Well: What Housework Has to Do With Waistlines

Phys Ed

Gretchen Reynolds on the science of fitness.

One reason so many American women are overweight may be that we are vacuuming and doing laundry less often, according to a new study that, while scrupulously even-handed, is likely to stir controversy and emotions.

The study, published this month in PLoS One, is a follow-up to an influential 2011 report which used data from the U.S. Bureau of Labor Statistics to determine that, during the past 50 years, most American workers began sitting down on the job. Physical activity at work, such as walking or lifting, almost vanished, according to the data, with workers now spending most of their time seated before a computer or talking on the phone. Consequently, the authors found, the average American worker was burning almost 150 fewer calories daily at work than his or her employed parents had, a change that had materially contributed to the rise in obesity during the same time frame, especially among men, the authors concluded.

But that study, while fascinating, was narrow, focusing only on people with formal jobs. It overlooked a large segment of the population, namely a lot of women.

“Fifty years ago, a majority of women did not work outside of the home,” said Edward Archer, a research fellow with the Arnold School of Public Health at the University of South Carolina in Columbia, and lead author of the new study.

So, in collaboration with many of the authors of the earlier study of occupational physical activity, Dr. Archer set out to find data about how women had once spent their hours at home and whether and how their patterns of movement had changed over the years.

He found the information he needed in the American Heritage Time Use Study, a remarkable archive of “time-use diaries” provided by thousands of women beginning in 1965. Because Dr. Archer wished to examine how women in a variety of circumstances spent their time around the house, he gathered diaries from both working and non-employed women, starting with those in 1965 and extending through 2010.

He and his colleagues then pulled data from the diaries about how many hours the women were spending in various activities, how many calories they likely were expending in each of those tasks, and how the activities and associated energy expenditures changed over the years.

As it turned out, their findings broadly echoed those of the occupational time-use study. Women, they found, once had been quite physically active around the house, spending, in 1965, an average of 25.7 hours a week cleaning, cooking and doing laundry. Those activities, whatever their social freight, required the expenditure of considerable energy. (The authors did not include child care time in their calculations, since the women’s diary entries related to child care were inconsistent and often overlapped those of other activities.) In general at that time, working women devoted somewhat fewer hours to housework, while those not employed outside the home spent more.

Forty-five years later, in 2010, things had changed dramatically. By then, the time-use diaries showed, women were spending an average of 13.3 hours per week on housework.

More striking, the diary entries showed, women at home were now spending far more hours sitting in front of a screen. In 1965, women typically had spent about eight hours a week sitting and watching television. (Home computers weren’t invented yet.)

By 2010, those hours had more than doubled, to 16.5 hours per week. In essence, women had exchanged time spent in active pursuits, like vacuuming, for time spent being sedentary.

In the process, they had also greatly reduced the number of calories that they typically expended during their hours at home. According to the authors’ calculations, American women not employed outside the home were burning about 360 fewer calories every day in 2010 than they had in 1965, with working women burning about 132 fewer calories at home each day in 2010 than in 1965.

“Those are large reductions in energy expenditure,” Dr. Archer said, and would result, over the years, in significant weight gain without reductions in caloric intake.

What his study suggests, Dr. Archer continued, is that “we need to start finding ways to incorporate movement back into” the hours spent at home.

This does not mean, he said, that women — or men — should be doing more housework. For one thing, the effort involved is such activities today is less than it once was. Using modern, gliding vacuum cleaners is less taxing than struggling with the clunky, heavy machines once available, and thank goodness for that.

Nor is more time spent helping around the house a guarantee of more activity, over all. A telling 2012 study of television viewing habits found that when men increased the number of hours they spent on housework, they also greatly increased the hours they spent sitting in front of the TV, presumably because it was there and beckoning.

Instead, Dr. Archer said, we should start consciously tracking what we do when we are at home and try to reduce the amount of time spent sitting. “Walk to the mailbox,” he said. Chop vegetables in the kitchen. Play ball with your, or a neighbor’s, dog. Chivvy your spouse into helping you fold sheets. “The data clearly shows,” Dr. Archer said, that even at home, we need to be in motion.

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What's next for revitalized Chicago Loop?









