Editor’s Comment
At the end of this month’s issue you will find two testimonials about two people whom Safe Harbor has helped. It makes my day every time one comes across my desk because it let’s me know that we are fulfilling our slogan of “Changing lives every day.”
On many a call that I receive, it is not uncommon for me to ask the person to keep me posted on his or her progress as the person walks that sunlit road to wellness. Months go by. Then the call or email comes in, commonly beginning with, “You may not remember me, but…” And, yes, I do remember them.
I have often told my children that I believe it is incumbent upon all of us to contribute more to life than we take out of it, so that at the end of our days, we can look back and know that the world is better off for us having passed through.
For those of us at Safe Harbor, our way of making that better world is to do all we can to point the way to recovery for so many who suffer from deep emotional and mental turmoil.
We donate our time, sometimes our evenings and our weekends, and often from our own pockets to keep this work robust and to reach as many as we can with our message of hope.
But running a nonprofit requires more than just hard work and good hearts. In our society, we have bills to pay for our phones, postage, stationery, travel costs, printing, equipment, and a host of other small and large items. In short, we require money.
We make one annual effort at fundraising and that time is now, culminating in our Fourth Annual Awards Benefit (see below). Many individuals have donated their time and talent to make this event happen. All of those who will be presenting want to see Safe Harbor’s efforts prosper in the world.
You can help by buying your tickets early, buying them for someone else, helping us cover the cost of the event or by generously donating to our cause in general. Our target is to raise $250,000 because there is so much more work to do.
The next time we publish one of those emails that starts, “You may not remember me, but…” I hope that it can bring a smile to your face, knowing that, through your donations, you too are changing lives every day.
Five Announcements
Dr. Laura Schlessinger, Dr. Doris Rapp Headline Safe Harbor Event, Oct. 7
Mark your calendar for October 7, Safe Harbor’s remarkable Fourth Annual Awards Benefit – this year featuring three internationally-recognized authors who are legends in their fields.
Dr. Doris Rapp, author of the blockbuster books Is This Your Child? and Is This Your Child’s World? plus the recent Our Toxic World, is the world’s leading spokesperson on how allergies affect child behavior. Her work on Donahue, Oprah, and through lectures around the world has dramatically impacted a generation of children. One television appearance alone prompted over 100,000 letters from viewers.
Safe Harbor is privileged to honor Dr. Rapp with our 2004 Lighthouse Award, presented annually to men and women who benefit humanity by forwarding truly safe and effective mental health treatments.
Dr. Laura Schlessinger, America’s top radio therapist with over 10 million weekly listeners, has generously agreed to donate her time as our keynote speaker. Dr. Laura finds common ground with Safe Harbor as a champion of children, a public voice encouraging the use of psychiatric drugs only as a last resort, and a promoter of the philosophy that full recovery comes from taking responsibility for one’s health and one’s life.
Dr. Laura, author of seven New York Times bestsellers, including her recent mega-hit The Proper Care and Feeding of Husbands, will answer questions from the audience.
Also honored will be Melvyn Werbach, M.D., renowned nutritional psychiatrist and editor of numerous internationally popular texts such as Nutritional Influences on Illness and Nutritional Influences on Mental Illness.
Ticket prices: $95 in advance; $125 at the door
Special seating at Dr. Laura’s or Dr. Rapp’s table: $500
SEATING IS LIMITED – THIS EVENT IS GENERATING A LOT OF BUZZ SO BOOK EARLY!
THIS EVENT WILL NOT BE VIDEOED – THIS IS A ONE-TIME OPPORTUNITY!
Where: Glendale Hilton, 100 W. Glenoaks Blvd., Glendale, California
When: 7:30 PM, Thursday, October 7.
Prizes, including jewelry made by Dr. Laura, will be raffled off.
Tickets can be purchased online at https://secure.corpsite.com/secure_alternative/conference.htm or at (323) 257-7338 or mail checks to Safe Harbor, 1718 Colorado Blvd. Los Angeles, CA 90041.
Safe Harbor Los Angeles Talk and Support Group, Sep. 8
Come see a showing of “Underlying Physical Causes of Mental Disorders” by Dan Stradford, president of Safe Harbor. This talk was originally delivered and taped in Boston.
We also meet for an hour for our support group.
