Labor Relations Board Rulings Could Be Undone



By ruling that Mr. Obama’s three recess appointments last January were illegal, the federal appeals court ruling, if upheld, would leave the board with just one member, short of the quorum needed to issue any rulings. The Obama administration could appeal the court ruling, but no announcement was made on Friday.


If the Supreme Court were to uphold Friday’s ruling, issued by the United States Court of Appeals for the District of Columbia Circuit, it would mean that the labor board did not have a quorum since last January and that all its rulings since then should be nullified.


Many Republicans and business groups applauded Friday’s ruling. They often assert that the appointments Mr. Obama made to the board have transformed it into a tool of organized labor. But many Democrats and labor unions say Mr. Obama’s appointments restored ideological balance to the board after it was tipped in favor of business interests under President George W. Bush


Mark G. Pearce, the board’s chairman, issued a statement saying the board disagreed with the ruling and suggested that other appeals courts hearing cases about the constitutionality of Mr. Obama’s appointments could reach a different conclusion.


“In the meantime, the board has important work to do,” said Mr. Pearce, whose agency oversees enforcement of the laws governing strikes and unionization drives. “We will continue to perform our statutory duties and issue decisions.”


Unless the Senate confirms future nominees to the board — Senate Republicans have blocked several of Mr. Obama’s board nominees — Mr. Pearce will be the only member left if Friday’s ruling is upheld. The board has five seats.


Representative Darrell Issa, a California Republican who is the chairman of the Oversight and Government Reform Committee, issued a statement that urged the recess appointees to “do the right thing and step down.” He added, “To avoid further damage to the economy, the N.L.R.B. must take the responsible course and cease issuing any further opinions until a constitutionally sound quorum can be established.”


The three disputed recess appointees included two Democrats, Sharon Block, deputy labor secretary, and Richard Griffin, general counsel to the operating engineers’ union; and one Republican, Terence Flynn, a counsel to a board member. Mr. Flynn resigned last May after being accused of leaking materials about the group’s deliberations. Another Republican member, Brian Hayes, stepped down when his term expired last month.


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40 Years After Roe v. Wade, Thousands March to Oppose Abortion


Drew Angerer/The New York Times


Pro-life activists made their way down Constitution Avenue toward the Supreme Court during the March for Life in Washington on Friday.







WASHINGTON — Three days after the 40th anniversary of the decision in Roe v. Wade, the landmark Supreme Court case that legalized abortion, tens of thousands of abortion opponents from around the country came to the National Mall on Friday for the annual March for Life rally, which culminated in a demonstration in front of the Supreme Court building.




On a gray morning when the temperature was well below freezing, the crowd pressed in close against the stage to hear more than a dozen speakers, who included Tony Perkins, the president of the Family Research Council; Representative Diane Black, Republican of Tennessee, who recently introduced legislation to withhold financing from Planned Parenthood, and Senator Rand Paul, Republican of Kentucky; Cardinal Seán Patrick O’Malley of Boston; and Rick Santorum, the former senator from Pennsylvania and Republican presidential candidate.


Mr. Santorum spoke of his wife’s decision not to have an abortion after they learned that their child — their daughter Bella, now 4 — had a rare genetic disorder called Trisomy 18.


“We all know that death is never better, never better,” Mr. Santorum said. “Bella is better for us, and we are better because of Bella.”


Jeanne Monahan, the president of the March for Life Education and Defense Fund, said that the march was both somber and hopeful.


“We’ve lost 55 million Americans to abortion,” she said. “At the same time, I think we’re starting to win. We’re winning in the court of public opinion, we’re winning in the states with legislation.”


Though the main event officially started at noon, the day began much earlier for the participants, with groups in matching scarves engaged in excited chatter on the subway and gaggles of schoolchildren wearing name tags around their necks. Arriving on the Mall, attendees were greeted with free signs (“Defund Planned Parenthood” and “Personhood for Everyone”) and a man barking into a megaphone, “Ireland is on the brink of legalizing abortion, which is not good.”


The march came two months after the 2012 campaign season, in which social issues like abortion largely took a back seat to the focus on the economy. But the issue did come up in Congressional races in which Republican candidates made controversial statements about rape or abortion. In Indiana, Richard E. Mourdock, a Republican candidate for the Senate, said in a debate that he believed that pregnancies resulting from rape were something that “God intended,” and in Illinois, Representative Joe Walsh said in a debate that abortion was never necessary to save the life of the mother because of “advances in science and technology.” Both men lost, hurt by a backlash from female voters.


Recent polls show that while a majority of Americans do not want Roe v. Wade to be overturned entirely, many favor some restrictions. In a Gallup poll released this week, 52 percent of those surveyed said that abortions should be legal only under certain circumstances, while 28 percent said they should be legal under all circumstances, and 18 percent said they should be illegal under all circumstances. In a Pew poll this month, 63 percent of respondents said they did not want Roe v. Wade to be overturned completely, and 29 percent said they did — views largely consistent with surveys taken over the past two decades.


“Most Americans want some restrictions on abortion,” Ms. Monahan said. “We see abortion as the human rights abuse of today.”


Speaker John A. Boehner of Ohio, who spoke via a recorded video, called on the protest group, particularly the young people, to make abortion “a relic of the past.”


“Human life is not an economic or political commodity, and no government on earth has the right to treat it that way,” he said.


The crowd was dotted with large banners, many bearing the names of the attendees’ home states and churches and colleges. Gary Storey, 36, stood holding a handmade sign that read “I was adopted. Thanks Mom for my life.” Next to him stood his adoptive mother, Ellen Storey, 66, who held her own handmade sign with a picture of her six children and the words “To the mothers of our four adopted children, ‘Thank You’ for their lives.”


Mr. Storey said he was grateful for the decision by his biological mother to carry through with her pregnancy. “Beats the alternative,” he joked.


Last week, the Planned Parenthood Federation of America started a new Web site, and on Tuesday, its president, Cecile Richards, released a statement supporting abortion rights.


“Planned Parenthood understands that abortion is a deeply personal and often complex decision for a woman to consider, if and when she needs it,” she said. “A woman should have accurate information about all of her options around her pregnancy. To protect her health and the health of her family, a woman must have access to safe, legal abortion without interference from politicians, as protected by the Supreme Court for the last 40 years.”


This article has been revised to reflect the following correction:

Correction: January 25, 2013

A summary that appeared on the home page of NYTimes.com with an earlier version of this article misstated the day of the march. It took place on Friday, not Thursday.



Read More..

40 Years After Roe v. Wade, Thousands March to Oppose Abortion


Drew Angerer/The New York Times


Pro-life activists made their way down Constitution Avenue toward the Supreme Court during the March for Life in Washington on Friday.







WASHINGTON — Three days after the 40th anniversary of the decision in Roe v. Wade, the landmark Supreme Court case that legalized abortion, tens of thousands of abortion opponents from around the country came to the National Mall on Friday for the annual March for Life rally, which culminated in a demonstration in front of the Supreme Court building.




On a gray morning when the temperature was well below freezing, the crowd pressed in close against the stage to hear more than a dozen speakers, who included Tony Perkins, the president of the Family Research Council; Representative Diane Black, Republican of Tennessee, who recently introduced legislation to withhold financing from Planned Parenthood, and Senator Rand Paul, Republican of Kentucky; Cardinal Seán Patrick O’Malley of Boston; and Rick Santorum, the former senator from Pennsylvania and Republican presidential candidate.


Mr. Santorum spoke of his wife’s decision not to have an abortion after they learned that their child — their daughter Bella, now 4 — had a rare genetic disorder called Trisomy 18.


“We all know that death is never better, never better,” Mr. Santorum said. “Bella is better for us, and we are better because of Bella.”


Jeanne Monahan, the president of the March for Life Education and Defense Fund, said that the march was both somber and hopeful.


“We’ve lost 55 million Americans to abortion,” she said. “At the same time, I think we’re starting to win. We’re winning in the court of public opinion, we’re winning in the states with legislation.”


Though the main event officially started at noon, the day began much earlier for the participants, with groups in matching scarves engaged in excited chatter on the subway and gaggles of schoolchildren wearing name tags around their necks. Arriving on the Mall, attendees were greeted with free signs (“Defund Planned Parenthood” and “Personhood for Everyone”) and a man barking into a megaphone, “Ireland is on the brink of legalizing abortion, which is not good.”


The march came two months after the 2012 campaign season, in which social issues like abortion largely took a back seat to the focus on the economy. But the issue did come up in Congressional races in which Republican candidates made controversial statements about rape or abortion. In Indiana, Richard E. Mourdock, a Republican candidate for the Senate, said in a debate that he believed that pregnancies resulting from rape were something that “God intended,” and in Illinois, Representative Joe Walsh said in a debate that abortion was never necessary to save the life of the mother because of “advances in science and technology.” Both men lost, hurt by a backlash from female voters.


