Monday, 31 December 2012

State Department made "grievous mistake" over Benghazi: Senate report

The U.S. Consulate in Benghazi is seen in flames during a protest by an armed group said to have been protesting a film being produced in the United States September 11, 2012. REUTERS/Esam Al-Fetori

The U.S. Consulate in Benghazi is seen in flames during a protest by an armed group said to have been protesting a film being produced in the United States September 11, 2012.

Credit: Reuters/Esam Al-Fetori

By Tabassum Zakaria and Mark Hosenball

WASHINGTON | Mon Dec 31, 2012 1:24pm EST

WASHINGTON (Reuters) - The State Department made a "grievous mistake" in keeping the U.S. mission in Benghazi open despite inadequate security and increasingly alarming threat assessments in the weeks before a deadly attack by militants, a Senate committee said on Monday.

A report from the Senate Homeland Security Committee on the September 11 attacks on the U.S. mission and a nearby CIA annex, in which the U.S. ambassador to Libya and three other Americans died, faulted intelligence agencies for not focusing tightly enough on Libyan extremists.

It also faulted the State Department for waiting for specific warnings instead of improving security.

The committee's assessment, "Flashing Red: A Special Report On The Terrorist Attack At Benghazi," follows a scathing report by an independent State Department accountability review board that resulted in a top security official resigning and three others at the department being relieved of their duties.

Joseph Lieberman, an independent senator who chairs the committee, said that in thousands of documents it reviewed, there was no indication that Secretary of State Hillary Clinton had personally denied a request for extra funding or security for the Benghazi mission. He said key decisions were made by "midlevel managers" who have since been held accountable.

Republican Senator Susan Collins said it was likely that others needed to be held accountable, but that decision was best made by the Secretary of State, who has the best understanding "of how far up the chain of command the request for additional security went."

The attacks and the death of U.S. Ambassador Christopher Stevens put diplomatic security practices at posts in risky areas under scrutiny and raised questions about whether intelligence on militant activity in the region was adequate.

The Senate report said the lack of specific intelligence of an imminent threat in Benghazi "may reflect a failure" by intelligence agencies to focus closely enough on militant groups with weak or no operational ties to al Qaeda and its affiliates.

"With Osama bin Laden dead and core al Qaeda weakened, a new collection of violent Islamist extremist organizations and cells have emerged in the last two to three years," the report said. That trend has been seen in the "Arab Spring" countries undergoing political transition or military conflict, it said.

NEED FOR BETTER INTELLIGENCE

The report recommended that U.S. intelligence agencies "broaden and deepen their focus in Libya and beyond, on nascent violent Islamist extremist groups in the region that lack strong operational ties to core al Qaeda or its main affiliate groups."

Neither the Senate report nor the unclassified accountability review board report pinned blame for the Benghazi attack on a specific militant group. The FBI is investigating who was behind the assaults.

President Barack Obama, in an interview on NBC's "Meet the Press" on Sunday, said the United States had "very good leads" about who carried out the attacks. He did not provide details.

The Senate committee said the State Department should not have waited for specific warnings before acting on improving security in Benghazi.

It also said it was widely known that the post-revolution Libyan government was "incapable of performing its duty to protect U.S. diplomatic facilities and personnel," but the State Department failed to fill the security gap.

"Despite the inability of the Libyan government to fulfill its duties to secure the facility, the increasingly dangerous threat assessments, and a particularly vulnerable facility, the Department of State officials did not conclude the facility in Benghazi should be closed or temporarily shut down," the report said. "That was a grievous mistake."

The Senate panel reviewed changing comments made by the Obama administration after the attack, which led to a political firestorm in the run-up to the November presidential election and resulted in U.S. Ambassador to the United Nations Susan Rice withdrawing her name from consideration to replace Clinton, who is stepping down early next year.

Rice had said her initial comments that the attack grew out of a spontaneous protest over an anti-Islam film were based on talking points provided by intelligence agencies.

Lieberman said it was not the job of intelligence agencies to formulate unclassified talking points and they should decline such requests in the future.

The report said the original talking points included a line saying "we know" that individuals associated with al Qaeda or its affiliates participated in the attacks. But the final version had been changed to say: "There are indications that extremists participated," and the reference to al Qaeda and its affiliates was deleted.

The report said that while James Clapper, the director of national intelligence, had offered to provide the committee with a detailed chronology of how the talking points were written and evolved, this had still not been delivered to Capitol Hill because the administration had spent weeks "debating internally" whether or not it should turn over information considered "deliberative" to Congress.

(Editing by Warren Strobel and David Brunnstrom)


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Connecticut attorney general says Newtown legal claim misguided

By Edith Honan

Mon Dec 31, 2012 3:12pm EST

n">(Reuters) - A $100 million claim filed against the state of Connecticut in the wake of a school shooting that left 20 children and six adults dead two weeks ago is misguided, Connecticut's attorney general said in a statement on Monday.

Last week, a New Haven-based attorney filed an intention to sue the state on behalf of a 6-year-old survivor of the December 14 attack - the second deadliest school shooting in U.S. history.

Under Connecticut law, any claim against the state must be approved by the state claims commissioner before it can move forward. The state attorney general serves as the state's defense attorney.

"Our hearts go out to this family, and to all the children and families affected by the Newtown shootings," Attorney General George Jepsen said in a statement. "They deserve a thoughtful and deliberate examination of the causes of this tragedy and of the appropriate public policy responses."

A public policy response by the U.S. Congress and the Connecticut state legislature would be "more appropriate" than legal action, said a spokeswoman for Jepsen.

"Although the investigation is still under way, we are aware of no facts or legal theory under which the State of Connecticut should be liable for causing the harms inflicted at Sandy Hill Elementary School," the statement added.

Connecticut attorney Irv Pinsky said he filed a claim on Thursday with state Claims Commissioner J. Paul Vance Jr.

Vance said on Monday that he has not yet seen the claim and could not comment on a pending legal matter.

The unidentified client, referred to as Jill Doe, heard "cursing, screaming, and shooting" over the school intercom when the gunman, 20-year-old Adam Lanza, opened fire at Sandy Hill Elementary School, according to the claim.

Pinsky's claim said that the state Board of Education, state Department of Education and state education commissioner had failed to take appropriate steps to protect children from "foreseeable harm" and had failed to provide a "safe school setting."

"We all know it's going to happen again," Pinsky said last week. "Society has to take action."

Pinsky said he was approached by the child's parents within a week of the shooting. He did not immediately respond to a request for comment on Monday.

The shooting, in which Lanza took his own life, has prompted extensive debate about gun control and the suggestion by the National Rifle Association that schools be patrolled by armed guards. Police have said the gunman killed his mother, Nancy Lanza, at their home in Newtown before going to the school about 5 miles away.

Earlier on Monday, a spokesman for Adam Lanza's father, Peter Lanza, said the family had claimed the gunman's body from the state medical examiner's office. Plans for Lanza's burial were not disclosed.

(Additional reporting by Chris Francescani; Editing by Dan Burns and Leslie Gevirtz)


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Los Angeles man charged with setting homeless woman on fire

LOS ANGELES | Mon Dec 31, 2012 3:04pm EST

LOS ANGELES (Reuters) - A 24-year-old Los Angeles area man accused of setting a homeless woman on fire as she slept on a bus stop bench was charged on Monday with attempted murder and aggravated mayhem.

Prosecutors say Dennis Petillo doused the 67-year-old woman with a flammable liquid as she slept on a bench in the Los Angeles section of Van Nuys in the early morning hours of December 27 and then set her on fire.

The woman, who has not been identified by authorities, survived the attack but remains hospitalized in critical condition.

Petillo, who was scheduled to make an initial court appearance on Monday afternoon, faces a maximum sentence of life in prison if he is convicted at a trial.

Prosecutors said they would ask that he be held on $1.03 million bail.

(Reporting by Dan Whitcomb; Editing by Tim Dobbyn)


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Newtown gunman's body collected by father's family

By Peter Rudegeair

Mon Dec 31, 2012 1:18pm EST

n">(Reuters) - The body of gunman who killed 27 people and himself in Newtown, Connecticut, this month in the second-deadliest school shooting in U.S. history has been collected by his family from the state medical examiner's office, a spokesman for his father's family said on Monday.

A location and date for Adam Lanza's burial was not disclosed. His father, Peter Lanza of Stamford, Connecticut, claimed the body, said the spokesman, who spoke on condition of anonymity.

Connecticut's chief medical examiner released Lanza's body on December 27, a spokesman for the office said.

Police say Lanza, 20, shot and killed his mother, Nancy Lanza, in her home on December 14 before forcing his way into Sandy Hook Elementary School and killing 20 first-grade students, six faculty members and himself.

"Like so many of you, we are saddened, but struggling to make sense of what has transpired," Peter Lanza said in a statement the day after the shooting.

Peter Lanza and Nancy Lanza divorced in 2009, and Adam Lanza continued to live with his mother in Newtown about 5 miles from the Sandy Hook school.

Police have so far offered no motive behind the attack. Connecticut State Police spokesman Lt. Paul Vance has said it will likely be months before a final report on the incident is released.

The shooting ranks as the second deadliest at a U.S. school or college, exceeded only by the 2007 massacre at Virginia Tech University in Blacksburg, Virginia, which left 32 people dead.

The incident has renewed the debate about gun control in the United States. President Barack Obama on Sunday called the day of the Newtown shooting the worst day of his presidency and has pledged to bring the full weight of his office behind efforts to pass new gun control measures.

(This story corrects the headline and first two paragraphs to specify Adam Lanza's body was collected from the medical examiner but no burial or service has occurred)

(Editing by Dan Burns and David Gregorio)


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2012 most expensive year for motorists: AAA

Customers wait in line for gas at a Hess fuelling station in Brooklyn, New York, November 9, 2012. REUTERS/Brendan McDermid

Customers wait in line for gas at a Hess fuelling station in Brooklyn, New York, November 9, 2012.

Credit: Reuters/Brendan McDermid

NEW YORK | Mon Dec 31, 2012 12:19pm EST

NEW YORK (Reuters) - The average gasoline price in 2012 was a record-high $3.60 a gallon, topping the previous high of $3.51 in 2011, travel group AAA said on Monday.

AAA blamed refinery outages, major hurricanes and unrest in the Middle East for the rise.

Drivers in states like Hawaii, Alaska, California and New York paid the highest prices.

However, the price fell to $3.30 a gallon in December, the lowest monthly average for the year, AAA said.

