Marla Sokoloff Blogs: Adventures in Baby Traveling

Shady ladies in Hawaii – Courtesy Marla Sokoloff

Our celebrity blogger Marla Sokoloff is a new mama!

Since audiences first got to know her at age 12 as Gia on Full House, Sokoloff has had many memorable TV roles — Jody on Party of Five, Lucy on The Practice, Claire on Desperate Housewives – as well as turns on the big screen in Whatever It Takes, Dude, Where’s My Car? and Sugar & Spice.

Sokoloff, 32, also sings and plays guitar and released an album, Grateful, in 2005.

She wed her husband, music composer Alec Puro, in November 2009 and the couple — plus pup Coco Puro — make their home in Los Angeles.

You can find Marla, now mom to 11-month-old daughter Elliotte Anne, on Twitter.

Happy 2013! I don’t know about you, but I’m completely amazed at how fast 2012 flew by! I must admit, on New Year’s Day I found myself a little weepy to say goodbye to the year that my little Elliotte came into this world. I realized that as long as I’m on this earth I will always have a soft spot for the year 2012, as it was a complete life and game-changer for me. (Clearly it’s also the year that turned me into a total sap!)

As far as resolutions go, I have a few. They include the usual suspects (exercise more, get more sleep, drink more than four sips of water per day!) but my main focus is going to be on my beloved iPhone and our very dysfunctional relationship.

I really want to work on being in the present and putting that thing down so I can suck up every delicious moment with my family. The social media and pinboards will just have to wait until after my daughter goes to bed. Baby steps!

Last week we hit a huge milestone … Elliotte took her first steps and is now walking (albeit a bit drunk-like) almost on her own! The moment was truly unbelievable and one that left me in tears (shocking … I know) as I was simply overwhelmed with joy. I was just so proud of her.

This is where my resolution isn’t a good thing because — had I not had my trusty iPhone glued to my body — I might have missed the moment. Her grandparents would have killed me! I’m just saying…

Happy New Year! – Courtesy Marla Sokoloff

We spent our Christmas vacation in paradise on the Big Island of Hawaii, but I’m here to tell you that getting there was nothing short of a nightmare. I’m not going to lie or candy-coat this blog at all because this experience was one I never want to relive.

All of my friends warned me about baby airplane travel … basically it could go either way. Kids are wild cards and you never really know what you’re going to get. So in preparation for my little wild card, I boarded our flight armed with earplugs and chocolates for the innocent passengers that could potentially be caught in the line of fire, so to speak. All the while knowing that I will never need to bring out said earplugs … I mean, my child is perfect after all!

This wasn’t Elliotte’s first flight — over the summer we traveled to San Francisco and my little angel slept for the hour flight each way, so I was certain we had this Hawaiian excursion in the bag.

I came equipped with two giant diaper bags. One was filled with diaper bag essentials (diapers, wipes, pacifiers, bottles, change of clothes for both of us) and the other ridiculously large bag was filled with toys and snacks. So many toys and snacks!! If this plane went down, Elliotte could feed the whole cabin with her copious supply of puffs and Cheerios. Basically the plan was, if this kid wasn’t sleeping, I was going to keep her busy and well-fed!

My special edition diaper bag also contained an emergency item. An SOS of sorts. An article that is generally considered a baby no-no in my house, but one that was only to be revealed if absolutely 100 percent necessary. Friends, I’m talking about the iPad. I loaded my secret weapon up with episodes of Sesame Street and adorable farm animal applications that looked like they would keep Elliotte entertained for at least a temper tantrum or two.

Very much like the aforementioned earplugs, I felt pretty confident that our no-no item wouldn’t be making an appearance.

Before takeoff… – Courtesy Marla Sokoloff

As our flight took off, I could see that Elliotte was not the happy camper I know and love. Her face turned beet-red within seconds and she was thrashing in her carseat as if it was a torture device. The tears were flowing fast and her scream was one that could not be silenced.

I looked at my husband, whose eyes said, “Bring out the iPad!!” but I knew it was way too early in our journey to pull such tricks out of sleeves.

As Alec handed out the chocolate and earplugs to our unlucky neighbors, I brought out some of Elliotte’s favorite toys. Every toy that was presented was met with a louder scream. I moved on to my trusted stash of snacks — surely a handful of puffs would soothe this outburst. Fail. I sang. I danced. I peek-a-booed. Nothing.

How can this be? The seat belt sign hasn’t even been turned off yet and I have pretty much emptied out the contents of my special-edition diaper bag!

Once the captain decided to put me out of my misery and turned the seat belt sign off, I ripped Elliotte out of her carseat (the one I brought thinking she would sleep in) and decided a nice walk down the aisle would do us both some good.

That mission was quickly aborted as the scream-fest continued to unaffected rows that were surely enjoying their cocktails and weekly gossip magazines.

My beach baby in Hawaii – Courtesy Marla Sokoloff

I handed her off to my husband and I took a much-needed break, as well as the first deep breath I had taken since leaving Los Angeles International Airport. We were now three-and-a-half hours into our six-hour flight and Elliotte showed no signs of slowing down. It was in this moment that I turned to my family and saw the chaos.