Recent polls show that while a majority of Americans do not want Roe v. Wade to be overturned entirely, many favor some restrictions. In a Gallup poll released this week, 52 percent of those surveyed said that abortions should be legal only under certain circumstances, while 28 percent said they should be legal under all circumstances, and 18 percent said they should be illegal under all circumstances. In a Pew poll this month, 63 percent of respondents said they did not want Roe v. Wade to be overturned completely, and 29 percent said they did — views largely consistent with surveys taken over the past two decades.


“Most Americans want some restrictions on abortion,” Ms. Monahan said. “We see abortion as the human rights abuse of today.”


Speaker John A. Boehner of Ohio, who spoke via a recorded video, called on the protest group, particularly the young people, to make abortion “a relic of the past.”


“Human life is not an economic or political commodity, and no government on earth has the right to treat it that way,” he said.


The crowd was dotted with large banners, many bearing the names of the attendees’ home states and churches and colleges. Gary Storey, 36, stood holding a handmade sign that read “I was adopted. Thanks Mom for my life.” Next to him stood his adoptive mother, Ellen Storey, 66, who held her own handmade sign with a picture of her six children and the words “To the mothers of our four adopted children, ‘Thank You’ for their lives.”


Mr. Storey said he was grateful for the decision by his biological mother to carry through with her pregnancy. “Beats the alternative,” he joked.


Last week, the Planned Parenthood Federation of America started a new Web site, and on Tuesday, its president, Cecile Richards, released a statement supporting abortion rights.


“Planned Parenthood understands that abortion is a deeply personal and often complex decision for a woman to consider, if and when she needs it,” she said. “A woman should have accurate information about all of her options around her pregnancy. To protect her health and the health of her family, a woman must have access to safe, legal abortion without interference from politicians, as protected by the Supreme Court for the last 40 years.”


This article has been revised to reflect the following correction:

Correction: January 25, 2013

A summary that appeared on the home page of NYTimes.com with an earlier version of this article misstated the day of the march. It took place on Friday, not Thursday.



Read More..

Gadgetwise Blog: Is January the Time to Buy Electronics?

At the International Consumer Electronics Show in Las Vegas in early January, manufacturers tantalized consumers with new electronics soon to hit the shelves. But what does that do to the prices of current models that are being replaced? Is this a golden buying opportunity?

Yes and no. Yes for TVs, no for laptops. I’ll explain.

Decide.com, which tracks the price of electronics, studied what happened to the cost of TVs and laptops in past years after C.E.S.

What it found is that TV prices dip to near yearly lows after the show, matching holiday prices. With the average price of the top 250 TVs at $1,057, the post-show average is projected to drop an average of $211, to $846, based on data from previous  years. That is a 20 percent savings.

Laptops don’t drop so steeply. After the show, the 100 most popular laptops have historically been discounted 8 percent. This year that would mean the top 100 laptops, which average $780 in price, would be reduced $62, to $718.

Laptop price are lowest in late June through early July, right before the back to school sales, and during the last two weeks of September, after those sales, according to Decide.com’s data. At those times the discounts are typically 10 percent.

Of course, averages can be deceiving. Prices are volatile all year around, so a particular TV or computer you want could be discounted far more at any time.

There are a number of browser add-ons and apps that let you track prices of individual products, or you can use Decide.com – but it will cost you. Membership is $5 a month or $30 a year for full access.

Read More..

At Least 8 Die in Egyptian Riots after Soccer Verdict





CAIRO — An Egyptian court sentenced 21 people to death on Saturday on charges related to one of the world’s deadliest incidents of soccer violence, touching off an attempted jailbreak and a riot that killed at least 16 in the Mediterranean port city that is home to most of the defendants.




The verdict follows deadly clashes between police and demonstrators on Friday, the second anniversary of the uprising that overthrew Egypt’s longtime leader Hosni Mubarak. Such cycles of violence, often lasting for weeks and costing dozens of lives, have occurred regularly in the last two years.


Avid soccer fans from both teams, known as Ultras, hold the police at least partly responsible for the Port Said deaths and have criticized President Mohamed Morsi for doing little to overhaul the force.


Immediately after the verdict, two police officers were shot dead outside Port Said’s main prison when angry relatives tried to storm the facility to free the defendants. Police fired tear gas and rubber bullets, as well as live rounds, at the crowd outside the prison, killing six, security officials said.


Security officials said the military was being deployed to Port Said — the second such deployment in less than 24 hours. The army is often used to keep order by top generals who took over after Mr. Mubarak was ousted, but the military has kept a much lower profile since Mr. Morsi was elected as president in June. The military was also deployed overnight in the city of Suez after eight people died in clashes between security forces and protesters opposed to President Morsi.


Judge Sobhi Abdel-Maguid read out the death sentences related to the Feb. 1 riot in Port Said that killed 74 fans of the Cairo-based Al-Ahly team. Defendants’ lawyers said all those sentenced were fans of the Port Said team, Al-Masry. Executions in Egypt are usually carried out by hanging.


The judge said in his statement, read live on state TV, that he would announce the verdict for the remaining 52 defendants on March 9.


Among those on trial are nine security officials, but none were handed sentences Saturday, lawyers and security officials say.


Fans of al-Ahly, whose stands were attacked by the rival club Al-Masry in the Feb. 1 incident in Port Said, had promised more violence if the accused did not receive death sentences. In the days leading up to the verdict, Al-Ahly fans warned of bloodshed and retribution. Hundreds of Al-Ahly fans gathered outside the Cairo sports club in anticipation of the verdict, chanting against the police and the government.


Before the judge could read out the names of the 21, families erupted in screams of "Allahu akbar!" Arabic for God is great, with their hands in the air and waving pictures of the deceased. One man fainted while others hugged one another. The judge smacked the bench several times to try and contain reaction in the courtroom.


The verdict is not expected to ease tensions between the two rival teams. The judge is expected to make public his reasons for the death sentences March 9, when the remaining 52 defendants receive their sentences.


A Port Said resident and lawyer of one defendant given a death sentence said the verdict was nothing more than "a political decision to calm the public."


"There is nothing to say these people did anything and we don’t understand what this verdict is based on," the lawyer, Mohammed al-Daw, said.


The violence began after the Port Said’s home team won the match, 3-1. Al-Masry fans stormed the pitch after the game ended, attacking Cairo’s Al-Ahly fans.


Authorities shut off the stadium lights, plunging it into darkness. In the exit corridor, the fleeing crowd pressed against a chained gate until it broke open. Many were crushed under the crowd of people trying to flee.


Survivors described a nightmarish scene in the stadium. Police stood by doing nothing, they said, as fans of Al-Masry attacked supporters of the top Cairo club stabbing them and throwing them off bleachers.


Al-Ahly survivors said supporters of Al-Masry carved the words "Port Said" into their bodies and undressed them while beating them with iron bars.


While there has long been bad blood between the two rival teams, many blamed police for failing to perform the usual searches for weapons at the stadium.


Both Al-Ahly Ultras and Al-Masry Ultras widely believe that former members of the ousted government of Mr. Mubarak helped instigate the attack, and that the police at the very least were responsible for gross negligence. It is not clear what kind of evidence, if any, was presented to the court to back up claims that the attack had been orchestrated by governmentofficials.


As is customary in Egypt, the death sentences will be sent to the nation’s top religious authority, the Grand Mufti, for approval, though the court has final say on the matter.


All of the defendants — who were not present in the courtroom Saturday for security reasons — have the right to appeal the verdict.


The incident was the world’s deadliest soccer violence in 15 years.


Read More..

DealBook: Despite Calm, Draghi Raises Economic Concerns

DAVOS, Switzerland — Dubbing 2012 as the year the euro was relaunched, the president of the European Central Bank expressed concern that renewed calm on financial markets had not yet led to economic growth and better lives for European citizens.

Mario Draghi, the E.C.B. president and the person who can probably take more credit than anyone for the relative tranquility that greets visitors to the World Economic Forum this year, used an appearance here to take stock of the state of the euro zone.

Mr. Draghi said that central bank measures last year had prevented a banking crisis. And he also praised government leaders for steps they took to strengthen the currency union, for example agreeing to put the E.C.B. in charge of supervising banks — a change that will be phased in over the next year.

And the net effect of those moves? ‘‘To say the least the jury is still out,’’ Mr. Draghi said. ‘‘We haven’t seen an equal momentum on the real side of the economy. That’s where we have to do some more.’’

The euro zone economy has stabilized at a very low level, Mr. Draghi said, and should begin to recover in the second half of 2013.

Data released Friday supported the thesis of a gradual recovery. The Ifo business climate index, a closely watched indicator of business confidence in Germany, rose more than expected. The survey suggested that the euro zone’s largest economy is growing again after a contraction at the end of 2012.

