Cinemax series 'Banshee' aims to hold on to viewers beyond TV









SAN FRANCISCO — As the opening credits of the new Cinemax series "Banshee" begin, the dial of an old steel safe spins, tumblers locking to reveal a combination that viewers can use to crack open "the vault" on the show's website.


This is where each week the creators of "Banshee" will spill the dark secrets hidden in haunting photographs that appear on the distressed surface of a wooden bar in the show's title sequence.


"Fast forward at your own peril," the show's executive producer and showrunner, Greg Yaitanes, said of TV viewers who might be tempted to skip the opening credits.





With the help of a Silicon Valley start-up, Yaitanes is trying something that has rarely — if ever — been attempted in TV: He is using the title sequence to push the borders of the fictional world of "Banshee" beyond the TV screen and onto desktops, smartphones and tablets.


"Television shows like 'Banshee' are designing worlds so rich, it takes multiple screens and viewing environments for the worlds to be fully realized," said Steve Anderson, associate professor of cinematic arts at USC. "But this is the first time I've seen that kind of content being delivered in a TV title sequence."


Television shows want to do everything they possibly can to hold on to TV viewers, especially younger adults who are increasingly multitasking on tablets and phones while watching TV. Eighty-five percent of tablet and smartphone owners use their devices while watching TV at least once a month, with nearly 40% of them doing it daily, according to Nielsen. And, nearly half of 18- to 24-year-olds use their smartphones while watching TV at least once a day.


"Any kind of visual entertainment aimed at that generation can only be a good thing," said Jeffrey Okun, chairman of the Visual Effects Society.


"Banshee," the new series from Alan Ball, executive producer of HBO's "True Blood," debuts Friday on Cinemax, a premium pay channel and sister network to HBO that is owned by media giant Time Warner Inc. It tells the story of Lucas Hood, a master thief who gets out of prison and tracks the woman he loves to a small town in Pennsylvania Amish country. Hunted by the gangsters he conned, Hood, played by Antony Starr, steals the identity and badge of the new sheriff of Banshee, where no one is who they seem.


With just 12 million American households subscribing to Cinemax, "Banshee" needed a digital edge to build a following. It got that edge from Tin Punch Media. The new Silicon Valley company started by Yaitanes' brother Jason and Twitter co-founder Biz Stone created the opening titles.


"We wanted the title sequence to extend the universe of the show onto the Web and beyond," Stone said. "Every week there is something new: a clue, a twist or some kind of complexity."


Opening credits used to be an afterthought in television. TV title design reached its zenith in the 1960s then mostly languished for decades. Financial constraints kept TV titles "horrifically static," Okun said.


Television has made a dramatic comeback over the last decade — and with that comeback have been higher budgets, giving producers a new way in the first few seconds to hook their trigger-happy audience with their fingers just inches from the remote.


Now a new generation of digitally savvy showrunners such as Yaitanes is using the opening titles to try to hold viewers' attention long after the final credits roll.


When he directed Fox's "House," Yaitanes had just a five-second title sequence. With "Banshee" he had 75 seconds. Yaitanes said he was determined not to waste a single one of them.


"For me it opened up the question: Why hasn't anyone really used that real estate to tell a story?" Yaitanes said. "That's more than a minute of storytelling that could be used to enrich the viewers' experience."


Yaitanes already planned to tell the story of "Banshee" across multiple media channels –- a graphic novel, a Twitter feed @BansheeDeva and the "Banshee" website, which will feature 13 prequel videos — more than 30 minutes of unseen material — that shed light on the back stories of key characters.


But he also had ambitious plans for the opening titles. He wanted a different sequence for each of the 10 episodes to keep viewers glued to their screens, and he wanted to give the show's fans a digital "rabbit hole" that they could tumble down and explore.


He challenged Tin Punch Media, a three-person shop in San Francisco and Boston, and other title houses to come up with a groundbreaking concept.


After reading the script, Yaitanes, Tin Punch Media's creative director, said he seized on the power of still photographs: the final image of Jack Nicholson in Stanley Kubrick's "The Shining" or the series of black-and-white stills of Jake's boxing matches in Martin Scorsese's "Raging Bull."


In one of the photographs in the "Banshee" pilot's title sequence, Sugar Bates, an aging bar owner down on his luck — played by Frankie Faison — is captured in his youth when he was a boxing champion. It conveys Bates' deep longing to climb back into the ring of life, something he thinks may be possible now that Hood has come to Banshee, Yaitanes said.


