Broncos, Ravens tied at 21 after 1st half

DENVER (AP) — Torrey Smith breezed past Champ Bailey for two long touchdowns as the Baltimore Ravens' quick-strike ability allowed them to keep up with the AFC's top-seeded Denver Broncos and head into halftime tied at 21 Saturday.

Smith had just two catches in the first half, but they covered 91 yards and both went for scores.

He sped past Bailey for a 59-yard TD in the first quarter and then beat him down the sideline for a 32-yard TD catch 36 seconds left before the break that capped a three-play, 58-yard drive that began after Matt Prater botched a 52-yard field goal attempt that would have given Denver a double-digit lead.

Smith beat Bailey several other times only to see Joe Flacco overthrow him, and Denver defensive coordinator Jack Del Rio was sure to reconsider his scheme not giving Bailey any safety help over the top so they could stay in and counter Baltimore's tough tight ends.

Running back Knowshon Moreno's first touchdown catch of the season, a 13-yard grab from Peyton Manning in tight coverage by linebacker Dannell Ellerbe, had given the Broncos a 21-14 lead.

The Ravens rebounded from Trindon Holliday's 90-yard punt return touchdown, the longest in NFL playoff history, to score two TDs in a 42-second span in the first quarter.

The 13-degree temperature at kickoffs made this the coldest playoff game ever played in Denver. The wind chill was 2. The only colder game played in Denver was against San Diego on Dec. 10, 1972, when the temperature was 9 degrees.

Manning, the league's only four-time MVP, was 0-3 in previous playoff games below 40 degrees, all while playing for the Indianapolis Colts, who released him last year after a series of neck operations.

Manning had a stellar bounce-back season in Denver, throwing for 4,659 yards and a team-record 37 TDs.

Wearing gloves on both hands for the first time in his career — the one on the right hand as much a concession to the altered feel of his grip following the four neck surgeries as it was for the wintry weather, Manning threw a 15-yard TD toss to Brandon Stokley to tie it at 14.

Holliday got the scoring started when he fielded Sam Koch's punt, broke one tackle and raced down the Ravens' sideline, avoiding the punter as he galloped into the end zone. The previous longest TD on a punt return in a playoff game was Jermaine Lewis' 88-yarder for Baltimore in 2001.

Jacoby Jones botched the ensuing kickoff return, losing the handle on the ball as he brought it out before smothering it at the 6.

After a key pass interference call on Tony Carter allowed the Ravens to get out from the shadow of their end zone, Baltimore tied it at 7 when Smith got behind Bailey and hauled in Flacco's 59-yard touchdown toss.

Forty-two seconds later, cornerback Corey Graham picked off a Manning pass that deflected off receiver Eric Decker and returned it 39 yards for the score — and the Broncos trailed for the first time since Dec. 2 against Tampa Bay.

The Broncos were trying to avoid becoming yet another No. 1 seed to lose in the divisional round. Since 2005, eight of the 14 top-seeded teams lost their first game in the playoffs, four in each conference.

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Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL

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‘Bodega Clinicas’ Draw Interest of Health Officials

HUNTINGTON PARK, Calif. — The “bodega clinicas” that line the bustling commercial streets of immigrant neighborhoods around Los Angeles are wedged between money order kiosks and pawnshops. These storefront offices, staffed with Spanish-speaking medical providers, treat ailments for cash: a doctor’s visit is $20 to $40; a cardiology exam is $120; and at one bustling clinic, a colonoscopy is advertised on an erasable board for $700.

County health officials describe the clinics as a parallel health care system, serving a vast number of uninsured Latino residents. Yet they say they have little understanding of who owns and operates them, how they are regulated and what quality of medical care they provide. Few of these low-rent corner clinics accept private insurance or participate in Medicaid managed care plans.

“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, the chairman of the family medicine department at the David Geffen School of Medicine at the University of California, Los Angeles.

Not that researchers have not tried. Dr. Dowling, for one, has canvassed the clinics for years to document physician shortages as part of his research for the state. What he and others found was that the owners were reluctant to answer questions. Indeed, multiple attempts in recent weeks to interview owners and employees at a half-dozen of the clinics in Southern California proved fruitless.

What is certain, however, is that despite their name, many of these clinics are actually private doctor’s offices, not licensed clinics, which are required to report regularly to federal and state oversight bodies.

It is a distinction that deeply concerns Kimberly Wyard, the chief executive of the Northeast Valley Health Corporation, a nonprofit group that runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Ms. Wyard of the bodega clinicas, “and it’s unclear what they’re doing.”

But with deadlines set by the federal Affordable Care Act quickly approaching, health officials in Los Angeles are vexed over whether to embrace the clinics and bring them — selectively and gingerly — into the network of tightly regulated public and nonprofit health centers that are driven more by mission than by profit to serve the uninsured.

Health officials see in the clinics an opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to two million uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care.

And the clinics, public health officials point out, are already well established in the county’s poorest neighborhoods, where they are meeting the needs of Spanish-speaking residents. The clinics also could continue to serve a market that the Affordable Care Act does not touch: illegal immigrants who are prohibited from getting health insurance under the law.

