Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges that he detains mothers who can't pay their bills.

Lazarus Omondi says it's the only way he can keep his medical center running. Now, a New York-based group filed a lawsuit this month in hopes of forcing Pumwani to stop the practice.

Two mothers who live in a mud-wall and tin-roof slum near the maternity hospital said Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards with sticks would beat mothers who tried to leave without paying, one of the women said.

Omondi says one solution to the problem would be a national health insurance program.

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Winter storm whips across Northeast

CONCORD, N.H. (AP) — A powerful winter storm brought snow to inland parts of the Northeast and driving rain and wind to areas along the coast Thursday, a day after it swept through the nation's middle, dumping a record snowfall in Arkansas and ruining holiday travel plans for thousands.

The storm, which was blamed for nine deaths, pushed through the Upper Ohio Valley and made its way into the Northeast Wednesday night. By Thursday morning, there was anywhere from a few inches of snow to a foot in some locations.

National Weather Service spokesman David Roth said the Northeast's heaviest snowfall would be in northern Pennsylvania, upstate New York and inland sections of several New England states before the storm ended Friday morning and headed to Canada.

The East Coast's largest cities — New York, Philadelphia and Boston — were seeing mostly high winds and rain Thursday morning. Other areas were getting a messy mix of rain and snow or just rain — enough to slow down commuters and those still heading home from visits with family.

Thousands of travelers were trying to make it home Thursday after the fierce storm stranded them at airports or relatives' homes around the region. Some inbound flights were delayed in Philadelphia and New York's LaGuardia, but the wet and windy weather wasn't leading to delays at other major East Coast airports.

A flight that landed safely in Pittsburgh during the storm Wednesday night got stuck in snow for about two hours on the tarmac.

The American Airlines flight arrived between 8 and 9 p.m., but then ran over a snow patch and got stuck.

Airport spokeswoman Joan Jenny told the Pittsburgh Post-Gazette workers tried for nearly two hours to tow the plane to the gate before deciding to bus passengers to the terminal.

Hundreds of flights were canceled or delayed on Wednesday and scores of motorists got stuck on icy roads or slid into drifts. Said John Kwiatkowski, an Indianapolis-based meteorologist with the weather service: "The way I've been describing it is as a low-end blizzard, but that's sort of like saying a small Tyrannosaurus rex."

The storm system spawned Gulf Coast region tornadoes on Christmas Day, startling people like Bob and Sherry Sims of Mobile, Alabama, who'd just finished dinner.

"We heard that very distinct sound, like a freight train," said Bob Sims. They headed for a center bathroom.

Power was still out at the Sims' home on Wednesday, but the house wasn't damaged and they used a generator to run heaters to stay warm. Some neighbors were less fortunate, their roofs peeled away and porches smashed by falling trees.

The storm also left freezing temperatures in its aftermath, and forecasters said parts of the Southeast from Virginia to Florida saw severe thunderstorms.

Schools on break and workers taking holiday vacations meant that many people could avoid messy commutes, but those who had to travel were urged to avoid it. Snow was blamed for scores of vehicle accidents as far east as Maryland, and about two dozen counties in Indiana and Ohio issued snow emergency travel alerts, urging people to go out on the roads only if necessary.

About 40 vehicles got bogged down trying to make it up a slick hill in central Indiana, and four state snowplows slid off roads as snow fell at the rate of 3 inches an hour in some places.

Officials in Ohio blamed the bad weather for a crash that killed an 18-year-old girl, who lost control of her car Wednesday afternoon and smashed into an oncoming snow plow on a highway northeast of Cincinnati.

A man and a woman in Evansville, Ind., were killed when the scooter they were riding went out of control on a snowy street Wednesday and they were hit by a pickup truck.

Two passengers in a car on a sleet-slickened Arkansas highway were killed Wednesday in a head-on collision, and two people, including a 76-year-old Milwaukee woman, were killed Tuesday on Oklahoma highways. Deaths from wind-toppled trees were reported in Texas and Louisiana.

The day after Christmas wasn't expected to be particularly busy for AAA, but its Cincinnati-area branch had its busiest Wednesday of the year. By mid-afternoon, nearly 400 members had been helped with tows, jump starts and other aid, with calls still coming in, spokesman Mike Mills said.

