Athletes cash in on California's workers' comp

SACRAMENTO — In his seven-year career with the Denver Broncos, running back Terrell Davis, a former Super Bowl Most Valuable Player, dazzled fans with his speed and elusiveness.

At the end of his rookie year in 1995, he signed a $6.8-million, five-year contract. Off the field he endorsed Campbell's soup. And when he hung up his cleats, he reported for the National Football League Network and appeared in movies and TV shows.

So it may surprise Californians to find out that in 2011, Davis got a $199,000 injury settlement from a California workers' compensation court for injuries related to football. This came despite the fact Davis was employed by a Colorado team and played just nine times in California during an 88-game career, according to the NFL.

Davis was compensated for the lifelong effects of multiple injuries to the head, arms, trunk, legs and general body, according to California workers' compensation records.

He is not alone.

Over the last three decades, California's workers' compensation system has awarded millions of dollars in benefits for job-related injuries to thousands of professional athletes. The vast majority worked for out-of-state teams; some played as little as one game in the Golden State.

All states allow professional athletes to claim workers' compensation payments for specific job-related injuries — such as a busted knee, torn tendon or ruptured spinal disc — that happened within their borders. But California is one of the few that provides additional payments for the cumulative effect of injuries that occur over years of playing.

A growing roster of athletes are using this provision in California law to claim benefits. Since the early 1980s, an estimated $747 million has been paid out to about 4,500 players, according to an August study commissioned by major professional sports leagues. California taxpayers are not on the hook for these payments. Workers' compensation is an employer-funded program.

Now a major battle is brewing in Sacramento to make out-of-state players ineligible for these benefits, which are paid by the leagues and their insurers. They have hired consultants and lobbyists and expect to unveil legislation next week that would halt the practice.

"The system is completely out of whack right now," said Jeff Gewirtz, vice president of the Brooklyn Nets — formerly the New Jersey Nets — of the National Basketball Assn.

Major retired stars who scored six-figure California workers' compensation benefits include Moses Malone, a three-time NBA most valuable player with the Houston Rockets, Philadelphia 76ers and other teams. He was awarded $155,000. Pro Football Hall of Fame wide receiver Michael Irvin, formerly with the Dallas Cowboys, received $249,000. The benefits usually are calculated as lump-sum payments but sometimes are accompanied by open-ended agreements to provide lifetime medical services.

Players, their lawyers and their unions plan to mount a political offensive to protect these payouts.

Although the monster salaries of players such as Los Angeles Lakers guard Kobe Bryant and Denver Broncos quarterback Peyton Manning make headlines, few players bring in that kind of money. Most have very short careers. And some, particularly football players, end up with costly, debilitating injuries that haunt them for a lifetime but aren't sufficiently covered by league disability benefits.

Retired pros increasingly are turning to California, not only because of its cumulative benefits but also because there's a longer window to file a claim. The statute of limitations in some states expires in as little as a year or two.

"California is a last resort for a lot of these guys because they've already been cut off in the other states," said Mel Owens, a former Los Angeles Rams linebacker-turned-workers' compensation lawyer who has represented a number of ex-players.

To understand how it works, consider the career of Ernie Conwell. A former tight end for the St. Louis Rams and New Orleans Saints, he was paid $1.6 million for his last season in 2006.

Conwell said that during his 11-year career, he underwent about 18 surgeries, including 11 knee operations. Now 40, he works for the NFL players union and lives in Nashville.

Hobbled by injuries, he filed for workers' compensation in Louisiana and got $181,000 in benefits to cover his last, career-ending knee surgery in 2006, according to the Saints. The team said it also provided $195,000 in injury-related benefits as part of a collective-bargaining agreement with the players union.

But such workers' compensation benefits paid by Louisiana cover only specific injuries. So, to deal with what he expects to be the costs of ongoing health problems that he said affect his arms, legs, muscles, bones and head, Conwell filed for compensation in California and won.

Even though he played only about 20 times in the state over his professional career, he received a $160,000 award from a California workers' compensation judge plus future medical benefits, according to his lawyer. The Saints are appealing the judgment.

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Oscars expand social media outreach for 85th show

LOS ANGELES (AP) — The Academy of Motion Picture Arts and Sciences is encouraging celebrities to tweet during the Oscars.

The film organization has expanded its digital outreach for the 85th Academy Awards with a new feature that lets stars to snap photos of themselves backstage during Sunday's ceremony and instantly post them online.

What Twitter calls a "Magic Mirror" will take photo-booth-style pictures of participating stars in the green room and send them out on the academy's official Twitter account. Organizers expect multiple celebrity mash-ups.

The backstage green room is a private place for stars to hang out before taking the stage and is typically closed to press and photographers.

The Magic Mirror is "giving access to fans at home a part of the show they never got to experience before," Twitter spokeswoman Elaine Filadelfo said Friday.

A new video-on-demand/instant replay feature also being introduced Sunday will allow Oscar fans to view show highlights online moments after they happen and share them with friends on Twitter and Facebook. Dozens of clips from the red carpet and the awards telecast will be available on the official Oscar website beyond Sunday's ceremony.

Oscar.com also offers other behind-the-scenes interactive features, including various backstage camera perspectives and a new live blog that aggregates the show's presence across social media. It will track the traffic on whatever makes a splash, like Angelina Jolie's right leg did last year.

The academy wants to make its second-screen experience just as rich as its primary one.

"Social media is now mainstream," said Christina Kounelias, chief marketing officer for the academy.

"We're not doing social media to reach out to young kids," said the academy's digital media director, Josh Spector. "We're doing it to connect with all Oscar fans."

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Jason Bateman gives Ernest Borgnine's estate a new identity

Markus Canter and Cristie St. James, who share the title luxury properties director at Prudential in Beverly Hills, like Jason Bateman's real estate sense. The actor got privacy, potential and a knoll location for $3 million.

Actor Jason Bateman and his wife, actress Amanda Anka, are dropping anchor in the Beverly Crest area with the purchase of the estate of Ernest Borgnine for $3 million.

The gated country English compound sits on a half-acre knoll. The 6,148-square-foot home features a formal entry hall, a grand staircase, a paneled library, an office, a den, six bedrooms and seven bathrooms. There is a guesthouse and a swimming pool.

Bateman, 44, stars in the comic film "Identity Thief," released this month. He is known to generations of TV viewers for his roles in "Arrested Development" (2003-present) and "Valerie," later retitled "The Hogan Family" (1986-91). Anka, 44, has appeared in "Bones" (2008), "Notes From the Underbelly" (2007) and "Beverly Hills, 90210" (1996).