What’s more, the E.C.B. said Friday that more euro-zone banks than expected had chosen to make early repayment of three-year central bank loans they took out a year ago. The volume of early repayment is seen as a sign that at least some banks are healthier than they were, and able to raise money on their own. The E.C.B. said 278 banks would pay back 137 billion euros, of a total of 489 billion euros they borrowed a year ago at exceedingly low interest rates.

Banks could borrow the money at the E.C.B.’s benchmark interest rate, currently 0.75 percent. But some may have felt that there was a stigma attached. Even though the E.C.B. does not disclose borrowers, banks may have been concerned about appearing weak in the eyes of the central bank. In addition, banks needed to post bonds or other assets as collateral, and some may now prefer to deploy the assets elsewhere.

Looking ahead, Mr. Draghi described 2013 as a year of implementation, when the E.C.B. and governments would begin carrying out decisions they made last year.

The E.C.B. would begin assuming authority over banks, he said, and governments would carry out changes designed to improve their ability to respond to crises and police each other’s spending. As central supervisor, the E.C.B. central bank is expected to be more willing than national regulators to force sick banks to confront their problems.

Mr. Draghi defended the E.C.B.’s position that euro zone governments must continue to work to get spending under control. Austerity — a word Mr. Draghi said he does not like — has been a de facto condition for measures the central bank has taken to contain the crisis and give governments space for economic reforms.

‘‘Fiscal consolidation is unavoidable,’’ Mr. Draghi said during on-stage questioning by John Lipsky, a former first deputy managing director of the International Monetary Fund. ‘‘There can’t be any sustainable growth, any sustainable equity achieved through an endless creation of debt.’’

But Mr. Draghi conceded that budget cutting can push countries into recession, and he said governments should cut spending on operations rather than curtailing outlays for infrastructure projects like bridges and roads.

Asked by Mr. Lipsky whether the E.C.B. would follow the U.S. Federal Reserve in setting benchmarks for unemployment that would prompt the central bank to lower rates or take other action, Mr. Draghi said no.

But, in what could signal a subtle shift in E.C.B. thinking, Mr. Draghi suggested that the central bank can pursue economic growth as part of its prime mandate to defend price stability.

‘‘We have given plenty of evidence we can do so within the existing framework,’’ Mr. Draghi said.

Read More..

The New Old Age Blog: Time to Recognize Mild Cognitive Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, published and periodically updated by the American Psychiatric Association, is one of those documents few laypeople ever read, but many of us are affected by.

It can make it easier or harder to get an insurance company or Medicare to cover treatments, for example. It factors into a variety of legal and governmental decisions.

And on a personal basis, a psychiatric diagnosis may be welcome (having a name and a treatment plan for what’s bothering us can be comforting) or not (are we really suffering from a mental disorder if we seem depressed after a family member dies?).

That last question refers to a change in the new DSM5, to be published in May, that has generated considerable controversy and that I discussed in an earlier post: the removal of the “bereavement exclusion,” once part of the diagnosis of Major Depressive Disorder.

Another element of the revised DSM could also affect readers: It will include something called Mild Neurocognitive Disorder. The task force revising the manual wanted to align psychiatry with the rest of medicine, which has already begun to distinguish between levels of impairment, said its chairman, David Kupfer, a University of Pittsburgh psychiatrist.

True enough, as we have reported before. Neurologists call it Mild Cognitive Impairment, a stage where cognitive decline becomes noticeable enough to affect daily functioning, yet people can still live independently and have not progressed to dementia.

In fact, a large proportion of people with mild cognitive problems never will develop dementia — but doctors and researchers cannot yet determine who will and who won’t. Biomarkers that could identify the biological brain changes that presage dementia are still years away.

Will it be helpful, then, for health professionals using the DSM5 — most of them not psychiatrists, but primary care doctors — to begin diagnosing Mild Neurocognitive Disorder? Particularly as there is no treatment that can reverse it or reliably slow its progression, if it would progress?

Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center and a member of the working group that developed the new DSM5 criteria, said he thought the newly recognized disorder would be useful. “The predementia phase is becoming increasingly important,” he told me in an interview.

Counseling could help people compensate for the memory loss and other deficits they are experiencing, for example. With a DSM-recognized diagnosis, those approaches are more likely to be covered by insurers.

Besides, “one argument against Alzheimer’s therapies is that we wait too late, when there’s too much damage to the central nervous system to repair,” Dr. Petersen said, referring to several recent disappointing drug trials. In the future, with earlier diagnoses, “you may be able to intervene, stop the process and forestall the dementia.”

But as we have seen with screening tests for other diseases, early detection does not always lead to better health or longer lives. It can, however, lead to unnecessary treatments and procedures involving risks of their own. Could that happen with Mild Neurocognitive Disorder?

“It will lead to wild overdiagnosis,” predicted Allen Frances, an emeritus professor of psychiatry at Duke and the chairman of the task force that developed the previous DSM edition. Indeed, about a quarter of people initially diagnosed with mild cognitive impairment are later determined to be normal, a prominent researcher told my colleague Judy Graham last year.

“People will get unnecessary tests and start getting weird treatments that have no proven efficacy,” said Dr. Frances, who has criticized a number of DSM5 changes. “They’re going to worry like crazy about being demented.”

Dr. Petersen agreed that it was a legitimate concern, but “by and large, we’re becoming better at distinguishing between the normal cognitive effects of aging and disease.” (The American Psychiatric Association will publish a specialized DSM for primary care physicians, Dr. Kupfer pointed out, to help guide them through diagnoses.)

It is hard for patients and families to know how to react when experts disagree. But keep in mind that contemporary health care aims for what is called shared decision-making. That means patients and professionals discuss options and weigh the risks and benefits of treatments and procedures, their likely outcomes, patients’ preferences, and come to agreement on how to proceed. This essay in the New England Journal of Medicine calls shared decision-making “the pinnacle of patient-centered care.”

So when Dr. Frances refers to the DSM5 as “a guide, not a bible,” and urges skepticism about some of its diagnoses, he is advocating an approach that patients and families should probably bring to any medical decision.

Seeking further information, asking questions, assessing options — those are reasonable responses if, a few weeks after a loved one’s death, a doctor says you may have major depression. Or if she thinks your memory loss could mean Mild Neurocognitive Disorder.

“The shorter the evaluation, the less the person knows you, the less he or she can explain and justify the diagnosis, the more tests and treatments that will result, the more a person should be cautious and get a second opinion,” Dr. Frances said.

Whatever the DSM5 says, it’s hard to argue with that.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

The New Old Age Blog: Time to Recognize Mild Cognitive Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, published and periodically updated by the American Psychiatric Association, is one of those documents few laypeople ever read, but many of us are affected by.

It can make it easier or harder to get an insurance company or Medicare to cover treatments, for example. It factors into a variety of legal and governmental decisions.

And on a personal basis, a psychiatric diagnosis may be welcome (having a name and a treatment plan for what’s bothering us can be comforting) or not (are we really suffering from a mental disorder if we seem depressed after a family member dies?).

That last question refers to a change in the new DSM5, to be published in May, that has generated considerable controversy and that I discussed in an earlier post: the removal of the “bereavement exclusion,” once part of the diagnosis of Major Depressive Disorder.

Another element of the revised DSM could also affect readers: It will include something called Mild Neurocognitive Disorder. The task force revising the manual wanted to align psychiatry with the rest of medicine, which has already begun to distinguish between levels of impairment, said its chairman, David Kupfer, a University of Pittsburgh psychiatrist.

True enough, as we have reported before. Neurologists call it Mild Cognitive Impairment, a stage where cognitive decline becomes noticeable enough to affect daily functioning, yet people can still live independently and have not progressed to dementia.

In fact, a large proportion of people with mild cognitive problems never will develop dementia — but doctors and researchers cannot yet determine who will and who won’t. Biomarkers that could identify the biological brain changes that presage dementia are still years away.

Will it be helpful, then, for health professionals using the DSM5 — most of them not psychiatrists, but primary care doctors — to begin diagnosing Mild Neurocognitive Disorder? Particularly as there is no treatment that can reverse it or reliably slow its progression, if it would progress?

Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center and a member of the working group that developed the new DSM5 criteria, said he thought the newly recognized disorder would be useful. “The predementia phase is becoming increasingly important,” he told me in an interview.

Counseling could help people compensate for the memory loss and other deficits they are experiencing, for example. With a DSM-recognized diagnosis, those approaches are more likely to be covered by insurers.

Besides, “one argument against Alzheimer’s therapies is that we wait too late, when there’s too much damage to the central nervous system to repair,” Dr. Petersen said, referring to several recent disappointing drug trials. In the future, with earlier diagnoses, “you may be able to intervene, stop the process and forestall the dementia.”

But as we have seen with screening tests for other diseases, early detection does not always lead to better health or longer lives. It can, however, lead to unnecessary treatments and procedures involving risks of their own. Could that happen with Mild Neurocognitive Disorder?

