Japan eased safety standards ahead of Boeing 787 rollout

TOKYO (Reuters) - Japan's government stepped in to give Boeing Co's now-grounded 787 Dreamliner and its made-in-Japan technology a boost in 2008 by easing safety regulations, fast-tracking the rollout of the groundbreaking jet for Japan's biggest airlines, according to records and participants in the process.

The concessions by an advisory panel to Japan's transport ministry reflected pressure from All Nippon Airways (ANA) and Japan Airlines (JAL) and a push to support Japanese firms that supply 35 percent of the 787 from the carbon-fiber in its wings to sophisticated electrical systems and batteries used to save fuel, people involved in the deliberations told Reuters.

"I believe the request for the changes came initially from the airlines. Ultimately, it was a discussion of measures to lower operating costs for the airlines," said Masatoshi Harigae, head of aviation at Japan's Aerospace Exploration Agency, one of the outside advisers who urged the eased regulatory standards.

There is no suggestion that easing regulatory standards contributed to the problems facing the Dreamliner, idled around the world after a string of malfunctions ranging from fuel leaks to battery meltdowns. There is also no evidence to suggest that continuing the mandate for more frequent manual inspections for new aircraft, including the Boeing 787, before 2008 would have helped catch signs of trouble earlier.

The looser regulations did not specifically address the risk of the Dreamliner's powerful batteries catching fire, the risk that safety investigators have zeroed in on in recent weeks.

But the steps taken by Japan's Civil Aviation Bureau in 2008 underscore how the deep commercial ties between Boeing and its Japanese suppliers and the backing of ANA and JAL helped build support for an easing of certification standards, based on a review of meeting records by the advisory panel released by the Ministry of Land, Infrastructure and Transport and comments from three of the seven experts who participated.

ANA and JAL declined to comment, deferring questions on regulatory standards to aviation officials and the ministry.

"We have not brought down our standards in comparison to other countries. This was a pragmatic revision," Tatsuyuki Shimazu, Chief Air Worthiness Engineer at the Civil Aviation Bureau, said.

ONGOING PROBE

Earlier this month, ANA was forced to make an emergency landing on a 787 domestic flight after a battery overheated and partially melted, triggering smoke alarms in the cockpit. The probe into that incident may take weeks or months as investigators still lack basic data to understand what went wrong, people involved have said.

In the meantime, the indefinite grounding of the Dreamliner has raised costs for both ANA and JAL and threatened to push back plans both carriers had for growth and new routes based on the new aircraft, analysts have said.

After three meetings by a panel of industry and policy experts that concluded in March 2008, Japan's transport ministry said it would adopt 40 proposals to streamline regulations surrounding new aircraft. At the time, the ministry said the easier regulatory standards were designed in part to "quickly realize the benefits from the introduction of the 787."

ANA, the Dreamliner's biggest customer, and JAL committed to buy the first 787 in 2004, helping Boeing kick-start orders for the futuristic plane. Both subsequently increased their orders, with ANA planning to eventually fly 66 Dreamliners.

"At the time there was a lot of confidence in the aircraft. It was a discussion of measures to lower operating costs for the airlines," said Harigae.

Japan's government agencies often convene blue-ribbon panels of outside experts to review regulatory policy changes, as the transport ministry did for aircraft safety rules in 2007.

QUICKER TURNAROUNDS

Changes endorsed by the aviation group, including 40 revised safety guidelines, were presented as an effort to bring Japan into line with the framework of regulations in other markets, including the United States. At least five recommendations in the advisory report benefited the 787. Four mentioned support for the Dreamliner directly.

Three of the rule changes dealt with abbreviated testing and approval of pilots who had been cleared to fly the Boeing 777 and were preparing to switch to the 787. "It (787) is highly innovative and its safety is also advanced, but it's also very similar in design to the 777," said Kinya Fujiishi, an aviation journalist who sat on the panel. "This is why we thought it would be fine to revise the rule."

