Singer feared dead in Mexican plane crash

MONTERREY, Mexico (AP) — Mexico's music world mourned Jenni Rivera, the U.S.-born singer presumed killed in a plane crash whose soulful voice and openness about her personal troubles had made her a Mexican-American superstar.

Authorities have not confirmed her death, but Rivera's relatives in the U.S. say they have few doubts that she was on the Learjet 25 that disintegrated on impact Sunday in rugged territory in Nuevo Leon state in northern Mexico.

"My son Lupillo told me that effectively it was Jenni's plane that crashed and that everyone on board died," her father, Pedro Rivera, told dozens of reporters gathered in front of his Los Angeles-area home. "I believe my daughter's body is unrecognizable."

He said that his son would fly to Monterrey Monday.

Messages of condolence poured in from fellow musicians and celebrities.

Mexican songstress and actress Lucero wrote on her Twitter account: "What terrible news! Rest in peace ... My deepest condolences for her family and friends." Rivera's colleague on the Mexican show "The Voice of Mexico," pop star Paulina Rubio, said on her Twitter account: "My friend! Why? There is no consolation. God, please help me!"

Born in Long Beach, California, Rivera was at the peak of her career as perhaps the most successful female singer in grupero, a male-dominated regional style influenced by the norteno, cumbia and ranchero styles.

A 43-year-old mother of five children and grandmother of two, the woman known as the "Diva de la Banda" was known for her frank talk about her struggles to give a good life to her children despite a series of setbacks.

She was recently divorced from her third husband, was once detained at a Mexico City airport with tens of thousands of dollars in cash, and she publicly apologized after her brother assaulted a drunken fan who verbally attacked her in 2011.

Her openness about her personal troubles endeared her to millions in the U.S. and Mexico.

"I am the same as the public, as my fans," she told The Associated Press in an interview last March.

Rivera sold 15 million records, and recently won two Billboard Mexican Music Awards: Female Artist of the Year and Banda Album of the Year for "Joyas prestadas: Banda." She was nominated for Latin Grammys in 2002, 2008 and 2011.

Transportation and Communications Minister Gerardo Ruiz Esparza said "everything points toward" the wreckage belonging to the plane carrying Rivera and six other people to Toluca, outside Mexico City, from Monterrey, where the singer had just given a concert.

"There is nothing recognizable, neither material nor human" in the wreckage found in the state of Nuevo Leon, Ruiz Esparza said. The impact was so powerful that the remains of the plane "are scattered over an area of 250 to 300 meters. It is almost unrecognizable."

A mangled California driver's license with Rivera's name and picture was found in the crash site debris.

No cause was given for the plane's crash, but its wreckage was found near the town of Iturbide in Mexico's Sierra Madre Oriental, where the terrain is very rough.

The Learjet 25, number N345MC, took off from Monterrey at 3:30 a.m. local time and was reported missing about 10 minutes later. It was registered to Starwood Management of Las Vegas, Nevada, according to FAA records. It was built in 1969 and had a current registration through 2015.

Also believed aboard the plane were her publicist, Arturo Rivera, her lawyer, makeup artist and the flight crew.

Though drug trafficking was the theme of some of her songs, she was not considered a singer of "narco corridos," or ballads glorifying drug lords like other groups, such as Los Tigres del Norte. She was better known for singing about her troubles in love and disdain for men.

Her parents were Mexicans who had migrated to the United States. Two of her five brothers, Lupillo and Juan Rivera, are also well-known singers of grupero music.

She studied business administration and formally debuted on the music scene in 1995 with the release of her album "Chacalosa". Due to its success, she recorded two more independent albums, "We Are Rivera" and "Farewell to Selena," a tribute album to slain singer Selena that helped expand her following.

At the end of the 1990s, Rivera was signed by Sony Music and released two more albums. But widespread success came for her when she joined Fonovisa and released her 2005 album titled "Partier, Rebellious and Daring."

Besides being a singer, she is also a businesswoman and actress, appearing in the indie film Filly Brown, which was shown at the Sundance Film Festival, as the incarcerated mother of Filly Brown.

She was filming the third season of "I love Jenni," which followed her as she shared special moments with her children and as she toured through Mexico and the United States. She also has the reality shows: "Jenni Rivera Presents: Chiquis and Raq-C" and her daughter's "Chiquis 'n Control."