Borgnine, who died last year at 95, is remembered for his Oscar-winning performance in "Marty" (1955) and his work in the title role as commander of a madcap crew in the sitcom "McHale's Navy" (1962-65). Until 2011 he was the voice of Mermaidman on "SpongeBob SquarePants."

The estate came on the market in October for the first time in 60 years priced at $3.395 million.

Billy Rose, Paul Lester and Aileen Comora of the Agency in Beverly Hills were the listing agents. Richard Ehrlich of Westside Estate Agency represented the buyers.

Where pair spent days of their lives

Soap star Peter Reckell and his wife, singer Kelly Moneymaker, have sold their custom-built, eco-friendly home in Brentwood for $3.35 million.

Before building the 3,345-square-foot house, the couple had the existing home on the site torn down, crated and shipped to Mexico for reuse by Habitat for Humanity. Then they designed and built a three-bedroom, four-bathroom contemporary that uses solar power.

Green elements include a photovoltaic system with battery backup, skylights, recycled glass terrazzo floors with radiant heating, recycled denim and organic cotton insulation, bamboo cabinets and doors, a roof garden and a water reclamation system.

A temperature-controlled wine cave and a recording studio are among other features.

Along with an indoor/outdoor koi pond, a meditation fountain and a solar infinity pool, outdoor amenities include a 16th century East Indian temple that was turned into a pavilion.

"This is my sanctuary," Reckell said. It frames views of the Santa Monica Mountains Conservancy.

Reckell, 57, played Bo Brady on "Days of Our Lives" from 1983 through last year. The show began in 1965. He also appeared in "Knots Landing" (1988-89). He is an avid environmentalist and bikes to work.

Moneymaker, 42, is a former member of the music group Exposé. She was inspired to build an environmentally friendly home because the carpet and other elements in the old house bothered her allergies and affected her voice.

Public records show they bought the property in 2003 for $1.14 million.

Daniel Banchik of Prudential's West Hollywood office was the listing agent. Scott Segall of John Aaroe Group represented the buyer.

Another rock owner for home

Hard Rock Cafe co-founder Peter Morton has made his mark on L.A.'s real estate scene of late, buying the old Elvis Presley estate in Beverly Hills at year-end for $9.8 million.

But flying under the radar was his bigger off-market purchase midyear for a property in Bel-Air at $25 million, public records show. Area real estate agents not involved in the transaction say Morton plans to take down the existing home and build another on the site. The estate had belonged to Joseph Farrell, who founded National Research Group Inc. in 1978 and brought market testing to Hollywood. Farrell died in December 2011.

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Gunfire and deadly crash rattle the Las Vegas Strip

LAS VEGAS — A spectacular predawn crash on the Strip — triggered when bullets fired from a black Range Rover peppered a Maserati — hit this resort city right between the eyes. In the end, three people were dead and a major intersection under lockdown during a three-state manhunt for the shooters, leaving even casino veterans used to the extraordinary scratching their heads.

The mayhem was sparked, witnesses told police, by a quarrel early Thursday at a hotel valet stand.

The two vehicles left the Aria resort hotel and were heading north on Las Vegas Boulevard at 4:20 a.m., an hour when the casino marquees shine brightly but the gambling thoroughfare is largely empty. At Harmon Avenue, occupants inside the Range Rover opened fire on the Maserati, police said.

The silver-gray sports car, which was struck several times, sped into the intersection at Flamingo Road, ramming a Yellow cab. The taxi exploded, killing the driver and a passenger. Four other vehicles in the intersection were also involved in the crash and explosion, but officers offered no details.

"Omg Omg Omg that car just blew up!" one witness tweeted shortly after the crash, posting a photo of the wreckage. "God Bless their Souls! Omg!"

The driver of the Maserati died later at a hospital, police said. A passenger in the vehicle received minor injuries and was being interviewed by investigators. At least three others were also injured.

Police in Nevada, California, Arizona and Utah were on alert for the distinctive black Range Rover SUV, described as having dark-tinted windows, black rims and out-of-state paper dealer plates.

"We are going to pursue these individuals and prosecute them," Clark County Sheriff Doug Gillespie said at an afternoon news conference. "This act was totally unacceptable. It's not just tragic but unnecessary — the level of violence we see here in Las Vegas and across America."

Authorities had not publicly identified the dead. But a Las Vegas television station late Thursday identified the taxi driver as Michael Boldon, 62, who the station said had recently moved here from Michigan to care for his 93-year-old mother.

The victim's son, who drives a limousine, told Fox News 5 that he last talked with his father after 3 a.m., and later called his cellphone shortly after the crash to warn him to avoid the Strip. But there was no answer.

The station also identified the driver of the Maserati as Ken Cherry, a rap artist from Oakland who also is known as "Kenny Clutch." The station quoted family members identifying Cherry as the driver. An Internet video of a Cherry song called "Stay Schemin" shows two men in a vehicle on the Strip.

Police had more questions than answers.

"It began with a dispute at a nearby hotel and spilled onto the streets," said Capt. Chris Jones of the Las Vegas Police Robbery and Homicide Division.

The morning's events threw the Strip into disarray all day. The gambling boulevard's busiest and best-known intersection was cordoned off by yellow police tape until nightfall, keeping traffic and curious pedestrians away from the carnage. Even skywalks were blocked off.

While slot machines beeped and card games continued inside casinos around the accident scene — including the Bellagio, Caesars Palace and Paris Las Vegas — hotel bell captains were fielding questions from tourists who had awakened to news of the crash and the Strip shutdown. The alleys and side streets between nearby hotels were clogged with pedestrians who inched along on narrow sidewalks, past delivery doors, many making their own paths between the landscaped bushes and palm trees.

Even casino industry workers were thrown into turmoil. Hotel maids and dealers who finished their midnight shifts after dawn were left without bus service home. "I'm stranded," said Tiruselam Kefyalew, 25, a maid. "What a day to leave my cellphone at home."

Limousine drivers who normally prowl the city's gambling core improvised detours. Some said the police blockade would cost them $500 or more in lost business and tips.

"Most people understand, but you have your complainers," said Jim DeSanto, a limo driver who waited for fares outside Bally's casino. "Those people will complain, even when everything is perfect."

Well after noon, guests peered out nearby hotel windows and others leaned into the street to glimpse the crime scene.

"Hey, honey, it must have happened right here," one man told his wife as they left Caesars around noon. The tourist, who would only say that he had arrived from Tampa, Fla., the previous evening, had looked out his hotel window at 4:30 to see a vehicle in flames.

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Mindy McCready's funeral set for Tuesday in Fla.

