WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

___

Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

__

Online:

WHO report: http://bit.ly/YDCXcb

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Women far outnumbered by men in L.A. council races

Tina Hess says she never planned to be an L.A. City Council candidate.

But last November, when she turned her attention to local races after the presidential election, she was shocked to see not a single woman running to represent her Westside district. And in seven other council races across the city, only a handful of women were running, compared with dozens of men.

"I just saw this void," said Hess, a city prosecutor who lives in Del Rey. She decided to enter the race when she realized the city could soon be without a single woman on its 15-member lawmaking body. Mayoral candidate Jan Perry, the only woman currently serving on the council, departs on June 30 because of term limits.

Hess is one of several female candidates waging uphill battles against men who have raised considerably more money.

In the west San Fernando Valley, attorney Joyce Pearson and business owner Elizabeth Badger are in a six-person field looking to replace Councilman Dennis Zine. Pearson has raised nearly $90,000 for her campaign, according to the most recent reports. Her main opponent, Assemblyman Bob Blumenfield, collected nearly twice that amount during the same period.

In the east Valley, two women are running in a lopsided four-way race against former Assemblyman Felipe Fuentes. In the most recent fundraising reports, Fuentes had raised 10 times as much money as two of his opponents — actress and community volunteer Krystee Clark and education activist Nicole Chase.

In South Los Angeles, Ana Cubas is facing seven male candidates. In a news conference this week, she urged voters not to let the council become a male-only outpost of city government. "Do we want to go back to 1933?" she asked, pointing to a picture from that era in which no women sit at the council's horseshoe of desks.

In the mayor's race, City Controller Wendy Greuel makes frequent reference to the fact that she would be L.A.'s first female mayor. Perry, in turn, would be the first African American woman to hold the post, if elected.

But Cubas, a former aide to Councilman Jose Huizar, complained that City Hall leaders and the media haven't brought enough attention to the dwindling number of women on the council. She pointed out that local newspapers, including The Times, have failed to endorse any female candidates in next week's elections.

"I cannot believe that there wasn't a single qualified female candidate," she said.

Cubas said the current trend could have long-term consequences because the council often serves as a pipeline for other elected positions.

She has pledged, if elected, to form a women's political caucus and groom a female candidate to run to replace her. She has also promised to make gender a major focus, vowing to ensure female and male employees are paid the same for equal work.

She was joined by Rita Walters, who previously served as the councilwoman in Perry's district. In the 1990s and early 2000s, the city made great strides by electing women to the council, which at one point had five female members. The idea of a council without women in 2013, Walters said, "just pains me."

kate.linthicum@latimes.com

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Malaysia Said to Open Fire on Armed Filipinos

MANILA — Shots have been fired in a tense standoff between a group of armed Filipinos and Malaysian police officer who have them surrounded in a remote northeast area of Malaysia, a Philippine presidential spokesman said Friday.

The group, which is occupying an isolated village in attempt to revive a historical claim to the area, tried early Friday morning to breach the perimeter established by Malaysian police, said Ricky Carandang, a Philippine presidential spokesman.

The group claims the territory in Malaysia’s Sabah State as its own, and has rejected a plea from President Benigno S. Aquino III of the Philippines to leave. The group’s seizure of the coastal village has complicated relations between the Philippines and Malaysia.

After the group tried to breach the perimeter, the Malaysian police fired warning shots to force them to return to the cordoned off area and no one was injured, Mr. Carandang said.

“They apparently tried to leave the area and were stopped,” Mr. Carandang said by telephone. “We have conflicting reports but this is what we have verified so far.”

The group’s leader, who is based in Manila, claimed on Friday that the Malaysian police opened fire on them. The leader, Prince Rajah Mudah Agbimuddin Kiram, told the Philippine radio station DZBB that the group was fighting back and that there had been Filipino casualties.

The episode began Feb. 12, when the group, which is seeking to revive a historical claim to part of Borneo, arrived by boat from the Philippines and seized the land. The Philippines on Monday sent a navy vessel to the area with medical and diplomatic personnel to pick up the group or escort them back to the Philippines, hoping to resolve the situation.

Mr. Aquino said Tuesday that his government had sent emissaries to meet with Mr. Kiram to resolve the issue.

“These are your people, and it behooves you to recall them,” Mr. Aquino said to the leader in his Tuesday statement. “It must be clear to you that this small group of people will not succeed in addressing your grievances, and that there is no way that force can achieve your aims.”