The Los Angeles monthly Support/Educational Group is held on the second Wednesday evening of each month, from 7 to 9 pm at the Safe Harbor office, 1718 Colorado Blvd in the Eagle Rock section of Los Angeles. Parking is available on Colorado Blvd. or on side streets. Various health practitioners present topics related to alternative treatments for mental health with time for questions and sharing among the group participants. This group is a forum for persons interested in alternative mental health to gather, learn, and share. It is open to the public, and all are welcome.
An RSVP phone call or email is appreciated to give us a idea of attendance. One can call the Safe Harbor office at (323) 257-7338, email Safe Harbor SafeHarborProj@aol.com; or contact Jeri Marston, RN (310) 822-2895, jerimarston@comcast.net
Free Pfeiffer Seminars on Mood, Learning and Behavior Disorders
Learn about the benefits of nutrient therapy for ADD/HD, Autism, Behavior Disorders, Depression, Anxiety, and Schizophrenia.
Two Free 2-hour seminars
Monday and Tuesday, September 20th and 21st, 6:30 pm to 8:30 pm
Embassy Suites Hotel
150 Anza Blvd.
Burlingame, CA
650-342-4600 (for directions only)
Dr. Bill Walsh and his team from the Pfeiffer Treatment Center will share their work on the Peninsula. The Pfeiffer Treatment Center (Naperville, Ill.) has treated over 18,000 children and adults with nutritional therapies for a wide range of behavioral and mental health disorders. Dr. Walsh will speak at the Embassy Suites Hotel in Burlingame, CA (150 Anza Blvd.) on Monday and Tuesday evenings, Sept. 20th and 21st from 6:30 p.m. to 8:30 p.m. His seminar, “The Role of Nutrients in Mood, Learning and Behavior Disorders,” is free. Monday’s seminar will focus on mental health and behavioral disorders, while Tuesday’s seminar will be on Autistic Spectrum Disorders.
For more seminar information call 630-505-0300.
6-Week Workshop in Chino, California to Discuss Physical Causes Underlying Mental Disorders
Learn the science behind nutritional treatments for mental disorders in a series of Saturday morning workshops with
• Nancy Mullan, MD, Burbank psychiatrist
• Stuart Shipko, MD, Pasadena psychiatrist
• Prof. James Croxton, educator, physiological psychology
• Dan Stradford, President of Safe Harbor
Week 1: Stress and Neurological Structures and Processes
Week 2: Nutritional Factors Relative to Brain Structure and Function
Week 3: Hormonal Issues, Cerebral Allergies, and Food Intolerances
Week 4: How Pollutants and Toxins Affect Brain Function
Week 5: Medical Causes of Mental Disorders
Week 6: Resources for Alternative Mental Health Care
PLUS hear the personal stories of people who have recovered from mental disorders through nutrition, diet changes, and other natural means.
Presented by NAMI (National Alliance for the Mentally Ill) Chino Valley (formerly NAMI Chino Hills), in partnership with Safe Harbor, the nation’s leading nonprofit agency for non-pharmaceutical mental health education.
Schedule: Each Saturday, Sept. 25 through Oct. 30, 2004, 10:00 AM – 12:30 PM.
Location: 6251 Schaefer Ave., Unit G, Chino, California.
Fee (all six weeks): $38 / two attendees together: $58.
Each additional family member: $10.
Seating is limited, so register early!
Phone numbers:
NAMI: (909)923-7517
Safe Harbor: (323) 257-7338
Make checks payable to “Safe Harbor” or “NAMI Chino Valley” and send to Safe Harbor, 1718 Colorado Blvd., Los Angeles, CA 90041
VISA, MasterCard, AMEX accepted.
For more information contact www.alternativementalhealth.com or call the above numbers.
Safe Harbor to Present at Alternatives 2004 Conference, Denver, Oct. 14
Safe Harbor New York chapter president Dana Barnes and Safe Harbor founder Dan Stradford will present a workshop at the Alternatives 2004 Conference in Denver, Colorado, on Thursday, October 14, from 2:00 PM to 3:15 PM. The topic will be “Natural Alternatives for Mental Health Recovery.”