In 2009, she was detained at the Mexico City airport when she declared $20,000 in cash but was really carrying $52,167. She was taken into custody. She said it was an innocent mistake and authorities gave her the benefit of the doubt and released her.

In 2011, her brother Juan assaulted a drunken fan at a popular fair in Guanajuato. In the face of heavy criticism among her fans and on social networks, Rivera publicly apologized for the incident during a concert in Mexico City, telling her fans: "Thank you for accepting me as I am, with my virtues and defects."

On Saturday night, Rivera had given a concert before thousands of fans in Monterrey. After the concert she gave a press conference during which she spoke of her emotional state following her recent divorce from former Major League Baseball pitcher Esteban Loaiza, who played for teams including the New York Yankees and Los Angeles Dodgers.

"I can't get caught up in the negative because that destroys you. Perhaps trying to move away from my problems and focus on the positive is the best I can do. I am a woman like any other and ugly things happen to me like any other woman," she said Saturday night. "The number of times I have fallen down is the number of times I have gotten up."

Rivera had announced in October that she was divorcing Loaiza after two years of marriage.

There have been several high-profile crashes involving Learjets, known as swift, longer-distance passenger aircraft popular with corporate executives, entertainers and government officials.

A Learjet carrying pro-golfer Payne Stewart and five others crashed in northeastern South Dakota in 1999. Investigators said the plane lost cabin pressure and all on board died after losing consciousness for lack of oxygen. The aircraft flew for several hours on autopilot before running out of fuel and crashing in a corn field.

Former Blink 182 drummer Travis Barker was severely injured in a 2008 Learjet crash in South Carolina that killed four people.

That same year, a Learjet slammed into rush-hour traffic in a posh Mexico City neighborhood, killing Mexico's No. 2 government official, Interior Secretary Juan Camilo Mourino, and eight others on the plane, plus five people on the ground.

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Associated Press Writer Galia Garcia-Palafox and Olga R. Rodriguez contributed to this report from Mexico City.

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The New Old Age Blog: Training Needed for Home Care Is Lacking

“H” from Chicago, I heard you when you joined a lively discussion over hospice at home here a couple of weeks ago and asked, “where can family members get the training to do all the nursing tasks?”

In the comments section, many readers wrote in to say that caring for relatives at the end of their lives was a duty and a privilege. Others said they were unprepared for the physical and emotional burdens of doing so.

Your question stood out because of its practical character. Do caregivers have to figure out how to handle all these complicated medical issues on their own? Or is some help out there?

For an answer, I called two of the authors of “Home Alone: Family Caregivers Providing Complex Chronic Care,” put out by the United Hospital Fund and the AARP Public Policy Institute. That study recently made headlines by reporting that 46 percent of the nation’s 42 million caregivers handle medical and nursing tasks such as giving injections, caring for wounds or administering I.V.s.

Susan Reinhard, senior vice president and director of the AARP Public Policy Institute, sighed when I reached her, and said “this is a huge gap,” referring to a notable absence of available training in demanding caregiving tasks.

To the extent training exists through local agencies on aging, disease-specific organizations or social service groups, it deals mostly with so-called “activities of daily living” — helping someone bath, dress, eat, or use the bathroom — not the demands of nursing-style care, Ms. Reinhard observed.

Really, this kind of training should be the responsibility of health care providers, but doctors and nurses often give only cursory, unsatisfactory explanations of complex tasks that fall to caregivers, said Carol Levine, director of the Families and Health Care Project of the United Hospital Fund.

That leaves the burden on caregivers to be assertive and ask for help, these experts agreed. If someone is hospitalized and ready to return home, they suggest asking a nurse or another provider “show me what you are doing so I can learn how to do it,” and then asking “now, watch me do it and tell me if I am doing it wrong or right.”

Don’t give up after the first time if you feel awkward or uncomfortable. Ask to do the task again, and ask again for feedback.

No videos or written manuals, can substitute for this one-on-one, hands-on instruction. If you don’t get it to your satisfaction before a loved-one is ready to go home, don’t sign the form that says you have been given instructions on what to do, Ms. Reinhard advised. The hospital is legally obligated to ensure that discharges are safe, and this operates in your favor.

The same goes for the pharmacy: don’t sign that sheet that the pharmacist hands you indicating that you have been adequately informed about the medications you are purchasing. If you are concerned about the number of prescriptions, what they are for, their possible side effects and whether all are necessary, ask the pharmacist to sit down with you and go over all this information. Again, don’t leave until you are satisfied.