"There's something magical about a still photograph, and I pictured this as an album of this town on a table, and someone is sifting through the photographs for clues about who these people are," Yaitanes said.


The images that flash quickly on the screen are jarring. They are all "Banshee-ized," shot in such a way that they obscure far more than they reveal, giving the whole sequence an unsettling, almost sinister look and feel that sets the tone for the show, Yaitanes said.


Stone, a founding advisor to Tin Punch Media, came up with the idea of using cinemagraphs, still photographs that move in a fleeting way to capture a vivid moment in time. At the end of the opening credits, viewers see a close-up of a raven-haired woman, a shard of memory from Hood's happier times with Ana, the woman he has come to Banshee to find. In an unexpected flutter of movement, Ana, played by Ivana Milicevic, blinks.


Dunstan Orchard, Tin Punch Media's director of new media, brainstormed the idea of an online safe where viewers could unlock the dark secrets the cagey characters in Banshee have tried to bury. Using interactive video technology, the vault will eventually contain all 10 title sequences and commentary from the show's creators.


"It took a Silicon Valley start-up that did not know anything about titles to understand what we were after," Yaitanes said. "As far as someone is willing to go with 'Banshee,' there will be something there for them."


jessica.guynn@latimes.com





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Irvine City Council overhauls oversight, spending on Great Park









Capping a raucous eight-hour-plus meeting, the Irvine City Council early Wednesday voted to overhaul the oversight and spending on the beleaguered Orange County Great Park while authorizing an audit of the more than $220 million that so far has been spent on the ambitious project.


A newly elected City Council majority voted 3 to 2 to terminate contracts with two firms that had been paid a combined $1.1 million a year for consulting, lobbying, marketing and public relations. One of those firms — Forde & Mollrich public relations — has been paid $12.4 million since county voters approved the Great Park plan in 2002.


"We need to stop talking about building a Great Park and actually start building a Great Park," council member Jeff Lalloway said.





The council, by the same split vote, also changed the composition of the Great Park's board of directors, shedding four non-elected members and handing control to Irvine's five council members.


The actions mark a significant turning point in the decade-long effort to turn the former El Toro Marine base into a 1,447-acre municipal park with man-made canyons, rivers, forests and gardens that planners hoped would rival New York's Central Park.


The city hoped to finish and maintain the park for years to come with $1.4 billion in state redevelopment funds. But that money vanished last year as part of the cutbacks to deal with California's massive budget deficit.


"We've gone through $220 million, but where has it gone?" council member Christina Shea said of the project's initial funding from developers in exchange for the right to build around the site. "The fact of the matter is the money is almost gone. It can't be business as usual."


The council majority said the changes will bring accountability and efficiencies to a project that critics say has been larded with wasteful spending and no-bid contracts. For all that has been spent, only about 200 acres of the park has been developed and half of that is leased to farmers.


But council members Larry Agran and Beth Krom, who have steered the course of the project since its inception, voted against reconfiguring the Great Park's board of directors and canceling the contracts with the two firms.


Krom has called the move a "witch hunt" against her and Agran. Feuding between liberal and conservative factions on the council has long shaped Irvine politics.


"This is a power play," she said. "There's a new sheriff in town."


The council meeting stretched long into the night, with the final vote coming Wednesday at 1:34 a.m. Tensions were high in the packed chambers with cheering, clapping and heckling coming from the crowd.


At one point council member Lalloway lamented that he "couldn't hear himself think."


During public comments, newly elected Orange County Supervisor Todd Spitzer chastised the council for "fighting like schoolchildren." Earlier this week he said that if the Irvine's new council majority can't make progress on the Great Park, he would seek a ballot initiative to have the county take over.


And Spitzer angrily told Agran that his stewardship of the project had been a failure.


"You know what?" he said. "It's their vision now. You're in the minority."


mike.anton@latimes.com


rhea.mahbubani@latimes.com





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Netflix announces ‘Super HD’ and 3D streaming for select ISPs






Netflix (NFLX) on Tuesday announced new enhanced streaming options for users on select ISPs. Following a series of rumors that suggested as much, Netflix has confirmed the availability of “Super HD” streaming — which is simply Netflix’s branding for 1080p content — and 3D video streaming. Both services are available immediately with a huge caveat: only Netflix subscribers with Cablevision or Google Fiber Internet service have access to the new content. For those lucky subscribers, Super HD and 3D content is accessible using a number of devices including the Wii U, compatible Roku players, the Apple TV, Windows 8 PCs and select smart TVs and Blu-ray players. Netflix’s full press release follows below.



