Another Look at a Drink Ingredient, Brominated Vegetable Oil

James Edward Bates for The New York Times

Sarah Kavanagh, 15, of Hattiesburg, Miss., started an online petition asking PepsiCo to change Gatorade’s formula.

Sarah Kavanagh and her little brother were looking forward to the bottles of Gatorade they had put in the refrigerator after playing outdoors one hot, humid afternoon last month in Hattiesburg, Miss.

But before she took a sip, Sarah, a dedicated vegetarian, did what she often does and checked the label to make sure no animal products were in the drink. One ingredient, brominated vegetable oil, caught her eye.

“I knew it probably wasn’t from an animal because it had vegetable in the name, but I still wanted to know what it was, so I Googled it,” Ms. Kavanagh said. “A page popped up with a long list of possible side effects, including neurological disorders and altered thyroid hormones. I didn’t expect that.”

She threw the product away and started a petition on Change.org, a nonprofit Web site, that has almost 200,000 signatures. Ms. Kavanagh, 15, hopes her campaign will persuade PepsiCo, Gatorade’s maker, to consider changing the drink’s formulation.

Jeff Dahncke, a spokesman for PepsiCo, noted that brominated vegetable oil had been deemed safe for consumption by federal regulators. “As standard practice, we constantly evaluate our formulas and ingredients to ensure they comply with federal regulations and meet the high quality standards our consumers and athletes expect — from functionality to great taste,” he said in an e-mail.

In fact, about 10 percent of drinks sold in the United States contain brominated vegetable oil, including Mountain Dew, also made by PepsiCo; Powerade, Fanta Orange and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

The ingredient is added often to citrus drinks to help keep the fruit flavoring evenly distributed; without it, the flavoring would separate.

Use of the substance in the United States has been debated for more than three decades, so Ms. Kavanagh’s campaign most likely is quixotic. But the European Union has long banned the substance from foods, requiring use of other ingredients. Japan recently moved to do the same.

“B.V.O. is banned other places in the world, so these companies already have a replacement for it,” Ms. Kavanagh said. “I don’t see why they don’t just make the switch.” To that, companies say the switch would be too costly.

The renewed debate, which has brought attention to the arcane world of additive regulation, comes as consumers show increasing interest in food ingredients and have new tools to learn about them. Walmart’s app, for instance, allows access to lists of ingredients in foods in its stores.

Brominated vegetable oil contains bromine, the element found in brominated flame retardants, used in things like upholstered furniture and children’s products. Research has found brominate flame retardants building up in the body and breast milk, and animal and some human studies have linked them to neurological impairment, reduced fertility, changes in thyroid hormones and puberty at an earlier age.

Limited studies of the effects of brominated vegetable oil in animals and in humans found buildups of bromine in fatty tissues. Rats that ingested large quantities of the substance in their diets developed heart lesions.

Its use in foods dates to the 1930s, well before Congress amended the Food, Drug and Cosmetic Act to add regulation of new food additives to the responsibilities of the Food and Drug Administration. But Congress exempted two groups of additives, those already sanctioned by the F.D.A. or the Department of Agriculture, or those experts deemed “generally recognized as safe.”

The second exemption created what Tom Neltner, director of the Pew Charitable Trusts’ food additives project, a three-year investigation into how food additives are regulated, calls “the loophole that swallowed the law.” A company can create a new additive, publish safety data about it on its Web site and pay a law firm or consulting firm to vet it to establish it as “generally recognized as safe” — without ever notifying the F.D.A., Mr. Neltner said.

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Jobless claims post fourth straight big decline

WASHINGTON -- Initial claims for unemployment benefits posted their fourth straight big decline last week to their lowest level since early October as the impact of Superstorm Sandy on the jobs market continued to dissipate.

There were 343,000 new jobless claims in the week that ended Saturday, down 29,000 from the previous week's revised level, the Labor Department reported Thursday. The drop was larger than economists had forecast.

The less-volatile four-week average also dropped, to 381,500 from the previous week's reading of 408,500.

Initial unemployment claims are now back to about the same level they were before Sandy hit the Northeast on Oct. 29-30. Economists say that claims below about 350,000 a week are consistent with strong jobs growth.