Often, caregiving tasks will change as someone with a chronic condition like Parkinson’s disease or heart failure becomes more frail. Should this happen, consider calling a home care agency and asking for a nurse to come out and teach you how to administer oxygen or help transfer someone safely from a bed to a wheelchair, Ms. Reinhard said.

You may want to videotape the session so you can view it several times; most of us don’t pick these skills up right away and need repeat practice, Ms. Levine said.

Be as specific in your request for help as possible. Rather than complaining that you are overwhelmed, say something along the lines of, “I want to make sure I know how to clean this wound and prevent an infection” or “I need to know what texture the food should be so I can feed mom without having her choke,” Ms. Levine suggested.

Her organization has prepared comprehensive materials for caregivers called “Next Step in Care.” While the focus isn’t on nursing-style caregiving tasks, three might be useful: a self-assessment tool for family caregivers, a medication management guide, and a guide to hospice and palliative care.

Other helpful materials are few and far between. Ms. Levine’s staff identified a $24.95 American Red Cross training manual for family caregivers that has a DVD explaining the mechanics of transfers and a few other complicated tasks. Also, some videos are available for free at www.mmlearn.org, a Web site that says its mission is to provide caregivers with online training and education.

Asked about model programs, Ms. Reinhard said she knew of only one: the Schmieding Home Caregiver Training Program in Arkansas, operated by the Donald W. Reynolds Institute on Aging of the University of Arkansas for Medical Sciences. The Schmieding program trains family caregivers as well as professional caregivers who work in people’s homes or nursing homes.

On the family side, it offers eight hours of instruction in “physical needs” associated with caregiving — managing incontinence, skin care, turning someone regularly in bed, using adaptive equipment, transfers from a bed to a wheelchair, helping patients remain mobile, and more. Classes are offered at five sites and four more are planned in the next several years, said Robin McAtee, associate director of the Reynolds Institute on Aging. If people, churches or senior centers want the instruction, which is free, Schmieding nurses will take the program to them. One-on-one instruction for tasks is also available on request.

A separate eight-hour program is available for caregivers dealing with dementia, who have additional concerns.

At a Web site called Elder Stay at Home, Schmieding sells a package of materials (three DVDs and a booklet, for $99) summarizing the content of its family caregiver training program. Separately, it has begun selling its curriculum for paid caregivers, and programs in California, Hawaii and Texas are among the first buyers. The University of Arkansas for Medical Sciences also has received a $3.7 million innovation grant from the government to expand the caregiver training program more broadly and develop online training materials.

Ms. Reinhard said AARP would like to see Schmieding-style programs rolled out across the country and begin to offer structured, reliable support to caregivers now providing nursing-style care in homes with little or no assistance.

What else am I missing here? Do you know of resources or other organizations providing intensive caregiver training along the lines of what I’ve been discussing? Where would you suggest people turn for this kind of help?

Editor’s Note:

Correction: An earlier version of this post contained an incorrect spelling of the first name of the director of the Families and Health Care Project of the United Hospital Fund. She is Carol Levine, not Carole Levine.

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AIG to sell Century City aircraft leasing firm to Chinese investors

WASHINGTON --  American International Group announced it is selling a majority stake in its Century City aircraft leasing company to Chinese investors as the insurance giant continued to shed non-essential assets to help pay off its government bailout money.

AIG has been trying to sell International Lease Finance Corp. since the 2008 financial crisis. The firm owns or manages more than 1,000 aircraft, which it rents to nearly every major airline worldwide. 

The aircraft leasing company's headquarters will remain in Los Angeles, according to AIG and the investor group led by Weng Xianding, chairman of New China Trust Co. They announced the sale late on Sunday.

The Chinese investors, which also include China Aviation Industrial Fund and P3 Investments, have agreed to buy 80.1% of the company, known as ILFC, for about $4.23 billion. They have an option to acquire another 9.9% stake.

The deal values the company at $5.28 billion.

AIG will keep at least 10% of ILFC. The sale, which faces regulator reviews in the U.S. and China, is expected to close in the spring.

“While ILFC is an extremely strong business platform and AIG will retain a minority stake as a passive investor, the aircraft leasing business is not core to our insurance operations," AIG Chief Executive Robert Benmosche said.

"Upon completion, the transaction will have a positive impact on AIG’s liquidity and credit profile and will enable us to continue to focus on our core insurance businesses,” he said.

