Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."

"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.

"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.

Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

___

Associated Press reporter Tom Odula contributed to this report.

Read More..

Stock index futures steady; budget talks eyed

PARIS (Reuters) - Stock index futures pointed to a steady Wall Street open, with S&P 500 futures down 0.11 percent, Dow Jones futures down 0.03 percent and Nasdaq 100 futures up 0.05 percent at 4.54 a.m. ET.

European shares were flat to slightly lower in early trade on Friday as investors waited to see if a deal to avoid the U.S. "fiscal cliff" would be reached before further boosting their exposure to equities. <.eu/>

President Barack Obama and lawmakers are launching a last-chance round of budget talks days before a New Year's deadline to reach a deal or watch the economy go off a "fiscal cliff." Obama and Vice President Joe Biden will meet congressional leaders from both parties at the White House on Friday at 3 p.m. EST.

On the macro front, investors awaited pending home sales data for November. Economists in a Reuters survey expect a 1.0 percent rise compared with a 5.2 percent gain in the previous month.

Investors in U.S.-based funds favored stock exchange-traded funds (ETFs) and emerging market equity mutual funds as the year wound down, data from Thomson Reuters' Lipper service showed on Thursday.

Satellite television provider DirecTV Group said its service fees would rise by an average of 4.5 percent in February due to increasing programming costs.

A Chinese court fined Apple 1 million yuan ($160,400) for hosting third-party applications on its App Store that were selling pirated electronic books, the official Xinhua news agency reported on Friday.

U.S. stocks fell for a fourth day on Thursday, but recovered most of their losses after the House of Representatives, in the barest sign of progress, said it would come back to work on avoiding the "fiscal cliff" this weekend.

The Dow Jones industrial average <.dji> slipped 18.28 points, or 0.14 percent, to 13,096.31 at the close. The Standard & Poor's 500 Index <.spx> declined 1.73 points, or 0.12 percent, to end at 1,418.10. The Nasdaq Composite Index <.ixic> dropped 4.25 points, or 0.14 percent, to close at 2,985.91.

(Reporting by Blaise Robinson; Editing by Helen Massy-Beresford)

Read More..

Peace envoy Brahimi, Syria diplomats in Moscow talks

MOSCOW (Reuters) - Russia will host Syria peace envoy Lakhdar Brahimi this week after Syrian officials held talks in Moscow on Thursday as part of a diplomatic drive to try to agree a plan to end the 21-month-old conflict, Russia's foreign ministry said.

Talks have moved to Moscow, a long-time Syria ally, after a flurry of meetings Brahimi held in Damascus this week, but the international envoy has disclosed little about his negotiations.

Brahimi, who saw Syrian President Bashar al-Assad on Monday and is planning to hold a series of meetings with Syrian officials and dissidents this week, is trying to broker a peaceful transfer of power.

More than 44,000 Syrians have been killed in a revolt against four decades of Assad family rule, a conflict that began with peaceful protests in March last year, but which has descended into civil war.

However, past peace efforts have floundered, with world powers divided over what has become an increasingly sectarian struggle between mostly Sunni Muslim rebels and Assad's security forces, drawn primarily from his Shi'ite-rooted Alawite minority.

Syrian Deputy Foreign Minister Faisal Makdad and an aide held talks at Russia's Foreign Ministry for less than two hours on Thursday, but declined to disclose any details of their visit.

A Russian Foreign Ministry source had said earlier that they would meet Foreign Minister Sergei Lavrov and Mikhail Bogdanov, the Kremlin's envoy for Middle East affairs.

Syrian and Lebanese sources said Makdad had been sent to Moscow to discuss the details of a peace plan proposed by Brahimi.

Foreign Ministry spokesman, Alexander Lukashevich, played down the idea that a specific plan was on the table in Moscow talks, at least none agreed by Moscow and Washington.

"We plan to discuss a range of issues linked to a political and diplomatic settlement in Syria, including Brahimi's efforts aimed at ending the violence and the launch of a comprehensive national dialogue," Lukashevich told reporters.

'TRYING TO FEEL A WAY OUT'

Asked about rumors of a Russian-American plan to resolve the conflict, he said: "There has not been and is no such plan."

"In our talks with Mr. Brahimi and with our American colleagues, we are trying to feel a way out of this situation on the basis of our common plan of action that was agreed in Geneva in June."