NASHVILLE, Tenn. (AP) — Mindy McCready's funeral has been scheduled for Tuesday in her hometown of Fort Myers, Fla.

The funeral for the late country star will be held at Crossroads Church and will be private. A Friday news release says a memorial organized by friends and the music community is tentatively scheduled for March 6 at Cathedral of the Incarnation.

McCready committed suicide Sunday at her home in Heber Springs, Ark., days after leaving a court-ordered substance abuse treatment program. The 37-year-old mother of two died from a single gunshot to the head about a month after her longtime boyfriend David Wilson was believed to have killed himself in the same location.

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Stocks bounce back after steep 2-day slide

Strong earnings results from big U.S. companies offered investors a whiff of hope Friday. Stocks rose after a two-day slump, but remained on track for their worst week this year.

Hewlett-Packard had the biggest gain in the Dow Jones industrial average and the Standard & Poor's 500 index. It posted fiscal first-quarter earnings late Thursday that beat all forecasts, a relief after months of bad news for the computer maker. H-P rose $1.76, or 10 percent, to $18.86.

Cabot Oil & Gas Corp. was the S&P 500's second-best performer, jumping a day after reporting earnings that beat analysts' expectations. It rose $4.21, or 8 percent, to $58.07.

American International Group Inc. rose after its fourth-quarter operating results exceeded forecasts. The company's net loss was $4 billion, mainly because of claims related to Superstorm Sandy, in the first full quarter after it finished repaying its $182 billion government bailout. Its stock rose 88 cents, or 2 percent, to $38.16.

The Dow was up 63 points at 13,943 as of noon Eastern time. The S&P 500 rose six to 1,508. The Nasdaq composite index rose 14 to 3,145.

All three U.S. indexes remain down for the week. The S&P 500 is on track for its first weekly loss of the year.

Bill Stone, chief investment strategist with PNC Wealth Management, said he expects stocks to hold up despite this week's volatility.

“You're going to get bumps and bruises along the way, but we do believe things are actually getting better, so I think there's underlying demand” for stocks, Stone said.

Stocks plunged Wednesday afternoon after minutes from the Federal Reserve's latest policy meeting spooked investors. The minutes revealed disagreement at the Fed over how long to keep buying bonds in an effort to boost the economy. The slide continued Thursday.

Many analysts believe that the Fed's bond-buying and resulting low interest rates have driven this year's stock rally, which lifted indexes to their highest levels since the 2008 financial crisis.

U.S. stocks followed European stocks higher after a survey of German business optimism rose sharply, adding to evidence that the country will avoid a recession. Germany's economic vitality is crucial for the beleaguered region, offsetting economic contraction in surrounding countries.

“Germany is really the bedrock” of the region's economy, Stone said. “If it gives way, then you have real problems.”

France's CAC-40 closed up 2.2 percent, Germany's DAX 1 percent.

Among the other corporate news moving markets:

— Abercrombie & Fitch sank after a key sales metric declined in the all-important holiday quarter. Its stock fell $3.10, or 6 percent, to $45.95.

— WebMD Health Corp. soared after the health website operator reported better-than-expected revenue and an optimistic outlook for 2013. The stock rose $3.51, or 22 percent, to $19.81.

— Texas Instruments Inc. rose strongly after saying it will increase its dividend by one-third and buy back up to $5 billion more of its own stock. TI rose $1.47, or 5 percent, to $33.95.

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Bulgari shows off Liz Taylor's gems

It isn't easy sometimes to be an ordinary person in Los Angeles, so near to and yet so far from the city's glamorous events.

You hear about the grand Oscar parties, but you will never be invited. The award ceremony may be taking place minutes from where you live, but you watch it at home, on TV, in your sweat pants — and you might as well be in Dubuque.

Rodeo Drive too can make you feel like a scrap on the cutting room floor. As you stroll the wide and immaculate sidewalks of Beverly Hills' iconic shopping street, you pass by boutiques you'd feel self-conscious walking into. In the windows are baubles and trinkets you could never in three lifetimes afford.

Which is why it is rather nice to be invited to make a private appointment at the house of Bulgari, the fine Italian jeweler that opened its doors in 1884.

Elizabeth Taylor loved Bulgari jewels. Richard Burton, whose torrid affair with her began during the filming of "Cleopatra" in Rome, accompanied her often to the flagship shop on the Via Condotti. He liked to joke that the name Bulgari was all the Italian she knew.

So it is fitting that starting Oscar week, the jeweler is celebrating the Oscar-winning star with an exhibit of eight of her most treasured Bulgari pieces.

They are heavy on diamonds and emeralds — of rare size, gleam and value.

And Bulgari knows their value well.

After Taylor's death, it reacquired some of the gems at a Christie's auction. One piece, an emerald-and-diamond brooch that also can be worn as a pendant, sold for $6,578,500 — breaking records both for sales price of an emerald and for emerald price per carat ($280,000).

That brooch, whose centerpiece is an octagonal step-cut emerald weighing 23.44 carats, was Burton's engagement present to Taylor. He followed it upon their marriage (his second, her fifth) with a matching necklace whose 16 Colombian emeralds weigh in at 60.5 carats. Bulgari bought the necklace back too, for $6,130,500.

They are in the exhibit, along with Burton's engagement ring to Taylor and a delicate brooch — given to her by husband No. 4, Eddie Fisher — whose emerald and diamond flowers were set en tremblant so that they gently fluttered as Taylor moved.

The jewels are not for sale.

On Tuesday night, actress Julianne Moore wore the Burton necklace, with pendant attached, at a gala for Bulgari's top clients. At the dinner hour, guests were escorted along a lavender-colored carpet to a nearby rooftop that had been transformed into a Roman terrace.

Those honored guests, of course, got private viewings of Taylor's jewels.

But so did Amanda Perry, a healer from West Hollywood who arrived the next morning for one of the first appointments available to the public.

Someone had emailed news of the collection to the 35-year-old Taylor fan. She walked in off the street Tuesday, when the exhibit was open only to press — and Sabina Pelli, Bulgari's glamorous executive vice president, fresh from Rome, was taking sips of San Pellegrino brought to her on a silver tray between back-to-back interviews that started at 5 a.m.

The camera crews were long gone when Perry came back Wednesday. She had the exhibit, and handsome sales associate Timothy Morzenti of Milan, entirely to herself.

In a black suit, still wearing on his left hand the black glove he dons to handle fine jewels, Morzenti whisked Perry off via a private elevator to the exhibit on the second floor. The jewels stood in vitrines mounted high off the ground. Behind them were photos and a slide show of Taylor, bejeweled.