The Philippines has been coordinating with the Malaysian government to resolve the issue peacefully, but Malaysian police officials in the area where the standoff is taking place had earlier suggested that they were prepared to use force if necessary.

Floyd Whaley reported from Manila, and Gerry Mullany from Hong Kong.

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American Idol Reveals Its Top 20

By Steve Helling

02/28/2013 at 11:20 PM EST

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

Michael Becker/FOX

American Idol has been on the air for 12 seasons. From the early days of Kelly Clarkson, the judges continually hounded the contestants on song choice. Simon Cowell (remember him?) would criticize contestants for being "cabaret," "old-fashioned" and, worst of all, "boring." Some of this season's contestants have been watching Idol since they were in elementary school, which makes it all the more inexplicable that they still choose to sing songs like Peggy Lee's "Fever," which is 57 years old.

The show began with the 10 contestants rising from the floor, Hunger Games-style. Five of them will continue, while five of them met their end. Find out who made it through to the next round …
Spoiler Alert! The final picks for the Top 20 follow:

Cortez Shaw: His ballad arrangement of David Guetta's "Titanium" was excellent – and it was a nice change to hear a song that was current and relevant. "Your range surprised me today," judge Randy Jackson said. "When you hit those big notes, I was shocked."

Burnell Taylor: He's lost 40 lbs. since auditioning, and singing John Legend's "This Time," he brought down the house – despite oddly exaggerated hand movements. "I would pay to hear you sing," said Nicki Minaj, sharing the best compliment of the night. Mariah Carey was also pleased, simply saying, "This was fantastic."

Lazaro Arbos: After delivering an emotional performance of Keith Urban's "Tonight I Want to Cry," the 21-year-old singer from Naples, Fla., was unanimously sent through to the next round. The Cuban-born Arbos has arguably the season's most poignant backstory, with a severe stutter that vanishes when he sings. Minaj remains a big fan, telling him: "You feel it. You stay in it. Don't change nothing."

Nick Boddington: The New York City bartender performed "Say Something Now" by James Morrison and did a passable – if unremarkable – job. "I kept waiting for the feeling of being connected to you as a person," said Urban. Carey agreed, saying, "I needed to feel you more connected to the song."

Vincent Powell: Singing Lenny Williams's "'Cause I Love You," he effortlessly broke into a falsetto that elicited cheers from the audience. After calling him a "sexy old-fashioned" singer, Minaj added, "I could envision a whole bunch of 50-year-olds throwing their panties at you." Powell, who works his day job as a church worship leader, laughed nervously.

And yes, it was guys' night, but finalist Zoanette Johnson made a cameo when she stood up and cheered Powell's performance, prompting host Ryan Seacrest to run over with a microphone. (For a brief moment, It felt like a '90s-era episode of Ricki Lake, which is actually a very good thing.) "Get it, Papa Smurf," Johnson screamed. "You go get it."

Leave it to Zoanette to steal the show on guy's night.

Tonight's finalists will join Charlie Askew, Curtis Finch Jr., Paul Jolley, Elijah Liu and Devin Velez – and 10 female finalists – to sing for America's votes next week.

Who are you rooting for?

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WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

___

Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

__

Online:

WHO report: http://bit.ly/YDCXcb

Read More..

Bell jurors ordered to begin anew after panelist is dismissed

After nearly five days of deliberations, jurors in the Bell corruption trial were ordered Thursday to begin anew after a member of the panel was dismissed for misconduct and replaced by an alternate.

The original juror, a white-haired woman identified only as Juror No. 3, told Los Angeles County Superior Court Judge Kathleen Kennedy she had gone onto a legal website to look up jury instructions and then asked her daughter to help find a definition for the word "coercion."

Although all but one defense attorney requested that the woman stay, Kennedy said the juror needed to be removed. "She has spoken about the deliberations with her daughter, she has conducted research on the Internet, and I've repeatedly, repeatedly throughout this trial — probably hundreds of times — cautioned the jury not to do that," the judge said.

The removal came after jurors notified the judge that they were deadlocked and that continued deliberations seemed fruitless.

It was unclear how to interpret the day's events, whether the dismissed juror had been a lone holdout or an indication of a fractured jury.

The juror started to tell the judge which way she was leaning in the case, saying she had gone online "looking to see at what point can I get the harassment to stop.... How long do I have to stay in there and deliberate with them when I have made my decision that I didn't think there was —"

Kennedy cut her off before she could finish.

