Study: Drug coverage to vary under health law

0 comments

WASHINGTON (AP) — A new study says basic prescription drug coverage could vary dramatically from state to state under President Barack Obama's health care overhaul.


That's because states get to set benefits for private health plans that will be offered starting in 2014 through new insurance exchanges.


The study out Tuesday from the market analysis firm Avalere Health found that some states will require coverage of virtually all FDA-approved drugs, while others will only require coverage of about half of medications.


Consumers will still have access to essential medications, but some may not have as much choice.


Connecticut, Virginia and Arizona will be among the states with the most generous coverage, while California, Minnesota and North Carolina will be among states with the most limited.


___


Online:


Avalere Health: http://tinyurl.com/d3b3hfv


Read More..

Philippines death toll climbs, hundreds still missing after typhoon

0 comments

NEW BATAAN, Philippines (Reuters) - Blocked roads and severed communications in the southern Philippines frustrated rescuers on Wednesday as teams searched for hundreds of people missing after the strongest typhoon this year killed at least 283 people.


Typhoon Bopha, with central winds of 120 kph (75 mph) and gusts of up to 150 kph (93 mph), battered beach resorts and dive spots on Palawan island on Wednesday but it was weakening as it moved west.


Hardest hit was the southern island of Mindanao, where Bopha made landfall on Tuesday. It triggered landslides and floods along the coast and in farming and mining towns inland.


Interior Minister Manuel Roxas said 300 people were missing.


"Entire families were washed away," Roxas, who inspected the disaster zone, told reporters.


Most affected areas were cut off by destroyed roads and collapsed bridges and army search-and-rescue teams were being flown in by helicopter.


Power was cut and communications were down.


According to tallies provided by the military and disaster agency officials, 283 people were killed.


Thousands of people were in shelters and officials appealed for food, water and clothing. Dozens of domestic flights were suspended on Wednesday.


The governor of the worst-hit province, Compostela Valley, in Mindanao said waves of water and mud came crashing down mountains and swept through schools, town halls and clinics where huddled residents had sought shelter.


The death toll in the province stood at 160. In nearby Davao Oriental province, where Bopha made landfall, 110 people were killed.


"The waters came so suddenly and unexpectedly, and the winds were so fierce," the Compostela Valley governor, Arthur Uy, told Reuters by telephone.


He said irrigation reservoirs on top of mountains had given way sending large volumes of water down to the valleys. Torrential rain often triggers landslides down slopes stripped of their forest cover.


Damage to agriculture and infrastructure in the province was extensive, Uy said.


STUNNED


Corn farmer Jerry Pampusa, 42, and his pregnant wife were marooned in their hut but survived.


"We were very scared," Pampus said. "We felt we were on an island because there was water everywhere."


Another survivor, Francisco Alduiso, said dozens of women and children who had taken shelter in a village centre, had been swept away.


"We found some of the bodies about 10 km (6 miles) away," Alduisa told Reuters. The only building left standing in his village was the school.


Another survivor, Julius Julian Rebucas, said his mother and brother disappeared in a flash flood.


"I no longer have a family," a stunned Rebucas said.


An army commander said two dozen people had been pulled from the mud in one area and were being treated in hospital.


About 20 typhoons hit the Philippines every year, often causing death and destruction.


Almost exactly a year ago, Typhoon Washi killed 1,500 people in Mindanao.


(Additional Reporting by Rosemarie Francisco and Manny Mogato; Editing by Robert Birsel)



Read More..

Typhoon pounds the Philippines, killing at least 7

0 comments

MANILA, Philippines (AP) — One of the strongest typhoons to hit the Philippines this year barreled across the country's south on Tuesday, killing at least seven people and forcing more than 50,000 to flee from inundated villages.


Typhoon Bopha slammed into the Davao region at dawn, its ferocious winds ripping roofs from homes and its 500-kilometer- (311-mile-) wide rain band flooding low-lying farmland. The storm, packing winds of 160 kilometers (99 miles) per hour and gusts of up to 195 kph (121 mph), toppled trees, triggered landslides and sent flash floods surging across the region's mountains and valleys.