Netflix “Open Connect” Delivery Network Gains Widespread Global Acceptance
Cablevision Most Recent Major Provider to Join Open Connect
New Super HD and 3D Video Formats Available on Open Connect






[More from BGR: Apple’s next iPhone to reportedly feature larger screen and ‘brand new exterior design’]


Jan 8, 2013


LAS VEGAS, Jan. 8, 2013 /PRNewswire/ — Netflix Open Connect, the single purpose video content delivery network launched last year, is now delivering the majority of Netflix international traffic and is growing at a rapid pace in the domestic market.


In early 2012 Netflix began enabling Internet service providers (ISPs) to receive, at no cost to them, Netflix video directly at the interconnection point of the ISP’s choice. By connecting directly through Open Connect, ISPs can more effectively manage their networks and more efficiently deliver Internet services to consumers, including the more than 1 billion hours of Netflix TV shows and movies consumers watch every month.


Netflix Open Connect is now widely deployed around the world, serving the vast majority of Netflix video in Europe, Canada and Latin America, and a growing proportion in the U.S., where Netflix has over 25 million streaming members.


“Leading-edge ISPs around the world such as Cablevision, Virgin Media, British Telecom, Telmex, Telus, TDC, GVT, among many others, are already participating in Open Connect to provide the highest-possible quality Netflix service to consumers,” said Netflix Chief Executive Officer Reed Hastings. “Our goal is to have all of our members served by Open Connect as soon as possible.”


“Optimum is committed to providing the highest-quality TV, phone and Internet to our customers, and our new partnership with Netflix supports this critical objective,” said James L. Dolan, president and CEO of Cablevision, the most recent major provider to join Open Connect. “With Open Connect, we are establishing a direct local connection with Netflix that delivers a higher-quality Netflix viewing experience for Optimum customers than Verizon or AT&T can provide, including access to new Netflix Super HD and 3D TV shows and movies.”


Netflix Super HD and 3D


Now available through Open Connect partners, Netflix Super HD is the highest quality video format offered by Netflix, providing an even better picture on 1080p HDTVs.


In the U.S., Netflix is also for the first time offering a small number of titles streaming in 3D through Open Connect partners. Available for 3D viewing are, among other titles, the action fantasy drama “Immortals,” Red Bull Media House’s snowboarding documentary “The Art of Flight,” and a number of titles from the Discovery/Sony/Imax joint venture 3net Studios – including the native, original 3D series “African Wild,” “Scary Tales,” and “Live Fire.” Depending on member demand, Netflix will consider adding 3D titles and expanding availability to international markets.


“These new Super HD and 3D formats are more challenging to deliver than our other video streams, which is why we will deliver them through Open Connect,” said Ken Florance, vice president of content delivery at Netflix. “Any ISP that wants to be able to deliver our new formats can do so easily and for free.”


Netflix members can verify if their ISP is part of Open Connect and provides access to Netflix Super HD and, in the U.S. only, 3D on this Web site: http://www.netflix.com/superhd


ISPs that are not yet on Open Connect can contact Netflix at openconnect.netflix.com to start their Open Connect relationship. As part of Open Connect, Netflix is also sharing its hardware design and the open source software components. These designs are suitable for any other provider of large media files and are very cost efficient.



Linux/Open Source News Headlines – Yahoo! News





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'Lincoln' leads Oscars with 12 nominations


BEVERLY HILLS, Calif. (AP) — The Civil War saga "Lincoln" leads the Academy Awards with 12 nominations, including best picture, director for Steven Spielberg and acting honors for Daniel Day-Lewis, Sally Field and Tommy Lee Jones.


Also among the 9 nominees for best picture Thursday: the old-age love story "Amour"; the Iran hostage thriller "Argo"; the independent hit "Beasts of the Southern Wild"; the slave-revenge narrative "Django Unchained"; the musical "Les Miserables"; the shipwreck story "Life of Pi"; the lost-souls romance "Silver Linings Playbook"; and the Osama bin Laden manhunt chronicle "Zero Dark Thirty."


Chronicling Abraham Lincoln's final months as he engineers passage of the 13th Amendment abolishing slavery, "Lincoln" stars best-actor contender Day-Lewis in a monumental performance as the 16th president, supporting-actress nominee Field as the notoriously headstrong Mary Todd Lincoln and supporting-actor prospect Jones as abolitionist firebrand Thaddeus Stevens.


