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.

___

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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Islamists rally behind Mursi as Egypt's rifts widen

CAIRO (Reuters) - Egypt's President Mohamed Mursi called a December 15 referendum on a draft constitution on Saturday as at least 200,000 Islamists demonstrated in Cairo to back him after opposition fury over his newly expanded powers.


Speaking after receiving the final draft of the constitution from the Islamist-dominated assembly, Mursi urged a national dialogue as the country nears the end of the transition from Hosni Mubarak's rule.


"I renew my call for opening a serious national dialogue over the concerns of the nation, with all honesty and impartiality, to end the transitional period as soon as possible, in a way that guarantees the newly-born democracy," Mursi said.


Mursi plunged Egypt into a new crisis last week when he gave himself extensive powers and put his decisions beyond judicial challenge, saying this was a temporary measure to speed Egypt's democratic transition until the new constitution is in place.


His assertion of authority in a decree issued on November 22, a day after he won world praise for brokering a Gaza truce between Israel and the Palestinian Islamist Hamas movement, dismayed his opponents and widened divisions among Egypt's 83 million people.


Two people have been killed and hundreds wounded in protests by disparate opposition forces drawn together and re-energized by a decree they see as a dictatorial power grab.


A demonstration in Cairo to back the president swelled through the afternoon, peaking in the early evening at least 200,000, said Reuters witnesses, basing their estimates on previous rallies in the capital. The authorities declined to give an estimate for the crowd size.


"The people want the implementation of God's law," chanted flag-waving demonstrators, many of them bussed in from the countryside, who choked streets leading to Cairo University, where Mursi's Muslim Brotherhood had called the protest.


Tens of thousands of Egyptians had protested against Mursi on Friday. "The people want to bring down the regime," they chanted in Cairo's Tahrir Square, echoing the trademark slogan of the revolts against Hosni Mubarak and Arab leaders elsewhere.


Rival demonstrators threw stones after dark in the northern city of Alexandria and a town in the Nile Delta. Similar clashes erupted again briefly in Alexandria on Saturday, state TV said.


"COMPLETE DEFEAT"


Mohamed Noshi, 23, a pharmacist from Mansoura, north of Cairo, said he had joined the rally in Cairo to support Mursi and his decree. "Those in Tahrir don't represent everyone. Most people support Mursi and aren't against the decree," he said.


Mohamed Ibrahim, a hardline Salafi Islamist scholar and a member of the constituent assembly, said secular-minded Egyptians had been in a losing battle from the start.


"They will be sure of complete popular defeat today in a mass Egyptian protest that says 'no to the conspiratorial minority, no to destructive directions and yes for stability and sharia (Islamic law)'," he told Reuters.


Mursi has alienated many of the judges who must supervise the referendum. His decree nullified the ability of the courts, many of them staffed by Mubarak-era appointees, to strike down his measures, although says he respects judicial independence.


A source at the presidency said Mursi might rely on the minority of judges who support him to supervise the vote.


"Oh Mursi, go ahead and cleanse the judiciary, we are behind you," shouted Islamist demonstrators in Cairo.


Mursi, once a senior Muslim Brotherhood figure, has put his liberal, leftist, Christian and other opponents in a bind. If they boycott the referendum, the constitution would pass anyway.


If they secured a "no" vote to defeat the draft, the president could retain the powers he has unilaterally assumed.


And Egypt's quest to replace the basic law that underpinned Mubarak's 30 years of army-backed one-man rule would also return to square one, creating more uncertainty in a nation in dire economic straits and seeking a $4.8 billion loan from the IMF.


"NO PLACE FOR DICTATORSHIP"


Mursi's well-organized Muslim Brotherhood and its ultra-orthodox Salafi allies, however, are convinced they can win the referendum by mobilizing their own supporters and the millions of Egyptians weary of political turmoil and disruption.


"There is no place for dictatorship," the president said on Thursday while the constituent assembly was still voting on a draft constitution which Islamists say enshrines Egypt's new freedoms.


Human rights groups have voiced misgivings, especially about articles related to women's rights and freedom of speech.


