitals overnight, according to a post on Miller’s official Facebook page.

The cause of the accident was not immediately clear. Police believe no other vehicles were involved.

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Agency Investigates Deaths and Injuries Associated With Bed Rails

Thomas Patterson for The New York Times

Gloria Black’s mother died in her bed at a care facility.

In November 2006, when Clara Marshall began suffering from the effects of dementia, her family moved her into the Waterford at Fairway Village, an assisted living home in Vancouver, Wash. The facility offered round-the-clock care for Ms. Marshall, who had wandered away from home several times. Her husband Dan, 80 years old at the time, felt he could no longer care for her alone.

Thomas Patterson for The New York Times

Gloria Black, visiting her mother’s grave in Portland, Ore. She has documented hundreds of deaths associated with bed rails and said families should be informed of their possible risks.

But just five months into her stay, Ms. Marshall, 81, was found dead in her room apparently strangled after getting her neck caught in side rails used to prevent her from rolling out of bed.

After Ms. Marshall’s death, her daughter Gloria Black, who lives in Portland, Ore., began writing to the Consumer Product Safety Commission and the Food and Drug Administration. What she discovered was that both agencies had known for more than a decade about deaths from bed rails but had done little to crack down on the companies that make them. Ms. Black conducted her own research and exchanged letters with local and state officials. Finally, a letter she wrote in 2010 to the federal consumer safety commission helped prompt a review of bed rail deaths.

Ms. Black applauds the decision to study the issue. “But I wish it was done years ago,” she said. “Maybe my mother would still be alive.” Now the government is studying a problem it has known about for years.

Data compiled by the consumer agency from death certificates and hospital emergency room visits from 2003 through May 2012 shows that 150 mostly older adults died after they became trapped in bed rails. Over nearly the same time period, 36,000 mostly older adults — about 4,000 a year — were treated in emergency rooms with bed rail injuries. Officials at the F.D.A. and the commission said the data probably understated the problem since bed rails are not always listed as a cause of death by nursing homes and coroners, or as a cause of injury by emergency room doctors.

Experts who have studied the deaths say they are avoidable. While the F.D.A. issued safety warnings about the devices in 1995, it shied away from requiring manufacturers to put safety labels on them because of industry resistance and because the mood in Congress then was for less regulation. Instead only “voluntary guidelines” were adopted in 2006.

More warnings are needed, experts say, but there is a technical question over which regulator is responsible for some bed rails. Are they medical devices under the purview of the F.D.A., or are they consumer products regulated by the commission?

“This is an entirely preventable problem,” said Dr. Steven Miles, a professor at the Center for Bioethics at the University of Minnesota, who first alerted federal regulators to deaths involving bed rails in 1995. The government at the time declined to recall any bed rails and opted instead for a safety alert to nursing homes and home health care agencies.

Forcing the industry to improve designs and replace older models could have potentially cost bed rail makers and health care facilities hundreds of million of dollars, said Larry Kessler, a former F.D.A. official who headed its medical device office. “Quite frankly, none of the bed rails in use at that time would have passed the suggested design standards in the guidelines if we had made them mandatory,” he said. No analysis has been done to determine how much it would cost the manufacturers to reduce the hazards.

Bed rails are metal bars used on hospital beds and in home care to assist patients in pulling themselves up or helping them out of bed. They can also prevent people from rolling out of bed. But sometimes patients — particularly those suffering from Alzheimer’s — can get confused and trapped between a bed rail and a mattress, which can lead to serious injury or even death.

While the use of the devices by hospitals and nursing homes has declined as professional caregivers have grown aware of the dangers, experts say dozens of older adults continue to die each year as more rails are used in home care and many health care facilities continue to use older rail models.

Since those first warnings in 1995, about 550 bed rail-related deaths have occurred, a review by The New York Times of F.D.A. data, lawsuits, state nursing home inspection reports and interviews, found. Last year alone, the F.D.A. data shows, 27 people died.

