CDC says US flu season starts early, could be bad


NEW YORK (AP) — Flu season in the U.S. is off to its earliest start in nearly a decade — and it could be a bad one.


Health officials on Monday said suspected flu cases have jumped in five Southern states, and the primary strain circulating tends to make people sicker than other types. It is particularly hard on the elderly.


"It looks like it's shaping up to be a bad flu season, but only time will tell," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.


The good news is that the nation seems fairly well prepared, Frieden said. More than a third of Americans have been vaccinated, and the vaccine formulated for this year is well-matched to the strains of the virus seen so far, CDC officials said.


Higher-than-normal reports of flu have come in from Alabama, Louisiana, Mississippi, Tennessee and Texas. An uptick like this usually doesn't happen until after Christmas. Flu-related hospitalizations are also rising earlier than usual, and there have already been two deaths in children.


Hospitals and urgent care centers in northern Alabama have been bustling. "Fortunately, the cases have been relatively mild," said Dr. Henry Wang, an emergency medicine physician at the University of Alabama at Birmingham.


Parts of Georgia have seen a boom in traffic, too. It's not clear why the flu is showing up so early, or how long it will stay.


"My advice is: Get the vaccine now," said Dr. James Steinberg, an Emory University infectious diseases specialist in Atlanta.


The last time a conventional flu season started this early was the winter of 2003-04, which proved to be one of the most lethal seasons in the past 35 years, with more than 48,000 deaths. The dominant type of flu back then was the same one seen this year.


One key difference between then and now: In 2003-04, the vaccine was poorly matched to the predominant flu strain. Also, there's more vaccine now, and vaccination rates have risen for the general public and for key groups such as pregnant women and health care workers.


An estimated 112 million Americans have been vaccinated so far, the CDC said. Flu vaccinations are recommended for everyone 6 months or older.


On average, about 24,000 Americans die each flu season, according to the CDC.


Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.


A strain of swine flu that hit in 2009 caused a wave of cases in the spring and then again in the early fall. But that was considered a unique type of flu, distinct from the conventional strains that circulate every year.


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Online:


CDC: http://www.cdc.gov/flu/weekly


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Wall Street dips as investors seek cliff progress

NEW YORK (Reuters) - Stocks finished slightly lower in a quiet session on Tuesday as the back-and-forth wrangling over the "fiscal cliff" gave investors little reason to act.


Trading volume was light as legislators continue to negotiate a deal to avoid a $600 billion package of tax hikes and federal spending cuts that would begin January 1 and could push the economy into recession.


Just 5.86 billion shares changed hands on the New York Stock Exchange, the Nasdaq and the NYSE MKT, below the year's daily average of 6.48 billion shares.


A key measure of investor anxiety has remained muted. The CBOE Volatility Index or VIX <.vix>, a gauge of market anxiety, was at 17.13, up 2.9 percent. It has not traded above 20 since July.


Optimism for progress was dented after remarks by President Barack Obama, who rejected a Republican proposal to resolve the crisis as "out of balance" and said any deal must include a rise in income tax rates on the wealthiest Americans.


"People don't know if what's going on is political posturing or real negotiations that represent progress," said Bernard Baumohl, managing director and chief global economist at the Economic Outlook Group in Princeton, New Jersey.


Expectations of higher taxes on dividends beginning in 2013 have pushed many companies to pay special dividends this year or advance their next payback to investors. Coach became the latest to move up the date of its next dividend payment, and the news lifted shares of the upscale leather-goods maker earlier in the session. By the close, though, Coach was down 1.2 percent at $57.52.


One of the S&P 500's top sectors for the day was health care <.gspa>, considered a defensive group.


The Dow Jones industrial average <.dji> fell 13.82 points, or 0.11 percent, to 12,951.78 at the close. The Standard & Poor's 500 Index <.spx> dipped 2.41 points, or 0.17 percent, to 1,407.05. The Nasdaq Composite Index <.ixic> shed 5.51 points, or 0.18 percent, to close at 2,996.69.


The market has been sensitive to rhetoric from Washington, as a failure to reach an agreement could send the U.S. economy back into recession. Still, many expect a resolution to be found, which could extend the S&P 500's rally of 12 percent so far this year.