Dr. Mark Ghaly, the deputy director of community health for the Los Angeles County Department of Health Services, said bodega clinicas — a term he seems to have coined — that agree to some scrutiny could be a good way of addressing the physician shortage in those neighborhoods.

“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”

Los Angeles is not the only city with a sizable Latino population where the clinics have become a part of the streetscape. Health care providers in Phoenix and Miami say there are clinics in many Latino neighborhoods.

But their presence in parts of the Los Angeles area can be striking, with dozens in certain areas. Visits to more than two dozen clinics in South Los Angeles and the San Fernando Valley found Latino women in brightly colored scrubs handing out cards and coupons that promised a range of services like pregnancy tests and endoscopies. Others advertised evening and weekend hours, and some were open around the clock.

Such all-hours access and upfront pricing are critical, Latino health experts say, to a population that often works around the clock for low wages.

Also important, officials say, is that new immigrants from Mexico and Central America are more accustomed to corner clinics, which are common in their home countries, than to the sprawling medical complexes or large community health centers found in the United States. And they can get the kind of medical treatments — including injections of hypertension drugs, intravenous vitamins and liberally dispensed antibiotics — that are frowned upon in traditional American medicine.

The waiting rooms at the clinics reflected the everyday maladies of peoples’ lives: a glassy-eyed child resting listlessly on his mother’s lap, a fit-looking young woman waiting with a bag of ice on her wrist, a pensive middle-aged man in work boots staring straight ahead.

For many ordinary complaints, the medical care at these clinics may be suitable, county health officials and medical experts say. But they say problems arise when an illness exceeds the boundaries of a physician’s skills or the patient’s ability to pay cash.

Dr. Raul Joaquin Bendana, who has been practicing general medicine in South Los Angeles for more than 20 years, said the clinics would refer patients to him when, for example, they had uncontrolled diabetes. “They refer to me because they don’t know how to handle the situation,” he said.

The clinic physicians by and large appear to have current medical licenses, a sample showed, but experts say they are unlikely to be board certified or have admitting privileges at area hospitals. That can mean that some clinics try to treat patients who face serious illness.

Olivia Cardenas, 40, a restaurant worker who lives in Woodland Hills, Calif., got a free Pap smear at a clinic that advertises “especialistas,” including in gynecology. The test came back abnormal, and the doctor told Ms. Cardenas that she had cervical cancer. “Come back in a week with $5,000 in cash, and I’ll operate on you,” Ms. Cardenas said the doctor told her. “Otherwise you could die.”

She declined to pay the $5,000. Instead, a family friend helped her apply for Medicaid, and she went to a hospital. The diagnosis, it turned out, was correct.

Health care experts say the clinics’ medical practices would come under greater scrutiny if they were brought closer into the fold.

But being connected would mean the clinics’ cash-only business model would need to change. Dr. Dowling said the lure of newly insured patients in 2014 might draw them in. “To the extent there are payments available,” he said, “the legitimate ones might step up to the plate.”

This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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Aaron Swartz, Internet Activist, Dies at 26

Michael Francis McElroy for The New York Times

Aaron Swartz in 2009.

Aaron Swartz, a wizardly programmer who as a teenager helped develop code that delivered ever-changing Web content to users and later became a steadfast crusader to make that information freely available, was found dead on Friday in his New York apartment.

He was 26.

 An uncle, Michael Wolf, said that Mr. Swartz had apparently hanged himself, and that Mr. Swartz’s girlfriend had discovered the body.

At 14, Mr. Swartz helped create RSS, the nearly ubiquitous tool that allows users to subscribe to online information. He later became an Internet folk hero, pushing to make many Web files free and open to the public. But in July 2011, he was indicted on federal charges of gaining illegal access to JSTOR, a subscription-only service for distributing scientific and literary journals, and downloading 4.8 million articles and documents, nearly the entire library.

Charges in the case, including wire fraud and computer fraud, were pending at the time of Mr. Swartz’s death, carrying potential penalties of up to 35 years in prison and $1 million in fines.

“Aaron built surprising new things that changed the flow of information around the world,” said Susan Crawford, a professor at the Cardozo School of Law in New York who served in the Obama administration as a technology adviser. She called Mr. Swartz “a complicated prodigy” and said “graybeards approached him with awe.”

Mr. Wolf said he would remember his nephew as a young man who “looked at the world, and had a certain logic in his brain, and the world didn’t necessarily fit in with that logic, and that was sometimes difficult.”

The Tech, a newspaper of the Massachusetts Institute of Technology, reported Mr. Swartz’s death early Saturday.

Mr. Swartz led an often itinerant life that included dropping out of Stanford, forming companies and organizations, and becoming a fellow at Harvard University’s Edmond J. Safra Center for Ethics.

He formed a company that merged with Reddit, the popular news and information site. He also co-founded Demand Progress, a group that promotes online campaigns on social justice issues — including a successful effort, with other groups, to oppose a Hollywood-backed Internet piracy bill.