Joining Day-Lewis in the best-actor field are Bradley Cooper as a psychiatric patient trying to get his life back together in "Silver Linings Playbook"; Hugh Jackman as Victor Hugo's tragic hero Jean Valjean in "Les Miserables"; Joaquin Phoenix as a Navy vet who falls in with a cult in "The Master"; and Denzel Washington as a boozy airline pilot in "Flight."


Nominated for best actress are Jessica Chastain as a CIA operative hunting bin Laden in "Zero Dark Thirty"; Jennifer Lawrence as a troubled young widow struggling to heal in "Silver Linings Playbook"; Emmanuelle Riva as an ailing woman tended by her husband in "Amour"; Quvenzhane Wallis as a spirited girl on the Louisiana delta in "Beasts of the Southern Wild"; and Naomi Watts as a mother caught up in a devastating tsunami in "The Impossible."


Along with Field, supporting-actress nominees are Amy Adams as a cult leader's devoted wife in "The Master"; Anne Hathaway as an outcast mother reduced to prostitution in "Les Miserables"; Helen Hunt as a sex surrogate in "The Sessions"; and Jacki Weaver as an unstable man's doting mom in "Silver Linings Playbook."


Besides Jones, the supporting-actor contenders are Alan Arkin as a wily Hollywood producer in "Argo"; Robert De Niro as a football-obsessed patriarch in "Silver Linings Playbook"; Philip Seymour Hoffman as a dynamic cult leader in "The Master"; and Christoph Waltz as a genteel bounty hunter in "Django Unchained."


The Oscars feature a best-picture field that ranges from five to 10 films depending on a complex formula of ballots from the 5,856 voting members of the Academy of Motion Picture Arts and Sciences.


Winners for the 85th Oscars will be announced Feb. 24 at a ceremony aired live on ABC from Hollywood's Dolby Theatre.


"Family Guy" creator and vocal star Seth MacFarlane — a versatile performer whose work includes directing and voicing for the title character of last summer's hit "Ted" and a Frank Sinatra-style album of standards — is the Oscar host.


Thursday's nominees will be announced at 8:40 a.m. EST by "The Amazing Spider-Man" star Emma Stone and MacFarlane, the first time that an Oscar show host has joined in the preliminary announcement since 1972, when Charlton Heston participated on nominations day.


___


Online:


http://www.oscars.org


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Flu Widespread, Leading a Range of Winter’s Ills





It is not your imagination — more people you know are sick this winter, even people who have had flu shots.




The country is in the grip of three emerging flu or flulike epidemics: an early start to the annual flu season with an unusually aggressive virus, a surge in a new type of norovirus, and the worst whooping cough outbreak in 60 years. And these are all developing amid the normal winter highs for the many viruses that cause symptoms on the “colds and flu” spectrum.


Influenza is widespread, and causing local crises. On Wednesday, Boston’s mayor declared a public health emergency as cases flooded hospital emergency rooms.


Google’s national flu trend maps, which track flu-related searches, are almost solid red (for “intense activity”) and the Centers for Disease Control and Prevention’s weekly FluView maps, which track confirmed cases, are nearly solid brown (for “widespread activity”).


“Yesterday, I saw a construction worker, a big strong guy in his Carhartts who looked like he could fall off a roof without noticing it,” said Dr. Beth Zeeman, an emergency room doctor for MetroWest Medical Center in Framingham, Mass., just outside Boston. “He was in a fetal position with fever and chills, like a wet rag. When I see one of those cases, I just tighten up my mask a little.”


Massachusetts General Hospital in Boston started asking visitors with even mild cold symptoms to wear masks and to avoid maternity wards. The hospital has treated 532 confirmed influenza patients this season and admitted 167, even more than it did by this date during the 2009-10 swine flu pandemic.


At Brigham and Women’s Hospital, 100 patients were crowded into spaces licensed for 53. Beds lined halls and pressed against vending machines. Overflow patients sat on benches in the lobby wearing surgical masks.


“Today was the first time I think I was experiencing my first pandemic,” said Heidi Crim, the nursing director, who saw both the swine flu and SARS outbreaks here. Adding to the problem, she said, many staff members were at home sick and supplies like flu test swabs were running out.


Nationally, deaths and hospitalizations are still below epidemic thresholds. But experts do not expect that to remain true. Pneumonia usually shows up in national statistics only a week or two after emergency rooms report surges in cases, and deaths start rising a week or two after that, said Dr. Gregory A. Poland, a vaccine specialist at the Mayo Clinic in Minnesota. The predominant flu strain circulating is an H3N2, which typically kills more people than the H1N1 strains that usually predominate; the relatively lethal 2003-4 “Fujian flu” season was overwhelmingly H3N2.