In Arkansas, some of the nearly 200,000 people who lost power could be without it for as long as a week because of snapped poles and wires after ice and 10 inches of snow coated power lines, said the state's largest utility, Entergy Arkansas.

Gov. Mike Beebe, who declared a statewide emergency, sent out National Guard teams, and Humvees transported medical workers and patients. Snow hadn't fallen in Little Rock on Christmas since 1926, but the capital ended Tuesday with 10.3 inches of it.

Other states also had scattered outages.

As the storm moved east, New England state highway departments were treating roads and getting ready to mobilize with snowfall forecasts of a foot or more.

Few truckers were stopping into a TravelCenters of America truck stop in Willington, Conn., near the Massachusetts border early Thursday. Usually 20 to 30 an hour stop in overnight, but high winds and slushy roads had cut that to two to three people an hour.

"A lot of people are staying off the road," said Louis Zalewa, 31, who works there selling gasoline and staffing the store. "I think people are being smart."

As usual, winter-sports enthusiasts welcomed the snow. At Smiling Hill Farm in Maine, Warren Knight was hoping for enough snow to allow the opening of trails.

"We watch the weather more carefully for cross-country skiing than we do for farming. And we're pretty diligent about farming. We're glued to the weather radio," said Knight, who described the weather at the 500-acre farm in Westbrook as being akin to the prizes in "Cracker Jacks — we don't know what we're going to get."

Behind the storm, Mississippi's governor declared states of emergency in eight counties with more than 25 people reported injured and 70 homes left damaged.

Cindy Williams stood near a home in McNeill, Miss., where its front had collapsed into a pile of wood and brick, a balcony and the porch ripped apart. Large oak trees were uprooted and winds sheared off treetops in a nearby grove. But she focused instead on the fact that all her family members had escaped harm.

"We are so thankful," she said. "God took care of us."

___

Associated Press writers Rick Callahan and Charles Wilson in Indianapolis, Kelly P. Kissel in Little Rock, Ark.; Jim Van Anglen in Mobile, Ala.; Holbrook Mohr in Jackson, Miss.; Julie Carr Smyth and Mitch Stacy in Columbus, Ohio; Amanda Lee Myers in Cincinnati; David Dishneau in Hagerstown, Md.; and David Sharp in Portland, Maine, contributed to this report.

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New Japan PM: Saving economic crisis top mission

TOKYO (AP) — Japan's newly installed Prime Minister Shinzo Abe says his top mission is to avert economic and diplomatic crises.

Abe was elected as Japan's leader Wednesday. The rise of Abe, whose nationalist positions have in the past angered Japan's neighbors, brings back the conservative, pro-business Liberal Democratic Party that governed for most of the post-World War II era to power. The left-leaning government of the Democratic Party of Japan lasted three years.

Abe vowed to pull Japan out of deflation through bold economic measures, and said he would step up an alliance with the United States to stabilize Japan's diplomacy shaken by increasing territorial threats from its neighbors.

Abe, who was also prime minister in 2006-2007, led the LDP to victory in parliamentary elections Dec. 16.

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Ticket rush: Film fans hand Hollywood record cash

LOS ANGELES (AP) — The big deal for Hollywood is not the record $10.8 billion that studios took in domestically in 2012. It's the fact that the number of tickets sold went up for the first time in three years.

Thanks to inflation, revenue generally rises in Hollywood as admission prices climb each year. The real story is told in tickets, whose sales have been on a general decline for a decade, bottoming out in 2011 at 1.29 billion, their lowest level since 1995.

The industry rebounded this year, with ticket sales projected to rise 5.6 percent to 1.36 billion by Dec. 31, according to box-office tracker Hollywood.com. That's still well below the modern peak of 1.6 billion tickets sold in 2002, but in an age of cozy home theater setups and endless entertainment gadgets, studio executives consider it a triumph that they were able to put more butts in cinema seats this year than last.

"It is a victory, ultimately," said Don Harris, head of distribution at Paramount Pictures. "If we deliver the product as an industry that people want, they will want to get out there. Even though you can sit at home and watch something on your large screen in high-def, people want to get out."

Domestic revenue should finish up nearly 6 percent from 2011's $10.2 billion and top Hollywood's previous high of $10.6 billion set in 2009.

