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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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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Enrique Peña Nieto Takes Office as Mexico’s President

MEXICO CITY — Enrique Peña Nieto became president of Mexico early Saturday, beginning a six-year term in which he has promised to accelerate economic growth, reduce the violence related to the drug war and forge closer, broader ties with the United States.

Mr. Peña Nieto took office at 12:01 a.m. during a short ceremony at the presidential residence with his predecessor, Felipe Calderón. Mr. Peña Nieto is scheduled to take the oath of office before Congress on Saturday morning and then deliver a speech before an audience of domestic and foreign dignitaries, including Vice President Joseph R. Biden Jr., with whom he will also meet privately.

Mr. Peña Nieto, 46, a lawyer who served as governor of Mexico State, has vowed to continue Mr. Calderón’s efforts to work with American law enforcement agencies to quell the violence linked to drug gangs that has killed tens of thousands in the past several years and tarnished Mexico’s image.

In recent weeks, his team has emphasized the need to bolster Mexico’s economy, which rebounded from a recession in 2009 and is now growing faster than the United States’ with an infusion of new manufacturing plants and other investment.

His administration plans more steps to stimulate the economy, arguing that generating better-paying jobs will go a long way toward reducing violence by providing alternatives to crime for the chronically underemployed.

Mr. Peña Nieto also plans to reorganize the federal security forces and intends to form paramilitary units with police duties to combat violence in rural areas and support local and state police departments that are too corrupt or poorly trained to fight crime.

Still, his administration will be watched closely to see whether it is propelling Mexico forward or backward.

Mr. Peña Nieto ushers in a new era for the Institutional Revolutionary Party, known as the PRI, which had ruled Mexico for more than 70 years before the more conservative National Action Party toppled it in 2000 and defeated it again in 2006.

But Mr. Peña Nieto and his associates said they represented a new, chastened party bent on promoting efficiency and economic change and promising to fight the kind of corruption long associated with it.

“It’s a very common misconception to think that the PRI’s return to power means the return of something that is already in history,” Luis Videgaray, who led the president’s transition team and will become the finance minister, said in a recent interview.

“The PRI of today is like any other party: a party that competes in a democracy, that accepts results and understands that only through good government would it be able to compete again in elections,” he said. “So I think that’s the biggest misconception that the PRI is something of the past, and it’s not.”

Mr. Peña Nieto begins his term on a politically shaky foundation. He won 38 percent of the vote in the July election, and for weeks afterward, political opponents complained about what they said were irregularities in the voting. The PRI-led coalition is the largest in Congress, but it does not have an absolute majority and will need alliances to get anything done.

In unveiling his cabinet on Friday, Mr. Peña Nieto relied largely on PRI stalwarts, including five former governors, but placed several young, foreign-educated technocrats from his inner circle, including Mr. Videgaray, in prominent positions to present a fresh face for the old party. Men dominate the cabinet, with only 3 of the 27 positions filled going to women.

The opposition, however, has its own challenges.

The leftist Party of the Democratic Revolution has split into factions, and the National Action Party is rebuilding without a clear leader after losing its 12-year grip on the presidency.

Randal C. Archibold contributed reporting.

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“Guardians of the Galaxy” director sorry for blog post seen as sexist, homophobic

LOS ANGELES (TheWrap.com) – James Gunn, the man entrusted with steering Marvel‘s “Guardians of the Galaxy” to the big screen, apologized publicly for a 2011 blog post that was criticized as sexist and homophobic.

Gunn, who is best known for directing the 2006 horror-comedy “Slither,” found himself under fire this week after reports about a blog post titled “The 50 Superheroes You Most Want to Have Sex With.” In it, he called the superhero Gambit a “Cajun fruit” and suggested that Iron Man could “turn” the lesbian Batwoman into a straight woman. He went on to joke that Batgirl, a masked avenger who happens to be a teen mother, was “easy.” The list was voted on by Twitter and Facebook users, but has since been removed from his site.

In a statement to the Gay & Lesbian Alliance Against Defamation (GLAAD), Gunn said his attempt at irreverence was misguided and stressed that he is a proponent of gay rights and women’s rights.

“A couple of years ago I wrote a blog that was meant to be satirical and funny,” Gunn said. “In rereading it over the past day I don’t think it’s funny. The attempted humor in the blog does not represent my actual feelings. However, I can see where statements were poorly worded and offensive to many. I’m sorry and regret making them at all.”

The post is an unwanted distraction from his efforts to give Marvel and its corporate owner the Walt Disney Company another hit. He plans to co-write the script for “Guardians of the Galaxy” in addition to directing. The film will be released in 2014.

