Advanced Breast Cancer May Be Rising Among Young Women, Study Finds

The incidence of advanced breast cancer among younger women, ages 25 to 39, may have increased slightly over the last three decades, according to a study released Tuesday.

But more research is needed to verify the finding, which was based on an analysis of statistics, the study’s authors said. They do not know what may have caused the apparent increase.

Some outside experts questioned whether the increase was real, and expressed concerns that the report would frighten women needlessly.

The study, published in The Journal of the American Medical Association, found that advanced cases climbed to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976 — an increase of 1.37 cases per 100,000 women in 34 years. The totals were about 250 such cases per year in the mid-1970s, and more than 800 per year in 2009.

Though small, the increase was statistically significant, and the researchers said it was worrisome because it involved cancer that had already spread to organs like the liver or lungs by the time it was diagnosed, which greatly diminishes the odds of survival.

For now, the only advice the researchers can offer to young women is to see a doctor quickly if they notice lumps, pain or other changes in the breast, and not to assume that they cannot have breast cancer because they are young and healthy, or have no family history of the disease.

“Breast cancer can and does occur in younger women,” said Dr. Rebecca H. Johnson, the first author of the study and medical director of the adolescent and young adult oncology program at Seattle Children’s Hospital.

But Dr. Johnson noted that there is no evidence that screening helps younger women who have an average risk for the disease and no symptoms. “We’re certainly not advocating that young women get mammography at an earlier age than is generally specified,” she said.

Expert groups differ about when screening should begin; some say at age 40, others 50.

Breast cancer is not common in younger women; only 1.8 percent of all cases are diagnosed in women from 20 to 34, and 10 percent in women from 35 to 44. However, when it does occur, the disease tends to be more deadly in younger women than in older ones. Researchers are not sure why.

The researchers analyzed data from SEER, a program run by the National Cancer Institute to collect cancer statistics on 28 percent of the population of the United States. The study also used data from the past when SEER was smaller.

The study is based on information from 936,497 women who had breast cancer from 1976 to 2009. Of those, 53,502 were 25 to 39 years old, including 3,438 who had advanced breast cancer, also called metastatic or distant disease.

Younger women were the only ones in whom metastatic disease seemed to have increased, the researchers found.

Dr. Archie Bleyer, a clinical research professor in radiation medicine at the Knight Cancer Institute at the Oregon Health and Science University in Portland who helped write the study, said scientists needed to verify the increase in advanced breast cancer in young women in the United States and find out whether it is occurring in other developed Western countries. “This is the first report of this kind,” he said, adding that researchers had already asked colleagues in Canada to analyze data there.

“We need this to be sure ourselves about this potentially concerning, almost alarming trend,” Dr. Bleyer said. “Then and only then are we really worried about what is the cause, because we’ve got to be sure it’s real.”

Dr. Johnson said her own experience led her to look into the statistics on the disease in young women. She had breast cancer when she was 27; she is now 44. Over the years, friends and colleagues often referred young women with the disease to her for advice.

“It just struck me how many of those people there were,” she said.

Dr. Donald A. Berry, an expert on breast cancer data and a professor of biostatistics at the University of Texas’ M. D. Anderson Cancer Center in Houston, said he was dubious about the finding, even though it was statistically significant, because the size of the apparent increase was so small — 1.37 cases per 100,000 women, over the course of 30 years.

More screening and more precise tests to identify the stage of cancer at the time of diagnosis might account for the increase, he said.

“Not many women aged 25 to 39 get screened, but some do, but it only takes a few to account for a notable increase from one in 100,000,” Dr. Berry said.

Dr. Silvia C. Formenti, a breast cancer expert and the chairwoman of radiation oncology at New York University Langone Medical Center, questioned the study in part because although it found an increased incidence of advanced disease, it did not find the accompanying increase in deaths that would be expected.

A spokeswoman for an advocacy group for young women with breast cancer, Young Survival Coalition, said the organization also wondered whether improved diagnostic and staging tests might explain all or part of the increase.