The year was led by a pair of superhero sagas, Disney's "The Avengers" with $623 million domestically and $1.5 billion worldwide and the Warner Bros. Batman finale "The Dark Knight Rises" with $448 million domestically and $1.1 billion worldwide. Sony's James Bond adventure "Skyfall" is closing in on the $1 billion mark globally, and the list of action and family-film blockbusters includes "The Hunger Games," ''The Twilight Saga: Breaking Dawn — Part Two," ''Ice Age: Continental Drift," ''Madagascar 3: Europe's Most Wanted," ''The Amazing Spider-Man" and "Brave."

Before television, movies were the biggest thing going, with ticket sales estimated as high as 4 billion a year domestically in the 1930s and '40s.

Movie-going eroded steadily through the 1970s as people stayed home with their small screens. The rise of videotape in the 1980s further cut into business, followed by DVDs in the '90s and big, cheap flat-screen TVs in recent years. Today's video games, mobile phones and other portable devices also offer easy options to tramping out to a movie theater.

It's all been a continual drain on cinema business, and cynics repeatedly predict the eventual demise of movie theaters. Yet Hollywood fights back with new technology of its own, from digital 3-D to booming surround-sound to the clarity of images projected at high-frame rates, which is being tested now with "The Lord of the Rings" prelude "The Hobbit: An Unexpected Journey," shown in select theaters at 48 frames a second, double the standard speed.

For all of the annoyances of theaters — parking, pricy concessions, sitting next to strangers texting on their iPhones — cinemas still offer the biggest and best way to see a movie.

"Every home has a kitchen, but you can't get into a good restaurant on Saturday night," said Dan Fellman, head of distribution for Warner Bros. "People want to escape. That's the nature of society. The adult population just is not going to sit home seven days a week, even though they have technology in their home that's certainly an improvement over what it was 10 years ago. People want to get out of the house, and no matter what they throw in the face of theatrical exhibition, it continues to perform at a strong level."

Even real-life violence at the movie theater didn't turn audiences away. Some moviegoers thought twice about heading to the cinema after a gunman killed 12 people and injured 58 at a screening of "The Dark Knight Rises" in Colorado last summer, but if there was any lull in attendance, it was slight and temporary. Ticket sales went on a tear for most of the fall.

While domestic revenues inch upward most years largely because of inflation, the real growth areas have been overseas, where more and more fans are eager for the next Hollywood blockbuster.

International business generally used to account for less than half of a studio film's overall receipts. Films now often do two or even three times as much business overseas as they do domestically. Some movies that were duds with U.S. audiences, such as "Battleship" and "John Carter," can wind up being $200 million hits with overseas crowds.

Whether finishing a good year or a bad one, Hollywood executives always look ahead to better days, insisting that the next crop of blockbusters will be bigger than ever. The same goes this time as studio bosses hype their 2013 lineup, which includes the latest "Iron Man," ''Star Trek," ''Hunger Games" and "Thor" installments, the Superman tale "Man of Steel" and the second chapter in "The Hobbit" trilogy.

Twelve months from now, they hope to be talking about another revenue record topping this year's $10.8 billion.

"I've been saying we're going to hit that $11 billion level for about three years now," said Paul Dergarabedian, a box-office analyst for Hollywood.com. "Next year I think is the year we actually do it."

___

Online:

http://www.hollywood.com

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

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

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

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

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

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

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

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

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

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

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

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

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

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

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

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

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

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

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

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

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

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

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

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

___

Online:

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

___

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

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Snowstorm heads east after South twisters; 3 dead

MOBILE, Ala. (AP) — An enormous storm system that dumped snow and sleet on the nation's midsection and unleashed damaging tornadoes around the Deep South began punching its way toward the Northeast on Wednesday, slowing holiday travel.

Post-Christmas travelers braced for flight delays and a raft of weather warnings for drivers, a day after rare winter twisters damaged buildings in Louisiana and Alabama.

Snow and ice covered roads in southern Illinois and southern Indiana early Wednesday. Officials urged residents to stay home if they can. State police reported numerous slide-off accidents in the Evansville, Ind., area and white-out conditions on Interstate 64 in Indiana with wind gusts around 30 mph.

The storm system headed from the Gulf Coast to New England has been blamed for three deaths and several injuries, though no one was killed outright in the tornadoes. The storms also left more than 100,000 without power for a time across the South, darkening Christmas celebrations.