The economy added 146,000 new jobs in November as the economy weathered Sandy's impact better than expected. The unemployment rate dropped to 7.7%, but its continued high level triggered new efforts announced Wednesday by the Federal Reserve to bring it down.

Sandy didn't help the jobs market. After the storm struck, jobless claims shot up to 451,000 in mid-November, the highest level in more than a year and a half.

Claims jumped by 43,956 in New York, 31,094 in New Jersey, 7,037 in Pennsylvania and 1,808 in Connecticut as the storm caused layoffs in construction, transportation and several other sectors.

Those impacts have been lessening over the past month.

For the week that ended Nov. 24, the latest state-level figures available, Pennsylvania had an increase of 14,636 jobless claims and New York had 11,025, though it's unclear how many of those were storm-related.

California had the biggest increase that week, 24,411. But the Labor Department said that was because of a backlog from the previous week, when state offices were closed because of Thanksgiving.

ALSO:

Fed to tie interest rate to job gains

New jobless claims surged last week after Superstorm Sandy

Unemployment rate falls to 7.7% as job growth weathers Hurricane Sandy

Follow Jim Puzzanghera on Twitter and Google+.

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Ravi Shankar, sitar master, dies at 92

Ravi Shankar was already revered as a master of the sitar in 1966 when he met George Harrison, the Beatle who became his most famous disciple and gave the Indian musician-composer unexpected pop-culture cachet.

Suddenly the classically trained Shankar was a darling of the hippie movement, gaining widespread attention through memorable performances at the Monterey Pop Festival, Woodstock and the 1971 Concert for Bangladesh.

Harrison called him "the godfather of world music," and the great violinist Yehudi Menuhin once compared the sitarist's genius to Mozart's. Shankar continued to give virtuoso performances into his 90s, including one in 2011 at Walt Disney Concert Hall.

PHOTOS: Ravi Shankar | 1920 - 2010

Shankar, 92, who introduced Indian music to much of the Western world, died Tuesday at a hospital near his home in Encinitas. Stuart Wolferman, a publicist for his record label Unfinished Side Productions, said Shankar had undergone heart valve replacement surgery last week.

Well-established in the classical music of his native India since the 1940s, he remained a vital figure on the global music stage for six decades. Shankar is the father of pop music star Norah Jones and Anoushka Shankar, his protege and a sitar star in her own right.

Before the 1950s, Indian classical music — with its improvised melodic excursions and complex percussion rhythms — was virtually unknown in America. If Shankar had done nothing more than compose the movie scores for Indian filmmaker Satyajit Ray's "Apu" trilogy in the 1950s, he "would be remembered and revered," Times music critic Mark Swed wrote last fall.

PHOTOS: Notable deaths of 2012

Shankar was on a path to international stardom during the 1950s, playing the sitar in the Soviet Union and debuting as a soloist in Western Europe and the United States. Two early albums also had considerable impact, "Three Classical Ragas" and "India's Master Musician."

During his musical emergence in the West, his first important association was with violinist Menuhin, whose passion for Indian music was ignited by Shankar in 1952. Their creative partnership peaked with their "West Meets East" release, which earned a Grammy Award in 1967. The recording also showed Shankar's versatility — and the capacity of Indian music to inspire artists from different creative disciplines.

He presented a new form of classical music to Western audiences that was based on improvisation instead of written compositions. Shankar typically played in the Hindustani classical style, in which he was accompanied by a player of two tablas, or small hand drums. Concerts in India that often lasted through the night were generally shortened to a few hours for American venues as Shankar played the sitar, a long-necked lute-like stringed instrument.

At first, he especially appealed to fans of jazz music drawn to improvisation. He recorded "Improvisations" (1962) with saxophonist Bud Shank and "Portrait of a Genius" (1964) with flutist Paul Horn, gave lessons to saxophonist John Coltrane (who named his saxophone-playing son Ravi), and wrote a percussion piece for drummer Buddy Rich and Alla Rakha.

On the Beatles' 1965 recording "Norwegian Wood," Harrison had played the sitar and met Shankar the next year in London.

Shankar was "the first person to impress me," among the impressive people the Beatles met, "because he didn't try to impress me," Harrison later said. The pair became close and their friendship lasted until Harrison's death in 2001.