(Reporting by Selam Gebrekidan)


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New York bomb suspects had "terrorist encyclopedia"

By Chris Francescani

NEW YORK | Mon Dec 31, 2012 1:06pm EST

NEW YORK (Reuters) - Police arrested a New York City couple in their apartment on Saturday after authorities investigating a credit card theft found a highly explosive compound, bomb-making manuals, a sawed-off shotgun and ammunition, officials said on Monday.

Morgan Gliedman, 27, and Aaron Greene, 31, are being charged with two counts of suspicion of criminal possession of a weapon, for the shotgun, court documents show.

One sheaf of papers found in the apartment had a cover page that read "The Terrorist Encyclopedia," according to court documents.

Greene has been arraigned and held without bail, according to a law enforcement official involved in the investigation, who was not authorized to discuss the ongoing investigation.

Gliedman had not yet been arraigned on Monday morning, said a spokeswoman for Manhattan District Attorney Cyrus Vance Jr.

Police went to the couple's Greenwich Village apartment Saturday to question Gliedman, the daughter of a prominent New York doctor, to investigate a credit card theft, according to a second law enforcement official.

At the apartment, detectives discovered a plastic bottle containing seven grams of Hexamethylene triperoxide diaminean, or HMTD, court documents show.

HMTD is commonly used in homemade bombs. The discovery prompted the evacuation of nearby buildings, the second source said.

Police also discovered a cache of bomb-making manuals and handwritten notebooks containing chemical formulas, the second source said.

Additionally, investigators recovered a 12-gauge Mossberg 500 shotgun, ammunition, nine high-capacity rifle magazines and a flare launcher, the second source said.

Law enforcement officials said Gliedman was the son of Paul Gliedman, director of radiation oncology at Beth Israel Hospital in Brooklyn.

Neither Gliedman nor his wife, Susyn Schops Gliedman, a Douglas Elliman realtor, returned calls for comment.

Morgan Gliedman studied creative writing at The School of The Art Institute of Chicago, according to her Facebook page, which contains a photo of Gliedman outside a pink dressing room, posing in a black, scoop-neck sweater and red checkered skirt.

Greene attended Harvard University in Cambridge, Massachusetts, according to the New York Post, which first reported the arrests.

The newspaper quoted a law enforcement source as saying that Greene was an Occupy Wall Street activist whose political views were "extreme."

Two spokesmen for Occupy Wall Street's New York chapter said they had no knowledge of Greene.

(Reporting by Chris Francescani; Editing by Daniel Trotta and Nick Zieminski)


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Ban on demanding Facebook passwords among new 2013 state laws

The Facebook logo is shown at Facebook headquarters in Palo Alto, California May 26, 2010. REUTERS/Robert Galbraith

The Facebook logo is shown at Facebook headquarters in Palo Alto, California May 26, 2010.

Credit: Reuters/Robert Galbraith

By James B. Kelleher

CHICAGO | Mon Dec 31, 2012 11:12am EST

CHICAGO (Reuters) - Employers in California and Illinois will be prohibited from demanding access to workers' password-protected social networking accounts and teachers in Oregon will be required to report suspected student bullies thanks to new laws taking effect in 2013.

In all, more than 400 measures were enacted at the state level during 2012 and will become law in the new year, according to the National Conference of State Legislatures (NCSL).

Some of the statutes, which deal with everything from consumer protection to gun control and healthcare, take effect at the stroke of midnight. Others will not kick in until later in the year.

The raft of measures includes a new abortion restriction in New Hampshire, public-employee pension reform in California and Alabama, same-sex marriage in Maryland, and a requirement that private insurers in Alaska cover autism in kids and young adults, NCSL said.

In New Hampshire, a rarely used form of late-term abortion will become illegal except to save the life of the mother - and even then only if two doctors from separate hospitals certify the procedure is medically necessary.

John Lynch, the state's outgoing Democratic governor, had vetoed the measure, saying it would threaten the lives of women in rural areas. But the state's Republican-controlled legislature later overrode him.

In California and Illinois, laws that take effect at 12:01 a.m. local time will make it illegal for bosses to request social networking passwords or non-public online account information from their employees or job applicants.

Michigan's Republican Governor Rick Snyder signed a similar measure into law earlier this month that took effect immediately. The Michigan law also penalizes educational institutions for dismissing or failing to admit a student who does not provide passwords and other account information used to access private internet and email accounts, including social networks like Facebook and Twitter.

But workers and job seekers in all three states will still need to be careful what they post online: Employers may continue to use publicly available social networking information. So inappropriate pictures, tweets and other social media indiscretions can still come back to haunt them.

Gun violence - in places where it's all too common, such as Chicago, and in places where it's unexpected, such as Sandy Hook Elementary School in Newtown, Connecticut - was big news in 2012. But only a handful of new state firearms laws are set to take effect in 2013.

In Michigan, the definition of a "pistol" under the law will now include any firearm less than 26 inches in length. The new definition encompasses some rifles with folding stocks and will make the weapons subject to the same restrictions as pistols.

In Illinois, certain guns currently regulated by state law, including paintball guns, will be excluded from the definition of a firearm and participants in military re-enactments will be exempt from some weapons laws.

Another big story in 2012 was the effort by lawmakers in a number of cash-strapped states to put their public employee pension funds on a sounder financial footing.

In California and Alabama, reforms designed to begin to address the unfunded liabilities of those retirement systems will take effect in 2013.

Among the other new laws on the books in 2013:

* In California, prison workers and peace officers will now be prohibited from having sex with inmates and prisoners in transport.

* In Illinois, sex offenders will be prohibited from distributing candy on Halloween, or playing Santa or the Easter Bunny.

* In Oregon, employers won't be allowed to advertise a job vacancy if they won't consider applicants who are currently out of work.

* In Kentucky, residents will be prohibited from releasing feral or wild hogs back into the wild and Illinois will ban the possession and sale of shark fins.

* And in Florida, the term "motor vehicle" will no longer apply to the specialized all-terrain vehicles with over-sized tires known as "swamp buggies" that are popular in some parts of the state.

(Reporting by James B. Kelleher; Editing by Greg McCune and Nick Zieminski)


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Parking dispute may have led to Maine shooting deaths: police

By Daniel Lovering

CAMBRIDGE, Massachusetts | Sun Dec 30, 2012 7:11pm EST

CAMBRIDGE, Massachusetts (Reuters) - A dispute between neighbors over street parking may have led to the shooting deaths of two Maine teenagers, authorities said on Sunday after charging a 74-year-old man with murder in connection with the incident.

Derrick Thompson, 19, and his girlfriend, Alivia Welch, 18, were killed on Saturday night in their apartment inside a two-unit home in Biddeford, Maine, about 15 miles southwest of Portland, state police spokesman Steve McCausland said.

Thompson's mother, Susan Johnson, 44, who reported the shootings to authorities shortly after 7 p.m. EST, was being treated for gunshot wounds at Maine Medical Center in Portland, state police. A six-year-old boy also was removed from the building uninjured.

James Pak, who owns the building and lives in the other unit, was arrested on Saturday and charged with two counts of murder.

Police had been summoned to the residence earlier on Saturday because of an argument over parking, McCausland said. A Biddeford police spokeswoman said the city banned street parking from 8 p.m. until 7 a.m. to allow for snow removal.

McCausland said the dispute appeared to have been resolved before the shooting occurred but gave no further details.

Pak was being held in a local jail and was expected to appear in court on Monday or Wednesday. It was unclear whether he had an attorney. (Edited by Karen Brooks and Paul Simao)


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Woman dies in car crash near Kennedy airport

NEW YORK | Sun Dec 30, 2012 4:07pm EST

NEW YORK (Reuters) - A woman was killed and three other people were injured when a car sped off the road not far from New York's John F. Kennedy International Airport early on Sunday, police said.

The driver, who sustained minor injuries, was in police custody but no charges have been announced, said a spokeswoman for the New York Police Department.

Police were called at about 4:30 a.m. with reports of a car in the water, and concluded that the driver had lost control of the vehicle.

A female passenger, 25-year-old Dominique Jamison, was pronounced dead at Jamaica Hospital. Two other passengers and the driver were hospitalized with minor injuries and two passengers left the scene on their own, police said.

(Reporting By Edith Honan; Editing by David Brunnstrom)


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Senate, House agriculture committees in deal to avert milk price spike

By Jim Wolf

WASHINGTON | Sun Dec 30, 2012 10:19pm EST

WASHINGTON (Reuters) - Farm-state lawmakers have agreed to a one-year extension of the expiring U.S. farm law that, if enacted, would head off a possible doubling of retail milk prices to $7 or more a gallon in early 2013.

The extension would end a 32-month attempt to update farm subsidies dating from the Depression era, when farmers were crushed by low prices and huge crop surpluses, to meet today's high-wire challenges of tight food supplies, high operating costs and volatile markets.

House Agriculture Committee Chairman Frank Lucas, an Oklahoma Republican, said on Sunday he hoped the legislation would be passed by Congress and signed by President Barack Obama by Tuesday to avoid higher prices for milk in grocery stores.

The bill was listed among measures that could be called for a vote on Monday in the House of Representatives although action was not guaranteed.

Despite consensus on the need to extend the farm bill, lawmakers continue to discuss how long the extension should be.

Representative Tom Cole, an Oklahoma Republican, told reporters late on Sunday a nine-month farm bill extension was being considered as part of deal being crafted in the Senate to stave off the "fiscal cliff" of automatic tax hikes and spending cuts that begin kicking in on January 1.

"There's good chance that if there is a package out of the Senate, it will include something on the farm bill. The easiest thing to get done would be nine months of current law," Cole said.

A second Republican, Representative Steven LaTourette, said a nine-month extension could be part of the fiscal cliff package or could move separately if the fiscal talks fail.

House Republican leaders refused to call a vote during the fall on a full-scale, $500 billion farm bill on grounds it might fail because it did not cut spending enough.

Grain, soybean and cotton growers would get another round of the $5 billion "direct payment" subsidy that all sides agreed to kill in a new farm bill. The payments are made regardless of need. Reformers say the payments are unjustified when crop prices and farm income are at near-record levels.

DISASTER MONEY AND A NEW DAIRY PROGRAM

Also in the extension, lawmakers would revive agricultural disaster-relief programs that ran out of money a year ago and create a new dairy subsidy program. It would compensate dairy farmers whenever milk prices are low and feed prices are high. The so-called margin protection program would require farmers to limit production to avert a long run of low dairy prices.

Traditionally, the dairy program sets a minimum price for milk through government purchase of butter, cheese and dry milk. If Congress does not act, the dairy support price will revert on Tuesday to the level dictated by an outmoded 1949 law and which is roughly double the price now paid to farmers.

The potential retail milk price has been estimated at $6 to $8 a gallon versus current levels near $3.50.