"Which piece would you like to see first?" Morzenti asked her as a security guard stood by. "I personally love the emerald ring."

Then he proceeded at leisure to explain Bulgari-signature sugar-loaf cuts and trombino ring settings, while tossing in occasional Taylor stories.

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YouTube data now part of Billboard Hot 100 chart

NEW YORK (AP) — Viral videos are hits on the Web, and now they can help propel a song to the top of the Billboard charts.

Billboard has announced that U.S. YouTube data is now one of the factors when ranking Hot 100 songs and songs on its other charts.

The new rule went into effect this week, with the viral-video hit "Harlem Shake" debuting at No. 1. Other factors include radio airplay, digital download sales, physical single sales, on-demand audio streaming and online radio streaming. Billboard's new rule incorporates all official videos on YouTube, including Vevo.

"Harlem Shake," by Brooklyn producer Baauer, features few lyrics. The video has a heavy dance-flavored beat. It became a viral success thanks to hundreds of YouTube videos of people dancing to the song.

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Well: Getting Patients to Think About Costs

A colleague and I recently got into a heated discussion over health care spending. It wasn’t that he disagreed with me about the need to rein in costs; but he said he was frustrated every time he tried to do so.

Earlier that week, for example, he had tried to avoid ordering a costly M.R.I. scan for a patient who had been suffering from headaches. After a thorough examination, my colleague was convinced the headaches were the result of stress.

But the patient was not.

“She wouldn’t leave until she got that M.R.I.,” my colleague said. Even after he had explained his conclusions several times, proposed a return visit in a month to reassess the situation and ran so far overtime that his office nurse knocked on the door to make sure nothing had gone awry, the patient continued to insist on getting the expensive study.

When my colleague finally evoked cost – telling the woman that while an M.R.I. might ferret out rare causes, it didn’t make sense to spend the enormous fee on something of such marginal benefit – the woman became belligerent. “She yelled that this was her head we were talking about,” he recalled. “And expensive tests like this were the reason she had health insurance.”

Face flushed, he paused to take a deep breath. “Yeah, I may be all for controlling costs,” he finally said. “But are our patients?”

According to a new study in the journal Health Affairs, his concern about patients may not be far off the mark.

A growing number of initiatives aimed at controlling spiraling health care costs have been championed in recent years, aiming to replace the current model in which doctors are reimbursed for every office visit, test or procedure performed. These programs range from pay-for-performance, where doctors can earn more money by meeting predetermined quality “goals” like controlling patients’ blood sugar or high blood pressure, to accountable care organizations, where clinicians and hospitals in partnership are paid a lump sum to cover all care.

Their uninspired monikers aside, all of these plans share one defining feature: doctors are to be the key agents of change. Whether linked with quality measures, bundled payments or satisfaction scores, it is the doctors’ behavior and choice of treatments that result in savings, goes the thinking.

But as the new study reveals, doctors need to take into account more than just symptoms and diseases when deciding what to prescribe and offer. They must also consider their patients’ opinions and willingness to be cost conscious when it comes to their own care.

The researchers conducted more than 20 patient focus groups and asked the participants to imagine themselves with various symptoms and a choice of diagnostic and treatment options that varied only slightly in effectiveness but significantly in cost. They were asked, for example, to choose between an M.R.I. or a CT scan for a severe long-standing headache, with the M.R.I. being much more expensive but also more likely to catch some extremely rare problems.

When it came to their own treatment, “patients for the most part did not want cost to play any role in decision-making,” said Dr. Susan Dorr Goold, one of the study authors and a professor of internal medicine and health management and policy at the University of Michigan in Ann Arbor. Most did not want their doctors to take expenditures into account, and many made it clear that they would ask for the significantly more expensive medications, procedures or diagnostic studies, even if those options were only slightly better than the cheaper alternatives. “That puts doctors, whose primary responsibility is to their individual patients, in a very difficult position.”

A majority of the participants refused to consider the expenses borne by insurers or by society as a whole when making their choices. Some doubted that one individual’s efforts would have any real overall impact and so gave up considering cost-savings altogether. Others said they would go out of their way to choose the more expensive options, viewing such decisions as acts of defiance and a kind of well-deserved “payback” after years of paying insurance premiums.

Underlying all of these comments was the belief that cost was synonymous with quality. Even when the focus group leaders reminded participants that the differences between proposed options were nearly negligible, participants continued to choose the more expensive options as if it were beyond question that they must be more efficacious or foolproof.

The study’s findings are disheartening. But Dr. Goold and her co-investigators believe that public beliefs and attitudes about cost and quality can be changed. They cite the dramatic transformation in attitudes about end-of-life care as an example of how initiatives to improve understanding can lead people to make higher quality and more cost-effective decisions, like choosing hospices over hospitals.

“We need to begin to talk about these issues in a way that doesn’t turn it into a discussion pitting money against life, and we need to find ways of getting people to think about not spending money on things that offer marginal benefit” Dr. Goold said. “Because it’s going to be tough otherwise trying to implement any cost-saving measures, if patients don’t accept them.”

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Freddie Mac: 30-year mortgage rate rises slightly to 3.56%

The average interest rate for a 30-year fixed home loan was 3.56% early this week, according to the giant mortgage finance company Freddie Mac. The low rates are helping to spur more construction of new homes. (Katie Falkenberg / For The Times)

By E. Scott Reckard

February 21, 2013, 8:01 a.m.

Lenders were offering 30-year fixed mortgages at an average 3.56% this week, up slightly from last week, while the 15-year fixed loan held steady at 2.77%, according to Freddie Mac’s weekly survey.

Start rates on adjustable mortgages were flat to slightly higher, Freddie Mac said in the survey, released Thursday.

The 30-year rate, pegged at 3.53% for the three previous weeks, is now up about a quarter of a percentage point from its record lows late last year.  

QUIZ: How much do you know about mortgages?

The favorable rates have helped to drive housing demand, pushing prices higher. The online real-estate site Zillow Inc. said Thursday that nearly 2 million U.S. homeowners were freed from negative equity in 2012, meaning their mortgages were no longer larger than the value of their homes.

The low rates also are encouraging new-home construction, although new-home starts slipped slightly in January compared to December.

Freddie Mac asks lenders each week what terms they are offering borrowers on popular types of loans. In the latest survey, the borrowers would have paid an average 0.8% of the loan amount in upfront fees and discount points to the lenders.