Differences within the Republican Party came to the fore on Tuesday as one senator opposed to raising taxes lashed out at Republican House Speaker John Boehner for proposing to increase revenue by closing some tax loopholes.


Congressional Republicans recently proposed steep spending cuts to bring down the budget deficit, but gave no ground on Obama's call to raise tax rates on the rich. The proposal was quickly dismissed by the White House.


"We're on hold trying to figure it out, but investors are stressed since they have to make decisions soon about how to proceed with their investments if taxes are indeed going up. We could see a real pick-up in volume over the next week or so," Baumohl said.


Netflix Inc was the S&P 500's top percentage gainer, advancing 14 percent to $86.65 after Walt Disney Co agreed to give the company exclusive TV distribution rights to its movies, starting in 2016.


Darden Restaurants Inc shares plunged 9.6 percent to $47.40 as the S&P 500's worst performer after the company warned that its latest quarter would miss expectations after unsuccessful promotions led to a decline in sales at its Olive Garden, Red Lobster and LongHorn Steakhouse chains.


In contrast, Big Lots Inc surged 11.5 percent to $31.27 after the close-out retailer posted a smaller-than-expected loss and boosted its full-year adjusted earnings forecast.


MetroPCS Communications shares tumbled 7.5 percent to $9.96 after Sprint Nextel appeared unlikely to make a counter-offer for the wireless service provider.


Almost half of the stocks traded on the New York Stock Exchange closed lower, while 50 percent of Nasdaq-listed shares closed in negative territory.


After the closing bell, Pandora Media Inc


shares plunged 23 percent after the company reported its third-quarter results.

(Editing by Jan Paschal)

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5 Nations Summon Israeli Envoys to Protest Settlement Plans





JERUSALEM — Britain, France, Spain, Sweden and Denmark summoned the Israeli ambassadors to their countries on Monday to protest Israel’s plans for increased settlement construction, an unusually sharp diplomatic step that reflected the growing frustration abroad with Israel’s policies on the Palestinian issue.




After the General Assembly voted overwhelmingly last week to upgrade the status of the Palestinians at the United Nations, Israel announced plans for 3,000 more housing units in contested areas east of Jerusalem and around the West Bank.


Israel raised particular alarms with its decision to continue planning and zoning work for the development of a contentious area known as E1, a project vehemently opposed internationally because it would partially separate the northern and southern West Bank, harming the prospects of a contiguous Palestinian state.


The move raised questions in Israel about whether the country’s leaders were putting domestic political interests ahead of its foreign relations, with Israeli elections scheduled for late January.


“Bibi had to do something” in response to the United Nations vote, said Prof. Shmuel Sandler of the Begin-Sadat Center for Strategic Studies at Bar-Ilan Universiy, referring to the prime minister of Israel, Benjamin Netanyahu, by his nickname, “first because he is Bibi and second because of the elections.”


Mr. Sandler said that Mr. Netanyahu, a conservative, was making the mistake of competing against those further to his right, adding, “But I don’t think he expected such a reaction” internationally.


Yet Israel remained defiant. The prime minister’s office issued a statement on Monday, saying, “Israel will continue to stand for its essential interests, even in the face of international pressure, and there will be no change in the decision it has taken.”


A press officer for United Nations Secretary General Ban Ki-moon said in a statement on Sunday that construction in E1 “would represent an almost fatal blow to remaining chances of securing a two-state solution.”


European countries long opposed to Israeli settlement construction went beyond their usual statements of condemnation.


The countries that called in the Israeli ambassadors “expressed their strong protests about the announced settlement plans,” said Yigal Palmor, the spokesman for the Israeli Foreign Ministry.


Mr. Palmor said that the Israeli ambassadors told their hosts that Israel has been warning for months that the Palestinian bid at the United Nations would not go unanswered and would have implications.


Israel has described the bid as a unilateral Palestinian step that violates previous signed agreements. The Palestinians have long refused to negotiate with Israel without a halt in settlement construction.