Agriculture Secretary Tom Vilsack, during an interview broadcast by CNN, said higher milk prices - if it comes to that - would ripple throughout all commodities "if this thing goes on for an extended period of time."

Senator Debbie Stabenow, chairwoman of the Senate Agriculture Committee, said the "responsible short-term farm bill extension ... not only stops milk prices from spiking, but also prevents eventual damage to our entire agriculture economy."

TWO FALLBACKS IF EXTENSION FALTERS

House Republican leaders readied two alternatives, if needed, to the one-year extension. One was a one-month extension of the now-expired 2008 farm law without disaster funds or the new dairy program and the other was a one-month suspension of the dairy provisions of the 1949 law.

It was not clear which bill would be called for debate, a farm lobbyist said on Sunday. A small-farm activist said any package passed by Congress must include rural economic development funds and money for soil conservation on "working lands," the largest of USDA's conservation programs.

"If a new farm bill doesn't pass this Congress, we'll soon hold another mark-up and just keep working until one is enacted next year," said Stabenow, a Michigan Democrat.

It would be the first time on record that Congress began drafting a farm bill during a two-year session and had to carry it into the following session, congressional researchers said. Hearings on the new farm bill began April 21, 2010.

HOUSE, SENATE DISPUTE ON BIG CUTS

While dairy producers generally support the so-called margin-protection program as the answer to high feed costs, processors and foodmakers oppose it. They say it is wrong-minded in its premise of curtailing production when prices are low, and it will destroy a healthy export market for dairy products.

The rejuvenated disaster programs would cover losses from this year's widespread drought, especially for livestock producers, although tree farmers, honey bees and farm-raised fish are also covered. Maximum payment would be $100,000.

Senators passed a farm bill in June estimated to save $23 billion over 10 years, with most of the cuts in crop subsidies and conservation programs. The House Agriculture Committee approved a bill with $35 billion in cuts in July, half of it in food stamps for the poor - the biggest cut in food stamps in a generation.

Fiscally conservative House Republicans have called for larger cuts in farm subsidies and food stamps while some House Democrats opposed any food stamp cuts.

(Additional reporting by Charles Abbott, David Lawder and Richard Cowan; Editing by Ros Krasny, Maureen Bavdek, Jan Paschal and Eric Walsh)


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Nine killed, more than 25 hurt in Oregon bus crash: state police

Rescue personnel respond to the scene of a charter bus crash on I-84, east of Pendleton, Oregon in this December 30, 2012 handout photo. Five people were killed and at least 20 injured in the incident. Police said the bus may have gone out of control on the highway before crashing through a guardrail and down an embankment. REUTERS/Oregon State Police/Handout

Rescue personnel respond to the scene of a charter bus crash on I-84, east of Pendleton, Oregon in this December 30, 2012 handout photo. Five people were killed and at least 20 injured in the incident. Police said the bus may have gone out of control on the highway before crashing through a guardrail and down an embankment.

Credit: Reuters/Oregon State Police/Handout

By Teresa Carson

PORTLAND, Oregon | Sun Dec 30, 2012 10:54pm EST

PORTLAND, Oregon (Reuters) - Nine people were killed and at least 26 others injured on Sunday when a charter bus headed to Canada from Las Vegas skidded off an icy mountain highway and crashed down an embankment in northeastern Oregon.

The Oregon State Police said a preliminary investigation showed the charter bus, carrying about 40 people through the Blue Mountains en route to Vancouver, British Columbia, "lost control on the snow/ice covered westbound lanes of Interstate 84" near Pendleton.

The bus crashed through a guardrail alongside the road and went down an embankment of around 200 feet. Crews trained in rope rescue were needed to bring victims back up to the highway, police said.

State Police spokesman Lt. Gregg Hastings said nine people had been confirmed killed in the crash.

"We are continuing to try and confirm the total number of passengers and number of injured persons transported to area hospital or secondary locations due to severity of injuries." the state police said in a written statement.

The bus driver survived the crash but investigators said he had not yet been interviewed because of the severity of his injuries.

St. Anthony Hospital in Pendleton initially received 26 of the injured, spokesman Larry Blanc said. Five of those patients were stabilized and transported to a secondary hospital by air for further treatment.

"About 10:30 this morning we got the call and declared a Code D, which means we bring in extra staff and supplies," he said, adding that D stands for "disaster."

"There are various types of injuries. Some of the injured were able to walk in on their own," Blanc said. "We are taking a lot of CT scans and assessing the injuries

Blanc said that of the 21 patients who remained at St. Anthony, some had been treated and released and were being provided food and shelter by the Red Cross. Some of them were children, he said.

Brycie Jones, spokeswoman for Oregon Health and Science University said that hospital had received four patients from the bus crash.

Jones said she could not disclose their identities or condition and it was not immediately clear if the patients had come from another hospital.

Authorities identified the charter company as Mi Joo Tour & Travel, based in Vancouver, British Columbia and said the bus was headed there as part of a round-trip from Las Vegas, Nevada.

Representatives for Mi Joo could not be reached for comment on Sunday evening.

Police said the names of the dead and wounded would not be released until next of kin were notified, which could take several days because many were believed to be from out of the country.

Pendleton is in northeast Oregon near the border with Washington state, about 200 miles east of Portland.

(Reporting by Teresa Carson; Writing by Dan Whitcomb; Editing by Cynthia Osterman and Todd Eastham)


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Obama endorses gay marriage proposal in Illinois

By Karen Brooks

Sun Dec 30, 2012 6:43pm EST

n">(Reuters) - President Obama is endorsing a proposal by the Illinois legislature to legalize gay marriage, a White House spokesman told Reuters on Sunday.

It's an unusual move by a president - most of whom rarely weigh in on state legislative matters. Obama served in the Illinois state senate.

Obama, who said earlier this year that he supports same-sex marriage, believes "it's wrong to prevent couples who are in loving, committed relationships and want to marry, from doing so," said White House spokesman Shin Inouye.

"Were the president still in the Illinois State Legislature, he would support this measure that would treat all Illinois couples equally," Inouye said.

Chicago state Senator Heather Steans will introduce a gay marriage proposal this week, said Rikeesha Phelon, spokeswoman for Illinois Senate President John Cullerton. She added that Democratic leaders are confident they have the votes to win approval - possibly even before the legislature's newly elected Democratic super-majority takes office on January 10.

If it passes, that would make Illinois the tenth state to approve same-sex nuptials.

Passage in President Barack Obama's home state would be a symbolic victory for gay rights activists, particularly after the president endorsed same-sex marriage in May.

One issue to be resolved is whether Illinois should allow religious groups the option of declining to perform same-sex marriages. New York granted such an exception in 2011 in order to secure the legislative votes to legalize gay marriage there.

No Midwest state has approved gay marriage by a vote of its legislature. Iowa's Supreme Court ruled in 2009 that same-sex marriage was legal, a decision some opponents have been trying to overturn ever since.

In June, 2011, Illinois legalized civil unions, which grant some of the rights of marriage to same sex partners. But gay rights activists said that did not go far enough.

All prominent Democrats in Illinois have endorsed gay marriage, including Chicago Mayor Rahm Emanuel and Governor Pat Quinn, as well as 260 Illinois faith leaders who published a letter supporting same-sex marriage last week.

The Catholic Conference of Illinois, which represents Catholic bishops in the state, said on its website that marriage should be reserved for a man and a woman.

Nine of the 50 U.S. states plus the District of Columbia, have already legalized gay marriage. Another 31 states have passed constitutional amendments banning it.

(Writing by Karen Brooks; editing by Todd Eastham)


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Pro-marijuana campaign looks ahead after 2012 victories

A marijuana starter plant is for sale at Canna Pi medical marijuana dispensary in Seattle, Washington in this November 20, 2012 file photograph. The passage of the ballot measures in Colorado and Washington state in November 2012 allowed personal possession of the drug for people 21 and older. That same age group will be allowed to buy the drug at special marijuana stores under rules set to be finalized next year in 2013. REUTERS/Anthony Bolante/Files

1 of 3. A marijuana starter plant is for sale at Canna Pi medical marijuana dispensary in Seattle, Washington in this November 20, 2012 file photograph. The passage of the ballot measures in Colorado and Washington state in November 2012 allowed personal possession of the drug for people 21 and older. That same age group will be allowed to buy the drug at special marijuana stores under rules set to be finalized next year in 2013.

Credit: Reuters/Anthony Bolante/Files

By Alex Dobuzinskis

LOS ANGELES | Sun Dec 30, 2012 5:14pm EST

LOS ANGELES (Reuters) - After a decades-long campaign to legalize marijuana hit a high mark in 2012 with victories in Washington state and Colorado, its energized and deep-pocketed backers are mapping out a strategy for the next round of ballot-box battles.

They have their sights set on ballot measures in 2014 or 2016 in states such as California and Oregon, which were among the first in the country to allow marijuana for medical use. Although those states more recently rejected broader legalization, drug-law reform groups remain undeterred.

"Legalization is more or less repeating the history of medical marijuana," said Ethan Nadelmann, executive director of the Drug Policy Alliance. "If you want to know which states are most likely to legalize marijuana, then look at the states that were the first to legalize medical marijuana."

The passage of the ballot measures in Colorado and Washington state in November allowed personal possession of the drug for people 21 and older. That same age group will be allowed to buy the drug at special marijuana stores under rules set to be finalized next year.

No other states have legalized marijuana, America's most widely used illicit drug, for recreational use. The drug remains illegal under federal law. Connecticut and Massachusetts also approved medical marijuana in 2012.

The efforts in Washington and Colorado demonstrated significant funding might.

The Drug Policy Alliance spent more than $1.6 million as one of the main funders of the Washington state campaign. Peter Lewis, chairman of insurance company Progressive Corp, gave $2.5 million to the Washington campaign, and travel guide author Rick Steves chipped in another $350,000, according to records.

Ahead of the Colorado vote, the Washington, D.C.-based Marijuana Policy Project, which has been active in campaigns around the country, gave about $1 million to the effort, state records show.

A big question mark hangs over whether the pro-legalization momentum could be slowed if the federal government takes an aggressive stance against the new laws.

The U.S. Department of Justice has been mostly silent on the issue. President Barack Obama said in a TV interview this month it did not make sense for the federal government to "focus on recreational drug users in a state that has already said that, under state law, that's legal."

CHANGING TIDE?

In 1996, California became the first state to allow medical marijuana by a popular vote, and Oregon and Washington state were part of a second wave in 1998. But Oregon rejected a marijuana legalization ballot measure in November, while California voters did the same in 1972 and 2010.