But he also found trouble when he took part in efforts to release information to the public that he felt should be freely available. In 2008, he took on PACER, or Public Access to Court Electronic Records, the repository for federal judicial documents.

The database charges 10 cents a page for documents; activists like Carl Malamud, the founder of public.resource.org, have long argued that such documents should be free because they are produced at public expense. Joining Mr. Malamud’s efforts to make the documents public by posting legally obtained files to the Internet for free access, Mr. Swartz wrote an elegant little program to download 20 million pages of documents from free library accounts, or roughly 20 percent of the enormous database.

 The government abruptly shut down the free library program, and Mr. Malamud feared that legal trouble might follow even though he felt they had violated no laws. As he recalled in a newspaper account of the events, “I immediately saw the potential for overreaction by the courts.” He recalled telling Mr. Swartz: “You need to talk to a lawyer. I need to talk to a lawyer.”

 Mr. Swartz recalled in a 2009 interview, “I had this vision of the feds crashing down the door, taking everything away.” He said he locked the deadbolt on his door, lay down on the bed for a while and then called his mother.

 

When an article about his Pacer exploit was published in The New York Times, Mr. Swartz responded in a blog post in a typically puckish manner, announcing the story in the form of a personal ad: “Attention attractive people: Are you looking for someone respectable enough that they’ve been personally vetted by The New York Times, but has enough of a bad-boy streak that the vetting was because they ‘liberated’ millions of dollars of government documents? If so, look no further than page A14 of today’s New York Times.

The federal government investigated but decided not to prosecute.

In 2011, however, Mr. Swartz went beyond that, according to a federal indictment. In an effort to provide free public access to JSTOR, he broke into computer networks at M.I.T. by means that included gaining entry to a utility closet on campus and leaving a laptop that signed into the university network under a false account, federal officials said.

Ravi Somaiya contributed reporting.

This article has been revised to reflect the following correction:

Correction: January 12, 2013

An earlier version of this article incorrectly identified the police who arrested Mr. Swartz, and when they did so. The police were from Cambridge, Mass., not the Massachusetts Institute of Technology campus force, and the arrest occurred two years before Mr. Swartz’s suicide, but not two years to the day.

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Sri Lankan Parliament Impeaches Chief Justice

NEW DELHI — Defying a court order, Sri Lanka’s Parliament voted overwhelmingly on Friday to impeach the nation’s chief justice, a significant step in a worsening showdown between the legislature and the judiciary that has alarmed democracy advocates and many foreign governments.

President Mahinda Rajapaksa must now decide whether he is willing to take the last step in the impeachment process and dismiss Chief Justice Shirani Bandaranayake of the Supreme Court, who was seen as a Rajapaksa loyalist until September, when the court struck down provisions of a law that would have given greater power to the government’s economic development minister, Basil Rajapaksa, who is also the president’s brother.

The chief justice’s fall from grace since that ruling has been dizzying, with the state-controlled media sharply criticizing her. Impeachment proceedings began in November.

A parliamentary committee issued a guilty verdict against her in December, saying she had misused her power and failed to adequately declare her assets. Last week, an appeals court annulled the verdict and forbade further action by the Parliament against Chief Justice Bandaranayake.

The Parliament’s willingness to ignore the court’s ruling and impeach the chief justice anyway set the nation up for a possible constitutional crisis. Saliya Peiris, a lawyer for Chief Justice Bandaranayake, told The Associated Press that his client would not recognize the impeachment and that her next step would be announced later.

Since President Rajapaksa dominates the Parliament, the impeachment effort is widely seen by many democracy advocates as an effort by the president and his family to further consolidate power and eliminate any impediment to their almost complete control.

“The entire impeachment process is clearly politically motivated as a punishment to the chief justice for daring to apply the constitution in a way that went against the Rajapaksa administration,” Alan Keenan, of the International Crisis Group, said in an interview.

The parliamentary committee found Chief Justice Bandaranayake unfit for office on charges of failing to disclose details of 20 bank accounts and intervening in cases before the court in which she had a financial interest. She was also alleged to have sought to protect her husband from corruption charges.

She had protested the rapidity of the parliamentary proceeding and her inability to confront or cross-examine her accusers.

Lawmakers voted 155 to 49 on Friday to impeach.

On Wednesday, Victoria Nuland, the United States State Department spokeswoman, said that the department had “serious concerns about the actions that were taken to impeach the chief justice” and that the proceedings raised “serious questions about the process and government pressure on the judiciary.”

The United States Embassy in Colombo released a statement Friday repeating those concerns.

“This impeachment calls into question issues about the separation of powers in Sri Lanka and the impact of its absence on democratic institutions,” it said in a statement.

President Rajapaksa and his brothers are widely credited with ending one of the world’s longest and bloodiest civil wars in 2009 by defeating the separatist Liberation Tigers of Tamil Eelam. The war’s end brought stability to much of the country and has increased opportunities for tourism. But he and his brothers have been accused of being involved in unlawful killings by security forces and government-allied paramilitary groups, and a United Nations panel ruled that accusations against the Sri Lankan government of war crimes were credible and should be investigated.