Another approved rule change exempted Boeing's new jet from the need for detailed inspections by ground crew after each landing that would have meant higher costs - and longer delays - for the airlines with each flight. Participants said the panel concluded such checks were not needed because of the Dreamliner's sophisticated on-board diagnostic system.

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A violent Saturday leaves 7 dead

Four shootings -- two of them double homicides -- and a stabbing left 7 people dead Saturday, authorities said.

In what appeared to be the last homicide of the day, a man in his 30s was fatally stabbed about 11:50 p.m. in the South Shore neighborhood, police said.

The stabbing happened during an argument in the 2500 block of East 73rd Street, Chicago Police News Affairs Officer Ron Gaines said.

The man was found unresponsive on the scene.

Less than two hours earlier, about 10:05 p.m., a man was killed in the Englewood neighborhood, making him the sixth person shot day Saturday, police said.

The 38-year-old man died on the scene, in the 7000 block of South Carpenter Street, Gaines said.

Earlier, in the second double homicide of the day, a 16-year-old boy and a 32-year-old man were gunned down in the West Garfield Park neighborhood about 5 p.m., police said.

Officers responded to a call of a person shot in the 4200 block of West Congress Parkway and found the two lying dead outside on the ground, according to the police.

Both victims lived in Chicago, police said. 

No one has been arrested.

Police had the crime scene near Genevieve Melody Elementary School taped off at least one block to the north, east and west, while neighbors milled about to get a better look.

On West Van Buren Street, a body could be scene lying in the roadway, near the curb and a bus stop.

A man who only identified himself as the teen victim's uncle said the boy, whose family lived nearby, had simply gone to run an errand.

"He was just going to the store," the man said. "They just killed him just like that."

Later, the man paced back and forth on the sidewalk, shaking his head in disbelief.

"He goes to school and everything," he said to a police officer.

This man and the boy were the 4th and 5th people killed today, and the shooting was the city's second double homicide.

chicagobreaking@tribune.com

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Well: Ask Well: Squats for Aging Knees

You are already doing many things right, in terms of taking care of your aging knees. In particular, it sounds as if you are keeping your weight under control. Carrying extra pounds undoubtedly strains knees and contributes to pain and eventually arthritis.

You mention weight training, too, which is also valuable. Sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee, says Joseph Hart, an assistant professor of kinesiology and certified athletic trainer at the University of Virginia, who often works with patients with knee pain.

An easy exercise to target those muscles is the squat. Although many of us have heard that squats harm knees, the exercise is actually “quite good for the knees, if you do the squats correctly,” Dr. Hart says. Simply stand with your legs shoulder-width apart and bend your legs until your thighs are almost, but not completely, parallel to the ground. Keep your upper body straight. Don’t bend forward, he says, since that movement can strain the knees. Try to complete 20 squats, using no weight at first. When that becomes easy, Dr. Hart suggests, hold a barbell with weights attached. Or simply clutch a full milk carton, which is my cheapskate’s squats routine.

Straight leg lifts are also useful for knee health. Sit on the floor with your back straight and one leg extended and the other bent toward your chest. In this position, lift the straight leg slightly off the ground and hold for 10 seconds. Repeat 10 to 20 times and then switch legs.

You can also find other exercises that target the knees in this video, “Increasing Knee Stability.”

Of course, before starting any exercise program, consult a physician, especially, Dr. Hart says, if your knees often ache, feel stiff or emit a strange, clicking noise, which could be symptoms of arthritis.

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Pitching Chicago to China

World Business Chicago Vice Chairman Michael Sacks and former Commerce Secretary William Daley leave Sunday on a six-day business mission to China, Sacks' first official foreign trip as a top adviser to Mayor Rahm Emanuel.

Sacks said that he and Daley will pay their own way to China while World Business Chicago, a nonprofit that acts as the city's economic development agency, will cover the travel costs for two staff members, including one from the mayor's office.

