Kenya hospital imprisons new mothers with no money

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Associated Press reporter Tom Odula contributed to this report.

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Toyota Agrees to $1B Settlement in Acceleration Case

Toyota has agreed to pay more than $1 billion to customers to settle a class action lawsuit that alleged its vehicles accelerated dangerously and without warning, according to statements by the carmaker and the plaintiffs' attorney.

The deal, which still needs approval by a federal judge in California, includes a $250 million fund to be paid to Toyota owners who sold their cars at a loss following reports of vehicle malfunctions, as well as the installation of a brake override system in about 3.25 million vehicles

An additional $250 million fund will be created to pay those owners whose vehicles are not eligible for the retrofitted brakes.

David Zalubowski/AP PHoto

Toyota recalled more than 14 million vehicles after reports of sudden, unexplained acceleration in several models began to surface between 2009 and 2010. There were also reports of brake problems with the Prius hybrid.

Toyota insists that it was not an electrical flaw that caused the acceleration problems, but driver error, floor mats and sticky gas pedals.

Both the National Highway Traffic Safety Administration and NASA have said there is nothing in wrong with programs that run the vehicles' onboard computers

"From the very start, this was a challenging case," said Steve Berman, the plaintiffs' lawyer. "We brought in automotive experts, physicists and some of the world's leading theoreticians in electrical engineering to help us understand what happened to drivers experiencing sudden acceleration."

The settlement also includes $30 million to be given to outside groups to study automotive safety.

In a statement, Toyota agreed to the deal.

"In keeping with our core principles, we have structured this agreement in ways that work to put our customers first and demonstrate that they can count on Toyota to stand behind our vehicles." said Toyota spokesman Christopher P. Reynolds.

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Syria to discuss Brahimi peace proposals with Russia

BEIRUT (Reuters) - Syrian President Bashar al-Assad sent a senior diplomat to Moscow on Wednesday to discuss proposals to end the conflict convulsing his country made by international envoy Lakhdar Brahimi, Syrian and Lebanese sources said.

Brahimi, who saw Assad on Monday and is planning to hold a series of meetings with Syrian officials and dissidents in Damascus this week, is trying to broker a peaceful transfer of power, but has disclosed little about how this might be done.

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

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

Deputy Foreign Minister Faisal Makdad flew to Moscow to discuss the details of the talks with Brahimi, said a Syrian security source, who would not say if a deal was in the works.

However, a Lebanese official close to Damascus said Makdad had been sent to seek Russian advice on a possible agreement.

He said Syrian officials were upbeat after talks with Brahimi, the U.N.-Arab League envoy, who met Foreign Minister Walid Moualem on Tuesday a day after his session with Assad, but who has not outlined his ideas in public.

"There is a new mood now and something good is happening," the official said, asking not to be named. He gave no details.

Russia, which has given Assad diplomatic and military aid to help him weather the 21-month-old uprising, has said it is not protecting him, but has fiercely criticized any foreign backing for rebels and, with China, has blocked U.N. Security Council action on Syria.

"ASSAD CANNOT STAY"

A Russian Foreign Ministry source said Makdad and an aide would meet Foreign Minister Sergei Lavrov and Mikhail Bogdanov, the Kremlin's special envoy for Middle East affairs, on Thursday, but did not disclose the nature of the talks.

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

Given the scale of the bloodshed and destruction, Assad's opponents insist the Syrian president must go.

Moaz Alkhatib, head of the internationally-recognized Syrian National Coalition opposition, has criticized any notion of a transitional government in which Assad would stay on as a figurehead president stripped of real powers.

Comments on Alkhatib's Facebook page on Monday suggested that the opposition believed this was one of Brahimi's ideas.

"The government and its president cannot stay in power, with or without their powers," Alkhatib wrote, saying his Coalition had told Brahimi it rejected any such solution.

While Brahimi was working to bridge the vast gaps between Assad and his foes, fighting raged across the country and a senior Syrian military officer defected to the rebels.

Syrian army shelling killed about 20 people, at least eight of them children, in the northern province of Raqqa, a video posted by opposition campaigners showed.

The video, published by the Syrian Observatory for Human Rights, showed rows of blood-stained bodies laid out on blankets. The sound of crying relatives could be heard in the background.

The shelling hit the province's al-Qahtania village, but it was unclear when the attack had occurred.

STRATEGIC BASE

Rebels relaunched their assault on the Wadi Deif military base in the northwestern province of Idlib, in a battle for a major army compound and fuel storage and distribution point.