In the gold-mining province of Compostela Valley, the fierce wind and rain forced a wall of mud and boulders to cascade down on a house, killing three children. Their bodies were wrapped in blankets by their grieving relatives and placed on a basketball court in Maparat village.


"The only thing we could do was to save ourselves. It was too late for us to rescue them," said Valentin Pabilana, who survived the landslide.


A soldier died and 20 villagers were missing after a flash flood raced down a mountain in Andap town, washing away a truck, according to Compostela Valley Governor Arturo Uy and military officials.


In nearby Davao Oriental, a poor agricultural and gold-mining province about 1,000 kilometers (620 miles) southeast of Manila, an elderly woman was killed when her house was struck by a tree felled by howling wind, said Benito Ramos, an ex-army general who now heads the government's disaster-response agency.


A man died a few hours later when a tree knocked him down while he was traveling on a scooter on a road in Misamis Oriental province. One storm-related death was also reported on central Siquijor island, Ramos said.


He said the death toll was expected to rise once soldiers and police gain access to some far-flung villages isolated by floods, fallen trees and downed communications.


Regional disaster-response officer Liza Maso told The Associated Press by telephone that she was trying to confirm an army report that a flash flood washed away a truck carrying an undetermined number of people in New Bataan town, also in Compostela Valley.


While some 20 typhoons and storms normally lash the archipelago nation annually, the southern provinces being battered by Bopha are unaccustomed to fierce typhoons. A rare storm that took the area by surprise last December killed more than 1,200 people and left many more homeless and traumatized.


Officials were taking no chances this year, and President Benigno Aquino III made an appeal on national TV Monday for people in Bopha's path to move to safety and take storm warnings seriously.


"This typhoon is not a joke," Aquino said after meeting top officials in charge of disaster-response.


"But we can minimize the damage and loss of lives if we help each other," he added.


Aquino outlined preparations, including evacuations and the deployment of army search and rescue boats in advance. Authorities also ordered small boats and ferries not to venture out along the country's eastern seaboard, warning of rough seas with up to 4-meter (13-foot) waves.


In Compostela Valley, authorities halted mining operations and ordered villagers to evacuate to prevent a repeat of deadly losses from landslides and the collapse of mine tunnels seen in previous storms.


Bopha, a Cambodian word for flower or a girl, is the 16th weather disturbance to hit the Philippines this year. Forecasters say at least one more storm may hit the country before Christmas.


___


Associated Press writer Teresa Cerojano contributed to this report.


Read More..

Yahoo sees several flaws in $2.7 billion Mexico ruling: source

0 comments











SAN FRANCISCO (Reuters) – Yahoo Inc believes it has “numerous” grounds to appeal a Mexico City civil court‘s $ 2.7 billion preliminary judgment against the company, including both errors in procedure and in application of law, a person familiar with the matter told Reuters on Monday.


The ruling in the case, which involves allegations of breach of contract related to an online yellow pages listings service, was made by the 49th Civil Court of the Federal District of Mexico City, Yahoo said on Friday.












The case has perplexed many investors and tech-industry observers since Yahoo disclosed it, particularly given the large value of the “non-final” judgment.


The lawsuit was brought by Worldwide Directories S.A. de C.V. and Ideas Interactivas S.A. de C.V. against Yahoo and Yahoo de Mexico, Yahoo said.


The companies could not be reached for comment, although Carlos Bazan-Canabal, who describes himself as a founder of Worldwide Directories, told Reuters via email that he had contracted a U.S.-based law firm to handle the Yahoo case.


He declined to comment further on the matter.


Bazan-Canabal operates a number of web sites. He said on one that he joined Yahoo in 1999, adding that he is a former executive of Yahoo Mexico, and that he helped to launch that company. Yahoo could not immediately be reached for comment on this.


The details of the suit remained unclear on Monday. Documents from local courts in Mexico are not available for public consultation. Yahoo declined to comment.


Yahoo signed a commercial relationship with the two companies in 2002, the person familiar with the matter said. Yahoo terminated the relationship with the companies in 2009, the person said.


Yahoo’s appeal is expected to be heard by a panel of three judges in a superior court in Mexico City, the person said who was not authorized to speak publicly on the matter. It was not clear when Yahoo might file its appeal.