US Total Construction Spending data by YCharts

ALSO:

Refinances surge thanks to help for underwater borrowers

Gary Winnick asking $225 million for 8.4-acre Bel-Air estate

Banks have provided $45.8 billion in aid under mortgage settlement

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shareDiv.innerHTML = templateHTML;

/* append the new div to the end of the document, which is hidden already with CSS */
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/* Store the div in both a regular JavaScript variable and as a jQuery object so we can reference them faster later */
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return this.each(function() {
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var makeURLS = function (link, message){
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fbURL = fbConstruct.join(''),

newHTML = [
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shareHTML = newHTML.join('');
/* Load in our new HTML */
shareTip.innerHTML = shareHTML;
};

/* Since the shareTip will automatically fade out when the user mouses out of an element */
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$shareTip.hover(function(){
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message,
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height = eso.height(),
width = eso.width(),
offset = eso.offset(),
link;


link = eso.children('a').attr('href');
message = escape( eso.find('img').attr('alt') ) || eso.attr(settings.message_attr);

if (link.search('http://') === -1){
link = 'http://www.latimes.com' + link;
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link = encodeURIComponent(link);

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Interstate 5 reopens through the Grapevine

From Times Staff

February 20, 2013, 9:44 a.m.

The California Highway Patrol has reopened a stretch of Interstate 5 through the Grapevine that was closed earlier today because of ice.

The highway was opened to vehicles with escorts at about 9:15 a.m., said CHP Officer Ed Jacobs. The freeway was closed between Castaic and Grapevine Road about 6:35 a.m., Jacobs said.

Comments are filtered for language and registration is required. The Times makes no guarantee of comments' factual accuracy. Readers may report inappropriate comments by clicking the Report Abuse link next to a comment. Here are the full legal terms you agree to by using this comment form.

';
shareDiv.innerHTML = templateHTML;

/* append the new div to the end of the document, which is hidden already with CSS */
document.body.appendChild(shareDiv);

/* Store the div in both a regular JavaScript variable and as a jQuery object so we can reference them faster later */
var shareTip = document.getElementById('shareTip'),
$shareTip = $('#shareTip');

/* This extends our settings object with any user-defined settings passed to the function and returns the jQuery object shareTip
was called on */
return this.each(function() {
if (options) {
$.extend(settings, options);
}

/* This is a hack to make sure the shareTip always fades back to 100% opacity */
var checkOpacity = function (){
if ( $shareTip.css('opacity') !== 1 ){
$shareTip.css({'opacity': 1});
}
};

/* Function that replaces the HTML in the shareTip with the template we defined at the top */
/* It will wipe/reset the links on the social media buttons each time the function is called */
var removeLinks = function (){
shareTip.innerHTML = templateHTML;
};

/* This is the function that makes the links for the Tweet / Share functionality */

var makeURLS = function (link, message){
/* Here we construct the Tweet URL using an array, with values passed to the function */
var tweetConstruct = [
'http://twitter.com/share?url=', link, '&text=', message, '&via=', settings.twitter_account
],
/* Then join the array into one chunk of HTML */
tweetURL = tweetConstruct.join(''),

/* Same story for Facebook */
fbConstruct = [
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],

fbURL = fbConstruct.join(''),

newHTML = [
''
],
shareHTML = newHTML.join('');
/* Load in our new HTML */
shareTip.innerHTML = shareHTML;
};

/* Since the shareTip will automatically fade out when the user mouses out of an element */
/* we have to specifically tell the shareTip we want it to stay put when the user mouses over it */
/* This effectively gives the user a 500 ms (or whatever) window to mouse */
/* from the element to the shareTip to prevent it from popping out */
$shareTip.hover(function(){
$shareTip.stop(true, true);
$shareTip.show();
checkOpacity();
}, function(){
$(this).fadeOut(settings.speed);
});

/* This function handles the hover action */
$(this).hover(function(){
/* remove the old links, so someone doesn't accidentally click on them */
removeLinks();

/* If there's already an animation running on the shareTip, stop it */
$shareTip.stop(true, true);

var eso = $(this),
message,
/* Store the width and height of the shareTip and the offset of the element for our calculations */
height = eso.height(),
width = eso.width(),
offset = eso.offset(),
link;


link = eso.children('a').attr('href');
message = escape( eso.find('img').attr('alt') ) || eso.attr(settings.message_attr);

if (link.search('http://') === -1){
link = 'http://www.latimes.com' + link;
}
link = encodeURIComponent(link);

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if (offset.top

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Autopsy confirms Mindy McCready's death as suicide

HEBER SPRINGS, Ark. (AP) — Authorities in Arkansas say preliminary autopsy results confirm country music singer Mindy McCready's death was a suicide.

The Cleburne County sheriff said in a statement Wednesday that preliminary autopsy results from Arkansas' state crime lab show McCready's death was a suicide from a single gunshot wound to the head.

Investigators have said McCready apparently shot and killed her late boyfriend's dog before she turned the gun on herself Sunday at her home in Heber Springs, Ark. Authorities found McCready's body and the dog on the front porch where her longtime boyfriend, musician David Wilson, died last month of a gunshot wound to the head.

Authorities are investigating Wilson's death as a suicide but haven't determined an official cause of death yet.

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Well: Caffeine Linked to Low Birth Weight Babies

New research suggests that drinking caffeinated drinks during pregnancy raises the risk of having a low birth weight baby.

Caffeine has long been linked to adverse effects in pregnant women, prompting many expectant mothers to give up coffee and tea. But for those who cannot do without their morning coffee, health officials over the years have offered conflicting guidelines on safe amounts during pregnancy.

The World Health Organization recommends a limit of 300 milligrams of caffeine a day, equivalent to about three eight-ounce cups of regular brewed coffee. The American College of Obstetricians and Gynecologists stated in 2010 that pregnant women could consume up to 200 milligrams a day without increasing their risk of miscarriage or preterm birth.

In the latest study, published in the journal BMC Medicine, researchers collected data on almost 60,000 pregnancies over a 10-year period. After excluding women with potentially problematic medical conditions, they found no link between caffeine consumption – from food or drinks – and the risk of preterm birth. But there was an association with low birth weight.

For a child expected to weigh about eight pounds at birth, each day that the mother consumed 100 milligrams of caffeine from any source equated to a loss of between three-quarters of an ounce to an ounce in birth weight. Even after the researchers excluded from their analysis smokers, a group that is at higher risk for complications and also includes many coffee drinkers, the link remained.

One study author, Dr. Verena Sengpiel of the Sahlgrenska University Hospital in Sweden, said the findings were not definitive because the study was observational, and correlation does not equal causation. But they do suggest that women might put their caffeine consumption “on pause” while pregnant, she said, or at least stay below two cups of coffee per day.

