Fewer cancer patients pick CPR after video demo

NEW YORK (Reuters Health) – Dying cancer patients are less likely to want aggressive end-of-life care if they watch a short video about CPR than if they simply hear about it, according to a new study.

“These are huge differences. You will die very differently if you watch the video than if you don’t,” said Dr. Angelo Volandes, the study’s lead author from Boston’s Massachusetts General Hospital.

“All these patients had a terminal condition. It’s not like there was another treatment they were trying…So (CPR) was prolonging the dying process,” he said.

The researchers found in a group of 150 cancer patients, who were thought to have less than a year to live, 48 percent wanted CPR after being told about it, compared to 20 percent in the group who also watched a video showing compressions on a dummy and the inserting of a breathing tube.

“It’s one of the most important issues in American medicine today. People are getting medical interventions that, if they had more knowledge, they would simply not want,” said Volandes.

The new study builds off previous research with similar findings by the same group. The earlier research, however, was only conducted with brain cancer patients at one medical center.

For the new study, published in the Journal of Clinical Oncology, the researchers included a wider variety of cancer patients at four medical centers in Massachusetts, New York and Tennessee.

All of the patients who agreed to participate in the study were read a standardized description of CPR — described as pressing on their chest and using an electric shock to “get your heart to beat again if it stops.”

The description also said CPR does not revive most patients with advanced cancer, and the patient would likely be put in the ICU with a breathing machine if it worked.

The researchers then randomly selected 70 of the patients to watch a three-minute video demonstration.

In the group that was only told about CPR, about half of the 80 patients said they wouldn’t want doctors or nurses to revive them. That compared to 79 percent of the patients who also watched the video.

Nine out of every ten patients who watched the video also said it was “helpful.”

PART OF A BIGGER CONVERSATION

Volandes told Reuters Health that the video may reinforce the information patients usually get from their doctors.

“People aren’t clinicians. They don’t have clinic experience to understand what this looks like,” he said.

Dr. Susan Gaeta, an assistant professor at The University of Texas MD Anderson Cancer Center in Houston, told Reuters Health she likes the idea of using the videos, but said they need to be part of a bigger conversation.

“What we’re trying to do is to have conversation with patients on what their goals and values are,” said Gaeta.

She added that the question should not be, “Do you want this?” It should be, “Is this medically appropriate based on your goals and values?”

Volandes said their collection of 25 videos on various topics, including CPR and breathing tubes, are used by over 30 healthcare systems across the country.

Gaeta added that her hospital is developing their own videos that incorporate their focus of goals and values.

SOURCE: http://bit.ly/TP4qV1 Journal of Clinical Oncology, online December 10, 2012.

Diseases/Conditions News Headlines – Yahoo! News

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Aides: Chavez in tough fight, may miss swearing-in

CARACAS, Venezuela (AP) — Somber confidants of President Hugo Chavez say he is going through a difficult recovery after cancer surgery in Cuba, and one close ally is warning Venezuelans that their leader may not make it back for his swearing-in next month.

Information Minister Ernesto Villegas said Wednesday night that Chavez was in “stable condition” and was with close relatives in Havana. Reading a statement, he said the government invites people to “accompany President Chavez in this new test with their prayers.”

Villegas expressed hope about the president returning home for his Jan. 10 swearing-in for a new six-year term, but said in a written message on a government website that if Chavez doesn’t make it, “our people should be prepared to understand it.”

Villegas said it would be irresponsible to hide news about the “delicateness of the current moment and the days to come.” He asked Venezuelans to see Chavez’s condition as “when we have a sick father, in a delicate situation after four surgeries in a year and a half.”

Moving to prepare the public for the possibility of more bad news, Vice President Nicolas Maduro looked grim when he acknowledged that Chavez faced a “complex and hard” process after his latest surgery.

At the same time, officials sought to show a united front amid the growing worries about Chavez’s health and Venezuela’s future. Key leaders of Chavez’s party and military officers appeared together on television as Maduro gave updates on Chavez’s condition.

“We’re more united than ever,” said Maduro, who was flanked by National Assembly President Diosdado Cabello and Oil Minister Rafael Ramirez, both key members of Chavez’s inner circle. “We’re united in loyalty to Chavez.”

