India Ink: India's Police Force Lags Much of World

A recent spate of violent crimes against women in northern India has led to increased scrutiny of the Indian police force. In Delhi, after the gang rape and subsequent death of a young woman, residents called for the resignation of the city’s chief of police and the retraining of the overwhelmingly male police force.

But perhaps the question that should be asked about India’s police officers is whether there are enough of them in the first place.

On the basis of police per capita, India is the second lowest among 50 countries ranked by the United Nations Office on Drugs and Crime, using 2010 data. Police forces around the world are commonly measured as the number of police per 100,000 people, and India has 129. Only Uganda fares worse.

While this ratio has increased significantly in India over the last decade, it remains far behind many other major economies. (The worldwide average is closer to 350).

Scotland, for example, has around 330 officers per 100,000; South Africa had 327, the United States had 238 officers, and Canada had 201, according to 2011 data.

Not surprisingly, some studies suggest that adding police officers reduces crime. “A nation with a larger proportion of police officers is somewhat more likely to have a lower crime rate,” said a 2006 report by the Institute for the Study of Civil Society, which looked at law enforcement data from European countries.

Just weeks before the gang rape in New Delhi on Dec.16, the Indian Supreme Court laid down guidelines to check sexual harassment, including greater deployment of female police officers in public spaces:

All states and Union Territories are directed to depute plain-clothed female police officers in the precincts of bus-stands and stops, railway stations, metro stations, cinema theatres, shopping malls, parks, beaches, public service vehicles, places of worship to monitor and supervise incidents of sexual harassment.

But, without significant increase in hiring, that may be difficult. The number of female police constables in the country was only 84,479 out of 1,585,117 officers, or about 5 percent of the total police force in 2011.

India’s judiciary is also considered understaffed. The country’s judge-to-population ratio would be the fourth lowest in the world, if the country were included in a 2008 U.N. study that looked at 65 countries. Only Guatemala, Nicaragua and Kenya had a lower ratio than India, which only had 14 judges per million population in 2008.

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“Banshee” head Greg Yaitanes: secrets galore, but hold the olives

NEW YORK (TheWrap.com) – Like many TV creators, Greg Yaitanes isn’t crazy about the alternate identities people adopt online – and the Emmy-winning former “House” executive producer gets to explore anonymity and becoming someone else in the new Cinemax series “Banshee.”

“I’ve been harassed by ‘House’ Twitter fans for years now. I’m always kind of surprised at people’s level of saying something that they would never say to my face – that they would never say to another human being’s face,” he said.

Not that Yaitanes has a problem with social media – he was an early investor in Twitter, and used a litany of apps and new technology to make his pulpy drama, executive produced by Alan Ball, as scrappy as a tech startup.

With “Banshee,” Yaitanes gets to explore “the best of the wish fulfillment that people have of reinventing themselves or being able to disappear. In a way, all the characters are reinventing themselves.”

Those characters include a thief who steals the identity of the sheriff in Banshee, Pa., his cat burglar ex-girlfriend, who has eked out a new life as a homemaker, and the villain, a man who becomes a criminal mastermind after he is ousted from his Amish community. Then there’s the identity thief – Job – who keeps changing which gender he appears to be.

We talked with Yaitanes about how he made his show look expensive, how to describe Job, and the importance of counting olives.

The Wrap: The show looks expensive – starting with a sequence in New York in which a bus falls over and skids through an intersection. Can you talk about how you kept costs down?

Yaitanes: It’s a way of thinking from working with startups. They’re often one, two, three man operations when they first operate. Twitter was an example of that. You have to look at what is the simplest, most effective way to do this, to deliver to the consumer. We had a very specific box that “Banshee” could be made in, in terms of our budget.

The first thing that came to mind was what I call the “one olive.” The one olive is a story that originates with American Airlines back in the ’80s, when American Airlines took one olive out of their inflight meal – and saved $ 40,000. It’s all about challenging and making everybody their own producer and their own CEO and asking, ‘What is that one thing I can take out that either saves money or makes us that more efficient over the course of 100 days?’