My seat was littered with toys and Cheerios and my poor child looked like a complete mess. Her face was tear-stained and her clothes were covered in squeezable applesauce. (Another failed mission.)

I knew it was time to bring out the big guns. Elmo needed to step in and he better be bringing his A-game.

I placed Elliotte on my lap and out came the iPad. Images of all of my favorite characters appeared on the screen and I instantly felt comforted by my childhood friends. Not only because they are the same characters that were my source of calm as a child, but also I knew they were the lifesavers we so desperately needed.

Well … I guess iPads and big yellow birds aren’t that comforting to teething babies that are 30,000 feet up in the air. The iPad went flying and I sunk into my seat holding my very unhappy girl tight. I was officially out of ideas.

Hawaiian fun in the sun – Courtesy Marla Sokoloff

A kind woman in front of me asked to hold Elliotte. She saw in my eyes that I was breaking down and she was a mom who got it. She understood. She didn’t judge or hate us for disrupting the beginning of her holiday vacation — she was happy to help because she had once been in our shoes with her own child. Elliotte enjoyed the break from her parents and was actually smiling in her arms.

We finally arrived in paradise and upon landing, Alec and I decided that we were moving to Hawaii as we were never going to step foot on a plane ever again.

In all fairness, in between Thanksgiving and Christmas, Elliotte went from having two teeth to eight teeth so I think the plane and cabin pressure exacerbated any existing pain she was already having. Our journey home was slightly better and she even slept for two beautiful hours!

Thank you for letting me share my story — I would absolutely love to hear some of your travel woes! I’m sure it’s even more fun for those of you who have multiple children.

Don’t forget to follow me on Twitter @marlasok or leave your comments below!

Until next time … xo,

– Marla Sokoloff

More from Marla’s PEOPLE.com blog series:

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Lilly drug chosen for Alzheimer's prevention study

Researchers have chosen an experimental drug by Eli Lilly & Co. for a large federally funded study testing whether it's possible to prevent Alzheimer's disease in older people at high risk of developing it.

The drug, called solanezumab (sol-ah-NAYZ-uh-mab), is designed to bind to and help clear the sticky deposits that clog patients' brains.

Earlier studies found it did not help people with moderate to severe Alzheimer's but it showed some promise against milder disease. Researchers think it might work better if given before symptoms start.

"The hope is we can catch people before they decline," which can come 10 years or more after plaques first show up in the brain, said Dr. Reisa Sperling, director of the Alzheimer's center at Brigham and Women's Hospital in Boston.

She will help lead the new study, which will involve 1,000 people ages 70 to 85 whose brain scans show plaque buildup but who do not yet have any symptoms of dementia. They will get monthly infusions of solanezumab or a dummy drug for three years. The main goal will be slowing the rate of cognitive decline. The study will be done at 50 sites in the U.S. and possibly more in Canada, Australia and Europe, Sperling said.

In October, researchers said combined results from two studies of solanezumab suggested it might modestly slow mental decline, especially in patients with mild disease. Taken separately, the studies missed their main goals of significantly slowing the mind-robbing disease or improving activities of daily living.

Those results were not considered good enough to win the drug approval. So in December, Lilly said it would start another large study of it this year to try to confirm the hopeful results seen patients with mild disease. That is separate from the federal study Sperling will head.

About 35 million people worldwide have dementia, and Alzheimer's is the most common type. In the U.S., about 5 million have Alzheimer's. Current medicines such as Aricept and Namenda just temporarily ease symptoms. There is no known cure.

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Online:

Alzheimer's info: http://www.alzheimers.gov

Alzheimer's Association: http://www.alz.org

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Follow Marilynn Marchione's coverage at http://twitter.com/MMarchioneAP

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Wall Street Week Ahead: Earnings, money flows to push stocks higher

NEW YORK (Reuters) - With earnings momentum on the rise, the S&P 500 seems to have few hurdles ahead as it continues to power higher, its all-time high a not-so-distant goal.

The U.S. equity benchmark closed the week at a fresh five-year high on strong housing and labor market data and a string of earnings that beat lowered expectations.

Sector indexes in transportation <.djt>, banks <.bkx> and housing <.hgx> this week hit historic or multiyear highs as well.

Michael Yoshikami, chief executive at Destination Wealth Management in Walnut Creek, California, said the key earnings to watch for next week will come from cyclical companies. United Technologies reports on Wednesday while Honeywell is due to report Friday.

"Those kind of numbers will tell you the trajectory the economy is taking," Yoshikami said.

Major technology companies also report next week, but the bar for the sector has been lowered even further.

Chipmakers like Advanced Micro Devices , which is due Tuesday, are expected to underperform as PC sales shrink. AMD shares fell more than 10 percent Friday after disappointing results from its larger competitor, Intel . Still, a chipmaker sector index <.sox> posted its highest weekly close since last April.