Analysts say Maduro could eventually face challenges in trying to hold together the president’s diverse “Chavismo” movement, which includes groups from radical leftists to moderates, as well as military factions.

Tapped by the 58-year-old president over the weekend as his chosen political heir, Maduro is considered to be a member of radical left wing of Chavez’s movement that is closely aligned with Cuba’s communist government.

Cabello, a former military officer who also wields power within Chavez’s movement, shared the spotlight with Maduro by speaking at a Mass for Chavez’s health at a military base.

Just returned from being with Chavez for the operation, Cabello called the president “invincible” but said “that man who is in Havana … is fighting a battle for his life.”

After Chavez’s six-hour operation Tuesday, Venezuelan television broadcast religious services where people prayed for Chavez, interspersed with campaign rallies for upcoming gubernatorial elections.

On the streets of Caracas, people on both sides of the country’s deep political divide voiced concerns about Chavez’s condition and what might happen if he died.

At campaign rallies ahead of Sunday’s gubernatorial elections, Chavez’s candidates urged Venezuelans to vote for pro-government candidates while they also called for the president to get well.

“Onward, Commander!” gubernatorial candidate Elias Jaua shouted to a crowd of supporters at a rally Wednesday. Many observers said it was likely Chavez’s candidates could get a boost from their supporters’ outpouring of sympathy for Chavez.

Opposition leader Henrique Capriles, who lost to Chavez in the October presidential election and is running against Jaua, complained Wednesday that Chavez’s allies are taking advantage of the president’s health problems to try to rally support. He took issue with Jaua’s statement to supporters that “we have to vote so that the president recovers.”

Maduro looked sad as he spoke on television, his voice hoarse and cracked at times after meeting in the pre-dawn hours with Cabello and Ramirez. The pair returned to Venezuela about 3 a.m. after accompanying Chavez to Cuba for his surgery.

“It was a complex, difficult, delicate operation,” Maduro said. “The post-operative process is also going to be a complex and hard process.”

Without giving details, Maduro reiterated Chavez’s recent remarks that the surgery presented risks and that people should be prepared for any “difficult scenarios.”

The constitution says presidents should be sworn in before the National Assembly, and if that’s not possible then before the Supreme Court.

Former Supreme Court magistrate Roman Duque Corredor said a president cannot delegate the swearing-in to anyone else and cannot take the oath of office outside Venezuela. A president could still be sworn in even if temporarily incapacitated, but would need to be conscious and in Venezuela, Duque told The Associated Press.

If a president-elect is declared incapacitated by lawmakers and is unable to be sworn in, the National Assembly president would temporarily take charge of the government and a new presidential vote must be held within 30 days, Duque said.

Chavez said Saturday that if an election had to be held, Maduro should be elected president.

The dramatic events of this week, with Chavez suddenly taking a turn for the worse, had some Venezuelans wondering whether they were being told the truth because just a few months ago the president was running for his fourth presidential term and had said he was free of cancer.

Lawyer Maria Alicia Altuve, who was out in bustling crowds in a shopping district of downtown Caracas, said it seemed odd how Maduro wept at a political rally while talking about Chavez.

“He cries on television to set up a drama, so that people go vote for poor Chavez,” Altuve said. “So we don’t know if this illness is for that, or if it’s that this man is truly sick.”

Some Chavez supporters said they found it hard to think about losing the president and worried about the future. His admirers held prayer vigils in Caracas and other cities this week, holding pictures and singing hymns.

Chavez has undergone four cancer-related surgeries since June 2011. He has also undergone months of chemotherapy and radiation treatments. Throughout his treatments, Chavez has kept secret some details of his illness, including the exact location and type of the tumors.

Ecuadorean President Rafael Correa wished his close ally the best, while also acknowledging the possibility that cancer might end his presidency. “Chavez is very important for Latin America, but if he can’t continue at the head of Venezuela, the processes of change have to continue,” Correa said at a news conference in Quito.

___

Associated Press writer Christopher Toothaker contributed to this report.

Latin America News Headlines – Yahoo! News

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Britney Spears, Taylor Swift are top-earning women in music

NEW YORK (Reuters) – Pop star Britney Spears edged past Taylor Swift to claim the title of top-earning woman in music after bringing in an estimated $ 58 million from her album, endorsements and a perfume in the past year, Forbes said on Wednesday.

