The New Old Age: The Gift of Reading

This is the year of the tablet, David Pogue of The Times has told us, and that may be good news for seniors who open holiday wrappings to find one tucked inside. They see better with tablets’ adjustable type size, new research shows. Reading becomes easier again.

This may seem obvious — find me someone over 40 who doesn’t see better when fonts are larger — but it’s the business of science to test our assumptions.

Dr. Daniel Roth, an eye specialist and clinical associate professor at the Robert Wood Johnson Medical School in New Brunswick, N.J., offered new evidence of tablets’ potential benefits last month at the annual meeting of the American Academy of Ophthalmology.

His findings, based on tests conducted with 66 adults age 50 and over: older people read faster (a mean reading speed of 128 words per minute) when using an iPad, compared to a newspaper with the same 10-point font size (114 words per minute).

When the font was increased to 18 points — easy to do on an iPad — reading speed increased to 137 words per minute.

“If you read more slowly, it’s tedious,” Dr. Roth said, explaining why reading speed is important. “If you can read more fluidly, it’s more comfortable.”

What makes the real difference, Dr. Roth theorizes, is tablets’ illuminated screen, which heightens contrast between words and the background on which they sit.

Contrast sensitivity — the visual ability to differentiate between foreground and background information — becomes poorer as we age, as does the ability to discriminate fine visual detail, notes Dr. Kevin Paterson, a psychologist at the University of Leicester, who recently published a separate study on why older people struggle to read fine print.

“There are several explanations for the loss of sensitivity to fine detail that occurs with older age,” Dr. Paterson explained in an e-mail. “This may be due to greater opacity of the fluid in the eye, which will scatter incoming light and reduce the quality of the projection of light onto the retina. It’s also hypothesized that changes in neural transmission affect the processing of fine visual detail.”

Combine these changes with a greater prevalence of eye conditions like macular degeneration and diabetic retinopathy in older adults, and you get millions of people who cannot easily do what they have done all their lives — read and stay connected to the world of ideas, imagination and human experience.

“The No. 1 complaint I get from older patients is that they love to read but can’t, and this really bothers them,” Dr. Roth said. The main option has been magnifying glasses, which many people find cumbersome and inconvenient.

Some words of caution are in order. First, Dr. Roth’s study has not been published yet; it was presented as a poster at the scientific meeting and publicized by the academy, but it has not yet gone through comprehensive, rigorous peer review.

Second, Dr. Roth’s study was completed before the newest wave of tablets from Microsoft, Google, Samsung and others became available. The doctor made no attempt to compare different products, with one exception. In the second part of his study, he compared results for the iPad with those for a Kindle. But it was not an apples to apples comparison, because the Kindle did not have a back-lit screen.

This section of his study involved 100 adults age 50 and older who read materials in a book, on an iPad and on the Kindle. Book readers recorded a mean reading speed of 187 words per minute when the font size was set at 12; Kindle readers clocked in at 196 words per minute and iPad readers at 224 words per minute at the same type size. Reading speed improved even more drastically for a subset of adults with the poorest vision.

Again, Apple’s product came out on top, but that should not be taken as evidence that it is superior to other tablets with back-lit screens and adjustable font sizes. Both the eye academy and Dr. Roth assert that they have no financial relationship with Apple. My attempts to get in touch with the company were not successful.

A final cautionary note should be sounded. Some older adults find digital technology baffling and simply do not feel comfortable using it. For them, a tablet may sit on a shelf and get little if any use.

Others, however, find the technology fascinating. If you want to see an example that went viral on YouTube, watch this video from 2010 of Virginia Campbell, then 99 years old, and today still going strong at the Mary’s Woods Retirement Community in Lake Oswego, Ore.

Ms. Campbell’s glaucoma made it difficult for her to read, and for her the iPad was a blessing, as she wrote in this tribute quoted in an article in The Oregonian newspaper:

To this technology-ninny it’s clear
In my compromised 100th year,
That to read and to write
Are again within sight
Of this Apple iPad pioneer

Caregivers might be delighted — as Ms. Campbell’s daughter was — by older relatives’ response to this new technology, a potential source of entertainment and engagement for those who can negotiate its demands. Or, they might find that old habits die hard and that their relatives continue to prefer a book or newspaper they can hold in their hands to one that appears on a screen.