World powers believe Russia, which has given Assad military and diplomatic aid to help him weather the uprising, has the ear of the Syrian government and must be a key player in peace talks.

Moscow has tried to distance itself from Assad in recent months and has said it is not propping him up, but Lukashevich reiterated its stance that Assad's exit from power could not be a precondition for negotiations.

Setting such a condition, he said, would violate the terms of an agreement reached by world powers in Geneva on June 30 that called for a transitional government in Syria.

"The biggest disagreement ... is that one side thinks Assad should leave at the start of the process - that is the U.S. position, and the other thinks his departure should be a result of the process - that would be the Russian position," Dmitry Trenin, an analyst at the Moscow Carnegie Center, told Reuters.

But Trenin said battlefield gains made by the Syrian rebels were narrowing the gap between Moscow and Washington.

On Saturday, Lavrov said Syria's civil war had reached a stalemate, saying international efforts to get Assad to quit would fail. Bogdanov had earlier acknowledged that Syrian rebels might win.

Lavrov has said this month that Russia had no intention of offering Assad asylum and would not act as messenger for other nations seeking his exit. He has also said Russia lacks the sway to persuade him to step down.

(Additional reporting by Nastassia Astrasheuskaya; Writing by Alissa de Carbonnel; Editing by Andrew Osborn)

Read More..

Kate Winslet Marries in Secret

By Mike Fleeman

12/26/2012 at 09:10 PM EST

Talk about a Titanic secret.

Kate Winslet has tied the knot with Richard Branson's nephew, Ned Rocknroll, her rep tells PEOPLE.

"I can confirm that Kate Winslet married Ned Rock'nRoll in NY earlier this month in a private ceremony attended by her two children and a very few friends and family," the rep says. "The couple had been engaged since the summer."

According to British media reports, Leonardo DiCaprio gave away the bride in a ceremony so secret that the bride and groom's parents didn't know about it.

The Oscar-, Golden Globe- and Emmy-winning actress, 37, has been dating Rocknroll, 34, (his legal name) since fall of 2011.

In August 2011, she and Rocknroll were on the same Caribbean island owned by Branson when a fire broke out and Winslet rescued Branson's 90-year-old mother.

Winslet previously was married to Sam Mendes and Jim Threapleton.

• Reporting by JULIE JORDAN

Read More..

Predicting who's at risk for violence isn't easy

CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.

Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.

But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.

"They're yellow flags. They only become red flags once the blood is spilled," he said.

Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.

Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)

Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.

Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.

"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."

The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."

In a guidelines for families, the academy lists several risk factors for violence, including:

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.

Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.

Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.

According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.

Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.

Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.

And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.

All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.

Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.

Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.

Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.

___

Online:

American Academy of Child & Adolescent Psychiatry: http://www.aacap.org

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Read More..

Stock futures signal steady open

PARIS (Reuters) - U.S. stock index futures pointed to a steady open on Wall Street on Thursday, with futures for the S&P 500 up 0.04 percent, Dow Jones futures up 0.05 percent and Nasdaq 100 futures down 0.02 percent at 0941 GMT.

European shares rose early on Thursday in their first trading session following the Christmas break, with investors focusing on Washington's last-ditch efforts to avoid a damaging bout of fiscal tightening next year. <.eu/>

Efforts to prevent the U.S. economy from going over its 'fiscal cliff' resumed on Wednesday with less than a week to go before the potentially disastrous tax hikes and spending cuts kick in.

In a sign that there may be a way through the deadlock in Congress, Republican House of Representatives Speaker John Boehner offered to at consider any bill the Democrat-controlled Senate produced. President Barack Obama will try to revive budget crisis talks when he returns to Washington on Thursday after cutting short his Christmas break.

U.S. stocks fell on Wednesday, dragged lower by retail stocks after a report showed consumers spent less in the holiday shopping season than last year.

The 2012 holiday season may have been the worst for retailers since the 2008 financial crisis, with sales growth far below expectations, forcing many to offer massive post-Christmas discounts in hopes of shedding excess inventory.