“It kills me that some other outsider like myself, despite his or her gender or sexuality, might feel hurt or attacked by something I said,” he added in his apology. “We’re all in the same camp, and I want to do my best to make this world a better place for all of us. I’m learning all the time. I promise to be more careful with my words in the future. And I will do my best to be funnier as well. Much love to all.”

Internet News Headlines – Yahoo! News

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Dennis Quaid Files for Divorce, Seeks Joint Custody

By Mike Fleeman

11/30/2012 at 09:20 PM EST

Kimberly Buffington-Quaid and Dennis Quaid

Casey Rodgers/NBC/AP

Dennis Quaid is ready to end his marriage for good.

After his wife of eight years, Kimberly Buffington-Quaid, sought legal separation in October, the Vegas star filed Friday for divorce in Los Angeles Superior Court.

The actor requests joint physical and legal custody of their 4-year-old twins, Thomas and Zoe, and offers to pay spousal support, according to the petition.

This will be the third divorce for Quaid, 58, who was previously married to Meg Ryan and P.J. Soles.

Kimberly, a former real estate agent, initially filed for divorce in March. She
put the divorce on hold a month later, pulling the papers so they could work on their marriage, before then filing for separation.

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Kenya village pairs AIDS orphans with grandparents

NYUMBANI, Kenya (AP) — There are no middle-aged people in Nyumbani. They all died years ago, before this village of hope in Kenya began. Only the young and old live here.

Nyumbani was born of the AIDS crisis. The 938 children here all saw their parents die. The 97 grandparents — eight grandfathers among them — saw their middle-aged children die. But put together, the bookend generations take care of one another.

Saturday is World AIDS Day, but the executive director of the aid group Nyumbani, which oversees the village of the same name, hates the name which is given to the day because for her the word AIDS is so freighted with doom and death. These days, it doesn't necessarily mean a death sentence. Millions live with the virus with the help of anti-retroviral drugs, or ARVs. And the village she runs is an example of that.

"AIDS is not a word that we should be using. At the beginning when we came up against HIV, it was a terminal disease and people were presenting at the last phase, which we call AIDS," said Sister Mary Owens. "There is no known limit to the lifespan now so that word AIDS should not be used. So I hate World AIDS Day, follow? Because we have moved beyond talking about AIDS, the terminal stage. None of our children are in the terminal stage."

In the village, each grandparent is charged with caring for about a dozen "grandchildren," one or two of whom will be biological family. That responsibility has been a life-changer for Janet Kitheka, who lost one daughter to AIDS in 2003. Another daughter died from cancer in 2004. A son died in a tree-cutting accident in 2006 and the 63-year-old lost two grandchildren in 2007, including one from AIDS.

"When I came here I was released from the grief because I am always busy instead of thinking about the dead," said Kitheka. "Now I am thinking about building a new house with 12 children. They are orphans. I said to myself, 'Think about the living ones now.' I'm very happy because of the children."

As she walks around Nyumbani, which is three hours' drive east of Nairobi, 73-year-old Sister Mary is greeted like a rock star by little girls in matching colorful school uniforms. Children run and play, and sleep in bunk beds inside mud-brick homes. High schoolers study carpentry or tailoring. But before 2006, this village did not exist, not until a Catholic charity petitioned the Kenyan government for land on which to house orphans.

Everyone here has been touched by HIV or AIDS. But only 80 children have HIV and thanks to anti-retroviral drugs, none of them has AIDS.

"They can dream their dreams and live a long life," Owens said.

Nyumbani relies heavily on U.S. funds but it is aiming to be self-sustaining.

The kids' bunk beds are made in the technical school's shop. A small aquaponics project is trying to grow edible fish. The mud bricks are made on site. Each grandparent has a plot of land for farming.

The biggest chunk of aid comes from the United States President's Emergency Plan for AIDS Relief (PEPFAR), which has given the village $2.5 million since 2006. A British couple gives $50,000 a year. A tree-growing project in the village begun by an American, John Noel, now stands six years from its first harvest. Some 120,000 trees have already been planted and thousands more were being planted last week.

"My wife and I got married as teenagers and started out being very poor. Lived in a trailer. And we found out what it was like to be in a situation where you can't support yourself," he said. "As an entrepreneur I looked to my enterprise skills to see what we could do to sustain the village forever, because we are in our 60s and we wanted to make sure that the thousand babies and children, all the little ones, were taken care of."

He hopes that after a decade the timber profits from the trees will make the village totally self-sustaining.