Country-pop singer Swift, 22, was a close second with an estimated $ 57 million paycheck thanks to her tour – which made more than $ 1 million each night – a contract with CoverGirl cosmetics, her own line of fragrances and her new album “Red.”

R&B star Rihanna, 24, earned an estimated $ 53 million to put her at No. 3, two places up from last year, followed by Lady Gaga, 26, who slipped from No. 1 in 2011 to fourth place with $ 52 million.

Katy Perry, 28, the only musician other than Michael Jackson to produce five No. 1 hit singles from one album, rounded out the top five with about $ 45 million in earnings.

“I think people love the comeback story – Britney never really finished her run as a superstar,” Steve Stoute, marketing expert and author of “The Tanning of America” told Forbes.

Spears, 31, who was No. 10 last year, earned most of her money from her latest album “Femme Fatale” and her tour, according to Forbes, which compiled the list with estimated earnings from May 2011 to May 2012.

In September, Spears became a judge on the reality TV singing show “The X Factor,” reportedly for $ 15 million.

Despite their huge incomes, only eight of the top women music earners were among the 25 best-paid musicians, which Forbes attributes in part to career breaks to have children.

Madonna made the list in ninth place with an estimated $ 30 million in earnings, which did not include profits from her latest tour because it was outside the time period considered for the ranking.

Forbes compiled the list after estimating pretax income based on record sales, touring information merchandise sales and interviews with concert promoters, lawyers and managers.

The full list can be found at http://www.forbes.com/sites/zackomalleygreenburg/2012/12/12/the-top-earning-women-in-music-2012/

(Reporting by Patricia Reaney; Editing by Nick Zieminski and Maureen Bavdek)

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North Korea’s new leader burnishes credentials with rocket

SEOUL/TOKYO (Reuters) – North Korea successfully launched a rocket on Wednesday, boosting the credentials of its new leader and stepping up the threat the isolated and impoverished state poses to its opponents.

The rocket, which North Korea says put a weather satellite into orbit, has been labeled by the United States, South Korea and Japan as a test of technology that could one day deliver a nuclear warhead capable of hitting targets as far as the continental United States.

“The satellite has entered the planned orbit,” a North Korean television news-reader clad in traditional Korean garb triumphantly announced, after which the station played patriotic songs with the lyrics “Chosun (Korea) does what it says”.

The rocket was launched just before 10 a.m. Korea time (9 p.m. ET on Tuesday), according to defense officials in South Korea and Japan, and easily surpassed a failed April launch that flew for less than two minutes.

The North American Aerospace Defense Command (NORAD) said that it “deployed an object that appeared to achieve orbit”, the first time an independent body has verified North Korean claims.

North Korea followed what it said was a similar successful launch in 2009 with a nuclear test that prompted the United Nations Security Council to stiffen sanctions that it originally imposed in 2006 after the North’s first nuclear test.

The state is banned from developing nuclear and missile-related technology under U.N. resolutions, although Kim Jong-un, the youthful head of state who took power a year ago, is believed to have continued the state’s “military first” programs put into place by his deceased father Kim Jong-il.

North Korea lauded Wednesday’s launch as celebrating the prowess of all three Kims to rule since it was founded in 1948.

“At a time when great yearnings and reverence for Kim Jong-il pervade the whole country, its scientists and technicians brilliantly carried out his behests to launch a scientific and technological satellite in 2012, the year marking the 100th birth anniversary of President Kim Il Sung,” its KCNA news agency said.

Washington condemned Wednesday’s launch as a “provocative action” and breach of U.N. rules, while Japan’s U.N. envoy called for a Security Council meeting. However, diplomats say further tough sanctions are unlikely to be agreed at the body as China, the North’s only major ally, will oppose them.

“The international community must work in a concerted fashion to send North Korea a clear message that its violations of United Nations Security Council resolutions have consequences,” the White House said in a statement.

Japan’s likely next prime minister, Shinzo Abe, who is leading in opinion polls ahead of an election on December 16 and who is known as a North Korea hawk, called on the United Nations to adopt a resolution “strongly criticizing” Pyongyang.