Which reading enhancement products have you used, and what experiences have you had?

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Bernanke calls high unemployment rate 'an enormous waste'

WASHINGTON -- Despite the moderate pace of recovery, the Federal Reserve is so worried about the stubbornly high level of unemployment that it promised to extend its unprecedented stimulus steps until there is "substantial improvement," Fed Chairman Ben S. Bernanke said.

"The conditions now prevailing in the jobs market represent an enormous waste of economic and human potential," Bernanke told reporters Wednesday.

The new goal for the Fed is to get the jobless rate down to 6.5%, the first time it has tied interest rates to a specific unemployment target.

Fed policymakers said Wednesday they would keep short-term interest rates near zero until the unemployment rate fell to 6.5% or lower and the long-term outlook for inflation topped 2.5%.

Previously, the Fed used a time-range target, saying it was unlikely to raise its benchmark interest rate until at least mid-2015.

The new targets produce roughly the same timetable, as the Fed doesn't project unemployment would get to 6.5% until mid-2015.

Fed policymakers believed that tying interest rates more explicitly to the state of the economy was better than a vaguer date target, Bernanke said.

The jobs market also is affected by the threat of large tax increases and government spending cuts coming on Jan. 1, he said.

It is crucial for Washington politicians to come together soon on a deal to resolve the so-called fiscal cliff so it doesn't derail the recovery, Bernanke said.

The tax increases and spending cuts would have "very significant adverse effects on the economy and the unemployment rate."

And although the Fed would consider more stimulus if the fiscal cliff was not resolved, there would be little the Fed could do to help, he said.

"We cannot offset the full impact of the fiscal cliff," Bernanke said. "It’s just too big given the tools we have available and the limitations on our policy toolkit at this point."

US Unemployment Rate data by YCharts

ALSO:

Fed renews stimulus efforts, ties interest rates to jobless rate

Big-company CEOs cautious about growth because of 'fiscal cliff'

More Americans optimistic on economy even as 'fiscal cliff' looms

Follow Jim Puzzanghera on Twitter and Google+.

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'Right-to-work' measure passes in Michigan Legislature

Controversial "right-to-work" legislation covering public-sector employees passed the Michigan House of Representatives on Tuesday, bringing it one step closer to being signed into law.

The House passed the bill, 58 to 51, as union opponents of the measure booed inside the Capitol and an estimated 12,000 people rallied outside. The state's Senate approved the bill last week.

The House is now scheduled to vote on a right-to-work bill for private-sector employees, which would cover Michigan's auto industry. If that measure passes, Michigan would become the 24th right-to-work state, meaning unions cannot require members to pay dues as a condition of employment.

Michigan is the fourth state in the Midwest to become embroiled in labor controversy since 2010, when a slate of Republican governors were swept into statehouses across the nation. The speed with which the right-to-work measure are being passed worries some labor experts, who say that it was once unimaginable that Michigan, where 17.5% of the workforce is unionized, would become a right-to-work state.

"Michigan could prove defining," said Harley Shaiken, a labor expert at UC Berkeley. "What happens here, given the role of unions historically in Michigan, and the larger political implications of right-to-work, will mean a lot."

But even as the Rev. Jesse Jackson rallied protesters on the steps of Lansing City Hall, labor leaders were hurriedly seeking ways to reverse the legislation down the road.

Michigan can't go the way of Ohio, where a referendum last year reversed legislation that would have restricted collective bargaining. Michigan's right-to-work legislation is attached to an appropriations bill, meaning it can't be reversed by referendum. Also, it may be too risky to wait and go the way of Wisconsin, where litigation continues after a judge struck down parts of a collective bargaining law.

However, in Michigan, there is an option of a "statutory initiative," which would be permitted if opponents of the bills can collect enough signatures to equal 8% of the votes cast in the last gubernatorial election, union leaders say. A so-called veto referendum could be triggered by collecting signatures equal to 5% of the votes cast.