As deaths continued after the F.D.A. warning, a working group put together in 1999 and made up of medical device makers, researchers, patient advocates and F.D.A. officials considered requiring bed rail makers to add warning labels.

But the F.D.A. decided against it after manufacturers resisted, citing legal issues. The agency said added cost to small manufacturers and difficulties of getting regulations through layers of government approval, were factors against tougher standards, according to a meeting log of the group in 2000 and interviews.

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L.A.'s revamped teacher evaluation system getting mixed grades

Third-grade teacher Kelly Vallianos wanted to find an engaging way for her students to learn about measuring perimeters. One idea — to have students design a restaurant floor plan — was too difficult, she feared.

But with the help of colleagues, she found a way to tailor that fifth-grade idea to her younger students at Dominguez Elementary School, who excitedly sketched out an imaginary pizzeria.

Vallianos credits the Los Angeles Unified School District's new teacher evaluation system for sparking deeper and more collaborative conversations with administrators, who she said gave her ideas to make the lesson work.

The district's new performance reviews have come under fire by United Teachers Los Angeles, which opposes the controversial element of using student test scores as one factor in measuring teacher effectiveness.

But largely lost in the debate is the fact that the system's centerpiece is a new classroom observation process that, despite some drawbacks, is being praised by many as a better way to help teachers improve.

"It's a more reflective, much more well-rounded process," said Vallianos, who has been teaching for 19 years.

Teachers are ranked on a scale on instruction, lesson plans, classroom environment and dozens of other criteria. A highly effective teacher, for instance, will be able to intellectually engage all students and prompt them to lead their own discussion topics. An ineffective teacher will generate all questions and most answers, involving just a handful of students.

During observations, administrators type notes into their laptops and later rate each of 61 skills. Principals and other administrators conducting the observations must pass a test to ensure they are fairly and accurately scoring instructors. Conferences with teachers before and after the classroom visits are required.

The method is meant to make observations more useful, uniform and objective, using evidence rather than opinions. But it's an elaborate process and has provoked widespread criticism that it takes too long for principals who are already overwhelmed with increasing workloads. And those who can't type well take even longer, administrators say.

"The technology is creating great difficulty and frustration," said Judith Perez, president of the Associated Administrators of Los Angeles. "It feels like an immense amount of pressure on people without alleviating their workload."

Teachers union President Warren Fletcher agrees that a better system is needed; UTLA has designed its own. He said "the jury is still out" on the district's observation process but added that it shares some common elements with the union's proposal.

The new system also includes evidence of student achievement — which could be in the form of test scores — feedback from students and parents, and the teacher's contributions to the school community.

The new observations were tested last year on a voluntary basis with about 450 teachers and 320 administrators; this year, every principal and one volunteer teacher at each of the district's 1,200 schools are expected to be trained.

Officials have not yet announced when the system will be used for every teacher — or when the ratings will begin to count for decisions on layoffs, tenure or pay. But in a video shown at the training sessions, L.A. Supt. John Deasy made the stakes clear.

"We have perhaps no greater responsibility than assuring that every student in this district is taught by an effective teacher in a school led by an effective leader," he said.

Many educators agree that the current evaluation system — known as Stull for the state law that created it — doesn't promote that goal of top-notch teachers for every student. Criticized as a perfunctory checklist of expectations that doesn't help teachers improve, the system awarded 99.3% of L.A. Unified teachers the highest rating in 2009-10 — even though only 45% of district students that year performed at grade level for reading and 56% were proficient in math.

The new system has given teachers like Lisa Thorne a boost. Thorne, a math teacher at Hamilton High School, said the new process is "unwieldy" but far more helpful in homing in on her strengths and weaknesses.

After the self-evaluation part of the process, Thorne chose to focus on improving her work with small groups of students, prompting her to try such techniques as using a three-dimensional pegboard to teach geometry. And she started a new computer-based class to help struggling ninth-graders master algebra. Administrators had seen her use the techniques with older students during a class visit and were impressed enough to give her the green light, she said.

"I would definitely say the new system is an improvement, because it's more specific about what they're looking for," Thorne said. "It helps to get the conversation going with administrators."