The text limits the president to two four-year terms, requires him to secure parliamentary approval for his choice of prime minister, and introduces a degree of civilian oversight over the military - though not enough for critics.


The draft constitution also contains vague, Islamist-flavored language that its opponents say could be used to whittle away human rights and stifle criticism.


For example, it forbids blasphemy and "insults to any person", does not explicitly uphold women's rights and demands respect for "religion, traditions and family values".


The draft injects new Islamic references into Egypt's system of government but retains the previous constitution's reference to "the principles of sharia" as the main source of legislation.


"We fundamentally reject the referendum and constituent assembly because the assembly does not represent all sections of society," said Sayed el-Erian, 43, a protester in Tahrir and member of a party set up by opposition figure Mohamed ElBaradei.


Several independent newspapers said they would not publish on Tuesday in protest. One of the papers also said three private satellite channels would halt broadcasts on Wednesday.


Egypt cannot hold a new parliamentary election until a new constitution is passed. The country has been without an elected legislature since the Supreme Constitutional Court ordered the dissolution of the Islamist-dominated lower house in June.


The court is due to meet on Sunday to discuss the legality of parliament's upper house.


"We want stability. Every time, the constitutional court tears down institutions we elect," said Yasser Taha, a 30-year-old demonstrator at the Islamist rally in Cairo.


(Additional reporting by Marwa Awad, Yasmine Saleh and Tom Perry; Editing by Myra MacDonald and Jason Webb)


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What's the Latest Fashion Trend the Duchess Is Starting?







Style News Now





11/29/2012 at 06:15 PM ET











Katy Perry, Kate Middleton, Emily BluntGetty; Startraks (2)


After a quiet Thanksgiving holiday, Hollywood stars were out en force this week, dazzling (and sometimes disappointing) in a whole host of haute looks. And just in time for holiday party dress season, we saw some emerging trends you may want to try. Read on for more …



Up: Sleeves with personality: Katy Perry and Naomi Watts proved that dresses with sleeves don’t have to be snoozey — in fact, they can make a real statement on an otherwise plain dress. Perry added a floor-length cape to her midnight-blue Naeem Khan design, while Watts went for a winged look in a black below-the-knee number.




Up: Ladies in collars: So long are the days of navel-baring necklines — at least for the cooler months — since stars like the Duchess of Cambridge, Rihanna, Rose Byrne and Lucy Hale are taking a cue from the guys and donning shirts and dresses with buttoned-up collars. And because the trend is having such a major moment, we have a feeling it will last well into awards season, even at the most formal of events like the Oscars.



Down: White dresses with cutouts: Winter white gowns and cutouts are both huge trends this season, but when combined the look feels rather summery. Need proof? Just check out Emily Blunt in her Calvin Klein Collection dress. Even though she looks pretty, the whole ensemble feels better suited for August — not November.


Tell us: Which trend are you most excited to try? Vote below!






Want more Trend Report? Click to hear what we think about peplum, turtlenecks and yellow dresses.


–Jennifer Cress


GET ALL THE LATEST RED CARPET NEWS AND PHOTOS HERE!




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Egyptians protest after draft constitution raced through

CAIRO (Reuters) - Tens of thousands of Egyptians protested against President Mohamed Mursi on Friday after an Islamist-led assembly raced through approval of a new constitution in a bid to end a crisis over the Islamist leader's newly expanded powers.


"The people want to bring down the regime," they chanted in Tahrir Square, echoing the chants that rang out in the same place less than two years ago and brought down Hosni Mubarak.


Mursi said a decree halting court challenges to his decisions, which sparked eight days of protests and violence by Egyptians calling him a new dictator, was "for an exceptional stage" and aimed to speed up the democratic transition.


"It will end as soon as the people vote on a constitution," he told state television while the constituent assembly was still voting on a draft, which the Islamists say reflects Egypt's new freedoms. "There is no place for dictatorship."


But the opposition cried foul. Liberals, leftists, Christians, more moderate Muslims and others had withdrawn from the assembly, saying their voices were not being heard.