No cases have been resistant to Tamiflu, which can ease symptoms if taken within 48 hours, and this year’s flu shot is well-matched to the H3N2 strain, the C.D.C. said. Flu shots are imperfect, especially in the elderly, whose immune systems may not be strong enough to produce enough antibodies.


Simultaneously, the country is seeing a large and early outbreak of norovirus, the “cruise ship flu” or “stomach flu,” said Dr. Aron J. Hall of the C.D.C.’s viral gastroenterology branch. It includes a new strain, which first appeared in Australia and is known as the Sydney 2012 variant.


This week, Maine’s health department said that state was seeing a large spike in cases. Cities across Canada reported norovirus outbreaks so serious that hospitals were shutting down whole wards for disinfection because patients were getting infected after moving into the rooms of those who had just recovered. The classic symptoms of norovirus are “explosive” diarrhea and “projectile” vomiting, which can send infectious particles flying yards away.


“I also saw a woman I’m sure had norovirus,” Dr. Zeeman said. “She said she’d gone to the bathroom 14 times at home and 4 times since she came into the E.R. You can get dehydrated really quickly that way.”


This month, the C.D.C. said the United States was having its biggest outbreak of pertussis in 60 years; there were about 42,000 confirmed cases, the highest total since 1955. The disease is unrelated to flu but causes a hacking, constant cough and breathlessness. While it is unpleasant, adults almost always survive; the greatest danger is to infants, especially premature ones with undeveloped lungs. Of the 18 recorded deaths in 2012, all but three were of infants under age 1.


That outbreak is worst in cold-weather states, including Colorado, Washington, Wisconsin, Minnesota and Vermont.


Although most children are vaccinated several times against pertussis, those shots wear off with age. It is possible, the authorities said, that a new, safer vaccine introduced in the 1990s gives protection that does not last as long, so more teenagers and adults are vulnerable.


And, Dr. Poland said, if many New Yorkers are catching laryngitis, as has been reported, it is probably a rhinovirus. “It’s typically a sore, really scratchy throat, and you sometimes lose your voice,” he said.


Though flu cases in New York City are rising rapidly, the city health department has no plans to declare an emergency, largely because of concern that doing so would drive mildly sick people to emergency rooms, said Dr. Jay K. Varma, deputy director for disease control. The city would prefer people went to private doctors or, if still healthy, to pharmacies for flu shots. Nursing homes have had worrisome outbreaks, he said, and nine elderly patients have died. Homes need to be more alert, vaccinate patients, separate those who fall ill and treat them faster with antivirals, he said.


Dr. Susan I. Gerber of the C.D.C.’s respiratory diseases branch, said her agency has not seen any unusual spike of rhinovirus, parainfluenza, adenovirus, coronavirus or the dozens of other causes of the “common cold,” but the country is having its typical winter surge of some, like respiratory syncytial virus “that can mimic flulike symptoms, especially in young children.”


The C.D.C. and the local health authorities continue to advocate getting flu shots. Although it takes up to two weeks to build immunity, “we don’t know if the season has peaked yet,” said Dr. Joseph Bresee, chief of prevention in the agency’s flu division.


Flu shots and nasal mists contain vaccines against three strains, the H3N2, the H1N1 and a B. Thus far this season, Dr. Bresee said, H1N1 cases have been rare, and the H3N2 component has been a good match against almost all the confirmed H3N2 samples the agency has tested.


About a fifth of all flus this year thus far are from B strains. That part of the vaccine is a good match only 70 percent of the time, because two B’s are circulating.


For that reason, he said, flu shots are being reformulated. Within two years, they said, most will contain vaccines against both B strains.


Joanna Constantine, 28, a stylist at the Guy Thomas Hair Salon on West 56th Street in Manhattan, said she recently was so sick that she was off work and in bed for five days — and silenced by laryngitis for four of them.


She did not have the classic flu symptoms — a high fever, aches and chills — so she knew it was probably something else.


Still, she said, it scared her enough that she will get a flu shot next year. She had not bothered to get one since her last pregnancy, she said. But she has a 7-year-old son and a 5-year-old daughter, “and my little guys get theirs every year.”


Jess Bidgood contributed reporting.



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Nearly one-third of U.S. homeowners have no mortgage









What mortgage meltdown?


While millions of Americans have suffered the angst of lost homes, equity and pride, nearly a third of the nation's homeowners have no mortgage at all, according to an estimate released Thursday by real estate website Zillow.