The Dow Jones industrial average <.dji> slipped 24.49 points, or 0.19 percent, to 13,114.59 at Wednesday's close. The Standard & Poor's 500 Index <.spx> shed 6.83 points, or 0.48 percent, to 1,419.83. The Nasdaq Composite Index <.ixic> dropped 22.44 points, or 0.74 percent, to 2,990.16.

(Reporting by Blaise Robinson; Editing by John Stonestreet)

Read More..

Spring Wish denied as suicide bomber brings down Afghan juice empire

KABUL (Reuters) - When a Taliban suicide bomber killed two people on the edge of the Afghan capital this month, there was another casualty - a global fruit juice business optimistically called "Spring Wish" which provided work for thousands of farmers across the country.

Mustafa Sadiq's empire had been expanding healthily, bringing in badly needed foreign capital, before the attack inflicted the kind of financial loss cash-strapped Afghanistan can ill afford.

The pomegranate juice business was nearly wiped out in the split second it took the militant to detonate explosives in a truck parked near the factory on December 17.

Pieces of shredded metal were scattered everywhere. Chairs were hurled across the office where Sadiq had spent so much time figuring out how to beat the odds against decades of war, instability and hopelessness.

Sadiq was in Dubai drumming up new export deals when an assistant called with the bad news. The call that Sadiq said he did not get is also troubling him.

"So far no officials, for the sake of sympathy, have called us," Sadiq, 40, told Reuters, standing beside a year's supply of juice in containers that were ruined in the attack - nearly $10 million in losses overall.

"In this situation they should have called me and asked what kind of help they could provide. The agriculture, finance, commerce ministries. Nobody so far has visited or called."

The impact of the war, and expectations for the future, are often seen only through the eyes of Western or Afghan soldiers, or officials who point to the progress that has been made.

Sadiq offers another perspective. Some workers told him the bomber triggered the loudest blast they had heard in 30 years.

A Soviet invasion of Afghanistan in 1979 was followed by a decade of resistance by mujahideen fighters who drove them out. Then warlords carved out fiefdoms and destroyed half of the capital in the civil war that followed.

DIRTY POLITICS

The Taliban took over, were toppled in 2001 and are now raising fears they may return when U.S.-led NATO troops hand over security to Afghan forces in 2014.

But Sadiq does not see the Taliban as the biggest threat to Afghanistan's future. Instead, he says, officials have turned politics into a commercial enterprise driven by corruption.

"Government employees think it's time to fill their pockets and grab whatever they can. That will pave the way for civil war," said Sadiq, as workers feverishly loaded boxes of the little fruit juice left onto a truck, and others worked to rebuild a brick wall.

"You have to struggle, not run away. It is kind of like running away now. They have walls around themselves sitting there and they do not have contact with ordinary Afghans."

His disillusionment is shared by the Afghanistan Chamber of Commerce and Industries.

"There is no guarantee for investment in Afghanistan. People are afraid of the government, there is no rule of law. Government officials can do anything they want," the chamber's first vice-chairman, Jan Alokzai, told Reuters.

"President (Hamid) Karzai's words are only on paper and don't have any value."

Afghanistan's U.S.-backed government says it is committed to building up the economy, attracting foreign investment and helping Afghans secure a brighter future. Karzai says it is contracts with foreigners that spread graft.

WISHFUL THINKING?

The government has highlighted 2014 as a year to invest in Afghanistan, which relies heavily on foreign aid, and to take advantage of its cheap labor and land leases.

In each of the 10 years following 2014, the government hopes revenues from oil, natural gas, iron, copper and other mining ventures will generate $4 billion in revenue.

Sadiq spent time in Europe, waiting for an opportunity to return and invest in his homeland. He eventually opened a factory in an industrial park along Kabul's dusty Jalalabad Road in 2008, from where he broke into overseas markets.

Spring Wish, which employed about 1,000 people, was selling produce to the health conscious in Europe, Asia and the Middle East, bringing money into Afghanistan, while anxious Afghans carted $4.5 billion in cash out of the country last year to safety.

But when asked about the maps on a wall identifying parts of Afghanistan which offer opportunities for farmers and businesses like his, Sadiq could only put his head in his hands and cry.

The dark red seeds from Sadiq's fruits were prized in Europe for their antioxidant qualities, and in Japan where many believe they can help fight cancers. He seems most proud of the fact that he helped 40,000 farmers across Afghanistan earn a living.

