Kate's Illness Sometimes Linked to Twins













Hyperemesis gravidarum, the reason newly pregnant Kate Middleton is in the hospital, is a rare but acute morning sickness that results in weight loss and accounts for about 2 percent of all morning sickness, doctors say.


The condition is sometimes associated with women having twins, experts said.


Women diagnosed with hyperemesis gravidarum have lost 5 percent of their pre-pregnancy weight, or 10 pounds, said Dr. Ashley Roman, a professor and OB/GYN at New York University Langone Medical Center.


It poses little danger to the tiny heir, doctors said.


"It's traditionally thought that nausea and vomiting is a sign of a healthy pregnancy," Roman said


Dr. Nancy Cossler, an OB/GYN at University Hospitals in Ohio said the condition does not cause loss of pregnancy or birth defects, but it can be a torture to endure.


"The biggest problem with this is how it interferes with your life," Cossler said. "Constantly feeling sick and puking is difficult."


Click here to read about other women with hyperemesis gravidarum.


Hyperemesis gravidarum is thought to be caused by higher levels of the pregnancy hormone, hCG, or human chorionic gonadotropin, Cossler said. Extra hCG can often be brought on by carrying more than one fetus, she said.






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In other words, it could be a sign that Middleton is carrying twins. Although there's very little data on twins and hyperemesis gravidarum, one study showed that women carrying twins had a 7.5 percent higher risk of experiencing the acute morning sickness, Roman said.


The extreme morning sickness is usually diagnosed about nine weeks into the pregnancy, and in most cases resolves itself by 16 or 20 weeks, Roman said. In rare cases, it can last the whole pregnancy.


"As the pregnancy is in its very early stages, Her Royal Highness is expected to stay in hospital for several days and will require a period of rest thereafter," a statement from St. James Palace said. Prince William is at the hospital with Middleton, according to the Britain's Press Association.


Click here for photos of Kate through the years.


Roman said doctors prescribe vitamins and ginger capsules at first. If that doesn't stop the vomiting, they will prescribe antihistamines and stronger anti-nausea medications.


Women with hyperemesis gravidarum are also treated with fluids, said Dr. Jessica Young, an OB/GYN at Vanderbilt University. But if left untreated, a pregnant woman who is severely dehydrated for a long period of time could die, "just like any person," Young said.


In extreme cases in which the woman is losing weight and unable to eat, doctors will treat her with intravenous nutrition, Young said.


Hospital stays can vary, and women will often have to be admitted more than once before the condition passes, doctors said.


Hyperemesis gravidarum is somewhat mysterious because some expectant mothers have acute morning sickness during only one of their pregnancies, but have no morning sickness for subsequent pregnancies.


There is a chance that higher levels of hCG, which likely caused Middleton's nausea, could be a sign of a molar pregnancy instead of twins, Cossler said. This would mean Middleton is carrying only a benign growth in her uterus instead of a fetus, or she is carrying a fetus with abnormal DNA and a benign growth. Neither is considered a viable pregnancy.


However, Cossler said molar pregnancies become apparent early on, and doctors would already know whether Middleton had one.


"They would not have released this information," Cossler said of the birth announcement. "I'm certain that they have already eliminated both of those [types of molar pregnancies]."



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Israel says will stick with settlement plan despite condemnation

JERUSALEM (Reuters) - Israel rejected concerted criticism from the United States and Europe on Monday over Prime Minister Benjamin Netanyahu's decision to expand settlement building after the United Nations' de facto recognition of Palestinian statehood.


Washington urged Israel to reconsider its plan to erect 3,000 more homes in the occupied West Bank and East Jerusalem, saying the move hindered peace efforts with the Palestinians.


Britain, France, Spain, Sweden and Denmark summoned the Israeli ambassadors in their capitals to give similar messages.


An official in Netanyahu's office said Israel would not bend. "Israel will continue to stand by its vital interests, even in the face of international pressure, and there will be no change in the decision that was made," the official said.


Angered by the U.N. General Assembly's upgrading on Thursday of the Palestinians' status in the world body from "observer entity" to "non-member state", Israel said the next day it would build the new dwellings for settlers.


Such projects, on land Israel captured in a 1967 war, are considered illegal by most world powers and have routinely drawn condemnation from them. Approximately 500,000 Israelis and 2.5 million Palestinians live in the two areas.