Michael Edwards has only been in town for a few months, but the new executive director of the Chicago Loop Alliance says the warm reception he's getting makes him feel part of something distinctly Chicago.


There's the strong handshake upon meeting. Direct eye contact. A hearty "Welcome to Chicago," he notes. "It's really a dynamic thing," Edwards says with a laugh. "I get it all the time."


A Buffalo, N.Y., native who took the role in November, Edwards arrived at a crucial time for the alliance, which is charged with representing downtown businesses and promoting the area as a destination to live, work and play. On the rebound from the Great Recession, the Loop is aiming to solidify its place as a hub for businesses, retail and residents — from college students to urban professionals to empty nesters who seek easy access to transportation, Millennium Park and museums.





But the return hasn't been easy. During the economic downturn, vacancies shot up, but a rash of new apartments are under construction in downtown Chicago. Target Corp. filled the long-empty Carson Pirie Scott & Co. storefront with its new urban format on State Street in July, and a few blocks up The Gap will open a new store in the spring. State Street's crown jewel, Block 37, is still trying to land a big tenant to drive more foot traffic to the mall.


Now that vacancies are declining and rents are climbing, Edwards and other civic leaders are aiming to figure out what's next for the business district and State Street retail corridor.


At its annual meeting Tuesday, Edwards and the Chicago Loop Alliance announced development of a five-year strategic plan aimed at clarifying the organization's role in economic development, housing, transportation, tourism, culture and services in the Loop. It's the first ever in the organization's history.


The process will tap input from business owners, elected officials, civic leaders and alliance board members, said Edwards, who held similar positions in Pittsburgh and Spokane, Wash. He replaced executive director Ty Tabing, who left in the summer to head up an economic development organization in Singapore.


The strategic planning process is under way, and a draft is due in June. Oakland, Calif.- based MIG Inc. was hired to assist in developing the new strategy.


With the Loop moving in the right direction, it's time to shift gears and ask residents and business owners what they think of its opportunities and challenges, as well as the role of the alliance, Edwards says.


The need for a new plan is driven in part by Edwards' arrival, but also by the fact that the State Street special service area, one of 44 local tax districts that fund expanded services and programs with a property tax levy, is up for renewal in 2016. The State Street SSA collects about $2.5 million annually.


Part of the planning process will include determining whether the SSA, which is administered by the Chicago Loop Alliance and pays for such services as public way maintenance and district marketing, security and economic development, should be expanded to encompass all of the Loop's business and retail districts, including Dearborn Street and Wabash Avenue as well as North Michigan Avenue, he said.


No decisions have been yet, Edwards said. "We're pretty focused on State Street, but can we provide that level of service to other areas?" he said.


Edwards said the new strategy will also determine whether the alliance, which has an annual budget of about $3.4 million, should take on a larger role as an advocate for the Loop.


"We have a website that's all about our members that gets about 10,000 hits a year, and we need about 2 million hits a year. And we need to control the narrative about what's going on downtown," he said.


With other local organizations such as Choose Chicago and World Business Chicago tasked with touting the region, "Is there a role for us to amplify this notion that we're an authentic American city that's an economic engine for the region?" asked Edwards. "Is there a role for the CLA to help promote that or not?"


If the new focus of the alliance has yet to be determined, Edwards has few opinions. Any new partnerships with other local groups, he said, will have to be formed "organically."


And he predicts the alliance's focus will likely shift to "typical downtown management duties — keeping the area safe and clean," coupled with "a little more economic development sensibility as opposed to an arts sensibility," he said.


For years, the Chicago Loop Alliance has run the PopUp Art Loop program in which public art was showcased in vacant storefronts. But the number of empty retail spaces along State Street has been cut in half, to about six, Edwards said.


Now that State Street has evolved, it's time the alliance's role evolved too, according to officials.


"We're seeing a lot of tremendous opportunities for growth in the Loop, whether it's in retail, new companies coming downtown, new residents or tourism," said Martin Stern, executive vice president and managing director at US Equities Realty and board chairman of the Chicago Loop Alliance.


Added Edwards: "There's a sort of feeling that we need to be more focused, provide more value, provide more leadership."


crshropshire@tribune.com


Twitter @corilyns





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Chicago could see 6 inches of snow in Tuesday storm









Abundant sunshine and temperatures close to 50 degrees in the past few days teased sober Midwestern sensibilities.