Eduardo Solorzano, principal of San Fernando Middle School, agrees. In particular, he said, the focus on careful note-taking has given him specific examples to use in helping teachers improve.

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How One <em>Myst</em> Fan Made Himself a Real-Life Linking Book

The classic PC game Myst was known for drawing people in to its massive, surreal world. But maker Mike Ando took a little piece of that world and drew it into ours. He made a lovingly authentic replica of the Linking Book that helps the main character — you — navigate the world.

Myst was a ground-breaking point-and-click adventure game created by Cyan Worlds, made of hundreds of beautifully rendered scenes whose combined size made the game so big that it needed a CD-ROM to play, back when many computers didn’t have them. It was the first breakout hit in PC gaming and from its release in 1993 it held the title of best-selling PC game until 2002 when The Sims surpassed it.

The game spawned four sequels, along with novels, music, and an MMO that is still online and being powered by donations from the fan base. The games have been widely ported and the game — once so huge that you needed special hardware to run it — is now available for download on iOS (among other places). In other words, it’s a pretty big deal.

At the core of Myst’s story was a mystical technology called Linking Books that pulled players into other realms, called Ages. They were these beautiful old tomes that, when opened, showed an animated preview of the Age to which you’d be linked.

“Ever since I first played the game, I always wanted my own linking book,” says Ando, “Of course, there was no way my old bulky 486 would fit within a book, but as time marched on technology advanced and computers became smaller. Eventually technology caught up and it was possible to shrink everything down to fit inside the book.”

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“Lincoln” Women: How Sally Field and Gloria Reuben Stole Daniel Day-Lewis’ Show

LOS ANGELES (TheWrap.com) – Steven Spielberg‘s “Lincoln” is, on the face of it, a standard “great man” biopic. Basked in a honeydew light, overflowing with sage advice, Daniel Day-Lewis‘ Great Emancipator is depicted as constantly and self-consciously speaking to the ages well before he belongs to them.

But let us now praise the film’s not-as-famous women. For what rescues “Lincoln” from bombast are the slier and subtler performances by a trio of fantastic and often under-utilized actresses – Sally Field, Gloria Reuben and S. Epatha Merkerson.

Each one uses her limited screen time to etch a devastating portrait of the limitations that faced women in a male-dominated society. After all, if the legislators debating the merits of the 13th Amendment in the movie fret openly that abolishing slavery will begin a slippery slope to black enfranchisement, they seem even more horrified at the prospect that it one day might lead to granting women the right to vote.

Though some critics have griped about Spielberg’s penchant for speechifying in “Lincoln,” there has been near universal praise for Day-Lewis and for Tommy Lee Jones’ work as the wily Thaddeus Stevens. Field’s take on First Lady Mary Todd Lincoln – a woman Louis C.K. quipped on “Saturday Night Live” recently was “historically insane” – has been more divisive.

In TheWrap, for instance, Steve Pond wrote, “Sally Field may well be nominated for Supporting Actress for her Mary Todd Lincoln, but to me her hysteria was one of the least-successful parts of the film.”

Yet Field’s work is in many ways more revelatory than that of Day-Lewis. True, the Irish-Anglo acting god daringly gives the 16th president a historically accurate high voice and indelibly paints a picture of a great orator with an outhouse sense of humor, but his modifications are slight tweaks to the Lincoln myth. Field’s interpretation is a whole-scale reinvention.

Field’s Mary is privately unhinged, true. But she is also a smooth Washington operator, comfortable sparring with Stevens over her White House redecorating and forcibly pressuring her husband to carry the 13th Amendment to the finish line while wielding little more than a fan.

Even her mania is rooted in the death of her young son Willy; an empathetic anchor that keeps Mary from becoming simply the backwoods, social-climbing hysteric she’s been portrayed as in the past.

In screenwriter Tony Kushner, Field finds an eager co-conspirator. As Kushner confessed on NPR, the Lincolns had a turbulent relationship in part because of Abraham Lincoln’s emotional coldness.

