Marine special forces squad awarded Navy Cross, Silver Stars

CAMP PENDLETON — In a ceremony replete with praise for their courage and resourcefulness, four members of an elite Marine special forces squad received medals Monday for their actions during a lengthy firefight in Afghanistan.

But one key squad member, whose dedication and coolness under fire were noted in the official after-action report, was not in attendance: Posha, the military working dog.

The German shepherd was with the Marines when they landed in a helicopter-borne assault to clear out a Taliban command post and quickly found two pressure-plate bombs on the main route to the Taliban compound.

Once those two explosives were marked, the dog and his handler searched for booby traps around an enemy weapons cache. Posha also provided protection and "combat mentorship" to the Afghan army commandos who were teamed with the Marines.

And when Taliban fighters attacked from multiple locations with small-arms fire and rocket-propelled grenades, Posha did not flinch and instead offered comfort to wounded Marines and Afghan commandos.

Posha, who had also served in combat in Iraq, survived the daylong fight without a scratch. But after the Marine Special Operations Command unit returned to Camp Pendleton, Posha was diagnosed with cancer and had to be euthanized last year.

At Monday's ceremony Sgt. William Soutra Jr., 27, received the Navy Cross for his actions in July 2010, for handling Posha, carrying the fight to the Taliban and directing the Afghan commandos.

Maj. James T. Rose, Staff Sgt. Frankie J. Shinost and Navy corpsman Patrick B. Quill received Silver Stars.

Rose risked enemy fire to direct a counterattack; Shinost rushed directly at the Taliban positions and called in air support; Quill tried desperately to save the life of a wounded Marine and helped carry the wounded to the evacuation helicopter as the battle raged.

The awards were presented by Navy Secretary Ray Mabus on behalf of President Obama. While the four were being singled out for their bravery, the awards, Mabus said, "are also honoring all of those with whom they have served."

In talking later to reporters, Soutra said Posha "made me the Marine I am today."

Posha, who was trained to sniff out bombs, "did his job the entire deployment. It's been a year now, but it still hurts when I think about how he got cancer and had to be put down."

Soutra said that Posha, during two combat deployments together, "was my best friend. He always reacted the same way. He saved my life."

Soutra's older brother, Joe, 30, an auto parts salesman, said that his brother enlisted in the Marine Corps to be near dogs. "Billy has always loved dogs, but mom never would let us have one," he said. "When he said he was enlisting in the Marine Corps, we knew why: So he could have a dog."

Rose said Posha and other working dogs "are combat multipliers and life-savers." Their role in the special forces command is particularly significant, given the intensity of the missions. Rose's unit had casualties in 18 of 19 missions.

"Every mission we went on was a gunfight from sunup to sundown," Rose said.

In 2009, Soutra and Posha deployed to Iraq, where the two did so well that Soutra was meritoriously promoted, a rarity in the Marine Corps. In 2010, Soutra and Posha deployed to Afghanistan to be part of a unit assigned to strike at high-value targets of the enemy in the onetime Taliban stronghold of Helmand province.

Now Soutra is training with another dog in hopes of redeploying to Afghanistan. But Posha will always be special — Soutra has Posha's ashes in an urn under his bed.

"When it's my time to go, I want us to be buried together," Soutra said, in a quiet voice with touches of his upbringing in Worcester, Mass. "That way we will always be together."

tony.perry@latimes.com

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Carbon Dioxide Emissions Hit Record in 2011, Researchers Say

Global emissions of carbon dioxide were at a record high in 2011 and are likely to take a similar jump in 2012, scientists reported Sunday — the latest indication that efforts to limit such emissions are failing.

Emissions continue to grow so rapidly that an international goal of limiting the ultimate warming of the planet to 3.6 degrees Fahrenheit, established three years ago, is on the verge of becoming unattainable, said researchers affiliated with the Global Carbon Project.

Josep G. Canadell, a scientist in Australia who leads that tracking program, said Sunday in a statement that salvaging the goal, if it can be done at all, “requires an immediate, large and sustained global mitigation effort.”

Yet nations around the world, despite a formal treaty pledging to limit warming — and 20 years of negotiations aimed at putting it into effect — have shown little appetite for the kinds of controls required to accomplish those stated aims.