Encouraged perhaps by spring training photos, some people deliberately ventured outside. Some even hopped on bicycles for spins. Maybe they dared to think that spring could break a little early this year.


But on Tuesday morning, for the second time in less than a week, a blustery mix of freezing rain, sleet and snow is forecast to hit the Chicago area. Accumulations could reach 6 inches.








Sure, weather predictions being what they are around here, many will shrug off the warnings and be brazenly optimistic. But it might be best to recall the adage that those who ignore history are sure to be victimized by it.


Chicago has plenty of late-season snow history and, regardless of what materializes, the prudent will keep their salt dry, snow shovels handy and snowblowers primed for the next couple of months.


National Weather Service records from 2011 show that 54 of the previous 139 years — nearly 40 percent — experienced at least one day with an inch or more of snowfall on or after March 25. A total of 17 of those years brought multiple days with more than an inch of snow to Chicago.


One year, 1926, included six days when more than an inch of snow fell after March 25.


And, like some cruel trick, the later in the season the snow falls, the heavier and deadlier it tends to be. On the other hand, it also generally melts faster.


Among the grimmest of those late snowfalls was the deadly storm of April 15-17, 1961, when a rainy low-pressure system stalled and kept looping over the Chicago region. It transformed cold rain into nearly 7 inches of snow. Six people died from the storm's effects; four were victims of snow-shoveling heart attacks.


That storm remains the latest major snowfall of 6 inches or more in the Chicago area.


More recently, the area was hit with nearly 2 inches of snow on March 27, 2008. On March 29, 2009, 1.2 inches accumulated. A week later, more than 2 inches of snow fell.


Tuesday's forecast, which calls for heavier snow north of Interstate 80 and winds whipping up to 35 mph, weighed on Jason Marker's mind while he stood at the Downers Grove Metra station Monday.


"I have a job interview tomorrow," said Marker, 30, of Downers Grove. "It's going to be tough getting there because I have to ride my bike."


Still, he said the winter has been a moderate one so far, "but maybe it will catch up with us tomorrow."


Ashley Feuillan and Bernard Thomas, also of Downers Grove, will be commuting in opposite directions Tuesday morning. Thomas commutes to a job in Aurora, which he starts at 7 a.m. Feuillan hops the train to Columbia College Chicago three times a week.


Both said they plan to leave earlier Tuesday.


"I actually like the snow," said Feuillan, 24, "but it can be a hassle when you're trying to get someplace."


Rather than focusing on what could be a nasty storm, Thomas, 40, kept an upbeat perspective.


"It hasn't been a bad winter," he said. "We haven't really had any big snowstorms."


If the forecast is accurate, Jake Weimer could receive a little relief.





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Horse Meat in European Beef Raises Questions on U.S. Exposure





The alarm in Europe over the discovery of horse meat in beef products escalated again Monday, when the Swedish furniture giant Ikea withdrew an estimated 1,670 pounds of meatballs from sale in 14 European countries.




Ikea acted after authorities in the Czech Republic detected horse meat in its meatballs. The company said it had made the decision even though its tests two weeks ago did not detect horse DNA.


Horse meat mixed with beef was first found last month in Ireland, then Britain, and has now expanded steadily across the Continent. The situation in Europe has created unease among American consumers over whether horse meat might also find its way into the food supply in the United States. Here are answers to commonly asked questions on the subject.


Has horse meat been found in any meatballs sold in Ikea stores in the United States?


Ikea says there is no horse meat in the meatballs it sells in the United States. The company issued a statement on Monday saying meatballs sold in its 38 stores in the United States were bought from an American supplier and contained beef and pork from animals raised in the United States and Canada.


“We do not tolerate any other ingredients than the ones stipulated in our recipes or specifications, secured through set standards, certifications and product analysis by accredited laboratories,” Ikea said in its statement.


Mona Liss, a spokeswoman for Ikea, said by e-mail that all of the businesses that supply meat to its meatball maker  issue letters guaranteeing that they will not misbrand or adulterate their products. “Additionally, as an abundance of caution, we are in the process of DNA-testing our meatballs,” Ms. Liss wrote. “Results should be concluded in 30 days.”