“We’re looking at this data with caution,” said the spokeswoman, Michelle Esser. “We don’t want to invite panic or alarm.”

She said it was important to note that the findings applied only to women who had metastatic disease at the time of diagnosis, and did not imply that women who already had early-stage cancer faced an increased risk of advanced disease.

Dr. J. Leonard Lichtenfeld
, deputy chief medical officer of the American Cancer Society, said he and an epidemiologist for the society thought the increase was real.

“We want to make sure this is not oversold or that people suddenly get very frightened that we have a huge problem,” Dr. Lichtenfeld said. “We don’t. But we are concerned that over time, we might have a more serious problem than we have today.”

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DreamWorks Animation takes $87 million write-down on 'Guardians'

DreamWorks Animation SKG said it would take an $87-million charge on last year's holiday movie "Rise of the Guardians," marking the largest write-down the studio has ever taken for one of its own movies.

Analysts had estimated that the studio would take a write-down of from $70 million to nearly $100 million on the film, which represented a rare box-office misfire for DreamWorks, creator of the popular "Shrek," "Kung Fu Panda" and "Madagascar" films.

"Rise of the Guardians," which cost about $145 million to make, has generated $302 million in global box-office ticket sales since its debut in late November, well short of a typical DreamWorks Animation movie.

IN CASE YOU MISSED IT: Oscars 2013:  Winner list | Red carpet | Highlights

The film -- about a group of folk heroes, including the Tooth Fairy and Santa Claus, who join forces to protect children from an evil nemesis -- faced tough competition during a record Thanksgiving weekend at the holiday box office, losing business to "Lincoln," "Life of Pi," "Twilight: Breaking Dawn Part 2," "Skyfall" and Disney's animated hit "Wreck-It Ralph."

"While 'Rise of the Guardians' did not achieve the level of box-office success that we have come to expect from a DreamWorks Animation film, we have made several changes to our future slate that we believe will position us well for the next two years,” said Jeffrey Katzenberg, chief executive of DreamWorks Animation. "We are now looking ahead to our next release -- and our first under our new distribution agreement with 20th Century Fox -- 'The Croods' on March 22, 2013.”

"Rise of the Guardians" was the studio's biggest money-loser since 2006's "Flushed Away," co-produced with British-based Aardman Animations. DreamWorks took a $109-million write-down on that movie.

DreamWorks also said it took a fourth-quarter charge of $54 million related to the company's decision to return "Me & My Shadow" back to development, a write-off of a number of other development projects in the amount of $20 million and a charge of $4.6 million related to restructuring activities. The studio has already taken steps to lay off up to 20% of its workforce following the decision to shelve production of "Me and My Shadow."

As part of the changes, DreamWorks shifted the release date for its movie "Mr. Peabody & Sherman" from Nov. 1 to March 7, 2014, at the recommendation of its new distributor, 20th Century Fox.

Removing one of three movies from its slate this year increased pressure on the studio to cut costs to make up for the reduced business.

As a result of the charges, the company reported a net loss of $82.7 million, or $.98 cents a share, in the fourth quarter, on revenues of $264.7 million. For the year, DreamWorks reported total revenue of $749.8 million and a net loss of $36.4 million, or a loss of $0.43 per share.

ALSO:

DreamWorks Animation plans staff cuts

Analyst predicts $96 million write-down for 'Rise of the Guardians'

DreamWorks Animation shares fall after poor debut for 'Rise of the Guardians'

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Bank of America should just play the tape of disputed sales call

It's perhaps not so surprising that a Bank of America customer discovered recurring payments on his credit card bill for a service he swears he never signed up for. This kind of thing happens a lot.

What is surprising is that BofA told the customer to pound sand when he requested proof that he authorized the bank by phone to enroll him in its Credit Protection Plus program, which came with a $212.50 monthly charge.

BofA's stance: Trust us, we're right. We have nothing to prove.