Maybe $ 1,000 isn’t particularly exciting, but when you do it across a season, that’s an official day of shooting. That’s seven more minutes of content that we can get done that day.

We just looked for all these small ways that I feel put nearly an episode’s worth of saving back into the show, so we could make our show more robust and make the action scenes that much bigger and get the actor that we really want.

These are things that the audience gets to enjoy.

What are some of the cost-saving measures?

We also tried to find our olives by using the apps and technology that’s right in front of us, like Skype and Facetime and iChat so we don’t have to fly everybody around? I think probably 75 percent of the crew including directors were hired through some form of video conferencing. You saw the pilot, with the bus crash. We scouted all of that via Google Streetview. We could find blocks and circle around and look up and down and did all the legwork until we absolutely had to go to New York. So we saved on those flights, those hotels, those per diems.

You’ve invested in so many social media sites. Is there something that want to say on the show about the changing nature of identity when we can all take on different personalities online? Your main character, Lucas Hood (Antony Starr) actually takes on another person’s life.

Lucas does the most obvious adoption. A lot of people’s secrets and new identities and new lives are happening before the series starts, which is why we’ve shot an entire online series with our cast.

One of those characters, Job, is constantly in flux – even in terms of whether he appears male or female. Is he transgendered?

He’s straddling this line of androgyny. We specifically don’t want to answer questions about Job’s sexuality… he is a chameleon. He has something that he can tap into depending on his situation. By the time you get to the finale you won’t believe where Job goes.

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GLAAD Award Nominees: Modern Family, Glee, The New Normal Make the Grade

By Stephen M. Silverman

01/16/2013 at 06:00 AM EST

Adam Lambert (left) and Frank Ocean

David Livingston/Getty; McCarten/PictureGroup

Last July when emerging R&B star Frank Ocean published an emotional letter detailing an early love affair with a man, his "coming out" story made headlines in the hip-hop world and beyond.

Now, the Grammy-nominated songwriter is being honored by GLAAD, the nation's lesbian, gay, bisexual and transgender media advocacy and anti-defamation organization.

Ocean is among the 120 nominees for the 24th Annual GLAAD Media Awards, the organization announced early Wednesday morning. He is being recognized for his critically-lauded Channel Orange album.

Other musician nominees include Adam Lambert (for his album Tresspassing).

Among the other familiar nominee names in the mix of 25 English-language and 33-Spanish language categories are: TV's Modern Family, Smash, Glee, The New Normal, Anderson Cooper 360, The Amazing Race and The Daily Show. For motion pictures, The Best Exotic Marigold Hotel, The Perks of Being a Wallflower and ParaNorman – plus the documentaries How to Survive a Plague and Vito – are nominated.

Also being recognized: PEOPLE (for outstanding magazine coverage overall) and PEOPLE En Español – for two magazine articles: "Amor genuine," by Cristina Saralegui, and "La lucha de Bamby," by Isis Sauceda.

For a complete list of nominees, click here.

"Images and stories from the LGBT community continue to push support for equality to historic levels," GLAAD president Herndon Graddick said in a statement with the announcement of the nominees. "Now more than ever, viewers not only accept gay and transgender characters and plot lines, they expect them – just as they both accept and expect LGBT people to be a valuable part of their everyday lives."

The GLAAD Media Awards ceremonies will be held in New York on March 16, at the New York Marriott Marquis; in Los Angeles on April 20, at the JW Marriott; and in San Francisco on May 11, at the Hilton Union Square.

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ER visits tied to energy drinks double since 2007

SAN FRANCISCO (AP) — A new government survey suggests the number of people seeking emergency treatment after consuming energy drinks has doubled nationwide during the past four years, the same period in which the supercharged drink industry has surged in popularity in convenience stores, bars and on college campuses.

From 2007 to 2011, the government estimates the number of emergency room visits involving the neon-labeled beverages shot up from about 10,000 to more than 20,000. Most of those cases involved teens or young adults, according to a survey of the nation's hospitals released late last week by the Substance Abuse and Mental Health Services Administration.

The report doesn't specify which symptoms brought people to the emergency room but calls energy drink consumption a "rising public health problem" that can cause insomnia, nervousness, headache, fast heartbeat and seizures that are severe enough to require emergency care.