Does the United States import any beef from countries where horse meat has been found?


No. According to the Department of Agriculture, the United States imports no beef from any of the European countries involved in the scandal. Brian K. Mabry, a spokesman for the department’s Food Safety and Inspection Service, said: “Following a decision by Congress in November 2011 to lift the ban on horse slaughter, two establishments, one located in New Mexico and one in Missouri, have applied for a grant of inspection exclusively for equine slaughter. The Food Safety and Inspection Service (F.S.I.S.) is currently reviewing those applications.”


Has horse meat been found in ground meat products sold in the United States?


No. Meat products sold in the United States must pass Department of Agriculture inspections, whether produced domestically or imported. No government financing has been available for inspection of horse meat for human consumption in the United States since 2005, when the Humane Society of the United States got a rider forbidding financing for inspection of horse meat inserted in the annual appropriations bill for the Agriculture Department. Without inspection, such plants may not operate legally.


The rider was attached to every subsequent agriculture appropriations bill until 2011, when it was left out of an omnibus spending bill signed by President Obama on Nov. 18. The U.S.D.A.  has not committed any money for the inspection of horse meat.


“We’re real close to getting some processing plants up and running, but there are no inspectors because the U.S.D.A. is working on protocols,” said Dave Duquette, a horse trader in Oregon and president of United Horsemen, a small group that works to retrain and rehabilitate unwanted horses and advocates the slaughter of horses for meat. “We believe very strongly that the U.S.D.A. is going to bring inspectors online directly.”


Are horses slaughtered for meat for human consumption in the United States?


Not currently, although live horses from the United States are exported to slaughterhouses in Canada and Mexico. The lack of inspection effectively ended the slaughter of horse meat for human consumption in the United States; 2007 was the last year horses were slaughtered in the United States. At the time financing of inspections was banned, a Belgian company operated three horse meat processing plants — in Fort Worth and Kaufman, Tex., and DeKalb, Ill. — but exported the meat it produced in them.


Since 2011, efforts have been made to re-establish the processing of horse meat for human consumption in the United States. A small plant in Roswell, N.M., which used to process beef cattle into meat has been retooled to slaughter 20 to 25 horses a day. But legal challenges have prevented it from opening, Mr. Duquette said. Gov. Susana Martinez of New Mexico opposes opening the plant and has asked the U.S.D.A. to block it.


Last month, the two houses of the Oklahoma Legislature passed separate bills to override a law against the slaughter of horses for meat but kept the law’s ban on consumption of such meat by state residents. California, Illinois, New Jersey, Tennessee and Texas prohibit horse slaughter for human consumption.


Is there a market for horse meat in the United States?


Mr. Duquette said horse meat was popular among several growing demographic groups in the United States, including Tongans, Mongolians and various Hispanic populations. He said he knew of at least 10 restaurants that wanted to buy horse meat. “People are very polarized on this issue,” he said. Wayne Pacelle, chief executive of the Humane Society of the United States, disagreed, saying demand in the United States was limited. Italy is the largest consumer of horse meat, he said, followed by France and Belgium.


Is horse meat safe to eat?


That is a matter of much debate between proponents and opponents of horse meat consumption. Mr. Duquette said that horse meat, some derived from American animals processed abroad, was eaten widely around the world without health problems. “It’s high in protein, low in fat and has a whole lot of omega 3s,” he said.


The Humane Society says that because horse meat is not consumed in the United States, the animals’ flesh is likely to contain residues of many drugs that are unsafe for humans to eat. The organization’s list of drugs given to horses runs to 29 pages.


“We’ve been warning the Europeans about this for years,” Mr. Pacelle said. “You have all these food safety standards in Europe — they do not import chicken carcasses from the U.S. because they are bathed in chlorine, and won’t take pork because of the use of ractopamine in our industry — but you’ve thrown out the book when it comes to importing horse meat from North America.”


The society has filed petitions with the Department of Agriculture and Food and Drug Administration, arguing that they should test horse meat before allowing it to be marketed in the United States for humans to eat.


This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated how many pounds of meatballs Ikea was withdrawing from sale in 14 European countries. It is 1,670 pounds, not 1.67 billion pounds.