This didn't sit well with Craig Chatfelter, 60, of Lake Hughes after he realized he'd paid more than $4,000 in Credit Protection Plus charges over 19 months — and, yes, he blames himself in part for not having kept closer tabs on his card statements.

"When you phone Bank of America, they say they record all calls," he told me. "OK, so play me the tape. Show me the proof that I really signed up for this.

"I'd never sign up for anything like this," Chatfelter insisted. "Never in a million years. I'm self-employed. I don't sign up for anything that comes with extra fees."

Betty Riess, a BofA spokeswoman, acknowledged that "this is not the type of experience we want customers to have."

However, she was less forthcoming when it came to addressing Chatfelter's reasonable request for proof of his enrollment in the bank's program. More on that in a moment.

Chatfelter, who works as a real estate appraiser, remembers being pitched by the bank for Credit Protection Plus, which can cancel up to 18 monthly credit card payments if you lose your job or are hospitalized.

"They had contacted me because there was an unauthorized payment on my account," he said. "They had me change my card number, which I did."

During the same call, a BofA service rep asked if Chatfelter wanted to sign up for credit protection. He said he declined the offer.

Months passed. It wasn't until last March that Chatfelter noticed the $212.50 charge on his bill. He accepts that he should have spotted it sooner, but said that, like many people, he seldom looked closely at his statement.

Whatever the case, once Chatfelter realized that he'd paid $4,037.50 for the unwanted service, he contacted the bank and canceled his membership in the program. Then he asked for a refund.

A service rep promptly offered to give back six months' worth of payments, or $1,275, which the bank did. The remainder would depend on the outcome of an investigation by the bank.

In April, Chatfelter was informed that "the records maintained by Bank of America indicate that you enrolled for this protection during a customer service call on Sept. 3, 2010."

The bank's records also indicated that Chatfelter was mailed a "welcome package" spelling out the details of the plan.

He wasn't impressed. Chatfelter contacted the bank again to reiterate that he'd never agreed to enroll in the program and that he didn't recall any "welcome package." He once again asked for all his money to be refunded.

In June, BofA sent a letter stating that its records indicated that Chatfelter enrolled in the credit-protection program on Sept. 6, 2010 — three days later than the bank stated in its prior correspondence.

The bank said that it had refunded $1,275 as "a one-time goodwill courtesy" and that "this adjustment is not to be construed at any time or for any purpose as an admission of liability on our part."

"We consider this matter settled," BofA said in its letter to Chatfelter.

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Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative, which will provide the vaccine and help pay for the campaign.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

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Bank of America should just play the tape of disputed sales call

It's perhaps not so surprising that a Bank of America customer discovered recurring payments on his credit card bill for a service he swears he never signed up for. This kind of thing happens a lot.

What is surprising is that BofA told the customer to pound sand when he requested proof that he authorized the bank by phone to enroll him in its Credit Protection Plus program, which came with a $212.50 monthly charge.

BofA's stance: Trust us, we're right. We have nothing to prove.

This didn't sit well with Craig Chatfelter, 60, of Lake Hughes after he realized he'd paid more than $4,000 in Credit Protection Plus charges over 19 months — and, yes, he blames himself in part for not having kept closer tabs on his card statements.

"When you phone Bank of America, they say they record all calls," he told me. "OK, so play me the tape. Show me the proof that I really signed up for this.

"I'd never sign up for anything like this," Chatfelter insisted. "Never in a million years. I'm self-employed. I don't sign up for anything that comes with extra fees."

Betty Riess, a BofA spokeswoman, acknowledged that "this is not the type of experience we want customers to have."

However, she was less forthcoming when it came to addressing Chatfelter's reasonable request for proof of his enrollment in the bank's program. More on that in a moment.

Chatfelter, who works as a real estate appraiser, remembers being pitched by the bank for Credit Protection Plus, which can cancel up to 18 monthly credit card payments if you lose your job or are hospitalized.