In a shift that raised the alarm among Palestinians and in world capitals, Netanyahu's pro-settler government also ordered "preliminary zoning and planning work" for thousands of housing units in areas including the "E1" zone east of Jerusalem.


Such construction in the barren hills of E1 has never been put into motion in the face of opposition from Israel's main ally, the United States. Building in the area could bisect the West Bank, cut off Palestinians from Jerusalem and further dim their hopes for a contiguous state.


Israeli television stations reported Jerusalem's district planning commission would soon approve plans for several thousand more housing units, including more than 1,000 Israel had shelved two years ago after angering Washington by publishing the plans before a visit by Vice President Joe Biden.


The settlement plan, U.N. Secretary-General Ban Ki-moon said, would deal "an almost fatal blow" to a two-state solution to the Israeli-Palestinian conflict.


French President Francois Hollande said he was "extremely concerned" and Washington made clear it would not back such Israeli retaliation over the U.N. vote, sought by Palestinians after peace talks collapsed in 2010 over settlement building.


"We urge Israeli leaders to reconsider these unilateral decisions and exercise restraint as these actions are counterproductive and make it harder to resume direct negotiations to achieve a two state solution," White House spokesman Jay Carney told a briefing.


Ahead of a Netanyahu visit this week, Germany, considered Israel's closest ally in Europe, urged it to refrain from expanding settlements, and Russia said it viewed the Israeli moves with serious concern.


RETALIATION


Israeli Finance Minister Yuval Steinitz said Israel could not have remained indifferent to the Palestinians' unilateral move at the United Nations.


"I want to tell you that those same Europeans and Americans who are now telling us 'naughty, naughty' over our response, understand full-well that we have to respond, and they themselves warned the Palestinian Authority," he said.


Palestinian chief negotiator Saeb Erekat said building in E1 "destroys the two-state solution, (establishing) East Jerusalem as the capital of Palestine and practically ends the peace process and any opportunity to talk about negotiations in the future".


The United States, one of the eight countries to vote alongside Israel against the Palestinian resolution at the General Assembly, has said both were counterproductive to the resumption of direct peace talks.


In Europe, only the Czech Republic voted against the status upgrade while many countries, including France, backed it. Netanyahu plans to visit Prague this week to express his thanks.


In the Gaza Strip, Sami Abu Zuhri, spokesman for the governing Hamas Islamist movement, called the settlements "an insult to the international community, which should bear responsibility for Israeli violations and attacks on Palestinians".


Israeli police arrested three Jewish settlers on Monday whom they suspect of arson and other crimes against Palestinian property in the West Bank, including the torching of a car.


Attackers have often proclaimed they are exacting a "price tag" for steps taken against the settler movement by Palestinians, or by the Israeli government.


Alongside the settlement plans, Israel announced it would withhold about $100 million in Palestinian tax revenues from the Palestinian Authority, which exercises limited self-rule in the West Bank, saying Palestinians owed $200 million to Israeli firms.


"These are not steps towards peace, these are steps towards the extension of the conflict," Spanish Foreign Minister Jose Manuel Garcia-Margallo said.


Only three weeks ago, Netanyahu won strong European and U.S. support for a Gaza offensive that Israel said was aimed at curbing persistent cross-border rocket fire.


Favored by opinion polls to win a January 22 national election, he brushed off the condemnation and complaints at home that he is deepening Israel's diplomatic isolation.


Netanyahu told his cabinet on Sunday that his government "will carry on building in Jerusalem and in all the places on the map of Israel's strategic interests".


But while his housing minister has said the government would soon invite bids from contractors to build 1,000 homes for Israelis in East Jerusalem and more than 1,000 in West Bank settlement blocs, the E1 plan is still in its planning stages.


"No one will build until it is clear what will be done there," the minister, Ariel Attias, said on Sunday.


Israel froze much of its activities in E1 under pressure from former U.S. President George W. Bush, and the area has been under the scrutiny of his successor, Barack Obama.


Israel cites historical and Biblical links to the West Bank and Jerusalem and regards all of the holy city as its capital, a claim that is not recognized internationally.