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Canada natives block Harper’s office, threaten unrest

OTTAWA (Reuters) – Aboriginal protesters blocked the main entrance to a building where Canada’s prime minister was preparing to meet some native leaders on Friday, highlighting a deep divide within the country’s First Nations on how to push Ottawa to heed their demands.

The noisy blockade, which lasted about an hour, ended just before Prime Minister Stephen Harper and his aides met with about 20 native chiefs, even as other leaders opted to boycott the session.

Chiefs have warned that the Idle No More aboriginal protest movement is prepared to bring the economy to its knees unless Ottawa addresses the poor living conditions and high jobless rates facing many of Canada’s 1.2 million natives.

Native groups complain that successive Canadian governments have ignored treaties aboriginals signed with British settlers and explorers hundreds of years ago, treaties they say granted them significant rights over their territory.

The meeting was hastily arranged under pressure from an Ontario chief who says she has been subsiding only on liquids for a month. It took place in the Langevin Block, a building near Parliament in central Ottawa where the prime minister and his staff work.

Outside in the freezing rain, demonstrators in traditional feathered headgear shouted, waved burning tapers, banged drums and brandished banners with slogans such as “Treaty rights not greedy whites” and “The natives are restless.”

Until midday on Friday, it was uncertain if the meeting would go ahead, with many native leaders urging a boycott and others saying it was important to talk to the government.

“Harper, if you want our lands, our native land, meaning everyone of us, over my dead body, Harper, you’re going to do this,” said Raymond Robinson, a Cree from Manitoba.

“You’ll have to come through me first. You’ll have to bury me first before you get them,” he shouted toward the prime minister’s office from the steps outside Parliament.

The aboriginal movement is deeply split over tactics and not all the chiefs invited to the meeting turned up. Some leaders wanted Governor-General David Johnston, the official representative of Queen Elizabeth, Canada’s head of state, to participate.

Johnston has declined the invitation, saying it is not his place to get involved in policy discussions. He instead was later hosting a ceremonial meeting with native leaders at his residence.

The elected leader of the natives, Assembly of First Nations National Chief Shawn Atleo, was one of those who attended the meeting with Harper.

He said his people wanted a fundamental transformation in their relationship with the federal government, and would press for a fair share of revenues from resource development as well as action on schools and drinking water.

BANGED ON THE DOOR

Gordon Peters, grand chief of the association of Iroquois and Allied Nations in Ontario, threatened to “block all the corridors of this province” next Wednesday unless natives’ demands were met. Ontario is Canada’s most populous province and has rich natural resources.

Peters told reporters that investors in Canada should know their money was not safe.

“Canada cannot give certainty to their investors any longer. That certainty for investors can only come from us,” he said.

Manitoba Grand Chief Derek Nepinak, who said on Thursday that aboriginal activists have the power to bring the Canadian economy to its knees, was one of the leaders of the protest at the Langevin Block.

“We’re asking him to come out here and explain why he won’t speak to the people,” said Nepinak, who banged on the door at the main entrance to Harper’s offices after choosing to boycott the meeting.

Nepinak and other Manitoba chiefs are also demanding that Ottawa rescind parts of recent budget acts that they say reduce environmental protection for lakes and rivers. The most recent budget act also makes it easier to lease lands on the reserves where many natives live, a change some natives had requested to spur development but which others regard with suspicion.

Ottawa spends around C$ 11 billion ($ 11.1 billion) a year on its aboriginal population, but living conditions for many are poor, and some reserves have high rates of poverty, addiction, joblessness and suicide.

Harper agreed to the meeting with chiefs after pressure from Ontario chief Theresa Spence, who has been surviving on water and fish broth for the last month as part of a campaign to draw attention to the community’s problems. Spence, citing Johnston’s absence, said she would not attend.

“We shared the land all these years and we never got anything from it. All the benefits are going to Canadian citizens, except for us,” Spence told reporters. “This government has been abusing us, raping the land.”

In Nova Scotia, a group of about 10 protesters blockaded a Canadian National Railway Co line near the town of Truro on Friday afternoon, CN spokesman Jim Feeny said.

A truck had been partially moved onto the tracks and was cutting off the movement of container traffic on CN’s main line between the Port of Halifax and Eastern Canada, he said. Passenger services by Via Rail had also been disrupted.

The incident was the latest in a series of rail blockades staged by protestors in recent weeks to press the demands.

($ 1=$ 0.98 Canadian)

(Additional reporting by Louise Egan in Ottawa and Nicole Mordant in Vancouver; Editing by Vicki Allen and Dan Grebler)

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Alabama's Lacy, Milliner, Fluker enter NFL draft

TUSCALOOSA, Ala. (AP) — Alabama tailback Eddie Lacy, cornerback Dee Milliner and right tackle D.J. Fluker are entering the NFL draft after helping lead the Crimson Tide to a second straight national title.

Lacy and Milliner announced their plans to skip their senior seasons Friday at a news conference. Fluker couldn't be there for the announcement because he was traveling.

