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.


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..

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..

Bits Blog: Apple Takes Aim at Providers of Under-Age Laborers

Labor recruiters in China last year knowingly provided underage workers to a supplier that built parts for products from Apple and other companies.

That finding was included in Apple’s 2013 report on labor conditions at its suppliers, where more than 1.5 million workers make or assemble the ingredients that go into the iPhone, iPad and other products. The report, posted late Thursday night, is the latest installment in the company’s annual assessment of how well its suppliers are complying with Apple’s code of conduct, which dictates standards for workplace safety and other labor conditions. The 2013 report is the result of 393 audits at Apple suppliers, the company said.

Apple said it found no cases of underage workers at its final assembly suppliers in 2012 — including big companies like Foxconn — but it discovered such violations deeper within its network of suppliers at subcontractors. Apple described in the report how “dishonest third-party labor agents” in China work to skirt Apple’s policy against underage laborers. In January of last year, Apple said it audited a company that makes circuit board components found in Apple’s and other companies’ products, Guangdong Real Faith Pingzhou Electronics Co., and discovered 74 cases of workers who were under the age of 16.

As part of the investigation, it found that Shenzhen Quanshun Human Resources Co., a large labor agency in China’s Shenzhen and Henan provinces, had provided the children to the maker of circuit board parts, conspiring with their families to forge documents to represent them as older than they were. Apple said it reported the labor agency to the provincial governments, which fined the agency and revoked its license. The children were returned to their families, Apple said in the report.

The report said Apple’s audits showed 92 percent compliance with its policy of a 60-hour maximum workweek.

Read More..

Myanmar Military Said to Make Progress in Fight Against Rebels





BANGKOK — Myanmar government troops on Saturday captured a crucial hilltop position outside the headquarters of ethnic Kachin rebels, two observers of the fighting said, a significant advance in a long and bloody campaign near the border with China.




The intense fighting come amid increased foreign criticism of the campaign and heightened tensions between the Burmese ethnic majority and minority groups, who make up one third of the country’s population.


In comments that are likely to anger Myanmar’s minorities, the country’s opposition leader, Daw Aung San Suu Kyi, expressed admiration for the military during a visit to Hawaii, where among other activities she is giving a speech titled “Peace Takes Courage and Compassion.”


“I’ve often been criticized for saying that I’m fond of the Burmese army, but I can’t help it — it’s the truth,” Ms. Aung San Suu Kyi, whose father was the founder of the modern Burmese army, said on Friday at the East-West Center in Honolulu.


The comments by Ms. Aung San Suu Kyi, who won the Nobel Peace Prize in 1991, were made in the context of the military’s role in helping secure independence from Britain. But given the timing they are likely to further alienate ethnic minorities, who have criticized her for not speaking out forcefully against the Kachin campaign.


The Myanmar military ruled Myanmar for five decades, brutally suppressing dissent and jailing its opponents, including Ms. Aung San Suu Kyi. A civilian government took power in 2011.


National reconciliation between the Burmese majority and many ethnic groups is seen as a crucial component of Myanmar’s moves toward democracy under President Thein Sein.


The fighting in Kachin has displaced tens of thousands of civilians in wintry conditions.


The military’s capture of the hilltop position, Hkayabum, comes a week after the government, in an apparent attempt to allay criticism by foreign governments over the air and ground campaign, announced a cease-fire with the rebels.


That cease-fire never went into effect, independent observers say. Instead the Myanmar army continued an intensive artillery assault on rebel positions.


“It’s been a nonstop barrage,” said Ryan Roco, an American photographer documenting the fighting from the front lines. “It’s raining mortars.”


Khon Ja, a Kachin humanitarian worker, said it was possible that rebel forces would retake the hilltop position and described the fighting as “cat and mouse.”


A spokesman for the government, Ye Htut, said he was not aware whether Hkayabum had been taken but that government troops are “very close to the post and heavy fighting is ongoing.”


The Myanmar government has repeatedly said it was acting in self-defense against the Kachin Independence Army, the rebel group known by its acronym KIA.


A statement by the Myanmar foreign ministry published in state newspapers on Saturday said the rebels had “attacked military column with strong forces” immediately after the cease-fire was announced on Jan. 18 and that the military, or Tatmadaw, as it is known in Burmese, had no choice but to fight back.