BEIJING BLOCK

China had expressed “deep concern” prior to the launch which was announced a day after a top politburo member, representing new Chinese leader Xi Xinping, met Kim Jong-un in Pyongyang.

On Wednesday its tone was measured, regretting the launch but calling for restraint on possible counter-measures, in line with previous policy when it has effectively vetoed tougher sanctions.

“China believes the Security Council’s response should be cautious and moderate, protect the overall peaceful and stable situation on the Korean peninsula, and avoid an escalation of the situation,” Chinese Foreign Ministry spokesman Hong Lei told journalists.

Bruce Klingner, a Korea expert at the Heritage Foundation, told a conference call: “China has been the stumbling block to firmer U.N. action and we’ll have to see if the new leadership is any different than its predecessors.”

A senior adviser to South Korea’s president said last week it was unlikely there would be action from the U.N. and that Seoul would expect its allies to tighten sanctions unilaterally.

Kim Jong-un, believed to be 29 years old, took power when his father died on December 17 last year and experts believe the launch was intended to commemorate the first anniversary of the death.

The April launch was timed for the centennial of the birth of Kim Il Sung, the grandfather of its current ruler.

Wednesday’s success puts the North ahead of the South which has not managed to get a rocket off the ground.

“This is a considerable boost in establishing the rule of Kim Jong-un,” said Cho Min, an expert at the Korea Institute of National Unification.

There have been few indications the secretive and impoverished state, where the United Nations estimates a third of the population is malnourished, has made any advances in opening up economically over the past year.

North Korea remains reliant on minerals exports to China and remittances from tens of thousands of its people working on labor projects overseas.

The 22 million population often needs handouts from defectors who have escaped to South Korea in order to afford basic medicines.

Given the puny size of its economy – per capita income is less than $ 2,000 a year – one of the few ways the North can attract world attention is by emphasizing its military threat.

Pyongyang wants the United States to resume aid and to recognize it diplomatically, although the April launch scuppered a planned food deal.

It is believed to be some years away from developing a functioning nuclear warhead although it may have enough plutonium for around half a dozen nuclear bombs, according to nuclear experts.

The North has also been enriching uranium, which would give it a second path to nuclear weapons as it sits on vast natural uranium reserves.

“A successful launch puts North Korea closer to the capability to deploy a weaponized missile,” said Denny Roy, a senior fellow at the East-West Center in Hawaii.

“But this would still require fitting a weapon to the missile and ensuring a reasonable degree of accuracy. The North Koreans probably do not yet have a nuclear weapon small enough for a missile to carry.”

Pyongyang says that its development is part of a civil nuclear program, but has also boasted of it being a “nuclear weapons power”.

(Additional reporting by Jumin Park and Yoo Choonsik in SEOUL; David Alexander, Matt Spetalnick and Paul Eckert in WASHINGTON; Linda Sieg in TOKYO; Sui-Lee Wee in BEIJING; Rosmarie Francisco in MANILA; Writing by David Chance; Editing by Raju Gopalakrishnan)

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Facebook revises privacy controls in effort to make them more accessible, comprehensible

SAN FRANCISCO – Facebook is trying to make its privacy controls easier to find and understand in an effort to turn the world’s largest social network into a more discreet place.

The fine-tuning announced Wednesday will include several revisions that will start rolling out to Facebook Inc.‘s more than 1 billion users in the next few weeks.

The biggest change will be a new “privacy shortcuts” section that will appear as a tiny lock on the right-hand side at the top of people’s news feeds. This feature offers a drop-down box where users will be able to get answers to common questions such as “Who can see my stuff?”

Other updates will include a tool that will enable individuals to review all the publicly available pictures identifying them on Facebook.

Social Media News Headlines – Yahoo! News

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‘Lincoln,’ ‘Les Mis,’ ‘Playbook’ lead SAG awards

LOS ANGELES (AP) — The Civil War saga “Lincoln,” the musical “Les Miserables” and the comic drama “Silver Linings Playbook” boosted their Academy Awards prospects Wednesday with four nominations apiece for the Screen Actors Guild Awards.