“It will lead to wild overdiagnosis,” predicted Allen Frances, an emeritus professor of psychiatry at Duke and the chairman of the task force that developed the previous DSM edition. Indeed, about a quarter of people initially diagnosed with mild cognitive impairment are later determined to be normal, a prominent researcher told my colleague Judy Graham last year.

“People will get unnecessary tests and start getting weird treatments that have no proven efficacy,” said Dr. Frances, who has criticized a number of DSM5 changes. “They’re going to worry like crazy about being demented.”

Dr. Petersen agreed that it was a legitimate concern, but “by and large, we’re becoming better at distinguishing between the normal cognitive effects of aging and disease.” (The American Psychiatric Association will publish a specialized DSM for primary care physicians, Dr. Kupfer pointed out, to help guide them through diagnoses.)

It is hard for patients and families to know how to react when experts disagree. But keep in mind that contemporary health care aims for what is called shared decision-making. That means patients and professionals discuss options and weigh the risks and benefits of treatments and procedures, their likely outcomes, patients’ preferences, and come to agreement on how to proceed. This essay in the New England Journal of Medicine calls shared decision-making “the pinnacle of patient-centered care.”

So when Dr. Frances refers to the DSM5 as “a guide, not a bible,” and urges skepticism about some of its diagnoses, he is advocating an approach that patients and families should probably bring to any medical decision.

Seeking further information, asking questions, assessing options — those are reasonable responses if, a few weeks after a loved one’s death, a doctor says you may have major depression. Or if she thinks your memory loss could mean Mild Neurocognitive Disorder.

“The shorter the evaluation, the less the person knows you, the less he or she can explain and justify the diagnosis, the more tests and treatments that will result, the more a person should be cautious and get a second opinion,” Dr. Frances said.

Whatever the DSM5 says, it’s hard to argue with that.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

Apple Labor Audits Uncover Underage Workers



SAN FRANCISCO — Apple stepped up audits of working conditions at major suppliers last year, discovering multiple cases of employment of underage workers, discrimination and wage problems.


The company, which relies heavily on Asia-based partners like Foxconn Technology Group of Taiwan to assemble its devices, said Thursday that it had conducted 393 audits, up 72 percent from 2011, reviewing sites where more than 1.5 million workers make its gadgets.


In recent years, Apple has faced accusations of building its profits on the backs of poorly treated and severely underpaid workers in China.


That criticism came to the fore around 2010, after reports of suicides at Foxconn drew attention to the long hours that migrant laborers frequently endured, often for a pittance in wages and in severely cramped living conditions.


Foxconn is the trading name of Hon Hai Precision Industry. The company employs 1.2 million workers across China.


Under Tim Cook, who took over as chief executive from Steve Jobs in 2011, Apple has taken steps to improve its record and increase transparency, with measures like the extensive audits of its sprawling supply chain. Last year, it agreed to separate audits by the independent Fair Labor Association.


In an interview Thursday, the senior vice president of operations at Apple, Jeff Williams, said the company had increased its efforts to solve two of the most challenging issues: ensuring there are no underage workers in its supply chain and limiting work time to 60 hours a week.


Apple is now investigating its smaller suppliers — which typically face less oversight on such issues — to bring them into compliance, sometimes even firing them.


“We go deep in the supply chain to find it,” Mr. Williams said. “And when we do find it, we ensure that the underage workers are taken care of, the suppliers are dealt with.”


In one case, Apple terminated its relationship with a component maker after discovering 74 cases in which underage workers were being employed. Apple also found that an employment agency had forged documents to allow children to work illegally at the supplier.


Apple reported both the supplier and the employment agency to the local authorities, the company said in its latest annual report on the conditions in its supply chain.


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India Ink: Five Questions For: Aminatta Forna

Aminatta Forna’s most recent novel, “The Memory of Love,” won the Commonwealth Writers’ Prize Best Book Award for 2011. 

Her previous novels include the “The Devil that Danced on the Water” and “Ancestor Stones,” which won the 2007 German Liberaturpreis, the Hurston Wright Legacy Award for Debut Fiction in 2007 and the Aidoo-Snyder Book Prize in the United States in 2010. India Ink interviewed her at the Jaipur Literature Festival.  

What are the occupational hazards of being a writer?

I don’t have a pension plan! I love it so much I can’t say that there are any but I think that a lot of people can write – some people write one book and never write another – and the reason that writers continue to write is that we are people who are capable of living in a room on our own with imaginary friends for the rest of our life. If you can do that, then you can be a writer but many people find they can’t do that.

What is your everyday writing ritual?

Most writers I know go for word counts, and I used to be a journalist so I guess that’s ingrained. But if you do something you have to have a goal. Some writers deny it but I think most people feel they have to have some sort of goal. We bought a house about 10 years ago and did up this whole room exactly the way I thought I wanted it as a writer and I discovered I couldn’t write a word in it. I had to go and write the whole book in the British library. Now I do work in that room.

I don’t have very many little fetishes but the one I do have is that I like a particular mug to drink out of. It’s just a small china cup and I get very upset if my husband moves it. He just can’t understand why it matters so much. And of course I’ve got a hoard of displacement activities – all the things you do when you should be writing. I put on the wash, I do the dishes, and I organize things. But they’re part of the ritual so at the beginning of a book the house is always very, very clean. But then once I’ve got past the end of the beginning as it were, once the book has got a certain momentum, then the house gets increasingly untidy because the writing takes over. But I firmly believe that all of those activities are part of the process of thinking. But nobody can talk to you while you do them. Which my husband does understand and the lady who cleans my house also understands.

Why does the Jaipur Literature Fest matter to you?

These festivals are just burgeoning all over the world and that’s really good because books are apparently under threat and we always hear that the publishing industry is dying yet there’s quite obviously a very strong interest in books and the ideas that books contain. But Jaipur in particular matters because it is away from what was once the center – it is the shifting of the center from outside the West and into these emerging cultural and economic powerhouses like India. Kenya’s now got a wonderful book festival, people are talking about maybe locating one in West Africa. The reason I come is because I can talk to audiences who are not the kind of people I find walking down the street in London.

How do you deal with your critics?

Well I understood quite early on that if I was going to accept the good ones I would have to accept the bad ones too so I try and take it on the chin. But when I did your job I went to interview Vikram Seth, and his response to me was, “It’s one person’s opinion.”

Why should we read your latest book, ‘The Memory of Love’?

Increasingly there are those of us who write from outside the center and those are the writers that I’m most interested in because they bring me into worlds that I did not previously know. And that as a writer is what I try to create. To both look at the particular of a world that other people might not know and look at the extremes that people face but also find the universality of that.

It’s also a good story.

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DealBook: Commerzbank to Cut Up to 6,000 Jobs

LONDON – Commerzbank, the second-largest lender in Germany, is planning to cut up to 6,000 jobs in a bid to increase earnings, joining other European banks that have announced restructuring plans in recent months.

The bank said on Thursday that it expected to eliminate 4,000 to 6,000 jobs by 2016, or 7 to 10 percent of its work force.

The layoffs will affect Commerzbank’s global operations, particularly a retail division that had expanded rapidly in recent years, according to a person with direct knowledge of the matter who spoke on condition of anonymity because he was not authorized to speak publicly.

In the wake of tougher capital requirements, sluggish economic growth and growing concerns about risky trading activity, several European banks have announced efforts to reduce their work forces, shed unwanted assets and increase capital reserves.

In October, the Swiss financial giant UBS said it would eliminate 10,000 jobs in its investment bank in a move to reduce exposure to risky trading activity and to focus on its wealth management division.

Barclays, which is to formally announce its own restructuring plan on Feb. 12, also started consulting with staff members in its investment banking unit this week over potential layoffs.

The expected job cuts at Barclays could result in up to a 10 percent reduction, or around 2,000 jobs, in the division, according to two people with direct knowledge of the matter who spoke on condition of anonymity because they were not authorized to speak publicly. On Thursday, Barclays started to reduce the size of its investment banking staff in Asia by 15 percent, or 70 jobs, according to one of the people.

On Jan. 17, the firm’s new chief executive, Antony P. Jenkins, told staff members they should leave the bank if they did not want to help rebuild its reputation. Barclays agreed last year to a $450 million settlement with American and British authorities over the manipulation of the London interbank offered rate, or Libor, a crucial benchmark rate.

The layoffs at Commerzbank come after efforts by the bank’s chief executive, Martin Blessing, to sell some of the firm’s 160 billion euros ($213 billion) of noncore assets, including shipping and real estate investments. The bank is also trying to reduce its exposure to European sovereign debt because of continuing volatility in countries like Spain and Greece.

