Europe: Germany: Funds for Global Health Fund Reinstated

Signaling that it was pleased with changes in the Global Fund to Fight AIDS, Tuberculosis and Malaria, Germany announced Thursday that it would reinstate the annual pledge of 200 million euros (about $267 million) it had made since the fund’s early days. In 2011, Germany temporarily held back half its contribution and threatened to hold back future funds in protest against inefficiencies, thefts by some grantee countries and infighting among the fund’s top executives. Other contributions dried up, forcing the fund to cancel a planned round of grants. Since then, both the fund’s executive director and inspector general have departed, and it was run for one year by a Brazilian banker; he devised an overhaul of the grant-making process that is to take effect next month. In November, Dr. Mark Dybul, the Bush administration’s global AIDS czar, became the new executive director. The fund recently announced that it cut its operating expenses by 5 percent in 2012 while still making 26 percent more in grants than it did in 2011. Of the grants that had been audited, Dr. Dybul said, only 0.5 percent had been lost to fraud. The fund plans a new fund-raising round for later this year. The United States is the fund’s largest supporter, providing roughly a third of its budget.

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Pictures from the Week in Business

The port of Tokyo. Following the lead of their counterparts in the United States, Japan’s central bankers announced on Tuesday what they called a groundbreaking effort to reinvigorate the country’s long-moribund economy and defeat deflation. With no room left to cut interest rates and previous steps unsuccessful, the Bank of Japan is taking a page from the Federal Reserve’s playbook and will pump trillions more yen into the economy by directly buying government bonds and other assets.

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787 Dreamliner's safety systems failed, NTSB says

After investigating a fire that broke out on Boeing Co.'s 787 Dreamliner passenger jet, the National Transportation Safety Board said that backup protections in the aircraft's lithium-ion batteries and electronics systems failed.

But the safety agency hasn't reached a conclusion on the cause of the fire that occurred in Boston on Jan. 7 and partly led to last week's grounding of Dreamliners worldwide that remains in effect.

Speaking to reporters Thursday from Washington, NTSB Chairwoman Deborah Hersman said the agency hadn't determined what happened, but she added that the redundant safety systems installed by Boeing did not work.

The Federal Aviation Administration grounded the jet Jan. 16 after an emergency landing by All Nippon Airways in Japan because of a second fire believed to involve the plane's onboard lithium-ion batteries. Shortly after the FAA's decision, countries around the world prohibited the new plane from flying.

"These events should not happen," said the safety board's chairwoman. "As far as design of the aircraft, there are multiple systems to protect against a battery event like this. Those systems did not work as intended."

The decision on whether 787s should continue to be grounded in the U.S. belongs to the FAA. The independent safety board is responsible for collecting forensic evidence and conducting tests to determine what happened.

There is no timeline to when tests will be completed, but Hersman said the agency has "all hands on deck" looking into the problem. Investigators around the world are disassembling and scanning the batteries.

In its search for the exact cause of the fires, the NTSB has said it is looking for possible contaminants or manufacturing defects. The agency is also working with officials from Boeing, the FAA and the Navy, as well as investigators in France and Japan.

Japan, where the second fire occurred, is also where Boeing's lithium-ion batteries are made by Kyoto-based GS Yuasa Corp. The Japan Transport Safety Board, the country's version of the FAA, is heading up the investigation into All Nippon's emergency landing and reported fire.

So far, the NTSB's investigators in the Boston fire have found that overheating was caused by short circuits and "thermal runaway," a chain reaction in which heat spreads rapidly from cell to cell, Hersman said. "The significance of these events cannot be understated."

Boeing said in a statement that it is working with its airline customers and the regulatory agencies to get the matter resolved but that it is not permitted to comment directly on the ongoing investigations.

"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. "The safety of passengers and crew members who fly aboard Boeing airplanes is our highest priority."

The 787's battery systems were called into question on Jan. 7 when a smoldering fire was discovered on the underbelly of the plane operated by Japan Airlines after the 183 passengers and 11 crew members had deplaned at the gate.