Several emergency physicians said they had seen a clear uptick in the number of patients suffering from irregular heartbeats, anxiety and heart attacks who said they had recently downed an energy drink.

More than half of the patients considered in the survey who wound up in the emergency room told doctors they had downed only energy drinks. In 2011, about 42 percent of the cases involved energy drinks in combination with alcohol or drugs, such as the stimulants Adderall or Ritalin.

"A lot of people don't realize the strength of these things. I had someone come in recently who had drunk three energy drinks in an hour, which is the equivalent of 15 cups of coffee," said Howard Mell, an emergency physician in the suburbs of Cleveland, who serves as a spokesman for the American College of Emergency Physicians. "Essentially he gave himself a stress test and thankfully he passed. But if he had a weak heart or suffered from coronary disease and didn't know it, this could have precipitated very bad things."

The findings came as concerns over energy drinks have intensified following reports last fall of 18 deaths possibly tied to the drinks — including a 14-year-old Maryland girl who died after drinking two large cans of Monster Energy drinks. Monster does not believe its products were responsible for the death.

Two senators are calling for the Food and Drug Administration to investigate safety concerns about energy drinks and their ingredients.

The energy drink industry says its drinks are safe and there is no proof linking its products to the adverse reactions.

Late last year, the FDA asked the U.S. Health and Human Services to update the figures its substance abuse research arm compiles about emergency room visits tied to energy drinks.

The Substance Abuse and Mental Health Services Administration's survey was based on responses it receives from about 230 hospitals each year, a representative sample of about 5 percent of emergency departments nationwide. The agency then uses those responses to estimate the number of energy drink-related emergency department visits nationwide.

The more than 20,000 cases estimated for 2011 represent a small portion of the annual 136 million emergency room visits tracked by Centers for Disease Control and Prevention.

The FDA said it was considering the findings and pressing for more details as it undertakes a broad review of the safety of energy drinks and related ingredients this spring.

"We will examine this additional information ... as a part of our ongoing investigation into potential safety issues surrounding the use of energy-drink products," FDA spokeswoman Shelly Burgess said in a statement.

Beverage manufacturers fired back at the survey, saying the statistics were misleading and taken out of context.

"This report does not share information about the overall health of those who may have consumed energy drinks, or what symptoms brought them to the ER in the first place," the American Beverage Association said in a statement. "There is no basis by which to understand the overall caffeine intake of any of these individuals — from all sources."

Energy drinks remain a small part of the carbonated soft drinks market, representing only 3.3 percent of sales volume, according to the industry tracker Beverage Digest. Even as soda consumption has flagged in recent years, energy drinks sales are growing rapidly.

In 2011, sales volume for energy drinks rose by almost 17 percent, with the top three companies — Monster, Red Bull and Rockstar — each logging double-digit gains, Beverage Digest found. The drinks are often marketed at sporting events that are popular among younger people such as surfing and skateboarding.

From 2007 to 2011, the most recent year for which data was available, people from 18 to 25 were the most common age group seeking emergency treatment for energy drink-related reactions, the report found.

"We were really concerned to find that in four years the number of emergency department visits almost doubled, and these drinks are largely marketed to younger people," said Al Woodward, a senior statistical analyst with the Substance Abuse and Mental Health Services Administration who worked on the report.

Emergency physician Steve Sun said he had seen an increase in such cases at the Catholic hospital where he works on the edge of San Francisco's Golden Gate Park.

"I saw one young man who had mixed energy drinks with alcohol and we had to admit him to the hospital because he was so dehydrated he had renal failure," Sun said. "Because he was young he did well in the hospital, but if another patient had had underlying coronary artery disease, it could have led to a heart attack."

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Follow Garance Burke on Twitter at http://twitter.com/garanceburke

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L.A. Unified to overhaul struggling Crenshaw High

No school has meant more to the African American community in Los Angeles than Crenshaw High. For most of its 45 years, it has been an established neighborhood hub, known for championship athletic teams and arts programs, sending graduates to top colleges.