Harrison was instrumental in getting Shankar booked at the now legendary Monterey Pop Festival in 1967. They partnered in organizing the Concert for Bangladesh and were among the producers who won a Grammy in 1972 for the subsequent album. They toured together in 1974, and Harrison produced Shankar's career-spanning mid-1990s boxed set, "In Celebration."

But Shankar came away from his festival appearances with mixed feelings about his rock generation followers. He expressed hope that his performances might help young people better understand Indian music and philosophy but later said "they weren't ready for it."

"All the young people got interested … but it was so mixed up with superficiality and the fad and the drugs," Shankar told The Times in 1996. "I had to go through several years to make them understand that this is a disciplined music, needing a fresh mind."

When Shankar was criticized in India as a sellout for spreading his music in the West, he responded in the early 1970s by lowering his profile and reaffirming his classical roots. He followed his first concerto for sitar and orchestra in 1971 with another a decade later.

"Our music has gone through so much development," Shankar told The Times in 1997. "But its roots — which have something to do with its feelings, the depth from where you bring out the music when you perform — touch the listeners even without their knowing it."

In the 1980s and '90s, Shankar maintained a busy performing schedule despite heart problems. He recorded "Tana Mana," an unusual synthesis of Indian music, electronics and jazz; oversaw the American premiere of his ballet, "Ghyanshyam: The Broken Branch"; and collaborated with composer Philip Glass on the album "Passages."

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Top 2012 searches include Whitney, PSY, Sandy

LOS ANGELES (AP) — The world’s attention wavered between the tragic and the silly in 2012, and along the way, Web surfers searched in huge numbers to find out about a royal princess, the latest iPad, and a record-breaking skydiver.

Whitney Houston was the “top trending” search of the year, according to Google Inc.’s year-end “zeitgeist” report. Google‘s 12th annual roundup is “an in-depth look at the spirit of the times as seen through the billions of searches on Google over the past year,” the company said in a blog post Wednesday.

People around the globe searched en masse for news about Houston‘s accidental drowning in a bathtub just before she was to perform at a pre-Grammy Awards party in February.

Google defines topics as “trending” when they garner a high amount of traffic over a sustained period of time.

Korean rapper PSY’s “Gangnam Style” music video trotted into second spot, a testament to his self-deprecating giddy-up dance move. The video is approaching a billion views on YouTube.

Superstorm Sandy, the damaging storm that knocked out power and flooded parts of the East Coast in the midst of a U.S. presidential campaign, was third.

The next biggest trending searches globally were a pair of threes: the iPad 3 tablet from Apple Inc. and Diablo 3, a popular video game.

Rounding out the Top 10 were Kate Middleton, who made news with scandalous photos and a royal pregnancy; the 2012 Olympics in London; Amanda Todd, a Canadian teen who was found dead of an apparent suicide in October after being bullied online; Michael Clarke Duncan, the “Green Mile” actor who died of a heart attack in September at age 54; and “BBB12,” the 12th edition of “Big Brother Brasil,” a reality show featuring scantily clad men and women living together.

Some trending people, according to Google, were:

— Felix Baumgartner, an Austrian skydiver who became the first to break the sound barrier without a vehicle with a 24-mile plummet from Earth’s stratosphere;

— Jeremy Lin, the undrafted NBA star who exploded off the New York Knicks bench and sparked a wave of “Linsanity”;

— Morgan Freeman, the actor whose untimely death turned out not to be true.

The Internet also continued its rise as a popular tool for spreading addictive ideas and phrases known as “memes.” Remember LOL? If you don’t know what it means by now, someone may “Laugh Out Loud” at you.

This year, Facebook said its top memes included “TBH (To Be Honest),” ”YOLO (You Only Live Once),” ”SMH (Shake My Head).” Thanks to an endlessly fascinating U.S. presidential campaign, “Big Bird” made the list after Republican candidate Mitt Romney said he might consider cutting some funds for public broadcasting.

Yahoo said its own top-searched memes for the year included “Kony 2012,” a reference to the short film and campaign against Ugandan militia leader Joseph Kony; “stingray photobomb” for an unusual vacation snapshot that went viral; and “binders full of women,” another nod to Romney for his awkward description of his search for women cabinet members as Massachusetts’ governor.

And people were happy to pass on popular Twitter posts by retweeting them. According to Twitter, the year’s most popular retweets were President Barack Obama‘s “Four more years,” and Justin Bieber’s farewell to six-year-old fan Avalanna Routh, who died of a rare form of brain cancer: “RIP Avalanna. i love you”.