(Additional reporting by Crispian Balmer, Dan Williams, Nidal al-Mughrabi in Gaza, Jihan Abdalla in Ramallah, Steve Gutterman in Moscow, Gareth Jones in Berlin, John Irish and Elizabeth Pineau in Paris and Tim Castle in London; writing by Jeffrey Heller; editing by Philippa Fletcher)


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6 weeks' jail for SMRT bus driver involved in strike






SINGAPORE: A SMRT bus driver from China has been sentenced to six weeks' jail for taking part in an illegal strike.

Bao Feng Shan, 38, admitted that he committed the offence on 26 November.

He appeared grim in court on Monday, as the charge was read out to him in Mandarin, accusing him of "commencing" the strike between 6am and 7am on 26 November at Woodlands Dormitory.

Bao, who did not engage a lawyer, acknowledged the "adverse effects" of the strike.

Speaking through a court interpreter, he said he was "deeply remorseful and apologetic".

Bao, who teared several times, also apologised to the government of Singapore, SMRT and his family.

He said a jail sentence would have adverse effects on his eight-year-old daughter.

Bao was deployed to Kranji Depot to drive Service 106 at the time of the offence.

The tall and bespectacled man had been working for SMRT since 2008.

Some time between 6am and 7am on 26 November, he joined many drivers in refusing to go to work.

Deputy Public Prosecutor Peggy Pao told the court that Bao was not happy that he was not entitled to the same year-end bonuses and increments as his Malaysian counterparts.

He did not give notice of his intention to strike on 26 and 27 November.

The court heard that Bao did not start the strike, but took on a participatory role.

But DPP Pao pointed out that although Bao was not charged as an instigator, he was "far from a mere passive participant".

She acknowledged that there may have been "a genuine sense of frustration" but stressed that there was no justification to resort to a strike.

The DPP had pushed for a deterrent sentence of six weeks' jail, on the grounds of the "considerable public disquiet" caused by the strike.

She said a lenient approach may encourage others to think that they can commit similar offences and "conveniently express remorse to escape custodial sentence".

She stressed that the illegal strike was not a case of a few workers refraining from work but was a large-scale organised effort to use illegal means to coerce the management of SMRT into giving in to the workers' demands.

During sentencing, Senior District Judge See Kee Oon highlighted an aggravating factor - that the act was calculated to cause obstruction and inconvenience to transport services.

He noted that Bao did not return to work the next day, even though he was advised to do so by SMRT and the manpower ministry.

He also made a number of threatening comments, warning of further strikes if the demands were not met.

The judge acknowledged Bao's plea of leniency, saying he showed remorse by pleading guilty right after he was charged.

But he agreed with the prosecution that deterrence must be a primary consideration and that a jail sentence was warranted.

He said while Bao may have been motivated by sense of grievance, he went against the law.

Bao is the first of five SMRT drivers who have been charged to plead guilty.

Four other drivers were charged last Thursday with instigating the drivers to take part in the strike.

They are He Jun Ling (32), Gao Yue Qiang (32), Liu Xiangying (33), Wang Xianjie, (33).

One of them, He, faces an additional charge of making an online post about the strike.

The four are currently remanded at the Central Police Station.

SMRT said 171 bus drivers did not report for work on 26 November and 88 of them continued to stay away from work on 27 November.

Twenty-nine of them were sent back to China on Sunday. The remaining drivers involved will be let off with police warning letters.

- CNA/xq



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FDI in retail to safeguard international market mafias' interest: BJP

ANI Dec 1, 2012, 03.28PM IST

NEW DELHI: India's main opposition Bharatiya Janata Party (BJP) today said retail reform is a step taken by the Congress led-federal government to safeguard the interests of the international market mafias at the cost of national interest.

BJP vice president Mukhtar Abbas Naqvi said on Saturday that voting inside the parliament would decide as to who is in favour of national interest and who is working for international interests.

"The government feels that their responsibility is to safeguard the interest of international market mafias instead of national interest and for saving the interest of international market mafias, the government is ready to compromise with national interests. Now, the parliament will decide as to who is in support of international market mafias and who are supporting national interests," said Naqvi.

The government's decision to allow foreign supermarket chains such as Wal-Mart had triggered protest not only from opposition parties but also from some of its allies.

BJP had sought debate on the issue of allowing Foreign Direct Investment (FDI) in the retail sector, under the rule that entails voting after discussions.