Activist Ahmed Kaddour said rebels were firing mortars and had attacked the base with a vehicle rigged with explosives.

The British-based Observatory, which uses a network of contacts in Syria to monitor the conflict, said a rebel commander was among several people killed in Wednesday's fighting, which it said was among the heaviest for months.

The military used artillery and air strikes to try to hold back rebels assaulting Wadi Deif and the town of Morek in Hama province further south. In one air raid, several rockets fell near a field hospital in the town of Saraqeb, in Idlib province, wounding several people, the Observatory said.

As violence has intensified in recent weeks, daily death tolls have climbed. The Observatory reported at least 190 had been killed across the country on Tuesday alone.

The head of Syria's military police changed sides and declared allegiance to the anti-Assad revolt.

"I am General Abdelaziz Jassim al-Shalal, head of the military police. I have defected because of the deviation of the army from its primary duty of protecting the country and its transformation into gangs of killing and destruction," the officer said in a video published on YouTube.

A Syrian security source confirmed the defection, but said Shalal was near retirement and had only defected to "play hero".

Syrian Interior Minister Mohammed Ibrahim al-Shaar left Lebanon for Damascus after being treated in Beirut for wounds sustained in a rebel bomb attack this month.

(Additional reporting by Laila Bassam; Writing by Alistair Lyon; Editing by Andrew Osborn)

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US childhood obesity dips for first time in decades: study

CHICAGO: Obesity rates among small children may finally be on the decline after more than tripling in the United States the past 30 years, a study out Wednesday indicated.

The study found that obesity rates peaked in 2004 and then declined slightly among low-income children aged two to four who receive benefits from a federal food stamp program called SNAP.

"To our knowledge, this is the first national study to show that the prevalence of obesity and extreme obesity among young US children may have begun to decline," wrote lead author Liping Pan of the Centres for Disease Control and Prevention (CDC).

"The results of this study indicate modest recent progress of obesity prevention among young children. These findings may have important health implications because of the lifelong health risks of obesity and extreme obesity in early childhood."

Obesity is most prevalent among minority and low-income families and has been associated with a range of health problems and premature death.

The researchers analysed data from a paediatric nutrition surveillance system which monitors almost half of the children eligible for federally funded maternal and child health and nutrition programs.

They were able to access height and weight data from 27.5 million children aged two to four in the 30 states which consistently reported their data.

In 1998, obesity levels were at 13.05 percent of the children. This rose to a peak of 15.36 percent in 2004 before declining to 14.94 percent in 2010.

Extreme obesity rates rose from 1.75 percent in 1998 to a peak of 2.22 percent in 2003 before slipping down to 2.07 percent in 2010, the study published in the Journal of the American Medical Association found.

In an accompanying editorial, Dr. David Ludwig said the declines seen are not enough, and he urged an overhaul of the federal food stamp program (SNAP) to help low-income families tackle obesity by eliminating junk food and adding more fruit and vegetables to their diet.

"SNAP is essential for hunger prevention in the United States, but its exclusive focus on food quantity contributes to malnutrition and obesity, and is misaligned with the goal of helping beneficiaries lead healthier lives," wrote Ludwig, who works in an obesity prevention centre at Boston Children's Hospital.

While other federal food programs, like the free meals offered in schools, have been revised to focus on healthful eating, SNAP has no regulations to influence the quality of food purchased.

Ludwig noted that it pays for an estimated US$4 billion in soft drinks per year, which adds up to about 20 million servings of soda a day.

"The public pays for sugary drinks, candy, and other junk foods included in SNAP benefits twice: once at the time of purchase, and later for the treatment of diet-induced disease through Medicaid and Medicare," he wrote.

"The nation's US$75 billion investment in SNAP could provide a major opportunity to reduce the burden of diet-related disease among low-income children and families if policies that promote nutritional quality are instituted."

More than a third of US children were overweight in 2008, the CDC found in a previous study.

Childhood obesity rates jumped from seven percent of children aged six to 11 in 1980 to 20 percent in 2008. The number of obese teens aged 12 to 19 jumped from five percent to 18 percent over the same period.