This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated the last year that horses were slaughtered in the United States. It is 2007, not 2006.




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5 of top 15 teaching hospitals in Chicago area















































Five of the country's top 15 major teaching hospitals are in the Chicago area, according to an annual study released Monday that evaluates performance in 10 categories of publicly available data.

The study, conducted by Truven Health Analytics, the former health care business of Thomson Reuters, listed seven Chicagoland hospitals among the nation's top 100, including four owned by Advocate Health Care.

Researchers evaluated 2,922 acute-care hospitals using information from the federal Centers for Medicare and Medicaid Services, including cost, patient satisfaction and quality measures, such as re-admission rates, patient safety, mortality and medical complications.  Hospitals do not apply or pay for inclusion on the list, which has been produced since 1993.


The seven Illinois hospitals that made the Top 100


  • Advocate Christ Medical Center in Oak Lawn

  • Advocate Illinois Masonic Medical Center in Chicago

  • Advocate Lutheran General Hospital in Park Ridge

  • Advocate Good Samaritan Hospital in Downers Grove

  • Central DuPage Hospital in Winfield

  • NorthShore University HealthSystem in Evanston

  • Northwestern Memorial Hospital in Chicago













pfrost@tribune.com | Twitter: @peterfrost




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State lawmaker's bill seeks to limit use of drones to fight crime









SPRINGFIELD — As the Obama administration comes under fire for its use of unmanned drones in foreign lands, a state senator is pressing to have Illinois join the national debate on whether states should regulate drones to ensure the high-tech snooping isn't used to invade the privacy of ordinary citizens on U.S. soil.


Democratic Sen. Daniel Biss has introduced legislation that would require police to get a search warrant before using a drone to gather evidence. Along with banning the use of lethal and nonlethal weapons on the drones — except in emergencies — the proposal would require information a drone gathers to be destroyed unless it is part of an investigation.


Under the legislation, Illinois would step up to combat the issue of drones flying over U.S. airspace. President Barack Obama signed a Federal Aviation Administration mandate last year requesting the agency integrate unmanned aircraft into the national system.





With the possibility of drones becoming the latest aircraft traversing the skies, Biss said this is "the exact moment states should be looking into" unmanned aircraft legislation.


"We're heading into a world where technology surveillance is unreal," the Evanston lawmaker said.


More than 20 states are pursuing similar legislation, according to the National Conference of State Legislatures. While some states are trying to regulate unmanned aircraft use, others are trying to impose moratoriums that ban them, Biss said.


Virginia lawmakers approved a two-year moratorium on the aircraft in the state last week to allow time for a study. The legislation awaits the governor's signature.


In Illinois, authorities in Cook and Champaign counties are considering the use of drones to combat crime.


Cook County Sheriff Tom Dart is in the "exploratory stages" of looking into drone technology for future operations, spokesman Frank Bilecki said. If the county were to employ any drones, they would be "specifically for law enforcement use" and not to invade personal privacy, Bilecki said.


Dart's thinking is that drones would be cheaper to use and cost less taxpayer money than using helicopters for aerial operations, Bilecki said. A small, unmanned aircraft used for search and rescue can cost on average between $38,000 and $50,000, much less than in years past, said James Hill, president of AirCover Integrated Solutions, a California-based drone manufacturer.


To gain traction at the Capitol, Biss potentially might have to overcome resistance from law enforcement leaders. To that end, Biss said he's talking with police chiefs, the Illinois State Police and other police agencies to iron out any wrinkles.


The American Civil Liberties Union thinks the time is ripe to look at drone regulations.


"Technology is changing," said Ed Yohnka, spokesman for the ACLU's Illinois chapter. "And the idea is we need to get ahead of the technology to be better prepared."


raguerrero2@tribune.com



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Shia LaBeouf and Alec Baldwin “Incompatible”? Actor tweets about exit From “Orphans”






(Please note that this story contains strong language in paragraphs 10 and 21.)


LOS ANGELES (TheWrap.com) – Shia LaBeouf is taking a cue from his former co-star Alec Baldwin and using Twitter to defend his actions – in this case his split from “Orphans” on Broadway.