"They had contacted me because there was an unauthorized payment on my account," he said. "They had me change my card number, which I did."

During the same call, a BofA service rep asked if Chatfelter wanted to sign up for credit protection. He said he declined the offer.

Months passed. It wasn't until last March that Chatfelter noticed the $212.50 charge on his bill. He accepts that he should have spotted it sooner, but said that, like many people, he seldom looked closely at his statement.

Whatever the case, once Chatfelter realized that he'd paid $4,037.50 for the unwanted service, he contacted the bank and canceled his membership in the program. Then he asked for a refund.

A service rep promptly offered to give back six months' worth of payments, or $1,275, which the bank did. The remainder would depend on the outcome of an investigation by the bank.

In April, Chatfelter was informed that "the records maintained by Bank of America indicate that you enrolled for this protection during a customer service call on Sept. 3, 2010."

The bank's records also indicated that Chatfelter was mailed a "welcome package" spelling out the details of the plan.

He wasn't impressed. Chatfelter contacted the bank again to reiterate that he'd never agreed to enroll in the program and that he didn't recall any "welcome package." He once again asked for all his money to be refunded.

In June, BofA sent a letter stating that its records indicated that Chatfelter enrolled in the credit-protection program on Sept. 6, 2010 — three days later than the bank stated in its prior correspondence.

The bank said that it had refunded $1,275 as "a one-time goodwill courtesy" and that "this adjustment is not to be construed at any time or for any purpose as an admission of liability on our part."

"We consider this matter settled," BofA said in its letter to Chatfelter.

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Brown's school funding plan draws mixed reactions

In the Anaheim City School District, where most students are low-income and struggling to learn English, teachers need special training, extra tutoring time and lots of visual materials to help their pupils achieve at grade level.

In the well-heeled Palos Verdes Peninsula Unified School District, poverty and limited English are not widespread problems. But officials there say their student needs include more expensive Advanced Placement classes to challenge them with college-level material in high school.

Who should get more state educational dollars? Last week, school districts got their first glimpse of how that question would be answered under Gov. Jerry Brown's proposed new funding formula: Anaheim would receive an estimated $11,656 per student annually; Palos Verdes would get $8,429 by the time the plan is fully implemented in seven years.

And that disparity draws distinctly different reactions.

"It's great news," said Darren Dang, Anaheim's assistant superintendent of administrative services. "Given our demographics, we'll be getting much-needed resources for our students."

But Lydia Cano, Palos Verdes' deputy superintendent of business services, said she believed the new scheme would shortchange her students. Disadvantaged students already receive a bigger share of state and federal dollars, she said.

"It's not fair," she said. "It will make the divide even bigger."

In the most significant change in four decades in how school dollars would be distributed, Brown is proposing to give all districts a base grant, then add an extra 35% of that for each student who is low-income, struggling with English or in foster care. If such students make up more than 50% of a district's population, another 35% supplement would be given.

The formula is part of Brown's proposed budget, which requires the Legislature's approval.

Under the proposal, the state would do away with most so-called categorical funding — which was earmarked for such specific uses as textbooks, remediation and low-income student aid. Instead, the money would be given directly to districts with no strings attached, to promote Brown's goal of greater local control.

The plan is aimed at reforming what most educators agree is an inequitable, burdensome and overly complex funding system. It is grounded in a 2008 report coauthored by state Board of Education President Michael Kirst that compiled research showing that parental income and English language ability are two critical factors in academic achievement.

Kirst argued that it was more important to help needy students gain grade-level skills than it is to provide college-level work for top-achieving high schoolers. "These are judgments about political priorities," he said.

About 20 states currently distribute extra dollars to needier students, including Rhode Island and New York, according to Margaret Weston of the Public Policy Institute of California. Poor districts in California already receive about 20% more in state and federal dollars than do affluent ones, but Brown's formula would increase that share, she said.