-AFP/fl

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Gulvez thought NCC would help him become a cop

NEW DELHI: By the time Gulvez Ahmad reached the final year of his B Com Honours course, he had changed his mind. He had joined the NCC in school thinking it would boost his chances in a career in policing . But when his father, Kafeel Ahmad, saw him off on December 21, he was looking forward finishing college and joining an MBA programme . Ahmad was one of the five students from the Delhi unit of the National Cadet Corps who drowned in the Periyar at Kochi on Wednesday . The others are Dilshad Alam, Tabish Baqri, Mohammad Zeeshan and Hemanth Kumar.

"He was called Hafiz," says Ahmad's uncle, Faheemuddin, "It means one who has learnt the Quran by heart. He was austere like a maulavi" But Ahmad, a student of Shaheed Bhagat Singh College , was a sharp one as well. Neighbours say he brought home awards and shields, was the "brightest of them all" and was expected to shine more. The news reached his home in Old Govindpura before his father, an embroiderer , did. "He was so young. I even accompanied to the railway station the day he left," says an inconsolable Kafeel Ahmad. Of the 96 cadets attending the trekking camp in Kochi, 53 were from Delhi.

"We've been trying to talk to him on the phone since morning but somebody would disconnect. In the evening, his mobile was switched off," says Dilshad Alam's mother. Dilshad's family was told that two of the five kids had slipped into the river and the other three had been trying to rescue them. "Dilshad could not swim," says his sister Ayesha Jabeen. He, along with Tabish and Zeeshan were engineering students at Jamia Millia Islamia University . Tabish and Zeeshan, were from Uttar Pradesh; Dilshad's family, is based close to the university , in Zakir Nagar. Alam's mother always checked on him when he went out on trips and this was his first one out of the state with the NCC. His father, Khursheed Alam, doesn't hold a steady job and is away most of the time. There was a lot riding on Dilshad's engineering degree.

Baqri came to Delhi from Amroha in Uttar Pradesh three years ago. His younger brother Danish - Baqri was one of six siblings - is concerned about the arrival of his body. "He called us four to five days ago to tell us he is leaving for the trip. My parents are devastated . They have fallen silent," says Danish. They heard of the tragedy on Wednesday evening. Mohammad Zeeshan, another engineering student at Jamia, was from Uttar Pradesh too. The only school student among the casualties was Hemanth Kumar, a student of Government Boys Senior Secondary School at GBlock , Kalkaji.

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Gunman Killed Firemen With Bushmaster, Left Note

A convicted killer, who shot dead two firefighters with a Bushmaster assault rifle after leading them into an ambush when they responded to a house fire he set in Western New York, left behind a typewritten note saying he wanted to "do what I like doing best, killing people," police said.

William Spengler, 62, set his home and a car on fire early Monday morning with the intention of setting a trap to kill firefighters and to see "how much of the neighborhood I can burn down," according to the note he wrote and which police found at the scene. The note did not give a reason for his actions.

Spengler, who served 18 years in prison for beating his 92-year-old grandmother to death with a hammer in 1981, hid Monday morning in a small ditch beside a tree overlooking the sleepy lakeside street in Webster, N.Y., where he lived with his sister, police said today in a news conference.

Police said they found remains in the house, believed to be that of the sister, Cheryl Spengler, 67.

As firefighters arrived on the scene after a 5:30 a.m. 911 call on the morning of Christmas Eve, Spengler opened fire on them with the Bushmaster, the same semi-automatic, military-style weapon used in the Dec. 14 rampage killing of 20 children in Newtown, Conn.

"This was a clear ambush on first responders… Spengler had armed himself heavily and taken area of cover," said Gerald Pickering, the chief of the Webster Police Department.

Armed with a Smith & Wesson .38 caliber revolver, a Mossman 12-gauge shotgun, and the Bushmaster, Spengler killed two firefighters, and injured two more as well as an off-duty police officer at the scene.

As a convicted felon, Spengler could not legally own a firearm and police are investigating how he obtained the weapons.

One firefighter tried to take cover in his fire engine and was killed with a gunshot through the windshield, Pickering said.

Responding police engaged in a gunfight with Spengler, who ultimately died, likely by a self-inflicted gunshot wound to the head.

As police engaged the gunman, more houses along Lake Ontario were engulfed, ultimately razing seven of them. Some 33 people in adjoining homes were displaced by the fire.

SWAT teams were forced to evacuate residents using armored vehicles.

Police identified the two slain firefighter as Lt. Michael Chiapperini, a 20-year veteran of the Webster Police Department and "lifetime firefighter," according to Pickering, and Tomasz Kaczowka, who also worked as a 911 dispatcher.

Two other firefighters were wounded and remain the intensive care unit at Strong Memorial Hospital in Rochester, N.Y.