“People always think about Mary as being difficult and she absolutely was, but Lincoln wasn’t easy either,” Kushner said. “He was remote and complicated and rather interestingly fond of telling her things that would upset her horribly, like these dreams that he kept having and he would leave her kind of in a state night after night, telling her that he was having these kind of scary dreams.

It’s an enormously complicated relationship and the family is a tragic family.”

The only false note in an otherwise galvanizing portrayal, is having Mary deliver a line that is a too historically self-aware.

“All anyone will remember about me was that I was crazy and ruined your happiness,” Mary says at one point – to which my companion let forth a large guffaw.

Field who packed 25 pounds onto her slender frame and allowed the camera to scan her creased face is a revelation – it’s a reminder that the plucky star of “Norma Rae” is good for more than Boniva ads.

But Mary Todd Lincoln isn’t the only female who elbows her way into this big screen men’s club. Gloria Reuben‘s Elizabeth Keckley is also a marvel.

Dramaturgically it’s a thankless role with Reuben’s freed slave seamstress frequently used as a stand-in for all-antebellum African American suffering. Yet Reuben grounds the performance in a simmering fury and heartbreak, using her eyes to register the peigns of hurt that greets the racist slights Keckley is exposed to on a daily basis.

Her conversation in the White House portico with Daniel Day-Lewis about the meaning of emancipation is a bravura moment – a reminder of just how long a walk to freedom 19th century blacks faced.

Likewise, S. Epatha Merkerson‘s Lydia Smith is perhaps the greatest master class in doing a lot with a little since Judi Dench captured a Best Supporting Actress Oscar in 1998 for her eight-minute cameo in “Shakespeare in Love.”

Smith, the housekeeper and (spoiler alert) common-law wife of Thaddeus Stevens, has two fleeting scenes. In one, she gently removes Jones’ coat as he enters their Washington, D.C., home after the amendment passes, in the other she reads the constitutional addition aloud in bed to her secret-paramour. It is, in the words of another Kushner play, a reminder that “the world only spins forward.”

Indeed, the entire film represents a major step forward for Spielberg whose earlier boy’s adventures were largely all-male affairs. Aside from Embeth Davidtz’s frightened maid in “Schindler’s List,” Whoopi Goldberg’s martyr-like Celie in “The Color Purple” and Karen Allen’s fiery adventurer in “Raiders of the Lost Ark,” the Spielberg women are a weightless bunch. Even great actresses like Julianne Moore in “The Lost World” are given gossamer thin screen time.

Here, transported by Kushner’s words, he allows these women to step forward out of the shadows and into history. Next time maybe he’ll let them take center stage.

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Psychotherapy’s Image Problem Pushes Some Therapists to Become ‘Brands’

Illustration by Matt Dorfman. Photograph by Jens Mortensen for The New York Times.

In the summer of 2011, after I completed six years of graduate school and internship training and was about to start my psychotherapy practice, I sat down with my clinical supervisor in the Los Angeles office we’d be sharing. It had been a rigorous six years, transitioning from my role as a full-time journalist always on tight deadlines to that of a therapist whose world was broken into slow, thoughtful hours listening and trying to help people come to a deeper understanding of their lives. My supervisor went over the filing systems, billing procedures and ethical quandaries like whether to take referrals from current clients, but we never discussed how I would get these clients. I fully assumed, in what now seems like an astounding fit of naïveté, that I’d send out an e-mail announcement and network with doctors, and to paraphrase “Field of Dreams,” if I built it, they would come.

Except that they didn’t. What nobody taught me in grad school was that psychotherapy, a practice that had sustained itself for more than a century, is losing its customers. If this came as a shock to me, the American Psychological Association tried to send out warnings in a 2010 paper titled, “Where Has all the Psychotherapy Gone?” According to the author, 30 percent fewer patients received psychological interventions in 2008 than they did 11 years earlier; since the 1990s, managed care has increasingly limited visits and reimbursements for talk therapy but not for drug treatment; and in 2005 alone, pharmaceutical companies spent $4.2 billion on direct-to-consumer advertising and $7.2 billion on promotion to physicians, nearly twice what they spent on research and development.