Delegates from nearly 200 nations are meeting in Doha, Qatar, for the latest round of talks under the treaty, the United Nations Framework Convention on Climate Change. Their agenda is modest this year, with no new emissions targets and little progress expected on a protocol that is supposed to be concluded in 2015 and take effect in 2020.

Christiana Figueres, the executive secretary of the climate convention, said the global negotiations were necessary, but were not sufficient.

“We won’t get an international agreement until enough domestic legislation and action are in place to begin to have an effect,” she said in an interview. “Governments have to find ways in which action on the ground can be accelerated and taken to a higher level, because that is absolutely needed.”

The new figures show that emissions are falling, slowly, in some of the most advanced countries, including the United States. That apparently reflects a combination of economic weakness, the transfer of some manufacturing to developing countries and conscious efforts to limit emissions, like the renewable power targets that many American states have set. The boom in the natural gas supply from hydraulic fracturing is also a factor, since natural gas is supplanting coal at many power stations, leading to lower emissions.

But the decline of emissions in the developed countries is more than matched by continued growth in developing countries like China and India, the new figures show. Coal, the dirtiest and most carbon-intensive fossil fuel, is growing fastest, with coal-related emissions leaping more than 5 percent in 2011, compared with the previous year.

“If we’re going to run the world on coal, we’re in deep trouble,” said Gregg H. Marland, a scientist at Appalachian State University who has tracked emissions for decades.

Over all, global emissions jumped 3 percent in 2011 and are expected to jump 2.6 percent in 2012, researchers reported in two papers released by scientific journals on Sunday. It has become routine to set new emissions records each year, although the global economic crisis led to a brief decline in 2009.

The level of carbon dioxide, the most important heat-trapping gas in the atmosphere, has increased about 41 percent since the beginning of the Industrial Revolution, and scientists fear it could double or triple before emissions are brought under control. The temperature of the planet has already increased about 1.5 degrees Fahrenheit since 1850.

Further increases in carbon dioxide are likely to have a profound effect on climate, scientists say, leading to higher seas and greater coastal flooding, more intense weather disasters like droughts and heat waves, and an extreme acidification of the ocean. Many experts believe the effects are already being seen, but they are projected to worsen.

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Nintendo president apologizes for bulky day-one Wii U firmware update

As we noted in our first impressions, Nintendo’s (NTDOY) Wii U is charting new ground with its wireless GamePad and touchscreen controls that engage gamers in the living room like never before. But before you can even set up the Wii U, a mandatory firmware update is required upon power up. Gamers everywhere were frustrated to learn that the firmware update, which is pegged anywhere between 1GB and 5GB, takes hours to download and could even ”brick” new consoles if the power was cut off. In an email conversation with IGN, Nintendo’s global president and CEO Satoru Iwata said was “very sorry” that Wii U owners were experiencing network issues and that other services such as Nintendo TVii weren’t available at launch. Iwata said he believes “users should be able to use all the functions of a console video game machine as soon as they open the box.” 

Gone are the days when electronics are sold as finished products with set features out of the box. It has become normal for today’s connected electronics to require frequent firmware updates and patches to fix compatibility with other gadgets and to add new features. At what point should consumers stop tolerating devices that don’t work immediately after unboxing? The way we see it, the answer might be “never,” as it’s hard to argue against the fact that new software updates breathe new life into aging consoles.

Iwata also explained that the Wii U’s “Miiverse” online service isn’t meant to replicate existing services such as Xbox LIVE.

“We have not thought that offering the same features that already exist within other online communities would be the best proposal for very experienced game players,” Iwata told IGN.

Nintendo fans can read more Nintendo nuggets over at IGN’s feature that includes mention of a new 3D Super Mario and Zelda game.

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Gaming News Headlines – Yahoo! News

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Kellan Lutz, Hugh Jackman Take Bites and Swipes & More Casting News

By Julia Haskins

12/02/2012 at 07:00 PM EST

Kellan Lutz (left) and Hugh Jackman

Christopher Polk/Getty, Han Myung-Gu/WireImage

It's comeback time. Whether seeking revenge or reprising beloved roles, a fresh crop of movies shows that the best characters always come back for more.

Twilight's Kellan Lutz feasts on others as a vampire, but this time, he's utilizing his own body for powers, Zimbio reports.