Commerzbank said it would start negotiations with employee unions in early February to decide on the final number of layoffs. The announcement comes a day after Mr. Blessing was spotted at a party on Wednesday night at the luxury Belvedere hotel in Davos, whose attendees also included Deutsche Bank’s co-chief executive Anshu Jain. The Commerzbank chief is attending the World Economic Forum in the Swiss town.

Commerzbank received an 18.2 billion euro bailout from the German government in 2008 after its mistimed acquisition of a rival German bank, Dresdner, for 5.5 billion euros at the height of the financial crisis. As part of the deal, the German government still owns a 24 percent stake in Commerzbank.

Shares in Commerzbank bank rose less than 1 percent in morning trading in Frankfurt on Thursday.

European banks have been struggling through a series of recent financial scandals, mounting demands to increase capital reserves and growing political pressure to increase lending to stimulate local economies.

The Continent’s major financial institutions will begin reporting earnings next week, and analysts will be waiting to see if they will follow UBS’s lead in announcing major changes in response to these pressures.

“We believe that UBS has kicked off the much-awaited industry restructuring, even if each bank takes a different path,” Citigroup banking analysts told investors in a research note.

Neil Gough reported from Hong Kong. Jack Ewing contributed reporting from Davos.

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The New Old Age Blog: Grief Over New Depression Diagnosis

When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.

“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”

But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.

First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.

Traditionally, depression has been underdiagnosed in older adults. When people’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? A few decades back, Dr. Kupfer said, “what was striking to me was the lack of anyone getting a depression diagnosis, because that was ‘normal aging.’” We don’t find depression in old age normal any longer.

But critics of the D.S.M. 5 now argue that depression may become overdiagnosed, because this version removes the so-called “bereavement exclusion.” That was a paragraph that cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts.

Without that exception, you could be diagnosed with this disorder if you are feeling empty, listless or distracted, a month after your parent or spouse dies.

“D.S.M. 5 is medicalizing the expected and probably necessary process of mourning that people go through,” said Allen Francis, a professor emeritus at Duke who chaired the D.S.M. IV task force and has denounced several of the changes in the new edition. “Most people get better with time and natural healing and resilience.”

If they are diagnosed with major depression before that can happen, he fears, they will be given antidepressants they may not need. “It gives the drug companies the right to peddle pills for grief,” he said.

An advisory committee to the Association for Death Education and Counseling also argued that bereaved people “will receive antidepressant medication because it is cheaper and ‘easier’ to medicate than to be involved therapeutically,” and noted that antidepressants, like all medications, have side effects.

“I can’t help but see this as a broad overreach by the APA,” Eric Widera, a geriatrician at the University of California, San Francisco, wrote on the GeriPal blog. “Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.”

But Dr. Kupfer said the panel worried that with the exclusion, too many cases of depression could be overlooked and go untreated. “If these things go on and get worse over time and begin to impair someone’s day to day function, we don’t want to use the excuse, ‘It’s bereavement — they’ll get over it,’” he said.

The new entry for major depressive disorder will include a note — the wording isn’t final — pointing out that while grief may be “understandable or appropriate” after a loss, professionals should also consider the possibility of a major depressive episode. Making that distinction, Dr. Kupfer said, will require “good solid clinical judgment.”

Initial field trials testing the reliability of D.S.M. 5 diagnoses, recently published in The American Journal of Psychiatry, don’t bolster confidence, however. An editorial remarked that “the end results are mixed, with both positive and disappointing findings.” Major depressive disorder, for instance, showed “questionable reliability.”

In an upcoming post, I’ll talk more about how patients might respond to the D.S.M. 5, and to a new diagnosis that might also affect a lot of older people — mild neurocognitive disorder.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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The New Old Age Blog: Grief Over New Depression Diagnosis

When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.

“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”

But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.

First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.

Traditionally, depression has been underdiagnosed in older adults. When people’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? A few decades back, Dr. Kupfer said, “what was striking to me was the lack of anyone getting a depression diagnosis, because that was ‘normal aging.’” We don’t find depression in old age normal any longer.

But critics of the D.S.M. 5 now argue that depression may become overdiagnosed, because this version removes the so-called “bereavement exclusion.” That was a paragraph that cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts.

Without that exception, you could be diagnosed with this disorder if you are feeling empty, listless or distracted, a month after your parent or spouse dies.

“D.S.M. 5 is medicalizing the expected and probably necessary process of mourning that people go through,” said Allen Francis, a professor emeritus at Duke who chaired the D.S.M. IV task force and has denounced several of the changes in the new edition. “Most people get better with time and natural healing and resilience.”

If they are diagnosed with major depression before that can happen, he fears, they will be given antidepressants they may not need. “It gives the drug companies the right to peddle pills for grief,” he said.

An advisory committee to the Association for Death Education and Counseling also argued that bereaved people “will receive antidepressant medication because it is cheaper and ‘easier’ to medicate than to be involved therapeutically,” and noted that antidepressants, like all medications, have side effects.

“I can’t help but see this as a broad overreach by the APA,” Eric Widera, a geriatrician at the University of California, San Francisco, wrote on the GeriPal blog. “Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.”

But Dr. Kupfer said the panel worried that with the exclusion, too many cases of depression could be overlooked and go untreated. “If these things go on and get worse over time and begin to impair someone’s day to day function, we don’t want to use the excuse, ‘It’s bereavement — they’ll get over it,’” he said.

The new entry for major depressive disorder will include a note — the wording isn’t final — pointing out that while grief may be “understandable or appropriate” after a loss, professionals should also consider the possibility of a major depressive episode. Making that distinction, Dr. Kupfer said, will require “good solid clinical judgment.”

Initial field trials testing the reliability of D.S.M. 5 diagnoses, recently published in The American Journal of Psychiatry, don’t bolster confidence, however. An editorial remarked that “the end results are mixed, with both positive and disappointing findings.” Major depressive disorder, for instance, showed “questionable reliability.”

In an upcoming post, I’ll talk more about how patients might respond to the D.S.M. 5, and to a new diagnosis that might also affect a lot of older people — mild neurocognitive disorder.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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Bits Blog: Keeping the Internet Safe From Governments

Even before the World Conference on International Telecommunications took place last month in Dubai, Internet activists anticipated trouble. So did Congress, which issued a resolution calling it “essential” that the Internet remain “stable, secure and free from governmental control.”

The worries proved prescient. The conference, which supposedly was going to modernize some ancient regulations, instead offered a treaty that in the eyes of some critics would have given repressive states permission to crack down on dissent. The United States delegate refused to sign it. Fifty-four other countries, including Canada, Peru, Japan and most of Western Europe, voted no as well.

The OpenNet Initiative estimates that about a third of Internet users live in countries that engage in “substantive” or “pervasive” blocking of Internet content. They tended to be among the 89 countries that signed the treaty, including Russia, Cambodia, Iran, China, Cuba, Egypt and Angola.

Those in favor of a free and open Internet have long had a problem with the International Telecommunication Union, the affiliate of the United Nations that ran the conference. They see the I.T.U., which dates back to 1865, as longing for the pre-Internet era, when its influence and fortunes were greater. As a result, activists think, the I.T.U. has become aligned with, and a tool of, countries that desire more governmental control over public speech.

In the wake of the Dubai meeting, there are renewed calls to scale back United States financing of the I.T.U. drastically. The logic is, why are taxpayers supporting an organization whose motives they oppose?

“Paying for both sides of a conflict is unsustainable and illogical, and should simply be corrected,” says the De-Fund the I.T.U. Web site, which has posted a petition on the White House Web site.

The De-Fund site notes that the petition is not asking the United States government to take an unprecedented first step. “Many of our free-market democratic allies, led by Germany, France, Spain and Finland, have already de-funded the I.T.U. Likewise, right-thinking American companies like I.B.M., Cingular, Microsoft, Fox, Agilent, Sprint, Harris, Loral and Xerox, and others, have already withdrawn their private-sector contributions from the I.T.U.”

The petition was the brainchild of Bill Woodcock, the Berkeley-based research director of Packet Clearing House, a nonprofit institute. “This is really about whether people should be allowed to say what they think,” Mr. Woodcock said. “The Internet enables free speech, and that makes it very dangerous to countries that try to control public discourse.”

The United States government contributes about 8 percent of the I.T.U.’s budget. The 55 countries that voted against the treaty contribute about three-quarters of it. If the White House receives 25,000 signatures by Feb. 10, it will review and quite possibly act on the petition. As of Tuesday, it had about 600 signatures with minimal publicity.

A spokesman for the I.T.U., which is based in Switzerland, did not respond to an e-mail seeking comment.

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India Ink: India Rape Trial Starts With Renewed Ban on Media Coverage

The trial of five men accused in the gang rape of a 23-year-old woman in a moving bus in New Delhi is being watched closely as a symbol of India’s commitment to justice for women, but information about the ongoing court proceedings may be scarce.