All three films were nominated for overall performance by their casts. Also nominated for best ensemble cast were the Iran hostage-crisis thriller “Argo” and the British retiree adventure “The Best Exotic Marigold Hotel.”

Directed by Steven Spielberg, “Lincoln” also scored individual nominations for Daniel Day-Lewis in the title role as best actor, Sally Field for supporting actress as Mary Todd Lincoln and Tommy Lee Jones for supporting actor as abolitionist firebrand Thaddeus Stevens.

“Les Miserables,” from “The King’s Speech” director Tom Hooper, had nominations for Hugh Jackman for best actor as Victor Hugo’s long-suffering hero Jean Valjean and Anne Hathaway for supporting actress as a woman fallen into prostitution, plus a nomination for its stunt ensemble.

“Silver Linings Playbook,” made by “The Fighter” director David O. Russell, also had lead-acting nominations for Bradley Cooper and Jennifer Lawrence as lost souls who find a second chance at love and Robert De Niro for supporting actor as a football-obsessed dad.

Besides Lawrence, best-actress nominees are Jessica Chastain as a CIA analyst pursuing Osama bin Laden in “Zero Dark Thirty”; Marion Cotillard as a woman who finds romance after tragedy in “Rust and Bone”; Helen Mirren as Alfred Hitchcock’s strong-willed wife in “Hitchcock”; and Naomi Watts as a woman caught in the devastation of a tsunami in “The Impossible.”

Joining Cooper, Day-Lewis and Jackman in the best-actor field are John Hawkes as a polio victim aiming to lose his virginity in “The Sessions” and Denzel Washington as a boozy airline pilot in “Flight.”

SAG nominees are almost all familiar names in Hollywood’s awards season. Eighteen of the 20 film acting contenders are past Academy Awards nominees and 13 have won Oscars, among them five two-time winners. Only Cooper and Jackman have never before earned Oscar nominations.

One of the year’s most-acclaimed films, Paul Thomas Anderson’s “The Master,” earned only one nomination, supporting actor for Philip Seymour Hoffman as a mesmerizing cult leader. The film was snubbed on nominations for ensemble, lead actor Joaquin Phoenix and supporting actress Amy Adams.

Other individual performances overlooked by SAG voters include Anthony Hopkins in the title role of “Hitchcock,” Keira Knightley in the title role of “Anna Karenina,” Bill Murray as Franklin Roosevelt in “Hyde Park on Hudson” and “Argo” director Ben Affleck, who also starred in the film.

The SAG Awards will be presented Jan. 27. The guild nominations are one of Hollywood’s first major announcements on the long road to the Feb. 24 Oscars Awards, whose nominations will be released Jan. 10.

Nominations for the Golden Globes, the second-biggest film honors after the Oscars, come out Thursday.

Maggie Smith had four individual and ensemble nominations. Along with sharing the ensemble honor for “Best Exotic Marigold Hotel,” Smith joined the cast of “Downton Abbey” among TV ensemble contenders and had nominations for supporting film actress as a cranky retiree in “Marigold Hotel” and TV drama actress for “Downton Abbey.”

Nicole Kidman earned two individual nominations, as supporting film actress as a woman smitten with a prison inmate in “The Paperboy” and best actress in a TV movie or miniseries as war correspondent Martha Gellhorn in “Hemingway & Gellhorn.”

Bryan Cranston had three overall nominations, as best actor in a TV drama for “Breaking Bad,” an ensemble honor for that show and a film ensemble honor for “Argo.”

Along with “Breaking Bad” and “Downton Abbey,” best TV drama ensemble contenders are “Boardwalk Empire,” ”Homeland” and “Mad Men.” TV comedy ensemble nominees are “30 Rock,” ”The Big Bang Theory,” ”Glee,” ”Modern Family,” ”Nurse Jackie” and “The Office.”

___

Online:

http://www.sagawards.org

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Venezuela’s Chavez in “complex” post-operation condition: VP

CARACAS (Reuters) – Venezuelan President Hugo Chavez is in a “complex” and delicate condition after his latest surgery for cancer in Cuba, Vice President Nicolas Maduro said on Wednesday.

Looking grave-faced in an address to the nation, he urged Venezuelans to unite in prayer for their 58-year-old president, and to keep faith that Chavez would return soon.