Joseph Hofsetter was shot once. He sustained an injury to his pelvis and has "a long road to recovery," said Dr. Nicole A. Stassen, a trauma physician.

The second firefighter, Theodore Scardino, was shot twice and received injuries to his left shoulder and left lung, as well as a knee.

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Egypt approves constitution drafted by Mursi allies

CAIRO (Reuters) - Egyptian voters overwhelmingly approved a constitution drafted by President Mohamed Mursi's allies, results announced on Tuesday showed, proving that liberals, leftists and Christians have been powerless to halt the march of Islamists in power.

Final elections commission figures showed the constitution adopted with 63.8 percent of the vote in the referendum held over two days this month, giving Mursi's Islamists their third straight electoral victory since veteran autocrat Hosni Mubarak was toppled in a 2011 revolution.

Opposition groups had taken to the streets to block what they see as a move to ram through a charter that mixes politics and religion dangerously and ignores the rights of minorities.

Mursi says the text - Egypt's first constitution since Mubarak's fall - offers enough protection for minorities, and adopting it quickly is necessary to end two years of turmoil and political uncertainty that has wrecked the economy.

"I hope all national powers will now start working together now to build a new Egypt," Murad Ali, a senior official in the Muslim Brotherhood's Freedom and Justice Party, told Reuters.

"I see this as the best constitution in Egypt's history."

In a sign that weeks of unrest have taken a further toll on the economy, the government ordered new restrictions on foreign currency apparently designed to prevent capital flight. Leaving or entering with more than $10,000 cash is now banned.

Two years since waves of unrest broke out across the Middle East and North Africa - sweeping away long-entrenched rulers in Tunisia, Libya and Yemen as well as Egypt - well-organized Islamist parties have emerged as the main beneficiaries.

Urban secularists and liberals who were behind the revolts complain that their success has been hijacked.

"We need a better constitution," said Khaled Dawood, an opposition spokesman. "It does not represent all Egyptians."

Mursi's opponents say the new constitution could allow clerics to intervene in lawmaking, while offering scant protections to minorities and women. Mursi dismisses those criticisms, and many Egyptians are fed up with street protest movements that have prevented a return to normality.

Immediately after the announcement, a small group of protesters set tires on fire and blocked traffic near the central Tahrir square, the cradle of Egypt's uprising, but there were no immediate signs of violence or major demonstrations.

Washington, which provides billions of dollars a year in military and other support for Egypt and regards it as a pillar of security in the Middle East, called on Egyptian politicians to bridge divisions and on all sides to reject violence.

"President Mursi, as the democratically elected leader of Egypt, has a special responsibility to move forward in a way that recognizes the urgent need to bridge divisions," State Department spokesman Patrick Ventrell said. He noted that many Egyptians had voiced "significant concerns" over the constitutional process.

WORSENING ECONOMY

The government says its opponents are worsening the economic crisis by prolonging political upheaval. It has pledged to impose unpopular tax increases and spending cuts to win a loan package from the International Monetary Fund.

The ban on travelling with more than $10,000 in cash followed a pledge by the central bank to take unspecified measures to protect Egyptian banks. Some Egyptians have begun withdrawing their savings in fear of more restrictions.

"I am not going to put any more money in the bank and neither will many of the people I know," said Ayman Osama, father of two young children.

He said he had taken out the equivalent of about $16,000 from his account this week and planned to withdraw more, adding that he had also told his wife to buy more gold jewellery.

The "yes" vote paves the way for a parliamentary election in about two months, setting the stage for another battle between surging Islamists and their fractious opponents.

The final result, announced by the election commission, matched - to the last decimal place - an earlier unofficial tally announced by Mursi's Muslim Brotherhood.

But the opposition said it was disappointed - it had appealed for the result to be amended to reflect what it described as major vote violations during the two-round vote.

Officials said there were no violations serious enough to change the result significantly. "We have seriously investigated all the complaints," said judge Samir Abu el-Matti of the Supreme Election Committee. The final turnout was 32.9 percent.

SENSE OF CRISIS

The referendum has sharpened painful divisions in the Arab world's most populous nation and a growing atmosphere of crisis has gripped Egypt's polarized society.

Anxiety about the economy deepened this week when Standard and Poor's cut Egypt's long-term credit rating. Prime Minister Hisham Kandil told the nation of 83 million on Tuesday the government was committed to fixing the economy.