As court proceedings began Thursday, the presiding judge said  there would be a blanket ban on reporting on the trial. The judge, Yogesh Khanna,  also warned defense lawyers, who have been openly speaking about the case, not to provide information about the proceedings to the press.

The five men accused in the Dec. 16 rape and murder of a physiotherapy student were ushered into the special fast-track court in South Delhi on Thursday at noon, flanked by policemen, with their faces were covered with gray woolen caps. During the two-hour court proceedings, the prosecution used the opening arguments to lay out charges against the men, which include gang rape, murder, robbery and destruction of evidence.

The police allege that the five accused men and a sixth teenager, who is being tried as a juvenile, committed a premeditated, vicious crime that included plans to kill their victim. The woman died nearly two weeks after the rape from injuries suffered during the attack, which included an assault with an iron rod. Her companion, a 29-year-old man, was also beaten, and is expected to testify  at the trial.

The court proceedings took place in room 305 of the Saket District Court complex, a small wood-paneled chamber. The next hearing will be on Monday, when the defendants’ lawyers will respond to the charges the prosecution has laid out.

The new fast-track court will try only cases related to crimes against women, and once trials have started, they will not adjourn for weeks or months, as is common in other courts. Several fast-track courts have already  been set up in Delhi to hear crimes against women in the wake of the Delhi gang rape, which brought thousands of protesters to the streets demanding justice for the victim and other victims of sexual assault.

Judge Khanna ordered  Monday that all court proceedings in ths current case would take place “in camera,” allowing only those directly connected with the case to be present in the courtroom, reiterating an earlier magistrate’s order on the case. He also renewed a blanket ban Monday on the printing or publishing of any information relating to the case’s proceedings.

Defense lawyers were instructed by the court during the proceedings to “honor the spirit” of the gag order, they said, after the special public prosecutor Dayan Krishnan said he would file a petition of contempt of court if lawyers for the defendants continued to brief the media on developments.

V. K. Anand, the lawyer for Ram Singh, one of the accused, confirmed Thursday that he would now also represent Mr. Singh’s brother Mukesh. Mr. Anand and Vivek Sharma, a second lawyer for accused, told the media after Thursday’s court proceedings that they could not answer any further questions.

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McDonald's December Sales Help Fourth-Quarter Profit







(Reuters) - McDonald's Corp reported an unexpected rise in sales in December at established U.S. restaurants, helping to lift its fourth-quarter profit above analysts estimates.




The world's largest restaurant chain on Wednesday said sales at U.S. eateries open at least 13 months rose 0.9 percent in December, compared with an average estimate compiled by Consensus Metrix calling for a 1.78 percent drop in the month.


A push by the company to have more of its restaurants open on Christmas and a shift of the limited-time offering of its popular McRib sandwich to December, both helped boost U.S. sales during the month.


But analysts said the early part of 2013 will be tough for the chain as it runs short of quick fixes for boosting U.S. sales that have been hurt by stiffer competition for customers who are pinching pennies in a weak economic recovery.


Net income at the world's biggest restaurant chain rose to $1.40 billion, or $1.38 per share, from $1.38 billion, or $1.33 per share, a year earlier.


Analysts on average forecast $1.33 a share, according to Thomson Reuters I/B/E/S.


Total sales rose 1.5 percent to $4.59 billion.


McDonald's fourth-quarter global sales at restaurants open at least 13 months rose 0.1 percent. Analysts on average had forecast a 0.3 percent decline, according to Consensus Metrix.


(Reporting By Lisa Baertlein in Los Angeles and Brad Dorfman in Chicago; Editing by Maureen Bavdek)


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The New Old Age Blog: Study Links Cognitive Deficits, Hearing Loss

There’s another reason to be concerned about hearing loss — one of the most common health conditions in older adults and one of the most widely undertreated. A new study by researchers at Johns Hopkins Medicine suggests that elderly people with compromised hearing are at risk of developing cognitive deficits — problems with memory and thinking — sooner than those whose hearing is intact.

The study in JAMA Internal Medicine was led by Dr. Frank Lin, a hearing specialist and epidemiologist who over the past several years has documented the extent of hearing problems in older people and their association with falls and the onset of dementia.

The physician’s work is bringing fresh, and some would say much-needed, attention to the link between hearing difficulties and seniors’ health.

In his new report, Dr. Lin looked at 1,984 older adults who participated over many years in the Health ABC Study, a long-term study of older adults conducted in Pittsburgh and Memphis. Participants’ mean age was 77; none had evidence of cognitive impairment when the period covered by this research began. In 2001 and 2002, they received hearing tests and cognitive tests; cognitive tests alone were repeated three, five and six years later.

The tests included the Modified Mini-Mental State exam, which is administered through an interview and yields an overall picture of cognitive status, and the Digit Symbol Substitution Test, a paper-only exercise that asks people to match symbols and numbers, which can reveal deficits in someone’s working memory and executive functioning.

Dr. Lin found that annual rates of cognitive decline were 41 percent greater in older adults with hearing problems than in those without, based on results from the Modified Mini-Mental State Exam. A five-point decline on that test is considered a “clinically significant” indicator of a change in cognition.

Using this information, Dr. Lin found that elderly people with hearing problems experienced a five-point decline on the exam in 7.7 years, compared with 10.9 years for those with normal hearing.

Results from the Digit Symbol Substitution Test showed the same downward trend, though not quite as steep: older people with hearing loss recorded a yearly rate of cognitive decline 32 percent greater on it than those with intact hearing. In both cases, the results showed an association only, with no proof of causality.

Still, given the fact that nearly two-thirds of adults age 70 and older have hearing problems, it is an important finding.

For caregivers and older adults, the bottom line is “pay attention to hearing loss,” said Kathleen Pichora-Fuller, a professor of psychology at the University of Toronto who was not involved in the study.

Most people seek medical attention for hearing difficulties 10 to 20 years after they first notice a problem, she said, because “there’s a stigma about hearing loss and people really don’t want to wear a hearing aid.” That means years of struggling with the consequences of impairment, without interventions that can make a difference.

One consequence that may help explain Dr. Lin’s findings is social isolation. When people have a hard time distinguishing what someone is saying to them, as is common in older age, they often stop accepting invitations to dinners or parties, attending concerts or classes, or going to family events. Over time, this social withdrawal can become a self-fulfilling prophecy, leading to the loss of meaningful relationships and activities that keep older people feeling engaged with others.

A substantial body of research by cognitive scientists has established that seniors’ cognitive health depends on exercising both body and brain and remaining socially engaged, and “now we have this intersection of hearing research and cognitive research lining up and showing us that hearing health is part of cognitive health,” said Dr. Pichora-Fuller, who originally trained as an audiologist.

Family physicians and internists, too, often dismiss older patients’ complaints about hearing, and should pay close attention to Dr. Lin’s research, she said.

“I hope this study will be a wake-up call to clinicians that auditory tests need to be part of the battery of tests they employ to look at an older person’s health,” agreed Patricia Tun, an adjunct associate professor of psychology at Brandeis University.

Although the tests are effective and cause no known harm, a panel of experts recently failed to recommend them for older adults because of a lack of supporting evidence, as I wrote last August.

Another potential explanation for Dr. Lin’s new finding lies in a concept known as “cognitive load” that Dr. Tun has explored through her research. Basically, this assumes that “we only have a certain amount of cognitive resources, and if we spend a lot of those resources of processing sensory input coming in — in this case, sound — it’s going to be processed more slowly and understand and remembered less well,” she explained.

In other words, when your brain has to work hard to hear and identify meaningful speech from a jumble of sounds, “you’ll have less mental energy for higher cognitive processing,” Dr. Tun said.

Even seniors who hear sounds relatively well often report that words sound garbled or mumbled, she noted, indicating a deterioration in hearing mechanisms that process complex speech.

Also, as yet unidentified biological or neurological pathways may affect both speech and cognition. Or hearing loss may exacerbate frailty and other medical conditions that older people oftentimes have in ways that are as yet poorly understood, Dr. Lin’s paper notes.

A limitation to his study is its reliance, in part, on the Modified Mini-Mental State exam, which asks older adults to respond to questions posed by an interviewer, according to Barbara Weinstein, a professor and head of the audiology program at CUNY’s Graduate Center.

Her research has shown that hearing-compromised seniors may not understand questions and answer incorrectly, confounding results. Another limitation arises from the failure to test participants’ hearing over time, as happened with cognitive tests, making associations more difficult to tease out.

Dr. Lin hopes to address this through another research project that would follow older adults over time and test whether interventions such as hearing aides help prevent the onset or slow the progression of cognitive decline. In the meantime, older people and caregivers should arrange for hearing tests if they have concerns, and consider getting a hearing aid if problems are confirmed.

Getting sound to the brain is the “first and most important step” in preventing sensory deprivation that can contribute to cognitive dysfunction, said Kelly Tremblay, a professor of speech and hearing science at the University of Washington.