Even in the mosque where Mursi said Friday prayers some opponents chanted "Mursi: void" before sympathizers surrounded him shouting in support, journalists and a security source said.


Tens of thousands gathered across the country, filling Tahrir Square and hitting the streets in Alexandria and other cities, responding to opposition calls for a big turnout. Rival demonstrators clashed after dark in Alexandria and the Nile Delta town of Al-Mahala Al-Kobra, some hurling rocks in anger.


An opposition leaflet distributed on Tahrir urged protesters in Cairo to stay overnight before Saturday's rallies by Islamists; the Muslim Brotherhood and its allies said they would avoid the square during their demonstrations backing Mursi.


The disparate opposition, which has struggled to compete with well-organized Islamists, has been drawn together and reinvigorated by the crisis. Tens of thousands had also protested on Tuesday, showing the breadth of public anger.


POTENT MACHINE


But Islamists have a potent political machine and the United States has looked on warily at the rising power of a group it once kept at arms length now ruling a nation that has a peace treaty with Israel and is at the heart of the Arab Spring.


Protesters said they would push for a 'no' vote in a constitutional referendum, which could happen as early as mid-December. If the new basic law were approved, it would immediately cancel the president's decree.


"We fundamentally reject the referendum and constituent assembly because the assembly does not represent all sections of society," said Sayed el-Erian, 43, a protester in Tahrir and member of a party set up by opposition figure Mohamed ElBaradei.


ElBaradei said in a statement the constitution had "lost legitimacy" and called for ending the polarization of Egypt.


The plebiscite on the constitution is a gamble based on the Islamists' belief they can mobilize voters again after winning every election held since Mubarak was toppled in February 2011.


Despite the big numbers opposed to him, Mursi can count on backing from the disciplined Brotherhood and Islamist allies, as well as many Egyptians who are simply exhausted by the turmoil.


"He just wants us to move on and not waste time in conflicts," said 33-year-old Cairo shopkeeper Abdel Nasser Marie. "Give the man a chance and Egypt a break."


But Mursi needs the cooperation of judges to oversee the vote, and many have been angered by a decree from Mursi they said undermined the judiciary. Some judges are on strike.


The assembly concluded the vote after a 19-hour session, faster than many expected, approving all 234 articles of the draft, covering presidential powers, the status of Islam, the military's role and human rights.


It introduces a presidential term limit of eight years - Mubarak served for 30. It also bring in a degree of civilian oversight over the military - though not enough for critics.


An Egyptian official said Mursi was expected to approve the document on Saturday and then has 15 days to hold a referendum.


"This is a revolutionary constitution," said Hossam el-Gheriyani, head of the assembly, urging members to campaign for the new constitution across Egypt, after the all-night session.


DEEPENING DIVISIONS


Critics argue it is an attempt to rush through a draft they say has been hijacked by the Muslim Brotherhood, which backed Mursi for president in a June election, and its Islamist allies.


Two people have been killed and hundreds injured in protests since the decree was announced on November 22, deepening the divide between the newly empowered Islamists and their critics.


Seeking to placate opponents, Mursi welcomed criticism but said there was no place for violence. "I am very happy that Egypt has real political opposition," he told state television.


He said Egypt needed to attract investors and tourists. The crisis threatens to derail a fragile economic recovery after two years of turmoil. Egypt is waiting for the International Monetary Fund to finalize a $4.8 billion loan to help it out.


An alliance of opposition groups pledged to keep up protests and said broader civil disobedience was possible to fight what it described as an attempt to "kidnap Egypt from its people".


Several independent newspapers said they would not publish on Tuesday in protest. One of the papers also said three private satellite channels would halt broadcasts on Wednesday.


The draft injects new Islamic references into Egypt's system of government but keeps in place an article defining "the principles of sharia" as the main source of legislation - the same phrase found in the previous constitution.


The president can declare war with parliament's approval, but only after consulting a national defense council with a heavy military and security membership. That was not in the old constitution, used when Egypt was ruled by ex-military men.