AIG has been making asset sales to pay off about $125 billion in bailout money it received from the Treasury Department and the Federal Reserve.

Treasury officials said in September that the government had made a $15.1 billion profit as it has been selling shares of AIG to reduce the taxpayer-owned stake to 15.9% from a high of 92%.

AIG data by YCharts

ALSO:

AIG in talks to sell aircraft-leasing company

Delta Air Lines adds humor to its safety videos

AIG stock sale nets additional $2.7 billion to boost U.S. profit

Follow Jim Puzzanghera on Twitter and Google+.

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Chavez to have more cancer surgery in Cuba

CARACAS, Venezuela—

Venezuelan President Hugo Chavez is heading back to Cuba on Sunday for more surgery for cancer, announcing on television that the illness has returned after two previous operations, chemotherapy and radiation treatment.

Chavez acknowledged the seriousness of his situation in an address Saturday night, saying for the first time that if he suffers complications Vice President Nicolas Maduro should take his place as Venezuela's leader and continue his socialist movement.

"There are risks. Who can deny it?" Chavez said, seated at the presidential palace beside Maduro and other aides.

"In any circumstance, we should guarantee the advance of the Bolivarian Revolution," Chavez said.

Outside medical experts said that based on Chavez's account of his condition, he is facing a very difficult fight against an aggressive type of cancer.

The president, who just returned from Cuba early Friday, said tests had found a return of "some malignant cells" in the same area where tumors were previously removed.

Chavez, who has yet to be sworn in for his new term after winning re-election on Oct. 7, said he would return to Havana on Sunday and would undergo the operation in the coming days.

Chavez's quick trip home appeared aimed at sending a clear directive to his inner circle that Maduro is his chosen successor. He called for his allies to pull together, saying: "Unity, unity, unity."

Chavez said his doctors had recommended he have the surgery right away, but that he had told them he wanted to return to Venezuela first.

"I want to go there. I need to go to Venezuela," Chavez recalled telling his doctors. "And what I came for was this," he said, seated below a portrait of independence hero Simon Bolivar, the inspiration of his Bolivarian Revolution movement.

Chavez named Maduro, his longtime foreign minister, as his choice for vice president three days after winning re-election. Maduro, a burly former bus driver, has shown unflagging loyalty and become a leading spokesman for Venezuela's socialist leader in recent years.

The vice president's expression was solemn as Chavez said that Maduro should become president if any complication were to prevent him from finishing his current term, which concludes in early January. Chavez said that if new elections are held, his movement's candidate should be Maduro.

"In that scenario, which under the constitution would require presidential elections to be held again, you all elect Nicolas Maduro as president," Chavez said. "I ask that of you from my heart."

Chavez held a small blue copy of the constitution in his hands and waved it. The Venezuelan constitution says that if a president-elect dies before taking office, a new election should be held within 30 days and that in the meantime the president of the National Assembly is to be in charge of the government.

While he spoke, Chavez was flanked by both Maduro and National Assembly President Diosdado Cabello.

Chavez is scheduled to be sworn in for a new six-year term Jan. 10, and he called his relapse a "new battle."

This will be his third operation to remove cancerous tissue in about a year and a half.

The 58-year-old president first underwent surgery for an unspecified type of pelvic cancer in Cuba in June 2011, after an operation for a pelvic abscess earlier in the month found the cancer. He had another cancer surgery last February after a tumor appeared in the same area. He has also undergone chemotherapy and radiation treatments.

Chavez said tests immediately after his re-election win had shown no sign of cancer. But he said he had swelling and pain, which he thought was due to "the effort of the campaign and the radiation therapy treatment."

"It's a very sensitive area, so we started to pay a lot of attention to that," he said, adding that he had reduced his public appearances.

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Rolling Stones rock Brooklyn at anniversary gig

NEW YORK (AP) — It sure didn't feel like a farewell.

The Rolling Stones — average age 68-plus, if you're counting — were in rollicking form as they rocked the Barclays Center in Brooklyn for 2½ hours Saturday night, their first U.S. show on a mini-tour marking a mind-boggling 50 years as a rock band.

And although every time the Stones tour, the inevitable questions arise, — whether it's "The Last Time," to quote one of their songs — there was no sign that anything is ending anytime soon.