The show, which begins previews in less than a month, was to be the “Transformers” star’s Great White Way debut. In a brief statement Wednesday, the actor’s departure was attributed to those pesky “creative differences.”


But LaBeouf, whose propensity to over-share has gotten him in trouble in the past, took to Twitter within hours of the announcement to post private emails from the show’s director Daniel Sullivan and co-stars Baldwin and Tom Sturridge.


He also mused about the role of theater in society and posted his audition video for the show (he’s twitchy, intense and, it must be said, pretty convincing as a criminal with a short fuse).


The correspondence does little to clarify the reasons for his abrupt exit, though his exchange with Sullivan hints at chemistry issues with Baldwin.


“I’m too old for disagreeable situations,” Sullivan writes. “You’re one hell of a great actor. Alec is who he is. You are who you are. You two are incompatible. I should have known it. This one will haunt me. You tried to warn me. You said you were a different breed. I didn’t get it.”


But an individual close to the production told TheWrap that the split had nothing to do with Baldwin; it was due to conflicts between the star and the show’s producers, Frederick Zollo and Robert Cole.


Spokespeople for the production did not respond to requests for comment.


In his emails, LaBeouf also demonstrates a flair for the dramatic that New York theater critics will be denied an opportunity to see in the flesh.


“My dad was a drug dealer,” LaBeouf writes. “He was a shit human. But he was a man. He taught me how to be a man. What I know of men Alec is.”


“A man owns up,” he adds. “That’s why Mark McGuire is not a man.”


If the message from Baldwin is to be believed, LaBeouf’s former cast-mate wishes him well.


After LaBeouf apologizes for creating a “disagreeable situation,” Baldwin assures him he doesn’t have an “unkind word to say about you.”


“I’ve been through this before,” Baldwin writes. “It’s been a while. And perhaps some of the particulars are different. But it comes down to the fact that what we all do now is critical. Perhaps especially for you. When the change comes, how do we handle it, whether it be good or bad? What do we learn?”


A spokesman for Baldwin declined to comment and a spokeswoman for LaBeouf did not respond to requests for comment.


Sturridge also is complimentary in his note to LaBeouf.


“I was stunned by the work you were doing, the performance you were giving,” he writes.”I think you lifted the play to a place higher than maybe it even deserved to be.”


This is not the first time that LaBeouf has gotten in trouble for running his mouth off in public. In the past he irritated Steven Spielberg by speaking ill of their collaboration on “Indiana Jones and the Kingdom of the Crystal Skull”; said Oliver Stone played too nice when they teamed up on “Wall Street 2: Money Never Sleeps,” and once revealed that he hooked up with “Transformers” co-star Megan Fox when she was on a break from her husband Brian Austin Green.


His frank talk and propensity to criticize former collaborators has inspired at least one high-profile rebuke.


Harrison Ford told Details Magazine that he was displeased by his co-stars comments about the Indiana Jones sequel.


“I think I told him he was a f—ing idiot,” Ford said. “As an actor, I think it’s my obligation to support the film without making a complete ass of myself.”


On Wednesday and Thursday, LaBeouf also took the opportunity to share some colorful thoughts about acting, as well as some historical lessons of questionable veracity.


“Actors used to be buried with a stake through the heart,” he tweeted. “Those peoples performances so troubled on-lookers that they feared their ghosts.”


Oh, and based on his messages with Rick Sordelet, the show’s fight director and a faculty member at Yale University’s drama school, an MFA may be in LaBeouf’s future…possibly one from a certain New Haven-based institute of higher learning.


In a message, Sordelet hails LaBeouf’s work ethic and says he has been in touch with the head of the school’s acting program about having him matriculate.


“It must have been difficult for others in the room to be schooled by someone who’s raw talent and enthusiasm out matched theirs,” Sordelet writes.


Sounds like somebody might be passing James Franco on the quad some day soon.


Celebrity News Headlines – Yahoo! News




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‘Bloodless’ Lung Transplants for Jehovah’s Witnesses


Eric Kayne for The New York Times


SHARING HOME AND FAITH A Houston couple hosted Gene and Rebecca Tomczak, center, in October so she could get care nearby.







HOUSTON — Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.




She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.


The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.


Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?


By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.


By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.


“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”


Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.


Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.