But while the future is looking brighter, the losses the orphans' suffered can resurface, particularly when class lessons are about family or medicine, said Winnie Joseph, the deputy headmaster at the village's elementary school. Kitheka says she tries to teach the kids how to love one another and how to cook and clean. But older kids sometimes will threaten to hit her after accusing her of favoring her biological grandchildren, she said.

For the most part, though, the children in Nyumbani appear to know how lucky they are, having landed in a village where they are cared for. An estimated 23.5 million people in sub-Saharan Africa have HIV as of 2011, representing 69 percent of the global HIV population, according to UNAIDS. Eastern and southern Africa are the hardest-hit regions. Millions of people — many of them parents — have died.

Kitheka noted that children just outside the village frequently go to bed hungry. And ARVs are harder to come by outside the village. The World Health Organization says about 61 percent of Kenyans with HIV are covered by ARVs across the country.

Paul Lgina, 14, contrasted the difference between life in Nyumbani, which in Swahili means simply "home," and his earlier life.

"In the village I get support. At my mother's home I did not have enough food, and I had to go to the river to fetch water," said Lina, who, like all the children in the village, has neither a mother or a father.

When Sister Mary first began caring for AIDS orphans in the early 1990s, she said her group was often told not to bother.

"At the beginning nobody knew what to do with them. In 1992 we were told these children are going to die anyway," she said. "But that wasn't our spirit. Today, kids we were told would die have graduated from high school."

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On the Internet:

http://www.trees4children.org/

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U.S. regulators grill Edison on bid to restart part of San Onofre

Federal regulators grilled Southern California Edison publicly for the first time Friday on its proposal to restart part of the troubled San Onofre nuclear power plant.

San Onofre has been out of service for 10 months because of unusual wear on steam generator tubes. A small radiation leak developed as a result and prompted a shutdown in January. The steam generators had been replaced less than two years earlier, costing co-owners Edison and San Diego Gas & Electric a combined $771 million.

After months of inspections and testing, Edison presented a plan to the U.S. Nuclear Regulatory Commission in October to restart one of the two reactors at 70% power, for five months, before taking it offline for inspection. The company said that running the unit at reduced power would prevent the tube vibration that resulted in excessive wear.

The other unit, which had more serious issues, was not included in the restart proposal and will remain offline indefinitely.

Edison representatives sought to convince the commission that the units, although nearly identical in design, are different enough that Unit 2 can be run safely, while Unit 3 may not be able to operate again without extensive repairs. (Unit 1 of the plant has been permanently decommissioned.)

"Unit 2 is clearly different based on results," Edison Vice President of Engineering Tom Palmisano told NRC representatives, pointing out that Unit 2 showed substantially less of the unusual tube wear although its new steam generators had been operating for a year longer than Unit 3's.

Edison's analysis has blamed computer modeling by steam generator manufacturer Mitsubishi Heavy Industries for failing to predict the behavior of steam within the generators, leading to the excessive vibration, as well as design changes made to support bars, which failed to stop the vibration, particularly in Unit 3. Mitsubishi had no one present at the meeting.

The meeting took place amid increasing debate over the fate of the plant, which once supplied enough power for 1.4 million homes.

Also, just one day earlier, Edison announced that it had found evidence of potential tampering with a backup generator connected to the reactor that Edison does not plan to activate.

Workers found coolant in the generator's oil system in October, and Edison said in a statement Thursday that it had found evidence that the incident might have resulted from intentional tampering, although the evidence did not confirm that tampering had occurred. The company said that it has beefed up security and that the incident did not pose a safety risk. The reactor unit it is attached to has been defueled.

Activists and residents have demanded that San Onofre be decommissioned. Short of that, they have demanded that the NRC force Edison to go through a license amendment process, complete with a courtroom-like hearing, before deciding whether to allow the plant to restart its Unit 2 reactor.

Although Friday's meeting was set up as a technical discussion between Edison and the NRC, anti-nuclear activists arrived en masse to express their opposition to restarting the plant, with some chanting "Shut down San Onofre" at the outset. They were joined by a group of four Buddhist monks and nuns who had planned to march to San Onofre from Dana Point on Friday and hold a six-day vigil by the plant to call for its decommissioning.

They changed plans, though, after a local activist took a radiation reading with his portable Geiger counter and claimed that an old steam generator being prepared for shipping had caused a spike in radiation. They took up their vigil at a pier in nearby San Clemente instead.

One of the monks, Senji Kanaeda, who lives in Seattle but is originally from Japan, said he was concerned about nuclear power in part because of the disaster at Fukushima.

"We would like to pass a safe world to the next generation," he said.