"People say, why do you keep doing this?" mused 69-year-old Mick Jagger, the band's impossibly energetic frontman, before launching into "Brown Sugar." ''Why do you keep touring, coming back? The answer is, you're the reason we're doing this. Thank you for buying our records and coming to our shows for the last 50 years."

Jagger was in fine form, with strong vocals and his usual swagger — strutting, jogging, skipping and pumping his arms like a man half his age. And though he briefly donned a flamboyant feathered black cape for "Sympathy for the Devil" and later, some red-sequined tails, he was mostly content to prowl the stage in a tight black T-shirt and trousers.

The band's guitarists, the brilliant Keith Richards and Ronnie Wood, alternated searing solos and occasionally ventured onto a stage extension that brought them closer to the crowd. The now-gray Richards, wearing a red bandana, exuded the easy familiarity of a favorite uncle: "While we wait for Ronnie," he said at one point, "I'll wish you happy holidays." Watts, the dapper drummer in a simple black T-shirt, smiled frequently at his band mates.

The grizzled quartet was joined on "Gimme Shelter" by Mary J. Blige, who traded vocals with Jagger and earned a huge cheer at the end. Also visiting: the Texas blues guitarist Gary Clark Jr.

The sense of nostalgia was heightened by projections on a huge screen of footage of the early days, when the Stones looked like teenagers. At one point, Jagger reminisced about the first time the band played New York — in 1964.

A carton of milk cost only a quarter then, he said. And a ticket to the Rolling Stones? "I don't want to go there," he quipped. It was a reference to the sky-high prices at the current "50 and Counting" shows, where even the "cheap" seats cost a few hundred dollars and a prime seat cost in the $700 range or higher.

From the opening number, "Get Off Of My Cloud," the band played a generous 23 songs, including two new ones — "Doom and Gloom" and "One More Shot" — but mostly old favorites. The rousing encore included "Jumping Jack Flash," of course, but the final song was "Satisfaction." And though the song speaks of not getting any, the consensus of the packed 18,000-seat arena was that it was a satisfying evening indeed.

"If you like the Stones, this was as good a show as you could have had," said one fan, Robert Nehring, 58, of Westfield, N.J., who'd paid $500 for his seat. "It was worth it," he said simply.

The Brooklyn show was a coup for the new Barclays Center — there are no Manhattan shows. It followed two rapturously received Stones shows in London late last month. The band also will play two shows in Newark, N.J., on Dec. 13 and 15.

And just before that, the Stones will join a veritable who's who of British rock royalty and U.S. superstars at the blockbuster 12-12-12 Superstorm Sandy benefit concert at Madison Square Garden. Also scheduled to perform: Paul McCartney, the Who, Eric Clapton, Bruce Springsteen & The E Street Band, Alicia Keys, Kanye West, Eddie Vedder, Billy Joel, Roger Waters and Chris Martin.

In a flurry of anniversary activity, the band also released a hits compilation last month with two new songs, "Doom and Gloom" and "One More Shot," and HBO premiered a new documentary on their formative years, "Crossfire Hurricane."

The Stones formed in London in 1962 to play Chicago blues, led at the time by the late Brian Jones and pianist Ian Stewart, along with Jagger and Richards, who'd met on a train platform a year earlier. Bassist Bill Wyman and Watts were quick additions.

Wyman, who left the band in 1992, was a guest at the London shows last month, as was Mick Taylor, the celebrated former Stones guitarist who left in 1974 and replaced by Wood, the newest Stone and the youngster at 65.

The inevitable questions have been swirling about the next step for the Stones: another huge global tour, on the scale of their last one, "A Bigger Bang," which earned more than $550 million between 2005 and 2007? Something a bit smaller? Or is this mini-tour, in the words of their new song, really "One Last Shot?"

The Stones won't say. But in an interview last month, they made clear they felt the 50th anniversary was something to be marked.

"I thought it would be kind of churlish not to do something," Jagger told The Associated Press. "Otherwise, the BBC would have done a rather dull film about the Rolling Stones."

There certainly was nothing dull about the band's performance on Saturday, a show that brought together many middle-aged fans, to be sure, but also some of their children, who seemed to be enjoying the classic Stones brand of blues-tinged rock as much as their parents.

Yes, a Stone's average age might be a bit higher than that of the average Supreme Court justice. (To be fair, the newest justices bring the average down). But to watch these musicians play with vitality and vigor a half-century on is to believe that maybe they were right when they sang, "Time Is On My Side." At least for a few more years.