It's another exodus of talented underclassmen for a team that has won three of the past four national championships. Most of the four first-round picks in each of the past two drafts that left Alabama were underclassmen.

"I appreciate what they've done for the University of Alabama but we also acknowledge the fact that from a business standpoint, these guys are making good decisions about their future and what they can do," coach Nick Saban said.

Unlike recent groups of departing juniors from Alabama, only Milliner is pegged as a sure first-round pick.

He was a Jim Thorpe Award finalist and unanimous All-American after recording two interceptions and 22 pass deflections. He and guard Chance Warmack, who was a senior, are projected as the Tide's top current prospects.

"I think while I was here, I met all the goals and team affirmations that I set for myself as a freshman by winning a championship, becoming an All-American, just being part of a team that always loved to win," Milliner said. "I think I fulfilled all my goals and am ready and prepared to go to the next level."

Lacy was MVP of the national championship game against Notre Dame after rushing for 140 yards and scoring two touchdowns. He said he wasn't 100 percent healthy all season until the title game Monday night, but Lacy still ran for 1,322 yards and 17 touchdowns while averaging 6.5 yards per carry.

"We don't have a lot of years to play this position, so you have to go while you can," Lacy said. "I would love to come back. This is a great place. We have the best fans, but I really didn't want to risk coming back and not having such a good year or maybe even risking injury. I've had my share of injuries this year. I feel like you've got to get out while you can."

Lacy thinks he "made a pretty solid statement" in the title game, when he made a spin move into the end zone on a TD catch and on another run pushed 248-pound linebacker Danny Spond away with one hand.

Lacy was recruited in the same class as Trent Richardson, last year's No. 3 pick by Cleveland, but redshirted and then spent two seasons as a backup. He's not widely projected to follow Richardson and 2009 Heisman Trophy winner Mark Ingram into the first round. Lacy said he was projected as a second- or third-round pick in feedback from the NFL, but was impressive in the finale. Ordinarily, Saban only recommends projected first-round picks leave early.

"I'm fully supportive of what Eddie's doing," Saban said. "It's a little bit of a different situation than we've had in the past, but it's a little bit unique as well. Every one of these situations is unique to that particular individual and what his situation is. "

The 6-foot-6, 335-pound Fluker started 35 games for the Tide and was a second-team Associated Press All-American.

He was one of the Tide's top-rated signees in 2009 but came in overweight at about 395 pounds and was redshirted.

"I certainly feel like this year has been his best year as a player, and I feel that he's made a good decision about what he wants to do," said Saban, adding that Fluker has improved as much as any player on the team.

The mammoth Fluker, who wears a size-22 shoe, said in a statement that leaving early "is never an easy decision when you are playing at a place like Alabama."

"''These four years in Tuscaloosa have been the best four years of my life and I appreciate everyone who helped me along the way," he said.

Quarterback AJ McCarron, All-America linebacker C.J. Moseley and guard Anthony Steen have already said they're returning for their senior seasons. Saban didn't rule out other juniors possibly declaring for the draft before Tuesday's deadline.

The Tide does have promising players who have logged plenty of playing time behind Lacy and Milliner, especially. Two freshmen — tailback T.J. Yeldon (1,108 yards, 12 touchdowns) — and cornerback Geno Smith saw significant action.

"You've got people that are going to go to the NFL each year and you've got people behind them that are going to do the same things when their time comes," Milliner said.

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The New Old Age Blog: As Flu Rages, Caregiving Suffers

The flu started in the personal care center at Masonic Village in Elizabethtown, Pa., then moved to the nursing home. Within a few days, seven older adults had taken ill.

Administrators moved quickly: they shut down two floors of the buildings and told all visitors to stay away. All social activities stopped, and residents were asked to stay in their rooms.

The phones began to ring. “How is my wife doing?” an older spouse would ask. “What’s Mom eating?” a concerned daughter would inquire.

As the flu sweeps across the country, all kinds of issues are arising as institutions serving the elderly cope with outbreaks and nurses, home health aides and family members fall ill and can’t attend to the older people under their care.

One of the residents of Masonic Village was the mother-in-law of Joyce Heisey, director of nursing at this continuing care retirement community. She had come to the nursing home after a nasty fall and a subsequent hospitalization for rehabilitation.

“It was hard for her because she wasn’t accustomed to being in this kind of setting, and my father-in-law couldn’t visit,” said Ms. Heisey, who talked to her in-laws about their experiences. They declined to speak directly to a reporter.

Worried about isolation, the home sent recreation therapists into residents’ rooms for a few minutes each day and directed physical therapists to continue working with those undergoing rehabilitation, again in their rooms when possible.

In Collinsville, Ill., a city of about 42,000 that is 23 miles east of St. Louis, 20 percent of the staff at Home Instead Senior Care have called in sick, either struck by the flu themselves or at home taking care of a sick child.

“We’ve never seen it as bad as it is this year,” said Skip Brown, the agency’s owner. In previous years, about 5 percent of the staff have taken ill during flu season.