Critics highlighted other flaws, such as articles pertaining to the rights of women and freedom of speech.


A new parliamentary election cannot be held until a new constitution is passed. Egypt has been without an elected legislature since a court ordered the dissolution of the Islamist-dominated lower house in June.


(Additional reporting by Yasmine Saleh and Marwa Awad; Writing by Edmund Blair; Editing by Philippa Fletcher and Alastair Macdonald)


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Study: DVRs now in half of US pay-TV homes












NEW YORK (AP) — A new survey finds that digital video recorders are now in more than half of all U.S. homes that subscribe to cable or satellite TV services.


Leichtman Research Group‘s survey of 1,300 households found that 52 percent of the ones that have pay-TV service also have a DVR. That translates to about 45 percent of all households and is up from 13.5 percent of all households surveyed five years ago by another firm, Nielsen.












The first DVRs came out in 1999, from TiVo Inc. and ReplayTV. Later, they were built into cable set-top boxes. The latest trend is “whole-home” DVRs that can distribute recorded shows to several sets.


Even with the spread of DVRs, live TV rules. Nielsen found last year that DVRs accounted for 8 percent of TV watching.


Gadgets News Headlines – Yahoo! News


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All the Details on Katie Holmes's Broadway Premiere Look







Style News Now





11/30/2012 at 11:00 AM ET











Katie Holmes
Andrew H. Walker/Getty


Her performance received good reviews, but we’re not so sure people will be raving about the outfit Katie Holmes selected for the Dead Accounts premiere party.


For the Broadway play’s debut in N.Y.C. on Thursday evening, the star chose a busy feminine floral-print dress with black-and-white embellishment at the neckline, a black crochet panel at the waist and flared sleeves, plus a lemon clutch and Gio Diev strappy pumps.


We can’t say we strongly dislike any one part of the outfit (love the print, love the sexy touch at the waist, love the clutch, we could go on…), but all together, there’s just a lot going on with this ensemble … much like the plot of the play.


One aspect of her look we can’t critique: her Duchess of Cambridge-esque mane, a surprising — and welcome — departure from the way Holmes normally styles her hair (that would be stick-straight).


But we want to know what you think: Do you like Holmes’s outfit? What about her hair?


–Jennifer Cress


PHOTOS: SEE MORE RED CARPET STYLE IN ‘LAST NIGHT’S LOOK’




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Kenya village pairs AIDS orphans with grandparents

NYUMBANI, Kenya (AP) — There are no middle-aged people in Nyumbani. They all died years ago, before this village of hope in Kenya began. Only the young and old live here.

Nyumbani was born of the AIDS crisis. The 938 children here all saw their parents die. The 97 grandparents — eight grandfathers among them — saw their middle-aged children die. But put together, the bookend generations take care of one another.

Saturday is World AIDS Day, but the executive director of the aid group Nyumbani, which oversees the village of the same name, hates the name which is given to the day because for her the word AIDS is so freighted with doom and death. These days, it doesn't necessarily mean a death sentence. Millions live with the virus with the help of anti-retroviral drugs, or ARVs. And the village she runs is an example of that.

"AIDS is not a word that we should be using. At the beginning when we came up against HIV, it was a terminal disease and people were presenting at the last phase, which we call AIDS," said Sister Mary Owens. "There is no known limit to the lifespan now so that word AIDS should not be used. So I hate World AIDS Day, follow? Because we have moved beyond talking about AIDS, the terminal stage. None of our children are in the terminal stage."

In the village, each grandparent is charged with caring for about a dozen "grandchildren," one or two of whom will be biological family. That responsibility has been a life-changer for Janet Kitheka, who lost one daughter to AIDS in 2003. Another daughter died from cancer in 2004. A son died in a tree-cutting accident in 2006 and the 63-year-old lost two grandchildren in 2007, including one from AIDS.

"When I came here I was released from the grief because I am always busy instead of thinking about the dead," said Kitheka. "Now I am thinking about building a new house with 12 children. They are orphans. I said to myself, 'Think about the living ones now.' I'm very happy because of the children."