Alternatives 2004 is a national mental health conference organized by and for mental health consumers. This year’s theme is “Achieving the Promise of Recovery: New Freedom, New Power, New Hope.” For more information on the conference, go to www.mhselfhelp.org/alt2004.htm
Grant Awarded for Naturopathic Mental Health Treatments
The Mental Health Center of Greater Manchester was recently awarded a $40,000 Ittleson Foundation grant designated to support the agency’s efforts to integrate naturopathic medicine among the array of treatments available for behavioral and mental health concerns. The two-year grant will support efforts to develop a program model, treatment protocols and educational materials that can be replicated by other mental health programs throughout the country.
A year ago, The Center became one of the first community mental health centers in the United States to offer naturopathic medicine as a treatment option. At a time when more people are seeking alternatives to traditional medical care and, in particular, looking to rely less on medication to manage their symptoms, the demand for complementary therapies like those provided by naturopathic medicine is growing.
According to The Center’s Medical Director, Daniel P. Potenza, MD, “The Ittleson Foundation grant affords us an exciting and unique opportunity to establish a first-of-its-kind program model. Dr. Jeffrey Sager, the naturopathic doctor on our staff, will be developing the program model, treatment protocols, educational and program development materials that will be an invaluable tool for other mental health organizations locally and nationally who want to replicate the program.”
Dr. Sager, a licensed doctor of naturopathic medicine, joined the staff of The Center’s Bedford Counseling Associates one year ago. He is also on the staff of the Center for Life Management, the community mental health agency located in Derry.
Since 1932, The Ittleson Foundation has been serving the needs of the underprivileged and providing resources for not-for-profit organizations. Today, The Foundation continues a commitment to bringing a “venture capital” approach to philanthropy and is particularly interested in the areas of mental health, AIDS, and the environment.
For more information regarding Naturopathic Medicine services, contact The Mental Health Center of Greater Manchester at (603) 668-4111 or visit www.mhcgm.org.
Consumer Confidence in Pharmaceutical Companies Hits New Low
Pharmaceutical companies were ranked in the bottom half of industries considered to be doing “a good job of serving their consumers,” 11th out of 15 in a recent Harris Poll; only health insurance companies, oil companies, managed care companies, and tobacco companies had a worse ranking. The annual poll, of 978 adults, shows that the proportion of respondents saying they have a positive attitude towards the pharmaceutical industry fell from 79% in 1997 to 44% in 2004 – a bigger drop than for any other industry. See www.harrisinteractive.com.
Study Correlates Hyperactivity with Food Colorings, Preservatives
The results of a double blind, placebo-controlled study of the impact of artificial food colorings and benzoate preservatives on hyperactivity in preschool children by B. Bateman et al, University of Southampton, UK, were published in the June 2004 issue of Arch. Dis. Child ( http://adc.bmjjournals.com/cgi/content/full/89/6/506, http://adc.bmjjournals.com/cgi/reprint/89/6/506.pdf).
After a baseline assessment for allergies and hyperactivity symptoms, a sample of 1,873 3-year-olds were given a benzoate-free and artificial coloring-free diet for one week, followed by periods of either a placebo or a drink containing 20 mg daily of artificial colorings and 45 mg daily of sodium benzoate.
Behavior was assessed by parents’ ratings. There were significant reductions in reported hyperactive behavior during the one-week withdrawal phase, with significantly greater increases in hyperactive behavior resulting from being fed the chemicals than from the placebo.
The researchers concluded that artificial food coloring and benzoate preservatives have a general adverse effect on the behavior of 3-year-old children, detectable by parents though not by a simple clinic assessment. These results held true for the whole population regardless of history of atopy (allergic reactions), hyperactivity, both, or neither.
FDA Follow-Up Study Confirms Child Suicide Risks
Six months ago the Food and Drug Administration withheld an internal finding that antidepressant medications were associated with an increased risk of suicide among children, pending the results of a second staff analysis. Those results are in, reports the Wall Street Journal, and the news is not good.
Agency officials continued to withhold publication of the data pending a scheduled meeting in September. By then, the FDA will have dragged out its deliberations nine full months after British authorities warned physicians not to prescribe Paxil, Zoloft, Celexa, and similar drugs to depressed children.
Steven Hyman, former director of the National Institute of Mental Health, reviewed both FDA internal analyses at the request of The Washington Post and voiced “concern about the risk-benefit ratio of antidepressants in children.” Prior to reviewing the documents, Hyman had thought the British authorities were overreacting.