In the second incident, which involved All Nippon Airways, smoke was seen swirling from the right side of the cockpit after an emergency landing related to the plane's electrical systems. All 137 passengers and crew members were evacuated from the aircraft and slid down the 787's emergency slides. Video of the event was captured by an onboard passenger and has been broadcast worldwide.

No one has been reported hurt or injured. But the recent events have become a public relations nightmare for the Chicago company, which has long heralded the Dreamliner as a representation of 21st century air travel.

Boeing has taken 848 orders for 787s from airlines and aircraft leasing firms around the world. Depending on the version ordered, the price ranges from $206.8 million to $243.6 million per jet.

The company has delivered 50 787s to eight airlines worldwide. Six are owned by Chicago-based United Airlines — the only U.S. carrier that currently has 787s in its fleet.

In an earnings conference call on Thursday, United Continental Holdings Inc. Chief Executive Jeff Smisek defended the plane.

"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."

In trading Thursday, Boeing's stock closed up $1.03, or 1.4%, at $75.32. But the stock fell in after-hours trading, at one point dropping 30 cents, or 0.4%, to $75.02.

Problems are expected with any new plane — especially one as complicated and sophisticated as the 787. But the last time the FAA grounded a large commercial jet out of safety concerns was almost 34 years ago after a DC-10 crashed at Chicago O'Hare International Airport, killing all 271 aboard.

The 787, a twin-aisle aircraft that can seat 210 to 290 passengers, is the first large commercial jet with more than half its structure made of composite materials (carbon fibers meshed together with epoxy) rather than aluminum sheets. It's also the first large commercial aircraft that extensively uses electrically powered systems involving lithium-ion batteries.

william.hennigan@latimes.com

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Vine's Launch-Day Woes Include Bugs and Facebook Block

Twitter’s new social video app isn’t having a smooth launch day.

Despite being well-received, Vine has faced a mess of issues since it launched Thursday morning. First, server-side bugs led to users signing into other people’s accounts. Then the app had to disable video-sharing to social networks. And all day long, there’s been the general bugginess of trying to sign in via Twitter and find friends through Twitter or Facebook.

And as of Thursday evening, it appears that Facebook has blocked Vine’s access to its network.

When you try to find Facebook-connected friends on the app, an error message pops up: “Vine is not authorized to make this Facebook request.” This is only hours after the app had no problem connecting to, and pulling friend data from, your Facebook network.

Neither Facebook nor Vine or Twitter responded for comment at the time of publication.

Facebook cutting off Vine is another way for the social giant to exert its powers. Considering Facebook just released data about how third-party, Facebook-connected mobile apps have much more engaged users, it’s clear that Facebook doesn’t want to give Vine the same benefits.

But it’s a development that further illustrates the battles taking place between social giants — it comes on the heels of other competitive shenanigans, including Instagram dropping Twitter card integration, and Twitter subsequently cutting Instagram off from finding friends within its app.

All this strategic posturing is much more than just a headache for Vine. The app continues to enjoy a tremendous amount of launch-day buzz, and as new users are flocking in and signing up, they’re the ones being greeted with super-annoying roadblocks. It proves once again that when the social networks decide to stop playing nice, ultimately, the loser is you.

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The New Old Age Blog: Grief Over New Depression Diagnosis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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This post has been revised to reflect the following correction:

Correction: January 24, 2013

An earlier version of this post misspelled the surname of a professor emeritus at Duke who chaired the D.S.M. IV task force. He is Allen Frances, not Francis.

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Starbucks Earnings Increased 13% in Latest Quarter

The company’s results were helped by a 6 percent increase in global sales at cafes open at least a year.

The performance reflects the turnaround Starbucks has made since its struggles during the recession. After bringing back its founder, Howard Schultz, as chief executive in 2008, the company embarked on a reorganization that included closing underperforming stores in the United States.

Mr. Schultz has said that the company has the ability to keep growing even through a turbulent economy because most people see Starbucks as an “affordable luxury.”

Starbucks said it earned $432.2 million, or 57 cents a share, in the quarter, up from $382.1 million, or 50 cents a share, a year earlier. Revenue in the period ending Dec. 30, the first quarter of Starbucks’s fiscal year, rose 11 percent, to $3.8 billion. Analysts had expected a profit of 57 cents a share and revenue of $3.85 billion, according to FactSet.