A statutory initiative would allow voters to cast a ballot on right-to-work legisation in November 2014, when Gov. Rick Snyder, who has said he would support the legislation, will be up for reelection.

"There are multiple options for a referendum," a senior labor leader said Tuesday. "All options are on the table. This fight is far from over."

It’s unclear whether unions are promoting a referendum now to warn Snyder of the repercussions that signing the legislation would have.

Democrats including Sen. Carl Levin and Rep. John Dingell met with Snyder on Monday to urge him to veto the legislation. The governor promised to "seriously" consider their concerns, but Democrats remained worried that he would sign the bills.

“The governor has a choice: He can put this on the ballot, and let the voters make the determination, or he can jam it through a lame-duck session,” Dingell said Monday.

Snyder, a businessman before he became governor, was elected in 2010 by a landslide, beating his opponent by a nearly 2-to-1 margin. But only 35.5% of respondents said they thought he was doing an "excellent" or "good" job in a Michigan State University survey this fall, and that figure could fall as the controversy continues.

"I think this will pass, and be signed, and there will be a long struggle with the United Auto Workers and other unions,” said Kristin Dziczek, director of the labor and industry group at the Center for Automotive Research. "They’re going to focus their attentions on overturning this. I don’t think the war has even begun."

ALSO:

Obama blasts right-to-work in Michigan

Ohio votes to overturn new collective bargaining law

Protests re-ignite as Michigan right-to-work bill nears final OK

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Vindication for 2013 Rock Hall of Fame inductees

Randy Newman's glad he didn't have to do anything drastic to get into the Rock and Roll Hall of Fame. The members of Rush are choosing to let bygones be bygones. And Quincy Jones, well, he's still mad.

All were among inductees announced Tuesday by Flea of The Red Hot Chili Peppers at a news conference in Los Angeles. For most of this year's inductees, inclusion was a long time coming.

"I'm very happy," the 69-year-old Newman said Monday from his home in Los Angeles. "I thought I'd have to die first, but I'm glad I'm around to see it."

Newman is joined in the 2013 class by the eclectic group of rockers Rush and Heart, rap group Public Enemy, "Queen of Disco" Donna Summer and bluesman Albert King. Jones and his friend Lou Adler will enter the hall as Ahmet Ertegun Award winners for their contributions to rock beyond performance.

They will be inducted into the hall of fame April 18 in Los Angeles. The ceremony will mark the end of a long wait for fans of five of those six acts, who've been eligible for entry for some time. Public Enemy was inducted on its first ballot appearance, swelling the ranks of hip-hop entries.

In many ways, the 2013 class balances the scales, though not nearly soon enough for some new members.

"Well, it's about time, man," Jones said late Monday night in an interview from his home in Los Angeles. "But I promise you I'm not sitting around worrying about it."

Summer, who passed away at age 63 in May, gains entry after six years as a nominee. King, a deep influence on Jimi Hendrix and Stevie Ray Vaughn who died in 1992, now takes his place alongside all the other legendary blues guitarists in the hall.

Rush, one of the most-played staples of classic rock radio, gained entry following its first appearance on the ballot. But the Canadian trio became eligible in 1998 and was repeatedly left off the list, to the great consternation of its legion of fans who cried bias against prog rock. Heart also waited a decade to make it on the ballot, gaining entry during its second appearance.

After years of disappointment, then disinterest, Rush's Alex Lifeson said the band now feels "wonderful" about its entry into the hall and is especially happy for its followers.

"First of all it's all water under the bridge and it was a very tiny bridge," the 59-year-old guitarist said in a phone interview from his home in Toronto. "I think our fans are more upset than we were because they feel a real bond to this band and it's been an important part of their lives in some form, and to be snubbed was snubbing them at the same time. ... Perhaps there were times when I thought if this ever happens I'm not going to bother going, or who cares or whatever, but at the end of the day positive karma is an important thing and this is an important thing to a lot of our fans and people we know."

Jones was less forgiving of the long wait he had. The 79-year-old entertainment icon's fingerprints are all over the hall of fame. He pops up often at key moments in rock 'n' roll history and was even Ray Charles' presenter during the soul singer's induction at the inaugural 1986 ceremony. He never expected to wait so long for his own entry.