Yahoo’s most recent 10Q filing, which lists major ongoing legal proceedings, makes no mention of the lawsuit.


“We believe the $ 2.7 billion figure appears high based on the seemingly small size of Yahoo’s business in Mexico, but we believe shares could trade off modestly on the news,” wrote JP Morgan analyst Doug Anmuth in a note to investors following Friday’s announcement.


“It’s not clear how the Mexican court arrived at the $ 2.7 billion figure, but it would represent 40 percent of our projected 2012 year-end cash balance for Yahoo,” and equate to about $ 2.30 per share, he wrote.


Shares of Yahoo closed Monday’s regular session down 1.2 percent, or 22 cents, at $ 18.55.


(Additional reporting by Dave Graham in Mexico City and Sarah McBride in San Francisco; Editing by Bernard Orr)


Tech News Headlines – Yahoo! News


Read More..

Court upholds $319M verdict in 'Millionaire' case

0 comments

LOS ANGELES (AP) — A federal appeals court on Monday upheld a $319 million verdict over profits from the game show "Who Wants to Be a Millionaire" and rejected Walt Disney Co.'s request for a new trial.


A jury decided in 2010 that Disney hid the show's profits from its creators, London-based Celador International. The ruling Monday by a three-judge panel of the 9th U.S. Circuit Court of Appeals found no issues with the verdict or with a judge's rulings in the case.


"I am pleased that justice has been done," Celador Chairman Paul Smith said in a statement.


Disney did not immediately comment on the decision.


The ruling comes more than two years after the jury ruled in Celador's favor after a lengthy trial that featured testimony from several top Disney executives. The company sued in 2004, claiming Disney was using creative accounting to hide profits from the show, which first ran in the United States from August 1999 to May 2002 and was a huge hit for ABC.


The jury found that Celador was owed $269.2 million, and a judge later added $50 million in interest to the judgment.


The appeals court determined the verdict was not "grossly excessive or monstrous" and that it was not based on speculation or guesswork.


Read More..

Fossil fuel subsidies in focus at climate talks

0 comments

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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


___


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


____


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


Read More..

Does the GOP need a religious retreat?

0 comments

(Photo by Brandon Thibodeaux/Getty Images)


It's no surprise that Florida Sen. Marco Rubio took heat for an interview he gave to GQ magazine this month: Departing from scientific consensus, the rising Republican star refused to state whether the Earth is billions of years old or a few thousand, as many fundamentalist Christians believe.


What no one expected was the rebuke from televangelist and longtime Christian conservative leader Pat Robertson, dismissing theories of a "young Earth."


"If you fight science, you are going to lose your children," Robertson said last week during an appearance on the Christian Broadcast Network, the television empire he founded three decades ago.


Robertson wasn't directly speaking to Rubio, but the senator and others in his party might heed the advice. Viewed by many voters as anti-science and too conservative on social issues such as gay marriage, the Republican Party is in danger of losing young and less religious voters for years to come.


In a post-election breakdown by the Public Religion Research Institute, the Obama religious coalition mirrors the demographics of 18-29 year olds, whereas Romney's mirrors those of voters aged 65 and up.


On Nov. 6, as President Barack Obama won a narrow but clear victory over Mitt Romney, voters in four states expressed support for gay marriage. Anti-abortion candidates lost in several states, including Senate contenders Todd Akin of Missouri and Richard Mourdock of Indiana, both of whom stirred outrage from their remarks on rape.


Many experts believe these developments point in part to a decisive shift in the religious makeup of the country, one that could make or break a GOP comeback.


"The way Republicans speak is turning off the youngest, fastest growing groups in the country—Latinos and significantly, the unchurched, those with no religious affiliation," said Mark Rozell, a public policy professor at George Mason University who studies religion and politics. "To them, the Republicans are proselytizing."


Since the 1980s, organizations like Focus on the Family, the Moral Majority and the Christian Coalition cemented religious conservatives as visible and potent force in the Republican coalition and enforced discipline on social issues such as abortion and gay rights. But now, the religious landscape is changing beneath their feet.