The actor will star in Tatua as a tattooed assassin whose weapons are extracted from the ink on his body. The process is a strain on the hit man, but he must put that aside when his son is kidnapped by a dangerous foe.

Hugh Jackman is set to reprise his role as Wolverine in
X-Men: Days of Future Past, the Hollywood Reporter. Ian McKellen (Magneto) and Patrick Stewart (Professor Xavier), will also be joining Jennifer Lawrence, James McAvoy, Michael Fassbender and Nicholas Hoult.

Charlize Theron will star in an adaptation of the final installment of a South Korean revenge trilogy, the Hollywood Reporter also says. The original movie revolves around a woman wrongfully imprisoned for 13 years who then sets out to seek her long-awaited revenge. Writer William Monahan says the English-language remake will be "very American – and very unexpected."

The made-for-TV Disney channel movie Life-Size is getting a sequel, Variety reports. Tyra Banks will reprise her role as Eve, the doll who comes to life, and also executive produce the movie. No word yet on whether Lindsay Lohan, who played Eve's owner, will be making a return.

Also coming soon:

Beyoncé won't be slowing down after her Super Bowl performance in February. Just a couple weeks later, she'll introduce her still untitled, feature-length documentary on HBO, Deadline reports. The documentary airs Feb. 16.

Bridesmaids' Rose Byrne will be going through the motions as a newlywed in I Give it a Year, Zimbio reports. As if being newly married wasn't tough enough, the "too perfect" ex Anna Faris will be shaking up an already teetering balance.

Cate Blanchett will be stirring up her wicked ways as the evil stepmother in a live-action adaptation of Disney's Cinderella, also according to Zimbio.

And George Clooney is sticking to his winning formula by joining forces with his Argo team to produce an untitled crime drama, Variety reports.

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Asperger's dropped from revised diagnosis manual

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other changes include:

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

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

___

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

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San Diego mayor leaves office with his legacy intact

SAN DIEGO — On his last full day as mayor of San Diego, Jerry Sanders did something Sunday that took him back four decades.

He rode with a police officer assigned to the 2 p.m. to midnight shift patrolling downtown. In the mid-1970s, fresh out of San Diego State, Sanders was a rookie officer assigned to that same beat.

"I came in in a police car, I'm going out in a police car," Sanders, 62, had said with a laugh last week as he stood outside one of his signature achievements of his seven years as mayor: a new central library under construction.

A Republican in a city where Democrats hold a voter-registration edge and control the City Council, Sanders, who rose from beat cop to chief in his 26 years at the Police Department, has governed through relentless attempts at consensus and a deceptively low-key style that leans on sharing credit whenever possible.

Ask about the library project and Sanders says, "The library commission wouldn't take no for an answer."

Ask about his role in calming civic nerves during the 2007 wildfire that raged for days and destroyed hundreds of homes — a mayoral effort that led the local newspaper to compare him favorably to Rudy Giuliani after 9/11 — and Sanders mentions the help provided by two county supervisors.

Ask about his management style and he says he prefers to hire good people and then stay out of their way, but some who have worked with him point out that he watches even tiny details of important efforts.

Outside San Diego, Sanders may be remembered best for breaking with the GOP to endorse same-sex marriage, explaining that his daughter, a lesbian, should be free to marry someone she loves. He then campaigned against Proposition 8 and later went to Washington to join other — mostly Democratic — mayors to lobby Congress to repeal a law that defines marriage as between a man and woman.

In San Diego, his legacy includes guiding the city back from the precipice of its worst financial debacle in history through a series of politically controversial cutbacks in city services and then hard bargaining with labor unions that led to a salary freeze, reduction in health benefits for retirees, increased payments by employees to the pension fund and the end to guaranteed-benefit pensions for new hires.

Although the city's financial future, like that of other cities, remains uncertain, San Diego appears to be ahead of other cities, including Los Angeles, in dealing with the common problem of spiraling pension deficits.

"He did steady the local ship of state," said Steve Erie, political science professor at UC San Diego. "Whether he actually turned it around is another question."

Sanders lists the new library, the planned expansion of the waterfront convention center and the plan to remodel the core of Balboa Park as among his proudest achievements. All three faced opposition; the convention center and park plans are being fought in court.