"I was pissed off about it at first because I saw how it was going down and who was going in and who wasn't," Jones said with a deep laugh. "But I'm used to it, man. I've been around a long time, and I know how it works, you know. It's still an honor, man."

The 2013 class also continues the process of opening the hall of fame's doors a little bit wider.

In many cases, the delayed entry of this year's inductees had to do with a debate among its membership over the hall of fame's direction. The rock 'n' roll family sits under a big tent, but just how big it should be has been a matter of debate for the Cleveland, Ohio, institution.

The class may signal a new direction.

"That is an eclectic group," Newman said. "Well that's nice. It seems like they're broadening what they think rock 'n' roll is. That's good. There's no point being doctrinaire about music. ... People get awful strict. It's a hell of a thing to get strict about, isn't it?"

There was clearly no debate among the hall's membership about Public Enemy, which gained membership on its 25th anniversary.

The openly militant, always angry group helped elevate and define nascent rap in the 1980s and '90s. MC Chuck D said the group's induction is about more than simple membership.

"It's a great piece of news for the genre and our intention was to spread the light that our music is as legitimate as any other music," Chuck D said as the group traveled through Wyoming on tour Monday. " ... So this is significant to be alongside Grandmaster Flash and The Furious Five, Run DMC and the Beastie Boys and just to be able to say this accomplishment, we don't think it's solely due to us."

Lifeson hopes the hall's membership keeps up with the trend.

"Maybe it should be the Music Hall of Fame and not so much the Rock and Roll Hall of Fame," Lifeson said. "But maybe it all is rock 'n' roll. It started as a little seed and grew into this great big tree with a lot of branches. That's why it's so sad the whole progressive movement, bands like Yes and King Crimson, are not included in this. ... I hope there comes a time when these other artists and bands are included because they were equally as influential as any of the ones that are being inducted today."

___

Online:

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Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott.

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Global Update: Hand-Held Device Locates Hot Spots of Lead Contamination

Using a hand-held scanner to map hot spots where the soil is full of lead could protect children in mining towns against brain damage, scientists at Columbia University concluded in a new study.

Touched to the ground, the device, an X-ray fluorescence scanner, can measure the soil’s lead content in less than a minute, said Alexander van Geen, a geochemist at Columbia’s Lamont-Doherty Earth Observatory and an author of the study, which is in the current issue of the Bulletin of the World Health Organization. The “XRF guns,” which are often used by scrap-metal sorters, cost between $15,000 and $40,000.

His team tested the scanners in Cerro de Pasco, Peru, a town in the high Andes with mines dating back 1,400 years. Samples as close as 100 yards apart showed widely variable lead levels, so it is possible to find and mark off the areas most dangerous to young children, who get fine lead dust on their hands while playing and then put their fingers in their mouths.

“People assume the contamination is everywhere, and it’s not,” Dr. van Geen said. “It could be in one backyard and not in another.” Or, he said, in an untested playground, schoolyard, or any place where children gather.

The technology could be useful anywhere families live close to mines or smelters, which is common in Latin America and Africa, he said. Lead is a byproduct not just of lead mines, but of mining for gold, silver, copper and other metals.

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Seafood fraud widespread in N.Y., probe finds

There's a good chance that the white tuna sashimi served up at your favorite Manhattan sushi joint isn't white tuna at all.

Instead, 94% of the fish labeled as white tuna in New York turned out to be escolar, a type of snake mackerel with a toxin linked to digestive problems, according to an investigation by conservation and advocacy group Oceana.

DNA tests of 142 seafood samples taken from New York grocery stores, restaurants and sushi venues showed that 39% were mislabeled as different species, according to Oceana.

Earlier Oceana tests showed a 31% fraud rate in Miami, 48% in Boston and 55% in Los Angeles.

Quiz: The year in business

Out of 81 retail outlets probed in New York -- which included shops in Manhattan, Queens, Brooklyn, Staten Island, Commack, Scarsdale, Hudson and Edgewater, N.J. -- 58 featured improperly tagged items, the group said.