According to the A.P.A., therapists had to start paying attention to what the marketplace demanded or we risked our livelihoods. It wasn’t long before I learned that an entirely new specialized industry had cropped up: branding consultants for therapists.

I couldn’t imagine hiring a branding consultant to lure people to the couch. Psychotherapy is perhaps one of the few commercial businesses that doesn’t see itself as one, that views financial gain as unseemly when connected to the delicate work of emotional insight. Moreover, the field is predicated on strict concepts of authenticity, privacy and therapist-patient boundaries. Branding was the antithesis of what we did.

But a couple of months after setting up my office and waiting for people to call, I found myself wondering — first idly, then deliberately, and always guiltily — about those branding consultants and how exactly they helped therapists like me. Sitting at my desk one morning when my appointment book looked particularly dismal, a combination of curiosity and desperation got the best of me. On Google, I came across a branding consultant named Casey Truffo. Her Web site’s home page spoke directly to my situation: “You are called to be a therapist. Are you also called to poverty?” I immediately dialed her number.

The first thing Truffo told me when I reached her in her Orange County office was that I shouldn’t feel bad about my empty hours; nowadays, she said, even established veterans were struggling. Yes, the economy was bad, but the real issue was that psychotherapy had an image problem.

She told me about a therapist named Sandra Bryson. In 2009, Bryson called for help after her successful Oakland-based practice of 25 years lost patients when she stopped taking insurance. According to Truffo, Bryson shared a problem common to therapists: “a blah-sounding message and no angle.” Bryson had always done well as a generalist — treating anything from depression to grief to marital issues — but Truffo urged her to find a specialty, one that “captured the zeitgeist but didn’t feel played out.” Bryson mentioned that she liked helping parents and had an affinity for technology, and voilà — suddenly she had a brand. Not as a clinician addressing typical parenting issues like boundary-setting, which Truffo called “generic and old-school,” but as an expert who helps modern families navigate digital media. She also became a sought-after speaker on so-called hot issues like screen time, cyberbullying and sexting, and Bryson told me her practice, which is based on “mostly deep work,” had become “more advice-driven.” Now her schedule is full, and her income has increased about 15 percent a year.

“Nobody wants to buy therapy anymore,” Truffo told me. “They want to buy a solution to a problem.” This is something Truffo discovered in her own former private practice of 18 years, during which she saw a shift from people who were unhappy and wanted to understand themselves better to people who would come in “because they wanted someone else or something else to change,” she said. “I’d see fewer and fewer people coming in and saying, ‘I want to change.’ ”

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Dave Roberts brings diversity to the San Diego County supervisors

DEL MAR — In January, when he joins the San Diego County Board of Supervisors, Dave Roberts will be the only Democrat among four Republicans, the first Democrat on the board in more than two decades.

He will also be the first new supervisor in 18 years. And he will be the only one who is not a graduate of San Diego State. He has three degrees from American University in Washington, D.C.

He's also gay and married to a retired Air Force master sergeant. The two are adoptive parents to five former foster children, ages 4 to 17, who call them Daddy Dave and Daddy Wally.

With Roberts' election to a district representing a portion of San Diego and several seaside communities north of the city, diversity has arrived for the Board of Supervisors, long one of the region's most homogenous governing bodies.

"I'm going to bring some unique characteristics," Roberts, 51, said with a laugh during a family outing on the beach here.

Roberts hopes to concentrate on the same issues he focused on while serving on the Solana Beach City Council, where he is currently deputy mayor: regional fire protection, expansion of the San Dieguito River Park and "sensible" growth.

Roberts is a Democrat in the style of Republican-leaning northern San Diego County: fiscally conservative. He worked as a budget analyst for the Department of Defense and as a corporate vice president for the La Jolla-based defense contractor SAIC. He was a Republican until some in the GOP took exception to a gay man working in the Pentagon.