"This isn't a hard city to govern," he said, "but it's very hard to get consensus."

One of his disappointments is the failure to put together a project to build a new stadium for the San Diego Chargers and keep the NFL franchise from leaving the city.

The Chargers issue, in which the public wants the team to remain in San Diego but does not want to spend public money for a stadium, will now be left to Sanders' successor, Bob Filner, 70, a Democrat who left a safe seat in Congress to run to replace the termed-out Sanders. Filner will be sworn into office Monday.

Although he was reelected easily in 2008, voters in 2010 turned down his request for a half-cent boost in the sales tax, which Sanders said was desperately needed to avoid additional cuts in city services. "We gave voters the opportunity," he said.

In style, Filner and Sanders are opposites: Filner is confrontational; Sanders usually isn't. Sanders appears without ego; Filner is different.

"I tell Bob that he's the most obnoxious individual I've met and that's what I like about him," Sanders said.

Lest anyone think of him as a rhetorical milquetoast, it bears remembering that, during the 2008 reelection campaign, he turned to an opponent and directed a two-word obscenity at him.

Sanders was an anomaly as a politician when he was elected in 2005 to replace Dick Murphy, who resigned amid criticism over the pension deficit. Sanders had never before run for public office, although he was a well-known public figure after six years as the highly regarded police chief.

As chief, he expanded the city's "community oriented policing" style that emphasized close collaboration between the police and neighborhood groups.

Retiring from the city in 1999, he served as chief executive of the local United Way and as president of the local Red Cross chapter — arriving when both organizations were beset by personnel turmoil and financial problems.

Sanders and his wife, Rana Sampson, will soon depart for a long-delayed vacation to Italy. Sampson retired Friday as vice president for development and marketing for the San Diego Center for Children, which provides educational and mental health services for at-risk youth.

Upon the couple's return to San Diego, Sanders will become president and chief executive of the San Diego Regional Chamber of Commerce.

But first was that final shift as a beat cop downtown, asking people what help they need and providing a reassuring presence that says San Diego is a good place to live.

"Best job I ever had," Sanders said.

tony.perry@latimes.com

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IHT Rendezvous: Another 'nail house' in China gets hammered

HONG KONG — A renowned “nail house” in eastern China was finally hammered to the ground on Saturday, as the authorities demolished the house that was sitting smack dab in the middle of a new roadway.

The duck farmers who owned the five-story house, Luo Baogen and his wife, had refused to sell when local officials began buying up property in 2008 for a new highway in Zhejiang Province. More than 450 homeowners in the neighborhood took the government’s relocation offer, reportedly about $35,000 each.

But Mr. Luo resisted, even as construction began last year. The road, leading to a new train station outside the city of Wenling, was completed anyway — completely encircling the Luo house in a strange, bulging loop of tarmac.

Homes like Mr. Luo’s are known in China as nail houses “because such buildings stick out and are difficult to remove, like a stubborn nail,” according to Xinhua, the official Chinese news agency.

His refusal to move became something of a cause célèbre in China, especially on social media, and he was seen as a symbol of resistance to government land grabs, illegal midnight demolitions and rapacious development.

Mr. Luo’s home still had electricity and water, unlike other nail houses whose owners usually relent when their utilities are cut off.

Late last week, however, the couple agreed to move, accepting about $42,000 and a plot of ground for a new house, Xinhua said. New reports said Mr. Luo, 67, had originally put the value of his house at 600,000 renminbi, or about $96,000.

There was no clear or immediate explanation of why he gave in, although Xinhua quoted him as saying, “It was never a final solution for us to live in a lone house in the middle of the road. After the government’s explanations, I finally decided to move.”

Another Chinese nail house, in the sprawling city of Chongqing, drew nationwide attention in 2007 when its owner, a plucky woman named Wu Ping, refused to surrender her house for a new commercial development.

She was the lone holdout among 280 homeowners, and her husband, Yang Wu, stayed in the house as excavation went on around him. Their house eventually came to sit atop a free-standing mesa of land, and Mr. Yang was essentially marooned up there.

Ms. Wu brought him food, water and propane, which he hauled up on ropes, and he defiantly flew a Chinese flag above the house. Five stories below, Ms. Wu gave impassioned interviews and staged impromptu news conferences.