Studies suggest the number of unchurched has doubled in the past two decades and shot up by 25 percent in the last four years. The shift has taken place across the country and across economic classes, most notably among the young; one fifth of adults and one third of Americans under thirty now declare themselves religiously unaffiliated.


The new and expanding group of unchurched voters overwhelmingly support same sex-marriage and legal abortion, and so they gravitate toward the Democratic Party.


"It's clearly a concern—we have a lot of work to do," said Gary Marx, executive director of the Faith and Freedom Coalition, which worked to boost turnout among Catholics and evangelical voters.


The group, founded by conservative Christian activist Ralph Reed, helped deliver more religious voters to the polls this year than in 2008, but such efforts couldn't deliver a Romney victory.


In a press release following the election, Reed acknowledged that minorities and the young—and therefore, he might have added, the unchurched—made the difference for Obama.


Marx and his colleagues insist they aren't especially concerned about the growing secularization of young voters. They are primarily looking to diversify the GOP's religious coalition, Marx said.


To close the Latino gap, Marx says conservative activists are planning a major outreach effort to evangelical Hispanics and to Hispanic Catholics who attend Mass.


"We are casting a wider net—the politics of addition, not subtraction," Marx said, adding that Latinos and other minorities have been attracted to many conservative positions like education reform.


Marx pointed to Georgia, where Hispanic and black voters supported a state amendment allowing the state government to set up charter schools.


Marx also suggested the Democratic advantage with young minority voters was "candidate-centric" — a reflection of Obama's unique status as the first black president.


But the problem may run deeper, into the Republican base: There is growing evidence that young evangelicals are simply less interested in politicizing hot-button issues.


"Young evangelicals don't look at the country as a battlefield, but rather a mission field," says James Wilcox, a George Mason University political science professor. "They're are less scared than their forbearers: They see the 'War on Religion' narrative as nonsense; they see churches thriving, the outlets they have, and the extent of religious pluralism in this country."


The new generation sees community activism, rather than electoral politics, as the means for their faith to shape the world, Wilcox argues. They may disagree with liberals about same-sex marriage, but they also believe that states have the right to determine such policies.


Many younger evangelicals are also serious about addressing climate change, even as many high-profile conservatives have expressed doubt about whether climate change is real—with nominee Mitt Romney cracking jokes about it at this year's Republican National Convention.


None of this means the influence of religious conservatives on Republican politics is set to disappear. But it is most certainly about to change.


Between the rise of the unchurched and the moderation of young religious conservatives, experts say, a smaller movement may emerge — one that retains its current zeal but carries less sway over the selection of GOP nominees. Or the movement could retain its power by successfully diversifying and coming up with a new way to talk to voters.


"We plan to reach out with a softer, pro-family agenda—less emphasis on the sexual points, more talk about family," Marx of the Faith and Freedom Coalition said. He also said activists would develop a "forward-looking" policy agenda akin to President George W. Bush's "compassionate conservatism."


But at the same time, Marx believes that some of that message already has been lifted by social liberals: "It is true that gay rights activists have stolen that language of 'family' we've used successfully, and now use it for their purposes."


One way for religious conservatives to start again, Rozell said, would be to return the favor and take a tip from two much-heralded communicators: Presidents Ronald Reagan and Bill Clinton.


"Successful politicians can speak two languages, even if it's hard to do," Rozell said. Reagan did it, addressing both the Christian right and a largely secular small-government audience. Often times it's a shift in rhetoric rather than policy."


Rozell cited Republican Gov. Bob McDonnell of Virginia, a strong social conservative, who has maintained his popularity by using language that appeals to both religious and secular audiences.


Another strategy would be to borrow from the vocabulary of the other team, as Bill Clinton did when he co-opted the rhetoric of religious conservatives to crack down on the culture of sex and violence on TV.


"Put aside this talk of wars," Rozell says, "Republicans could easily adopt the rhetoric of "rights" and "tolerance" that liberals currently own, to speak to secular types about the value of pluralism and religious conscience."



Read More..

Japan inspecting tunnels after deadly collapse

0 comments

TOKYO (AP) — Japanese officials ordered the immediate inspection of tunnels across the country Monday after nine people were killed when concrete ceiling slabs fell from the roof of a highway tunnel onto moving vehicles below.