The free-and-clear class includes, predictably, retirees who have chipped away at their debts for decades, but also a surprisingly high percentage of young people and those who live in relatively affordable regions. In Los Angeles and Orange counties, only 20.7% of homeowners owned their properties outright, reflecting the region's pricey real estate.





Economists and housing analysts said that Zillow's estimates are in line with historical norms. But the proportion of these owners is likely to grow as the nation's baby boomers reach retirement. The fact that they can pay cash when they move will make them increasingly important players in a recovering housing market.


"Those are the people who have the greatest flexibility," said Svenja Gudell, a senior economist with Zillow.


As the economy picks up, regions with high percentages of free-and-clear owners probably will get a boost.


"That means there is a lot more disposable income," said Celia Chen, a housing economist with Moody's Economy.com. "That is positive for the local economy."


Out of the nation's largest metro areas, Pittsburgh, Tampa, New York, Cleveland and Miami had the highest percentages of mortgage-free homeowners. Washington, Atlanta, Las Vegas, Denver and Charlotte, N.C., had the lowest.


Throughout the Southland, the percentage of mortgage-free homeowners varied little by county. San Bernardino had the lowest percentage of free-and-clear homeowners, at 19.7%, and San Diego had the highest, at 21.5%. That compares with 29.3% nationally — or nearly 21 million homeowners.


A big factor in regional variation is median home values, with lower-priced areas not surprisingly having higher outright ownership rates.


Zillow also found that the nation's most elderly were the most likely to own their homes, with 77.6% of those older than 85 owning their homes outright, followed by those ages 74 to 84, at about 62.7%. One outlier was those homeowners ages 20 to 24. Out of that relatively young demographic, about 34.5% owned their homes outright. These homeowners could be young millionaires, those with trust funds or those who received help from their parents.


People who own their homes outright have always been a significant part of the housing market, said Guy Cecala, publisher of Inside Mortgage Finance. But the recent financial crisis may drive more people toward the financial security of having no house note.


"Clearly that is going to be a growing trend as our population ages," Cecala said. "The credit crisis has pushed more and more people to think that the best way they can prepare for retirement is with no mortgage at all."


Delia Fernandez, a certified financial planner in Los Alamitos, said that even with interest rates so low, those seeking her guidance for retirement often want to pay off debts. And that makes sense, particularly for those nearing retirement.


"The financial argument has always been to borrow other people's money and invest the rest," she said. But "that higher rate of return is not always guaranteed.… In the meantime, as you get closer and closer to retirement, people want to take on less and less risk."


Victor Robinette, a certified financial planner with Raymond James Financial Services Inc. in South Pasadena, said customers have been asking him more often these days about paying off the mortgage.


"During the boom days, and before, there was hardly any interest in paying off debt because people were so confident that the value of their home was going to go up," Robinette said. "Nowadays, after four or five years of being bruised, people really appreciate the comfort of having the house paid off. And so many people still have concerns about possibly losing their livelihood."


alejandro.lazo@latimes.com





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Weight-loss regimen a preferred choice for countering diabetes









After all those well-intentioned New Year's resolutions have yielded to the force of habit, many of the nation's 79 million obese adults will have a day of reckoning with their primary care physicians.


Lose weight and get active, the doctor will order, or risk developing diabetes. Then the MD will scribble a prescription.


For most patients, the prescribed treatment will not be a pill. It will be a 12-week program aimed at preventing Type 2 diabetes by getting obese adults to shed as little as 10 pounds and exercise for a little more than 20 minutes a day.





That regimen — the Diabetes Prevention Program — may soon become the blockbuster prescription medicine you've never heard of. In 2013, it is poised to become the envy of pharmaceutical companies, a new rival to programs such as Weight Watchers, and a target of opportunity for healthcare entrepreneurs.


Led by a trained coach, it is a testament to the power of a mentor and of setting modest goals in spurring healthful behavior. And it may be a crucial first test of the Affordable Care Act's focus on preventive health.


In nearly 30 clinical trials, scientists have established that the program is far more effective at helping people lose weight and prevent or delay the onset of diabetes than "usual care" — essentially, a doctor telling a patient to slim down and get active, and then sending him on his way. But the program hasn't been packaged in a form that healthcare providers can simply and cheaply offer to patients, said Dr. Jun Ma of the Palo Alto Medical Foundation Research Institute, who studies diabetes prevention.