"The Republicans wanted me to be fired," Roberts said. "That's when I changed political parties."

Some of his first experience in government came from working as a staffer to Sen. Lowell Weicker, a Republican from Connecticut. "I learned from working for Sen. Weicker that you can make change if you're in the right place," Roberts said.

In 2009, Democratic party officials encouraged Roberts to seek the party's nomination to face incumbent Brian Bilbray (R-Carlsbad) in the 50th Congressional District.

On the verge of declaring his candidacy, Roberts was alerted by social workers about two children who needed a "forever" home. He decided that the adoption process took precedence over his political career.

Now there are five children in the two-story home in Solana Beach once owned by singer Patti Page: Robert, 17; Alex, 12; Julian, 8; Joe, 5; and Natalee, 4. Three of the children have taken the last name Roberts, and two took his spouse's last name, Oliver.

"We don't like double names," Roberts said.

Roberts and Wally Oliver, 55, have been together for 14 years. They had a commitment ceremony in 1998 and married in July 2008 in the brief period when county clerks in California were allowed to issue same-sex marriage licenses.

The family may soon expand.

"Wally would like a baby," Roberts said. "We're not Jewish, but we believe in the Jewish proverb: 'If you can save one soul, you can save the world.'"

During his race against a Republican opponent, Roberts was endorsed by the retiring incumbent, Pam Slater-Price. He has also begun discussions with Supervisor Dianne Jacob, possibly the most fiscally conservative member of the board.

He also looks forward to working with Supervisor Bill Horn, an ex-Marine who supported Proposition 8, the measure to ban same-sex marriage, and has said he opposes gays in the military. "He says things from time to time that remind me of my father," Roberts said.

For all of their fiscal conservatism, the supervisors have not dabbled much in social issues in a way that might satisfy some elements in the GOP. The board took no position on Proposition 8. Health clinics in gay neighborhoods and AIDS prevention programs are funded without controversy.

Roberts may be different in another respect from his colleagues: He will not be assigning a staff member to send out his Twitter messages. He sends out his own tweets — lots of them, on topics political and personal.

Last week, among many tweets, was one announcing that he has hired his predecessor's chief-of-staff, praising him for his "broad experience, management style and network of contacts."

And the next tweet: "Took the kids out for frozen yogurt at Seaside Yogurt in Del Mar for a treat."

tony.perry@latimes.com

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WHO Announces Family Cluster of Cases of New Coronavirus

Holidays. It never fails.

Today, while the United States has been largely off-line following our Thanksgiving holiday (and while Northern Europe was on its way to the pub for Friday evening revelry), the World Health Organization announced four new cases of the novel coronavirus that caused a great deal of worry immediately before the October hajj season. (Earlier posts here and here.)

In its bulletin, released by the WHO’s Global Alert and Response team (GOAR), the agency said:

• Four additional laboratory-confirmed cases have been identified; one of the four has died.


• One case is in Qatar, the location of one of the original two cases earlier this year.


• Three of the new cases, including the dead person, are in Saudi Arabia, site of the other original case (who also died).


• Two of the three Saudi cases, including the dead person, are members of the same family.


• In that family, two other people have also fallen ill, and one has died. The man who recovered showed no laboratory evidence of infection with the novel coronavirus. Analysis of the case of the person who died is continuing.

A quick recap: This new virus concerns public health officials because it is related to the viral cause of SARS, which swept the globe in 2003, sickening more than 8,000 people and killing almost 800. News of it first emerged in September, when a post to the mailing list ProMED described the illness and death in June of a man who lived in Saudi Arabia. That bulletin caused physicians in London who were treating a man from Qatar to realize that their patient was suffering from the same illness. The timing and location of the cases caused international concern, because Saudi Arabia was about to host the annual hajj, which brings millions of observant Muslims to the country in closely crowded conditions, and thus could have been a transmission risk.

Since then, very little new has been released.