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The New Old Age Blog: Study Links Cognitive Deficits, Hearing Loss

There’s another reason to be concerned about hearing loss — one of the most common health conditions in older adults and one of the most widely undertreated. A new study by researchers at Johns Hopkins Medicine suggests that elderly people with compromised hearing are at risk of developing cognitive deficits — problems with memory and thinking — sooner than those whose hearing is intact.

The study in JAMA Internal Medicine was led by Dr. Frank Lin, a hearing specialist and epidemiologist who over the past several years has documented the extent of hearing problems in older people and their association with falls and the onset of dementia.

The physician’s work is bringing fresh, and some would say much-needed, attention to the link between hearing difficulties and seniors’ health.

In his new report, Dr. Lin looked at 1,984 older adults who participated over many years in the Health ABC Study, a long-term study of older adults conducted in Pittsburgh and Memphis. Participants’ mean age was 77; none had evidence of cognitive impairment when the period covered by this research began. In 2001 and 2002, they received hearing tests and cognitive tests; cognitive tests alone were repeated three, five and six years later.

The tests included the Modified Mini-Mental State exam, which is administered through an interview and yields an overall picture of cognitive status, and the Digit Symbol Substitution Test, a paper-only exercise that asks people to match symbols and numbers, which can reveal deficits in someone’s working memory and executive functioning.

Dr. Lin found that annual rates of cognitive decline were 41 percent greater in older adults with hearing problems than in those without, based on results from the Modified Mini-Mental State Exam. A five-point decline on that test is considered a “clinically significant” indicator of a change in cognition.

Using this information, Dr. Lin found that elderly people with hearing problems experienced a five-point decline on the exam in 7.7 years, compared with 10.9 years for those with normal hearing.

Results from the Digit Symbol Substitution Test showed the same downward trend, though not quite as steep: older people with hearing loss recorded a yearly rate of cognitive decline 32 percent greater on it than those with intact hearing. In both cases, the results showed an association only, with no proof of causality.

Still, given the fact that nearly two-thirds of adults age 70 and older have hearing problems, it is an important finding.

For caregivers and older adults, the bottom line is “pay attention to hearing loss,” said Kathleen Pichora-Fuller, a professor of psychology at the University of Toronto who was not involved in the study.

Most people seek medical attention for hearing difficulties 10 to 20 years after they first notice a problem, she said, because “there’s a stigma about hearing loss and people really don’t want to wear a hearing aid.” That means years of struggling with the consequences of impairment, without interventions that can make a difference.

One consequence that may help explain Dr. Lin’s findings is social isolation. When people have a hard time distinguishing what someone is saying to them, as is common in older age, they often stop accepting invitations to dinners or parties, attending concerts or classes, or going to family events. Over time, this social withdrawal can become a self-fulfilling prophecy, leading to the loss of meaningful relationships and activities that keep older people feeling engaged with others.

A substantial body of research by cognitive scientists has established that seniors’ cognitive health depends on exercising both body and brain and remaining socially engaged, and “now we have this intersection of hearing research and cognitive research lining up and showing us that hearing health is part of cognitive health,” said Dr. Pichora-Fuller, who originally trained as an audiologist.

Family physicians and internists, too, often dismiss older patients’ complaints about hearing, and should pay close attention to Dr. Lin’s research, she said.

“I hope this study will be a wake-up call to clinicians that auditory tests need to be part of the battery of tests they employ to look at an older person’s health,” agreed Patricia Tun, an adjunct associate professor of psychology at Brandeis University.

Although the tests are effective and cause no known harm, a panel of experts recently failed to recommend them for older adults because of a lack of supporting evidence, as I wrote last August.

Another potential explanation for Dr. Lin’s new finding lies in a concept known as “cognitive load” that Dr. Tun has explored through her research. Basically, this assumes that “we only have a certain amount of cognitive resources, and if we spend a lot of those resources of processing sensory input coming in — in this case, sound — it’s going to be processed more slowly and understand and remembered less well,” she explained.

In other words, when your brain has to work hard to hear and identify meaningful speech from a jumble of sounds, “you’ll have less mental energy for higher cognitive processing,” Dr. Tun said.

Even seniors who hear sounds relatively well often report that words sound garbled or mumbled, she noted, indicating a deterioration in hearing mechanisms that process complex speech.

Also, as yet unidentified biological or neurological pathways may affect both speech and cognition. Or hearing loss may exacerbate frailty and other medical conditions that older people oftentimes have in ways that are as yet poorly understood, Dr. Lin’s paper notes.

A limitation to his study is its reliance, in part, on the Modified Mini-Mental State exam, which asks older adults to respond to questions posed by an interviewer, according to Barbara Weinstein, a professor and head of the audiology program at CUNY’s Graduate Center.

Her research has shown that hearing-compromised seniors may not understand questions and answer incorrectly, confounding results. Another limitation arises from the failure to test participants’ hearing over time, as happened with cognitive tests, making associations more difficult to tease out.

Dr. Lin hopes to address this through another research project that would follow older adults over time and test whether interventions such as hearing aides help prevent the onset or slow the progression of cognitive decline. In the meantime, older people and caregivers should arrange for hearing tests if they have concerns, and consider getting a hearing aid if problems are confirmed.

Getting sound to the brain is the “first and most important step” in preventing sensory deprivation that can contribute to cognitive dysfunction, said Kelly Tremblay, a professor of speech and hearing science at the University of Washington.

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DealBook: Microsoft May Back Dell Buyout

The effort to take Dell private has gained a prominent, if unusual, backer: Microsoft.

The software giant is in talks to help finance a takeover bid for Dell that would exceed $20 billion, a person briefed on the matter said on Tuesday. Microsoft is expected to contribute up to several billion dollars.

An investment by Microsoft — if it comes to pass — could be enough to push a leveraged buyout of the struggling computer maker over the goal line. Silver Lake, the private equity firm spearheading the takeover talks, has been seeking a deep-pocketed investor to join the effort. And Microsoft, which has not yet made a commitment, has more than $66 billion in cash on hand.

Microsoft and Silver Lake, a prominent investor in technology companies, are no strangers. The private equity firm was part of a consortium that sold Skype, the online video-chatting pioneer, to Microsoft for $8.5 billion nearly two years ago. And the two companies had discussed teaming up to make an investment in Yahoo in late 2011, before Yahoo decided against selling a minority stake in itself.

A vibrant Dell is an important part of Microsoft’s plans to make Windows more relevant for the tablet era, when more and more devices come with touch screens. Dell has been one of the most visible supporters of Windows 8 in its products.

That has been crucial at a time when Microsoft’s relationships with many PC makers have grown strained because of the company’s move into making computer hardware with its Surface family of tablets.

Frank Shaw, a spokesman for Microsoft, declined to comment.

If completed, a buyout of Dell would be the largest leveraged buyout since the financial crisis, reaching levels unseen since the takeovers of Hilton Hotels and the Texas energy giant TXU. Such a deal is taking advantage of Dell’s still-low stock price and the abundance of investors willing to buy up the debt issued as part of a transaction to take the company private. And Silver Lake has been working with Dell’s founder, Michael S. Dell, who is expected to contribute his nearly 16 percent stake in the company to a takeover bid.

Yet while many aspects of the potential deal have fallen into place, including a potential price of up to around $14 a share, talks between Dell and its potential buyers may still fall apart.

Shares of Dell closed up 2.2 percent on Tuesday, at $13.12. They began rising after CNBC reported Microsoft’s potential involvement in a leveraged buyout. Microsoft shares slipped 0.4 percent, to $27.15.

Microsoft’s lending a hand to Dell could make sense at a time when the PC industry is facing some of the biggest challenges in its history. Dell is one of Microsoft’s most significant, longest-lasting partners in the PC business and among the most committed to creating machines that run Windows, the operating system that is the foundation of much of Microsoft’s profits.

But PC sales were in a slump for most of last year, as consumers diverted their spending to other types of devices like tablets and smartphones. Dell, the third-biggest maker of PCs in the world, recorded a 21 percent decline in shipments of PCs during the fourth quarter of last year from the same period in 2011, according to IDC.

In a joint interview in November, Mr. Dell and Steven A. Ballmer, Microsoft’s chief executive, exchanged friendly banter, as one would expect of two men who have been in business together for decades.

Mr. Dell said Mr. Ballmer had gone out of his way to reassure him that Microsoft’s Surface computers would not hurt Dell sales.

“We’ve never sold all the PCs in the world,” said Mr. Dell, sitting in a New York hotel room brimming with new Windows 8 computers made by his company. “As I’ve understood Steve’s plans here, if Surface helps Windows 8 succeed, that’s going to be good for Windows, good for Dell and good for our customers. We’re just fine with all that.”