Those killed in Sunday's accident were traveling in three vehicles in the 4.7-kilometer (3-mile) long Sasago Tunnel about 80 kilometers (50 miles) west of Tokyo. The tunnel, on a highway that links the capital to central Japan, opened in 1977 and is one of many in the mountainous country.

The transport ministry ordered that inspections be carried out immediately on 49 other tunnels around the country that are either on highways or roads managed by the central government and of similar construction.

Police and the highway operator Central Japan Expressway Co. were investigating why the concrete slabs in the Sasago Tunnel collapsed. An inspection of the tunnel's roof in September found nothing amiss, according to Satoshi Noguchi, a company official.

An estimated 270 concrete slabs, each weighing 1.4 metric tons (1.54 short tons), suspended from the arched roof of the tunnel fell over a stretch of about 110 meters (120 yards), Noguchi said.

The operator was exploring the possibility that bolts holding a metal piece suspending the panels above the road had become aged, he said. The panels, measuring about 5 meters (16 feet) by 1.2 meters (4 feet), and 8 centimeters (3 inches) thick, were installed when the tunnel was constructed in 1977.

Company President and CEO Takekazu Kaneko said that the company was inspecting other tunnels of similar structure, including a parallel tunnel for traffic going in the opposite direction. Both sections of the highway were shut down indefinitely.

Recovery work at the tunnel was suspended Monday while the roof was being reinforced to prevent more collapses, said Jun Goto, an official at the Fire and Disaster Management Agency

Yoshihiro Seto, an officer with the Yamanashi prefectural police, said they can't rule out that there are more bodies or survivors in the tunnel, but the possibility is low. Goto said they hope to resume recovery work on Tuesday.

Two people suffered injuries in the collapse.

Read More..

Study shows growth in second screen users

0 comments

NEW YORK (AP) — Television viewers were once called couch potatoes. Many are becoming more active while watching now, judging by the findings in a new report that illustrates the explosive growth in people who watch TV while connected to social media on smartphones and tablets.

The Nielsen company said that one in three people using Twitter in June sent messages at some point about the content of television shows, an increase of 27 percent from only five months earlier. And that was before the Olympics, which was probably the first big event to illustrate the extent of second screen usage.

"Twitter has become the second screen experience for television," said Deirdre Bannon, vice president of social media at Nielsen.

Social networking is becoming so pervasive that the study found nearly a third of people aged 18-to-24 reported using the sites while in the bathroom.

An estimated 41 percent of tablet owners and 38 percent of smartphone owners used their device while also watching television at least once a day, Nielsen said.

That percentage hasn't changed much; in fact, 40 percent of smartphone owners reported daily dual screen usage a year earlier, Nielsen said. The difference is that far more people own these devices and they are using them for a longer period of time. The company estimated that Americans spent a total of 157.5 billion minutes on mobile devices in July 2012, nearly doubling the 81.8 billion the same month a year earlier.

"There are big and interesting implications," Bannon said. "I think both television networks and advertisers are onto it."

The social media can provide networks with real-time feedback on what they are doing. The performance of moderators at presidential debates this fall was watched more closely than perhaps ever before, because people were instantly taking on Twitter to provide their own critiques.

It also makes for some conflicting information: Twitter buzzed with complaints last summer about NBC's policy of airing many Olympics events from London on tape delay, yet ratings for the prime-time Olympics telecast soared past expectations.

The increase in people watching television and commenting about it online would seem to run counter to another big trend this fall: more people recording programs and watching them at a later hour. Those contrary trends both increase the value of live event programming like awards shows or sporting events.

The Nielsen study also found that 35 percent of people who used tablets while watching TV looked up information online about the program they were watching. A quarter of tablet owners said they researched coupons or deals for products they saw advertised on television

As rapid as the use of social media while on television is growing in the United States, it already lags behind other countries. Nielsen said that 63 percent of people in the Middle East or Africa report using social media while on TV, and 52 percent of people in Latin America.

Read More..

Asperger's dropped from revised diagnosis manual

0 comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other changes include:

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

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

___

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

Read More..