Sacks and Daley will visit Hong Kong and Beijing before joining up with Choose Chicago CEO Don Welsh and the Chicago Symphony Orchestra in Shanghai.

There, they'll take in a CSO concert and co-host a reception for about 75 people, including tour operators, and China-based alumni of Northwestern University's Kellogg School of Management and the University of Chicago's Booth School of Business.

Sacks said he asked for Daley's help in selling Chicago to foreign officials, specifically the Chinese, after the former chief of staff to President Barack Obama returned home from Washington last year. Sacks said that was months before Daley said he was considering a run for governor in 2014.

"His gravitas, his stature as former commerce secretary and former chief of staff have made the quality of this trip better than anything I could have done myself," Sacks said. "I would not have been able to secure these meetings without him."

Daley and Sacks are expected to meet with 30-plus corporate executives, including the CEO of Hong Kong-based airline Cathay Pacific and billionaire Chinese entrepreneur Lu Guanqiu, whose son-in-law, Pin Ni, runs Elgin-based auto parts maker Wanxiang America Corp.; six Chinese officials, including the acting mayor of Beijing and China's commerce minister, Chen Deming; and U.S. Ambassador to China Gary Locke.

Sacks' role with World Business Chicago is a volunteer position. His day job is CEO of Grosvenor Capital Management. The investment firm is known as a hedge fund of funds because its primary business is to invest in multiple hedge funds on behalf of large investors, such as pension funds, corporations and sovereign wealth funds.

Sacks frequently travels abroad for his work, often adding city-related sales pitches to his itineraries. This, however, is his first foreign trip focused on his work at World Business Chicago.

Spertus changes name

The Spertus Institute this week will tweak its name — and with it, its identity — as part of an ongoing effort to recover from an unfortunately timed decision to open a new building on the eve of the financial crisis.

The institute, which has been a pillar of Jewish culture in Chicago since 1924, will now be called the Spertus Institute for Jewish Learning and Leadership. The institute also announced that its programming for children and families will be cut for the foreseeable future in favor of new academic offerings for people working at nonprofits.

"During the past 31/2 years, we eliminated a $3.8 million operating deficit, largely by dramatically reducing our programmatic footprint," said Hal Lewis, the institute's president, who took over in July 2009. "So I didn't have the money to go and get branding assistance. But I was convinced we had a branding challenge — because when I first became president I spent a good solid four months on a listening tour, in which people told me, 'Oh, yeah, I know something about Spertus,' but there was uncertainty about the work we did."

A grant from the Harvey L. Miller Foundation paid for most of the rebranding effort, which an outside consulting firm led.

"I should say I'm generally skeptical of consultants," Lewis said. "But they taught me something elegantly simple: Spend more time talking about the why and less time on the how. We know the enormous array of programs we offer ... but we never said why that's important. ... (The answer is) we believe that a learning Jewish community is a vibrant Jewish community. It is the historic experience of the Jewish people that learning doesn't stop at adolescence."

The institute has about 400 students in degree and certificate programs, from a one-day certificate in grant writing to a doctorate in Jewish studies, which can take up to 10 years to complete. The institute also offers public lectures on politics, arts and culture as well as museum-style exhibits.

Spertus plans to offer new leadership concentrations within its master's degree programs aimed at youth workers, camp counselors and early childhood teachers. It also plans to create programs in social entrepreneurship and lay-leader training. Lewis said also he may eliminate one of Spertus' existing education degrees, but these changes are not final and will not be announced until the spring.

"We were never best at early childhood education," Lewis said. "The synagogues are far better at that ... So this is not a retreat from one of our historic strong suits."

The seeds of the long-running overhaul of Spertus can be traced to the November 2007 opening of its building, an iconic glass sculpture at 610 S. Michigan Ave.

Lewis said so many assumptions about the building failed to materialize, such as revenue from room rentals. Nonprofits also heavily cut professional development funds during the recession, which, in turn, lowered enrollment because students were no longer able to get help paying for their master's degrees.