As she walks around Nyumbani, which is three hours' drive east of Nairobi, 73-year-old Sister Mary is greeted like a rock star by little girls in matching colorful school uniforms. Children run and play, and sleep in bunk beds inside mud-brick homes. High schoolers study carpentry or tailoring. But before 2006, this village did not exist, not until a Catholic charity petitioned the Kenyan government for land on which to house orphans.

Everyone here has been touched by HIV or AIDS. But only 80 children have HIV and thanks to anti-retroviral drugs, none of them has AIDS.

"They can dream their dreams and live a long life," Owens said.

Nyumbani relies heavily on U.S. funds but it is aiming to be self-sustaining.

The kids' bunk beds are made in the technical school's shop. A small aquaponics project is trying to grow edible fish. The mud bricks are made on site. Each grandparent has a plot of land for farming.

The biggest chunk of aid comes from the United States President's Emergency Plan for AIDS Relief (PEPFAR), which has given the village $2.5 million since 2006. A British couple gives $50,000 a year. A tree-growing project in the village begun by an American, John Noel, now stands six years from its first harvest. Some 120,000 trees have already been planted and thousands more were being planted last week.

"My wife and I got married as teenagers and started out being very poor. Lived in a trailer. And we found out what it was like to be in a situation where you can't support yourself," he said. "As an entrepreneur I looked to my enterprise skills to see what we could do to sustain the village forever, because we are in our 60s and we wanted to make sure that the thousand babies and children, all the little ones, were taken care of."

He hopes that after a decade the timber profits from the trees will make the village totally self-sustaining.

But while the future is looking brighter, the losses the orphans' suffered can resurface, particularly when class lessons are about family or medicine, said Winnie Joseph, the deputy headmaster at the village's elementary school. Kitheka says she tries to teach the kids how to love one another and how to cook and clean. But older kids sometimes will threaten to hit her after accusing her of favoring her biological grandchildren, she said.

For the most part, though, the children in Nyumbani appear to know how lucky they are, having landed in a village where they are cared for. An estimated 23.5 million people in sub-Saharan Africa have HIV as of 2011, representing 69 percent of the global HIV population, according to UNAIDS. Eastern and southern Africa are the hardest-hit regions. Millions of people — many of them parents — have died.

Kitheka noted that children just outside the village frequently go to bed hungry. And ARVs are harder to come by outside the village. The World Health Organization says about 61 percent of Kenyans with HIV are covered by ARVs across the country.

Paul Lgina, 14, contrasted the difference between life in Nyumbani, which in Swahili means simply "home," and his earlier life.

"In the village I get support. At my mother's home I did not have enough food, and I had to go to the river to fetch water," said Lina, who, like all the children in the village, has neither a mother or a father.

When Sister Mary first began caring for AIDS orphans in the early 1990s, she said her group was often told not to bother.

"At the beginning nobody knew what to do with them. In 1992 we were told these children are going to die anyway," she said. "But that wasn't our spirit. Today, kids we were told would die have graduated from high school."

___

On the Internet:

http://www.trees4children.org/

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Wall Street edges lower as "fiscal cliff" debate drags

NEW YORK (Reuters) - Stocks dipped on Friday as President Barack Obama and top Republicans remained at odds about how to avert a series of tax hikes and spending cuts next year that could push the economy into recession.


Trading has been choppy as investors react to a barrage of mixed statements from policymakers on the state of discussions about how to avoid going over the "fiscal cliff."


Obama accused a "handful of Republicans" in the U.S. House of Representatives of holding up legislation to extend tax cuts for middle-class Americans in order to try to preserve them for the wealthy.


Speaking shortly after the president, House Speaker John Boehner, the top Republican in Congress, said: "There is a stalemate; let's not kid ourselves."


The market, however, has remained resilient, with the benchmark S&P 500 set to finish the month almost flat as many investors are betting that a deal will be struck - if only at the zero hour.


"There is no sign of it from the rhetoric, but there are expectations it will happen," said Steve Goldman, principal at Goldman Management in Short Hills, New Jersey. "The rhetoric will get worse before it gets better."