France, Spain, Sweden and Denmark voted for the Palestinian upgrade, while Britain abstained. Although Israel had expected the resolution to pass, officials here expressed disappointment over the lack of support from several friendly European nations. Israel was particularly surprised by Germany’s decision to abstain in the vote, having expected Germany to go with Israel.


Prime Minister Benjamin Netanyahu is scheduled to visit Germany this week. Despite the so-called special relationship between Israel and Germany, Chancellor Angela Merkel has not minced words about her opposition to Israeli settlement construction in the past.


Philippe Lalliot, a spokesman for the French Foreign Ministry, said in a statement on Monday that “Settlement activity is illegal under international law, hurts the confidence necessary for a return to dialogue and constitutes an obstacle to a just peace founded on the two-state solution.”


The British Foreign Office said it deplored the Israeli settlement plans and that it had called on the Israeli government to reverse the decision.


But Israeli officials denied that the government’s policies were isolating Israel.


“It is well known that Europe and Israel have a different approach on settlements,” said one Israeli official, speaking on condition of anonymity. “There is nothing new here. If European countries would have behaved differently in their vote at the United Nations last week,” he continued, “we may have reacted differently.”


Analysts here said that after showing strong support for Israel during its military campaign last month against Hamas, the Islamic militant group that controls Gaza, European countries had felt the need to bolster the more moderate Palestinian wing led by President Mahmoud Abbas in its United Nations bid.


At the weekly cabinet meeting on Sunday, Mr. Netanyahu said, “Today we are building and we will continue to build in Jerusalem and in all areas that are on the map of the strategic interests of the State of Israel.”


But beyond the tit-for-tat measures set off by the United Nations vote, analysts pointed to a trend of deteriorating relations between Israel and Europe in particular.


“That is because the top-level people making decisions here in recent years are completely insular and out of touch with the rest of the world, especially regarding the Palestinians and the settlements,” said Mark Heller, a foreign-policy analyst at the Institute for National Security Studies at Tel Aviv University. “Self-righteousness may be good for domestic politics,” he said, but it is not a policy.”


At the United Nations General Assembly on Thursday, 138 nations voted in favor of upgrading the status of the Palestinians and 41 abstained. The nine that voted against it were Israel, the United States, Canada, the Czech Republic, the Marshall Islands, Micronesia, Nauru, Panama and Palau.


Scott Sayare contributed reporting from Paris.



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Kristin Chenoweth Dating Jake Pavelka















12/03/2012 at 04:40 PM EST







Kristin Chenoweth and Jake Pavelka


FilmMagic (2)


Everything appears to be rosy between Kristin Chenoweth and her new beau Jake Pavelka.

"We have been spending a little time together," Chenoweth tells PEOPLE of her dates with the former Bachelor star.

The actress, 44, met her new man, 34, at an event in October and it was not long before the couple was spotted dining together in West Hollywood as well as more recently at a cafe near Pavelka's home in Texas.

Squeezing dates into her busy schedule has proven difficult in the past, admits Chenoweth, who performed at an Audi-sponsored Trevor Project event Sunday, and is currently rehearsing to co-host the American Country Awards, airing Monday, Dec. 10 on Fox.

"A lot of people know that I got hurt in July," says Chenoweth of suffering a head injury while filming The Good Wife. "I am doing so much better but I think it slowed me down and I've realized life is short. I want to do things that make me happy."

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Fossil fuel subsidies in focus at climate talks

DOHA, Qatar (AP) — Hassan al-Kubaisi considers it a gift from above that drivers in oil- and gas-rich Qatar only have to pay $1 per gallon at the pump.

"Thank God that our country is an oil producer and the price of gasoline is one of the lowest," al-Kubaisi said, filling up his Toyota Land Cruiser at a gas station in Doha. "God has given us a blessing."

To those looking for a global response to climate change, it's more like a curse.

Qatar — the host of U.N. climate talks that entered their final week Monday — is among dozens of countries that keep gas prices artificially low through subsidies that exceeded $500 billion globally last year. Renewable energy worldwide received six times less support — an imbalance that is just starting to earn attention in the divisive negotiations on curbing the carbon emissions blamed for heating the planet.

"We need to stop funding the problem, and start funding the solution," said Steve Kretzmann, of Oil Change International, an advocacy group for clean energy.