Shares rose 11 cents on Thursday, to $54.57 a share.

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House GOP seeks steep cuts while raising debt ceiling

— Stepping up their austerity campaign, House Republicans plan to demand far deeper spending cuts from President Obama to balance the federal budget in just 10 years, an extraordinary goal that would hit Medicare and other safety-net programs.

House Speaker John A. Boehner (R-Ohio), confronted with a more conservative Republican majority, agreed to the dramatic initiative to coax reluctant rank-and-file lawmakers Wednesday to approve a temporary suspension of the $16.4-trillion debt limit without any cuts in spending.

The new proposal to balance the budget in a decade would zero out the federal deficit almost twice as fast as previous Republican efforts.

"It's time for us to get serious about how over the next 10 years we balance this budget and put America on a sustainable fiscal path," the speaker said after the debt ceiling measure passed the House, 285 to 144. It now goes to the Senate, which is also expected to approve it.

The House vote puts the White House and Congress on another collision course in the budget battles that are expected to consume the first months of Obama's second term.

Republicans, who agreed to tax increases on the wealthy in the year-end budget deal, have insisted that the next round of deficit reduction must come from the spending side of the ledger.

But because Republicans want to protect the Pentagon, their approach would require steep reductions in domestic programs — particularly education, infrastructure investment and the safety net for low- and moderate-income Americans.

House Republicans will write their new budget in the coming weeks, but similar blueprints for eliminating the deficit in 10 years have pointed to austere measures: turning Medicare into a voucher-like program and raising the age at which seniors become eligible, cutting food stamps and school lunch subsidies, and holding other domestic accounts flat.

Republicans believe the public will be on their side, even though they lost the presidential election with the architect of the last House budget on the ticket. Rep. Paul D. Ryan of Wisconsin, the wonkish Budget Committee chairman, again will take the lead in crafting the new budget.

Ryan said he did not see the electoral loss as a rejection of the party's principles. "I think we need to do a better job of applying our principles to the problems of today, to show solutions to the country's biggest problems and how they relate in people's everyday lives," he told reporters Wednesday at a breakfast hosted by the Wall Street Journal.

The nation has been running record yearly deficits, topping $1 trillion, almost since Obama took office. That largely stems from plummeting tax revenue during the recession and increased spending on the recovery effort and on healthcare costs for an aging population.

The debt load doubled during President George W. Bush's two terms with the wars overseas, and continues to rise toward levels that many economists say would destabilize interest rates and the economy. Closing the budget gap would require a $5-trillion adjustment over the decade.

Some economists, such as Paul N. Van de Water, a senior fellow at the Center on Budget and Policy Priorities, say the political effort that would require could be better focused elsewhere.

"Trying to balance the budget is a needlessly ambitious goal," he said. "Certainly a reasonable interim goal would be to cut deficits enough to make sure the debt doesn't keep rising as a share of the economy."

The Senate, which is controlled by Democrats, plans to contrast the Ryan approach with its own budget, which is expected to raise revenue by closing tax breaks for the wealthy and loopholes that benefit specific industries, including oil and gas.

"The American people went to the polls and strongly endorsed the Democrats' balanced approach that puts jobs and the middle class first, calls on the wealthy to pay their fair share," said Sen. Patty Murray (D-Wash.), the incoming chairman of the Senate Budget Committee.

Even before April 15, when the House and Senate face a deadline to pass budgets, a series of built-in deadlines will force both sides to negotiate. On March 1, the federal budget faces $1.2 trillion in automatic spending cuts that both sides want to alter. Then on March 27, Congress will need to approve money for routine government operations, or risk a shutdown.

After the short-term debt ceiling measure expires on May 18, the ceiling would need to be raised again, although the Treasury could take measures to extend borrowing into July.

Conservatives continue to object to raising the debt ceiling, as was evident Wednesday when 33 opposed the measure. That forced Boehner to find Democratic votes for passage.

Boehner had sweetened the legislation to attract support by attaching a provision that would temporarily withhold the pay of senators or representatives if their chamber failed to produce an annual budget by the deadline. The tactic drew Democratic and Republican votes.