The 2010 ballot measure in California failed to sway voters because it would have left regulation to a hodgepodge of local governments, instead of a uniform set of state rules, said Dale Gieringer, director of the California branch of the National Organization for the Reform of Marijuana Laws.

This month, California Lieutenant Governor Gavin Newsom became one of America's top state officials to call for reform of marijuana laws when he told the New York Times that laws against the drug "just don't make sense anymore."

Activists say they see demographic changes as giving them an advantage.

"We know that the younger generation is more supportive and the opposition really comes from the older generation. And as time goes on there's more of the younger generation and less of the older generation," Gieringer said.

"The second factor is we have these results in Colorado and Washington under our belt, so that sort of fertilizes the ground," he added.

One key point marijuana advocates are thrashing out is whether to pursue any ballot initiative in 2014, or wait until the presidential election of 2016, when the turnout of their reliable base of youth voters will likely be higher.

Regardless of when a ballot initiative might come to California, the nation's most populous state, groups opposing legalization vow to defeat it.

One of those is the California Police Chiefs Association.

"I have yet to hear a legalization proponent talk about how society will be enhanced, how the real social problems facing our country will be improved by legalizing yet another substance that compromises people's five senses," said John Lovell, government relations manager for the group.

A number of addiction specialists say that where marijuana is legalized, teenagers will come to believe the drug is harmless and more will use it.

Medical marijuana is already big business in California. The state Board of Equalization in its most recent analysis from 2009 estimated medical cannabis dispensaries ring up sales of $1.3 billion a year and pay sales taxes of $105 million.

(Reporting By Alex Dobuzinskis; Editing by Colleen Jenkins, Edith Honan, David Brunnstrom and Steve Orlofsky)


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Secretary of State Clinton hospitalized with blood clot

U.S. Secretary of State Hillary Clinton answers questions from the audience at the 2012 Saban Forum on U.S.-Israel relations gala dinner in Washington, in this file photo from November 30, 2012. Clinton was sent to the hospital December 30, 2012 with a blood clot stemming from a concussion she suffered earlier this month and was being assessed by doctors, a State Department spokesman said. REUTERS/Mary F. Calvert/Files

1 of 4. U.S. Secretary of State Hillary Clinton answers questions from the audience at the 2012 Saban Forum on U.S.-Israel relations gala dinner in Washington, in this file photo from November 30, 2012. Clinton was sent to the hospital December 30, 2012 with a blood clot stemming from a concussion she suffered earlier this month and was being assessed by doctors, a State Department spokesman said.

Credit: Reuters/Mary F. Calvert/Files

By Andrew Quinn

WASHINGTON | Sun Dec 30, 2012 11:04pm EST

WASHINGTON (Reuters) - U.S. Secretary of State Hillary Clinton was admitted to a New York hospital on Sunday with a blood clot linked to a concussion she suffered earlier this month, the State Department said in an announcement that looked sure to fuel speculation over the health of one of America's best-known political figures.

Clinton, 65, has been out of the public spotlight since mid-December, when officials said she suffered a concussion after fainting due to a stomach virus contracted during a trip to Europe.

"In the course of a follow-up exam today, Secretary Clinton's doctors discovered a blood clot had formed, stemming from the concussion she sustained several weeks ago," State Department spokesman Philippe Reines said in a statement.

"She is being treated with anti-coagulants and is at New York-Presbyterian Hospital so that they can monitor the medication over the next 48 hours," Reines said. "They will determine if any further action is required."

U.S. officials said on December 15 that Clinton, who canceled an overseas trip because of the stomach virus, suffered a concussion after fainting due to dehydration.

They have since described her condition as improving and played down suggestions that it was more serious. She had been expected to return to work this week.

Clinton's illness, already the subject of widespread political speculation, forced her to cancel planned testimony to Congress on December 20 in connection with a report on the deadly attack on the U.S. diplomatic post in Benghazi, Libya.

The attack became the subject of heated political debate in the run-up to the U.S. presidential election in November, and Republican lawmakers have repeatedly demanded that Clinton appear to answer questions directly.

Clinton's two top deputies testified in her place on the September 11 attack in Benghazi, which killed the U.S. ambassador and three other Americans and raised questions about security at far-flung diplomatic posts.

Some Republican commentators have implied that Clinton was seeking to avoid questioning on the subject, suggestions that have been strongly rebutted by State Department officials.

Clinton has stressed that she remains ready to testify and was expected to appear before lawmakers this month before she steps down, as planned, around the time of Obama's inauguration for his second term in late January.

After narrowly losing the Democratic presidential nomination to Obama in 2008, Clinton has been consistently rated as the most popular member of his Cabinet and is often mentioned as a potential presidential candidate in 2016.

Any serious medical concern could throw a fresh question mark over her future plans, although she has frequently alluded to her general good health.

BLOOD THINNERS

Dr. Edward Ellerbeck, a professor at the University of Kansas School of Medicine, said clots are more common in people who are sedentary, genetically predisposed, or on certain types of medicines such as the contraceptive pill or Estrogen replacements.

Ellerbeck, who is not treating Clinton, said clots are usually treated with blood thinners, typically for three to six months, and generally carry a low risk of further complications

Clinton is not known to have any of the risk factors that increase the risk of abnormal clotting, such as atherosclerosis or autoimmune disorders.

Head injuries such as the one she sustained earlier this month are associated more with bleeding than with clotting.

In one well-known case of bleeding following a head injury, actress Natasha Richardson hit her head skiing in 2009 and seemed fine, but died two days later of a hematoma, or bleeding between the outer membrane of the brain and the skull.

Clinton has said she wants to take a break from public life and has laughed off suggestions that she may mount another bid to become the first woman president of the United States - a goal she came close to reaching in 2008.

Her stint as secretary of state has further burnished the credentials she earned as a political partner to her husband, former President Bill Clinton, and later as a Democratic senator from New York.

In the four years since she became Obama's surprise choice as the top U.S. diplomat, Clinton has broken travel records as she dealt with immediate crises, including Libya and Syria, and sought to manage longer-term challenges, including U.S. relations with China and Russia.

She has maintained a punishing travel schedule, and was diagnosed with the virus after a December trip that took her to the Czech Republic, NATO headquarters in Brussels, Dublin and Belfast - where she had her last public appearance on December 7.

Officials announced on December 9 that she was ill with the stomach virus, forcing her to cancel a trip to North Africa and the Gulf that was to include a stop in Morocco for a meeting on the Syria crisis.

READY TO STEP DOWN

Clinton has repeatedly said that she only intended to serve one term, and aides said she was on track to leave office within the next few weeks, once a successor is confirmed by the Senate.

Her last months in office have been overshadowed by the Benghazi attack, the first to kill a U.S. ambassador in the line of duty since 1979, which brought sharp criticism of the State Department.

An independent inquiry this month found widespread failures in both security planning and internal management in the department.

It did not find Clinton personally responsible for any security failures, although she publicly took overall responsibility for Benghazi and the safety and security of U.S. diplomats overseas.

The State Department's top security officer resigned from his post under pressure and three other mid-level employees were relieved of their duties after the inquiry released its report.

The controversy also cost U.S. Ambassador to the United Nations Susan Rice her chance to succeed Clinton as secretary of state.

Rice drew heavy Republican criticism for comments on several television talk shows in which she said the attack appeared to be the result of a spontaneous demonstration rather than a planned assault. She ultimately withdrew her name for consideration for the top diplomatic job.

Obama on December 21 nominated Senator John Kerry, the Massachusetts Democrat who heads the Senate Foreign Relations Committee, to fill the position of secretary of state.

(Additional reporting by Jilian Mincer and Sharon Begley.; Editing by Eric Walsh and Christopher Wilson)


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Sunday, 30 December 2012

Storms on U.S. Plains stir memories of the "Dust Bowl"

Farmer Gail Wright is pictured next to a water pump which he says he is likely to shut down because the Ogallala Aquifer no longer provides adequate water near Sublette, Kansas, November 26, 2012. Residents of the Great Plains over the last year or so have experienced storms reminiscent of the 1930s Dust Bowl. Experts say the new storms have been brought on by a combination of historic drought, a dwindling Ogallala Aquifer underground water supply, climate change and government farm programs. Picture taken November 26. REUTERS/Kevin Murphy

1 of 5. Farmer Gail Wright is pictured next to a water pump which he says he is likely to shut down because the Ogallala Aquifer no longer provides adequate water near Sublette, Kansas, November 26, 2012. Residents of the Great Plains over the last year or so have experienced storms reminiscent of the 1930s Dust Bowl. Experts say the new storms have been brought on by a combination of historic drought, a dwindling Ogallala Aquifer underground water supply, climate change and government farm programs. Picture taken November 26.

Credit: Reuters/Kevin Murphy

By Kevin Murphy

LIBERAL, Kansas | Sun Dec 30, 2012 9:16am EST

LIBERAL, Kansas (Reuters) - Real estate agent Mark Faulkner recalls a day in early November when he was putting up a sign near Ulysses, Kansas, in 60-miles-per-hour winds that blew up blinding dust clouds.

"There were places you could not see, it was blowing so hard," Faulkner said.

Residents of the Great Plains over the last year or so have experienced storms reminiscent of the 1930s Dust Bowl. Experts say the new storms have been brought on by a combination of historic drought, a dwindling Ogallala Aquifer underground water supply, climate change and government farm programs.

Nearly 62 percent of the United States was gripped by drought, as of December 25, and "exceptional" drought enveloped parts of Kansas, Colorado, Oklahoma, Texas, and New Mexico, according to the U.S. Drought Monitor.

There is no relief in sight for the Great Plains at least through the winter, according to Drought Monitor forecasts, which could portend more dust clouds.

A wave of dust storms during the 1930s crippled agriculture over a vast area of the Great Plains and led to an exodus of people, many to California, dramatized in John Steinbeck's novel "The Grapes of Wrath."

While few people believe it could get that bad again, the new storms have some experts worried that similar conditions - if not the catastrophic environmental disaster of the 1930s - are returning to parts of Texas, Oklahoma, New Mexico, Kansas and Colorado.

"I hope we don't talk ourselves into complacency with easy assumptions that a Dust Bowl could never happen again," said Craig Cox, agriculture director for the Environmental Working Group, a national conservation group that supports converting more tilled soil to grassland. "Instead, we should do what it takes to make sure it doesn't happen again."

Satellite images on December 19 showed a dust storm stretching over an area of 150 miles from extreme southwestern Oklahoma across the Panhandle of Texas around Lubbock to extreme eastern New Mexico, said Jody James, National Weather Service meteorologist in Lubbock. Visibility was reduced to half a mile in places, stoked by high winds, he said. At least one person was killed and more than a dozen injured in car crashes.

"I definitely think these dust storms will become more common until we get more measurable precipitation," James said.