Meanwhile, Minister in the Prime Minister Office (PMO), V Narayanaswamy said the government would answer all the queries raised by the opposition parties in the parliament and will explain the benefits of allowing FDI in retail sector.

The lower house of parliament has set December 04 and 05 as the date to vote and debate on FDI. The dates for the upper house are yet to be decided.

Narayanaswamy said the government is confident of becoming victorious in the debate.

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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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Boehner on Fiscal Cliff Talks: 'You Can't Be Serious'













President Obama and his White House team appear to have drawn a line in the sand in talks with House Republicans on the "fiscal cliff."


Tax rates on the wealthy are going up, the only question is how much?


"Those rates are going to have to go up," Treasury Secretary Tim Geithner flatly stated on ABC's "This Week." "There's no responsible way we can govern this country at a time of enormous threat, and risk, and challenge ... with those low rates in place for future generations."


But the president's plan, which Geithner delivered last week, has left the two sides far apart.


In recounting his response today on "Fox News Sunday," House Speaker John Boehner said: "I was flabbergasted. I looked at him and said, 'You can't be serious.'


"The president's idea of negotiation is: Roll over and do what I ask," Boehner added.


The president has never asked for so much additional tax revenue. He wants another $1.6 trillion over the next 10 years, including returning the tax rate on income above $250,000 a year to 39.6 percent.






TOBY JORRIN/AFP/Getty Images















Obama Balances Fiscal Cliff, Defense Department Appointment Watch Video





Boehner is offering half that, $800 billion.


In exchange, the president suggests $600 billion in cuts to Medicare and other programs. House Republicans say that is not enough, but they have not publicly listed what they would cut.


Geithner said the ball is now in the Republicans' court, and the White House is seemingly content to sit and wait for Republicans to come around.


"They have to come to us and tell us what they think they need. What we can't do is to keep guessing," he said.


The president is also calling for more stimulus spending totaling $200 billion for unemployment benefits, training, and infrastructure projects.


"All of this stimulus spending would literally be more than the spending cuts that he was willing to put on the table," Boehner said.


Boehner also voiced some derision over the president's proposal to strip Congress of power over the country's debt level, and whether it should be raised.


"Congress is not going to give up this power," he said. "It's the only way to leverage the political process to produce more change than what it would if left alone."


The so-called fiscal cliff, a mixture of automatic tax increases and spending cuts, is triggered on Jan. 1 if Congress and the White House do not come up with a deficit-cutting deal first.


The tax increases would cost the average family between $2,000 and $2,400 a year, which, coupled with the $500 billion in spending cuts, will most likely put the country back into recession, economists say.



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Egypt's top court shuts down, blames Islamist protesters

CAIRO (Reuters) - Protests by Islamists allied to President Mohamed Mursi forced Egypt's highest court to adjourn its work indefinitely on Sunday, intensifying a conflict between some of the country's top judges and the head of state.


The Supreme Constitutional Court said it would not convene until its judges could operate without "psychological and material pressure", saying protesters had stopped the judges from reaching the building.


Several hundred Mursi supporters had protested outside the court through the night ahead of a session expected to examine the legality of parliament's upper house and the assembly that drafted a new constitution, both of them Islamist-controlled.


The cases have cast a legal shadow over Mursi's efforts to chart a way out of a crisis ignited by a November 22 decree that temporarily expanded his powers and led to nationwide protests against him and his Muslim Brotherhood group.


The court's decision to suspend its activities appeared unlikely to have any immediate impact on Mursi's drive to get the new constitution passed in a national referendum on December 15.


Judges supervise voting in Egypt, and Mursi will need them to oversee the referendum.


But in a blow to the president, an influential body representing judges decided on Sunday not to oversee the vote, the state news agency reported. The Judges' Club's decisions are not binding on members, however.


Vice President Mahmoud Mekky said on Sunday he was confident the judges would perform that role, despite calls by Mursi's critics in the judiciary for a boycott.


Three people have been killed and hundreds wounded in protests and counter-demonstrations over Mursi's decree.


At least 200,000 of Mursi's supporters attended a rally at Cairo University on Saturday. His opponents are staging an open-ended sit-in in Cairo's Tahrir Square, the cradle of the uprising that toppled Hosni Mubarak in February 2011.