After four years of crippling budget cuts, the Los Angeles Unified School District is expected to receive an estimated boost of $820 more per student over the next two years under Brown's proposal. By 2020, funding is expected to grow to $11,993 per student from $7,509 last year.

L.A. Supt. John Deasy hailed the governor's proposal. "It's morally the right thing to do and educationally the sound thing to do," he said.

Like many administrators, however, Deasy cautioned that it would take a few years of increases to make up for the state's devastating reductions since 2007. New spending could possibly begin in 2015, he said, adding that he would recommend restorations in summer school, counselors, arts and support staff, among other things.

He also said he would make it the district's "policy and practice" to send the state dollars for disadvantaged students directly to their schools to help them. Some officials, such as Dang in Anaheim, have expressed concerns about possible pressure to use the money for salary hikes.

Over the next five years, per-student funding is expected to grow by about $2,700, the state estimates showed. All school districts and charter schools would receive at least as much money this year as last.

In Los Angeles County, funding estimates range from a low of $7,863 per student in the Hermosa Beach City School District to $13,569 for Animo Leadership High, an independent charter school in Inglewood.

Long Beach, San Bernardino City and Santa Ana unified all are estimated to receive funding boosts of $800 to $1,000 per student over the next two years. But the state projects an increase of less than half that for more affluent districts, such as San Marino, Palos Verdes Peninsula and Manhattan Beach unified.

Julie Boucher, San Marino's assistant superintendent of business services, said she was dismayed that Brown was not proposing to first restore general funding that the state has cut since 2007 before allocating additional dollars to specific students.

San Marino's state funding has been slashed by $17 million since 2008 — a total equivalent to 60% of its annual budget. The district has received $3.1 million annually from its nonprofit fundraising foundation and $5.1 million from a parcel tax but still has worked with its employee unions to freeze salaries, require larger contributions for healthcare, cut 26 teaching positions and shorten the school calendar with unpaid furlough days, she said.

"It does not seem equitable given the fact that we're all down," she said of Brown's proposal. "First we need to be made whole. Don't rob Peter to pay Paul."

During a recent visit to Ponderosa Elementary School in Anaheim, however, educators demonstrated how teaching lower-income English learners is more costly and time-consuming.

In Bernadette Grzechowiak's fifth-grade classroom, for instance, students were learning how to find main ideas in a passage about Native Americans. But unlike fluent English speakers, she said, those with limited language skills need far more visual aids — presented every 60 to 90 seconds, according to research. Her room is filled with graphics about colonial America and sentence frames to teach them academic language, such as "One detail that supports the main idea is…"

Grzechowiak said she learned those and other techniques from a district-paid teaching coach.

Ponderosa has also spent $10,000 on a science book series heavy on photos and graphics to help students learning English. And the school has two full-time teachers to provide extra support for struggling students and a bilingual community liaison to help educate the school's largely immigrant parents about their children's academic needs.

"Kids are so hungry and ready to learn," said Maria Villegas, the principal. "It just takes time, opportunity and having a great staff."

teresa.watanabe@latimes.com

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Oscars have clear favorites, wild-card MacFarlane

LOS ANGELES (AP) — Some firsts and other rarities are possible at Sunday night's Academy Awards. But if the Oscars could be just a little less predictable, the show might really be one for the record books.

Ben Affleck's "Argo" looks like it will uniquely claim best picture without a directing nomination, while "Lincoln" filmmaker Steven Spielberg and star Daniel Day-Lewis are favored to join exclusive lists of three-time Oscar winners.

If some longshots came in, the night could produce two more three-time acting winners — Sally Field from "Lincoln" and Robert De Niro for "Silver Linings Playbook."

We could also have the oldest or youngest acting winner ever — 86-year-old "Amour" star Emmanuelle Riva and 9-year-old Quvenzhane (Kwa-VEHN-ja-nay) Wallis of "Beasts of the Southern Wild."

The ABC television broadcast itself could set some fresh highs or lows. Oscar overseers keep talking about pacing and trimming fat from a ceremony that's dragged on interminably, approaching four and a half hours one year. Can they keep it tight and lively enough that viewers don't think about gouging out their eyes around the three-hour mark?