The Diabetes Prevention Program is not rocket science. In 12 weekly sessions, a coach teaches obese subjects at high risk of developing diabetes to set goals for losing 5% to 7% of their body weight, limit the fat and calories they consume, track their food intake, get at least 150 minutes of exercise each week, and devise strategies to avoid gaining back lost pounds.


In trials, subjects who attended the tightly scripted sessions and followed the regimen were far more likely than those who were on their own to reach their weight-loss goals in three months — and to keep that weight off for more than a year. By doing so, they drove down their risk of developing Type 2 diabetes by 58%, according to a landmark report published in the New England Journal of Medicine in 2002.


The program, in short, is powerful medicine.


"If you could take it as a pill, it would definitely be commercialized," said Sean Duffy, a software designer and former Google employee who launched an online version of the program about a month ago.


In June, a panel of physicians and public health experts that advises the Department of Health and Human Services gave the program a mighty push into everyday medical practice. The U.S. Preventive Services Task Force recommended that doctors refer their obese patients to "intensive, multicomponent behavioral interventions" designed to promote weight loss and physical activity. It cited only one that met its strict standards: the Diabetes Prevention Program.


Under the Affordable Care Act, that carries significant weight. Starting in June, most health insurers will be required to make proven weight-loss and behavior-modification programs available without a copayment to obese customers with a doctor's referral.


No one knows whether expanded coverage of such programs can save money and head off a public health disaster. But without it, experts believe a tidal wave of Type 2 diabetes and heart disease — with a 20-year price tag estimated at $550 billion in the U.S. alone — is a virtual certainty.


For all its promise, the program has remained little more than a good idea — and a pretty expensive one at that — for years. The researchers who developed it at the University of Indiana pegged the cost of the trial's intensive 12-week phase and nine months of maintenance at about $1,300 per patient. To make it cheaper and more accessible, they trained a few YMCA chapters to deliver the program.


Today, about 75 chapters in 28 states and the District of Columbia offer it. The Centers for Disease Control and Prevention, which has been charged with broadening access to "lifestyle change" programs, disbursed $6.75 million in 2012 to encourage health insurers, public health advocates and employer groups to offer versions of the program.


But with more than 78 million people potentially in line to get it, demand far outstrips supply.


Researchers like Ma have been working on ways to use technology to make the program more widely available. In a study published last month in the Archives of Internal Medicine, she and her colleagues found that putting the 12-week curriculum on an inexpensive DVD and assigning a coach to answer questions and offer support helped 37% of obese participants lose 7% of their body weight — a rate more than twice as high as for those who got no help at all.


In a related study published in the same journal, researchers gave obese volunteers a personal digital device to monitor their weight, diet and physical activity and had them check in with a coach every other week. The volunteers lost more weight than trial subjects who were on their own.


The UnitedHealth Group's Diabetes Prevention and Control Alliance in Minnetonka, Minn., has worked to make the Diabetes Prevention Program available on demand to Comcast cable subscribers nationwide. UnitedHealth Group physicians and public health specialists worked with a TV production crew to create a reality-show version of the program. After the pilot aired last year in Philadelphia and Knoxville, Tenn., it took just three weeks to get 700 people to volunteer for a clinical trial of the TV-based program. The results of that will be published soon, said Dr. Deneen Vojta, chief clinical officer for the UnitedHealth program.


"These people lost a ton of weight," she said.


The growing scientific consensus around the diabetes program has not been lost on one of the nation's most ubiquitous and respected weight-loss programs, Weight Watchers. With 20,000 meetings a week across the United States, Weight Watchers International has the infrastructure that the Diabetes Prevention Program lacks. Like the diabetes program, its groups are run by coaches who give advice and encouragement and teach members to track their intake. The company has steadily added features — most recently a spate of food-tracking apps — as clinical trials showed their value.


Weight Watchers has been lobbying the government to recognize its programs as an effective tool for diabetes prevention. The stakes are huge: If insurers were required to cover the costs of patients' Weight Watchers memberships, the customer base could expand by leaps and bounds.


In Britain, the National Health Service will pay for the company's initial 12-week course, said David Kirchhoff, chief executive of Weight Watchers International in New York City. Given the program's widespread presence in the U.S. and evidence of its effectiveness in clinical trials, it makes sense for insurers here to pay too, he said.


Entrepreneurs are also getting in on the act. Duffy's San Francisco-based startup, Omada Health, launched an online version of the Diabetes Prevention Program called Prevent that may be the first of many digital spinoffs.