Gadgets News Headlines – Yahoo! News

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'Lincoln,' 'Les Mis,' 'Playbook' lead SAG awards

LOS ANGELES (AP) — The Civil War saga "Lincoln," musical "Les Miserables" and comic drama "Silver Linings Playbook" boosted their Academy Awards prospects Wednesday with four nominations apiece for the Screen Actors Guild Awards.

All three films were nominated for overall performance by their casts. Also nominated for best ensemble cast were the Iran hostage-crisis thriller "Argo" and the British retiree adventure "The Best Exotic Marigold Hotel."

Directed by Steven Spielberg, "Lincoln" also scored individual nominations for Daniel Day-Lewis in the title role as best actor, Sally Field for supporting actress as Mary Todd Lincoln and Tommy Lee Jones for supporting actor as abolitionist firebrand Thaddeus Stevens.

"Les Miserables," from "The King's Speech" director Tom Hooper, had nominations for Hugh Jackman for best actor as Victor Hugo's long-suffering hero Jean Valjean and Anne Hathaway for supporting actress as a woman fallen into prostitution, plus a nomination for its stunt ensemble.

"Silver Linings Playbook," made by "The Fighter" director David O. Russell, also had lead-acting nominations for Bradley Cooper and Jennifer Lawrence as lost souls who find a second chance at love and Robert De Niro for supporting actor as a football-obsessed dad.

Besides Lawrence, best-actress nominees are Jessica Chastain as a CIA analyst pursuing Osama bin Laden in "Zero Dark Thirty;" Marion Cotillard as a woman who finds romance after tragedy in "Rust and Bone;" Helen Mirren as Alfred Hitchcock's strong-willed wife in "Hitchcock;" and Naomi Watts as a woman caught in the devastation of a tsunami in "The Impossible."

Joining Cooper, Day-Lewis and Jackman in the best-actor field are John Hawkes as a polio victim aiming to lose his virginity in "The Sessions" and Denzel Washington as a boozy airline pilot in "Flight."

One of the year's most-acclaimed films, Paul Thomas Anderson's "The Master," earned only one nomination, supporting actor for Philip Seymour Hoffman as a mesmerizing cult leader. The film was snubbed on nominations for ensemble, lead actor Joaquin Phoenix and supporting actress Amy Adams.

Other individual performances overlooked by SAG voters include Anthony Hopkins in the title role of "Hitchcock," Keira Knightley in the title role of "Anna Karenina," Bill Murray as Franklin Roosevelt in "Hyde Park on Hudson" and "Argo" director Ben Affleck, who also starred in the film.

The SAG Awards will be presented Jan. 27. The guild nominations are one of Hollywood's first major announcements on the long road to the Feb. 24 Oscars Awards, whose nominations will be released Jan. 10.

Nominations for the Golden Globes, the second-biggest film honors after the Oscars, come out Thursday.

Maggie Smith had four individual and ensemble nominations. Along with sharing the ensemble honor for "Best Exotic Marigold Hotel," Smith joined the cast of "Downton Abbey" among TV ensemble contenders and had nominations for supporting film actress as a cranky retiree in "Marigold Hotel" and TV drama actress for "Downton Abbey."

Nicole Kidman earned two individual nominations, as supporting film actress as a woman smitten with a prison inmate in "The Paperboy" and best actress in a TV movie or miniseries as war correspondent Martha Gellhorn in "Hemingway & Gellhorn."

Bryan Cranston had three overall nominations, as best actor in a TV drama for "Breaking Bad," an ensemble honor for that show and a film ensemble honor for "Argo."

Along with "Breaking Bad" and "Downton Abbey," best TV drama ensemble contenders are "Boardwalk Empire," ''Homeland" and "Mad Men." TV comedy ensemble nominees are "30 Rock," ''The Big Bang Theory," ''Glee," ''Modern Family," ''Nurse Jackie" and "The Office."

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Online:

http://www.sagawards.org

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Stocks move higher on anticipation of Fed action

Stocks opened higher on Wall Street, extending a five-day winning streak, as investors awaited news on whether the Federal Reserve will announce more bond purchases to stimulate the U.S. economy.