However, rentals and other economic indicators are beginning to reverse. The falling stock market hurt Spertus' program endowment, slicing it to about $6 million, and its building endowment to about $12 million. Those funds are now at about $7 million and about $17 million, respectively, Lewis said.

Steven Nasatir, president of the Jewish United Fund/Jewish Federation of Metropolitan Chicago, said his organization is assisting Spertus with fundraising. He said without the branding and other program changes Lewis is making, Spertus would be "treading water."

"The name change is a manifestation of resetting goals and is a positive thing," he said. "People have to better understand what you're attempting to do."

Melissa Harris can be reached at mmharris@tribune.com or 312-222-4582.

Twitter @chiconfidential

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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.

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2012 stock report: Pains and gains

If you invested heavily in Illinois companies that provide consulting services, you had little reason to celebrate in 2012.

While the Standard & Poor's 500 index ended the year up 13 percent, most large businesses in the region that counsel other companies on how to improve their operations saw their stock prices drop.

Business support services was one of the few sectors getting clobbered in a 2012 Tribune ranking of Illinois and northwest Indiana stocks' performance.

Stock prices gained at about 70 percent of the 127 companies on the list, and about half outperformed the S&P 500. Bank owners such as Taylor Capital Group emerged from their 2011 doldrums, and Ulta Salon Cosmetics & Fragrance Inc. and Discover Financial Services marked their second consecutive year of soaring stock prices.

The year's biggest decliner, down 76 percent, was Groupon, as once-torrid revenue growth at the daily deals offerer started slowing.

Career Education was the second-worst performer; its stock fell 56 percent. The highly scrutinized for-profit school chain said it would close campuses and cut jobs amid sinking revenue and financial losses.

Sectors boosted by broad gains in 2012 included electrical parts and equipment, industrial machinery, and specialty chemicals.

Of seven Illinois banks on the list, all but one outperformed the S&P 500, with price appreciation of those six ranging from 16 to 86 percent.

In contrast, stocks of four of five professional services firms — Navigant Consulting, Huron Consulting Group, Heidrick & Struggles International and R.R. Donnelley & Sons — closed down 2 to 38 percent.

Each had its own set of issues.

Navigant's services, for example, include advising companies that face disputes, litigation and investigations, including government probes, as well as businesses that need help valuing potential mergers and acquisitions.

"You see fewer government investigations during an election year, as regulators are leaving their jobs, and they don't want to start new ones," said Tobey Sommer, a SunTrust Robinson Humphrey analyst. "Also, worries about the 'fiscal cliff' slowed M&A because CEOs didn't want to look foolish acquiring a company in September ahead of the fiscal cliff when they might have been able to buy it for 20 percent less in January had we gone off."

Meanwhile, Heidrick's troubles included a slowing market for executive searches. In early 2012, analysts expected Heidrick's annual earnings to be in the range of about $1.30 per share. It appears that it will earn closer to 57 cents a share.

Huron's earnings estimates during 2012 were also trimmed, to about $2.10 from about $2.40 a share as the timing of fee payments to its health care consulting business proved volatile.

"Its underlying demand is strong," but an increasing number of clients had signed contracts where a larger portion of revenue was contingent on the outcome of Huron's consulting work, said Randle Reece, analyst with Avondale Partners LLC. That made it harder for the company and the analysts who cover it to predict the timing of revenues, since they are deferred.

For investors interested in "Dumpster diving," Morningstar Inc. considers Exelon, WMS Industries and Caterpillar to be high quality yet undervalued this year, said Heather Brilliant, chief equities strategist.

Navigant is among the region's beaten-down stocks liked by stock research firm EVA Dimensions LLC. "Its fundamentals are improving, and it's really cheap," said EVA analyst Andrew Zamfotis.

Best of the best

Here are the top three stock gainers of 2012:

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Snow expected to fall through morning rush hour

Snow started falling about 4:45 a.m. near O'Hare International Airport, jeopardizing a 335-day streak of calendar days without snow, according to the National Weather Service.