And what about host Seth MacFarlane? He's a classy, low-key guy in person, with an old-fashioned Sinatra-style singing voice that he'll no doubt put to use in a show that's shaping up as a music-heavy, Broadway-style celebration of cinema.

Yet MacFarlane's career is built on pushing the envelope — or crumpling it and tossing it in the trash — as he's tested the boundaries of good taste with such brazen shows as his animated series "Family Guy" and last summer's obscenity-laden blockbuster "Ted," which earned him a songwriting Oscar nomination.

The result could be a fun night for younger, hipper TV audiences that Oscar organizers are courting but a crude awakening for traditionalists who like their Academy Awards to lean more toward the sacred than the profane. Or it could be that MacFarlane makes the most of the thankless task of shepherding the Oscars, striking a nice balance between respecting Hollywood and poking fun at it.

"I think a little bit of that injected into the mix will go a long way, but I do also have to be mindful, in this instance, of not losing the audience that's there every year," MacFarlane said. "It's a different audience from my own, but I do have to be respectful that they will be watching."

So maybe it's an Oscar show that's shaken, but not stirred up too much. That might suit one of the evening's special honorees, British super-spy James Bond, whose adventures will be the subject of a tribute to mark the 50th anniversary of his first big-screen outing in "Dr. No." Adele will perform her Oscar-nominated title tune to last year's Bond tale "Skyfall," while the show features Shirley Bassey, who sang the Bond theme songs for "Goldfinger," ''Diamonds Are Forever" and "Moonraker."

The show presents a salute to movie musicals of the last decade, with "Chicago" Oscar winner Catherine Zeta-Jones and "Dreamgirls" winner Jennifer Hudson joining "Les Miserables" cast members that include best-actor nominee Hugh Jackman, supporting-actress front-runner Anne Hathaway, Russell Crowe, Helena Bonham Carter and Amanda Seyfried.

Oscar producers Craig Zadan and Neil Meron have lined up a bubbly mix of young and old Hollywood as presenters, performers and special guests — from Barbra Streisand, Michael Douglas and Jane Fonda to "Harry Potter" star Daniel Radcliffe, "Twilight" star Kristen Stewart, and Robert Downey Jr. and his superhero colleagues from "The Avengers."

Along with front-runners Day-Lewis as best actor for "Lincoln" and Hathaway as supporting actress for "Les Miserables," the other favorites are Jennifer Lawrence as best actress for "Silver Linings Playbook" and Tommy Lee Jones as supporting actor for "Lincoln."

Day-Lewis would be only the sixth performer to earn three or more Oscars and the first to win three times as best actor. "Lincoln" also could make Spielberg just the fourth filmmaker to win three or more directing trophies.

Affleck's thriller "Argo" is in line for best picture after winning practically every top prize at earlier honors. Hollywood was shocked that Affleck was snubbed for a directing nomination, possibly earning the film some sympathy votes, particularly from actors, who love it when one of their own succeeds behind the camera.

The story of how Hollywood, Canada and the CIA teamed up to rescue six Americans during the Iranian hostage crisis, "Argo" would become just the fourth film in 85 years to claim the top prize without a best-directing nomination and the first since 1989's "Driving Miss Daisy."

The best-picture prize typically ends the Oscar show, but this time, MacFarlane and Kristin Chenoweth will perform a closing number on the Dolby Theatre stage that producers Zadan and Meron called a "'can't miss' moment."

Keeping the wraps on whatever surprises they have in store has been a chore for them and MacFarlane.

"It's been difficult. The press, as you know, is very nosy and sneaky. They're always sniffing around trying to get any advance notice," MacFarlane said. "It's like (expletive) Christmas. Wait till Christmas morning. Don't spoil the surprise."

___

AP Entertainment Writer Sandy Cohen contributed to this report.

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The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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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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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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