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Office Depot to buy OfficeMax in $1.2-billion deal

Office Depot Inc. is buying smaller rival OfficeMax Inc. in what it’s calling a “merger of equals,” creating a heftier office-supply company to challenge industry leader Staples.

In the $1.2-billion all-stock deal, OfficeMax shareholders will receive 2.69 Office Depot shares for each OfficeMax share, valued at $13.50 each.

Together, the two companies said they expect to better “meet the growing challenges of a rapidly changing industry,” anticipating annual revenue of about $18 billion. Staples had $25 billion in sales in 2011.

“Consumers and business-to-business customers are increasingly demanding a seamless omnichannel experience across retail stores, direct sales, telesales and digital environments,” the companies said in a statement. “By integrating these touchpoints effectively, the combined company expects to build lasting brand loyalty.”

Amazon.com and other online vendors, as well as mega-chains such as Wal-Mart, Costco and Target, are encroaching on the office-supply market, which research group IBISWorld values at $21.2 billion.

OfficeMax and Office Depot have suffered declining sales since the recession and fight to generate a 3% profit margin, compared to a margin of 8% or more at Staples, said IBISWorld analyst Dale Schmidt.

“The hope is that the resultant company could cut redundant costs, raising its profit margin, while retaining a market share that will compete with Staples,” he said. “However, with the ever-increasing popularity of online sales and big-box retailers, the brick-and-mortar chains of both Staples and the merged company will struggle to grow significantly."

Both companies’ boards unanimously approved the arrangement. The board of the fused business will feature equal representation from Office Depot and OfficeMax.

The current chief executives -- Neil Austrian of Office Depot and Ravi Saligram of OfficeMax -- will keep their jobs until a new head honcho is chosen.

The official announcement of the deal came Wednesday morning, several hours after Office Depot pulled an earlier, mistakenly posted version off its website.

Office Depot stock was down as much as 15.5% to $4.24 a share in morning trading. Similarly, OfficeMax stock swung up when the market opened, but by midday in New York was down nearly 3% to $12.62 a share.

ALSO:

Staples to close stores, cut costs, boost online presence

Gold at N.Y. Fed is intact, some purer than thought, audit finds

Staples stock jumps on report Bain, others are considering buyout

Read More..

Four dead, including suspect, in series of Orange County shootings

Orange County sheriff's officials said they don't know what prompted a series of shootings across multiple cities early Tuesday morning that left at least four people dead and others wounded.

Authorities believe the violence began in Ladera Ranch, south of Mission Viejo.

The first call came at 4:45 a.m. reporting a shooting on Red Leaf Lane, where deputies discovered a woman shot dead at the scene.

The suspect, described as a man in his 20s, fled the area in an SUV.

Sheriff's Department spokesman Jim Amormino said “multiple incidents” then occurred in Tustin and another at the Santa Ana border before the suspect apparently shot and killed himself in Orange.

“There’s a lot to sort out,” he said.

Tustin Police Lt. Paul Garaven said the suspect attempted to carjack multiple vehicles in Tustin, with  each shooting occurring a few minutes apart.

Police received a report about 5:30 a.m. of a carjacking near Red Hill Avenue and Nisson Road near the 5 Freeway in Tustin, Garaven said.

The carjacking suspect opened fire and wounded a bystander, he said.

Soon after that, another carjacking was reported near the 55 Freeway, Garaven said. The victim of that carjacking was killed, Garaven said. A body lay covered by a yellow tarp on Village Way near the McFadden Avenue freeway entrance.

Another shooting was reported on Edinger Avenue near the Micro Center in Tustin, Garaven said. Officers confirmed that another carjacking had taken place, he said.

One person was killed and another was taken to a hospital. Officers spotted the suspect in a stolen vehicle, followed him into the city of Orange and initiated a traffic stop near the intersection of East Katella Avenue and North Wanda Road, Garaven said.

The suspect then shot and killed himself, Garaven said. Garaven said there is “no threat to the community” because the suspect is deceased.

Bill Myers, who works at Allied Refrigeration at Edinger Avenue in Tustin, said he passed numerous police vehicles on his way to work early Tuesday.

The Micro Center, across the street from Allied Refrigeration, was roped off, and police were at the scene, Myers said.

Myers arrived at work at about 6:20 a.m. and said there was "a bunch of activity going on. It was pretty crazy."

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Clive Davis reveals in memoir that he's bisexual

NEW YORK (AP) — Record executive Clive Davis says he's bisexual.

In his new memoir, out Tuesday, the 80-year-old, who is twice divorced, reveals that he had sex with a man in the 1970s. Davis writes in "The Soundtrack of My Life" that he hadn't been repressed or confused during his marriages and that sex with a man "provided welcome relief."

He also writes that he started dating a man from 1990 to 2004, which he says was a "tough adjustment" for his son Mitchell. He says after "one trying year," he and his son worked things out. Davis is the father of three children.

Davis is the chief creative officer of Sony Music Entertainment. He writes that he's been in a "strong monogamous relationship" with a man for the last seven years.

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Ask Well: Coaxing Parents to Take Better Care of Themselves

Dear Reader,

Your dilemma of wanting to get your parents to change their ways to eat better and exercise reminds me of an old joke:

How many psychologists does it take to change a light bulb? Answer: Only one, but the light bulb has to really want to change.

Sounds like your parents may be about as motivated as the light bulb right now. Still, there are things you can do to encourage them to move in a healthier direction. But the first step should not be to hand them a book. Unless you lay some prior groundwork, that gesture may seem almost as patronizing as an impatient tone of voice – and probably as likely to backfire.

Instead, start a conversation in a caring, nonjudgmental way. Ask, don’t tell. “Say, ‘You know, I might not know what I am talking about, but I am really concerned about you,” suggested Kevin Leman, a psychologist in Tucson, Ariz., and author of 42 books on changing behavior in families and relationships. Ask simply if there is anything you can do to help.

Leading by example is also more effective than lecturing. “The son can role-model health by inviting his parents to dinner and serving healthful items that he is fairly certain they will find acceptable, or ask them if they are interested in going out dancing with him and his wife,” suggested Ann Constance, director of the Upper Peninsula Diabetes Outreach Network in Michigan.

Pleasure is a better motivator for change than pain or threats. Use the grandchildren as bait. Ask if they want to take the grandchildren to the zoo or a park that would require a good bit of walking around for everyone. Or the grandchildren could ask them to come along on one of those 2K fund-raiser-walks that many schools hold. After all, a day with the grandchildren is always a pleasure in itself. (O.K., usually a pleasure.)