The Dow Jones industrial average was up 38 points at 13,286 as of 9:46 a.m. in New York. The Standard and Poor's 500 was up four points at 1,432. The Nasdaq composite was up eight points at 3,030.

The U.S. central bank is expected to announce a revamped bond-buying plan at the end of a two-day policy meeting Wednesday to help hold down interest rates and encourage borrowing. The expectation is that the Fed will unveil a program Wednesday to buy $45 billion a month in long-term Treasurys. That would replace a program that expires at the end of the year.

Wall Street will also keep an eye on budget talks in Washington. Lawmakers are still trying to reach a deal to avoid the looming “fiscal cliff,” the sharp tax increases and spending cuts that will hit the economy in January if Congress and President Barack Obama are unable to thrash out an agreement.

House Speaker John Boehner and President Barack Obama spoke on the phone Tuesday, a day after the president offered to reduce his initial demand for $1.6 trillion in higher tax revenue over a decade to $1.4 trillion. Obama continues to insist that much of the revenue comes from raising top tax rates on the wealthy.

Both the Dow and the S&P have advanced for the past five days as optimism increased that a deal can be struck. The S&P is trading at its highest in five weeks and has now erased all of its post-election losses. Stocks fell immediately after the vote Nov. 6 on concern that a divided government would struggle to resolve the budget issue.

Chemicals giant DuPont advanced $1.10 to $44.78 after the company unveiled plans to buy back up to $1 billion of its shares next year and said that profit for this year will reach the high end of its forecasts.

The yield on the 10-year Treasury note rose 1 basis point to 1.66 percent.

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States pressed to guarantee Medicaid expansion

WASHINGTON — The Obama administration stepped up pressure on states Monday to guarantee insurance for all their low-income residents in 2014 under the new healthcare law, warning governors that the federal government would not pick up the total cost of partially expanding coverage.

"We continue to encourage all states to fully expand their Medicaid programs and take advantage of the generous federal matching funds to cover more of their residents," Health and Human Services Secretary Kathleen Sebelius wrote in a letter to governors.

But Sebelius indicated that governors who do not open their Medicaid programs to all eligible low-income residents would forfeit some of the federal aid promised by the Affordable Care Act.

"The law does not provide for a phased-in or partial expansion," the Department of Health and Human Services said in guidance accompanying Sebelius' letter.

Medicaid has become a major issue in the implementation of the law since the U.S. Supreme Court ruled in June that states can decide whether to expand their Medicaid programs in 2014.

The law originally required the states to open Medicaid to all Americans who earn less than 138% of the federal poverty level, a major change for a program that now largely covers poor children and mothers.

To ease the expansion, the law initially provides full federal funding to cover the new population. Currently, Medicaid costs are split between state and federal governments.

Nonetheless, several Republican governors have said they won't expand Medicaid, citing cost concerns. That prompted speculation that some states might partially expand Medicaid programs. But Obama administration officials said Monday the law did not authorize full federal funding for a more limited expansion.

A state that opens Medicaid to only some new low-income residents would qualify for reduced federal aid, requiring the state to come up with the remainder of the funding.

How the guidance will affect state decisions remains unclear.

Alan Weil, president of the National Academy for State Health Policy, said state leaders probably would not make final decisions until they worked out 2014 budgets next year. "A lot of what we have seen so far is posturing," he said.

But the administration's announcement drew quick criticism from the Republican Governors Assn.

"The Obama administration's refusal to grant states more flexibility on Medicaid is as disheartening as it is short-sighted," said Louisiana Gov. Bobby Jindal, the group's chairman. Jindal has said he will not expand Medicaid in his state.

In contrast, the administration's move was applauded by the National Assn. of Public Hospitals and Health Systems, whose members care for millions of the nation's uninsured, often without compensation. Dr. Bruce Siegel, the association president, said it "takes an important step toward significantly reducing the ranks of the uninsured."

The Obama administration is facing additional resistance from several Republican governors who have said they won't set up insurance exchanges — a cornerstone of the law that will allow Americans who don't get health benefits at work to shop for insurance plans that meet new minimum standards. The federal government can set up exchanges for states that refuse to do so.