“As KIA troops have constantly launched such terrorist attacks, the Tatmadaw had to take military actions just to protect and safeguard the peace and tranquillity of the community and for the prevalence of law and order,” the statement said.


Outside observers have challenged that view, saying the military has advanced their positions even as they claim to be acting in self-defense.


The United States embassy in Yangon said on Thursday that it was “deeply concerned” by what it called a continued offensive.


“The United States strongly opposes the ongoing fighting, which has resulted in civilian casualties and undermined efforts to advance national reconciliation,” the statement said.


Myanmar’s foreign ministry criticized the American statement, saying it was “endeavoring in good faith” to achieve a cease-fire.


In the same statement, the foreign ministry said it “strongly objects” to the use of the word “Burma” by the United States government. Using the country’s former name, it said, “may affect mutual respect, mutual understanding and cooperation which have recently been restored between the two countries.”


A military junta changed the country’s English name from Burma to Myanmar in 1989, soon after the bloody suppression of a popular uprising against military rule. The violent context of the name change made many foreign government reluctant to go along with it. But today most governments call the country Myanmar.


Wai Moe contributed reporting from Yangon.



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.


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.


Read More..

IHT Rendezvous: France Is Sweet on 'Sugar Man'

A love story is developing between the French and Rodriguez, the Detroit-born musician who flopped in the 1970s, was a star without knowing it in apartheid South Africa and was rediscovered last summer in the United States when the documentary “Searching for Sugar Man” was released.

The film tells the extraordinary story of a talented and philosophical musician who spent his life working in construction while struggling to bring up his three daughters, and the mind-boggling mutual discoveries in 1997: for him, that he was more famous than the Rolling Stones in South Africa, and for South African fans (who believed him to be dead), that he was alive.

The Swedish-U.K. film by Malik Bendjelloul which has made more than $3 million at the box office in the United States, and has been nominated for an Academy Award in the documentary category. In France the now-70-year-old Rodriguez has created something of a frenzy: the soundtrack album is among Sony France’s top sales on iTunes. Sony had planned on putting fewer than 3,000 CDs in stores, but after calls from vendors who sensed something was up, made 15,000 copies available.

“It is an honor and a pleasure,” said Rodriguez in an email message last week from Detroit about his popularity in France. “I’ve been to France a couple of times now. It feels like I’m on top of the world.”

The French public has had a tradition of adopting American artists that it considers underappreciated in the United States, from Josephine Baker to Woody Allen, from Paul Auster to Ben Harper. Le Figaro newspaper recently dubbed Rodriguez the “unloved” singer.

David Nivesse, from ARP Selection, the film’s French distributor, and Christophe Servel Molvaer, project manager for Sony Music Legacy, France, say that it all started last November when Rodriguez came to Paris for a private concert following a preview of the documentary.

“He played for half an hour and you could hear a pin drop. There were 600 people in the room and he got a standing ovation,” Mr. Servel Molvaer recalled. “I had never heard of him before. But from the beginning I was captivated by this soul-funk. It’s something magical, and people love his music from the moment they hear it.”

“Music is a language all it’s own,” wrote Rodriguez. “I’ve been playing ‘La Vie En Rose’ a lot lately when I’m looking for sounds. It’s the notes and the rhythms— that is what speaks to me. I’m a music lover. I do vocal against guitar. Sometimes it’s like any words will work. A lot of songs out there have fewer words than guttural sounds like oohs and ahhs and grunts. That works for some people too. I’m glad the French like my stuff. It’s had a long life and I feel lucky for that.”

“Searching for Sugar Man” was released Dec. 26 in just two Paris cinemas. It has beaten all records at the Left Bank Saint Germain movie theater where it is playing. It’s now playing in other cities in France including Bordeaux, Rennes and Nancy.

“We thought the film would do well but this is exceptional,” Mr. Nivesse said.

Rodriguez is playing concerts around the world now. One gig was scheduled for this June at La Cigale, a major Paris venue. It sold out within 72 hours. Another concert was added at the Zenith (capacity 6,500). He is also expected to play at the major French summer music festivals.

“I’ve been working 25 years in the business and never met anyone like this, with so much charisma, even though he doesn’t say much,” said Mr. Servel Molvaer.

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