“It’s really hard for our clients, most of whom are elderly,” Mr. Brown said. “All of a sudden you have another person coming in to your home that you’re not familiar with. That’s really hard for seniors, and we have to make sure they’re comfortable.”

One client, a 92-year-old woman with diabetes, was insistent that a stranger not come to help when her usual caregiver became sick and stayed home.

“The problem that we’re always concerned with is, what if an older person doesn’t eat and what if they don’t take their medication?” Mr. Brown said. Concerned, he called his client’s out-of-town daughter, who called an elderly neighbor, who agreed to accompany someone from the agency to make sure the older woman was all right.

As it turned out, she hadn’t taken insulin for a full day and was at risk of a diabetic crisis, which was averted when the agency worker intervened.

Things got bad so fast that after the second week of December, Mr. Brown required all staff members to get flu shots – and still they became ill. This year, the flu shot is effective about 62 percent of the time, the Centers for Disease Control and Prevention said on Friday.

Nationally, about 60 percent of health care workers get flu vaccines, which are voluntary in most hospitals, nursing homes and assisted-living facilities, according to Dr. Gregory Poland, director of the Mayo Clinic Vaccine Research Group. And when workers are struck by the flu, infections among residents can follow.

“The disruptions, the costs, the complications from this virus, no one should confuse it with a minor illness,” said Dr. Poland, who has advocated for mandatory immunizations for health care workers.

According to New York’s statewide influenza report for the week ended Jan. 5, 179 outbreaks have hit nursing homes this flu season — 57 of them during the week covered by the report alone. The state health department defines an outbreak as one confirmed case or two suspected cases of flu that are contracted in a nursing home.

Allison Chisholm, a nurse with Partners in Care, a home care agency operated by the Visiting Nurse Service of New York, had a flu shot on Dec. 27 and a week later took to bed with a fever and chills.

“It was so bad, my toenails were hurting. I had no appetite. I couldn’t move, I was so sore,” she said. “I knew it was the flu because I’m not a sickly person. I’ve never felt like that for 30 years.”

Ms. Chisholm had been seeing a woman in her 70s every day since October to treat a bone infection with intravenous antibiotics. “When I called her she could hear immediately that something was wrong,” Ms. Chisholm said. “She was concerned and said, ‘If you’re sick like that, don’t come – I don’t want to get what you have.’ ” A week later, the nurse said she got a phone call from the older woman checking in to see if she was better.

In this case, the client was due to end treatment the day after Ms. Chisholm fell ill, and she agreed to have a worker from the company that supplied her intravenous supplies administer her last IV therapy.

At the Martha Stewart Living Center, an outpatient center for older patients at Mount Sinai Medical Center, Dr. Audrey Chun, medical director, has been telling caregivers and other people who have any kind of upper respiratory problems — a cough, constant sniffles – to stay away from older people’s homes because of the risk of passing on an infection.

But do be sure to call in regularly to ask how your older relative or friend is feeling and whether they have unusual lethargy, breathing problems or disabling fatigue, said Jennifer Leeflang, senior director of private care services for Partners in Care. The agency has been getting about 10 requests a week for flu shots for homebound elderly ($100 for the visit and the shot). Other hospitals, like Montefiore Medical Center in the Bronx, are providing a similar service for home care agency patients.

New data released Friday by the federal Centers for Disease Control and Prevention underscores how vulnerable older adults are to flu and how many are being affected by the current outbreak. In the week ended Jan. 5, the rate of flu-related hospitalizations for people 65 and older was 53.4 per 100,000, more than twice that of another vulnerable group, newborns and children up to 4 years old. Hospitalizations are an indicator of the most serious flu cases.

That’s a big jump from the week before, when the rate of flu-related hospitalizations for people 65 and older stood at 29.3 per 100,000.

How has flu season affected your ability to provide — or get care — for your elderly relative? Share your experiences and advice here.

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DealBook: Possible Client Redemptions Weigh on SAC Capital

The hedge fund giant SAC Capital Advisors is steeling itself for a possible wave of withdrawal requests from clients amid the government’s intensifying scrutiny of its trading practices.

Investors have about a month to decide whether to pull money from SAC, the $14 billion fund owned by the billionaire investor Steven A. Cohen.

While posting one of the best investment track records on Wall Street across two decades, SAC has attracted billions of dollars from pension funds, wealthy families and other money management firms. But since late November, when federal prosecutors brought their latest criminal insider trading charge against a former SAC employee — a case they call the most lucrative insider trading scheme ever uncovered — those clients have been weighing whether continuing their relationship with the fund is worth the reputational risk.

The fund has a standard quarterly redemption deadline, and the next one will fall on Feb. 15. Already, several of SAC’s clients, including Lyxor Asset Management and Titan Advisors, have notified the fund that they intend to withdraw their money. Others, like Skybridge Capital, have told SAC they will continue to invest in the fund.

Questions remain about the intentions of several of SAC’s well-known clients, including the Blackstone Group, one of the world’s largest and most influential allocators to hedge funds. Blackstone has about $550 million invested in SAC, making it one of the fund’s largest outside investors. A Blackstone spokesman declined to comment.