His group presented research Monday showing that in addition to the fuel subsidies in developing countries, rich nations in 2011 gave more than $58 billion in tax breaks and other production subsidies to the fossil fuel industry. The U.S. figure was $13 billion.

The Paris-based Organization for Economic Cooperation and Development has calculated that removing fossil fuel subsidies could reduce carbon emissions by more than 10 percent by 2050.

Yet the argument is just recently gaining traction in climate negotiations, which in two decades have failed to halt the rising temperatures that are melting Arctic ice, raising sea levels and shifting weather patterns with impacts on droughts and floods.

In Doha, the talks have been slowed by wrangling over financial aid to help poor countries cope with global warming and how to divide carbon emissions rights until 2020 when a new planned climate treaty is supposed to enter force. Calls are now intensifying to include fossil fuel subsidies as a key part of the discussion.

"I think it is manifestly clear ... that this is a massive missing piece of the climate change jigsaw puzzle," said Tim Groser, New Zealand's minister for climate change.

He is spearheading an initiative backed by Scandinavian countries and some developing countries to put fuel subsidies on the agenda in various forums, citing the U.N. talks as a "natural home" for the debate.

The G-20 called for their elimination in 2009, and the issue also came up at the U.N. earth summit in Rio de Janeiro earlier this year. Frustrated that not much has happened since, European Union climate commissioner Connie Hedegaard said Monday she planned to raise the issue with environment ministers on the sidelines of the talks in Doha.

Many developing countries are positive toward phasing out fossil fuel subsidies, not just to protect the climate but to balance budgets. Subsidies introduced as a form of welfare benefit decades ago have become an increasing burden to many countries as oil prices soar.

"We are reviewing the subsidy periodically in the context of the total economy for Qatar," the tiny Persian gulf country's energy minister, Mohammed bin Saleh al-Sada, told reporters Monday.

Qatar's National Development Strategy 2011-2016 states it more bluntly, saying fuel subsides are "at odds with the aspirations" and sustainability objectives of the wealthy emirate.

The problem is that getting rid of them comes with a heavy political price.

When Jordan raised fuel prices last month, angry crowds poured into the streets, torching police cars, government offices and private banks in the most sustained protests to hit the country since the start of the Arab unrest. One person was killed and 75 others were injured in the violence.

Nigeria, Indonesia, India and Sudan have also seen violent protests this year as governments tried to bring fuel prices closer to market rates.

Iran has used a phased approach to lift fuel subsidies over the past several years, but its pump prices remain among the cheapest in the world.

"People perceive it as something that the government is taking away from them," said Kretzmann. "The trick is we need to do it in a way that doesn't harm the poor."

The International Energy Agency found in 2010 that fuel subsidies are not an effective measure against poverty because only 8 percent of such subsidies reached the bottom 20 percent of income earners.

The IEA, which only looked at consumption subsidies, this year said they "remain most prevalent in the Middle East and North Africa, where momentum toward their reform appears to have been lost."

In the U.S., environmental groups say fossil fuel subsidies include tax breaks, the foreign tax credit and the credit for production of nonconventional fuels.

Industry groups, like the Independent Petroleum Association of America, are against removing such support, saying that would harm smaller companies, rather than the big oil giants.

In Doha, Mohammed Adow, a climate activist with Christian Aid, called all fuel subsidies "reckless and dangerous," but described removing subsidies on the production side as "low-hanging fruit" for governments if they are serious about dealing with climate change.

"It's going to oil and coal companies that don't need it in the first place," he said.

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Associated Press writers Abdullah Rebhy in Doha, Qatar, and Brian Murphy in Dubai, United Arab Emirates, contributed to this report

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Karl Ritter can be reached at www.twitter.com/karl_ritter

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Wall Street sours on weak domestic factory data

NEW YORK (Reuters) - Stocks struggled to extend the previous week's gains, dropping on Monday as disappointing U.S. factory numbers dampened optimism about China's economic growth.


The declines broke a three-day streak of gains for the S&P 500, keeping it shy of its 50-day moving average of about 1,420, a level that the index has been below since October 22, and now serving as a key resistance point for investors.