Small markets had a 40% fraud rate, it said, while 12% of items purchased at national chains were mislabeled. Each of the 16 sushi bars targeted served fish that didn’t match its menu description.

Seafood purported to be red snapper turned out to be tilapia, white bass, ocean perch and even tilefish, which sits on the U.S. Food and Drug Administration's do-not-eat list because of its high mercury content.

The U.S. currently imports more than 90% of its seafood.

"With an increasingly complex and obscure seafood supply chain, plus lagging federal oversight and inspection of rising seafood imports, it is difficult to identify who along the supply chain perpetrates the fraud," according to the Oceana report.

In October, celebrity chefs such as Mario Batali, Rick Bayless and Thomas Keller joined 500 other restaurant owners on an Oceana petition to stop seafood fraud.

ALSO: 

Seafood in L.A. frequently mislabeled, group says

Target commits to 100% sustainable, traceable fish by 2015

S.F. Chinese group sues over shark fin ban, alleges discrimination

Read More..

Latin music star Jenni Rivera believed dead in plane crash

Fans of Mexican-American singing star Jenni Rivera held a vigil Sunday night in Lynwood

MEXICO CITY — Mexican American singer Jenni Rivera, the "diva de la banda" whose commanding voice burst through the limits of regional Latin music and made her a cross-border sensation and the queen of a business empire, was believed to have died Sunday when the small jet carrying her and members of her entourage crashed in mountainous terrain.

Rivera, a native of Long Beach, was 43. Mexico's ministry of transportation did not confirm her death outright, but it said that she had been aboard the plane and that no one had survived the crash. Six others, including two pilots, also were on board.

"Everything suggests, with the evidence that's been found, that it was the airplane that the singer Jenni Rivera was traveling in," said Gerardo Ruiz Esparza, Mexico's secretary of communications and transportation. Of the crash site, Ruiz said: "Everything is destroyed. Nothing is recognizable."

Word of the accident ricocheted around the entertainment industry, with performer after performer expressing shock and grief. Fans gathered outside Rivera's four-acre estate in Encino.

"She was the Diana Ross of Mexican music," said Gustavo Lopez, an executive vice president at Universal Music Latin Entertainment, an umbrella group that includes Rivera's label. Lopez called Rivera "larger than life" and said that based on ticket sales, she was by far the top-grossing female artist in Mexico.

"Remember her with your heart the way she was," her father, Don Pedro Rivera, told reporters in Spanish on Sunday evening. "She never looked back. She was a beautiful person with the whole world."

Rivera had performed a concert in Monterrey, Mexico, on Saturday night — her standard fare of knee-buckling power ballads, pop-infused interpretations of traditional banda music and dizzying rhinestone costume changes.

At a news conference after the show, Rivera appeared happy and tranquil, pausing at one point to take a call on her cellphone that turned out to be a wrong number. She fielded questions about struggles in her personal life, including her recent separation from husband Esteban Loaiza, a professional baseball player.

"I can't focus on the negative," she said in Spanish. "Because that will defeat you. That will destroy you.... The number of times I have fallen down is the number of times I have gotten up."

Hours later, shortly after 3 a.m., Rivera is believed to have boarded a Learjet 25, which took off under clear skies. The jet headed south, toward Toluca, west of Mexico City; there, Rivera had been scheduled to tape the television show "La Voz" — Mexico's version of "The Voice" — on which she was a judge.

The plane, built in 1969 and registered to a Las Vegas talent management firm, reached 11,000 feet. But 10 minutes and 62 miles into the flight, air traffic controllers lost contact with its pilots, according to Mexican authorities. The jet crashed outside Iturbide, a remote city that straddles one of the few roads bisecting Mexico's Sierra de Arteaga national park.

Wreckage was scattered across several football fields' worth of terrain. An investigation into the cause of the crash was underway, and attempts to identify the remains of the victims had begun.

Rivera, a mother of five and grandmother of two, was believed to have been traveling with her publicist Arturo Rivera, who was not related to her, as well as with her lawyer, hairstylist and makeup artist; reports of their names were not consistent. Their identities were not confirmed by authorities. The pilots were identified as Miguel Perez and Alejandro Torres.