(Reporting by Caracas newsroom; Editing by Will Dunham)

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Police identify Portland mall shooter

PORTLAND, Ore. (AP) — The gunman who killed two people and himself in a shooting rampage at an Oregon mall was 22 years old and used a stolen rifle from someone he knew, authorities said Wednesday.

Jacob Tyler Roberts had armed himself with an AR-15 semiautomatic rifle and had several fully loaded magazines when he arrived at a Portland mall on Tuesday, said Clackamas County Sheriff Craig Roberts.

The sheriff said the rifle jammed during the 22-year-old's attack, but he managed to get it working again. He later shot himself. The sheriff said authorities don't yet have a motive.

A law enforcement official has told The Associated Press the shooter did not have a criminal record. The official spoke on condition of anonymity because he was not authorized to discuss details of an ongoing criminal investigation.

Two people — a 54-year-old woman and a 45-year-old man — were killed, and another, Kristina Shevchenko, whose age could not be confirmed, was wounded and in serious condition on Wednesday.

The shooter, who wore a mask, fired randomly, investigators said. People at the mall were heroic in helping get shoppers out of the building, including off-duty emergency room nurses who rendered aid, Roberts said.

In response to previous mass shootings elsewhere, the first arriving officers were trained to form teams and go inside instead of waiting for SWAT. Employees at the mall also received training to handle such a situation.

"This could have been much, much worse," Roberts said.

The first 911 call came at 3:29 p.m. Tuesday. The first officers arrived a minute later. By 3:51 p.m., all the victims and the gunman and rifle had been found. Four SWAT teams spent hours clearing the 1.4 million square-foot mall, leaving shoppers and workers to hide in fear.

The mall Santa, Brance Wilson, was waiting for the next child's Christmas wish when shots rang out, causing the mall to erupt into chaos.

About to invite a child to hop onto his lap, Wilson instead dove for the floor and kept his head down as he heard shots being fired upstairs in the mall.

"I heard two shots and got out of the chair. I thought a red suit was a pretty good target," said Wilson, 68. Families waiting for Santa scattered. More shots followed, and Wilson crept away for better cover.

Witnesses said the gunman fired several times near the mall food court until the rifle jammed and he dropped a magazine onto the floor, then ran into the Macy's store.

Witnesses heard the gunman saying, "I am the shooter," as he fired rounds from a semi-automatic rifle inside the Clackamas Town Center, a popular suburban mall several miles from downtown Portland.

Some were close enough to the shooter to feel the percussion of his gun.

Police rapid-response teams came into the mall with guns drawn, telling everyone to leave. Shoppers and mall employees who were hiding stayed in touch with loved ones with cellphones and texting.

Kayla Sprint, 18, was interviewing for a job at a clothing store when she heard shots.

"We heard people running back here screaming, yelling '911,'" she told The Associated Press.

Sprint barricaded herself in the store's back room until the coast was clear.

Jason DeCosta, a manager of a window-tinting company that has a display on the mall's ground floor, said when he arrived to relieve his co-worker, he heard shots ring out upstairs.

DeCosta ran up an escalator, past people who had dropped for cover and glass littering the floor.

"I figure if he's shooting a gun, he's gonna run out of bullets," DeCosta said, "and I'm gonna take him."

DeCosta said when he got to the food court, "I saw a gentleman face down, obviously shot in the head."

"A lot of blood," DeCosta said. "You could tell there was nothing you could do for him."

He said he also saw a woman on the floor who had been shot in the chest.

Austin Patty, 20, who works at Macy's, said he saw a man in a white mask carrying a rifle and wearing a bulletproof vest. There was a series of rapid-fire shots in short succession as Christmas music played. Patty said he dove for the floor and then ran.

His Macy's co-worker, Pam Moore, told the AP the gunman was short, with dark hair.

Kira Rowland told KGW-TV that she was shopping at Macy's with her infant son when the shots started.

"All of a sudden you hear two shots, which sounded like balloons popping," Rowland told the station. "Everybody got on the ground. I grabbed the baby from the stroller and got on the ground."

Rowland said she heard people screaming and crying.

"I put the baby back in the stroller and ran," Rowland said.