Manufacturing activity in the United States surprisingly contracted in November, the Institute for Supply Management said, dropping to its lowest level in more than three years. Economic data has been mixed in recent months, fanning worries about the pace of growth at a time when investors are already concerned about the "fiscal cliff" issue in Washington.


The ISM number "was below expectations that were already conservative, and that puts an exclamation point on the concern many of us have about the cliff's impact on the economy," said Leo Grohowski, chief investment officer at BNY Mellon Wealth Management in New York.


Markets had opened higher as output by China's factories grew in November for the first time in more than a year, data showed. Investors look to strength from China, the world's second-largest economy, to offset weak growth in the United States and Europe.


Still, the fiscal cliff remains investors' primary focus, with political haggling continuing over how to deal with large automatic spending cuts and tax hikes scheduled to kick in next year. The worry is that the combination of reduced spending and higher taxes could tip the U.S. economy back into recession.


While off its highs for the year, the S&P 500 is still up 12.1 percent for 2012.


"This could be the last opportunity for investors to take profits" after an unexpectedly strong year, said Grohowski, who helps oversee about $170 billion in assets.


Materials were the weakest sector on Monday, led lower by Newmont Mining after the company said its CEO resigned. Newmont's stock fell 3 percent to $45.69. Dow component DuPont dropped 1.7 percent to $42.39. An S&P materials index <.gspm> lost 1.8 percent.


The Dow Jones industrial average <.dji> fell 59.98 points, or 0.46 percent, to 12,965.60 at the close. The Standard & Poor's 500 Index <.spx> declined 6.72 points, or 0.47 percent, to 1,409.46. The Nasdaq Composite Index <.ixic> dropped 8.04 points, or 0.27 percent, to end at 3,002.20.


U.S. Treasury Secretary Timothy Geithner pushed Republicans on Sunday to offer specific ideas to cut the deficit. He predicted that they would agree to raise tax rates on the rich to obtain a year-end deal to avoid the fiscal cliff.


Among other factors serving to offset the ISM report on U.S. factories were two developments in the euro zone: Spain formally requested the disbursement of more than $50 billion of European funds to recapitalize its crippled banking sector, while Greece said it would spend 10 billion euros ($13 billion) to buy back bonds in a bid to reduce its ballooning debt.


The PHLX Europe sector index <.xex> added 0.1 percent.


Dell shares gained 4.4 percent to $10.06. The stock was one of the biggest percentage gainers in both the S&P 500 and Nasdaq 100 <.ndx> after Goldman Sachs upgraded the stock to "buy" from "sell.


Advanced Micro Devices was the S&P's top gainer, rising 7.3 percent to $2.36. Options traders appeared to be betting on further gains ahead. Early options order flow was focused on upside April calls, including a sweep of 3,594 April $3.50 strike calls for 16 cents per contract when the market was 14 cents to 16 cents, said WhatsTrading.com options strategist Frederic Ruffy.


Retail stocks were among the weakest of the day, with J.C. Penney Co off 3.2 percent at $17.36 and Staples Inc off 2.3 percent at $11.43. Consumer discretionary names tend to underperform during periods of economic uncertainty as consumers focus on core purchases.


Volume was light, with about 5.58 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, well below last year's daily average of 7.84 billion.


Decliners outnumbered advancers on the NYSE by a ratio of 3 to 2, while on the Nasdaq, about 14 stocks fell for every 11 that rose.


(Additional reporting by Doris Frankel; Editing by Jan Paschal)


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Egyptian Court Postpones Ruling on Charter


Wissam Nassar


Egyptian police officers stood guard outside Egypt's Supreme Constitutional Court on Sunday, while supporters of President Mohamed Morsi protested near the entrance of the building.







CAIRO — Egypt’s highest court on Sunday postponed its much-awaited ruling on the legitimacy of the legislative assembly that drafted a new charter last week, accusing a crowd of Islamists of blocking judges from entering their building on what it called “a dark black day in the history of the Egyptian judiciary.”