On Sept. 27, the journal EuroSurveillance published two reports, a case definition and recommendation for public health measures by the European Centre for Disease Prevention and Control (the EU’s equivalent of the United States’ CDC) and the UK’s Health Protection Agency, and a first attempt at PCR-based identifying tests, by scientists at the HPA, in Berlin, and at the Erasmus Medical Center in Rotterdam, who collaborated on that first ProMED post.

On Oct. 17, the New England Journal of Medicine carried a description of the first Saudi case written by the authors of that first ProMED post, Dr. Ali Moh Zaki of the Soliman Fareek Hospital in Jiddah and Dr. Ron Fouchier and other staff from Erasmus.

On Nov. 4 and Nov. 20, ProMED carried reports of two additional cases beyond the first two, both in Saudi. The Nov. 4 report, of a man who fell ill in Riyadh and recovered, was submitted to ProMED by Dr. Ziad Memish, the Kingdom’s deputy minister for public health. The Nov. 20 report relayed an announcement from the Kingdom’s Ministry of Health reporting an additional case in Riyadh. (There has been no indication whether these cases are included in the four new ones announced by the WHO, or are separate. Prior to today’s brief announcement, the WHO had not issued any bulletins on the new virus since Oct. 10.)

Meanwhile, on Nov. 13, the UK’s Health Protection Agency announced that its laboratories had achieved a complete genome of the virus isolated from the case treated in London, finding it to be most closely related to a coronavirus isolated from bats in the Netherlands several years ago. (This is important because the SARS virus, originally thought to be harbored by civet cats, was identified in 2005 in bats as well.)

And in addition, there have been some indications that the flow of information on this new virus may not be complete as health authorities might wish. Among them: On Oct. 22, Dr. Memish complained on ProMED of “incomplete, even hysterical reporting” and said that the initial report of the first Saudi case “intentionally or inadvertently circumvented” “internal reporting mechanisms.” Two days later, Deborah Mackenzie of New Scientist reported that the physician who sent that first report, Dr. Zaki, lost his job in the Kingdom after official actions that he described to her as “threatening,” and fled to Egypt, where he is from.

So where does that leave us today?

The WHO statement is notable for what it does not say: It does not give ages, genders or places of residence for the new cases, and it has nothing to say about how they may have become infected — including whether person-to-person transmission of the virus has occurred, which would be one reasonable hypothesis given the family relationships.

But it does say that the agency assumes the virus to be more widely distributed than these cases suggest, and urges countries to be on the look-out for additional cases. Notably, it suggests testing patients with severe pneumonia even if they have no travel history to Saudi Arabia or Qatar, which is a lowering of the screening threshold from what the agency recommended earlier:

WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and is currently reviewing the case definition and other guidance related to the novel coronavirus. Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases. Member States should consider testing of patients with unexplained pneumonias for the new coronavirus even in the absence of travel or other associations with the two affected countries. In addition, any clusters of SARI or SARI in health care workers should be thoroughly investigated regardless of where in the world they occur.

Much more to come on this, I am sure. Over the weekend, consider following Helen Branswell of Canadian Press and Declan Butler of Nature, who got stories about this posted this afternoon; and also indefatigable emerging-diseases blogger Crawford Killian, who has picked up indications that the new Qatar case may actually be in Germany.

Update: I failed to notice that Mike Coston of Avian Flu Diary has confirmed the reports of the new Qatar case actually being in Germany. Mike found a statement from Germany’s Robert Koch Institute about the man’s illness. So (and I should have said this earlier), for more about this evolving story, you should follow Mike too.

SARS image, PHIL, CDC

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Justin Bieber will not face charges from paparazzo run-in

LOS ANGELES (Reuters) – Teenage pop star Justin Bieber will not face charges for an alleged altercation with a man who was taking photos of him at a suburban shopping center in May, Los Angeles prosecutors said on Wednesday.

Deputy District Attorney Mara McIlvain said in a report there was “insufficient evidence for proof beyond a reasonable doubt” that the Canadian singer scuffled with paparazzo Jose Hernandez-Duran before leaving the shopping center with his girlfriend, actress Selena Gomez.