The woman clasped her hands over her mouth and said, "I'm sorry."

Two defense attorneys thought she was leaning toward acquittal and wanted her to stay. "I would have preferred the deadlock to a guilty verdict," said Alex Kessel, the attorney for George Mirabal, one of six former council members charged with misappropriation of public funds.

The council members are charged with inflating their salaries in what prosecutors contend was a far-reaching web of corruption in which fat paychecks were placed ahead of the needs of the city's largely immigrant, working-poor constituents.

When attorneys and defendants were summoned to the courtroom Thursday morning, they were initially told that the jury appeared to be deadlocked.

"Your honor, we have reached a point where as a jury we have fundamental disagreements and cannot reach a unanimous verdict in this case," read a note signed by two jurors, including the foreman, that was given to Kennedy.

A note from another juror alerted the judge that Juror No. 3 had consulted an outside attorney. That did not appear to be the case, but her other actions were revealed under questioning from the judge.

The same juror made a tearful request Monday to be removed from the panel because she felt others were picking on her. Kennedy told the woman that although discussions can get heated, it was important to continue deliberating.

On Thursday, however, the juror again broke into tears and said she had spoken with her daughter about "the abuse I have suffered." She said her daughter told her, "Mom, they're trying to find the weak link."

The woman said she had turned to the Internet to better understand the rules about jury deliberations and came across the word "coercion." After her daughter helped her look up the word's definition, she wrote it down on a piece of paper and brought it with her to court. When the judge asked to see the paper she went into the jury room to retrieve it.

The woman later left the courtroom in tears.

With an alternate in place, Kennedy told the panel to act as if the earlier deliberations had not taken place. The alternate had sat in the jury box during the four-week trial but did not take part in deliberations.

Former council members Luis Artiga, Victor Bello, George Cole, Oscar Hernandez, Teresa Jacobo and Mirabal are accused of drawing annual salaries of as much as $100,000 a year by serving on boards that did little work and seldom met, part of a scandal that drew national attention to the small city in 2010.

Prosecutors said that Bell's charter follows state law regarding council members' compensation. In a city the size of Bell, council members should be paid no more than $8,076 a year.

The trial began in late January, and the case went to the jury last Friday.

As the jury resumed deliberations in downtown Los Angeles, the verdict was clearly in on the streets of Bell.

One resident unfurled old protest banners and signs from the days when the pay scandal was first exposed and then called former members of an activist group that had led the charge for reform in the city.

"We're holding our breaths and waiting," Denise Rodarte, a member of the grassroots group Bell Assn. to Stop the Abuse, said in regard to a verdict.

"It's cut and dry: Local elected officials were supposed to make a certain amount of money, and they made a lot more."

corina.knoll@latimes.com

jeff.gottlieb@latimes.com

Times staff writer Ruben Vives contributed to this report.

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India Ink: India’s Slowing Economy Forces Budget Decisions

NEW DELHI — Not too long ago, when India’s economy was roaring amid predictions of high growth rates for years to come, the finance minister could be forgiven for strutting during budget week. He got to march into India’s Parliament with the ceremonial briefcase bearing a budget stuffed with goodies.

But on Thursday, when the current finance minister, Palaniappan Chidambaram, arrives in Parliament, his steps will be heavier, and the mood is likely to be, too. Faced with slowing growth, persistent inflation and sagging investor confidence, India’s government is pinned between conflicting pressures: economists warn that tough steps are needed to avoid long-term fiscal problems, even as political leaders are leery of introducing unpopular measures before important elections this year.

On Wednesday, the government sought to change the pessimistic narrative, as the Finance Ministry released its annual economic survey and projected that economic growth would jump somewhere above 6 percent during the next fiscal year, predicting that the downturn was “more or less over and the economy is looking up.” Some economists were skeptical, given that similar rosy predictions in recent budgets have proved wrong.

“Let me remind you that last year the economic survey spoke of about 7.6 percent projected growth — and what we had was 5 percent growth,” said Ajay Bodke, head of investment strategy and advisory at Prabhudas Lilladher, a Mumbai brokerage. “That is not just a miss but a humongous miss.”

The consequences of the budget plans are especially high because India, once a darling of global investors and an anointed power-in-waiting, is struggling to regain its lost luster.

India’s estimated 5 percent growth rate for the current fiscal year compares with 8 percent in 2010. Ratings agencies have threatened to downgrade the country’s investment rating to “junk” status. Meanwhile, India’s political class has spent more than three years enmeshed in scandals, as a bickering Parliament has accomplished almost nothing.