Corporations still anticipate a harsher tax regime next year. Whole Foods Market Inc was the latest to announce a special cash dividend of $2.00 per share to skirt higher dividend tax rates in 2013. The stock was up 0.5 percent at $93.51.


The Dow Jones industrial average <.dji> dropped 14.56 points, or 0.11 percent, to 13,007.26. The Standard & Poor's 500 Index <.spx> fell 2.17 points, or 0.15 percent, to 1,413.78. The Nasdaq Composite Index <.ixic> lost 6.66 points, or 0.22 percent, to 3,005.37.


The S&P 500 was on track to end the month up about 0.1 pct, or nearly flat, after declining almost 2 percent in October. The index has recovered 4.5 percent since shedding 8 percent following the U.S. presidential election earlier in November.


"The correction from the S&P 500's September peak has allowed overbought momentum and optimistic sentiment conditions to recede, and we believe the index is closer to an intermediate-term buy signal than a sell signal," said Ari Wald, an analyst at PrinceRidge Group.


Yum Brands Inc shares slid 9.2 percent to $67.59. The company said late Thursday it expects a drop in fourth-quarter sales at established restaurants in China, where a cooling economy is making it difficult to exceed the 21 percent gain it enjoyed there a year earlier.


After a close relationship for several years, Facebook Inc and Zynga Inc revised terms of a partnership agreement, according to regulatory filings on Thursday. Under the new pact, Zynga, creator of the "Farmville" game, will have limited ability to promote its site on Facebook.


Zynga's stock dropped 6.5 percent to $2.45. Facebook's stock slipped 0.2 percent to $27.26.


The markets' reaction to data on Friday was muted.


Data from the Institute for Supply Management-Chicago showed that business activity in the U.S. Midwest expanded for the first time since August, buoyed by an improvement in the labor market.


But Commerce Department data showed U.S. consumer spending fell in October for the first time in five months as income growth stalled, suggesting slower economic growth in the fourth quarter.


Apple Inc's latest iPhone has received final clearance from Chinese regulators, paving the way for a December debut in a highly competitive market where the lack of a new model had severely eroded its share of product sales. Apple's stock fell 0.8 percent to $584.57.


Verisign Inc said the U.S. Department of Commerce had approved its agreement with ICANN to run the .com internet registry, but the company wouldn't be able to raise prices as before. The stock dropped 14 percent to $33.84.


(Editing by Bernadette Baum and Jan Paschal)


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Palestinians turn to U.N. for state recognition

UNITED NATIONS (Reuters) - The U.N. General Assembly is set to approve an implicit recognition of Palestinian statehood on Thursday despite threats by the United States and Israel to punish the Palestinian Authority by withholding funds for the West Bank government.


A resolution that would lift the Palestinian Authority's U.N. observer status from "entity" to "non-member state," like the Vatican, is expected to pass easily in the 193-nation General Assembly. At least 15 European states plan to vote for it.


Israel, the United States and a handful of other members are set to vote against what they see as a largely symbolic and counterproductive move by the Palestinians, which takes place on the 65th anniversary of the assembly's adoption of resolution 181 on the partition of Palestine into Jewish and Arab states.


Granting Palestinians the title of "non-member observer state" falls short of full U.N. membership - something the Palestinians failed to achieve last year. But it would allow them access to the International Criminal Court and other international bodies, should they choose to join them.


"The ICC issue is what the Israelis are really worried about," a U.N. official said on condition of anonymity. "They know this whole process isn't really symbolic except for that."


Palestinian President Mahmoud Abbas has been leading the campaign to win support for the resolution, which follows an eight-day conflict this month between Israel and Islamists in the Gaza Strip, who are pledged to Israel's destruction and oppose his efforts toward a negotiated peace.


The U.S. State Department made a last-ditch effort to get Abbas to reconsider, but the Palestinian Authority, which exercises limited self-rule in the Israeli-occupied West Bank, gave no sign that it was turning back.


