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.


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Wall Street heads for longest losing streak in three months

NEW YORK (Reuters) - Stocks fell on Friday, putting the S&P 500 on track for a fifth straight decline, as President Barack Obama and top congressional leaders were set to make a last-ditch attempt to steer the country away from severe fiscal austerity next year.


Obama and lawmakers from both political parties will meet at the White House on Friday afternoon for talks in an effort to agree on a solution before a New Year's deadline to keep large tax hikes and spending cuts from taking effect. Economists say that combination of automatic higher taxes and lower government spending - known as the "fiscal cliff" - could push the U.S. economy into a recession.


Trading was volatile and stocks rebounded from their session lows after unconfirmed reports that President Obama was about to offer a new plan to Republicans.


But investors' pessimism about achieving anything more than a stop-gap deal by the deadline was reflected in the benchmark S&P 500's drop of 1.3 percent so far this week. The broad index was on pace for its worst weekly performance since mid-November.


A five-day decline would be the S&P 500's longest losing streak in three months.


"There's a pretty good chance that we won't have something in hand by year-end," said Jonathan Golub, chief U.S. equity strategist at UBS, in New York. "It should be pretty obvious that that is now the majority case."


Golub, however, said investors were still counting on a deal that would avoid most of the tax hikes and spending cuts next year even if it does come after the deadline.


"It is widely believed that we're going to get a deal," he said. "We are not going to go over the cliff to the extent that we have a huge economic contraction."


With time running short, members of Congress may attempt to pass a retroactive fix to neutralize tax increases and spending cuts soon after the automatic fiscal policies come into effect on January 1.


The Dow Jones industrial average <.dji> fell 65.65 points, or 0.50 percent, to 13,030.66. The Standard & Poor's 500 Index <.spx> dropped 6.03 points, or 0.43 percent, to 1,412.07. The Nasdaq Composite Index <.ixic> slipped 7.29 points, or 0.24 percent, to 2,978.62.


"It doesn't matter which side wins, but at this point, nobody wants to play a game where there aren't rules," said Joe Costigan, director of equity research at Bryn Mawr Trust, in Bryn Mawr, Pennsylvania.


"So everybody is talking about what the prospects are for changes in the rules. But at the end of the day, nothing is happening."


Highlighting Wall Street's sensitivity to developments in Washington, stocks tumbled slightly more than 1 percent on Thursday after Senate Majority Leader Harry Reid warned that a deal was unlikely before the deadline. But late in the day, the three major U.S. stock indexes rebounded and ended down just 0.1 percent after the U.S. House of Representatives said it would hold an unusual Sunday session to work on a fiscal solution.


With many investors away for the holiday-shortened week, volume is expected to remain light and that could exacerbate the stock market's swings.


Positive economic data failed to alter the market's downtrend.


The National Association of Realtors said contracts to buy previously owned U.S. homes rose in November to their highest level in 2-1/2 years, while a report from the Institute for Supply Management-Chicago showed business activity in the U.S. Midwest expanded in December.


Barnes & Noble Inc shares rose 6.2 percent to $15.24 after the top U.S. bookstore chain said British publisher Pearson Plc had agreed to make a strategic investment in its Nook Media subsidiary. But Barnes & Noble also said its Nook business will not meet its previous projection for fiscal year 2013.


Shares of magicJack VocalTec Ltd jumped 8.5 percent to $17.67 after the company, which provides VoIP or voice over Internet protocol services, forecast more than $39 million in GAAP revenue and over 70 cents per share in operating income for the fourth quarter. The company also said it has appointed Gerald Vento as president and CEO, effective January 1.


The U.S.-listed shares of Canadian drugmaker Aeterna Zentaris Inc surged 16.1 percent to $2.52 after the company said it had reached an agreement with the U.S. Food and Drug Administration on a special protocol assessment by the FDA for a Phase 3 registration trial in endometrial cancer with AEZS-108 treatment.


(Reporting by Edward Krudy; Editing by Jan Paschal)



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Japan Might Revise Apology on Wartime Sex Slaves





TOKYO — A top official hinted on Thursday that Japan’s newly installed conservative government might seek to revise a two-decade-old official apology to women forced into sexual slavery during World War II, a move that would most likely outrage South Korea and possibly other former victims of Japanese militarism.