“It’s a supercritical moment, actually,” said Rajiv Kumar, an economist with the Center for Policy Research in New Delhi. “If you get it right, and this is a budget that can shore up the government’s credibility, they can turn it around.”

For investors and business leaders, the question is whether the government will make tough calls to address the country’s large fiscal and account deficits, curb huge subsidies for diesel fuel and petroleum products, unclog bureaucratic bottlenecks on stalled manufacturing, energy and infrastructure projects and create incentives to entice new investment.

Only a year ago, Pranab Mukherjee, then finance minister, unveiled a budget now regarded by many analysts as a major mistake. Desperate to increase revenues, the government spooked investors by giving broad latitude for tax collectors to pursue multinationals for billions of dollars in new, unexpected taxes. Investment slowed markedly, while investors and political opponents complained that India’s coalition government, led by the Indian National Congress Party, was endangering one of the world’s fastest-growing economies.

“The economy is in a deep crisis at the moment,” said Yashwant Sinha of the opposition Bharatiya Janata Party, a former finance minister, “and I only hope the crisis doesn’t become any deeper with more pre-election sops.”

Mr. Sinha and many independent economists warn that the economy cannot afford a repeat of 2008, when the government was preparing for national elections the following year. Then, the pre-election budget was filled with big spending measures, including pay raises for government workers and the forgiveness of billions of dollars in loans to farmers. The government was easily re-elected in 2009, but the new spending contributed to a fiscal deficit that rose to roughly 6 percent, from about 2 percent the previous year.

Neha Thirani Bagri contributed reporting from Mumbai, India.

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American Idol Reveals Its Top 10 Women

TV Watch

American Idol

02/27/2013 at 10:45 PM EST

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

Michael Becker/FOX

American Idol's's list of the top 10 women is complete!

After the first week of sudden-death rounds, the judges gave their stamp of approval to five more female singers Wednesday night. And they sent five others home.

Keep reading to find out who's in and who's out on Idol ...

Here are the five contestants who are moving on in the competition:

1. Zoanette Johnson: The Tulsa resident, 20, was the first to be put through by the judges, who showered her with praise for singing a spirited version of "Circle of Life" from The Lion King. Keith Urban declared her "queen of the jungle." Nicki Minaj told Zoanette, "You make me so emotional ... You're the person we're going to remember tonight."

2. Aubrey Cleland: After singing a slowed-down version of Beyoncé's "Sweet Dreams," Mariah Carey told Cleland, 19, "You're limitless." Nicki and Randy Jackson pointed out her commercial appeal. "Lookin' like a current artist, soundin' like one, feelin' like one," said Nicki of the performance.

3. Candice Glover: Taking on Aretha Franklin's "(You Make Me Feel Like) A Natural Woman" paid off for the singer, 23, who earned a standing ovation from Keith. Randy said she was "one of my favorite singers in the whole competition."

4. Breanna Steer: "You're extremely marketable and gorgeous and talented," Mariah told the singer, 18, after she sang a dramatic version of Jazmine Sullivan's "Bust Your Windows" that had Randy wanting to sign her up for a recording contract. "You got the whole package," he said. "You brought so much drama."

5. Janelle Arthur: She beat out the other country singer in the competition, Rachel Hale, for the final spot in the women's top 10 after singing Lady Antebellum's "Just a Kiss." Though Randy called Arthur, 23, his "favorite country singer in this competition," the other judges questioned her song choice. "[The song] doesn't give you a chance to really soar," Keith said. "The melody kept pulling you back."

These five will join the five female finalists announced last week – Kree Harrison, Amber Holcomb, Adriana Latonio, Angela Miller and Tenna Torres – as well as the five men – Charlie Askew, Curtis Finch Jr., Paul Jolley, Elijah Liu and Devin Velez. Ten more guys will sing Thursday (8 p.m. ET) and five will move on to round out season 12's top 20.

Did the judges make the right decisions? Sound off in the comments below.

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

___

On the Web:

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L.A. to ask high court to overturn ruling on homeless belongings

Citing an immediate public health threat, the city of Los Angeles will ask the U.S. Supreme Court on Thursday to overturn a lower-court ruling preventing the random seizure and destruction of belongings that homeless people leave temporarily unattended on public sidewalks.