Kaelynn Keelin was working two stores down from Macy's when the gunfire began. She watched windows of another store get shot out. She and her co-workers ran to get customers inside their own store to take shelter.

"If we would have run out, we would have run right into it," she said.

Shaun Wik, 20, was Christmas shopping with his girlfriend and opened a fortune cookie at the food court. Inside was written: "Live for today. Remember yesterday. Think of tomorrow."

As he read it, he heard three shots. He heard a man he believes was the gunman shout, "Get down!" but Wik and his girlfriend ran. He heard seven or eight more shots. He didn't turn around.

"If I had looked back, I might not be standing here," Wik said. "I might have been one of the ones who got hit."

Clackamas Town Center is one of the Portland area's biggest and busiest malls, with 185 stores and a 20-screen movie theater.

Holli Bautista, 28, was shopping at Macy's for a Christmas dress for her daughter when she heard pops that sounded like firecrackers. "I heard people running and screaming and saying 'Get out, there's somebody shooting,'" she told the AP.

She said hundreds of shoppers and mall employees started running, and she and dozens of other people were trying to escape through a department store exit.

Tiffany Turgetto and her husband were leaving Macy's through the first floor when they heard gunshots coming from the second floor of the mall. They were able to leave quickly through a Barnes & Noble bookstore before the police locked down the mall.

"I had left my phone at home. I was telling people to call 911. Surprisingly, people are around me, no one was calling 911. I think people were in shock," she said.

___

Associated Press writers Nigel Duara in Portland, Michelle Price in Phoenix, Pete Yost in Washington and Manuel Valdes in Seattle contributed to this report.

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Store employee saves customers during Ore. mall shooting

A store employee at the Clackamas Town Center
mall used his knowledge of the shopping complex to hustle a customer
out of the building during Tuesday's shooting rampage and then twice
went back inside to guide other shoppers to exits and safety.

Allan Fonseca, who works at Lancome counter in Macy's and was waiting on
Jocelyn Lay when they heard shots fired about 3:30 p.m. Thinking
quickly, Fonseca got her behind the counter to hide.

"We both just looked at each other and knew that this was a serious
situation and it was a gunman and we both just dove down below the
Lancome counter there for a little protection," Lay told "Good Morning
America." "And the gunfire just kept going off."

PHOTOS: Oregon Mall Shooting

Lay said that she began praying for the Lord to protect her and the
other shoppers in the mall. She said Fonseca, as a store employee, knew
exactly what to do, and she credits him as her hero.

"He said that we needed to evacuate, and he took me by the hand and took me down the escalator and out to safety," she said.

Once Fonseca was sure that she was safe, he then turned to her and said, "I'm going to go back and help other people."

Fonseca said that because he is familiar with the exits in the mall, he
felt that he would be able to help shoppers escape the gunfire.

"I felt that if I knew how to get out of the mall and out to safety then
I should share that knowledge with everyone else, like the shoppers
that don't come here regularly and don't know all of the exits," he
said. "So I decided to go back up because I wanted to see if there was
anybody in panic or didn't know where to do."

Fonseca returned to the mall and evacuated the lower level of the Macy's
store, and then went back up to the "shooting floor" to look for his
co-workers. Lay says she's not sure she would have done if he hadn't
been there to get her out of harm's way.

"I probably just would have stayed there and probably would have had a
little more fear because it's one of those situations where you've seen
in previous shootings, the gunman keep shooting and keep looking for
different people," she said. "I would have huddled there and hoped and
prayed."

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Facebook revises privacy controls in effort to make them more accessible, comprehensible

SAN FRANCISCO – Facebook is trying to make its privacy controls easier to find and understand in an effort to turn the world’s largest social network into a more discreet place.

The fine-tuning announced Wednesday will include several revisions that will start rolling out to Facebook Inc.‘s more than 1 billion users in the next few weeks.

The biggest change will be a new “privacy shortcuts” section that will appear as a tiny lock on the right-hand side at the top of people’s news feeds. This feature offers a drop-down box where users will be able to get answers to common questions such as “Who can see my stuff?”

Other updates will include a tool that will enable individuals to review all the publicly available pictures identifying them on Facebook.

Social Media News Headlines – Yahoo! News

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