Following a recent underperformance, an upside surprise from Apple on Wednesday could trigger a return to the stock from many investors who had abandoned ship.

Other major companies reporting next week include Google , IBM , Johnson & Johnson and DuPont on Tuesday, Microsoft and 3M on Thursday and Procter & Gamble on Friday.

CASH POURING IN, HOUSING DATA COULD HELP

Perhaps the strongest support for equities will come from the flow of cash from fixed income funds to stocks.

The recent piling into stock funds -- $11.3 billion in the past two weeks, the most since 2000 -- indicates a riskier approach to investing from retail investors looking for yield.

"From a yield perspective, a lot of stocks still yield a great deal of money and so it is very easy to see why money is pouring into the stock market," said Stephen Massocca, managing director at Wedbush Morgan in San Francisco.

"You are just not going to see people put a lot of money to work in a 10-year Treasury that yields 1.8 percent."

Housing stocks <.hgx>, already at a 5-1/2 year high, could get a further bump next week as investors eye data expected to support the market's perception that housing is the sluggish U.S. economy's bright spot.

Home resales are expected to have risen 0.6 percent in December, data is expected to show on Tuesday. Pending home sales contracts, which lead actual sales by a month or two, hit a 2-1/2 year high in November.

The new home sales report on Friday is expected to show a 2.1 percent increase.

The federal debt ceiling negotiations, a nagging worry for investors, seemed to be stuck on the back burner after House Republicans signaled they might support a short-term extension.

Equity markets, which tumbled in 2011 after the last round of talks pushed the United States close to a default, seem not to care much this time around.

The CBOE volatility index <.vix>, a gauge of market anxiety, closed Friday at its lowest since April 2007.

"I think the market is getting somewhat desensitized from political drama given, this seems to be happening over and over," said Destination Wealth Management's Yoshikami.

"It's something to keep in mind, but I don't think it's what you want to base your investing decisions on."

(Reporting by Rodrigo Campos, additional reporting by Chuck Mikolajczak and Caroline Valetkevitch; Editing by Kenneth Barry)

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In Regional Elections, a Microcosm of Trouble Ahead for Merkel

BERLIN — With the national parliamentary election scheduled for September, many in Germany are looking to Lower Saxony, which holds regional elections on Sunday, for clues of what could happen in Berlin this autumn.

Political experts insist that regional elections in Germany have traditionally had little direct influence on the outcome of national elections. But several similarities between Lower Saxony and the German government make it appear a microcosm of the larger political scene.

Like Chancellor Angela Merkel’s government, Lower Saxony’s is led by a center-right coalition of her Christian Democrats and the Free Democrats. The Christian Democratic candidate in the state, David McAllister, is personally popular with voters, as is the chancellor, helping him to close in on his Social Democratic rival, Stephan Weil, making for a tight race.

But also like the chancellor, Mr. McAllister will rely heavily on the Free Democrats’ winning enough votes to earn seats in the regional legislature to continue his current government. In recent surveys, the party has hovered around 5 percent, the threshold needed to secure representation at the regional and national levels.

That polling has focused attention on the vote in Lower Saxony as a make-or-break moment for the party and perhaps even for Ms. Merkel’s coalition in Berlin.

The Free Democratic Party ended a string of losses at the regional level by winning slightly more than 8 percent of the vote in two states last year, North Rhine-Westphalia and Schleswig-Holstein. But for now that performance has not translated into a stronger position at the national level.

Many blame a lack of leadership. The party chairman, Philipp Rösler, who also serves as economy minister, consistently ranks as among the country’s least-popular politicians. But Karl-Rudolf Korte, a professor of politics at the University of Duisburg-Essen, says the party’s problems reach deeper than who is at its helm.

“It is not a problem of personality — it is a problem of issues,” Mr. Korte said.

Regardless of the outcome Sunday, he predicts that the party would be well advised to go for a two-pronged approach, keeping Mr. Rösler as its leader, but choosing the party’s parliamentary leader, Rainer Brüderle, as its main candidate because of his popularity.

Traditionally the Free Democrats have provided a clear voice for individual citizens’ rights against an overly powerful nanny state. They have served in more governments in postwar Germany than any other political party, although as the junior coalition partner. Two respected presidents, Theodor Heuss and Walter Scheel, hailed from the Free Democrats, as did an influential former foreign minister, Hans-Dietrich Genscher.

Four years ago, the Free Democratic Party, or F.D.P., emerged with its strongest showing ever, earning 14.6 percent of the vote after campaigning on a promise to cut taxes. But with the euro crisis, that promise has been watered down and the party has failed to find other issues that resonate with voters.

At a party congress this month, Mr. Brüderle sought to drum up support by singling out legislation passed by the current coalition that clearly reflected the Free Democrats’ influence.

“The F.D.P. made the union better,” he said of the coalition, citing the scrapping of required military service, a €10 payment at doctors’ offices, policies affecting growth and consumer protection laws. “We need to believe in ourselves then many others will believe in us.”