'DIRTY 30S'

The Great Plains is a flat, semi-arid, area with few trees, where vast herds of buffalo once thrived on native grasses. Settlers plowed up most of the grassland in the late 19th and early 20th centuries to create the wheat-growing breadbasket of the United States, encouraged by high commodity prices and free "homestead" land from the government.

The era known as the "Dirty 30s" - chronicled by Ken Burns in a Public Broadcasting Service documentary that aired in November - was when a 1930s drought gripped the Great Plains and winds carried away exposed soil in massive dust clouds.

Bill Fitzgerald, 87, a farmer near Sublette, Kansas, remembers "Black Sunday" on April 14, 1935, when a clear, sunny day in southwest Kansas turned black as night by mid afternoon because of a massive cloud of dust that swept from Nebraska to the Texas panhandle.

"My older brother and I were in my dad's 1927 or '28 Chevy truck a mile north and a mile west of the house and we saw it rolling in," Fitzgerald said. "It was about 10 p.m. when it cleared enough for us to go home."

Farming practices have vastly improved since the 1930s. Farmers now leave plant remnants on the top of the soil and less soil is exposed, to preserve moisture and prevent erosion.

Irrigation beginning in the 1940s from the Ogallala aquifer, a huge network of water under the Great Plains, also made land less vulnerable to dust storms.

DRYING UP

But the Ogallala aquifer is drying up after years of drawing out more water than was replenished.

Many farmers have had to drill deeper wells to find water. Others are giving up on irrigation altogether, which means they can no longer grow crops of high-yielding and lucrative corn. They will instead grow wheat, cotton or grain sorghum on dry land, which depends completely on natural precipitation in an area that typically gets 20 inches of rain a year or less.

Near Sublette, Kansas, farmer Gail Wright said he would probably give up irrigating two square miles of his land and would plant wheat and grain sorghum instead of corn because of the diminishing aquifer. Drilling deeper wells would cost $120,000 each, Wright said.

"When we drilled those wells in the 1960s and 70s, we were doing 1,500 or 1,600 gallons per minute," said Wright. "Now, they are down to anywhere from 400 to 600 gallons per minute. We probably pumped out 200 feet of water."

Another farmer in Sublette, 79-year-old Lawrence Withers, whose family farms land his grandfather settled in 1887, is resigned to a future without irrigation.

"We have pumped 170 feet off the aquifer, that's gone. There's just a little tick of water at the bottom," he said.

The Ogallala supplies water to 176,000 square miles (456,000 square km) of land in parts of eight states from the Texas panhandle to southern South Dakota. That amounts to about 27 percent of all irrigated land in the nation, according to the U.S. Geological Survey.

The volume of water in the aquifer stood at about 2.9 billion acre feet in 2009, a decline of about 9 percent since 1950, according to the Geological Survey. About two-and-a-half times as much water was drawn out in the 14 years ended 2009 as during the prior 15-year period, data shows.

The water may run out in 25 years or less in parts of Texas, Oklahoma and southwest Kansas, although in other areas it has 50 to 200 years left, according to the Geological Survey.

Rationing has been imposed on irrigation in the region but it may be too little too late.

"It's a situation where across the Plains the demand far exceeds the annual recharge," said Mark Rude, executive director of the Southwest Kansas Groundwater Management District.

RECORD DROUGHT

The worst drought in decades has exacerbated the situation. The semi-arid area around Lubbock, which typically gets about 19 inches of rain a year, received less than 6 inches in 2011, the lowest ever recorded. This year was better but still far below normal at 12.5 inches, meteorologist James said.

Climate change is also having an impact on the region, said atmospheric scientist Katharine Hayhoe, co-director of the Climate Science Center at Texas Tech University in Lubbock.

"It is definitely hotter in the summer and drier in the summer because of climate change," she said.

The average annual temperature in Lubbock has increased by one full degree over the last decade, according to National Weather Service data, and the average amount of rainfall has fallen during summer months by about .50 inch over the decade.

Some say government policies are making things worse.

Federal government subsidized crop insurance pays farmers whether they produce a crop or not, encouraging farmers to plant even in a drought year.

Another subsidized U.S. government program that pays farmers to take sensitive marginal land out of crop production and put it into grassland is gradually shrinking.

In a possible case of history repeating itself, high commodity prices are encouraging farmers to break up the land and plant crops when the 10-year conservation contracts with the government expire, said environmentalist Cox. This is similar to what happened in the 1920s when vast areas of grassland were plowed up.

The government also has imposed restrictions on how much land can go into conservation reserves to save money at a time of massive U.S. budget deficits, he said.

The amount of land in conservation reserves has declined by more than 2.3 million acres over the last five years in five states of the Great Plains - Texas, Oklahoma, Kansas, Colorado and New Mexico, according to U.S. Agriculture Department data.

If most of that land is plowed up for crops it could lead to more dust storms in the future.

"I think you are probably going to see increased erosion if that happens," said Richard Zartman, Chairman of the Plant and Soil Science Department at Texas Tech, adding that it was unlikely to get as bad as the Dust Bowl days.

(Additional reporting by Greg McCune and Christine Stebbins; Editing by Claudia Parsons)


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Obama skeptical of NRA proposal to put more guns in schools

U.S. President Barack Obama (R) salutes as he returns via Marine One from a Christmas visit with his family in Hawaii, to the White House in Washington, December 27, 2012. REUTERS/Jonathan Ernst

U.S. President Barack Obama (R) salutes as he returns via Marine One from a Christmas visit with his family in Hawaii, to the White House in Washington, December 27, 2012.

Credit: Reuters/Jonathan Ernst

By Jeff Mason

WASHINGTON | Sun Dec 30, 2012 11:57am EST

WASHINGTON (Reuters) - President Barack Obama said in an interview broadcast on Sunday he hopes to get new U.S. gun control measures passed during the first year of his second term and is skeptical of a proposal by the National Rifle Association (NRA) gun lobby to put armed guards in schools.

Obama assigned Vice President Joe Biden to lead a task force to come up with proposals on guns at the beginning of 2013 after the massacre of 20 children and six adults by a gunman at an elementary school in Newtown, Connecticut, this month.

"I'd like to get it done in the first year. I will put forward a very specific proposal based on the recommendations that Joe Biden's task force is putting together as we speak. And so this is not something that I will be putting off," Obama told NBC's "Meet the Press" in an interview taped on Saturday.

"I am not going to prejudge the recommendations that are given to me. I am skeptical that the only answer is putting more guns in schools. And I think the vast majority of the American people are skeptical that that somehow is going to solve our problem," he said.

The influential NRA has said new gun laws are not a good answer and has called for some form of armed guards to be present in all U.S. schools.

Obama, who said the shooting was the worst day of his presidency, attended a memorial service for the Newtown victims and promised he would take swift action to prevent further massacres like that one from being repeated.

The president has faced criticism for failing to take on the gun lobby after other mass shootings that have occurred during his time in office. While bristling at the criticism, the president has indicated that this time something will get done.

"I'm going to be putting forward a package and I'm going to be putting my full weight behind it. And I'm going to be making an argument to the American people about why this is important and why we have to do everything we can to make sure that something like what happened at Sandy Hook Elementary does not happen again," he said in the interview.

"And the question then becomes whether we are actually shook up enough by what happened here that it does not just become another one of these routine episodes where it gets a lot of attention for a couple of weeks and then it drifts away. It certainly won't feel like that to me."

Gun control is a divisive issue in the United States, where the right to bear arms is enshrined in the Constitution, and the NRA has significant political sway.

Proponents of tighter gun laws hope that not having to run for re-election again will give Obama a strengthened hand, but any legislative measures would have to pass the Republican-controlled House of Representatives, which has been reluctant to support initiatives proposed by the Democratic president.

(Editing by Sandra Maler)


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Michigan hospital blazes trail in fight against fungal meningitis

Bonita Robbins (L ), a patient suffering with arachnoiditis due to a contaminated steroid injection, sits on her hospital bed as she and her husband Ed (C ) listen to Infectious Diseases doctor Anurag Malani at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan December 21, 2012. St. Joseph Mercy -- a 537-bed Catholic hospital located on the doorstep of the University of Michigan -- has played an outsized role in the fight against one of the largest fungal meningitis outbreaks in US history, treating 169 of the state's 223 cases, including 7 people who died. REUTERS/Rebecca Cook

1 of 8. Bonita Robbins (L ), a patient suffering with arachnoiditis due to a contaminated steroid injection, sits on her hospital bed as she and her husband Ed (C ) listen to Infectious Diseases doctor Anurag Malani at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan December 21, 2012. St. Joseph Mercy -- a 537-bed Catholic hospital located on the doorstep of the University of Michigan -- has played an outsized role in the fight against one of the largest fungal meningitis outbreaks in US history, treating 169 of the state's 223 cases, including 7 people who died.

Credit: Reuters/Rebecca Cook

By Julie Steenhuysen

CHICAGO | Sun Dec 30, 2012 7:04am EST

CHICAGO (Reuters) - After his first day working at St Joseph Mercy Ann Arbor hospital's newly created Fungal Outbreak Clinic, Dr David Vandenberg struggled to describe to his boss the enormity of what lay ahead. He settled on a line from the movie Jaws.

"We're going to need a bigger boat," Vandenberg told Dr Lakshmi Halasyamani, chief medical officer of the Michigan hospital, echoing the film's local police chief after he first eyes a 25-foot (7.5-metre) killer shark.

The St Joseph Mercy clinic has been at the front line of the fight against one of the biggest ever U.S. outbreaks of fungal meningitis, a killer infection that has been traced to tainted steroid shots from a Massachusetts pharmacy.

So far, 620 Americans have developed serious infections related to the outbreak, including 367 cases of deadly meningitis, and 39 people have died. Of the 19 U.S. states affected, Michigan has been worst hit, handling more than one third of the total cases in the outbreak.

St Joseph Mercy - a 537-bed Catholic hospital located in Ypsilanti, on the doorstep of the University of Michigan - has treated 169 of the state's 223 cases of infections that can cause meningitis, including 7 people who died.

At one point it was so overrun that 87 of its 537 beds, which are usually occupied by patients with cancer or heart ailments and the like, were occupied by patients with fungal meningitis and related infections.

Dr Tom Chiller, the fungal disease expert at the U.S. Centers for Disease Control and Prevention, who has been overseeing the outbreak, praised the work of the hospital in helping to limit deaths from the outbreak.

"They have been incredibly creative in dealing with these complicated patients," he said.

In all, almost 14,000 people seeking relief from back and joint pain received injections from moldy steroid shots made at the now-bankrupt New England Compounding Center in Massachusetts before they were recalled in late September.