“It would be premature to discuss any conclusions and results,” said FDA spokeswoman Kathleen Quinn. “Other people are going to have an opinion about it, but we are still reviewing it.”
The new analysis does little to allay the concerns of district attorneys and other public officials that crucial information about the safety and effectiveness of the drugs has been withheld from public scrutiny. Two-thirds of the trials conducted by drug manufacturers found that the medications performed no better than sugar pills, but details of the negative trials were kept from doctors and parents under the claim of safeguarding drug companies’ trade secrets.
Joseph Glenmullen, a Harvard psychiatrist and author of Prozac Backlash, a book about the side effects of antidepressants, said one company, Wyeth, had itself warned doctors not to prescribe its antidepressant Effexor for children, adding: “The companies are coming to this conclusion, and the British came to this conclusion, and the Canadians and the rest of Europe and the FDA’s own reviewer have come to this conclusion; why have they dragged their feet for over a year?”
The new “interim review” by FDA medical reviewer Tarek A. Hammad is a compilation of data with no narrative or interpretation. But both Hyman and Glenmullen said it showed an increased risk for children taking the drugs similar to that found in February by another FDA scientist, Andrew Mosholder.
Hammad’s review found that compared with depressed children who got placebos, children under antidepressants were 1.78 times as likely to attempt suicide or prepare for suicide. Mosholder found that children getting antidepressants had 1.9 times the risk of “serious suicide-related events.”
In a memo dated Feb. 18, Mosholder warned the new analysis would waste time: “In my view, it is unlikely that the new information will alter the basic finding of an association of … serious suicide-related events with active treatment.”
Given the risks, he urged the agency to take the interim step of officially discouraging the use of antidepressants other than Prozac for children. The FDA declined to do so but called for stronger warning labels to remind doctors to be vigilant about suicide. For more than a decade, the agency has said that depression, not antidepressants, causes suicidal behavior.
Multiple congressional investigations are underway into the controversy. The chairman of the Senate Finance Committee, Charles E. Grassley (R-Iowa), said in August: “…it’s fair to ask if the Food and Drug Administration is taking too much time to draw a conclusion.”
Glenmullen pointed out that no antidepressant apart from Prozac had demonstrated superiority to placebos in treating children’s depression. This may be why the British authorities excluded Prozac from their warning to doctors. The subject of their warning was that drugs, despite the billions being spent on them, did no measurable good at all – and increased suicidal behavior significantly.
All the company-sponsored trials, according to Hyman, excluded children who were suicidal to begin with. Thus the negative impact of these drugs – Prozac included – could be a great deal worse than disclosed in the reports that prompted British authorities to act.
Eat to Beat Depression
Almost half of adults in the UK eat to stifle feelings of loneliness, boredom and stress, finds a recent survey of 2,000 people. Yet, ironically, eating the right foods, plus appropriate supplementation, may be the very answer to beating the blues.
America’s CBS News recently reported on the breakthroughs being made in the treatment of depression by Patrick Holford’s Brain Bio Centre at the Institute for Optimum Nutrition in London. This short film follows the success story of a 21-year-old girl who experienced severe side-effects and withdrawal effects on anti-depressants and has found incredible improvement through the Brain Bio Centre’s diet and supplement strategy.
You can download the film and see it for yourself at www.mentalhealthproject.com.
Also see the new and expanded www.patrickholford.com.
Children + Vitamins = Increased School Attendance
Murrieta, CA – Teacher Johnnie Hill of Haworth, OK has been distributing Vitamin Relief USAtm vitamins everyday in her classroom for three years. She reports, “We had a very severe flu outbreak in our area this [past] winter. Some schools in our area closed due to high absenteeism. But because of the vitamins, not a single student in my classroom became ill. The students also seem to learn better…[which] may be related to the fact they are here every day.”
Ms. Hill is just one of hundreds of teachers and parents praising Vitamin Relief USAtm, a national initiative of The Healthy Foundation, which provides free daily multi-vitamins to thousands of at-risk children throughout the country. In fact, half of all parents participating in this year’s Vitamin Relief USAtm observational survey reported that their children were sick less often since taking daily vitamins. Almost one-third said their children earned higher grades. But the good news didn’t stop there. Marked improvements in the behavior, energy, appetites, and self-image of almost 2,900 children were also reported.