The fund has told its employees that it could face at least $1 billion of withdrawals, according to a report in The Wall Street Journal on Friday. A spokesman for SAC said it was “far too early to speculate about redemptions, and we do not expect redemptions to have a significant impact on our funds.”

Any withdrawals from clients would come after a year of decent performance for SAC. In 2012 the firm returned about 13 percent net of fees, which, while slightly underperforming the Standard & Poor’s 500-stock index, was superior to the results of the average hedge fund.

While a spate of redemptions can have a crippling effect on a hedge fund by forcing it to sell its holdings at unfavorable prices, SAC is more insulated than most of its competitors from the ill effects of client withdrawals. That is because only about 40 percent of the $14 billion that SAC manages comes from outside clients. The rest — a fortune of about $8 billion — belongs to Mr. Cohen and his employees.

Also, SAC has protected itself with a stringent redemption policy. Its clients can redeem only 25 percent of their investment each quarter. So, for example, if a client had $200 million invested with SAC and asked for its money back by the Feb. 15 deadline, SAC would return $50 million every three months beginning in March. That way, SAC is protected from a forced liquidation of its investment portfolio.

Still, an investor exodus can cause a hedge fund to shut down. Last month, Diamondback Capital Management, another hedge fund that became ensnared in the government’s insider trading investigation, closed after its investors sought to pull out roughly one-quarter of the fund’s assets.

Diamondback’s management decided that the most prudent course of action was to wind down rather than to reorganize the firm to manage the reduced amount of money.

Like Diamondback, SAC has become embroiled in the government’s broad crackdown on insider trading at hedge funds. At least seven former SAC traders and analysts have been tied to illegal trading while at the fund, and the Securities and Exchange Commission has warned SAC that it might file a civil action against the fund for failing to properly supervise its employees.

Mr. Cohen has told his employees that he believes he and the fund have at all times acted appropriately, and that the fund has fully cooperated with the government’s investigation.

In recent weeks, SAC has gone on a charm offensive in an effort to hold on to clients. It has told its investors that they will not be responsible for any penalties incurred as a result of any of the government’s legal inquiries. Instead, SAC has said, Mr. Cohen and his management company will pick up any costs.

There have also been changes at the fund. SAC told its staff last week that it was closing its office in Chicago, which is home to about a dozen employees. Such a move is not unusual, as the fund has closed offices before, like one in San Francisco, where it saw limited opportunities.

A spokesman said it did not make sense to have an office in Chicago. SAC has more than 1,000 employees — portfolio managers, analysts, traders and support staff — in five offices around the globe, with its headquarters in Stamford, Conn.

Though Mr. Cohen has told his friends and employees that he remains committed to managing money for outside clients, he could decide to follow in the footsteps of several fellow billionaire hedge fund managers.

A number of star investors, having already amassed billions in personal wealth, have decided to get out of the business of managing other people’s money. In recent years, for example, both George Soros and his onetime protégé, Stanley Druckenmiller, returned money to clients and set up so-called family offices to manage their own fortunes.

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The Lede Blog: Winter Brings Misery to Syria Refugees

For Syrian refugees in Zaatari refugee camp in Jordan, winter has brought bitter new hardship and at least one death.

More than 50,000 people are estimated to live in Zaatari camp, roughly one third of the nearly 150,000 Syrians who have sought refuge in Jordan from the 22-month long conflict gripping their country. As my colleagues have Rick Gladstone and Nick Cumming-Bruce reported, wind and rainy weather this week wrecked scores of refugee dwellings in Zaatari, where many tents flooded or collapsed. People were left shivering in the cold, and outrage soon boiled over in an angry riot that injured 11 people, over half of them aid workers from the charity group Save the Children. It was the latest in at least four violent episodes in recent weeks between refugees, aid workers and the police.

Video of the Zaatari camp on Monday, posted online by Syrian activists, showed an area almost as large as a football field covered in shallow, muddy water. Inside a soaked tent, a young boy told the cameraman that he and his family, including his injured father, “went to a neighbor’s tent because of the water.”

Tents in Zaatari refugee camp were flooded with shallow, muddy water on Monday.

The suffering in Zaatari was given a human face on Wednesday when an activist uploaded a moving video interview with a refugee in the camp named Khaled al-Hariri, an amputee who described the difficulty of getting proper medical care in the camp. According to the activist, Abushakraa Horanee, Mr. Hariri died on Tuesday night before the video was uploaded to Facebook and then copied to a Syrian activist YouTube channel. Mr. Horanee, the filmmaker, called Mr. Hariri, “the martyr of negligence and cold.”

Video of Khaled al-Zubi, a Syrian refugee in Jordan, accusing camp doctors of negligence.

In the video, Mr. Hariri, who lost a leg in Syria before fleeing to Jordan, said he suffered from a range of respiratory problems that went untreated by camp doctors. Mr. Hariri broke down crying as he explained his health problems and alleged negligence and poor treatment on the part of doctors in the camp, which is run by the United Nations. “I don’t even want my health to improve,” he said. “I want my brothers’ health, the people all around me, to improve.”