As Sadiq tries to persuade his staff to keep dreaming big and to rebuild, one question may haunt him for some time. The suicide bomber parked his truck in a lane between his company and a foreign firm.

The Taliban said it attacked an American company next door, but he still wonders whether his factory, which relied on Italian machinery and benefited from U.S. aid programs, was the target. And he acknowledges he is desperate for money from Western donors.

"Around 120 people were working here and this factory was totally destroyed in the suicide attack," said Mohammed Jaw, 28, a general operator for the company. "A number of our workers will lose their jobs and now everyone is concerned about what happens next."

Despite the loss, Sadiq's entrepreneurial and marketing spirit seems intact.

"Have you tried the juice with mulberry flavor?" he asked proudly. "It's really good."

Then a worker brought the moment back to reality. He lifted his cellphone to show a photograph of the suicide bomber's severed head.

(Additional reporting by Mirwais Harooni; Editing by Nick Macfie)

Read More..

Giada De Laurentiis: My Daughter Still Believes in Santa

Courtesy Giada De Laurentiis

The tree’s done. The stockings are hung. Giada De Laurentiis and her family — husband Todd Thompson and their daughter Jade Marie — are officially ready to host the holidays.

“Christmas Eve is the big tradition in an Italian family. It’s when my entire family gets together,” the newest face of Clairol tells PEOPLE exclusively.

“This year, for the first time, it will be held at my house … so Jade and I and my husband are very excited.”

On the menu for the family festivities is “a big fish dinner,” one that no doubt Jade will help her mother to prepare. After all, adds the celebrity chef, she is the unofficial taste tester.

“My daughter loves to cook. We have a lot of laughs together. I spend a lot of time in the kitchen and she loves hanging out with me,” De Laurentiis, 42, shares. “The reason she loves it so much is because she can stick her finger in everything and taste it as she goes along.”

Once the big dinner is done with, and the evening starts to wind down, De Laurentiis and Jade will start to prepare for the night’s biggest guest to arrive: Santa Claus. At 4½-years-old, her little girl is still a strong believer in the magic of it all, notes her proud mama.

“She leaves him little treats — for the reindeer and for him too — and she’s very much a believer in Santa,” De Laurentiis says. “I hope she’ll be a believer for a long time, I think it’s really fun for kids to be able to do that.”

Recently, the pair sat down to write out Jade’s wish list, but after much pleading on Jade’s part over the past few weeks, it’s no surprise as to what she hopes to find under the tree this year.

“The one thing she keeps asking me for over and over again is clip-on earrings. She must have seen them on somebody else, but she has asked me for clip-on earrings for the past month,” De Laurentiis notes. “I am on a mission to find clip-on earrings for her because I don’t think she’ll ever forgive me if I don’t.”

But based on her newly transformed play space, the “girly girl’s” specific accessory request should come as no surprise.

“She’s opened up her own little salon in her playroom. She gives free makeovers, she curls people’s hair and gives them little manicures as well,” De Laurentiis says. “I’ve always been a girly girl my whole life — maybe she will, maybe she won’t — but it’s a lot of fun to play with her right now.”

– Anya Leon with reporting by Kate Hogan

Read More..

Predicting who's at risk for violence isn't easy

CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.

Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.

But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.

"They're yellow flags. They only become red flags once the blood is spilled," he said.

Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.

Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)

Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.

Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.

"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."

The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."

In a guidelines for families, the academy lists several risk factors for violence, including:

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.

Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.

Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.

According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.

Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.

Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.

And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.

All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.

Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.

Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.

Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.

___

Online:

American Academy of Child & Adolescent Psychiatry: http://www.aacap.org

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Read More..

Yen falls, Nikkei surges as Japan gets a new government

TOKYO (Reuters) - The yen fell to a 20-month low against the dollar on Wednesday, buoying the benchmark Nikkei stock average to nine-month highs, as Japan swore in a new prime minister eager to pursue drastic stimulus steps to drive the country's economy out of deflation.

Asian shares and other assets were capped in thin holiday trade, with investors focusing on the fate of U.S. negotiations to avert a budget crunch looming at the end of the year.

Markets in Singapore <.ftsti>, Malaysia <.klse>, Indonesia <.jkse>, the Philippines <.psi> and South Korea <.ks11> reopened on Wednesday after closing on Tuesday for the Christmas holiday.