A poll by the Forsa Institute, published by the weekly Stern on Wednesday showed the Free Democratic Party getting only 3 percent support, which would translate to their ejection from lower house of Parliament, the Bundestag.

Such an outcome would force Ms. Merkel, whose center-right Christian Democrats appear to be stronger than ever, earning 43 percent support in the Forsa survey, to find a new partner in government.

The center-left Social Democrats, however, polled their lowest since 2011, earning only 23 percent, largely because of a plunge in popularity for their candidate in the national election, Peer Steinbrück.

Manfred Güllner, who heads the Forsa Institute, said that even if the Social Democratic candidate in Lower Saxony, Mr. Weil, could pull off a victory, it would be unlikely to translate into increased support for Mr. Steinbrück.

“The latest survey shows that peoples’ image of Mr. Steinbrück has become increasingly negative,” Mr. Güllner said. “People view him as greedy, arrogant and awkward. Very few people associate him with political competence.”

Mr. Steinbrück’s image as a former finance minister who shepherded Germany through the first days of the financial crisis has been battered by a drawn-out debate over his private earnings from a book and, more recently, a comment that Ms. Merkel benefited from a “women’s bonus.”

Even an attempt by Mr. Steinbrück to change that image by inviting undecided voters to his home for a personal talk backfired earlier this week when the media began reporting that the family of a person in Lower Saxony that was selected from 150 candidates included an active member of the party’s local branch.

A victory by the Social Democrats in Lower Saxony, however, could have a greater impact on national politics through the upper house of Parliament, the Bundesrat, which is made up of representatives of the country’s 16 states. Together with their main political allies, the Greens, they could form a majority.

“If a party is clever, such a majority can be used to block, drag out or otherwise delay any legislative procedure,” Mr. Korte said.

That power would effectively hamper the government’s ability to pass legislation, regardless of their popularity.

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ASUS in talks with Microsoft to develop a Windows Phone 8 smartphone

The PC industry is in shambles and manufacturers have begun to explore new options to increase revenue. According to The Wall Street Journal, ASUS (2357) is in talks with Microsoft (MSFT) on a licensing deal to offer Windows Phone 8 device. This makes sense for ASUS since smartphone shipments increased by nearly 50% in 2012, compared to a mere 3.2% growth in computer shipments, and the company already has experience in the mobile world after developing a variety of Android tablets.

[More from BGR: Cable companies called ‘monopolies that stifle competition and innovation’]

Benson Lin, the company’s corporate vice president of mobile communication products, revealed in a recent interview that ASUS was hoping to bring its PadFone, a smartphone that can dock into a larger tablet, to the Windows 8 ecosystem.

[More from BGR: Clash of the bantams: The bloody smartphone battle that will take shape in 2013]

“With our Padfone concept, the phone plus tablet, I think it makes sense for Windows 8,” Lin said. “There is no target timeline…but we are interested in making Windows phones.”

The executive also said that ASUS has been in talks with a variety of American carriers in the hopes that its smartphones will launch in the United States in 2013.

This article was originally published on BGR.com

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Inspiring Singers Outshine American Idol's Feuding Judges

TV Watch

American Idol

By Steve Helling

01/17/2013 at 11:00 PM EST

From left: Randy Jackson, Mariah Carey, Ryan Seacrest, Nicki Minaj and Keith Urban

George Holz/FOX

The second episode of American Idol delivered more drama, but a handful of singers managed to eclipse the ongoing feud between new judges Mariah Carey and Nicki Minaj. And that's no easy task considering one of the battling divas is wearing a blonde and pink wig.

The night's most memorable contestant was Lazaro Arbos. As he entered the audition room, one thing became immediately clear: the 21-year-old from Naples, Fla., had a severe stutter. Arbos, who emigrated from Cuba when he was 10, told viewers that he had few friends growing up due to his speech impediment.

But something magical happened when he began to sing. His stutter vanished and he gave a moving performance of "Bridge Over Troubled Water." As the judges unanimously put him through to Hollywood, Arbos dissolved into tears.

Equally inspiring was Mariah Pulice, a 19-year-old restaurant hostess from Darien, Ind. The last two years have been difficult for Pulice, who told judges she was recovering from anorexia. "If there was no music," she said, "I would not be alive." After singing the Beatles' "Let it Be," the judges were unanimous in their praise. "I really, really, really felt that song coming from you," said Minaj.

Carey agreed: "You touched me," she said. "I know what it's like to have to sing through tears. I'm proud of you."

But it wasn't all drama and emotion. Minaj started a baffling trend of asking handsome singers if they had a girlfriend. (She also managed to charm the shirts off of a couple of them, although you get the feeling they were happy to show their abs on national TV.) "You have a hole in your pants," she told one contestant. "Why are you looking?" he shot back.

And poor Keith Urban. Sitting between Minaj and Carey, he found himself in the crossfire. "I feel like a scratching post," he said at one point, before repeatedly banging his head on the table.

The judges found a lot of talent in Chicago. All told, 46 contestants were put through to Hollywood. The competition will head to Charlotte, N.C., next Wednesday.