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Associated Press writer David Bauder contributed to this report.

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New Taxes to Take Effect to Fund Health Care Law

WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

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Leaders and their feeders

A favorite question at entrepreneurship conferences is which world city has the entrepreneurial dynamism to become a major start-up capital on par with Silicon Valley. London, Singapore, Tel Aviv, New York and Berlin are usually cited.

Seldom, however, do you hear anyone propose Boulder, Colo.

That is, unless you are in the company of Brad Feld, an early-stage investor, technology entrepreneur and author of "Startup Communities: Building an Entrepreneurial Ecosystem in Your City," published by Wiley.

Feld is a regular speaker on venture capital investing and entrepreneurship, having founded his first company in 1987. Twitter is not a perfect measure of the quality of a person's opinions, but you do not get 113,000 followers without having a degree of respect from your peer group.

He is a Texan who co-founded his first company in Boston and for 20 years has been proud to call Boulder his home.

To him, this city of just 100,000 people, nestled near Rocky Mountain National Park and a short drive from Denver, is not just the best place to live. He also sees Boulder as an excellent example for those who wish to turn their own town into a start-up community.

"Although I don't have the data to support it, Boulder may have the highest entrepreneurial density in the world," he writes.

Having said that, Feld wants to make clear that all sorts of cities across the world can become home to job-creating new businesses if only they foster the necessary culture.

He sets out a framework for a successful start-up community — that it be led by entrepreneurs with a long-term commitment to the area, that the community be inclusive of anyone who wants to participate and that there be a constant stream of activities that engage all the parties.

Feld differentiates between the entrepreneurial "leaders" of a community and the "feeders," who must support but not try to take charge.

Feeders include government agencies, lawyers, accountants, local universities and angel investors. Problems often occur and areas fail to become start-up communities, he notes, when feeders, rather than the people creating the businesses, try to control the development of an entrepreneurial ecosystem.

This should serve as a warning to Mayor Michael Bloomberg's administration in New York, which is trying to nurture the city's collection of fast-growing Web businesses, nicknamed Silicon Alley.

The book is also an insight into why the U.S. is such an entrepreneurial nation. The generosity of spirit still prevalent in U.S. society shines through Feld's writing. It is a key reason why so many have felt it is where they can achieve their dreams.

"Give before you get" is a mantra repeated several times by Feld. A key message is the power of community, which relies on people committing to their neighborhood for a couple of decades at least.

He also has a short answer for the people who ask how they can create the next Silicon Valley: They can't.

"Trying to create the next Silicon Valley is a fool's errand," he writes. "If that's really your goal, save yourself a lot of heartache and simply move to Silicon Valley."

It is clear from the way he writes about Boulder that Feld has no intention of moving farther west himself any time soon. "I can't imagine a better place to live," he says.

My only criticism is that almost all of his frame of reference is the U.S. His only mention of anywhere else in the world is a brief account of a trip to see some start-ups in Iceland.

But if more people loved and contributed to the places they live, as Feld and others have evidently done in Boulder, we probably would have more start-up communities around the world for him to visit.

Moules is the enterprise correspondent of the Financial Times of London, in which this review first appeared. He is also author of "The Rebel Entrepreneur," published by Kogan Page.

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Surgeon infected patients during heart procedure, Cedars-Sinai admits

A heart surgeon at Cedars-Sinai Medical Center unwittingly infected five patients during valve replacement surgeries earlier this year, causing four of the patients to need a second operation.

The infections occurred after tiny tears in the latex surgical gloves routinely worn by the doctor allowed bacteria from a skin inflammation on his hand to pass into the patients' hearts, according to the hospital. The patients survived the second operation and are still recovering, hospital officials said.

The outbreak led to investigations by the hospital and both the L.A. County and California departments of public health. The federal Centers for Disease Control and Prevention was also consulted.

Hospital officials called it a "very unusual occurrence" probably caused by an unfortunate confluence of events: the nature of the surgery, the microscopic rips in the gloves and the surgeon's skin condition. Valve replacement requires the surgeon to use thick sutures and tie more than 100 knots, which can cause extra stress on the gloves, they said.

Nevertheless, the hospital's goal is to have zero infections, said Harry Sax, vice chairman of the hospital's department of surgery. "Any hospital-acquired infection is unacceptable," he said.