But some Democrats complained Wednesday that Republicans were simply setting up another "fiscal cliff." Rep. Sander M. Levin (D-Mich.) said, "House Republicans continue to play with economic fire."

lisa.mascaro@latimes.com

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CEO Tim Cook Hints at Apple's Future Growth in Q1 Earnings Call

Investors may have cringed at Apple’s revenue numbers in its Q1 2013 earnings call, but CEO Tim Cook took pains to point out that there is still a lot of room for growth when it comes to Apple product sales and profits.

There are a number of different ways Apple could continue to expand iPhone and iPad growth: introducing lower-priced options for emerging markets, bringing major changes to its product lines, or focusing on expanding to new geographic regions. For now, Apple seems to be focusing on the latter.

Although Apple has deeply embedded itself among U.S. mobile consumers, its presence abroad has been more slow going. And as with the past few quarters, that appears to be changing, particularly in China. “In terms of geographic distribution, we saw highest growth in China, and it was into the triple digits,” Cook said. Given that China is the world’s largest smartphone market, that’s the place you want it to happen and one of the few markets in the world that can keep the Apple growth machine humming.

Apple has had a difficult time in some emerging markets because of the iPhone’s high up-front cost. Other smartphone manufacturers like Samsung and Nokia have been aiming lower-end devices at these segments, but Apple’s only option is to flog its spendy iPhones. In China at least, buyers don’t seem to be put off by, something to which Cook was keen to draw attention. “It’s interesting to see how China is growing in importance for Apple so much so that they broke out their revenue [in its earnings release],” Gartner analyst Carolina Milanesi told Wired.

Uncharacteristically, Cook also drew attention to recent rumors circulating that iPhone demand could be waning due to reduced orders for iPhone 5 parts, gossip that fueled drops in Apple’s stock prices last week. Apple typically does not comment on rumors or reports.

“There have been lots of rumors about order cuts and so forth. Let me take a moment to make a comment on this,” Cook said in response to a question asking about the iPhone’s reported “deterioration in demand.” “I would suggest it’s good to question the accuracy of any kind of rumor about build plans… Even if a particular data point were factual, it would be impossible to accurately interpret what the data point meant for our overall business because the supply chain is very complex.”

And what about all those pesky other handsets available in a rainbow of screen sizes? Are those affecting iPhone sales, or will Apple ever expand to other screen sizes? Cook took a decidedly Steve Jobs (and Apple) approach, saying, “We put a lot of thinking into screen size and believe we picked the right one.” For years 3.5-inches was the right size, but in 2012 and 2013, the 4-inch display of the iPhone 5 is now Apple’s perfect phone size. It’s large enough to provide the user with a greater amount of information on screen (and make watching videos more pleasant), but not so large that it affects your ability to operate it with one hand.

As far as the iPad is concerned, the Windows-dominated PC space continues to be the area Apple hopes its slate will infiltrate. Although Cook openly acknowledged the iPad mini is likely cannibalized some iPad sales, and the iPad some Mac sales, he said that the Mac market is far smaller than that of Windows, and it’s out of Microsoft and its partners where the iPad will continue to take a chunk in the coming years.

“It is clear [the iPad] is already cannibalizing [Windows] some,” Cook said. “There’s a tremendous amount (of) opportunity there. I’ve said for two or three years now that the tablet market will be larger than the PC market at some point. You can see by the growth in tablets and pressure on PCs that those lines are beginning to converge.”

Now, if Cook can just get the line on his stock chart to move in the right direction.

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Obama inauguration TV viewership down by 17.2 million from 2009

LOS ANGELES (Reuters) – Some 20.6 million Americans watched President Barack Obama’s inauguration ceremony and related events on television, according to ratings data on Wednesday. That’s down sharply from his first inauguration in 2009.

TV ratings company Nielsen said 18 U.S. television networks and cable channels carried live coverage over about six hours of Monday’s swearing-in ceremony, speech and parade in Washington.

Monday’s TV audience was a drop of 17.2 million from 2009, when 37.8 million Americans – the highest number since Ronald Reagan’s 1981 inauguration – watched Obama formally take office as the first black president in U.S. history.