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Will Obama's order lead to surge in gun research?

MILWAUKEE (AP) — Nearly as many Americans die from guns as from car crashes each year. We know plenty about the second problem and far less about the first. A scarcity of research on how to prevent gun violence has left policymakers shooting in the dark as they craft gun control measures without much evidence of what works.

That could change with President Barack Obama's order Wednesday to ease research restrictions pushed through long ago by the gun lobby. The White House declared that a 1996 law banning use of money to "advocate or promote gun control" should not keep the Centers for Disease Control and Prevention and other federal agencies from doing any work on the topic.

Obama can only do so much, though. Several experts say Congress will have to be on board before anything much changes, especially when it comes to spending money.

How severely have the restrictions affected the CDC?

Its website's A-to-Z list of health topics, which includes such obscure ones as Rift Valley fever, does not include guns or firearms. Searching the site for "guns" brings up dozens of reports on nail gun and BB gun injuries.

The restrictions have done damage "without a doubt" and the CDC has been "overly cautious" about interpreting them, said Daniel Webster, director of the Center for Gun Policy and Research at the Johns Hopkins Bloomberg School of Public Health.

"The law is so vague it puts a virtual freeze on gun violence research," said a statement from Michael Halpern of the Union of Concerned Scientists. "It's like censorship: When people don't know what's prohibited, they assume everything is prohibited."

Many have called for a public health approach to gun violence like the highway safety measures, product changes and driving laws that slashed deaths from car crashes decades ago even as the number of vehicles on the road rose.

"The answer wasn't taking away cars," said Dr. Georges Benjamin, executive director of the American Public Health Association.

However, while much is known about vehicles and victims in crashes, similar details are lacking about gun violence.

Some unknowns:

—How many people own firearms in various cities and what types.

—What states have the highest proportion of gun ownership.

—Whether gun ownership correlates with homicide rates in a city.

—How many guns used in homicides were bought legally.

—Where juveniles involved in gun fatalities got their weapons.

—What factors contribute to mass shootings like the Newtown, Conn., one that killed 26 people at a school.

"If an airplane crashed today with 20 children and 6 adults there would be a full-scale investigation of the causes and it would be linked to previous research," said Dr. Stephen Hargarten, director of the Injury Research Center at the Medical College of Wisconsin.

"There's no such system that's comparable to that" for gun violence, he said.

One reason is changes pushed by the National Rifle Association and its allies in 1996, a few years after a major study showed that people who lived in homes with firearms were more likely to be homicide or suicide victims. A rule tacked onto appropriations for the Department of Health and Human Services barred use of funds for "the advocacy or promotion of gun control."

Also, at the gun group's urging, U.S. Rep. Jay Dickey, a Republican from Arkansas, led an effort to remove $2.6 million from the CDC's injury prevention center, which had led most of the research on guns. The money was later restored but earmarked for brain injury research.

"What the NRA did was basically terrorize the research community and terrorize the CDC," said Dr. Mark Rosenberg, who headed the CDC's injury center at the time. "They went after the researchers, they went after institutions, they went after CDC in a very big way, and they went after me," he said. "They didn't want the data to be collected because they were threatened by what the data were showing."

Dickey, who is now retired, said Wednesday that his real concern was the researcher who led that gun ownership study, who Dickey described as being "in his own kingdom or fiefdom" and believing guns are bad.

He and Rosenberg said they have modified their views over time and now both agree that research is needed. They put out a joint statement Wednesday urging research that prevents firearm injuries while also protecting the rights "of legitimate gun owners."

"We ought to research the whole environment, both sides — what the benefits of having guns are and what are the benefits of not having guns," Dickey said. "We should study any part of this problem," including whether armed guards at schools would help, as the National Rifle Association has suggested.

Association officials did not respond to requests for comment. A statement Wednesday said the group "has led efforts to promote safety and responsible gun ownership" and that "attacking firearms" is not the answer. It said nothing about research.

The 1996 law "had a chilling effect. It basically brought the field of firearm-related research to a screeching halt," said Benjamin of the Public Health Association.

Webster said researchers like him had to "partition" themselves so whatever small money they received from the CDC was not used for anything that could be construed as gun policy. One example was a grant he received to evaluate a community-based program to reduce street gun violence in Baltimore, modeled after a successful program in Chicago called CeaseFire. He had to make sure the work included nothing that could be interpreted as gun control research, even though other privately funded research might.

Private funds from foundations have come nowhere near to filling the gap from lack of federal funding, Hargarten said. He and more than 100 other doctors and scientists recently sent Vice President Joe Biden a letter urging more research, saying the lack of it was compounding "the tragedy of gun violence."

Since 1973, the government has awarded 89 grants to study rabies, of which there were 65 cases; 212 grants for cholera, with 400 cases, yet only three grants for firearm injuries that topped 3 million, they wrote. The CDC spends just about $100,000 a year out of its multibillion-dollar budget on firearm-related research, New York Mayor Michael Bloomberg has said.