“Though this is only an observational survey, reports from teachers and parents indicate that many children taking our daily vitamins show noticeable improvements within 30 days. In addition, children who have taken our daily vitamins for three years exhibit even greater improvements – particularly in immune strength.” states Michael Morton, Executive Director of The Healthy Foundation.
In December 2002, Congress awarded The Healthy Foundation an earmarked appropriation of $500,000 to conduct a scientific research study to measure the impact of vitamin intake on at-risk youth and their school performance. “Next year, we look forward to presenting the conclusive results of this study which will substantiate through formal research the impact that daily vitamins have on at-risk children and their academic performance.”
The Healthy Foundation provides daily vitamins to nearly 17,000 at-risk children at over 500 sites in 40 states. Its national initiative, Vitamin Relief USA – Children Firsttm, is a public/private partnership that distributes daily children’s chewable multivitamin/mineral supplements to children at risk for malnutrition and nutrient deficiency. Other Vitamin Relief USAtm programs include Senior Supporttm which provides daily multi-vitamins to 1,000 low-income seniors in Riverside, CA. and Healthy Familiestm which provides daily vitamins to almost 2,400 at-risk teens and adults.
The Healthy Foundation, a tax-exempt, non-profit foundation, is committed to improving the health status of children, seniors and adults through vitamin supplementation. To support The Healthy Foundation or for further information, please call 877-935-5348 or visit www.vitaminrelief.org.
Mercury to Be Banned from Baby Vaccines in Britain
Mercury will be banned from vaccines given to babies, Britain’s Department of Health announced Aug. 6, responding to fears of links between the metal and autism.
Doctors nationwide are being contacted over changes to the infant vaccine program for eight-week-old children. They are also being told to switch from a live polio vaccine taken orally to an injection to avoid rare cases of contamination. The injection, to be administered at two months of age, will combat diphtheria, tetanus, whooping cough, hib and polio.
The whooping cough vaccine had contained a form of mercury called thiomersal.
John Hutton, a health minister, said: “I can confirm that later this year we will be introducing a new form of childhood vaccination for diphtheria, tetanus, whooping cough, Hib (Haemophilus influenzae type b) and polio.”
Prozac Found in Britain’s Drinking Water
Britain’s Environment Agency has revealed that Prozac is building up both in river systems and groundwater used for drinking supplies, The Observer reported Aug. 8.
Environmentalists are calling for an urgent investigation into the revelations, characterizing the antidepressant accumulation as “hidden mass medication.” The government’s chief environment watchdog recently held a series of meetings with the pharmaceutical industry to discuss any repercussions for human health or the ecosystem.
The discovery raises fresh fears that GPs are overprescribing Prozac, Britain’s antidepressant of choice, according to The Observer article. In the decade up to 2001, overall prescriptions of antidepressants rose from nine million to 24 million a year. Prozac was the only leading antidepressant not covered by the British government’s warning to doctors not to prescribe these mind-altering chemicals to children due to suicide risks.
A recent report by the Environment Agency concluded Prozac could be potentially toxic in the water table. Whether or not it has reached toxic levels remains unknown. The government’s Drinking Water Inspectorate (DWI) was optimistic that the drug would be too “watered down” to be toxic.
Dr Andy Croxford, the Environment’s Agency’s policy manager for pesticides, told The Observer: “We need to determine the effects of this low-level, almost continuous discharge.”
Norman Baker, the Liberal Democrats’ environment spokesman, said the revelations exposed a failing by the government on an important public health issue. He added that the public should be told if they were inadvertently taking drugs like Prozac.
“This looks like a case of hidden mass medication upon the unsuspecting public,” Baker said. “It is alarming that there is no monitoring of levels of Prozac and other pharmacy residues in our drinking water.”
Experts say that Prozac finds its way into rivers and water systems from treated sewage water.
European studies have also expressed disquiet over the impact of pharmaceuticals building up in the environment, warning that an effect on wildlife and human health “cannot be excluded.”
“Advanced treatment processes installed for pesticide removal are effective in removing drug residues,” a DWI spokesman said.