Speaking a day after the new cabinet was named, Chief Cabinet Secretary Yoshihide Suga, who serves as the government’s top spokesman, refused to say clearly whether the new prime minister, Shinzo Abe, would uphold the 1993 apology, which was issued by the chief cabinet secretary at the time, Yohei Kono.


Mr. Suga said at a news conference, however, that it would be “desirable for experts and historians to study” the statement, which acknowledged the Imperial Army’s involvement in forcing thousands of Asian and Dutch women to provide sex for Japanese soldiers.


Mr. Suga seemed to keep his comments intentionally vague, adding only that the matter “should not be made into a political or diplomatic issue.” He also said the Abe government would uphold a broader apology, issued in 1995 to observe the 50th anniversary of the end of World War II, to all victims of Japan’s colonialism and aggression.


The sex slaves issue remains highly emotional in South Korea, a former Japanese colony. On Thursday, the South Korean Foreign Ministry responded to Mr. Suga’s comments by calling on Japan not to forget its militaristic past.


The Kono Statement has long been a sore point for Japanese rightists, who deny either that the women had been coerced or that the military had a hand in forcing them to become what many Japanese euphemistically call “comfort women.” These critics include Mr. Abe, an outspoken nationalist who has repeatedly called for revising the statement, most recently during an internal Liberal Democratic Party election in September.


The issue does not resonate broadly, however, among the general public, which would rather avoid confrontation with other Asian countries. During the national parliamentary elections this month that swept his Liberal Democrats back into power, Mr. Abe avoided talking about the matter, apparently so as not to be seen as too far to the right of mainstream voters.


His position has also caused concern in Washington, where the United States government has urged Japan and South Korea, its two closest Asian allies, to increase cooperation against security threats like North Korea.


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Ex-President George H.W. Bush Moved to Intensive Care After 'Setbacks'















12/27/2012 at 01:00 PM EST







George H. W. Bush in 2009


Ron Sachs-Pool/Getty


After suffering "a series of setbacks," including a "persistent fever," 88-year-old former President George H.W. Bush is in the intensive care unit of a Houston hospital, his spokesman says.

Originally admitted to Methodist Hospital on Nov. 23 with a stubborn cough related to bronchitis, Bush came down with the fever that prompted doctors to put him on a liquids-only diet this week, says spokesman Jim McGrath.

"He remains in guarded condition," says McGrath in a statement. "Doctors at Methodist continue to be cautiously optimistic about the current course of treatment. The President is alert and conversing with medical staff, and is surrounded by family."

Among those visiting the 41st president on Christmas were his wife Barbara, son Neil and a grandson. Since his hospitalization, he also has received visits from sons George W. Bush, the 43rd president, and Jeb Bush, the ex-governor of Florida, the Associated Press reports.

"He appreciates all the good wishes coming his way," his close aide, Jean Becker, says in an auto-reply to emails Thursday. "He would ask you to please put the harps away. He plans on staying put."

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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.


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Dow falls more than 1 percent

NEW YORK (Reuters) - Stocks fell for a fourth day in a row on Thursday and a measure of investor anxiety hit its highest in five months after the top Senate Democrat warned a deal to avoid fiscal austerity measures may not be reached by the December 31 deadline.


The comments by Senate Majority Leader Harry Reid just days before the hefty tax hikes and spending cuts go into effect pushed stocks down. The S&P 500 has lost 2.7 percent over the past four days, its worst such run in over a month.


A four-day drop would also mark the S&P 500's longest losing streak in three months as Wall Street wakes up to the possibility that a deal may not be reached until next year.


The CBOE VIX volatility index <.vix>, a measure of investor fear, jumped above 20 for the first time since July, climbing around 4 percent in another sign of growing concern. Investors fear the so-called fiscal cliff could push the economy into recession next year.


The VIX's "recent spike seems to suggest that market participants are bracing for a rather significant uptick in market volatility in early 2013," said Frederic Ruffy, options strategist at WhatsTrading.com.


Stocks in the materials and the financial sectors, which are more vulnerable to the economy's performance, took the brunt of the selling. Shares in Bank of America fell 2 percent to $11.29, while Freeport-McMoRan Copper & Gold fell 1.6 percent to $33.38.