The National Salvation Front, an alliance of liberal, leftist and socialist opposition groups, called for protests in Tahrir Square on Tuesday against Mursi holding the referendum on what it branded an "illegitimate constitution".


Mursi and the Muslim Brotherhood, which propelled him to power in a June election, hope to end the crisis by pushing through the new constitution hastily adopted by the drafting assembly on Friday. The next day the assembly handed the text to Mursi, who called the referendum and urged Egyptians to vote.


"The Muslim Brotherhood is determined to go ahead with its own plans regardless of everybody else. There is no compromise on the horizon," said Hassan Nafaa, a professor of political science at Cairo University.


DEEP SUSPICION


Outside the Supreme Constitutional Court, Muslim Brotherhood supporters rallied behind the referendum date. "Yes to the constitution," said a banner held aloft by one protester. Chants demanded the "purging of the judiciary".


The interior minister told the head of the court that the building was accessible and that the protests were peaceful, according a statement from the ministry.


The protest reflected the deep suspicion harbored by Egypt's Islamists towards a court they see as a vestige of the Mubarak era. The same court ruled in June to dissolve the Muslim Brotherhood-led lower house of parliament.


Since then, several legal cases have challenged the legitimacy of the upper house of parliament and the 100-member constituent assembly that wrote the constitution.


Those against the upper house have focused on the legality of the law by which it was elected, while the constitutional assembly has faced a raft of court cases alleging that the way it was picked was illegal.


Mursi believes securing approval for the new constitution in a popular referendum will bury all arguments on the legality of the constituent assembly, as well as controversy over the text it worked through the night to finish on Friday.


It will also override the November 22 decree that drew concern from Western governments and a rebellion by sections of the judiciary. The decree shielded Mursi from judicial oversight.


While the Islamists' critics, including representatives of the Christian minority, have accused the Brotherhood of trying to hijack the constitution, investors appear to have seen Mursi's moves as a harbinger of stability. They were also relieved that Saturday's mass Islamist protest went off calmly.


The main stock market index, which lost a tenth of its value in response to Mursi's November 22 decree, rallied more than 2 percent when the market opened on Sunday.


"The events that took place through the weekend, from the approval of the final draft of the constitution and the president calling a referendum, gave some confidence to investors that political stability is on track," said Mohamed Radwan of Pharos Securities, an Egyptian brokerage.


OPPOSITION INFURIATED


But opposition parties have been infuriated by what they see as the Brotherhood's attempt to ram through a constitution that does not enjoy national consensus. Mursi's opponents warn of deeper polarization ahead.


Liberal figures, including former Arab League chief Amr Moussa, pulled out of the constituent assembly last month, as did Christian representatives.


The draft constitution contains Islamist-flavored language which opponents say could be used to whittle away human rights and stifle criticism. It forbids blasphemy and "insults to any person", does not explicitly uphold women's rights and demands respect for "religion, traditions and family values".


New York-based Human Rights Watch said the draft constitution protected some rights while undermining others.


The text limits presidents to two four-year terms, requires parliamentary approval for their choice of prime minister, and introduces some civilian oversight of the military - although not enough for critics. Mubarak ruled for three decades.


Mursi described it as a constitution that fulfilled the goals of the revolution that ended Mubarak's rule. "Let everyone -- those who agree and those who disagree -- go to the referendum to have their say," he said.


The Islamists are gambling that they will be able to secure a "Yes" vote by mobilizing their core support base.


(Writing by Tom Perry; Editing by Alistair Lyon and Roger Atwood)


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India's "dancing bears" retire in animal rights victory






NEW DELHI: The sight of poorly-fed and badly-treated bears being forced to dance on the streets of India is a thing of the past as a campaign to wipe out the practice has finally borne fruit, activists say.

The tradition of forcing sloth bears to dance for entertainment dates back to the 13th century, when trainers belonging to the Muslim Kalandar tribe enjoyed royal patronage and performed before the rich and powerful.

Descendants of the tribe from central India had kept the tradition alive, buying bear cubs from poachers for about 1,200 rupees (US$22) and then hammering a heated iron rod through their sensitive snouts.

After removing the animal's teeth and claws, the bear trainer threaded a rope through its snout and then headed for the streets where onlookers would pay a few rupees for a show in which the bear would sway and jump around.