"It's so out of proportion to the burden, however you measure it," said Dr. Matthew Miller, associate professor of health policy at the Harvard School of Public Health. As a result, "we don't know really simple things," such as whether tighter gun rules in New York will curb gun trafficking "or is some other pipeline going to open up" in another state, he said.

What now?

CDC officials refused to discuss the topic on the record — a possible sign of how gun shy of the issue the agency has been even after the president's order.

Health and Human Services Secretary Kathleen Sebelius said in a statement that her agency is "committed to re-engaging gun violence research."

Others are more cautious. The Union of Concerned Scientists said the White House's view that the law does not ban gun research is helpful, but not enough to clarify the situation for scientists, and that congressional action is needed.

Dickey, the former congressman, agreed.

"Congress is supposed to do that. He's not supposed to do that," Dickey said of Obama's order. "The restrictions were placed there by Congress.

"What I was hoping for ... is 'let's do this together,'" Dickey said.

___

Follow Marilynn Marchione's coverage at http://twitter.com/MMarchioneAP

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Housing, job data push S&P to five-year high; Intel down late

NEW YORK (Reuters) - Stronger-than-expected data on housing starts and jobless claims lit a fire under stocks on Thursday, pushing the S&P 500 to a five-year high and its third day of gains.

A pair of economic reports lifted investors' sentiment. The number of Americans filing new claims for unemployment benefits fell to a five-year low last week and housing starts jumped last month to the highest since June 2008.

Strength in the housing and labor markets is key to sustained growth and higher corporate profits, helping to bring out buyers even on a day when earnings reports were mixed.

Gains were tempered by weakness in the financial sector, with Bank of America down 4.2 percent to $11.28 and Citigroup off 2.9 percent to $41.24 after their results.

In other negative earnings news, shares of chipmaker Intel fell 5.2 percent to $21.49 in extended-hours trading after the company forecast quarterly revenue that fell short of analysts' expectations. Intel had ended the regular session up 2.6 percent at $22.68.

The S&P 500 ended at its highest since December 2007 and now sits just 5.6 percent from its all-time closing high of 1,565.15.

"Having consolidated really for the last two weeks, the fact that we broke out, I think that that is sucking in quite a bit of money," said James Dailey, portfolio manager of TEAM Asset Strategy Fund in Harrisburg, Pennsylvania.

The Dow Jones industrial average <.dji> was up 84.79 points, or 0.63 percent, at 13,596.02. The Standard & Poor's 500 Index <.spx> was up 8.31 points, or 0.56 percent, at 1,480.94. The Nasdaq Composite Index <.ixic> was up 18.46 points, or 0.59 percent, at 3,136.00.

Better-than-expected earnings and revenue reported by online marketplace eBay late Wednesday helped the stock gain 2.7 percent to $54.33.

In the housing sector, PulteGroup Inc shares gained 4.9 percent to $20.29 and Toll Brothers Inc advanced 3.1 percent to $35.99. The PHLX housing sector index <.hgx> climbed 2.4 percent, reaching its highest close since August 2007.

Semiconductor shares <.sox> rose 2 percent to the highest close in eight months.

Financials were the only S&P 500 sector to register a slight decline for the day.

Bank of America's fourth-quarter profit fell as it took more charges to clean up mortgage-related problems. Citigroup posted $2.32 billion of charges for layoffs and lawsuits.

Energy shares led gains on the Dow as U.S. crude oil prices jumped more than 1 percent. Shares of Exxon Mobil were up 0.8 percent at $90.20 while shares of Chevron were up 0.7 percent at $114.75.

S&P 500 earnings are expected to have risen 2.3 percent in the fourth quarter, Thomson Reuters data showed. Expectations for the quarter have fallen considerably since October when a 9.9 percent gain was estimated.

Volume was roughly 6.5 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.

Advancers outpaced decliners on the NYSE by about 22 to 7 and on the Nasdaq by about 2 to 1.

(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry and Nick Zieminski)

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India Ink: A Hospital Network With a Vision

Fixes looks at solutions to social problems and why they work.

As the United States struggles to find new business models for health care, some innovators are looking to other industries, ones that provide high-quality services for low prices. In a recent article in The New Yorker, for example, Atul Gawande suggests that the Cheesecake Factory restaurant chain — with its size, central control and accountability for the customer experience — could be a model of sorts for health care. That’s not as outlandish as it seems. The world’s largest provider of eye care has found success by directly adapting the management practices of another big-box food brand, one that is not often associated with good health: McDonald’s.

Aravind can practice compassion successfully because it is run like a McDonald’s.

In 1976, Dr. Govindappa Venkataswamy — known as Dr. V — retired from performing eye surgery at the Government Medical College in Madurai, Tamil Nadu, a state in India’s south. He decided to devote his remaining years to eliminating needless blindness among India’s poor. Twelve million people are blind in India, the vast majority of them from cataracts, which tend to strike people in India before 60 — earlier than in the West. Blindness robs a poor person of his livelihood and with it, his sense of self-worth; it is often a fatal disease. A blind person, the Indian saying goes, is “a mouth with no hands.”