Reid criticized Republicans for refusing to go along with any tax increases as part of a compromise solution with Democrats. Referring to the fiscal cliff, he said: "It looks like where we're headed."


The Dow Jones industrial average <.dji> was down 106.63 points, or 0.81 percent, at 13,007.96. The Standard & Poor's 500 Index <.spx> was down 12.33 points, or 0.87 percent, at 1,407.50. The Nasdaq Composite Index <.ixic> was down 27.48 points, or 0.92 percent, at 2,962.68.


Frank Lesh, a futures analyst and broker at FuturePath Trading in Chicago, said his clients have been delaying trading due to uncertainty about the fiscal cliff, making the year-end period quieter than usual.


"With the added drama in Washington, we have got even more people sidelined," he said. "No one knows how this turns out or how the markets are going to react to it."


President Barack Obama arrived back in Washington from Hawaii to restart stalled negotiations with Congress. House Speaker John Boehner and other Republican leaders were to hold a conference call with Republican lawmakers. The expectation was that lawmakers would be told to get back to Washington quickly if the Senate passed a bill.


Treasury Secretary Timothy Geithner announced the first of a series of measures that should push back the date when the U.S. government will hit its legal borrowing authority - a limit known as the debt ceiling - by about two months.


Economic data seemed to confirm worries about the impact of the fiscal cliff on the economy.


The Conference Board, an industry group, said its index of consumer attitudes in December fell to 65.1 as the budget crisis dented growing optimism about the economy. The gauge fell more than expected from 71.5 in November.


However, the job market continues to mend. Initial claims for unemployment benefits dropped 12,000 to a seasonally adjusted 350,000 last week and the four-week moving average fell to the lowest since March 2008.


But recent signs that the economy is improving have taken a back seat to the political uncertainty.


"The U.S. equity market has not yet adequately responded to a genuinely improving macro backdrop, and is probably held back by uncertainties surrounding the resolution of the 'fiscal cliff'," said Goldman Sachs in a research note.


Marvell Technology Group fell 4.2 percent to $7.09 after it said it would seek to overturn a jury's finding of patent infringement. The stock had fallen more than 10 percent in the previous session after a jury found the company infringed patents held by Carnegie Mellon University and ordered the chipmaker to pay $1.17 billion in damages.


(Reporting by Edward Krudy; Additional reporting by Doris Frankel; Editing by Jan Paschal and Kenneth Barry)



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United Arab Emirates Arrests Suspects in Terror Plots





DUBAI, United Arab Emirates (Reuters) — Security forces in the United Arab Emirates have arrested members of a cell made up of militants from Saudi Arabia and the emirates who were planning to carry out attacks in both countries and in other states, the official Emirates News Agency said on Wednesday.




The federation of seven emirates, a major oil exporter and an ally of the United States, has had no attacks by Al Qaeda and other terrorist groups. But Islamist sentiment has risen in recent years, and Dubai, a business and tourism hub that attracts many Westerners, could make an attractive target for militants, analysts say.


The suspects had acquired materials and equipment for use in what the news agency called terrorist operations.


“The security authorities in the U.A.E., in coordination with the related security parties in Saudi Arabia, announced the arrest of an organized cell from the deviant group that was planning to carry out actions against national security of both countries and some brotherly states,” the agency said, without elaborating.


The phrase “deviant group” is often used by the authorities in Saudi Arabia to describe Al Qaeda.


In August, the Saudi authorities arrested a group of militants in Riyadh — mostly Yemeni nationals — suspected of having links to Al Qaeda. Thousands of people believed to be militants have been arrested since dozens were killed in terrorist attacks between 2003 and 2006 on Saudi residential compounds and offices for foreign workers and on government facilities.


The United States has poured aid into Yemen to stem the threat of attacks from the group Al Qaeda in the Arabian Peninsula and to try to prevent any spillover of violence into Saudi Arabia, the world’s top oil exporter.


In 2010, Al Qaeda in the Arabian Peninusla, formed with the merger of Al Qaeda’s Yemeni and Saudi branches, said it was behind a plot to send two parcel bombs to the United States. The bombs were intercepted in Britain and Dubai.