The photographer accused Bieber, 18, of leaving a van to kick him in the abdomen and punch him in the face. Officials called to the scene in Calabasas, 30 miles west of Los Angeles, found no apparent injury or trauma to the photographer.

A later doctor’s evaluation indicated “minor swelling” to the photographer’s right cheek and “redness” on his lower abdomen but labeled the injuries “superficial.”

McIlvain’s report indicated that Bieber became frustrated when photographers obstructed his vehicle as he attempted to leave the shopping center. He then left the vehicle, charged at Hernandez-Duran and fell after taking a swing at his camera.

Witnesses told investigators they could not determine if Bieber had struck Hernandez-Duran, who kept on taking photos of the singer after the incident. They said the photographer was approached by a lawyer soon after the run-in.

McIlvain said there were no photos of a scuffle between Bieber and Hernandez-Duran, even though many photographers were present.

Bieber’s publicist could not immediately be reached for comment.

The pop star swept the American Music Awards on Sunday, winning three, including the top prize of the night, and performed live during the show.

(Reporting By Eric Kelsey, editing by Piya Sinha-Roy and David Brunnstrom)

Music News Headlines – Yahoo! News

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Inquiry Sought in Death in Ireland After Abortion Was Denied

DUBLIN — India’s ambassador here has agreed to ask Prime Minister Enda Kenny of Ireland for an independent inquiry into the death of an Indian-born woman last month after doctors refused to perform an abortion when she was having a miscarriage, the lawyer representing the woman’s husband said Thursday.

The lawyer, Gerard O’Donnell, also said crucial information was missing from the files he had received from the Irish Health Service Executive about the death of the woman, Savita Halappanavar, including any mention of her requests for an abortion after she learned that the fetus would not survive.

The death of Dr. Halappanavar, 31, a dentist who lived near Galway, has focused global attention on the Irish ban on abortion.

Her husband, Praveen Halappanavar, has refused to cooperate with an investigation being conducted by the Irish health agency. “I have seen the way my wife was treated in the hospital, so I have no confidence that the H.S.E. will do justice,” he said in an interview on Wednesday night on RTE, the state television broadcaster. “Basically, I don’t have any confidence in the H.S.E.”

In a tense debate in the Irish Parliament on Wednesday evening, Robert Dowds of the Labour Party said Dr. Halappanavar’s death had forced politicians “to confront an issue we have dodged for much too long,” partly because so many Irish women travel to Britain for abortions.

“The reality is that if Britain wasn’t on our doorstep, we would have had to introduce abortion legislation years ago to avoid women dying in back-street abortions,” he said.

After the debate, the Parliament voted 88 to 53 against a motion introduced by the opposition Sinn Fein party calling on the government to allow abortions when women’s lives are in danger and to protect doctors who perform such procedures.

The Irish president, Michael D. Higgins — who is restricted by the Constitution from getting involved in political matters — also made a rare foray into a political debate on Wednesday, saying any inquiry must meet the needs of the Halappanavar family as well as the government.

In 1992, the Irish Supreme Court interpreted the current law to mean that abortion should be allowed in circumstances where there was “a real and substantial risk to the life of the mother,” including the threat of suicide. But that ruling has never been codified into law.

“The current situation is like a sword of Damocles hanging over us,” Dr. Peter Boylan, of the Irish Institute of Obstetricians and Gynecologists, told RTE last week. “If we do something with a good intention, but it turns out to be illegal, the consequences are extremely serious for medical practitioners.”

Dr. Ruth Cullen, who has campaigned against abortion, said that any legislation to codify the Supreme Court ruling would be tantamount to allowing abortion on demand and that Dr. Halappanavar’s death should not be used to make that change.

Dr. Halappanavar contracted a bacterial blood infection, septicemia, and died Oct. 28, a week after she was admitted to Galway University Hospital with severe back pains. She was 17 weeks pregnant but having a miscarriage and was told that the fetus — a girl — would not survive. Her husband said she asked several times for an abortion but was informed that under Irish law it would be illegal while there was a fetal heartbeat, because “this is a Catholic country.”

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