Ms. Tomczak had dismissed the prospect of a transplant for most of the two years she had struggled with sarcoidosis, a progressive condition of unknown cause that leads to scarring in the lungs. The illness forced her to quit a part-time job with Nielsen, the market research firm.


Then in April, on a trip to the South Carolina coast, she found that she was too breathless to join her frolicking grandchildren on the beach. Tethered to an oxygen tank, she watched from the boardwalk, growing sad and angry and then determined to reclaim her health.


“I wanted to be around and be a part of their lives,” Ms. Tomczak recalled, dabbing at tears.


She knew there was danger in refusing to take blood. But she thought the greater peril would come from offending God.


“I know,” she said, “that if I did anything that violates Jehovah’s law, I would not make it into the new system, where he’s going to make earth into a paradise. I know there are risks. But I think I am covered.”


Cutting Risks, and Costs


The approach Dr. Scheinin would use — originally called “bloodless medicine” but later re-branded as “patient blood management” — has been around for decades. His mentor at Methodist, Dr. Denton A. Cooley, the renowned cardiac pioneer, performed heart surgery on hundreds of Witnesses starting in the late 1950s. The first bloodless lung transplant, at Johns Hopkins, was in 1996.


But nearly 17 years later, the degree of difficulty for such procedures remains so high that Dr. Scheinin and his team are among the very few willing to attempt them.


In 2009, after analyzing Methodist’s own data, Dr. Scheinin became convinced that if he selected patients carefully, he could perform lung transplants without transfusions. Hospital administrators resisted at first, knowing that even small numbers of deaths could bring scrutiny from federal regulators.


“My job is to push risk away,” said Dr. A. Osama Gaber, the hospital’s director of transplantation, “so I wasn’t really excited about it. But the numbers were very convincing.”


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ComEd chief hopes to spark positive change









Every organization has its low point. For Commonwealth Edison, it was in summer 2011 when a storm left more than 850,000 people without power, some for days.


Customers flocked to the phones for information and were shocked to find that they were not only in the dark, but in the dark ages. They waited on hold for hours, only to hear the same message every 45 minutes. They couldn't find out when their power would be restored, what had caused the outage or how many other people were affected.


Residents raged about ComEd on Facebook and Twitter and to mayors, state representatives, and fire and police departments. Dealing with wires that blocked roadways, nursing homes without power and angry residents with spoiled groceries, these public officials turned back to ComEd — only to receive misinformation or no information at all.





For soon-to-be-instated CEO Anne Pramaggiore, it was a blaring wake-up call: Customers hated the utility.


"We heard our customers loud and clear that summer," Pramaggiore said. "Everything else in the world is instantaneous, and they don't understand why they have to sit and wait without power or information."


Fast-forward to today, and customers can text, call, look online, use an iPhone or Android app or communicate with a ComEd representative on Twitter or Facebook. In less than a year, the company's smartphone app has generated more than 1 million transactions and 59,000 downloads.


"We're on a mission to improve service to our customers," said Pramaggiore, 54.


The good news is that the company has nowhere to go but up. Since 1999, ComEd has consistently ranked among the worst utilities in the Midwest for customer satisfaction in surveys conducted by The American Customer Satisfaction Index and J.D. Power and Associates.


Two months ago, the company had zero pending complaints for the first time in its history after working its way out of backlog in "the thousands," according to Miguel Ortega, director of customer technology and support for ComEd.


"Anne gets it," he said. "I've been around for quite a while. I've been through a lot of CEOs. She has made it a priority to put the customer in every aspect of our business, which is a huge cultural change."


The shift comes at a time when ComEd's parent company, Exelon Corp., is squeezing its three regulated utilities for revenue. The money Exelon receives for producing its mostly nuclear-powered electricity is not what it once was because of increased competition from natural gas and wind.


As a regulated utility that is paid by customers to deliver electricity regardless of which supplier they choose, ComEd is in a position to provide a steady, predictable stream of income to its parent if it can garner support from the General Assembly to pass legislation that will benefit its bottom line. But to get there, Pramaggiore must convince legislators — the same ones who have spent years fielding complaints from constituents about ComEd's abysmal service — that the company can change.