Falling snow had failed to reach the ground overnight, blocked by a shield of dry air that ensures the flakes evaporate before hitting the ground.

“It’s been snowing very hard above the ground all night and there’s been really dry air so it evaporates before it hits the ground,” National Weather Service Meteorologist Gino Izzi said.

About a half hour into the storm, Illinois State Police in Chicago reported "slick conditions" and had already responded to six fender benders.

The snow should fall through the morning rush hour, though not much more than an inch – if that – is expected.

“We’re not looking for much to accumulate – up to an inch at worst, with high (temperatures) in the mid to upper 20s,” Izzi said. “Something like this wouldn’t be newsworthy if it wasn’t for the fact it hasn’t snowed all year.”

The Chicago Department of Streets and Sanitation deployed almost 200 of its 284 plow trucks to clear streets of snow and apply salt to the roads.

"We’re going to be monitoring the weather but at this point we’re looking at snow fall at least through the rush hour," said Anne Sheahan, spokeswoman for the Chicago Department of Streets and Sanitation.

An inch of snow today would end the 335-day streak but failing that, it would likely extend into next week, Izzi said.

"We don’t have much of a chance of snow for the next five or six days," Izzi said. "If we miss today – today’s our one shot until we get to the middle or end of next week."

Check back for more information.

pnickeas@tribune.com
Twitter: @peternickeas

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Somalia militants’ Twitter account down after hostage threat

NAIROBI (Reuters) – A Twitter account run by Somali militant group al Shabaab was unavailable on Friday, days after the al Qaeda-aligned rebels used the social media site to boast about killing a French agent and threatened to kill several Kenyan hostages.

Al Shabaab often used its Twitter account to claim responsibility for attacks on African Union and Somali government troops, as well as senior officials in the Horn of Africa nation and other bombings in the region.

But the militant group’s official Twitter account, which had thousands of followers, was offline on Friday with a message saying “Sorry, that user is suspended”.

It was not immediately clear why the account, which was created in 2011 under the HSM PRESS Twitter handle, was suspended. The account was still unavailable as of 0930 GMT.

Twitter said it does not comment on individual accounts and the Kenyan government denied it had filed any request for the account to be taken down.

“It’s an emphatic no. We would not try to negotiate or have anything to do with the Al Shabaab. We didn’t even know the account was suspended,” said government spokesman Muthui Kariuki.

Al Shabaab posted on the account on Wednesday a link to a video of two Kenyan civil servants held hostage in Somalia, telling the Kenyan government their lives were in danger unless it released all Muslims held on “so-called terrorism charges” in the country.

“Kenyan government has three weeks, starting midnight 24/01/2013 to respond to the demands of HSM if the prisoners are to remain alive,” the group said.

Last week the rebel group said on its Twitter account that it had executed French agent Dennis Allex, who was held hostage since 2009, after a French commando mission to rescue him failed.

Al Shabaab wants to impose their strict version of sharia, or Islamic law, across Somalia. However, it has lost significant territory in the southern and central parts of the country in the face of an offensive by African Union troops.

(Reporting by Drazen Jorgic and George Obulutsa; Editing by Jon Boyle)

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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.”

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NTSB: Dreamliner grounding indefinite

Boeing 787 Dreamliners will remain flightless birds for some time, it appears.

Federal investigators said Thursday they are still early in their probe of a Dreamliner battery fire in Boston Jan. 7. That fire, along with a subsequent 787 battery problem in Japan, led to groundings of Boeing's breakthrough plane model in the U.S. and elsewhere.

The revelation at a news conference Thursday afternoon that investigators still have not found a cause may suggest grounded Dreamliners, including six owned by Chicago-based United Airlines, won't be airborne anytime soon.

"We are early in our investigation. We have a lot of activity to undertake," said National Transportation Safety Board Chairman Deborah A.P. Hersman, pointing to one upcoming forensic test that alone takes a week. "There is a lot more work to be done before we can identify what caused this event."