CDC experts initially feared death rates in the 40 to 50 percent range; instead, only about 6 percent of those infected have died, and the CDC credits the creative and dogged efforts of state and local health officials for keeping the death rates so low.

The first wave of the outbreak involved the most severe cases of meningitis - an inflammation of the membranes that cover the brain and spinal cord. But starting in mid-October, patients who had been recovering from meningitis were developing potentially fatal localized infections near the site where contaminated drug was injected to treat back or neck pain.

As they started seeing more cases of these local, secondary infections, the staff at St Joseph's devised a bold plan to screen all patients in their database looking for potential new infections that might have been missed in the first wave.

On December 20, the CDC issued an alert to doctors incorporating some of lessons learned by the efforts of doctors at St Joseph's and other hospitals, calling for increased screening of patients who may be harboring localized infections.

A BEWILDERING FUNGI

Among the patients who developed secondary infections was Bonita Robbins, a 72-year-old retired nurse from Pinckney, Michigan, who received doses of the tainted drug at the Michigan Pain Specialists clinic in the nearby town of Brighton while seeking relief for lower-back pain.

The first shot brought some relief, the second did little to ease her aches, and the third was contaminated. In October, Robbins went to St Joseph's with a severe headache, back pain and pain in her thighs.

She spent 37 days in the hospital taking two kinds of antifungal drugs.

Dr Anurag Malani, an infectious disease specialist treating Robbins, said the challenge with the outbreak was that there was no medical literature to fall back on.

"No one has ever seen anything of this magnitude related to fungal infections, ever," he said.

Chiller said U.S. doctors had never treated meningitis caused by Exserohilum rostratum, the environmental mold causing most of the infections.

"It's just a rare, rare cause of infection." Seeing that mold in the meninges - membranes covering the brain and spinal cord - is "completely new."

Initially, St Joseph's Fungal Outbreak Clinic was started in order to coordinate the care of patients after their discharge, which included overseeing the administration of a complex regime of anti-fungal drugs.

It morphed into something bigger when some of its 53 patients with meningitis started returning with infections near the site in their back or neck where the contaminated drug was injected.

Then came a wave of patients like Robbins, who had been ruled out for meningitis with a spinal tap, but were still complaining of pain near their injection site.

GETTING THE 'BIGGER BOAT'

"When it became obvious that the number of patients would be a much higher percentage than anticipated by the CDC, we expanded our clinic and started enlisting the help of several other hospitals," Vandenberg said.

Many of the patients had spinal abscesses, an infection in the space between the outside covering of the spinal cord and the bones of the spine. Others developed arachnoiditis, an infection of nerves within the spinal canal.

The decision to screen all patients in the hospital database who might have received tainted injections was not taken at the recommendation of the CDC.

"That was our own decision," said Vandenberg, a specialist in internal medicine overseeing the screening effort.

He admitted that the strategy was aggressive, but said that, especially early on, doctors feared the local infections might be precursors to meningitis, making catching them early a potentially life-saving move.

Excluding patients who had already been screened and those who had injections in areas other than the spine, the hospital targeted about 500 patients for MRI scans.

Most so far have had private insurance that covers the screening. For the uninsured, the hospital's Patient Financial Services department has been helping them to apply for financial support.

"We did over 400 MRIs in about a 4-week period," Vandenberg said. The hospital screened so many patients, in fact, that the state of Michigan sent in an emergency mobile MRI unit to help.

Vandenberg got the task of reading stacks of MRI reports, sometimes as many as 30 a day.

So far, about 20 percent of the MRIs have shown up as abnormal, meaning that patients have to come back for surgery and treatment.

Vandenberg makes all of those calls personally. Not all of them go smoothly. He likens the gravity of the conversation - learning you have a potentially deadly new disease that requires months of treatment with risky drugs - to telling someone they have cancer.

After one especially tough call, in which a heart patient feared he would not survive the surgery he would need to clear his infection, Vandenberg cracked.

"I started crying. I probably haven't cried for 15 years."

SIGNS OUTBREAK IS EASING

But at last, after months of onslaught, there are signs the outbreak is easing.

Attendance at the hospital's daily support group has begun to taper off. And since the beginning of December, more than 50 patients with fungal infections have been discharged, while only 20 have been admitted, bringing the total number of fungus-related inpatient to 30.

Vandenberg nevertheless cautions that the outbreak is still far from over.

"Every single day of this screening program, we're finding one or two cases that are abnormal and need to be admitted," he said.

Vandenberg gave the CDC access to the clinic's database so the agency could see how the effort turned out, and this month, the CDC issued the alert to doctors incorporating some of the results of the MRI screening program.

The alert warned that some patients who got tainted injections but did not develop meningitis may still be at risk of localized infections.

And it urged doctors to consider ordering an MRI for all patients who still have pain, even if the pain is similar to what sent them in for treatment in the first place.

Chiller said the United States had not yet reached the end of the outbreak.

"Unfortunately, with fungi, the incubation periods are so long and they can remain indolent. I'm definitely concerned that we're going to continue to see more cases."

(Reporting by Julie Steenhuysen; Editing by Jilian Mincer, Mary Milliken and David Brunnstrom)


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Senate, House ag committees in deal to avert milk price spike

By Jim Wolf

WASHINGTON | Sun Dec 30, 2012 1:11pm EST

WASHINGTON (Reuters) - Farm-state lawmakers have agreed to a one-year extension of the expiring U.S. farm bill that, if enacted, would head off a possible doubling of retail milk prices to $7.OO or more a gallon in 2013.

The compromise measure resulted from bipartisan discussions in the House of Representatives' Agriculture Committee and talks with colleagues in the U.S. Senate, Frank Lucas of Oklahoma, the House panel's chairman, said in a statement Sunday.

"It is not perfect - no compromise ever is - but it is my sincere hope that it will pass the House and Senate and be signed by the President by January 1," Lucas, a Republican, said.

It was not immediately clear whether House and Senate leaders would bring the measure to a vote soon enough to avoid putting the so-called "dairy cliff" milk price spike into action.

Separately, lawmakers are working on a last-ditch effort to avert the similarly timed "fiscal cliff," when the biggest tax increases ever to hit Americans are set to start, paired with significant federal spending cuts

U.S. Agriculture Secretary Tom Vilsack, in an interview with CNN taped Friday and aired on Sunday, urged Congress to come up with such a solution, if only an extension of the old law that expired nearly three months ago, lest milk prices start rising after January 1, 2013.

Absent a new bill or an extension of current law, milk prices would revert to rules set in 1949, the last "permanent" farm legislation in the United States. Government price supports would kick in, based on production costs 64 years ago, plus inflation. The potential retail milk price has been estimated at $6.00 to $8.00 a gallon versus current levels near $3.50.

Lucas said in the statement that time had run out in Congress' current session to enact a new five-year farm bill, as farm-state lawmakers and the dairy lobby had hoped.

Vilsack told CNN that soaring milk prices - if it comes to that - would ripple throughout all commodities "if this thing goes on for an extended period of time."

The price of milk will not double on January 1, if Congress fails to act. Instead, prices would rise gradually as supplies are removed from normal markets and land instead in U.S. Department of Agriculture storage facilities.

With supplies more scarce in normal marketing channels, some milk distributors and dairy product manufacturers could have turned to imported supplies.

The Department of Agriculture is reviewing a range of options for administering programs should a permanent law become legally effective on January 1, a spokesman said on Friday.

The Senate passed its new five-year farm bill in June, and the House Agriculture Committee followed with a version in July.

But the House bill, with large cuts in food-stamp funding for lower-income Americans, has never been brought to a vote by the full House. The Senate and House have for months remained far apart on the issues of food stamps and crop subsidies.

Lucas said the year-long extension "provides certainty to our producers and critical disaster assistance to those affected by record drought conditions."

It would also mean another round of the direct subsidies to farmers that cost about $5 billion a year, and that both sides of debate had agreed earlier to eliminate.

(Additional reporting by Charles Abbott; Editing by Ros Krasny and Maureen Bavdek)


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Obama touts Hagel, says no decision on defense secretary job

US Democratic presidential candidate Senator Barack Obama (D-IL) (R) shares a laugh with Senator Chuck Hagel (R-NE) at the Amman Citadel in Amman July 22, 2008. REUTERS/Ali Jarekji

US Democratic presidential candidate Senator Barack Obama (D-IL) (R) shares a laugh with Senator Chuck Hagel (R-NE) at the Amman Citadel in Amman July 22, 2008.

Credit: Reuters/Ali Jarekji

By Jeff Mason and Tabassum Zakaria

WASHINGTON | Sun Dec 30, 2012 12:12pm EST

WASHINGTON (Reuters) - President Barack Obama offered strong support for former Republican Senator Chuck Hagel as the potential next U.S. defense secretary but said in remarks aired on Sunday that he had not yet decided on a nominee for the Pentagon post.

Hagel is considered a leading candidate to replace outgoing Secretary of Defense Leon Panetta, but the former Nebraska lawmaker has come under criticism for his record on Israel and for a comment that being gay was an inhibiting factor for being an ambassador.

"I've served with Chuck Hagel. I know him. He is a patriot. He is somebody who has done extraordinary work both in the United States Senate, somebody who served this country with valor in Vietnam," Obama told NBC's "Meet the Press" in an interview taped on Saturday and broadcast on Sunday.

Any nomination for defense secretary must be approved by the Senate where some lawmakers have voiced criticism about their former colleague.

"I think a lot of Republicans and Democrats are very concerned about Chuck Hagel's positions on Iran sanctions, his views toward Israel, Hamas and Hezbollah, and that there is wide and deep concern about his policies. All of us like him as a person," Republican Senator Lindsey Graham said.

"There would be very little Republican support for his nomination, at the end of the day, there will be very few votes," Graham said on Fox News Sunday.

Republican Senator Tom Coburn from Oklahoma said bluntly: "I cannot vote for Chuck Hagel."

Aside from his controversial statements, "he does not have the experience to manage a very large organization like the Pentagon," Coburn said on CBS' "Face the Nation." "If there's a place that we need great management it's the Pentagon."

Senator Richard Durbin, a Democrat from Illinois, said on the same television show that Hagel deserved "respect for the service he's given our country in the military and in the Senate" and should be given consideration. "He at least deserves a hearing and an opportunity," he said.

Obama said he had seen nothing that would disqualify Hagel.

The president said Hagel had apologized for his comments related to homosexuality, referred to by NBC's David Gregory in the interview.

"With respect to the particular comment that you quoted, he apologized for it," Obama said.

"And I think it's a testimony to what has been a positive change over the last decade in terms of people's attitudes about gays and lesbians serving our country. And that's something that I'm very proud to have led," he said.