But the Leimert Park campus has declined in recent years. Dropout rates have soared and student achievement has plummeted. L.A. Unified school Supt. John Deasy calls it one of the district's biggest disappointments.

In an effort to turn the school around, the Board of Education on Tuesday approved Deasy's drastic proposal to remake the campus into three magnets — and require teachers to reapply for their jobs.

Deasy's critics, including those at Crenshaw, were quick to complain. They say he is using an ax instead of a scalpel, that his approach would jettison talented people and abandon efforts that show some promise and deserve his support.

Rita Hall, a member of the school's first graduating class in 1969, told the board Tuesday that the school was once successful because of immense stability and support — which it lacks today. The campus, even through its struggles, is an important mainstay in the community.

"Crenshaw means family.... The board doesn't seem to recognize that there is a strong legacy and bond," Hall said. "We are very passionate about our school."

This is not the first time that Crenshaw, with an increasingly Latino student body, has been the focus of L.A. Unified's attention. Other efforts to turn around low achievement weren't successful. In 2005, the school lost its accreditation in a largely bureaucratic snafu. In 2008, the school failed to receive a state academic rating because it failed to test enough students.

Many parents are opposed to the new plan and pleaded with the board to delay the vote. Speakers blamed the district for the school's slow progress, telling the board that the campus has suffered through a parade of administrators — more than 30 principals and assistant principals over seven years, according to veteran Crenshaw teacher Alex Caputo-Pearl. The transition to magnet programs would be disruptive for students, they said.

Deasy argued that much of the sentiment expressed by parents and teachers is the reason the district is taking action to make sure student achievement becomes "dramatically and fundamentally better."

"It is a civil right for students to be able to read and do mathematics. It is a fundamental right to graduate — and it is not happening at Crenshaw," he said, adding, "Students are not learning. Students are not graduating. Students are not able to read."

Board member Marguerite Poindexter LaMotte, who represents the school and lives nearby, told the crowd to give the district a chance to transform the school into one that students could be proud of.

"We have got to change something at Crenshaw for the better," LaMotte said. "When they go to school in the morning — when I see them passing — I want them to say 'I go to Crenshaw and I'm proud to go to Crenshaw.' "

The board approved Deasy's plan unanimously with one member, Richard Vladovic, absent. After the vote, supporters began chanting "The fight is not over, we will take over!"

LaMotte quickly responded: "I'd want to know why anyone would want a child to go to a broken school."

The school, with more than 1,300 students — nearly all from low-income families — has made virtually no progress in increasing achievement in English and math. The percentage of students at grade level in English has declined slightly over four years, from 19% to 17%; in math, the figure has inched up — but only from 2% to 3%.

This year, there was an increase in Crenshaw's overall Academic Performance Index score, which includes results from all students tested. It rose from 554 to 569, which still leaves the campus among the lowest-performing in the state and, Deasy said, the worst in L.A. Unified. The school has also lost students, with many choosing other district schools or independent, publicly funded charter schools.

Deasy has authority under federal law to replace the staff at Crenshaw because of the school's poor performance, but he describes the move differently. Avoiding the term "reconstitution," which is used to describe a school that is substantially restaffed, he instead focuses on the changeover to a magnet program. But UCLA associate professor John Rogers said Deasy's move is essentially reconstitution under another guise.

The conversion echoes the strategy already employed at Westchester High, another comprehensive district high school where a majority of students are African American.

Magnet schools were designed to draw enrollment from across the district to promote integration.

District officials consider Westchester's changeover a significant improvement that allowed them to alter the culture of the school. Some Crenshaw parents, who followed events at Westchester, aren't persuaded.

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Pakistan Supreme Court Orders Arrest of Prime Minister

ISLAMABAD, Pakistan – Pakistan’s Supreme Court ordered the arrest of Prime Minister Raja Pervez Ashraf in a corruption case on Tuesday afternoon, dramatically raising the stakes in a tense standoff between the government and its opponents.

The court order came as an enigmatic preacher turned politician, Muhammad Tahir ul Qadri, addressed thousands of supporters outside Parliament and repeated calls for the government’s ouster. In earlier speeches, he said that a caretaker administration led by technocrats should take its place.