Severe thunderstorms were forecast for the Carolinas while a line of blizzard and winter storm warnings stretched from Arkansas up the Ohio River to New York and on to Maine.

Thirty-four tornadoes were reported in Texas, Louisiana, Mississippi and Alabama during the outbreak Tuesday, the National Weather Service said.

Rick Cauley's family was hosting relatives for Christmas when tornado sirens went off in Mobile. Not taking any chances, he and his wife, Ashley, hustled everyone down the block to take shelter at the athletic field house at Mobile's Murphy High School in Mobile.

It turns out, that wasn't the place to head.

"As luck would have it, that's where the tornado hit," Cauley said. "The pressure dropped and the ears started popping and it got crazy for a second." They were all fine, though the school was damaged, as were a church and several homes, but officials say no one was seriously injured.

Camera footage captured the approach of the large funnel cloud.

Mobile was the biggest city hit by numerous twisters. Along with brutal, straight-line winds, the storms knocked down countless trees, blew the roofs off homes and left many Christmas celebrations in the dark. Torrential rains drenched the region and several places saw flash flooding.

More than 325 flights around the U.S. were canceled as of Wednesday morning, according to the flight tracker FlightAware.com. The cancelations were mostly spread around airports that had been or soon would be in the path of the storm.

Holiday travelers in the nation's much colder midsection battled treacherous driving conditions from freezing rain and blizzard conditions from the same fast-moving storms. In Arkansas, highway department officials said the state was fortunate the snowstorm hit on Christmas Day when many travelers were already at their destinations.

Texas, meanwhile, dealt with high winds and slickened highways.

On Tuesday, winds toppled a tree onto a pickup truck in the Houston area, killing the driver, and a 53-year-old north Louisiana man was killed when a tree fell on his house. Icy roads already were blamed for a 21-vehicle pileup in Oklahoma, and the Highway Patrol there says a 28-year-old woman was killed in a crash on a snowy U.S. Highway near Fairview.

Trees fell on homes and across roadways in several communities in southern Mississippi and Louisiana. Mississippi Gov. Phil Bryant declared a state of emergency, saying eight counties reported damages and some injuries.

It included McNeill, where a likely tornado damaged a dozen homes and sent eight people to the hospital, none with life-threatening injuries, said Pearl River County emergency management agency director Danny Manley.

The snowstorm that caused numerous accidents pushed out of Oklahoma late Tuesday, carrying with it blizzard warnings for parts of northeast Arkansas, where 10 inches of snow was forecast. Freezing rain clung to trees and utility lines in Arkansas and winds gusts up to 30 mph whipped them around, causing about 71,000 customers to lose electricity for a time.

Christmas lights also were knocked out with more than 100,000 customers without power for at least a time in Texas, Arkansas, Oklahoma, Mississippi, Louisiana and Alabama.

Blizzard conditions were possible for parts of Illinois, Indiana and Kentucky up to Cleveland with predictions of several inches to a foot of snow. By the end of the week, that snow was expected to move into the Northeast with again up to a foot predicted

Jason Gerth said the Mobile tornado passed by in a few moments and from his porch, he saw about a half-dozen green flashes in the distance as transformers blew. His home was spared.

"It missed us by 100 feet and we have no damage," Gerth said.

In Louisiana, quarter-sized hail was reported early Tuesday in the western part of the state and a WDSU viewer sent a photo to the TV station of what appeared to be a waterspout around the Lake Pontchartrain Causeway in New Orleans. There were no reports of crashes or damage.

Some mountainous areas of Arkansas' Ozark Mountains could get up to 10 inches of snow, which would make travel "very hazardous or impossible" in the northern tier of the state from near whiteout conditions, the weather service said.

The holiday may conjure visions of snow and ice, but twisters this time of year are not unheard of. Ten storm systems in the last 50 years have spawned at least one Christmastime tornado with winds of 113 mph or more in the South, said Chris Vaccaro, a National Weather Service spokesman in Washington, via email.

The most lethal were the storms of Dec. 24-26, 1982, when 29 tornadoes in Oklahoma, Missouri, Arkansas, Tennessee and Mississippi killed three people and injured 32.

In Mobile, a large section of the roof on the Trinity Episcopal Church is missing and the front wall of the parish wall is gone, said Scott Rye, a senior warden at the church in the Midtown section of the city.