In the world of regional Latin music — norteño, cumbia and ranchera are among the popular niches — Rivera was practically royalty.

Her father was a noted singer of the Mexican storytelling ballads known as corridos. In the 1980s he launched the record label Cintas Acuario. It began as a swap-meet booth and grew into an influential and taste-making independent outfit, fueling the careers of artists such as the late Chalino Sanchez. Jenni Rivera's four brothers were associated with the music industry; her brother Lupillo, in particular, is a huge star in his own right.

Born on July 2, 1969, Rivera initially showed little inclination to join the family business. She worked for a time in real estate. But after a pregnancy and a divorce, she went to work for her father's record label and found her voice, literally and figuratively.

She released her first studio album in 2003, when she was 34.

Her path had not been easy, but rather than running from it, she wrote it into her music — domestic violence; struggles with weight; raising her children alone, or "sin capitan," without a captain. She was known for marathon live shows that left audiences exhilarated and exhausted; by the fifth hour of one recent performance, she was drinking straight from a tequila bottle and launching into a cover of "I Will Survive."

In a witty and sometimes baffling stew of Spanish and English, she sang about her three husbands, about drug traffickers, in tribute to her father, in tribute to her gynecologist.

She became, in a most unlikely way, a feminist hero among Latin women in Mexico and the United States and a powerful player in a genre of music dominated by men and machismo. Regional Mexican music styles had long been seen as limiting to artists, but Rivera shrugged off the labels and brought traditional-laced music — some of which sounded perilously close to polka — to a massive pop audience.

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Fla. man sues ex-Elmo puppeteer, claims sex abuse

MIAMI (AP) — Another man on Monday sued the former Elmo puppeteer who resigned amid sex abuse allegations, claiming the voice actor befriended him in Miami and promised to be a father figure before flying the teen to New York to have sex with him.

The alleged victim is now the fourth to accuse Kevin Clash, who resigned from "Sesame Street" last month after 28 years. The three legal actions filed so far have been civil cases seeking financial compensation.

But the incident with the latest victim, referred to only as S.M., could involve criminal charges because the lawsuit claims Clash transported him across state lines for the purpose of engaging in sexual activity.

Attorney Jeff Herman said he encouraged his client to report the incident to authorities but it's unclear if the now-33-year-old alleged victim has done so.

Sexual abuse allegations against Clash triggered a media frenzy last month. He quickly denied the first claim, which was recanted the next day. But Clash then resigned after a 24-year-old college student, Cecil Singleton, sued him for $5 million, saying the actor engaged in sexual behavior with him when he was 15.

Singleton claims the voice actor met him in New York a dozen years ago after trolling gay telephone chat lines and seeking underage boys for sex.

In the latest case, the plaintiff said Clash approached him on Miami Beach, complimented his appearance and struck up a friendship. Clash returned home to New York, but stayed in touch with the teen, promising to be a dad to him. The youth, who was 16 or 17 at the time, had been molested by a teacher and was considering running away from home, according to the lawsuit.

"These are all vulnerable boys. None of them had father figures in their lives and they were looking for that father figure," said Herman, who represents three of the alleged victims.

The lawsuit says Cash paid for a plane ticket from Florida to New York in 1996 and arranged for a car service to pick up the teen and bring him to his upscale apartment, where he gave him cash and showered him with "attention and affection" and ultimately engaged in numerous sexual acts.

Herman said he is poring over receipts and other documents to see if the car service was paid for by Cash's employers at Sesame Street.

Phone calls and emails to publicists for Clash and Sesame Street were not immediately returned Monday.

Herman said the alleged victims didn't come forward sooner because they were afraid, but have found courage as others have spoken up.

He said they are compliant victims who participated in the sexual acts, but didn't consent because it's illegal for a minor to do so.

"Because they participated in the sex they feel like they're doing something wrong ... they're ashamed, they're embarrassed, not something they really want to talk about," he said.

Herman said he's been contacted by several other possible victims and is vetting their cases.