Microsoft has been willing to open its purse strings in the past to help close partners. Last April, Microsoft committed to invest more than $600 million in Barnes & Noble’s electronic books subsidiary, in a deal that ensures a source of electronic books for Windows devices. Microsoft also agreed in 2011 to provide the Finnish cellphone maker Nokia billions of dollars’ worth of various forms of support, including marketing and research and development assistance, in exchange for Nokia’s adopting Microsoft’s Windows Phone operating system.

A version of this article appeared in print on 01/23/2013, on page B1 of the NewYork edition with the headline: Microsoft May Back Dell Buyout.
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IHT Rendezvous: At Davos, Crisis Is the New Normal

DAVOS, Switzerland — In certain ways, the very setting of the World Economic Forum reflects the restless, challenged state of human affairs. Our footing is uncertain, as on this ski resort’s slithery streets, and we have steep slopes to climb, as the Magic Mountain will remind the global elite this week.

Barely into 2013, Mali and Algeria are new sites of hot war and chilling fear. Where the tumult that began in the Arab Spring will end is still as unclear as when it erupted — far from Davos — two years ago.

The challenge posed by the free flow of information in China went to the New Year streets in Guangzhou. Washington’s feuding politicians walked up to the brink before resolving not to jump off the so-called fiscal cliff. Europe seems to have averted a collapse of the euro, but even in Germany, growth is anemic.

Crisis, in short, is the new normal.

And while the business community determinedly seeks opportunity in troubled times, even many an entrepreneur views the years since the financial crisis of 2008 as what Rich Lesser, the new chief executive of the Boston Consulting Group, called “a higher period of turbulence and uncertainty in the global economy than we have experienced in a very long time.”

The days in which “quants” and algorithms reigned supreme are gone, their increasingly untrackable results having helped the financial system spin out of control in 2008 and 2009. The heady triumph of capitalism after 1989 is also a distant memory, although its chief effect — that capital went global — remains a driving force of our age.

But global capital does not solve big world issues: debt and financial crisis, political paralysis or gridlock, the transformative effects of the digital revolution, climate change, resource shortages, shifting demographics.

For those tasks, we must rely either on the nation state — an aging collective unit that does not readily serve transnational action — or on international institutions whose effectiveness is regularly questioned by the Davos crowd.

“The global economy has integrated, but global society is as fragmented as ever,” said Dennis J. Snower, president of the Kiel Institute for the World Economy.

In that fragmentation, there is an increasing lack of consensus about the global way forward. A few years ago, the inexorable rise of China led to talk of a new Beijing consensus, replacing the Washington consensus that epitomized the confident domination of the United States.

But China, while still growing, is growing less fast. It remains a one-party state, and its advance has arguably resulted more from enormous investment than creative increases in productivity. The challenges to its new leadership are clear: the need for financial reform; the perils of shadow banking and corruption; thick urban pollution; and, above all, the free flow of information, as seen in the standoff this month between a state censor in Guangzhou and journalists at the Southern Weekend and their supporters.

Ian Bremmer, head of the Eurasia Group political consulting firm, who in general sees a big return of politics in business calculations as the world becomes permanently restless, likened China to a large car that is racing toward a brick wall, “and we don’t know if they have steering” to skirt the obstacle, or whether they will hit it.

“As China grows wealthier,” he said in an interview, “entrenched Chinese will see the benefit of the rule of law” — a key element of the Washington consensus. But “the new leadership is not anywhere near there.”

For Yasheng Huang, a professor at the Sloan School of Management at the Massachusetts Institute of Technology, the saving grace of the incoming president, Xi Jinping, and his colleagues is that they are pragmatists. Pragmatism, he argued in an interview by phone, “means that you weigh the costs and benefits of certain actions.” It “checks the ideology.”

Yet even as China helps to sustain international growth — where would Europe’s purveyors of luxury be without the eager Chinese consumer? — it remains, like other emerging countries, self-absorbed.

“Look at the big debates of the last five years,” said Minxin Pei, like Mr. Huang a Chinese-born academic, who teaches at Claremont McKenna College in California. “It’s very hard to find one that originated in Beijing. People talk about China outside China, but still the country is very inward-looking.” This also feeds rising nationalism seen most markedly in the escalating dispute between China and Japan in the East China Sea.

As with China, so with Russia, India and Brazil, or indeed South Africa, Nigeria, Indonesia and other favorites of those who seek bright spots on a gloomy globe. In Brazil, “everything is focused on being Brazilian, how great it is,” noted Misha Glenny, a British analyst who has written on global mafias, cybercrime and is now working on a book about Brazil.

In these countries, absorbed in their own material advances and increasingly wary of a Washington-made prescription for their future, the “fiscal cliff” and debate about the limit on the United States deficit serve as proof that they are on the right path, though critics might dispute it.

“On the whole, we made a recovery from the crisis even faster than other countries,” President Vladimir V. Putin of Russia told a news conference last month. “Just look at the recession in Europe, while Russia has posted growth, albeit a modest one, but we still have a much better situation than in the once-prosperous euro zone, or even in the United States.”

In the United States, recent books have argued that the country’s status as a debtor nation is curbing its global reach. After the last-minute fiscal deal this month, a commentary of the kind believed to reflect high government thinking on the state-run Chinese news agency Xinhua noted tartly: “The American people were once better known for their ability to make tough choices on difficult issues.” It went on, “The Americans may be proud of their mature democracy, but the political gridlock in Washington really looks ugly from an outsider’s view.”

One example of how nations in transition are going their own way is Egypt, where President Mohamed Morsi seems to seek a geopolitical mix: a dose of Turkey, an Islamist-leaning democracy, with much-needed financial aid from China, and relations with Washington warm enough to garner more aid and collaborate on diplomacy like mediating the Israeli-Palestinian fighting over the Gaza Strip last November.

The fluid nature of this world is enhanced by digital communication. With the collapse in newspaper readership and the spread of social media, “everyone gets little snippets of information, and never fully understands the implications,” Mr. Glenny noted. “Very few people do deeper reading and thinking.”

This, he argued, increases people’s sense that “everything has just become too big to grasp and understand.”

A crucial topic for the dozen or so analysts interviewed for this article, and central also to discussions of increasingly important trends like the global rise of women, is education. Instead of machines being in charge, a nimble human mind, connecting individuals with collective wisdom, is seen as the antidote to cacophony, poverty and chaos.

In this view, more and better schooling will help lift hundreds of millions out of poverty, make it easier for populations to cope with change and stimulate the kind of innovation that Mr. Lesser sees already in technology, medicine and health care.

What kind of education is a topic that will be much debated at Davos, to judge from several scheduled sessions on disruptive universities and the like.

“We need government to recognize the need to build the next-gen work force,” Mr. Lesser said. This is “fundamental to staying competitive in the future,” he said. “The challenge goes beyond education. It’s also about good immigration policies.” In this way, he argued, a country facing demographic challenges — Germans, according to a government survey released last week, are the most childless adults in Europe — may preserve wealth and adapt to the future.

Whether by increasing online courses, interacting with students or raising the relatively dismal level of numeracy and literacy among American high school graduates, improving education “is one of the few things I can be unguardedly optimistic about,” said Niall Ferguson, the Harvard University historian. “The solutions are relatively cheap, simple and to hand.”

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Storm and Pension Costs Leave Verizon With Bigger Loss





Verizon Communications is still adding plenty of customers and selling a lot of phones, but the impact from Hurricane Sandy and pension costs sank the company’s quarterly earnings.


The company on Tuesday reported a fourth-quarter loss of $4.22 billion, or $1.48 a share, more than double the loss a year ago. Damages from Hurricane Sandy cost 7 cents a share, and pension charges reduced earnings by $1.55 a share, Verizon said. Revenue climbed to $30.05 billion, a 5.7 percent increase compared with a year ago.


Analysts had expected adjusted earnings of 50 cents a share, compared to actual adjusted earnings of 45 cents a share, and revenue of $29.75 billion, according to Thomson Reuters.


“Verizon seized growth opportunities in the fourth quarter to cap a year of solid progress across the entire business,” said Lowell McAdam, chief executive of Verizon, in a statement. “We delivered a total return of 13.2 percent to shareholders in 2012, and we enter 2013 ready to accelerate the momentum we’ve achieved and create significant shareholder value in the years to come.”


The company, based in New York, said that its wireless business was growing. Over the quarter, it sold 9.8 million smartphones, compared with 7.7 million in the same quarter a year ago, and added 2.1 million contract subscribers, the most valuable type of customer, versus 1.2 million a year ago. The company said its new shared data plans helped increase the money it made from subscribers; average monthly revenue from each account grew 6.6 percent to $146.80.


Verizon Wireless, the largest American wireless carrier, is leading the race to build out its fourth-generation network, called LTE, which is faster and more efficient than its predecessor. The company has deployed LTE in 476 cities; AT&T, the second-biggest American carrier, is in a distant second with 135 cities.


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