Dr. V started by establishing an 11-bed hospital with six beds reserved for patients who could not pay and five for those who would pay modest rates. He persuaded his siblings to join him in mortgaging their houses, pooling their savings and pawning their jewels to build it. Today, the Aravind Eye Care System is a network of hospitals, clinics, community outreach efforts, factories, and research and training institutes in south India that has treated more than 32 million patients and has performed 4 million surgeries. And it is still largely run by Dr V’s siblings and their spouses and children — he has at least 21 relatives who are eye surgeons. (Aravind’s story is well-told in depth in a new book, “Infinite Vision.”)

Aravind is not just a health success, it is a financial success. Many health nonprofits in developing countries rely on government help or donations, but Aravind’s core services are sustainable: patient care and the construction of new hospitals are funded by fees from paying patients. And at Aravind, patients pay only if they want to. The majority of Aravind’s patients pay only a symbolic amount, or nothing at all.

Dr V was guided by the teachings of the radical Indian nationalist and mystic Sri Aurobindo (Aravind is a southern Indian variation of Aurobindo), who located man’s search for his divine nature not in turning away from the world, but by engaging with it.

This philosophy, however, has produced a sustainable business model because of the other major influence on Dr. V: McDonald’s. Sri Aurobindo and McDonald’s are an unlikely pair. But Aravind can practice compassion successfully because it is run like a McDonald’s, with assembly-line efficiency, strict quality norms, brand recognition, standardization, consistency, ruthless cost control and above all, volume.

Aravind’s efficiency allows its paying patients to subsidize the free ones, while still paying far less than they would at other Indian hospitals. Each year, Aravind does 60 percent as many eye surgeries as the United Kingdom’s National Health System, at one one-thousandth of the cost.

Aravind’s ideas reach around the world. It runs hospitals in other parts of India with partners. It is also host to a parade of people who come to learn how it works, and it sends staff to work with other organizations. So far about 300 hospitals in India and in other countries are using the Aravind model. All are eye hospitals. But Aravind has also trained staff from maternity hospitals, cancer centers, and male circumcision clinics, among other places. Some share Aravind’s social mission. Others simply want to operate more efficiently.

The vast majority of people blind from cataracts in rural India have no idea why they are blind, nor that a surgery exists that can restore their sight in a few minutes. Aravind attracts these patients in two ways. First, it holds eye camps — 40 a week around the states of Tamil Nadu and Kerala. The camps visit villages every few months, offering eye exams, basic treatments, and fast, cheap glasses. Patients requiring surgery are invited with a family member to come to the nearest of Aravind’s nine hospitals; all transport and lodging, like the surgery, is free.

When Aravind surveyed the impact of its camps, it found to its dismay that they only attracted 7 percent of people in a village who needed care, mainly because they were infrequent. To provide a permanent presence in rural areas, Aravind established 36 storefront vision centers. They are staffed by rural women recruited and given two years’ training by Aravind. They have cameras, so doctors at Aravind’s hospitals can do examinations remotely. These centers increase Aravind’s market penetration to about 30 percent within one year of operation.

At Aravind’s hospitals, free patients lodge on a mat on the floor in a 30-person dormitory. Paying patients can choose various levels of luxury, including private, air-conditioned rooms. All patients get best-practice cataract surgeries, but paying patients can choose more sophisticated surgeries with faster recoveries (but not higher success rates). The doctors are identical, rotating between the free and paid wings.

Also standard for all patients is the Aravind assembly line. Dr. V spent a few days at McDonalds’ Hamburger University in Oak Brook,, Ill., but that visit was a product of his longstanding obsession with efficiency. “This man would go into an airport and walk around with the janitor and see how he cleans the toilet,” said Dr. S. Aravind, an eye surgeon with a masters degree in business who is Aravind’s director of projects. (He is Dr. V’s nephew, also named for Sri Aurobindo.) “He would go to a five star hotel and follow the catering people.”

Doctors are hard to find and expensive, so the surgical system is set up to get the most out of them. Patients are prepared before surgery and bandaged afterwards by Aravind-trained nurses. The operating room has two tables. The doctor performs a surgery — perhaps 5 minutes — on Table 1, sterilizes her hands and turns to Table 2. Meanwhile, a new patient is prepped on Table 1. Aravind doctors do more than 2,000 surgeries a year; the average at other Indian hospitals is around 300. As for quality, Aravind’s rate of surgical complications is half that of eye hospitals in Britain.

This volume is key to Aravind’s ability to offer free care. The building and staff costs are the same no matter how many surgeries each doctor performs. High volume means that these fixed costs are spread among vastly more people.

In the 1980s, Aravind faced a dilemma. A new surgery, which implanted a lens in the patient’s eye, had become the gold standard for treating cataracts. But these lenses were not made in India, and Aravind could persuade manufacturers to reduce their cost only from $100 to $70 per lens. Should Aravind begin providing first-class treatment for paying patients and second-class treatment for free ones? Or should it try to get enough money from paid patients to cover intraocular lenses for all? Neither was acceptable.