Describing his ill-health, Mr. Hariri said, “I have hoarseness, chest pain, and mucus. With my leg pain. Here my leg, all of it, is inflamed. My chest also, my chest is inflamed.”

When asked if he was given a medical diagnosis by camp doctors, Mr. Hariri responded:

Diagnosed? No one diagnosed me. I stayed here for three months and no doctor gave me a proper drug, no doctor told me ‘there is a drug for that’, no doctor gave me anything. I just want something that will give me some relief. I just want something to give me some relief, that’s all. Pain killers. They didn’t give me that. I don’t know, what can I do?

Asked how doctors in the camp hospital responded to his visit, he responded:

Their response? I would go at night from here to the emergency room and call on them and tell them ‘my brother, for God’s sake….’ I would tell the ambulance driver, ‘my brother, for God’s sake, I swear I can’t breathe. I need oxygen, I need oxygen.’ So the ambulance would arrive and they wouldn’t even pick me up themselves. My brother, the broken one, would pick me and my uncle. They would pick me up and put me in the ambulance. Is that okay?

I would go and sit there. I’d be wearing this track suit while it’s cold outside. I would ask ‘Where is the doctor for him to put me in a bed?’ And the doctor would say ‘there is no bed. You’re going to have to wait a bit for the patient to leave.’ ‘Doctor, I swear I’m very tired. At least give me oxygen, I want to breathe. I can’t breathe.’ I could not breath at all.

U.N. officials said that most dwellings in the camp withstood the recent rainfall and attributed tensions in Zaatari to a range of factors, including fear of worsening weather conditions and a surge of as many as 9,000 new residents in the last week. On Twitter, Unicef, the United Nations children’s agency, said the organization was fully focused on improving conditions in the camp.

We’re working around clock to tackle flooding in #Zaatari camp and ensure all refugees have shelter & sanitation http://t.co/8SYmLRUi #Syria

— UNICEF (@UNICEF) 10 Jan 13

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A Tale of 2 Strategies: The Twitter Genius of Chuck Grassley and Cory Booker

If you’re on Twitter and not following Sen. Chuck Grassley, you’re not using Twitter correctly.

The Iowa Republican is known for his colorful and personal Twitter feed. Take a gander: He personally tweets about everything from the History Channel to “Obamacare” to an incident in which he hit a deer with his car  (“assume dead”). Grassley’s tweets take us along for a ride, one that’s often riddled with spelling errors (which he has said is due to his distaste for typing and the iPhone’s auto-correct function).

Pres/Cong need 2work on Wash spending prob. No time 2waste b/4 Mar. Pres promised tax hike is done. Now he needs 2keep promise 4 less spend

— ChuckGrassley (@ChuckGrassley) January 4, 2013

Rained inIowa this weekend. Still 8 inches shortIowa still still listed dangerous drought pray For rain

— ChuckGrassley (@ChuckGrassley) December 17, 2012

Fred and I hit a deer on hiway 136 south of Dyersville. After I pulled fender rubbing on tire we continued to farm. Assume deer dead

— ChuckGrassley (@ChuckGrassley) October 26, 2012

Contrast Grassley’s tweets to another lawmaker known for his active and personal feed: Newark, N.J., Mayor Cory Booker. On Twitter, he’s part mayor, part celebrity. Booker tweets about city services and was widely praised for how he utilized the platform in the aftermath of superstorm Sandy to connect directly with residents. But then he’ll retweet someone who says she’s going to get a Cory Booker quote tattoo or someone who has a “political crush” on him. Sometimes, Booker tweets like a Kardashian.

Think so, call 9737334311. My people will tell u RT @hennybottle: Is the number to get downed wires removed same for all of essex county?

— Cory Booker (@CoryBooker) January 8, 2013

“Hey, Never Met U, Your tweet’s Crazy, I’ll DM My Number, So Call Me Maybe?” MT @ann_ralston: I have a non-sexual, political crush on you!

— Cory Booker (@CoryBooker) January 8, 2013

Wow. An honor I never quite imagined RT @rachelanncohen: deliberating between several Cory Booker quotes for my next tattoo.

— Cory Booker (@CoryBooker) January 8, 2013

I love you too! RT @alwoldegorgeous: I can actually say I am in love with @kimkardashian#girlcrush

— Kim Kardashian (@KimKardashian) December 12, 2012

Obviously, Booker is savvier with Twitter than Grassley, and he’s utilized the platform effectively, as he vies for statewide office. Booker’s a PR genius with social media. Grassley’s himself–typos, rants, and all. So while Booker probably doesn’t need to take Twitter lessons from the six-term senator, there’s something decidedly old school and earnest that’s kind of appealing about Grassley’s feed, something that would be nice to see in Booker’s feed, too.

Welcome to Twitter Pope Benedict. U will find it useful and interesting

— ChuckGrassley (@ChuckGrassley) December 3, 2012

CORRECTION: Grassley has served in the Senate for six terms.  An earlier version of the story incorrectly listed his tenure.

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