Tempted to give them the gift of a health club membership? “Save your money,” Dr. Leman said. Try a more indirect (and cheaper) approach. Create a mixed-tape of up-tempo music from their era. (“Songs they listened to from the ages of 12-to-17, which is what we all listen to for the rest of our lives,” said Dr. Leman) They will enjoy it any time — maybe even while walking.

If you really want someone you love to make a change, the key is to ask them to do something small and easy first because that increases the chances they will do something larger later. Psychologists call that “the foot in the door technique,” said Adam Davey, associate professor of public health at Temple University in Philadelphia, referring to a classic 1966 experiment called “Compliance Without Pressure.” In the study, which has been duplicated by others in many forms, researchers asked people to sign a petition or place a small card in a window in their home or car about keeping California beautiful or supporting safe driving. About two weeks later, the same people were asked to put a huge sign that practically covered their entire front lawn advocating the same cause.

“A surprisingly large number of those who agreed to the small sign agreed to the billboard,” because agreeing to the first small task built a bond between asker and askee “that increases the likelihood of complying with a subsequent larger request,” Dr. Davey explained.

Any plan for behavioral change is most likely to succeed if it is very specific, measurable and achievable, according to Ms.Constance.

And the new behavior should also be integrated into daily life — and repeated until it becomes a habit. For example, if you want to walk more, start with a 10-minute walk after dinner on Monday, Wednesday and Friday, Ms. Constance suggested. The next week, bump it up to 12 minutes.

Don’t give up, even if you meet initial resistance — it is never too late for your parents or you or any of us to change. “Taking up an exercise program into one’s 80s and 90s to build strength and flexibility can result in very tangible and enduring benefits in a surprisingly short time,” insisted Dr Davey.

As for instructive reading, Dr. Leman is partial to one of his own books, “Have a New You by Friday,” and Dr. Davey recommends “Biomarkers: The 10 Keys to Prolonging Vitality,” by William Evans. Ms. Constance recommends the Centers for Disease Control and Prevention’s Web site on physical activity and exercise tips for the elderly, as well as the National Institute of Health’s site on the DASH diet.

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Builder confidence ticks down in February, survey says

‏Builder confidence ticked down slightly in February, according to a survey, essentially leveling out at a level slightly below "good."

Builder confidence in how the market for newly constructed single-family homes will fare remained pretty much the same as last month, declining a point to 46, according to the National Assn. of Home Builders/Wells Fargo Housing Market Index.

"This is partly due to ongoing uncertainties about job growth and consumer access to mortgage credit," Rick Judson, a home builder and NAHB chairman, said in a statement. "But it's also a reflection of the fact that builders are now confronting rising costs for building materials and, in some markets, limited availability of labor and lots as demand for new homes strengthens."

The index is derived from a monthly survey that asks builders to rate their expectations for sales for the next six months as "good," "fair" or "poor."

The survey also asks builders to rate the volume of visits by prospective buyers.

All of these responses are scored to create an index. Any reading above 50 on that index means that more builders surveyed viewed their prospects as "good" than not.

The U.S. housing market has recovered significantly from deep depths over the last year, lifting the stocks and prospects of major builders. Jim O'Sullivan, chief U.S. economist for High Frequency Economics, noted in an emailed analysis that even with February’s decline in builder confidence, the sentiment index is still up considerably from its most recent lows.

"It is up from 28 one year ago and 16 two years ago," he wrote. "Still, the report suggests that the housing recovery may be temporarily pausing."

ALSO:

One-third of homeowners have no mortgage

2012 was a banner year for housing affordability

Investors fuel Southland housing gains as foreclosures plummet

Read More..

Jerry Buss dies at 80; Lakers owner brought 'Showtime' success to L.A.

Longtime Lakers owner Jerry Buss has died at the age of 80. Last week, it was revealed that he was hospitalized with an undisclosed form of cancer.

When Jerry Buss bought the Lakers in 1979, he wanted to build a championship team. But that wasn't all.

The new owner gave courtside seats to movie stars. He hired pretty women to dance during timeouts. He spent freely on big stars and encouraged a fast-paced, exuberant style of play.

As the Lakers sprinted to one NBA title after another, Buss cut an audacious figure in the stands, an aging playboy in blue jeans, often with a younger woman by his side.

PHOTOS: Jerry Buss through the years

"I really tried to create a Laker image, a distinct identity," he once said. "I think we've been successful. I mean, the Lakers are pretty damn Hollywood."

Buss died Monday of an undisclosed form of cancer at Cedars-Sinai Medical Center, according to his longtime spokesman, Bob Steiner. Buss was 80.

Lakers fans will remember Buss for bringing extraordinary success — 10 championships in three-plus decades — but equally important to his legacy was a sense of showmanship that transformed pro basketball from sport to spectacle.

Live discussion at 10:30: The legacy of Jerry Buss

"Jerry Buss helped set the league on the course it is on today," NBA Commissioner David Stern said. "Remember, he showed us it was about 'Showtime,' the notion that an arena can become the focal point for not just basketball, but entertainment. He made it the place to see and be seen."

His teams featured the likes of Kareem Abdul-Jabbar, Magic Johnson, Kobe Bryant, Shaquille O'Neal and Dwight Howard. He was also smart enough to hire Hall of Fame-caliber coaches in Pat Riley and Phil Jackson.

"I've worked hard and been lucky," Buss said. "With the combination of the two, I've accomplished everything I ever set out to do."

A Depression-era baby, Jerry Hatten Buss was born in Salt Lake City on Jan. 27, 1933, although some sources cite 1934 as his birth year. His parents, Lydus and Jessie Buss, divorced when he was an infant.

His mother struggled to make ends meet as a waitress in tiny Evanston, Wyo., and Buss remembered standing in food lines in the bitter cold. They moved to Southern California when he was 9, but within a few years she remarried and her second husband took the family back to Wyoming.

His stepfather, Cecil Brown, was, as Buss put it, "very tight-fisted." Brown made his living as a plumber and expected his children (one from a previous marriage, another son and a daughter with Jessie) to help.

TIMELINE: Jerry Buss' path

This work included digging ditches in the cold. Buss preferred bell hopping at a local hotel and running a mail-order stamp-collecting business that he started at age 13.

Leaving high school a year early, he worked on the railroad, pumping a hand-driven car up and down the line to make repairs. The job lasted just three months.

Until then, Buss had never much liked academics. But he returned to school and, with a science teacher's encouragement, did well enough to earn a science scholarship to the University of Wyoming.

Before graduating with a bachelor's degree in chemistry, when he was 19 he married a coed named JoAnn Mueller and they would eventually have four children: John, Jim, Jeanie and Janie.