"The main goals that the government is working towards now is plugging the budget deficit, and working on increasing growth to boost employment rates, curb inflation, and increase the competitiveness of Egyptian exports," he said.

The referendum follows Islamist victories in parliamentary and presidential elections, representing a decisive shift in a country at the heart of the Arab world where Mursi's Muslim Brotherhood was suppressed for generations by military rulers.

However, secularist and liberal opposition members hope they can organize better in time for the next parliamentary vote.

Hossam El-Din Ali, a 35-year-old newspaper vendor in central Cairo, said he agreed the new constitution would help bring some political stability but like many others he feared the possible economic austerity measures lying ahead.

"People don't want higher prices. People are upset about this," he said. "There is recession, things are not moving. But I am wishing for the best, God willing."

(Additional reporting by Patrick Werr, Tamim Elyan, Ahmed Tolba and Marwa Awad; Writing by Maria Golovnina)

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China and emerging powers to pay more for UN

UNITED NATIONS: China, Brazil, India and other emerging powers agreed to major increases in their United Nations payments as the global body hammered out a new budget deal this week to avoid its own fiscal cliff.

The boom countries will pay more as economic crisis allows European nations, such as Britain, Germany and France and Japan to cut their contributions.

While the sums involved are not huge by global standards -- the revised UN budget for 2012-2013 is $5.4 billion -- diplomats say the new shareout is a snapshot of the world's changing economic fortunes.

And the UN system has maintained sum of its quirks with Greece, despite its economic slump, still paying more than India, which aspires to become a permanent member of the UN Security Council.

UN contributions are worked out according to a country's share of global gross national income (GNI). China will pay an extra 61 per cent in UN fees, taking its share of the budget from 3.2 to 5.1 per cent. It will overtake Canada and Italy to become the sixth biggest UN contributor.

Brazil has agreed to an 82 per cent hike in payments. It will pay 2.9 per cent of the budget instead of 1.6 per cent. India's payments will increase 24 per cent, taking its budget share from 0.5 to 0.66 per cent. And Russia's payments will go up by 52 per cent.

The United States remains the major UN financier, though its contributions are pegged at 22 per cent while it accounts for 24.2 per cent of world GNI.

Other major contributors will all see payments decrease. Japan, in second place, will see a 13.5 per cent drop to 10.8 per cent of the budget. It previously accounted for 12.5 per cent of UN finances.

Germany's share of the budget will fall from 8.0 to 7.1 per cent, France from 6.1 to 5.6 per cent and Britain from 6.6 to 5.18 per cent.

"This is a start brought on by the economic crisis in Europe, but there will have to be more changes eventually," said one western diplomat.

Another noted the new payment breakdown reflects changes around the world, and that the contrast between Greece and India was "striking."

Greece's share of budget will decrease from 0.7 to 0.64 per cent. But its share of global GNI is 0.5 per cent, while India, which pays about the same amount, accounts for 2.2 per cent of world GNI.

A complicated series of rebates allows various countries to claim reductions in payments. China and the other emerging powers still pay less than their share of the world economy. The Europeans and Japan still pay more.

The UN's regular budget does not include its peacekeeping operations, which cost more than $7.5 billion a year and are paid for with separate assessments.

Under the deal agreed this week, a pay freeze has been ordered for the estimated 10,000 UN staff in New York.

- AFP/ck

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B S Yeddyurappa threatens to pull down Karnataka government

BANGALORE: A day after the ruling BJP in Karnataka sacked 30 of his followers, former chief minister and Karnataka Janata Party president B S Yeddyurappa on Tuesday threatened to destabilize the government. He said he would meet governor HR Bhardwaj with the request to ask the government to prove its majority.

"The government has been reduced to a minority. Chief minister Jagadish Shettar has no moral right to continue. I will apprise the governor of the situation," BSY told reporters in Mysore.

On Monday night, Shettar and state BJP chief KS Eshwarappa acted tough by sacking BSY followers, who were heading state-run boards and corporations, on charges of anti-party activities.

An upset BSY challenged Shettar stating that if the CM was confident of regaining power, he should dissolve the assembly and seek fresh mandate. "Let people decide who is fit enough to rule them," he said. "I will soon convene a meeting of my followers and decide the future course of action," BSY added.

BSY's plan to meet the governor is seen as a strategy to stall Shettar from presenting the budget.

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

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

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

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

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

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

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

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

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

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

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

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

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

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

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

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

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

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

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

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

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

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

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

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

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Online:

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

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

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