Secretary of State Hillary Clinton repeated to reporters in Washington on Wednesday the U.S. view that the Palestinian move was misguided and efforts should focus instead on reviving the stalled Middle East peace process.


"The path to a two-state solution that fulfills the aspirations of the Palestinian people is through Jerusalem and Ramallah, not New York," she said. "The only way to get a lasting solution is to commence direct negotiations."


Acknowledging strong European support for the Palestinians, Clinton said on Thursday: "We and our European partners agree on the most fundamental issues and share a common objective - two states living side by side in peace and security."


Speaking at an annual U.N. event in support of the Palestinians, Palestinian Foreign Minister Riyad al-Maliki appealed to U.N. member states to support Thursday's U.N. resolution. He also repeated his support for peace with Israel.


"Despite diminishing hopes and the decline of the situation on the ground due to Israel violations, we remain committed to the two-state solution and our hand remains extended in peace," he said at U.N. headquarters in New York.


State Department spokeswoman Victoria Nuland reiterated U.S. warnings that the move could cause a reduction of U.S. economic support for the Palestinians. The Israelis have also warned they might take significant deductions out of monthly transfers of duties that Israel collects on the Palestinians' behalf.


PALESTINIANS RALLY IN WEST BANK, GAZA


Despite its fierce opposition, Israel seems concerned not to find itself diplomatically isolated. It has recently toned down threats of retaliation in the face of wide international support for the initiative, notably among its European allies.


"The decision at the United Nations will change nothing on the ground," Israeli Prime Minister Benjamin Netanyahu said in Jerusalem. "It will not advance the establishment of a Palestinian state. It will delay it further.


But U.N. diplomats say that Israel's reaction might not be so measured if the Palestinians seek ICC action against Israel on charges of war crimes, crimes against humanity or other crimes the court would have jurisdiction over.


Russian Deputy Foreign Minister Mikhail Bogdanov was quoted by the Interfax news agency as calling on Washington and Israel to avoid "any hasty and destructive decisions."


"Supporting the Palestinian authorities is not only in the interest of the Palestinian side, but also of Israel and the whole international community that is longing for a peaceful political settlement," he said.


The European Union, a key donor for the Palestinians, has made clear it will not curtail aid after Thursday's vote.


Flag-waving Palestinians thronged the squares of the West Bank and Gaza Strip before Thursday's vote. In a rare show of unity, Abbas's Islamist rivals Hamas, who have ruled Gaza since a brief civil war in 2007, let backers of the president's Fatah movement hold demonstrations there.


Peace talks have been stalled for two years, mainly over Israeli settlements in the West Bank, which have expanded despite being deemed illegal by most of the world. There are 4.3 million Palestinians in the West Bank and Gaza.


In the draft resolution, the Palestinians have pledged to relaunch the peace process immediately following the U.N. vote, expected sometime after 3 p.m. (2000 GMT) on Thursday.


With strong support from the developing world that makes up the majority of U.N. members, it is virtually assured of securing more than the requisite simple majority. Palestinian officials hope for more than 130 yes votes.


Abbas has focused on securing as many votes as possible from Europe, and his efforts appear to have paid off.


Austria, Denmark, Norway, Finland, France, Greece, Iceland, Ireland, Italy, Luxembourg, Malta, Portugal, Spain, Sweden and Switzerland all pledged to support the resolution. Britain said it was prepared to vote yes, but only if the Palestinians fulfilled certain conditions.


The fiercely pro-Israel Czech Republic was planning to vote against the move, dashing European hopes of avoiding any no votes that would create a three-way split on the continent into supporters, abstainers and opposers.


It was unclear whether some of the many undecided Europeans would join the Czechs. Germany, Hungary, the Netherlands, Estonia and Lithuania plan to abstain.


(Andrew Quinn in Washington, Noah Browning in Ramallah, Jeffrey Heller in Jerusalem, Michelle Nichols in New York, Robert Mueller in Prague, Gabriela Baczynska and Reuters bureaux in Europe and elsewhere; Editing by Cynthia Osterman)


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