Although hundreds of security officers were on hand to ensure that judges of the Supreme Constitutional Court could get into the court, and civilians came and went without any problems, the accusations intensified a standoff between the judges appointed under former President Hosni Mubarak and Egypt’s new Islamist leaders that has thrown the political transition into a new crisis 22 months after Mr. Mubarak’s ouster.


Upon approaching the court on Sunday morning, the judges said in a statement that they saw crowds “closing the entrances of the roads to the gates, climbing the fences, chanting slogans denouncing its judges and inciting the people against them.”


The judges were prevented from entering “because of the threat of harm and danger to their safety,” the statement said, calling it “an abhorrent scene of shame and disgrace.”


As a result, the judges announced that they were “suspending the court’s sessions” until they could resume their work without “psychological and physical pressures.”


Anticipation of the court’s decision on the new constitution had set off the latest political crisis. Fear that the court would dissolve the assembly and undo months of work led President Mohamed Morsi, of the Muslim Brotherhood’s political party, to announce 10 days ago that his edicts were not be subject to judicial review until the completion of the constitution.


Despite Mr. Morsi’s attempt, the same anticipation of dissolution drove the Islamist-dominated assembly to rush out a hurried constitution before the court could act and against the objections of Egypt’s secular parties and the Coptic Christian Church. Judges appointed by Mr. Mubarak have previously dissolved the elected Parliament and the first constitutional assembly.


The sudden effort by the president and his Islamist allies to push through a constitution over any objections from their secular factions or the courts has unified the opposition, prompted hundreds of thousands of protesters to take to the streets and set off a wave of attacks on a dozen offices of the Brotherhood’s Freedom and Justice Party. A judicial trade association has urged judges across the country to go on strike, and some of the highest courts have joined it.


Over the weekend, Mr. Morsi continued to push his plans for the new constitution, setting a national referendum on it for Dec. 15.


“I pray to God and hope that it will be a new day of democracy in Egypt,” he said in a nationally televised speech, calling for a “national dialogue.”


But his recent tone and actions reminded critics of the autocratic ways of his predecessor, and have aroused a new debate here about his commitment to democracy and pluralism at a time when he and his Islamist allies dominate political life.


Mr. Morsi’s advisers call the tactics a regrettable but necessary response to genuine threats to the political transition from what they call the deep state — the vestiges of the autocracy of former President Mubarak, especially in the news media and the judiciary.


But his critics say they hear a familiar paranoia in Mr. Morsi’s new tone that reminds them of talk of the “hidden hands” and foreign plots that Mr. Mubarak once used to justify his authoritarianism.


“I have sent warnings to many people who know who they are, who may be committing crimes against the homeland,” Mr. Morsi declared in an interview with state television on Thursday night, referring repeatedly to secret information about a “conspiracy” and “real and imminent threats” that he would not disclose. “If anybody tries to derail the transition, I will not allow them.”


Mayy El Sheikh contributed reporting.



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Lady Gaga Goes on Safari in South Africa















12/02/2012 at 04:15 PM EST



As if Lady Gaga could get any more wild, she recently embarked on a safari while touring in South Africa.

Gaga – who surprised fans in Rio de Janeiro by playing soccer with neighborhood children earlier this month – took to Twitter to share her excitement over a pride of lions.

"SAFARI PICTURE: in this photo I'm about 10 feet from 13 lions, 2 cubs. I spent about 30 minutes w them and took a nap!" she Tweeted on Saturday, revealing a hat modified to fit her high ponytail.

"& yes I cut a hole in my bush hat so my pony could stick out," she later told her followers. "#SafariBarbie #Glambi my scarf was a gift from the Princess of Monaco, thanku!"

The singer, 26, is scheduled to perform at the Cape Town Stadium on Monday and raved about her experience in South Africa.

"Johannesburg was so wonderful, I can't really put it into words. Im so happy, I haven't slept yet. Laying in bed dreaming of the next tour," she Tweeted on Sunday.

Gaga is touring through March 2013.

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Asperger's dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term "Asperger's disorder" is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But "dyslexia" and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook "represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders," Dr. David Fassler, the group's treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders."

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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

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Cliff fight may knock out December rally

NEW YORK (Reuters) - In normal times, next week's slew of U.S. economic data could be a springboard for a December rally in the stock market.