The confluence of the two events stoked growing speculation that Pakistan’s powerful military was quietly supporting moves that would delay general elections that are due to take place this spring, most likely through the imposition of a military-backed caretaker administration.

“Victory, victory, victory. By the grace of God,” said Mr. Qadri at the conclusion of a speech to his supporters, who have vowed not to leave a public square outside Parliament until their demands are satisfied.

It was not certain that the events were linked. Some analysts said that in ordering the prime minister’s arrest, the court, which is led by the independent-minded chief justice Iftikhar Muhammad Chaudhry, was simply taking advantage of anti-government sentiment generated by Mr. Qadri to pursue its longstanding grudge against President Asif Ali Zardari.  

Whatever its motivations, the court’s actions added to the chaos in Pakistan, with the stock market dropping 3 percent after word of the court’s order came down.

In the order issued Tuesday, the Supreme Court ordered the National Accountability Bureau, a government body that investigates graft, to arrest Mr. Ashraf and 15 other senior current or former officials, including a former finance minister and a former finance secretary.

The case relates to longstanding allegations that Mr. Ashraf took millions of dollars in kickbacks as part of a deal to build two electricity plants while serving as minister for water and power between March 2008 and February 2011.

The order comes more than a year after two opposition figures filed a complaint in the Supreme Court against Mr. Ashraf. Three months later, in March 2012, the court ruled that the power plants were illegal, ordered their closure, and instituted proceedings against Mr. Ashraf.

The case has particular political resonance because Pakistan’s energy crisis, which has seen severe electricity rationing across the country, is the source of some of the main complaints against the government.

The information minister, Qamar Zaman Kaira, said the government had not received any official notification of the order to arrest Mr. Ashraf.

Fawad Chaudhry, a senior adviser to the prime minister, said that any such order would be "illegal and unconstitutional."

"Under the law, the court cannot arrest him," he said President Zardari called a meeting of senior advisers at his Karachi residence to discuss the crisis late Tuesday, Mr. Chaudhry added.

Mr. Zardari’s supporters have painted the prosecution as part of a politically-motivated drive by Justice Chaudhry to unseat Mr. Zardari. Mr. Ashraf came to power last June after the Supreme Court forced his predecessor, Yousaf Raza Gilani, to resign from office over another corruption-related case.

Whether there was any link between the court order and Mr. Qadri’s march on Islamabad – billed by the preacher as a “million man march” but in reality far smaller – the timing was certainly striking.

Mr. Qadri stormed onto the political scene in Pakistan after returning from a seven-year stint in Canada, where he also holds citizenship, armed with considerable funding that he has used for an intensive television advertising campaign and large rallies.

In his speech Tuesday, which was peppered with emotional Islamic references, he demanded the immediate resignation of the government and painted the country’s elected politicians as “criminals” who deserved to be prosecuted for corruption.

“There is no Parliament. There is a group of looters, thieves and dacoits!” he said in a  thundering voice, pointing to the building behind him. “Our lawmakers are the lawbreakers.”

In contrast, Mr. Qadri offered fulsome support for the military and the Supreme Court, both of which have been at odds with Mr. Zardari’s government at various points in recent years. “Now only two institutions are there – the judiciary and the armed forces,” he said.

Responding to the allegations that he is secretly supported by the military, Mr. Qadri said he was supported by Allah, the Prophet Muhammad and the 180 million people of Pakistan.

The government’s five-year term of office ends in mid-March. Under the constitution, elections are to take place within the following 60 days.

But Ayaz Amir, an opposition politician, said the crisis could actually benefit the government as it would enable it to play the “victim card.”

The developments raise doubts about the government’s ability to make headway in Pakistan’s efforts to achieve stability as a democracy. Should Mr. Ashraf’s administration complete its term and hold peaceful elections, it would be the first such transfer of power in Pakistan’s history.

But speculation that Mr. Qadri or the court could derail that transition grew steadily as events unfolded on Tuesday.

Theories about a link between the two players and the military are not easy to reconcile. Over the last year, Justice Chaudhry has openly clashed with top generals, as part of his court’s bid to carve out its independence from both civilian and military rulers.