On Christmas Eve, the church with about 500 members was crowded for services.

"Thank God this didn't happen last night," Rye said.

___

Associated Press writers Jay Reeves in Birmingham, Ala., Jeff Amy in Atlanta, Ramit Plushnick-Masti in Houston, Chuck Bartels in Little Rock, Ark., Janet McConnaughey in New Orleans and AP Business Writer Daniel Wagner in Washington, contributed to this report.

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Plane crash-lands on Myanmar road, 3 killed

YANGON, Myanmar (AP) — A flight packed with Christmas tourists crash-landed on a road in central Myanmar on Tuesday, killing three people and injuring 11, officials said.

Four foreigners were among the injured on the Air Bagan flight, the airline said. It said the fatalities were all Myanmar citizens: a tour guide and an 11-year-old child on board the plane and a man riding a motorcycle on the road where the plane came down.

The flight was carrying 63 passengers, including 51 foreigners, and six crew members from the city of Mandalay to Heho airport in Shan State, the gateway to a popular tourist destination, Inle Lake, Air Bagan said in a brief statement on its Facebook page.

Air Bagan identified the injured tourists as two Americans, a British national and a Korean. It described the incident as an "emergency landing."

Authorities gave a different and more dramatic account, saying the pilot mistook the road for a runway due to bad weather.

"While descending, the plane mistakenly landed ... due to fog beside the runway," state television reported. It said the aircraft made a hard landing on a road and then came to a stop in a nearby rice paddy field.

"The rear end of the plane broke and caught fire," state TV said, carrying a statement posted on Deputy Information Minister Ye Htut's Facebook page. Rescuers brought the fire under control about 45 minutes later, he said.

Witnesses said smoke filled the plane when it hit the ground and was still rising from the plane's badly charred wreckage hours later.

Airport officials in Heho said that injured passengers were taken to a hospital in the nearby city of Taunggyi for treatment.

Air Bagan is one of five private airlines that fly domestic routes in Myanmar. It is a unit of Htoo Trading Company, which is owned by business tycoon Tay Za.

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Mundie, one of Gates’ successors, to retire from Microsoft

NEW YORK (Reuters) – Craig Mundie, one of two Microsoft Corp executives who took over Bill Gates‘ role at the company, has relinquished control of Microsoft’s large research organization and is to retire from the company in 2014.

Mundie is taking on a new role as a senior adviser to Chief Executive Steve Ballmer, according to a memo circulated internally earlier this month but only made public on Monday.

Eric Rudder, another Microsoft veteran, is taking on responsibility for Microsoft Research, Trustworthy Computing, and the Technology Policy Group, which were all run by Mundie.

A 20-year Microsoft veteran, Mundie was one of two men hand-picked by co-founder Gates to take over leadership of the technical side of Microsoft when he retired from day-to-day work at the company in 2008.

Mundie took over responsibility for the company’s long-term research activities, while Ray Ozzie became chief software architect. Ozzie left Microsoft in 2010. According to Ballmer’s memo, Mundie will retire from Microsoft in 2014, when he will be 65.

Mundie’s new role was first reported on Monday by the All Things D tech blog.

(Reporting By Bill Rigby; Editing by Steve Orlofsky)

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Reaction to the death of actor Jack Klugman

Celebrities on Monday reacted to the death of "Odd Couple" star Jack Klugman, who died Monday at age 90. Here are samples of sentiments expressed on Twitter:

___

"R.I.P. Jack Klugman, Oscar, Quincy a man whose career spanned almost 50 years. I first saw him on the Twilight Zone. Cool guy wonderful actor." — Whoopi Goldberg.

___

"You made my whole family laugh together." — Actor Jon Favreau, of "Swingers," ''Iron Man" and other films.

___

"I worked with Jack Klugman several years ago. He was a wonderful man and supremely talented actor. He will be missed" — Actor Max Greenfield, of the "New Girl" on Fox.

___

"So sorry to hear that Jack Klugman passed away. I learned a lot, watching him on television" — Dan Schneider, creator of Nickelodeon TV shows "iCarly," ''Drake and Josh" ''Good Burger," ''Drake & Josh."

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

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

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

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

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

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

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

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

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

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

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

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

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

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

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

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

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

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

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

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

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

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

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

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

___

Online:

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

___

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

Read More..