Designed to win the CDC's seal of approval, Prevent resembles a Facebook version of the Diabetes Prevention Program while preserving the privacy of customers who prefer it. Incoming members are matched to a group, and everyone works toward a goal of losing 5% to 7% of their body weight in 12 weeks under the supervision of a coach. Members' weights are transmitted to the coach by a digital scale upon enrollment and weekly thereafter.


Early testing has shown that as groups jell, members learn from — and lean on — one another, Duffy said. He plans to sell the program at about $120 per month for four months, primarily to insurers and companies for use by their customers and employees.


Payment will be due only after users show results, he said.


melissa.healy@latimes.com





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European businesses slow to go online: study






BRUSSELS (Reuters) – European businesses are not doing enough to use the internet to grow their customer base and promote products, Belgian database and marketing firm Email-Brokers said after studying 13 million websites.


Belgium, Germany and the Netherlands have the highest proportion of companies online but even in these countries 40 percent of business have no internet presence, it found.






The European Commission has estimated that companies which exploit the full potential of the internet create, on average, more than twice as many jobs.


“It is one of the ways to create employment and economic growth and it is not Star Trek, it exists today,” Email-Brokers head William Vande Wiele said.


Britain and Liechtenstein were the most advanced in terms of e-commerce – defined as being able to process orders and payments, with 16 percent and 17 percent, respectively, of business sites offering it, compared with 6 percent in Belgium and 9 percent in Austria, Germany and the Netherlands.


Vande Wiele said many corporate websites were badly designed, and did not provide basics such as adequate contact information or company details.


In Belgium, 91 percent of all corporate websites did not meet such basic standards, compared with about 20 percent in Luxembourg and France, the study concluded.


“Sites which do not comply with such minimum standards do not inspire confidence and before buying something online a user will need a minimum level of confidence,” Vande Wiele said.


Many websites are not kept up to date, the study also found, with more than 80 percent of business sites in Belgium, Greece, Italy and Spain not updated for more than a year.


(Reporting by Robert-Jan Bartunek; Editing by Dan Lalor)


Internet News Headlines – Yahoo! News





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Beyonce, Clarkson to perform at Obama inauguration


WASHINGTON (AP) — Beyonce will sing the national anthem at President Barack Obama's inauguration ceremony.


The committee planning the Jan. 21 event also announced Wednesday that Kelly Clarkson will perform "My Country 'Tis of Thee" and James Taylor will sing "America the Beautiful" at the swearing-in ceremony on the Capitol's west front.


Richard Blanco, the son of Cuban exiles, is the 2013 inaugural poet, joining the ranks of Maya Angelou and Robert Frost to have served in that capacity. Blanco's works explore his family's exile from their native country and "the intersection of his cultural identities as a Cuban-American gay man," the inaugural planners announced.


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Recipes for Health: Cauliflower and Tuna Salad — Recipes for Health


Andrew Scrivani for The New York Times







I have added tuna to a classic Italian antipasto of cauliflower and capers dressed with vinegar and olive oil. For the best results give the cauliflower lots of time to marinate.




1 large or 2 small or medium cauliflowers, broken into small florets


1 5-ounce can water-packed light (not albacore) tuna, drained


1 plump garlic clove, minced or pureéd


1/3 cup chopped flat-leaf parsley


3 tablespoons capers, drained and rinsed


1 tablespoon fresh lemon juice


3 tablespoons sherry vinegar or champagne vinegar


6 tablespoons extra virgin olive oil


Salt and freshly ground pepper


1. Place the cauliflower in a steaming basket over 1 inch of boiling water, cover and steam 1 minute. Lift the lid for 15 seconds, then cover again and steam for 5 to 8 minutes, until tender. Refresh with cold water, then drain on paper towels.


2. In a large bowl, break up the tuna fish and add the cauliflower.


3. In a small bowl or measuring cup, mix together the garlic, parsley, capers, lemon juice, vinegar, and olive oil. Season generously with salt and pepper. Add the cauliflower and toss together. Marinate, stirring from time to time, for 30 minutes if possible before serving. Serve warm, cold, or at room temperature.


Yield: Serves 6 as a starter or side dish


Advance preparation: You can make this up to a day ahead, but omit the parsley until shortly before serving so that it doesn’t fade. It keeps well in the refrigerator for up to 5 days.


Nutritional information per serving: 188 calories; 15 grams fat; 2 grams saturated fat; 2 grams polyunsaturated fat; 10 grams monounsaturated fat; 10 milligrams cholesterol; 8 grams carbohydrates; 3 grams dietary fiber; 261 milligrams sodium (does not include salt to taste); 9 grams protein


Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”


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