Also Monday, Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington got conditional federal approval to operate their own exchanges. The six were the first to apply, and administration officials said approval for other states, including California, would probably follow.

noam.levey@latimes.com

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Luke Bryan cleans up at ACAs with 9 awards

Luke Bryan didn't want the American Country Awards to end.

He cleaned up during the fan-voted show, earning nine awards, including artist and album of the year. His smash hit "I Don't Want This Night To End" was named single and music video of the year.

Miranda Lambert took home the second most guitar trophies with three. Jason Aldean was named touring artist of the year. Carrie Underwood won female artist of the year, and a tearful Lauren Alaina won new artist of the year.

Bryan, Aldean, Keith Urban, Lady Antebellum and Trace Adkins with Lynyrd Skynrd were among the high-energy performances.

The third annual ACAs were held at Mandalay Bay in Las Vegas Monday night.

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Online: http://www.theACAs.com

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Follow http://www.twitter.com/AP_Country for the latest country music news from The Associated Press.

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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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Delta Buys 49% Virgin Atlantic Stake to Boost London Links

Delta Air Lines Inc. agreed to buy the 49 percent stake in Richard Branson’s Virgin Atlantic Airways Ltd. held by Singapore Airlines Ltd. for $360 million to boost its share of the lucrative trans-Atlantic travel market.

Delta and Virgin Atlantic, the biggest long-haul rival to British Airways at London’s Heathrow airport, will also begin a joint venture on 31 roundtrip daily flights between the U.K. and North America, the companies said today in a statement.

The deal positions Atlanta-based Delta to grab a bigger slice of the world’s biggest market for premium passengers. While Virgin founder Branson will retain control, it also marks the end of a go-it-alone strategy for a company the 62-year-old U.K. billionaire founded almost three decades ago.

“This is not a massive game-changer for Delta, but a nice slot-on,” said James Hollins, an analyst at Investec in London. “Where Virgin struggles to compete is the sheer scale of running a trans-ocean operation, the fuel headwinds and being able to offset that when you’re a small operator.”

Poor Performance

Singapore Air said it had been evaluating the position for some time and that an investment in Virgin spanning more than a decade “has not performed to expectations and the synergies the parties originally hoped for have not materialized.”

Delta and Virgin Atlantic said they will seek antitrust immunity from regulators, which would allow them to coordinate schedules and pricing and share costs and revenues from joint- venture flights regardless of whose plane operates the route.

Nine daily flights covered by the agreement will be from Heathrow to New York’s John F. Kennedy International Airport and New Jersey’s Newark Liberty International Airport, targeting the busiest airline route between Europe and the U.S.

Delta and Virgin Atlantic will also provide reciprocal frequent flier benefits, and allow elite passengers to use each other’s airport lounges. The statement made no mention of any plan for Virgin to join the U.S. carrier’s SkyTeam group, and alliance leader Air France-KLM Group plays no part in the deal.

“Our new partnership will strengthen both airlines and provide a more effective competitor between North America and the U.K.,” Delta Chief Executive Officer Richard Anderson said in the statement.

Delta advanced 1.6 percent to $10.30 at 8:35 a.m. before the start of regular New York trading. Singapore Airlines earlier closed 0.7 percent higher at S$10.75.

Brand Survives

The Virgin brand will be retained and Branson said in the statement that the deal “signals the start of a new era of expansion, financial growth and many opportunities.”

Branson began to review Virgin Atlantic’s alliance options as long ago as 2010 and said earlier this year the company was in advanced talks to join one of the three global groups.

Virgin had an 80.2 million-pound ($129 million) loss in the year ended Feb. 29 as high fuel prices crimped margins and an alliance of British Airways and AMR Corp.’s American Airlines intensified competition.

The rise of Middle Eastern carriers such as Qatar Airways Ltd. has also diverted long-haul traffic via Gulf hubs and established a new industry benchmark for in-flight service.

Singapore Air paid 600.3 million pounds for the Virgin stake in 1999, or $966 million now, and has written down about 96 percent of goodwill from the deal.

Profit Booked

The Asian carrier said in an e-mail that the deal with Delta will result in a profit being booked to its accounts, and that reciprocal arrangements with Virgin including code-shares, frequent-flyer ties and lounge access should remain in place.

The improved cash position may spur acquisitions in China or India after last month’s purchase of 10 percent of Virgin Australia Holdings Ltd. for A$105 million ($110 million).

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