The infections raise questions about what health conditions should prevent a surgeon from operating and how to get the best protection from surgical gloves. Surgeons with open sores or known infections aren't supposed to operate, but there is no national standard on what to do if they have skin inflammation, said Rekha Murthy, medical director of the hospital's epidemiology department. She added that there were also no national standards on types of gloves used, whether to wear double gloves or how many times surgeons should change those gloves during a procedure.

Healthcare-acquired infections are very common throughout the United States. Each year, infections cause 99,000 deaths in the country, including about 12,000 in California. Hospitals in the state are required to report certain infections to the California Department of Public Health. That reporting makes the public more aware of the quality of care provided at local hospitals and is an important tool for reducing infections, said Debby Rogers, deputy director of the department's Center for Health Care Quality.

Cedars-Sinai has low rates for hospital-acquired infections compared with the state and national average but has not performed as well on other surgical quality measures recently, according to the Leapfrog Group, an employer-backed nonprofit focused on healthcare quality. The organization gave the hospital a C rating last month on its national report card, down from an A in June, though it was not related to the infection outbreak.

"Clearly this hospital is making attempts to reduce infections, but they have more work to do," said Leah Binder, Leapfrog's chief executive.

Cedars-Sinai Medical Center conducts about 360 valve replacement surgeries each year and said infections occur in fewer than 1% of its cases — lower than the national average.

The hospital learned about the problem in June after three patients who had undergone valve replacement surgery showed signs of infection. Doctors diagnosed the patients with an infection called endocarditis. Concerned there might be a connection among the cases, epidemiologists analyzed the bacteria, staphylococcus epidermidis, and determined that it was an identical strain and therefore must have come from a single source. "It led to the question of gee, I wonder where it came from?" Murthy said.

Epidemiologists homed in on the surgeon with the skin inflammation. The bacteria matched, and then they made a surprising discovery: microscopic tears in the gloves typically worn by surgeons after performing valve replacement surgery. The surgeon, whose name was not released, was not allowed to operate again until he healed. He is still a member of the medical staff but no longer performs surgeries at the hospital.

The hospital soon found the same infection in two more patients. Officials also reached out to 67 patients who had heart valve replacements with the same surgeon but didn't find any other cases. One of the five infected patients was treated with antibiotics, and the other four had new valve replacement surgeries. Sax said the hospital apologized to the patients and has continued to monitor their health. The hospital has also covered the cost of their care, including follow-up treatment and all the related surgeries.

All surgeons doing valve replacements are now required to change gloves more frequently, officials said. Some surgeons are wearing double gloves during the operations, Sax said.

Following the outbreak, Cedars-Sinai did the proper follow-up to ensure the safety of their patients, said Dawn Terashita, a medical epidemiologist with L.A. County, who was notified in September. What occurred at Cedars-Sinai was an unintentional consequence of the surgery, she said.

"There is no way to keep a room entirely sterile and all the people in it sterile," she said. "You will always have risk of infection."

anna.gorman@latimes.com

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FCC chairman urges FAA to revise in-flight iPad rules

No, it doesn’t make any sense that you have to turn off your iPad or Kindle during airplane landings, and now the chairman of the Federal Communications Commission wants to see that change. In a letter to the Federal Aviation Administration, FCC chairman Julius Genachowski urged the agency to “enable greater use of tablets, e-readers, and other portable devices” on flights, The Hill reports. Genachowski went on to say that letting passengers use their devices more during flights is important because “mobile devices are increasingly interwoven in our daily lives” and that they “enable both large and small businesses to be more productive and efficient, helping drive economic growth and boost U.S. competitiveness.”

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Lupus forces singer Toni Braxton into LA hospital

LOS ANGELES (AP) — Singer Toni Braxton has been hospitalized in Los Angeles.

The R&B performer says in a Tweet on Friday that she's been hospitalized because of "minor health issues" related to Lupus. A spokeswoman confirmed the hospitalization but had no other details. "But no worries!," Braxton wrote to fans. "I will be out any day now."

The 45-year-old singer of "Un-break My Heart" revealed two years ago she has Lupus, a potentially deadly autoimmune disease that killed Braxton's uncle. She also suffers from a narrowing of the blood vessels in her heart.

Braxton said in a recent "20/20" interview that doctors told her the Lupus diagnosis meant her performing career would likely be diminished and the disease helped push her into a recent bankruptcy.

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Online:

http://tonibraxton.com

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