The solution was to get into manufacturing. In 1992, Aravind set up Aurolab, which now makes lenses (for $2 apiece), sutures and medicines. Aurolab is now a major global supplier of intraocular lenses and has driven down the price of lenses made by other manufacturers as well.

Aravind could not do its work without paying patients, of course — they subsidize free patients. They also improve service, by demanding high quality for their money. But it also works the other way around: the free patients improve service and price for patients who pay. “One of our big advantages is the scale of the work we do,” said Dr. Aravind. “You become a good resource center for training doctors, nurses, everybody. Because of high volume, doctors get better at what they do. They can develop subtle specialties.” And free patients make cost control a priority. “If 60 percent of your patients are paying very little or nothing, your cost structure is attuned towards that,” Dr. Aravind said.

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Whenever there is an innovator like Aravind, the question arises: how replicable is this? Do you need a Dr. V? Or is there a system that ordinary mortals can adapt?

The answer is a little of both. Other hospitals can and do successfully use the model. Lions Clubs International, which has worked to prevent blindness for more than a century, finances and supports a training institute. Aravind also works with the Berkeley-based Seva Foundation to grow eye hospitals in other countries. “There are a lot of eye hospitals in the developing world. Almost every single one is considerably underproducing,” said Suzanne Gilbert, the director of Seva’s Center for Innovation in Eye Care. “Surgical programs so often focus on the technique being used. Often the same level of scrutiny not applied to management, human resources and other systems that make the surgery work.”

Seva has worked with Aravind to establish hospitals in other countries (the Lumbini Eye Institute in Nepal has been particularly successful).  But its campaign to turn those hospitals into training centers has gone slowly. It’s hard to build those hospitals to be able to reach out while keeping good quality,” said Gilbert.   Seva was aiming to have 100 hospitals in the network by 2015, but has scaled back that goal.

“Of the 300 hospitals (that use Aravind’s model), I’d say 20 percent get the whole thing,” said Dr. Aravind. “Another 50 percent pick up pieces — how to make your operating tables more efficient, for example.  And the rest struggle.”

Combining paid and free care in a self-sufficient hospital is not possible for most health specialties. “The essential ingredient is volume that straddles the socioeconomic spectrum,” said Jaspal Sandhu, a Berkeley engineer who has studied Aurolab, and who is co-founder of the Gobee Group, a design firm that works with organizations to increase their social impact. “If you’re focusing on rich diseases or poor diseases, this model in existing form can’t really play out. The nice thing about cataracts is that it doesn’t greatly discriminate. And a cataract is a one-time hit. There’s a cure for it. You can treat it in a couple of days and it won’t come back.”

Male circumcision — an AIDS prevention measure — fits this description, and the World Health Organization’s guidelines for scaling up male circumcision uses Aravind’s principles. “When I was a doctor in a government hospital we did between 8 and maybe 12 circumcisions in a day per doctor,” said Dino Rech, a South African physician who has overseen the expansion of circumcision in several countries.  “With this model, the slowest doctors are doing 40 in a day — up to 60 for the faster ones.”

The McDonald’s part is the easiest piece of the Aravind model to export. More difficult to replicate is Aravind’s commitment to serving the largest number of free patients possible — indeed, to aim to eventually serve all of them. What’s needed, said Dr. Aravind, “is not leadership in the sense of organizing and making it work. It’s leadership that comes from empathizing with the community.”

Aravind spends a lot of resources recruiting free patients. “Never restrict demand. Build your capacity to meet the demand,” Dr. Aravind said. This community outreach work is the easiest part to sacrifice, he said. “This is where mission and leadership come in. People try to justify it with many things — we’ll build a bigger organization, then we’ll go back to community. If you have a choice between your paying and your free patients — well, the team is watching how you prioritize. Here’s its been internalized that this is the way we deal with any issue.  If someone can embody that, they can be like our founder.”

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Tina Rosenberg won a Pulitzer Prize for her book “The Haunted Land: Facing Europe’s Ghosts After Communism.” She is a former editorial writer for The Times and the author of, most recently, “Join the Club: How Peer Pressure Can Transform the World” and the World War II spy story e-book “D for Deception.”

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Commentary: Background Checks? Yes, but Leave Video Games Alone

COMMENTARY | I have mixed feelings toward the White House‘s gun violence response. I agree that background checks should be required before people are allowed to buy a firearm and that an assault weapon ban should be reinstated into law. While limiting the number of bullets in a weapon’s magazine will decrease the number of deaths in a mass shooting, the public does not need high-capacity magazines. Therefore any weapon using high-capacity magazines should be banned from public use, not just capping the magazines to 10 bullets.

But violent video games and other media images and scenes real-life violence? These media do not kill people. The shooters kill the people. Those who are mentally unstable may not understand that violent video games are not real life and should not be duplicated in real life. As long as gamers understand the difference between video games and real life, that shouldn’t be touched.

– Edmond, Okla.

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