Justice Chaudhry has stressed that his court will not act as a rubber stamp to military rule, as previous courts have, and earlier on Tuesday he reportedly stressed the importance of holding elections by mid-May.

Salman Masood contributed reporting.

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Verizon may be prepping a new mid-range Samsung smartphone with a 720p display

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Bachelor Sean Lowe: My Girl Must Love Dogs

For any of the 25 women looking to win over this season's Bachelor, Sean Lowe, here's a tip straight from the source: "The girl I'm dating must be into my dogs," he tells PEOPLE.

The proud pet parent to two pooches, a boxer named Lola and a chocolate Labrador named Ellie, Lowe says, "For so long it's just been me and my two dogs, and I'm certainly not going to replace them with any woman."

Having had both animals for the past six years, the hunk has developed a special bond with the duo – though he admits his quest for love has forced him to make some changes.

"For many years, my dogs would sleep in the bed with me," he says. "I'm a big guy and I've got two good-sized dogs, so it's a full bed. Then I just realized one day, 'Alright, if I get married and a woman's going to join me in the bed, there's not going to be enough room.' I had to break the dogs of the habit of sleeping in the bed."

Luckily for Lowe, the pair have taken to their new accommodations easily.

"They're very intelligent dogs; they pick up on things really quickly," he says. "They learn pretty fast."

To hear more from Sean Lowe – including how his dogs help him navigate the dating world – check out the video above.

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

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Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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L.A. voters could decide 3 pot measures on May ballot

Even in the complicated world of pot politics, it's a confusing prospect: In the May municipal election, Los Angeles voters could face not one but three ballot measures geared toward regulating medical marijuana dispensaries.

All three of the proposals would allow some pot shops to remain open, albeit under different regulations.

The first two measures, which are sponsored by two groups of medical marijuana activists with competing interests, qualified for the ballot last week. One would permit only those dispensaries that opened before a city moratorium in 2007. The other would allow any pot shop that meets certain requirements to operate and would raise taxes on medical marijuana sales by 20% to pay for city enforcement.

Neither of those options appeals to the City Council, which has struggled for years to regulate medical cannabis against a backdrop of ever-shifting case law and increasing pressure from federal drug enforcement officials. City Council President Herb Wesson said Monday that neither of the existing ballot measure proposals would "accomplish the goal of limiting the proliferation of medical marijuana dispensaries while providing adequate protections for our neighborhoods."

He and his colleagues decided to propose a ballot measure of their own. The council will vote Wednesday on whether to present it to voters in May.

The language of the new proposal is still being worked out, but it will probably require dispensaries to be at least 1,000 feet apart, according to Chris Koontz, who has worked on the issue as an aide to Councilman Paul Koretz. It will also include an increase of the medical marijuana tax.

Koontz acknowledged that voters might be confused by having to choose from three ballot measures with only slight differences. "I cannot believe this is how policy is made," he said. But he said the council passing its own law was a less viable option. It was unclear whether a previous Koretz proposal to allow only the pre-moratorium shops to stay open had the political will to clear the council, Koontz said, and even if the law had been approved, it might be invalidated in May if voters approve one of the other medical marijuana measures.

A supporter of one of those measures dismissed the council's action as "a political play."

David Welch, an attorney who is pushing for the measure that would allow any shop that meets certain requirements to operate, said the council should make laws "instead of punting the issue to the voters." Welch said he had not yet seen the details of the new proposal.

Neither had Yami Bolanos, the president of the Greater Los Angeles Collective Alliance, which is backing the competing proposal that would allow only the pre-moratorium dispensaries. She said she was also frustrated by the council, which she said has chosen not to work with the medical marijuana community.

"I'm kind of in disbelief," she said.

But Bolanos held open the possibility that her coalition, which includes a labor union that represents dispensary workers, might come around to support the council-backed proposal. After all, the council's law would allow older dispensaries like the ones she represents to stay open, although they would have to follow the 1,000-foot distance requirements.

"I can't tell you whether I would abandon my initiative to go to that one," Bolanos said. "But if that's what it takes, that's what it takes."

kate.linthicum@latimes.com

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