"It's taken us many years but all the tribesmen we keep track of have moved on to different livelihoods," Vivek Menon from the non-profit Wildlife Trust of India (WTI), told AFP on the sidelines of a bear conference in New Delhi last week.

"The tradition might still be present in people's minds, of course, but we don't know of any cases where Kalandars are still practising it."

The World Society for the Protection of Animals (WSPA) and India-based Wildlife SOS, which runs sanctuaries for bears, have also declared an end to the practice in the last few months -- 40 years after a government ban in 1972.

The key, say the donation-funded groups, has been bringing the Kalandars on board, providing them with money and incentives to re-train in other professions.

The success points the way for other campaigns, such as the one to rid India of its snake charmers who can still be spotted illegally plying their trade, often with the snakes' mouths sewn shut.

"It was very difficult to convince the bear trainers to give up their work. Most of them were very scared, they have never known any other way of life but this," WSPA campaign coordinator Aniruddha Mookerjee told AFP.

One of the owners to give up was Mohammed Afsar Khan, a 30-year-old father of three girls who used to work with his father and brother, travelling across central India with three bears in tow.

He says he used to earn about 300 rupees a day until he gave up the job six years ago.

"It's a hard life. You can never settle in one place, your children can't go to school, you end up feeling trapped. Then you are always worried about police harassing you for bribes," he said.

He handed over his bears to Wildlife Trust of India officers, who offered his family financial assistance and helped him and his younger brother learn driving skills.

He used the funds to rent a tractor and ferry bricks from kilns to construction sites in Chhattisgarh state. Today, he owns his tractor and earns about 500 rupees a day.

Declining bear populations

The bears recovered by the animal groups were often in a wretched state, suffering from infected snouts, root canal problems, even diseases such as tuberculosis which they contracted from humans.

The sloth bears also suffer from malnutrition after being fed bread, lentils and milk for years, leading to an extremely reduced life span.

Menon from WTI say that the dancing bear industry was also "a dominant cause behind the disappearance of the sloth bear" -- a focus at the conference on conservation and welfare of bears.

In the last three decades, the number of sloth bears -- a species native to South Asia -- has fallen by at least 30 per cent, according to the IUCN-SSC Bear Specialist Group (BSG). There are now less than 20,000 of them.

"The widespread poaching of bear cubs and the killing of mother bears clearly affects the population of the species," Menon told AFP.

"India is changing rapidly and this is an outmoded, inhumane tradition. The trainers themselves realise now that it is far easier for them to earn a living doing other jobs," Menon said.

Aziz Khan is another former bear-owner who never expected to leave his ancestral trade but was happy for the way out offered by WTI when officers approached him and his friends more than a decade ago.

"I didn't earn much, but I was afraid to leave it. I didn't know how else I would be able to feed my three kids," the 45-year-old told AFP.

WTI helped retrain Aziz Khan and his friends as bakers. They now run their own bakery, producing 350 loaves of bread each day.

"I have no regrets today, it was a dead-end job and I am glad I was able to move on," he said.

- AFP/xq



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FDI in retail to safeguard international market mafias' interest: BJP

NEW DELHI: India's main opposition Bharatiya Janata Party (BJP) today said retail reform is a step taken by the Congress led-federal government to safeguard the interests of the international market mafias at the cost of national interest.

BJP vice president Mukhtar Abbas Naqvi said on Saturday that voting inside the parliament would decide as to who is in favour of national interest and who is working for international interests.

"The government feels that their responsibility is to safeguard the interest of international market mafias instead of national interest and for saving the interest of international market mafias, the government is ready to compromise with national interests. Now, the parliament will decide as to who is in support of international market mafias and who are supporting national interests," said Naqvi.

The government's decision to allow foreign supermarket chains such as Wal-Mart had triggered protest not only from opposition parties but also from some of its allies.

BJP had sought debate on the issue of allowing Foreign Direct Investment (FDI) in the retail sector, under the rule that entails voting after discussions.

Meanwhile, Minister in the Prime Minister Office (PMO), V Narayanaswamy said the government would answer all the queries raised by the opposition parties in the parliament and will explain the benefits of allowing FDI in retail sector.

The lower house of parliament has set December 04 and 05 as the date to vote and debate on FDI. The dates for the upper house are yet to be decided.

Narayanaswamy said the government is confident of becoming victorious in the debate.

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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.

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

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