The Nielsen figures did not measure viewers who watched Monday’s daylong ceremonies online via live streaming on many TV channels, nor overseas audiences.

Second-term inaugurations of U.S. presidents have traditionally drawn smaller numbers of viewers than those for first terms.

Reagan’s 1981 inauguration drew the biggest television audience of the past 44 years, attracting some 41.8 million U.S. viewers, according to Nielsen.

(Reporting By Jill Serjeant; Editing by Bill Trott)

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Well: Long Term Effects on Life Expectancy From Smoking

It is often said that smoking takes years off your life, and now a new study shows just how many: Longtime smokers can expect to lose about 10 years of life expectancy.

But amid those grim findings was some good news for former smokers. Those who quit before they turn 35 can gain most if not all of that decade back, and even those who wait until middle age to kick the habit can add about five years back to their life expectancies.

“There’s the old saw that everyone knows smoking is bad for you,” said Dr. Tim McAfee of the Centers for Disease Control and Prevention. “But this paints a much more dramatic picture of the horror of smoking. These are real people that are getting 10 years of life expectancy hacked off — and that’s just on average.”

The findings were part of research, published on Wednesday in The New England Journal of Medicine, that looked at government data on more than 200,000 Americans who were followed starting in 1997. Similar studies that were done in the 1980s and the decades prior had allowed scientists to predict the impact of smoking on mortality. But since then many population trends have changed, and it was unclear whether smokers today fared differently from smokers decades ago.

Since the 1960s, the prevalence of smoking over all has declined, falling from about 40 percent to 20 percent. Today more than half of people that ever smoked have quit, allowing researchers to compare the effects of stopping at various ages.

Modern cigarettes contain less tar and medical advances have cut the rates of death from vascular disease drastically. But have smokers benefited from these advances?

Women in the 1960s, ’70s and ’80s had lower rates of mortality from smoking than men. But it was largely unknown whether this was a biological difference or merely a matter of different habits: earlier generations of women smoked fewer cigarettes and tended to take up smoking at a later age than men.

Now that smoking habits among women today are similar to those of men, would mortality rates be the same as well?

“There was a big gap in our knowledge,” said Dr. McAfee, an author of the study and the director of the C.D.C.’s Office on Smoking and Public Health.

The new research showed that in fact women are no more protected from the consequences of smoking than men. The female smokers in the study represented the first generation of American women that generally began smoking early in life and continued the habit for decades, and the impact on life span was clear. The risk of death from smoking for these women was 50 percent higher than the risk reported for women in similar studies carried out in the 1980s.

“This sort of puts the nail in the coffin around the idea that women might somehow be different or that they suffer fewer effects of smoking,” Dr. McAfee said.

It also showed that differences between smokers and the population in general are becoming more and more stark. Over the last 20 years, advances in medicine and public health have improved life expectancy for the general public, but smokers have not benefited in the same way.

“If anything, this is accentuating the difference between being a smoker and a nonsmoker,” Dr. McAfee said.

The researchers had information about the participants’ smoking histories and other details about their health and backgrounds, including diet, alcohol consumption, education levels and weight and body fat. Using records from the National Death Index, they calculated their mortality rates over time.

People who had smoked fewer than 100 cigarettes in their lifetimes were not classified as smokers. Those who had smoked at least 100 cigarettes but had not had one within five years of the time the data was collected were classified as former smokers.

Not surprisingly, the study showed that the earlier a person quit smoking, the greater the impact. People who quit between 25 and 34 years of age gained about 10 years of life compared to those who continued to smoke. But there were benefits at many ages. People who quit between 35 and 44 gained about nine years, and those who stopped between 45 and 59 gained about four to six years of life expectancy.

From a public health perspective, those numbers are striking, particularly when juxtaposed with preventive measures like blood pressure screenings, colorectal screenings and mammography, the effects of which on life expectancy are more often viewed in terms of days or months, Dr. McAfee said.

“These things are very important, but the size of the benefit pales in comparison to what you can get from stopping smoking,” he said. “The notion that you could add 10 years to your life by something as straightforward as quitting smoking is just mind boggling.”

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