Though the emirates have escaped much of the upheaval that has shaken the Arab world, the authorities there have moved swiftly to stem any sign of political dissent, detaining more than 60 Islamists this year over suspected threats to state security and links to foreign groups.


Those detainees, who belong to an Islamist group called Al-Islah, have confessed to setting up a secret organization with an armed force whose aim was to take power and establish an Islamic state, the local news media reported in September. The group denied the accusations.


Many of the detained Islamists are from the more religiously conservative northern emirates like Sharjah and Ras al-Khaimah, which produced one of the Sept. 11 hijackers.


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Harley Pasternak Blogs: The 5 Best Bodies of 2012






Celebrity Blog










12/26/2012 at 01:45 PM EST







Harley Pasternak


Courtesy Harley Pasternak


In 2012 we re-elected our president, fell in love with Honey Boo Boo and danced "Gangnam Style."

For me, 2012 was an incredibly rewarding year. First off, I'm healthy. Without health, nothing else matters. Second, as a fitness trainer I've been blessed with a profession that helps other people become healthier, feel better and look better. Below are five of my celebrity clients I was very proud to help this year. Their dedication to healthy eating and regular exercise sets a great example for all of their fans – including me.

1. Jessica Simpson's Post-Baby Weight Loss
Perhaps the biggest story this year in Hollywood bodies was Jessica's amazing post-baby transformation. With the help of Weight Watchers' point-based nutrition plan and three to four sessions a week with me, Jessica shed all her baby weight (and then some!).

During our workouts, we focused on training one upper body exercise, one lower body exercise and one core exercise to maximize calorie burn and muscle tone. I also got Jessica to wear a pedometer and go walking. Jessica even gave her whole Weight Watchers group pedometers to inspire them all to walk over 10,000 steps a day. (Of course, now that she's expecting baby No. 2, Jessica will modify her exercise and nutrition appropriately.)

2. Jordana Brewster
The Brazilian beauty and her husband Andrew have been longtime clients. As she appeared on both the big screen (The Fast and the Furious) and small screen (Dallas), Jordana was a busy – and fit! – lady.

Aside from our three workouts a week, she truly perfected her healthy eating lifestyle with three meals and two snacks a day. From my 5-factor oatmeal frittatas for breakfast, to my shrimp quesadillas for lunch and delicious stir-fries for dinner, Jordana was on top of her diet. She also started to use her blender this year, following some of my new Body Reset Diet recipes.

3. Maria Menounos
Fresh off of a grueling Dancing with the Stars season, the Extra host and WWE wrestler was riddled with injuries and had zero free time to exercise. So, we focused on her diet and non-gym physical activity to sculpt her incredible body into top form for the cover of Men's Health magazine.

Maria blended smoothies (from the Body Reset Diet) for breakfasts and lunches, cooked a variety of healthy salads, stir-fries and seafood for dinners, and ate her favorite Greek yogurt-covered snack bars between meals. It all paid off as she blew everyone away with her flawless photos.

4. The Year of the Kardashians
The Kardashian sisters continued to wow in 2012. Occasionally, I get the chance to kick their butts in the gym. I make sure to focus on their posterior muscle groups – the back, triceps, glutes and hamstrings – using strengthening moves like dumbbell deadlifts, superman and lying triceps extensions. These exercises improve posture and protect against injury.

I also got the girls and their age-defying mother, Kris Jenner, to get friendly with their blenders. The girls try to make at least one of their daily meals a delicious Body Reset Diet smoothie.

5. Megan Fox's Post-Baby Body

Harley Pasternak Blogs: The 5 Best Bodies of 2012| Celebrity Blog, Harley Pasternak, Jessica Simpson, Jordana Brewster, Khloe Kardashian, Kim Kardashian, Kourtney Kardashian, Kris Jenner, Megan Fox, Actor Class

Megan Fox and Brian Austin Green

John Shearer / Invision / AP

As 2012 was the year of many celeb post-baby transformations (including three of my clients), it's only fitting that the top two stories are new mommy bounce-backs. Largely due to the fact that Megan stayed so active and fit during her pregnancy, only three weeks after delivering baby Noah, she was red carpet ready and as stunning as ever. Megan and her husband, Brian Austin Green (also a client) made eating well and working out with me a top priority.