December is historically a strong month for markets. The S&P 500 has risen 16 times in the past 20 years during the month.


But the market hasn't been operating under normal circumstances since November 7 when a day after the U.S. election, investors' focus shifted squarely to the looming "fiscal cliff."


Investors are increasingly nervous about the ability of lawmakers to undo the $600 billion in tax increases and spending cuts that are set to begin in January; those changes, if they go into effect, could send the U.S. economy into a recession.


A string of economic indicators next week, which includes a key reading of the manufacturing sector on Monday, culminates with the November jobs report on Friday.


But the impact of those economic reports could be muted. Distortions in the data caused by Superstorm Sandy are discounted.


The spotlight will be more firmly on signs from Washington that politicians can settle their differences on how to avoid the fiscal cliff.


"We have a week with a lot of economic data, and obviously most of the economic data is going to reflect the effects of Sandy, and that might be a little bit negative for the market next week, but most of that is already expected - the main focus remains the fiscal cliff," said Peter Cardillo, chief market economist at Rockwell Global Capital in New York.


Concerns about the cliff sent the S&P 500 <.spx> into a two-week decline after the elections, dropping as much as 5.3 percent, only to rally back nearly 4 percent as the initial tone of talks offered hope that a compromise could be reached and investors snapped up stocks that were viewed as undervalued.


On Wednesday, the S&P 500 gained more than 20 points from its intraday low after House Speaker John Boehner said he was optimistic that a budget deal to avoid big spending cuts and tax hikes could be worked out. The next day, more pessimistic comments from Boehner, an Ohio Republican, briefly wiped out the day's gains in stocks.


On Friday, the sharp divide between the Democrats and the Republicans on taxes and spending was evident in comments from President Barack Obama, who favors raising taxes on the wealthy, and Boehner, the top Republican in Congress, who said Obama's plan was the wrong approach and declared that the talks had reached a stalemate.


"It's unusual to end up with one variable in this industry, it's unusual to have a single bullet that is the causal factor effect, and you are sitting here for the next maybe two weeks or more, on that kind of condition," said Sandy Lincoln, chief market strategist at BMO Asset Management U.S. in Chicago.


"And that is what is grabbing the markets."


BE CONTRARY AND MAKE MERRY


But investor attitudes and seasonality could also help spur a rally for the final month of the year.


The most recent survey by the American Association of Individual Investors reflected investor caution about the cliff. Although bullish sentiment rose above 40 percent for the first time since August 23, bearish sentiment remained above its historical average of 30.5 percent for the 14th straight week.


December is a critical month for retailers such as Target Corp and Macy's Inc . They saw monthly retail sales results dented by Sandy, although the start of the holiday shopping season fared better.


With consumer spending making up roughly 70 percent of the U.S. economy, a solid showing for retailers during the holiday season could help fuel any gains.


Ryan Detrick, senior technical strategist at Schaeffer's Investment Research in Cincinnati, believes the recent drop after the election could be a market bottom, with sentiment leaving stocks poised for a December rally.


"The concerns on the fiscal cliff - as valid as they might be - could be overblown. When you look at a lot of the overriding sentiment, that has gotten extremely negative," said Detrick.


"From that contrarian point of view with the historically bullish time frame of December, we once again could be setting ourselves up for a pretty nice end-of-year rally, based on lowered expectations."


SOME FEEL THE BIG CHILL


Others view the fiscal cliff as such an unusual event that any historical comparisons should be thrown out the window, with a rally unlikely because of a lack of confidence in Washington to reach an agreement and the economic hit caused by Sandy.


"History doesn't matter. You're dealing with an extraordinary set of circumstances that could very well end up in the U.S. economy going into a recession," said Phil Orlando, chief equity market strategist at Federated Investors in New York.


"And the likelihood of that is exclusively in the hands of our elected officials in Washington. They could absolutely drag us into a completely voluntary recession."


(Wall St Week Ahead runs every Friday. Questions or comments on this column can be emailed to: charles.mikolajczak(at)thomsonreuters.com )


(Reporting by Chuck Mikolajczak; Editing by Jan Paschal)


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