Obama came out in favor of gay marriage in the middle of his re-election bid this year. Earlier in his term he presided over the end of the "don't ask, don't tell" policy that prohibited gay men and women from serving openly in the U.S. military.

Hagel, who left the Senate in 2008, has faced questions about his record on Israel.

Some of Israel's leading U.S. supporters contend that Hagel at times opposed Israel's interests, voting several times against U.S. sanctions on Iran, and made disparaging remarks about the influence of what he called a "Jewish lobby" in Washington.

Obama, who has strained relations with Israeli Prime Minister Benjamin Netanyahu, has faced questions of his own from the American Jewish community about his approach to the U.S. ally.

Obama said Hagel was doing an "outstanding job" serving on an intelligence advisory board and gave no indication on when he would make his final decision about the defense chief job.

The president has already backed down once from a contentious nomination, choosing Democratic Senator John Kerry to replace Hillary Clinton as secretary of state rather than going with his presumed first choice, U.S. Ambassador to the United Nations Susan Rice, whom many Republicans opposed after she made controversial remarks about the September 11 attacks on a U.S. mission in Benghazi, Libya, that killed four Americans.

(Editing by Sandra Maler)


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EPA faces legal battles, might take easy confirmation road

U.S. Environmental Protection Agency Administrator Lisa Jackson testifies at a hearing of the House Subcommittee on Oversight and Investigations on Capitol Hill in Washington, September 22, 2011. REUTERS/Jonathan Ernst

U.S. Environmental Protection Agency Administrator Lisa Jackson testifies at a hearing of the House Subcommittee on Oversight and Investigations on Capitol Hill in Washington, September 22, 2011.

Credit: Reuters/Jonathan Ernst

By Valerie Volcovici

WASHINGTON | Sun Dec 30, 2012 5:11am EST

WASHINGTON (Reuters) - Regardless of who takes the reins, the U.S. Environmental Protection Agency will likely face continued legal battles in President Barack Obama's second term as it tries to finalize pollution rules for power plants, analysts said.

EPA Administrator Lisa Jackson, who spearheaded the Obama administration's regulation of carbon emissions, said on Thursday she will step down after almost four years.

Her tenure was marked by opposition from industry groups and Republican lawmakers to the EPA's first-ever crackdown on carbon emissions, as well as other anti-pollution measures.

Analysts said whoever succeeds Jackson will probably face a spate of lawsuits to challenge rules that the EPA will finalize governing power plants, industrial sources and oil and gas production.

"This is shaping up to be four years of litigation," said Christopher Guith, vice president for policy at the U.S. Chamber of Commerce's Energy Institute.

Given the partisan divide, Guith said, legislators would struggle to draft laws that could serve as alternatives to the EPA's pending suite of carbon and air regulation.

"As we look to an even more divided Congress, the action will be in the federal courts," he said.

The U.S. Court of Appeals for the District of Columbia circuit, which hears most challenges to federal environmental rules, is likely to be busy as industry groups and states bring their cases against the EPA's rules after they are finalized.

The court sided with the agency in most of the recent challenges, most notably upholding its decision to use the Clean Air Act to regulate carbon dioxide emissions.

David Doniger, policy director of the National Resources Defense Council's Climate and Clean Air Program, said this could bolster the EPA as it tackles rules that may be more controversial than those rolled out under Jackson.

"The agency has a very good batting record on the clean air side. Carbon and climate (regulations) have come through completely unscathed," he said.

CARETAKER ADMINISTRATOR?

After the EPA was a political lightning rod during the first Obama administration, the president is likely to seek out a safe, possibly internal choice as Jackson's successor, or to avoid the confirmation process altogether.

"There are just so many arrows pointed at this agency," said Susan Tierney, managing principal and energy and environment specialist at Boston-based Analysis Group

Bob Perciasepe, deputy EPA administrator, will take over on an interim basis and could continue in that role indefinitely.

He previously worked at the EPA during the Clinton administration, specializing in water and air quality. Before rejoining the agency, Perciasepe was a top official at the National Audubon Society, a major conservation group.

Tierney said she expects the EPA to stay the course on its current agenda, especially as the agency faces some court-ordered deadlines to finalize rules, such as for coal ash, industrial waste from coal-fired plants and ozone standards.

PRIORITY ON CLIMATE CHANGE?

Some environmentalists have criticized Obama for being too timid on climate issues during his first term. But in his acceptance speech on election night in November the president gave a nod to climate change, raising hopes for more activism.

The White House may lean on the EPA to tackle one of the largest sources of U.S. greenhouse gas emissions, the current fleet of power plants, said Jeremy Symons, senior vice president at the National Wildlife Federation.

"The president has made clear that climate change is one of his top three priorities for the second term, so that means EPA needs to do its job," Symons said.

This, he said, means the agency needs to finalize the rules for new power plants and the standards for limiting carbon emissions from existing power plants.

The NRDC's Doniger said once the EPA meets an April 2013 legal deadline to finalize the greenhouse gas rules for new power plants, it will then have to address standards for existing plants.

The EPA has to start promptly in the beginning of the second term, said Doniger, because the rulemaking process is "a multistep process that will take time."

The controversial task will almost certainly trigger lawsuits because the rules will target a large number of domestic power plants and could jeopardize electric reliability.

"It's high stakes litigation when you are talking about bringing 40 percent of generation under regulations. That's disastrous," the Chamber's Guith said.

Guith said that while the EPA does have the authority to regulate carbon dioxide using the Clean Air Act, its rules are too difficult for industry - forcing the litigation.

"This EPA has been so aggressive in pushing the envelope by way of the compliance timeline that it has made itself more vulnerable to lawsuits," he said.

The EPA may also face legal challenges from environmental groups and certain states. The NRDC, the Environmental Defense Fund and the Sierra Club joined a group of nine states led by New York that threatened to sue the EPA last year to propose air pollution standards for oil and gas drilling.

They said that the drilling, transportation and distribution resulted in a significant release of methane, a potent greenhouse gas that is not regulated by federal rules.

Doniger said the group is trying to negotiate a timeline with the EPA to set a rule but could sue the agency if it doesn't agree a schedule by February.

(Additional reporting by Ayesha Rascoe; Editing by Gary Hill)


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U.S. industry presses for duties on shrimp from seven countries

WASHINGTON | Fri Dec 28, 2012 9:35pm EST

WASHINGTON (Reuters) - U.S. shrimp producers filed a petition on Friday asking the Commerce Department to impose punitive duties on billions of dollars of shrimp from China, Vietnam, India, Indonesia, Malaysia, Thailand and Ecuador to offset what they said were unfair foreign government subsidies.

"Today's filing is about the survival of the entire U.S. shrimp industry," C. David Veal, executive director of the Coalition of Gulf Shrimp Industries, said in a statement.

The group represents shrimp fisherman in Alabama, Florida, Georgia, Louisiana, Mississippi and Texas who say they have lost U.S. market share to lower-priced imports from the six countries in Asia and the one in South America.

"Our harvesters, docks, and processors have all played a vital role in the economy and culture of the Gulf region throughout its history. This case will help determine whether together we can continue to create jobs, contribute to economic growth, and sustain communities across the Gulf states for years to come," Veal said.

The request could be awkward for the United States because it is engaged in regional free-trade talks with two of the countries targeted by the petition, Vietnam and Malaysia.

The threat of punitive U.S. duties on their shrimp exports could make those countries reluctant to agree to U.S. demands for market-opening in other sectors.

The seven countries named in the petition exported $4.3 billion worth of shrimp to the United States in 2011, accounting for 85 percent of U.S. imports and over three-quarters of the domestic market, the U.S. industry group said.

The Commerce Department has several weeks to decide whether to launch an investigation. Assuming it does, final countervailing duties could be in place by the end of 2013 if illegal foreign subsidies are found, the group said.

(Reporting By Doug Palmer; Editing by Peter Cooney)


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Tale of two cities: Chicago murder rate spikes, New York falls

Lakeshore Drive in Chicago seen at night, October 30, 2010. REUTERS/Larry Downing

Lakeshore Drive in Chicago seen at night, October 30, 2010.

Credit: Reuters/Larry Downing

By James B. Kelleher and Jonathan Allen

CHICAGO/NEW YORK | Fri Dec 28, 2012 7:02pm EST

CHICAGO/NEW YORK (Reuters) - In a sharp contrast between two of the nation's largest cities, Chicago recorded its 499th murder of 2012 on Thursday night while New York reported 414 murders as of Friday even though it has more than three times the population, according to police.

Plagued by gang violence, Chicago surpassed last year's murder total of 433 in October and is set for the highest rate of homicide since the third largest U.S. city recorded 512 in 2008. The number is likely to top 500 on the last weekend of the year.

New York Mayor Michael Bloomberg announced on Friday that the nation's largest city could finish the year with the lowest number of murders and shootings since 1963, when it began keeping comparable data. The number of murders this year in New York is only about one-fifth the total of 2,245 homicides recorded in the peak year of 1990.

CHICAGO LEADERS FRUSTRATED

The rising murder rate has frustrated Chicago Police Commissioner Garry McCarthy and Chicago Mayor Rahm Emanuel, who promised to make the city's streets safer when he took office in May 2011.

"It's unacceptable," McCarthy said in an interview with Reuters on Friday.

New York's Bloomberg trumpeted the news with Police Commissioner Raymond Kelly at a police recruit graduation ceremony in the borough of Brooklyn.

Kelly attributed the decline to the increasing use of stop-and-frisk tactics, when police can stop and search people on the street they consider suspicious.

"We're preventing crimes before someone is killed and before someone else has to go to prison for murder or other serious crimes," Kelly said in a statement.

Civil rights groups and some local politicians have criticized stop-and-frisk tactics, saying that most people stopped turn out to be innocent, and they unfairly target black and Latino men. The practice is the subject of a federal court case over whether it is unconstitutional.

New York has also spent $185 million to settle lawsuits filed against the police during the fiscal year 2011. A total of 8,882 suits were filed against the NYPD, a 10 percent increase from the prior year, according to a report by the city's comptroller's office.

MOST VICTIMS AFRICAN-AMERICAN

Chicago's McCarthy said the city's high murder rate, up 18 percent over last year as of December 16, was due to gang violence. Eighty percent of the homicides were gang-related and 80 percent of the victims were African-Americans, he said.

Blacks make up about 33 percent of the city's population, according to the 2011 estimate from the U.S. Census.

In August, six people were murdered in the city on a single weekend day, the highest one-day death toll of 2012.

McCarthy and other officials blame the surge on a splintering of the city's traditional gangs and the rise of new cliques and factions that are vying, often violently, for control of turf on the city's south and west sides.