The NTSB is the lead investigator of the battery fire in Boston aboard a Japan Airlines 787 aircraft.

Despite many aviation experts calling the 787's numerous mechanical glitches "teething pains" that all new airplane models go through, Hersman emphasized the gravity of fires on planes.

"This is an unprecedented event. We are very concerned. ... We do not expect to see fire events on board aircraft," she said. "This is a very serious air safety concern."

Nobody was hurt in the fire on the 787 in Boston or in an emergency landing in Japan after battery-related smoke and fumes on a different 787 were discovered.

The NTSB investigation will try to explain why multiple backup protections in the battery and the electronics systems aimed at preventing a fire failed, Hersman said.

"These events should not happen," she said. "As far as the design of the aircraft, there are multiple systems to protect against a battery event like this. Those systems did not work as intended. We need to understand why."

Besides fire, NTSB investigators found evidence of short circuits in the charred eight-cell, 63-pound battery and "thermal runaway," essentially uncontrolled spreading of heat. But those were symptoms, not necessarily causes, Hersman said. The batteries were made in Japan by Kyoto-based GS Yuasa Corp.

News that the NTSB investigation may be protracted -- longer than the few days some had predicted -- is bad news for Chicago-based Boeing.

Boeing last week halted deliveries of new 787s, until the FAA lifts the flight ban. However, Dreamliner production continues. Boeing is working to double monthly output in 2013 to help shrink a backlog of about 800 orders that swelled during multiple delays to the jet's debut, which came in late 2011.

Deliveries are important because that's when planemakers get large bulk payments on the purchase price of a jet. The 787's list price starts at about $207 million, but airlines typically buy at discount.

In a statement Thursday, Boeing said it is assisting in multiple investigations in the U.S. and Japan.

"The company has formed teams consisting of hundreds of engineering and technical experts who are working around the clock with the sole focus of resolving the issue and returning the 787 fleet to flight status," Boeing said.

Earlier Thursday, Boeing received a vote of confidence from United Airlines, the only U.S. airline  to own the new jet, during an earnings call with United Continental Holdings CEO Jeff Smisek. "History teaches us that all new aircraft types have issues, and the 787 is no different," Smisek said. "We continue to have confidence in the aircraft and in Boeing's ability to fix the issues, just as they have done on every other new aircraft model they've produced."

United had been using a Dreamliners on a route between Chicago and Houston. After the grounding, the route has been flown with a different aircraft.

Dreamliners in the U.S., Japan, Europe and elsewhere have been grounded since Jan. 16, after a 787 operated by All Nippon Airways made an emergency landing in Japan because battery-related smoke and fumes. That followed the fire in Boston that the NTSB is investigating.

The Dreamliner grounding was the first since the McDonnell Douglas DC-10 had its airworthiness certificate suspended following a deadly crash in Chicago in 1979.

Boeing has sold about 850 of its new aircraft, with 50 delivered to date. The plane is half made of a composite material, leading some to call it a "plastic plane." It makes greater use of electronics, powered by batteries, rather than heavy hydraulics. That makes the plane lighter and helps improve fuel efficiency, which is a big deal for airlines.

Boeing has said in statements that it is confident the 787 is safe, and it stands by the plane's integrity. It is cooperating with investigations in the U.S. and abroad.

Because of the groundings, LOT Polish Airlines scrapped its inaugural flight from O'Hare International Airport to Warsaw Jan. 16, just hours after the FAA grounded the plane. LOT officials said they would seek compensation from Boeing for having its two Dreamliners grounded. It will take delivery of the three more due in March only if the problems are resolved, the airline said.

After Thursday, it's clear nobody knows just when that might be.

"There is a tremendous amount of work going on all around the world," Hersman said. "We actually have two shifts of employees both here and in Japan who really are working around the clock to try to solve this."

gkarp@tribune.com

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