As my former colleague Howard W. French Jr. reported at the time, Ms. Wu’s defiance struck the same sort of nerve as Mr. Luo has:

It has a universal resonance in a country where rich developers are seen to be in cahoots with politicians and where both enjoy unchallenged sway. Each year, China is roiled by tens of thousands of riots and demonstrations, and few issues pack as much emotional force as the discontent of people who are suddenly uprooted, told that they must make way for a new skyscraper or golf course or industrial zone.

What drove interest in the Chongqing case was the uncanny ability of the homeowner to hold out for so long. Stories are legion in Chinese cities of the arrest or even beating of people who protest too vigorously against their eviction and relocation. In one often-heard twist, holdouts are summoned to the local police station and return home only to find their house already demolished.

Even the state-run newspaper China Daily seemed to sympathize, writing at the time that “experts believe that the outcry reflects a growing dissatisfaction among common people about the way sites are commandered and buildings demolished. On China’s portal Web sites like Sina, 85 percent of those polled showed support for the couple.”

Ms. Wu reached a settlement with the developer in April 2007, her home was promptly demolished and she became a national celebrity.

Eminent domain is a sensitive issue in many countries, of course, and a handful of Japanese farmers have held on to their small parcels for decades, despite efforts to expand Narita Airport outside Tokyo. Farmers, activists and leftist students fought the police to block construction at Narita in the 1970s, and one riot there left three police officers dead.

“The original plan drafted by the government in the 1970s envisioned three runways at Narita,” The Japan Times reported in April. “But it was unable to acquire the necessary land due to violent opposition from local residents and farmers, forcing it to open with just a single runway in May 1978.”

A second, short, provisional runway was built in time for the 2002 World Cup, but since then, the paper said, “the airport has relied entirely on a single 4,000-meter strip for all passenger and cargo flights.”

Part of the resistance efforts included the building of huts on the contested land, and in a compromise reached more than 40 years later, two of those huts were demolished last week.

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Ashley Hebert and J.P. Rosenbaum Are Married

People Exclusive

By Monica Rizzo

12/01/2012 at 06:15 PM EST

J.P. Rosenbaum and Ashley Hebert

Victor Chavez/Getty

It’s official: Bachelorette star Ashley Hebert and her fiancé J.P. Rosenbaum tied the knot Saturday afternoon in Pasadena, Calif.

Surrounded by family, friends and fellow Bachelor and Bachelorette alumni like Ali Fedotowsky, Emily Maynard, and Jason and Molly Mesnick, the couple said "I do" in an outdoor ceremony officiated by franchise host Chris Harrison.

"Today is all about our friends and family," Hebert, whose nuptials will air Dec. 16 on a two-hour special on ABC, tells PEOPLE. "It's about standing with J.P., looking around at all the people we love in the same room there to celebrate our love."

The 28-year-old dentist from Madawaska, Maine, met New York construction manager Rosenbaum, 35, on season 7 of The Bachelorette. The couple became engaged on the season finale.

Hebert and Rosenbaum are the second couple in the franchise's 24 seasons to make it from their show finale to the altar, following in the footsteps of Bachelorette Trista Rehn, who married Vail, Colo., firefighter Ryan Sutter in 2003.

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Asperger's dropped from revised diagnosis manual

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other changes include:

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

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

___

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

Read More..

Asian tourists flock to South Coast Plaza

It's Day 3 of his four-day visit, and, of course, Yuki Izuka — for the third time — is back at South Coast Plaza.

Sporting black slacks, leather tote, a pinstripe jacket and crisp tie, the pharmacist from Gunma, Japan, heads straight for the most glittering of shops: Tiffany.

He's on a mission to find a ring for his wife. "It is very expensive — but even more expensive in my home," he says. "Better if I can get something here."

Skipping tariffs and taxes, foreign shoppers flush with cash fill their Southern California trips with shopping sprees at places like South Coast Plaza, and increasingly, employees at the luxury shopping center are taking extraordinary steps to host them, trained to fulfill the tiniest of needs.

South Coast Plaza has become a destination for overseas Asians, who bundle trips to Disneyland with carefully plotted excursions to the retail mecca, stocking up on snug blue jeans, watches, luggage, purses and flashy sunglasses selling for $500 a pair.