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Mind: A Compromise on Defining and Diagnosing Mental Disorders

They plotted a revolution, fell to debating among themselves, and in the end overturned very little except their own expectations.

But the effort itself was a valuable guide for anyone who has received a psychiatric diagnosis, or anyone who might get one.

This month, the American Psychiatric Association announced that its board of trustees had approved the fifth edition of the association’s influential diagnostic manual — the so-called bible of mental disorders — ending more than five years of sometimes acrimonious, and often very public, controversy.

The committee of doctors appointed by the psychiatric association had attempted to execute a paradigm shift, changing how mental disorders are conceived and posting its proposals online for the public to comment. And comment it did: Patient advocacy groups sounded off, objecting to proposed changes in the definitions of depression and Asperger syndrome, among other diagnoses. Outside academic researchers did, too. A few committee members quit in protest.

The final text, which won’t be fully available until publication this spring, has already gotten predictably mixed reviews. “Given the challenges in a field where objective lines are hard to draw, they did a solid job,” said Dr. Michael First, a psychiatrist at Columbia who edited a previous version of the manual and was a consultant on this one.

Others disagreed. “This is the saddest moment in my 45-year career of practicing, studying and teaching psychiatry,” wrote Dr. Allen Frances, the chairman of a previous committee who has been one of the most vocal critics, in a blog post about the new manual, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM5.

Yet many experts inside and outside the process said the final document was not radically different from the previous version, and its lessons more mundane than the rhetoric implied. The status quo is hard to budge, for one. And when changes do happen, they are not necessarily the ones that were intended.

The new manual does extend the reach of psychiatry in some areas, as many critics feared it might. Hoarding is now a mental disorder (previously it was considered a symptom of obsessive-compulsive behavior). “Premenstrual dysphoric disorder,” a severe form of premenstrual syndrome, is also new (it was previously in the appendix).

And binge-eating disorder (also formerly in the appendix), a kind of severe, highly distressing gluttony, is now a full-blown diagnosis. This one by itself could tag millions of people considered healthy, if often overindulgent, with a psychiatric label, some experts said.

But the deeper story is one of compromise. It is most evident in how the committee handled three of the thorniest diagnoses in psychiatry: autism, depression and pediatric bipolar disorder.

The group working on depression declared early on that it wanted to eliminate the so-called bereavement exclusion, which stated that grieving the loss of a loved one should not be considered a clinical disorder, though it shares many of the same outward signs. Grief has always been a normal reaction to death, not a kind of depression.

Advocacy and support groups, such as those representing people who have lost a child, objected furiously to the idea that the bereaved might be given a diagnosis of depression.

“This was just astonishing, that they would eliminate the exclusion, and a distortion of the research on the subject,” said Jerome Wakefield, a professor of social work and psychiatry at New York University, who did not work on the manual.

In the end the committee cut a deal. It eliminated the grief exclusion but added a note in the text, reminding doctors that any significant loss — of a job, a relationship, a home — could cause depressive symptoms and should be carefully investigated.

“It’s like they took it all back,” Dr. Wakefield said. “I don’t like the way it was done — in a footnote — but it’s there.”

The debate over autism was even more furious, and it resulted in a similar rapprochement.

From the outset, the committee intended to tighten the definition of autism and simplify it, eliminating related labels like Asperger syndrome and “pervasive developmental disorder not otherwise specified,” or PDD-NOS. The rate of diagnosis of such conditions has exploded over the past decade, in part due to the vagueness of the definitions, and the committee wanted to draw clearer boundaries.

It proposed a single “autism spectrum disorder” category, with stricter requirements.

Some outside researchers raised concerns. In January one of them, Dr. Fred Volkmar of the Yale School of Medicine, who had quit the committee in protest, presented research suggesting that 45 percent or more of people who currently had an autism or related diagnosis would not have one under the proposed revision.

Autism groups reacted immediately, fearing that the change in the diagnosis would deny services to children and families who need them.

The committee countered with its own study, suggesting that the new definition would exclude about 10 percent of people currently with a diagnosis. And again, the experts took a half step back.