San Onofre is dealing with other issues as well. Edison is embroiled in a spat with the union representing many of the plant employees over the company's plans to lay off more than 700 workers. Daniel Dominguez, business manager of Utility Workers Union of America Local 246, wrote Edison executives expressing concerns that the layoffs could affect the plant's safety if it does restart.

Dominguez said in an interview that he is not concerned about Edison's restart plan from a technical perspective but is worried that the plant will not be able to safely operate with the reduced workforce, especially with cuts of highly skilled workers.

"We think it doesn't make sense to be doing layoffs while you're trying to restart a unit with significant challenges," he said.

abigail.sewell@latimes.com

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Mumbai Journal: Cultivating Vultures to Restore a Mumbai Ritual

Kuni Takahashi for The New York Times

A model of one of the Towers of Silence, top, where in Parsi tradition, dead bodies are placed for disposal by vultures.

MUMBAI, India — Fifteen years after vultures disappeared from Mumbai’s skies, the Parsi community here intends to build two aviaries at one of its most sacred sites so that the giant scavengers can once again devour human corpses.

Construction is scheduled to begin as soon as April, said Dinshaw Rus Mehta, chairman of the Bombay Parsi Punchayet. If all goes as planned, he said, vultures may again consume the Parsi dead by January 2014.

“Without the vultures, more and more Parsis are choosing to be cremated,” Mr. Mehta said. “I have to bring back the vultures so the system is working again, especially during the monsoon.”

The plan is the result of six years of negotiations between Parsi leaders and the Indian government to revive a centuries-old practice that seeks to protect the ancient elements — air, earth, fire and water — from being polluted by either burial or cremation. And along the way, both sides hope the effort will contribute to the revival of two species of vulture that are nearing extinction. The government would provide the initial population of birds.

The cost of building the aviaries and maintaining the vultures is estimated at $5 million spread over 15 years, much less expensive than it would have been without the ready supply of food.

“Most vulture aviaries have to spend huge sums to buy meat, but for us that’s free because the vultures will be feeding on human bodies — on us,” Mr. Mehta said.

Like the vultures on which they once relied, Parsis are disappearing. Their religion, Zoroastrianism, once dominated Iran but was largely displaced by Islam. In the 10th century, a large group of Zoroastrians fled persecution in Iran and settled in India. Fewer than 70,000 remain, most of them concentrated in Mumbai, formerly known as Bombay, where they collectively own prime real estate that was purchased centuries ago.

Among the most valuable of these holdings are 54 acres of trees and winding pathways on Malabar Hill, one of Mumbai’s most exclusive neighborhoods. Tucked into these acres are three Towers of Silence where Parsis have for centuries disposed of their dead.

The stone towers are open-air auditoriums containing three concentric rings of marble slabs — an outer ring for dead men, middle ring for deceased women and inner ring for dead children. For centuries, bodies left on the slabs were consumed within hours by neighborhood vultures, with the bones left in a central catchment to leach into the soil.

Modernity has impinged on this ancient practice in many ways. That includes the construction of nearby skyscrapers where non-Parsis could watch the grisly scenes unfold. But by far the greatest threat has been the ecological disaster visited in recent years on vultures.

India once had as many as 400 million vultures, a vast population that thrived because the nation has one of the largest livestock populations in the world but forbids cattle slaughter. When cows died, they were immediately set upon by flocks of vultures that left behind skin for leather merchants and bones for bone collectors. As recently as the 1980s, even the smallest villages often had thousands of vulture residents.

But then came diclofenac, a common painkiller widely used in hospitals to lessen the pain of the dying. Marketed under names like Voltaren, it is similar to the medicines found in Advil and Aleve; in 1993 its use in India was approved in cattle. Soon after, vultures began dying in huge numbers because the drug causes them to suffer irreversible kidney failure.

Diclofenac’s veterinarian use has since been banned, which may finally be having an effect. A recent study found that for the first time since the drug’s introduction, India’s vulture population did not decline over the past year.

Still, the numbers for three species have shrunk to only a few thousand, a tiny fraction of their former levels. With so few vultures left, the Parsi community set up mirrors around the Towers of Silence to create something akin to solar ovens to accelerate decomposition. But the mirrors are ineffective during monsoon months. So an increasing number of Parsis are opting for cremation, a practice many Parsi priests believe is an abomination since fire is sacred and corpses unclean.

Sruthi Gottipati contributed reporting.

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The X Factor Announces Top 6

TV Watch

The X Factor

11/29/2012 at 09:40 PM EST

From left; Demi Lovato, Britney Spears and Simon Cowell

FOX

Mario Lopez called the first elimination on Thursday's The X Factor a "bit of a shocker."