If the court takes up the matter, the case could have broad implications for cities nationwide grappling with how to keep streets clean and safe while respecting the property rights of those who live there.

Fresno faces more than 30 lawsuits arising from its efforts to clean up downtown homeless encampments. In Hawaii, activists living in a De-Occupy Honolulu encampment sought an injunction against city authorities after they allegedly seized and destroyed personal property during a raid, according to court documents.

The Supreme Court filing comes after two years of legal wrangling between Los Angeles officials and homeless advocates over a controversial campaign to clean up downtown's skid row, which has the highest concentration of homeless people in the city.

"We have an obligation to the homeless, as well as to the other residents and businesses on skid row, to ensure their health through regularly cleaning skid row's streets and sidewalks," City Atty. Trutanich said in a statement. "The current outbreak of tuberculosis among that most vulnerable population should serve as a stern reminder to us all of just who and what is at risk."

Carol Sobel, who represents the homeless plaintiffs, said the TB outbreak, which has infected nearly 80 people and killed 11, has nothing to do with the property left on the streets. She accused city officials of deliberately allowing conditions to deteriorate in order to bolster their case, saying: "They have a public health issue of their making."

The dispute began when eight homeless people accused city workers, accompanied by police, of seizing and destroying property they left unattended while they used a restroom, filled water jugs or appeared in court. The seven men and one woman had left their possessions — including identification, medications, cellphones and toiletries — in carts provided by social service groups and in some cases were prevented from retrieving them, Sobel said.

In a 2-1 decision last September, the U.S. 9th Circuit Court of Appeals ruled that the belongings the homeless leave on city sidewalks for a short period of time may be taken only if the possessions pose an immediate threat to public health or safety or constitute evidence of a crime. In such cases, the court said, the city may not summarily destroy the possessions and must notify the owners where they can collect them.

City attorneys question whether the 4th Amendment protection from unlawful seizures and the 14th Amendment guarantee of due process extend to people who violate a city ordinance requiring them to remove their possessions during posted cleanup times, especially when free storage is available.

They say the decision, which upheld an injunction against Los Angeles, has created a "public health disaster." Homeless people are leaving piles of possessions on the ground or in overflowing shopping carts, often covered by tarps and blankets, and sometimes with a note attached saying "not abandoned" or "mine," according to a draft of the filing reviewed by The Times.

"The presence of this unattended property makes it impossible to clean the sidewalks, leads to an accumulation of human waste and rotting food around and underneath, that in turn provides a breeding ground for vermin and bacteria," the filing said.

At the city's request, the Los Angeles County Department of Public Health inspected skid row last year and cited the city for violations of county and state health codes, including an accumulation of human waste, needles, condoms and a rat infestation. The city launched a major cleanup effort, during which workers removed 278 hypodermic needles, 94 syringes, 60 razor blades, 10 knives, 11 items of other drug paraphernalia and two 5-gallon buckets of feces, according to the filing.

Homeless advocates said the effort showed how street cleaning can and should be done. Homeless residents were notified in advance, given time to remove their belongings and treated courteously, they said. Any items left behind that were not deemed a hazard were bagged, tagged and stored for 90 days.

But city officials contend that the lower-court rulings are causing a drain on municipal resources by forcing city workers to sort through unattended items for hazards, exposing their employees to unreasonable health risks and leaving the city open to the possibility of endless litigation.

Just days after a cleanup, trash and debris begin to pile up again, said Andy Bales, who heads the Union Rescue Mission on skid row.

"We never, ever had to battle that before the injunction, which has taken skid row back at least eight years to before all the improvements," he said. "It has emboldened people to leave their stuff everywhere."

Estela Lopez, executive director of the Central City East Assn., a business improvement district that runs the storage facility for the homeless, said she worries the rulings will undermine efforts to get people off the streets.

"No one's mental illness, tuberculosis or staph infection gets better lying on a public sidewalk," Lopez said. "These are human beings who are often unable to make rational decisions for themselves and they need our help. Instead, we give them options that are self destructive like you can amass and hoard your belongings on the sidewalk."

Settlement negotiations are underway. Stan Goldman, a Loyola Law School professor, said it may be a long shot to ask the Supreme Court to weigh in, given how few cases it has taken up in recent years. But he said: "History has shown that the conservatives on the Supreme Court like nothing better than reversing liberal 4th Amendment decisions out of the 9th Circuit."

andrew.blankstein@latimes.com

alexandra.zavis@latimes.com

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