The new, streamlined definition was approved, but with language that took into account a person’s diagnostic history. “It’s explicit that anyone who’s had an Asperger’s or autism or PDD-NOS diagnosis before is now included,” said Catherine Lord, a committee member who worked on the new definition and who is director of the Center for Autism and the Developing Brain in New York. “Essentially everyone gets in.”

Pediatric bipolar disorder posed a different challenge.

In the 1990s and 2000s, psychiatrists began giving aggressive, explosive children a diagnosis of bipolar disorder in increasing numbers. The trend appalled many patient advocates and doctors.

Bipolar disorder, which is characterized by episodes of depression and mania, had previously been an adult problem; now the diagnosis is given to children as young as 2 — along with powerful psychiatric drugs and tranquilizers that also cause rapid weight gain. The committee wanted to stop the trend in its tracks, said experts who were involved.

Most of the children treated for bipolar disorder did not have it, recent research found. The committee settled on an alternative label: “disruptive mood dysregulation disorder,” or D.M.D.D., which describes extreme hostility and outbursts beyond normal tantrums.

“They essentially wanted to have some place for these kids, and D.M.D.D. was all they had in their kit,” said Dr. Gabrielle Carlson, a child psychiatrist at Stony Brook University Medical Center, who provided some outside consultation. “These are mostly kids who have A.D.H.D. or what we would call oppositional defiant disorder, but with this explosive feature. They need help; you can’t wait forever. The question was what to call it, without pretending we know enough to saddle them with a lifelong diagnosis” like bipolar disorder.

D.M.D.D. has its own problems, as many experts were quick to point out. It could be a symptom of an underlying condition, as Dr. Carlson argues. It could “medicalize” frequent temper tantrums. It’s brand new, and no one knows how it will play out in practice.

But it is now in the book — because it was the best solution available, experts inside and outside of the revision process said.

From beginning to end, many experts said, the process of defining psychiatric diagnoses is very much like finding the right one for an individual: it’s a process of negotiation, in many cases.

“That’s one of the take-aways from all this, and I think it’s a good one,” Dr. Carlson said. “A diagnosis is a hypothesis. It’s a start, and you have to start somewhere. But that’s all it is.”

One of the committee’s most ambitious proposals was perhaps the least noticed: a commitment to update the book continually, when there’s good reason to, rather than once every decade or so in a giant heave. That was approved without much fanfare.

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Facebook polls close: Facebook wins privacy vote by a landslide

The Facebook polls have closed and, even though Facebook had its biggest turnout ever, too few users cast ballots to have a say in the policy changes the giant social network proposed. (Mladen Antonov / AFP / GettyImages / December 10, 2012)

By Jessica Guynn

December 10, 2012, 12:41 p.m.

The Facebook polls have closed and, even though the social network had its biggest turnout ever, too few users cast ballots to have a say in the company's proposed policy changes.

Nearly 9 in 10 of those who voted were against the proposed changes, but only about 668,000 people cast ballots. That's an infinitesimal percentage of Facebook's 1 billion plus users.

Facebook requires that 30% of Facebook users participate for a vote to count. Facebook has held two earlier elections and neither met that threshold.

One of the proposed changes: Taking away Facebook users' right to vote on future changes. Facebook said it plans to give users other ways to weigh in on policy changes such as an "Ask the Chief Privacy Officer" question-and-answer forum on its website.

Among the other proposals that users voted on: whether Facebook can loosen restrictions on who can message you on Facebook and whether it can share information with its affiliates, including popular photo-sharing service Instagram.

Two privacy groups – the Electronic Privacy Information Center and the Center for Digital Democracy -- urged Facebook to withdraw the proposed changes.

Marc Rotenberg, executive director of the Electronic Privacy Information Center, called the vote "notable" and "historic" because it was roughly twice the size of the vote held in June and called on Facebook to heed the will of those Facebook users who did vote.

The next step will be a review of the Facebook vote by an outside auditor.

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Facebook users vote on their right to vote on Facebook policies

Facebook opens polls, users vote against privacy-policy changes

Facebook upsets some by seeking to take away users' voting rights

Follow me on Twitter @jguynn

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