"We could have seen it in American Vogue and we're here to get it," said Izuka, looking magazine model-sleek as he and his buddies walk past an Italian cafe and ride an escalator toward the center's Jewel Court, a cluster of high-end jewelry boutiques where foreigners pay cash for $100,000 necklaces or other sparkling baubles.

"I like to buy whatever I can because the prices are so low," says Lucas Xu, comparing the costs to those in China, his homeland.

"And every store has an Asian assistant," said Xu, an economics major in Colorado who has flown in with friends for a shopping excursion. "Wow."

"It's not just about selling somebody something. It's about making them feel important," says South Coast Plaza veteran Werner Escher.

In a sense, Escher is the director of foreign affairs at the center, though technically his title is director of domestic and international markets. He's been on the job more than four decades and travels to China at least once a year to firm up connections with influence makers. He partners with Disneyland and the Nixon Presidential Library & Museum, ready to whisk dignitaries from Beijing and Shanghai to the shopping center, even providing them chauffeurs and guides.

Under his direction, the staff is tightly focused on the foreign traveler.

There's a language-assistance program, with mall and store employees speaking more than 40 languages and dialects. Maps and directions are printed in Korean, Japanese, Spanish and Chinese, among others. Center executives carry business cards featuring Asian characters.

South Coast Plaza is now the first shopping center in the nation to accept UnionPay, China's leading credit card. Center reps also hand out VIP Passport booklets with exclusive offers for travelers. One afternoon, Escher shows it to Shelley Chen, who is from Guangzhou, an economic hub on China's southern coast. He bows and shakes her hand as she's on her way to look for a Gucci purse, having just graduated from law school.

"I like the famous names here," she says of the retailers. "My friends said I must come here."

Scott Hung, a sales director for a semiconductor company in Taiwan, wants to take home gifts for his twin boys. His boss is familiar with South Coast Plaza "and suggested me to go to this place," he said, asking about shops that carry children's goods and that have iPhone docking stations.

Visitors who are overseas celebrities get preferred treatment.

When Yang Mi, one of China's leading actresses, who boasts 22 million followers on Sina Weibo — similar to Twitter — came to South Coast, center officials entertained the actress and her entourage in a plush VIP Access Suite near Saks Fifth Avenue. They hosted the Chinese press corps, which swarmed in to interview and photograph her.

"For her to be here is major," Escher says. "It fills out the playlist of the people we want to attract."

Not to miss a beat, the center — which bills itself as a "shopping resort" — served as a ping-pong tournament venue to the top players in the U.S. and China. The cast of "Raise the Red Lantern," a production of the National Ballet of China, also descended on South Coast, accompanied by diplomats.

That's apart from outreach directed at the local Asian clientele, highlighting the lunar new year and the autumn moon festival. Managers at anchor stores like Macy's scramble to hire Chinese-speaking staff. And shopping at South Coast means visitors might avoid three taxes for luxury items imported to China: customs tariffs, value-added tax and consumption tax. Trade missions between Southern California and China can include a stop at one of the most upscale malls in America.

Concierge Stepheny Southa came to the aid of a pregnant guest recently. Speaking in Mandarin, the woman told her: "You're my size. I need to buy some clothes that I can wear after having the baby."

Southa said she went with the expectant mother to try on multiple outfits for her.

"We have the ability to satisfy someone who comes from a long distance," Southa says.

Robert Sun, founder of the American Chinese CEO Society, says he has taken guests from China's Shandong province to South Coast for dinner and to buy presents.

"They fall in love because of the large number of brand names. No other place can compare," he recalls. Foreign visitors are familiar with Beverly Hills and Rodeo Drive, Sun added, "but now they see South Coast as the best shopping. When somebody has a good experience buying, like, a bag, they go and tell their friends."

If there's one thing missing from the experience for shoppers from China, it's a Chinese restaurant. And shoppers have pointed that out, said Escher, who's been scouting candidates when he travels overseas. Officials hope to make an announcement by the lunar new year in February, an event they anticipate will be covered prominently by the ethnic media.

"Shopping," Escher says, "is the No. 1 activity when people travel."

anh.do@latimes.com

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