And so was the second.

The top eight contestants sang No. 1 hits Wednesday in an emotional night. Keep reading to find out which two performers were sent packing – and who's in season 2's top six ...

Paige Thomas was the first to go – which is shocking because she toned down her over-the-top performing style to sing Rick Astley's "Never Gonna Give You Up" like a like a "legitimate pop star," according to Simon Cowell.

That left Demi Lovato with just one singer on her team: CeCe Frey, who was told (by Cowell) to "pack her bags" Wednesday after her performance of "Lady Marmalade."

But L.A. Reid's contestant Vino Alan and Team Britney's Diamond White were in the bottom two and had to sing for survival. He performed "Trouble" and she sang Beyoncé's "I Was Here."

L.A. voted to send home Diamond; Britney returned the favor and voted to send home Vino. Demi voted Vino out as well. That left Simon ... and he fell in line with the female panelists, voting to get rid of Vino. Either one would have been a shock but Vino had been ranked third last week.

Here's how the top six rank this week:
1. Carly Rose Sonenclar
2. Tate Stevens
3. Emblem3
4. Fifth Harmony
5. CeCe Frey
6. Diamond White

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Clinton releases road map for AIDS-free generation

WASHINGTON (AP) — In an ambitious road map for slashing the global spread of AIDS, the Obama administration says treating people sooner and more rapid expansion of other proven tools could help even the hardest-hit countries begin turning the tide of the epidemic over the next three to five years.

"An AIDS-free generation is not just a rallying cry — it is a goal that is within our reach," Secretary of State Hillary Rodham Clinton, who ordered the blueprint, said in the report.

"Make no mistake about it, HIV may well be with us into the future but the disease that it causes need not be," she said at the State Department Thursday.

President Barack Obama echoed that promise.

"We stand at a tipping point in the fight against HIV/AIDS, and working together, we can realize our historic opportunity to bring that fight to an end," Obama said in a proclamation to mark World AIDS Day on Saturday.

Some 34 million people worldwide are living with HIV, and despite a decline in new infections over the last decade, 2.5 million people were infected last year.

Given those staggering figures, what does an AIDS-free generation mean? That virtually no babies are born infected, young people have a much lower risk than today of becoming infected, and that people who already have HIV would receive life-saving treatment.

That last step is key: Treating people early in their infection, before they get sick, not only helps them survive but also dramatically cuts the chances that they'll infect others. Yet only about 8 million HIV patients in developing countries are getting treatment. The United Nations aims to have 15 million treated by 2015.

Other important steps include: Treating more pregnant women, and keeping them on treatment after their babies are born; increasing male circumcision to lower men's risk of heterosexual infection; increasing access to both male and female condoms; and more HIV testing.

The world spent $16.8 billion fighting AIDS in poor countries last year. The U.S. government is the leading donor, spending about $5.6 billion.

Thursday's report from PEPFAR, the President's Emergency Plan for AIDS Relief, outlines how progress could continue at current spending levels — something far from certain as Congress and Obama struggle to avert looming budget cuts at year's end — or how faster progress is possible with stepped-up commitments from hard-hit countries themselves.

Clinton warned Thursday that the U.S. must continue doing its share: "In the fight against HIV/AIDS, failure to live up to our commitments isn't just disappointing, it's deadly."

The report highlighted Zambia, which already is seeing some declines in new cases of HIV. It will have to treat only about 145,000 more patients over the next four years to meet its share of the U.N. goal, a move that could prevent more than 126,000 new infections in that same time period. But if Zambia could go further and treat nearly 198,000 more people, the benefit would be even greater — 179,000 new infections prevented, the report estimates.

In contrast, if Zambia had to stick with 2011 levels of HIV prevention, new infections could level off or even rise again over the next four years, the report found.

Advocacy groups said the blueprint offers a much-needed set of practical steps to achieve an AIDS-free generation — and makes clear that maintaining momentum is crucial despite economic difficulties here and abroad.

"The blueprint lays out the stark choices we have: To stick with the baseline and see an epidemic flatline or grow, or ramp up" to continue progress, said Chris Collins of amFAR, the Foundation for AIDS Research.

His group has estimated that more than 276,000 people would miss out on HIV treatment if U.S. dollars for the global AIDS fight are part of across-the-board spending cuts set to begin in January.

Thursday's report also urges targeting the populations at highest risk, including gay men, injecting drug users and sex workers, especially in countries where stigma and discrimination has denied them access to HIV prevention services.

"We have to go where the virus is," Clinton said.

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