The couple moved to Southern California in 1953 when USC gave Buss a scholarship for graduate school. He earned a doctorate in physical chemistry in 1957. The degree brought him great pride — Lakers employees always called him "Dr. Buss."

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Singer Mindy McCready dies in apparent suicide

HEBER SPRINGS, Ark. (AP) — Perhaps there was one heartbreak too many for Mindy McCready.

The former country star apparently took her own life on Sunday at her home in Heber Springs, Ark. Authorities say McCready died of a suspected self-inflicted gunshot to the head and an autopsy is planned. She was 37, and left behind two young sons.

McCready had attempted suicide at least three times since 2005 as she struggled to cope amid a series of tumultuous public events that marked much of her adult life.

Speaking to The Associated Press in 2010, McCready smiled wryly while talking about the string of issues she'd dealt with over the last half-decade.

"It is a giant whirlwind of chaos all the time," she said of her life. "I call my life a beautiful mess and organized chaos. It's just always been like that. My entire life things have been attracted to me and vice versa that turn into chaotic nightmares or I create the chaos myself. I think that's really the life of a celebrity, of a big, huge, giant personality."

This time it seems the whirlwind overwhelmed McCready.

Her death comes a month after that of David Wilson, her longtime boyfriend and the father of her youngest son. He is believed to have shot himself on the same porch of the home they shared in Heber Springs, a small vacation community about 65 miles north of Little Rock. His death also was investigated as a suicide.

It was the most difficult moment in a life full of them. McCready issued a statement last month lamenting his death. And she called him her soul mate and a caregiver to her sons in an interview with NBC's "Today" show.

"I just keep telling myself that the more suffering that I go through, the greater character I'll have," she said, according to a transcript of the interview.

Like so many times before, McCready showed a little toughness in the midst of a personal storm, again endearing herself to her fans. But as usual, the brave face for the camera hid a much more complicated internal struggle that surfaced publicly time and again over the last 10 years.

This time, along with her remembrances of finding Wilson as he lay dying, she also answered questions about whether they'd argued earlier that evening about an affair and if she'd shot him.

"Oh, my God," the "Today" transcript reads. "No. Oh, my God. No. He was my life. We were each other's life."

It's unclear what circumstances led to McCready taking her own life, but it appears she was struggling again with twin issues that have persisted for years — substance abuse and the custody of her children. She checked into court-ordered rehab and gave her children up to foster care earlier this month after her father asked a judge to intervene, saying she'd stopped taking care of herself and her sons and was abusing alcohol and prescription drugs.

It's unclear why McCready was out of rehab.

A publicist for Billy McKnight, McCready's former boyfriend and the father of her oldest son, said the children remain in foster care. Arkansas Department of Human Services spokeswoman Amy Webb could not confirm their whereabouts, citing agency rules.

McCready's relationship with McKnight was one of the more difficult periods of her life. McKnight was arrested in 2005 on charges of attempted murder after authorities say he beat and choked her. And the two continued to struggle over their son with McKnight recently filing for custody in light of McCready's latest sting in rehab.

McKnight was unavailable for comment Monday morning.

McCready made headlines in April 2008 when she claimed a longtime relationship with baseball great Roger Clemens. Published reports at the time said she met the pitcher at a Florida karaoke bar when she was 15 and he was 28 and married. Clemens has denied the relationship.

On Monday, Clemens handed a written statement to reporters at the Houston Astros spring training facility in Kissimmee, Fla., where he is serving as a special instructor for the team.

"Yes, that is sad news. I had heard over time that she was trying to get peace and direction in her life. The few times that I had met her and her manager/agent they were extremely nice."

McCready also was engaged to actor Dean Cain in 1997, but their relationship fell apart as well.

Her troubles weren't just romantic. Over time she was arrested for fraudulently obtaining prescription drugs, probation violation, misdemeanor assault of her mother Gayle Inge and other problems.

In 2010, after a stint on Dr. Drew Pinsky's "Celebrity Rehab 3" where she was treated for "love addiction," she told The Associated Press she may have finally found love and the strength to get her life back on track.

Pinsky, whose publicist did not immediately respond to messages asking for comment, called McCready an "angel" in the season finale and expressed hope she would continue to seek treatment in a later interview. McCready suffered a seizure in one of the show's scarier moments. Tests showed she had suffered brain damage, something she attributed to her abuse at the hands of McKnight.

McCready is the fifth celebrity to pass away since appearing on Pinsky's show and the third from Season 3. Alice in Chains bassist Mike Starr and "Real World" participant Joey Kovar both died of overdoses.

She entered her relationship with Wilson, a producer and musician who was 34 when he died last month, a short time later. She'd just met Wilson and talked openly about their relationship in the 2010 interview. Wilson declined to speak on the record.

With a publicist, reporters, cameras, makeup artists and musicians swirling around her during a press day for her last album, "I'm Still Here," McCready fended off questions about a sex tape and said she and Wilson started out as friends.

"And I've never had a relationship like that before where we started completely as friends," she said. "It turned into friends really caring about each other and then it turned into love and I've never had that happen before."

Things didn't remain calm for long, though. Unhappy with custody arrangements, McCready took her older son from her mother, the boy's legal guardian, in late 2011. She fled to Arkansas without permission over what she called child abuse fears. Authorities eventually found McCready hiding in a home without permission and took the boy into custody.

She and Wilson had their son in April 2012.

___

Music Writer Chris Talbott reported from Nashville, Tenn. Sports Writer Noah Trister, in Kissimmee, Fla., contributed to this report.

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Well: Twins Don't Need C-Sections

Obstetricians increasingly recommend planned Caesarean sections for women having twins, but a new study has found that a C-section for healthy twins usually provides no advantage over vaginal delivery.

Researchers randomly assigned 2,800 mothers carrying healthy twins to either a planned C-section or a planned vaginal delivery. There was no difference in outcome between the two groups. There were serious medical problems, like bone fracture or abnormal levels of consciousness, in 36 babies delivered by C-section and 35 delivered vaginally. Twenty-one babies delivered by C-section died, as did 17 delivered vaginally.

Mothers fared equally well in each group, with serious health problems in 7.3 percent of the C-section mothers and in 8.5 percent of the vaginal delivery group.

The trial was carried out in well-equipped health care settings and by practitioners experienced in multiple births. “These skills should be available to anyone trained in obstetrics,” said the lead author, Dr. Jon Barrett, chief of maternal-fetal medicine at Sunnybrook Health Sciences Center in Toronto. “This indicates the need for the current generation of obstetricians who have these skills to impart them to their students and give women the opportunity for the best choice.”

Results of the study were presented at a medical conference in San Francisco last week.

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