I hope 2012 was an incredibly happy, healthy and successful year for all of you. And may next year bring you even more of the same.

Tweet me your New Year's resolutions @harleypasternak

Check back every Wednesday for more insider tips from celebrity trainer Harley Pasternak on Hollywood's hottest bodies – and learn how to get one yourself! Plus: follow Harley on Twitter at @harleypasternak

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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


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Retailers lead Wall Street lower, "cliff" still a concern

NEW YORK (Reuters) - Stocks fell on Wednesday, dragged lower by retail stocks after a report showed consumers were less enthusiastic about the holiday shopping season than last year.


Many investors said concerns about the "fiscal cliff" kept shoppers away from stores, suggesting markets may struggle to make any ground until next year.


Holiday-related sales rose 0.7 percent from October 28 through December 24, compared with a 2 percent increase last year, according to data from MasterCard Advisors SpendingPulse. The Morgan Stanley retail index <.mvr> skidded 1.8 percent while the SPDR S&P Retail Trust slipped 1.5 percent to 61.24.


"With the 'fiscal cliff' hanging over our heads, it was hard to convince people to shop, and now it's hard to convince investors that there's any reason to buy going into year-end," said Rick Fier, director of trading at Conifer Securities in New York.


President Barack Obama is due back in Washington early Thursday for a final effort to negotiate a deal with Congress to bridge a series of tax increases and government spending cuts set to begin next week, the so-called "fiscal cliff" many economists worry could push the economy into recession if it takes effect.


Coach Inc fell 6 percent to $54.08 as the biggest decliner on the S&P 500, followed by Ralph Lauren Corp , off 4 percent to $144.99. Online retailer Amazon.com fell 3.1 percent to $250.52. Gamestop Corp , Urban Outfitters and Abercrombie & Fitch were also among the S&P's biggest decliners.


The Dow Jones industrial average <.dji> was down 34.16 points, or 0.26 percent, at 13,104.92. The Standard & Poor's 500 Index <.spx> was down 6.57 points, or 0.46 percent, at 1,420.09. The Nasdaq Composite Index <.ixic> was down 18.82 points, or 0.62 percent, at 2,993.78.


Volume was light, with only 2.17 billion shares having traded at midday on the New York Stock Exchange, the Nasdaq and the NYSE MKT. Many senior traders were still on vacation during this holiday-shortened week and major European markets were closed for the day.


Still, Wednesday marked the third day of losses for the S&P 500 in its worst three-day decline since mid-November.


A Republican plan that failed to gain traction last week triggered the S&P 500's recent drop, highlighting the market's sensitivity to headlines centered on the budget talks.


During the last five trading days of the year and the first two of next year, it's possible for a "Santa rally" to occur. Since 1928, the S&P 500 has averaged a gain of 1.8 percent during that period and risen 79 percent of the time, according to data from PrinceRidge.


"While it's unlikely there could be a budget deal at any time, no one wants to get in front of that trade," said Conifer's Fier, who helps oversee about $12 billion in assets. "Investors can easily make up for any gains when there's more action in 2013."


The benchmark S&P 500 Index is up 12.8 percent for the year, and has recouped nearly all of the losses after the U.S. election, when the "fiscal cliff" concerns moved to the forefront. This is the best yearly gain for the S&P 500 since 2010.


Data showed U.S. single-family home prices rose in October, reinforcing the view that the domestic real estate market is improving, as the S&P/Case-Shiller composite index of 20 metropolitan areas gained 0.7 percent in October on a seasonally adjusted basis.


In the energy sector, China's Sinopec Group and ConocoPhillips will research potentially vast reserves of shale gas in southwestern China over the next two years, state news agency Xinhua reported. Conoco's stock fell 0.8 percent to $57.99.


An outage at one of Amazon.com Inc's web service centers hit users of Netflix Inc's streaming video service on Christmas Eve and was not fully resolved until Christmas Day, a spokesman for the movie rental company said on Tuesday. Netflix rose 0.8 percent to $90.97.


(Editing by Dan Grebler)



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