The spike in homicides was especially dramatic in the first quarter of the year, when murders jumped 66 percent. So far in the fourth quarter, McCarthy said, the murder rate is down 15 percent compared with the same period last year. Police have arrested 7,000 more gang members this year than in 2011, he said.

"We're doing what we can do and it's working," McCarthy said.

After mounting criticism of Emanuel and McCarthy earlier this year, the police chief announced a shakeup of his department, transferring some police managers among districts to bolster the battle against gangs.

McCarthy said Chicago faces a larger illicit gun problem than either New York or Los Angeles, the second-largest U.S. city.

"In the first six months of the year, we seized three guns for every gun seized in Los Angeles and nine guns for every gun confiscated by the New York Police Department," McCarthy said.

"When people ask me, 'What's different about Chicago?' that's one of the things I tell them. We have a proliferation of illegal firearms," he said.

Illinois does not ban assault weapons and the high-capacity magazines that increase their killing potential, as do New York and California. Emanuel has called for tougher gun controls in the aftermath of the recent Connecticut school shooting.

STEALING APPLE IPHONES

While Chicago's murder rate was up, most other categories of crime were down this year from 2011, including criminal sexual assault, robbery, motor vehicle theft and burglary, according to police statistics.

In New York, the number of rapes, robberies, felony assaults and burglaries increased between 1 and 3.4 percent compared to 2011, according to police statistics as of earlier this month. Grand larceny increased by 9 percent, which police said was because of thefts of expensive Apple products such as iPhones and iPads.

Chicago was not alone in recording a spike in murders this year. The murder rate in Detroit through December 16 was up more than 12 percent over 2011 and at the highest level in nearly two decades, according to the city's police department.

As of Friday, St. Louis had recorded 113 homicides, the same number as 2011 with one weekend to go in 2012, police spokesman David Marzullo said. Across the Mississippi River in East St. Louis, Illinois, 22 murders have been recorded this year in a town of only 27,000 people.

"The numbers just blow you away for a community as small as East St. Louis," said Brendan Kelly, state's attorney for St. Clair County, whose jurisdiction includes East St. Louis.

The East St. Louis murder rate is actually down from 30 in 2011 because of targeted patrolling of crime hot spots, Kelly said.

(Additional reporting by Tim Bross in St. Louis; Editing by Greg McCune and Leslie Gevirtz)


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U.S. mentally ill and their families face barriers to care

By Sharon Begley

NEW YORK | Sat Dec 29, 2012 8:27am EST

NEW YORK (Reuters) - Lori, a 39-year-old mother in New Jersey, would like to save for the usual things: college, retirement, vacations. But those goals are far down her wish list. For now, she and her husband are putting aside money for a home alarm system. They're not worried about keeping burglars out. They need to keep their son in.

Mike, 7, began seeing a psychiatrist in 2009, after one pre-school kicked him out for being "difficult" and teachers at the public school he later attended were worried about his obsessive thoughts and extreme anxiety. He was eventually diagnosed with bipolar disorder.

As she keeps trying to get help for him, "I am learning firsthand how broken the system is when dealing with mental illness," said Lori. (Surnames of patients and their families have been withheld to protect their privacy.)

"We fight with doctors, our insurance company, educators, each other; the list goes on and on ... It isn't even a system. It's not like there's a call center to help you figure out what to do and how to get help."

Last week, the National Rifle Association blamed mass shootings such as that at Sandy Hook Elementary School in Newtown, Connecticut, on the lack of a "national database of the mentally ill," who, it claimed, are especially prone to violence.

Dr. Paul Appelbaum, professor of psychiatry, medicine and law at Columbia University, disagrees, however. "Gun violence is overwhelmingly not about mental illness," he said. "The best estimate is that about 95 percent of gun violence is committed by people who do not have a diagnosis of mental illness."

But experts on mental illness agree with one implication of the NRA's argument: families trying to get help for a loved one with mental illness confront a confusing, dysfunctional system that lacks the capacity to help everyone who needs it - and that shunts many of the mentally ill into the criminal justice system instead of the healthcare system.

"Public mental health services have eroded everywhere, and in some places don't exist at all," said Richard Bonnie, professor of law and medicine at the University of Virginia. "Improving access to mental health services would reduce the distress and social costs of serious mental illness, including violent behavior."

Because mental health care is in such short supply, emergency cases receive priority. If a young man has a psychotic break and threatens his mother with a knife, "you can call the police and initiate an emergency evaluation," said Bonnie.

A psychiatrist called to the local emergency room may agree that the man is an imminent threat to himself or others, or cannot provide for his basic needs - the criteria for involuntary commitment in most states. Anything short of that and even someone with a diagnosis of severe mental illness cannot be involuntarily committed.

Critics argue that this emphasis on civil liberties lets dangerous people roam the streets, and cite numerous cases where it has been fatal. In October, for instance, a Tacoma, Washington, man who had been diagnosed with paranoid schizophrenia and was in and out of mental hospitals for years confessed to killing his father with a hatchet.

One lesson of such tragedies, experts say, is that psychiatrists' ability to predict who will be violent "is better than chance, but not much better," said Dr. Marvin Swartz, professor of psychiatry at Duke University.

Another is that the shortage of in-patient treatment has led everyone from judges to mental health professionals to look for any excuse to avoid committing someone involuntarily. There is often no place to put them, and admitting one patient means discharging another who might be equally ill.

"Getting people into hospitals is extremely difficult because of the shortage of beds," said Columbia University's Appelbaum.

The shortage extends to out-patient services, too, largely as a result of continuing budget cuts. Since 2009, states have cut more than $1.6 billion from such spending, found a 2011 report by the National Alliance on Mental Illness (NAMI), a nonprofit education and advocacy group. The result is "significant reductions in both hospital and community services," it said.

Connecticut, where Newtown is, is an exception. Its mental health budget rose from $676 million in 2009 to $715 million in 2012.

'THEY'RE ALL PSYCHOTIC'

More typical are Illinois (a reduction in spending on mental health of $187 million in that period), Ohio (down $26 million) and Massachusetts (down $55.6 million). "There's a waiting list for our program (in Boston) and it's hard to get in," said psychiatrist and NAMI medical director Ken Duckworth, who treats mentally ill patients.

There is room in his program for 60 people. The waiting list has 20, he said, "and they're all psychotic."

It wasn't supposed to be this way. The Community Mental Health Center Act, passed in 1963, called for federal funding of outpatient psychiatric facilities in towns and cities "so people would at least know where to start" when they or a family member needed a mental health evaluation or treatment, said Appelbaum. "It was supposed to be a single point of entry." But only about 650 of the 1,500 centers were built, and federal funding for staffing tailed off after four years when Congress did not appropriate more.

As a result, of the estimated 45.9 million U.S. adults 18 or older who had mental illness in 2010, some 11 million had "an unmet need for mental health care," estimates the Alliance for Health Reform, a nonprofit advocacy group.

One of those 11 million is Joseph. Even though he became violent, tried to jump out of a moving car, hit his wife and threatened to burn down their house, it was not enough to keep him in the psychiatric unit of their local New Jersey hospital.

He "cycled through the system," said his daughter. He went to the local emergency room five times, was arrested four times, went to the psychiatric unit three times, and spent 25 nonconsecutive days in a psychiatric hospital - all in three months in 2010.

Joseph's psychiatrist and family believed he should be in a state mental hospital, but his doctor did not show up to testify at a commitment hearing and the main evidence presented was a threatening letter Joseph had written to his wife. He was not deemed a danger to himself or others, and was released.

He did, however, cycle between jail and the psychiatric ward, making him one of many cases that "wind up in the criminal justice system instead of the healthcare system," said the University of Virginia's Bonnie. "Families watch their loved one unravel and can't get assistance, and then they get ensnared in the criminal justice system and can't get them out."

The difficulty getting outpatient care for the mentally ill is particularly widespread because most psychiatric hospitals were closed during the "de-institutionalization" of the 1960s and 1970s, an effort to provide more humane care than in the sometimes nightmarish wards.

One facility that closed was Fairfield Hills State Hospital, which opened in 1933, housed just over 4,000 mentally ill, long-term patients at its peak in the 1960s, and closed in 1995. It was located in Newtown.

"It's a metaphor for what we've done about mental health treatment in this country," said Duckworth. "A town that had a major treatment facility for 60 years has a mass shooting by someone who was mentally ill. We don't have a coordinated system of screening for, let alone treating, mental illness."

Even a diagnosis of mental illness with a possibility of harming oneself or others is no guarantee of help, even for young people.

"We estimate that fewer than one-quarter of the children, teenagers and young adults who have a mental health problem receive any treatment whatsoever," said Bernadette Melnyk, professor of psychiatry and pediatrics at Ohio State University College of Medicine. "And of those who do get treated, a substantial amount of the treatment is not the best, evidence-based kind."

For instance, a combination of cognitive-behavior therapy and medication is most effective at treating depression. "But very few patients receive the psychotherapy because we have such a severe shortage of mental health providers," said Melnyk.

Trying to get that help can drain a family emotionally.

'SOME SORT OF MONSTER'

"There are no professionals to help us with the tantrums or hysteria at the dentist or getting a haircut," said Lori, the New Jersey mother. "When Mike has a fit or screams obscenities in public, strangers assume he's a spoiled brat or some sort of monster."

"I worry that if he does not take good care of himself . . . well, let's just say that I can empathize with Adam Lanza's (the Newtown shooter's) family, too," she said.

To be sure, protecting the public from crime spurred by mental illness is only one argument for better psychiatric care. Every person who needs such care and doesn't get it is one more individual whose dreams of a full and productive life are shattered.

Virginia's Bonnie saw that firsthand when, after the 2007 Virginia Tech shooting rampage by Seung-Hui Cho, scores of families told him of their struggles to get help for loved ones with mental illness.

One young man, a brilliant college student and athlete, suffered his first psychotic break as an 18-year-old freshman and was diagnosed with paranoid schizophrenia. Robert was hospitalized nine times over 12 years, but when he attempted suicide after one stay his parents could not get him admitted again: he did not meet the "imminent danger" standard.

Feeling threatened by his "increasing psychotic behaviors," the parents told Bonnie, they called the police, who arrested and jailed Robert for breaking and entering the family home. Without treatment, his psychosis only became worse.

It is all too common for the mentally ill to wind up in the criminal justice system, not the health system, said Bonnie. "Families are suffering the consequences of the lack of mental health treatment all the time," he said. "Every once in a while they explode into public view" with a national tragedy like Newtown.

(Reporting by Sharon Begley; Editing by Jilian Mincer and Steve Orlofsky)


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