Testimonial: Bipolar Recovery through Safe Harbor
I feel that I have been extremely blessed by finding the nutritional information on AlternativeMentalHealth.com. My life was a wreck of constant chaos and drama before I figured out I could use a healthy diet and nutritional supplements to heal my mental problems. I couldn’t finish school and constantly ran from one interest to another, not finishing anything. I couldn’t get into healthy long-lasting relationships – I had drama relationships. For many years I dropped most of my classes in junior college every semester, and then started again the next semester. I couldn’t concentrate or focus. I had mood problems. I got suicidal thoughts for two days right before my period every month. One cup of coffee could send me into a elevated rush where I couldn’t fall asleep all night. I was hospitalized five times in the county mental health system, about once a year.
My family gave up on me and finally kicked me out of the family. They made me go to a special residential program – which I don’t recommend because they cost $5,000 a month and don’t use nutritional medicine. That program, despite the huge cost, didn’t work. I then became homeless. Then I was put in the system and was put on SSI. I was diagnosed first with ADD, then as bipolar, and then bipolar with schizoaffective. I was aimless in the system on medication. I still had problems with life, and had major food and internet and shopping addictions. My life was going nowhere and I felt the huge burden of stigma from society. I felt like an outcast and that no one would love me or understand me because I was not well on meds and I was going nowhere. At least at this point I did have a roof over my head, and less stress because I didn’t have to go to school or work.
Then one day I decided to use Google to search for alternative treatments for mental illness. I found this website and started to research the information. Also, by chance, an acquaintance recommended that I read Julia Ross’s book The Diet Cure. I read The Diet Cure cover to cover in a period of one or two days really thoroughly. I decided that it sounded a little too good to be true, but I thought I would go out and buy the supplies and give it a chance. I already knew I had a gluten allergy because I had been tested in grade school. And my mom fed me organic veggies as a kid. So part of it already made sense. I took out a loan and bought all of the food and supplements I thought I would need. There were a lot of them. I went to work and started following the diet exactly. I cut out all sugar, wheat, dairy, chocolate, and caffeine. Incidentally, I never do alcohol or drugs so I didn’t have to quit those.
After that my whole life changed around. I started being much more friendly and out-going. I started going to bed earlier and getting up earlier. I had control of going to sleep when I wanted to for the first time in years. The drugs never quite accomplished that. This was a major victory for me because I know that one of the major precursors to having my manias with delusional features was losing a night of sleep. I was always scared to lose sleep because I feared going nuts the next day. The next major thing I noticed, besides being in a good mood most of the time and being able to focus much, much better, was that I lost about 40 pounds. I went from a pants size of 13 down to a size seven or 10, depending on the brand. I had much, much more energy and constantly just felt exuberant and joyful about taking very long walks outside. I started working part-time to pay for my organic food and supplements. This was also a miracle because I had always been too apathetic to really hold down a job. I’m an artist and I started painting big acrylic paintings on canvas. I had always been encouraged in the arts by my family, but had never actually made much artwork. I drew maybe one picture a year at the most, most of my life. After I changed my diet I started painting all the time on a regular basis and I’ve shown my work twice since. I’ve painted at least 30 full paintings and some of them are quite large, around 30 by 40 inches. I started studying nutrition at an accredited nutrition college, but I plan on studying it in a independent study style to give me more free time and flexibility to make more artwork and develop my creative talents.
My relationships have blossomed and I have held onto and maintained many real friendships with people who are my good friends in good times and bad. I have completely changed my role in my family from the “problem child” to the supportive, happy, enthusiastic-about-life grown woman that I am now. I actually get along with my family now, which is a total miracle. I never could get along with my mother very well my whole life.
We actually can have a good time with each other and laugh now. I’ve had one long-term relationship that was meaningful and lasted around a year.
All in all, I feel that I’ve worked hard to create a state of wellness for myself in most aspects of my life. I feel that wellness is a process that one has to work on every day. I still work on my nutrition, my relationships, and my work every day. And I don’t take it for granted. I’m very thankful and grateful that I found this information about nutrition that I feel saved my life. I feel very happy and fulfilled in many ways and it wouldn’t be possible without AlternativeMentalHealth.com.
Help through Safe Harbor
Dear Safe Harbor,
We have a patient who came to us after looking us up on your site. He was depressed, anxious and on several psychiatric medications. In the last 21/2 months, he is off his medication. He is doing so much better emotionally. He is happier, less anxious, sleeps better and has hope for the future. Thank you for being there and referring others to get help.
Sincerely,
The office of Dr. Anita Pepi, DC, Los Angeles