Hong Kong and Australia remain closed on Wednesday. Europe also will not trade, but U.S. markets reopen later in the day.

MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was little changed. Shanghai shares <.ssec> were flat, but stayed in positive territory on the year after a 2.5 percent jump on Tuesday erased 2012 losses. It is set for a first annual gain in three years. South Korean shares <.ks11> ended nearly flat.

Shinzo Abe, whose party won a landslide victory in an election earlier this month, was elected Japan's premier on Wednesday. Abe, who is expected to appoint his cabinet later Wednesday, is calling for a mix of aggressive monetary policy easing and big fiscal spending to beat deflation and rein in the strong yen.

He has kept up pressure on the Bank of Japan to be more drastic and adopt a 2 percent inflation target to beat deep-rooted deflation, pushing the yen to a 20-month low of 85.38 yen on trading platform EBS on Wednesday. Traders eyed the dollar's 2011 high of 85.53 yen as the next target.

The euro rose as high as 112.55 yen on EBS, just below its 16-month high of 112.59 yen hit on December 19.

The weaker yen has bolstered hopes for better earnings from Japanese companies and underpinned the Nikkei, which has gained some 18 percent since mid-November when the election was scheduled, fuelling expectations for Abe's party to win. The yen has lost nearly 8 percent against the dollar in the same period.

The Nikkei <.n225> closed at a nine-month high with a 1.5 percent gain. <.t/>

"Most foreign funds have added Japanese shares and there are fewer participants today, but there still is a reason for the Nikkei to rise," said Hideyuki Okoshi, general manager at Chibagin Securities. "Not only exporters but investors are buying other stocks which could benefit under the new government."

Japanese government debt prices fell, with the 10-year bond futures hitting a three-month low of 143.65 in active trade. Ten-year JGB yields rose 1.5 basis points to 0.780 percent, matching a six-week high hit on December 19.

"We continue to see equities going high, so the pressure is on the long end of the JGB curve. For the short end of the curve, we continue to see the BOJ ease aggressively, so there is no change in that," said Tadashi Matsukawa, head of Japan fixed income at PineBridge Investments.

Minutes of the BOJ's policy-setting meeting in November, released on Wednesday, showed that some board members said the central bank must act decisively, without ruling out any policy options, if the outlook for the economy and prices worsens further.

"FISCAL CLIFF" RISK

The dollar was expected to stay firm this week as the U.S. fiscal impasse is likely to continue to sap investor appetite for risky assets and raise the dollar's safe-haven appeal.

Ten-year U.S. Treasury notes held steady in price to yield roughly 1.776 percent in Asia, little changed from late U.S. trade on Monday. The U.S. bond market was closed on Tuesday for Christmas.

"I think there is about a 50 percent chance of the cliff being avoided at the year-end through an agreement of some kind, even if it turns out to be just a short-term postponement," said Tomoaki Shishido, a rate analyst for Nomura Securities in Tokyo.

A U.S. official said on Tuesday that President Barack Obama may return to Washington from his Hawaiian holiday as early as Wednesday evening to address the unfinished negotiations over the "fiscal cliff" of some $600 billion in automatic spending cuts and tax increases set to start on January 1.

If the United States falls off the fiscal cliff, economists warn that the world's largest economy could plunge into recession and drag global economies down as well.

Data out of Asia on Wednesday underscored fragile global growth.

Exports in Thailand, Southeast Asia's second-largest economy, rose nearly 27 percent in November from a year ago, but that reflected recovery from flooding in late 2011 and not growth in global demand.

South Korea's key consumer sentiment index held steady in December from November and stood below the neutral point for a fifth consecutive month, diminishing hopes of a quick economic rebound.

Gold edged lower on Wednesday on uncertainty over the fiscal cliff, but a weaker yen sparked a rally in bullion futures on the Tokyo Commodity Exchange (TOCOM).

Brent crude climbed above $109 per barrel on Wednesday in thin trade, with investors hoping for a last-minute deal to avoid a U.S. fiscal crisis. U.S. crude futures also inched up 0.4 percent to $88.94.

(Additional reporting by Ayai Tomisawa and Dominic Lau in Tokyo and Masayuki Kitano in Singapore; Editing by Richard Borsuk)

Read More..