Legislation related to funding the so-called smart grid, passed into law in 2011 as part of the Energy Infrastructure Modernization Act, is making its way through Springfield and is worth about $1 billion to ComEd.


Within four years, Pramaggiore wants the utility that customers love to hate to be the utility that customers actually like, a plan she has spent countless hours communicating to every employee in the company.


"Whether you'll love your utility, I don't know. It's not the kind of business you ultimately love," said David Kolata, executive director of the Citizens Utility Board consumer advocacy group, a frequent opponent of ComEd. "We are encouraged and do think generally that her heart is in the right place. She does want to transform the company. Will that play out? It's too early to tell."


Inspires trust


While Pramaggiore's lawyerlike ability to boil down complex regulatory issues is impressive, her power lies in her charm. Gracious and savvy, she laughs easily and often, winning over opponents with humility and a down-to-earth speaking style that inspires trust.


Gloria Castillo, a personal friend of Pramaggiore and president of Chicago United, said her ability to listen is one of her greatest assets.


"Anne is really one of the highest-ranking women in energy anywhere in the country, but you never get the feeling that she thinks about herself in a way that's different," she said. "She's so striking. She has a unique ability to be so present in a conversation."


Indeed, Pramaggiore, a soccer mom who fits in at a Paul McCartney concert as easily as in a contentious hearing in Springfield, is disarming in her remarkable ability to appear unremarkable. She described her childhood in Dayton, Ohio, as a "quiet, suburban upbringing with good schools," with a father who was a civil engineer and a mom who was president of the local PTO.





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2 hurt, 19 arrested in melee near Ford City Mall









Two people suffered minor injuries and police arrested 19 teenagers during a disturbance involving crowds of young people Saturday at Ford City Mall on the Southwest Side, authorities said.


About 4:45 p.m., a large group of disruptive teens ran yelling through the mall, which is located at 7601 S. Cicero Ave., according to a mall official.


Officials closed the mall minutes later, but the chaotic scene continued outside, where police found between 100 and 200 people damaging vehicles in the shopping center's parking lot, according to a police report.





Two people were taken to hospitals, according to Chicago Fire Department Chief Joe Roccasalva, a department spokesman.

A CTA bus driver suffered minor injuries and was taken to Holy Cross Hospital, said Roccasalva, who added he did not know what happened to him.
 
A “kid’’ was also hurt, and that person was taken to Advocate Christ Medical Center in Oak Lawn, also in good condition, Roccasalva said.


About 50 police squad cars assigned to multiple South Side districts, including Chicago Lawn, Englewood and Deering, and a helicopter responded to the scene, police said.


Traffic came to a standstill as teenagers jumped on cars, both parked and moving, according to a police report obtained by the Tribune. Many of those involved ignored orders to disperse, and police arrested 19 people between the ages of 13 and 17, according to police.


The teenagers all face minor misdemeanor charges.


Officers did their best to control the disturbance, "trying to get everyone out of there safely," Chicago Police Department News Affairs Officer Veejay Zala said.


During the disturbance the CTA had to reroute the No. 79 buses, which travel on 79th Street, as well as other buses in the immediate area.


Earlier in the afternoon, members of the teen band Mindless Behavior had appeared at the mall food court from 2 p.m. to 4 p.m. to promote their new release, "All Around the World," said John Sarama, the mall's senior general manager.

The band's autograph signing drew approximately 1,000 parents and children, primarily mothers and girls between the ages of 6 and 13, Sarama said.

About 45 minutes after the band left, the chaos began, Sarama said.

"A group of older youths came into the mall with the intent of causing havoc and chaos and were running through the mall, screaming, yelling and so forth," he said.

Security staff contacted the police department, and mall officials closed the mall about 5 p.m., Sarama said.

The mall did not sustain any property damage apart from a single broken planter, and it will reopen Sunday at 11 a.m. as usual, Sarama said.

In the meantime, mall officials are at a loss as they try to understand what happened.

"Ford City is a family-oriented mall," he said. "We have not had an incident like this [in the past], and I’m still in a little bit of a state of shock actually.

"What would make these youths comes here to try and cause this kind of commotion and trouble?" he continued. "I don’t know. But they did have a plan in mind."

Tribune reporter Adam Sege contributed.


rsobol@tribune.com





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