Yen falls, Nikkei surges as Japan gets a new government

TOKYO (Reuters) - The yen fell to a 20-month low against the dollar on Wednesday, buoying the benchmark Nikkei stock average to nine-month highs, as Japan swore in a new prime minister eager to pursue drastic stimulus steps to drive the country's economy out of deflation.

Asian shares and other assets were capped in thin holiday trade, with investors focusing on the fate of U.S. negotiations to avert a budget crunch looming at the end of the year.

Markets in Singapore <.ftsti>, Malaysia <.klse>, Indonesia <.jkse>, the Philippines <.psi> and South Korea <.ks11> reopened on Wednesday after closing on Tuesday for the Christmas holiday.

Hong Kong and Australia remain closed on Wednesday. Europe also will not trade, but U.S. markets reopen later in the day.

MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was little changed. Shanghai shares <.ssec> were flat, but stayed in positive territory on the year after a 2.5 percent jump on Tuesday erased 2012 losses. It is set for a first annual gain in three years. South Korean shares <.ks11> ended nearly flat.

Shinzo Abe, whose party won a landslide victory in an election earlier this month, was elected Japan's premier on Wednesday. Abe, who is expected to appoint his cabinet later Wednesday, is calling for a mix of aggressive monetary policy easing and big fiscal spending to beat deflation and rein in the strong yen.

He has kept up pressure on the Bank of Japan to be more drastic and adopt a 2 percent inflation target to beat deep-rooted deflation, pushing the yen to a 20-month low of 85.38 yen on trading platform EBS on Wednesday. Traders eyed the dollar's 2011 high of 85.53 yen as the next target.

The euro rose as high as 112.55 yen on EBS, just below its 16-month high of 112.59 yen hit on December 19.

The weaker yen has bolstered hopes for better earnings from Japanese companies and underpinned the Nikkei, which has gained some 18 percent since mid-November when the election was scheduled, fuelling expectations for Abe's party to win. The yen has lost nearly 8 percent against the dollar in the same period.

The Nikkei <.n225> closed at a nine-month high with a 1.5 percent gain. <.t/>

"Most foreign funds have added Japanese shares and there are fewer participants today, but there still is a reason for the Nikkei to rise," said Hideyuki Okoshi, general manager at Chibagin Securities. "Not only exporters but investors are buying other stocks which could benefit under the new government."

Japanese government debt prices fell, with the 10-year bond futures hitting a three-month low of 143.65 in active trade. Ten-year JGB yields rose 1.5 basis points to 0.780 percent, matching a six-week high hit on December 19.

"We continue to see equities going high, so the pressure is on the long end of the JGB curve. For the short end of the curve, we continue to see the BOJ ease aggressively, so there is no change in that," said Tadashi Matsukawa, head of Japan fixed income at PineBridge Investments.

Minutes of the BOJ's policy-setting meeting in November, released on Wednesday, showed that some board members said the central bank must act decisively, without ruling out any policy options, if the outlook for the economy and prices worsens further.

"FISCAL CLIFF" RISK

The dollar was expected to stay firm this week as the U.S. fiscal impasse is likely to continue to sap investor appetite for risky assets and raise the dollar's safe-haven appeal.

Ten-year U.S. Treasury notes held steady in price to yield roughly 1.776 percent in Asia, little changed from late U.S. trade on Monday. The U.S. bond market was closed on Tuesday for Christmas.

"I think there is about a 50 percent chance of the cliff being avoided at the year-end through an agreement of some kind, even if it turns out to be just a short-term postponement," said Tomoaki Shishido, a rate analyst for Nomura Securities in Tokyo.

A U.S. official said on Tuesday that President Barack Obama may return to Washington from his Hawaiian holiday as early as Wednesday evening to address the unfinished negotiations over the "fiscal cliff" of some $600 billion in automatic spending cuts and tax increases set to start on January 1.

If the United States falls off the fiscal cliff, economists warn that the world's largest economy could plunge into recession and drag global economies down as well.

Data out of Asia on Wednesday underscored fragile global growth.

Exports in Thailand, Southeast Asia's second-largest economy, rose nearly 27 percent in November from a year ago, but that reflected recovery from flooding in late 2011 and not growth in global demand.

South Korea's key consumer sentiment index held steady in December from November and stood below the neutral point for a fifth consecutive month, diminishing hopes of a quick economic rebound.

Gold edged lower on Wednesday on uncertainty over the fiscal cliff, but a weaker yen sparked a rally in bullion futures on the Tokyo Commodity Exchange (TOCOM).

Brent crude climbed above $109 per barrel on Wednesday in thin trade, with investors hoping for a last-minute deal to avoid a U.S. fiscal crisis. U.S. crude futures also inched up 0.4 percent to $88.94.

(Additional reporting by Ayai Tomisawa and Dominic Lau in Tokyo and Masayuki Kitano in Singapore; Editing by Richard Borsuk)

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News Analysis: Getting Polio Campaigns Back on Track

How in the world did something as innocuous as the sugary pink polio vaccine turn into a flash point between Islamic militants and Western “crusaders,” flaring into a confrontation so ugly that teenage girls — whose only “offense” is that they are protecting children — are gunned down in the streets?

Nine vaccine workers were killed in Pakistan last week in a terrorist campaign that brought the work of 225,000 vaccinators to a standstill. Suspicion fell immediately on factions of the Pakistani Taliban that have threatened vaccinators in the past, accusing them of being American spies.

Polio eradication officials have promised to regroup and try again. But first they must persuade the killers to stop shooting workers and even guarantee safe passage.

That has been done before, notably in Afghanistan in 2007, when Mullah Muhammad Omar, spiritual head of the Afghan Taliban, signed a letter of protection for vaccination teams. But in Pakistan, the killers may be breakaway groups following no one’s rules.

Vaccination efforts are also under threat in other Muslim regions, although not this violently yet.

In Nigeria, another polio-endemic country, the new Islamic militant group Boko Haram has publicly opposed it, although the only killings that the news media have linked to polio were those of two police officers escorting vaccine workers. Boko Haram has killed police officers on other missions, unrelated to polio vaccinations.

In Mali, extremists took over half of the country in May, declaring an Islamic state. Vaccination is not an issue yet, but Mali had polio cases as recently as mid-2011, and the virus sometimes circulates undetected.

Resistance to polio vaccine springs from a combination of fear, often in marginalized ethnic groups, and brutal historical facts that make that fear seem justified. Unless it is countered, and quickly, the backlash threatens the effort to eradicate polio in the three countries where it remains endemic: Pakistan, Afghanistan and Nigeria.

In 1988, long before donors began delivering mosquito nets, measles shots, AIDS pills, condoms, deworming drugs and other Western medical goods to the world’s most remote villages, Rotary International dedicated itself to wiping out polio, and trained teams to deliver the vaccine.

But remote villages are often ruled by chiefs or warlords who are suspicious not only of Western modernity, but of their own governments.

The Nigerian government is currently dominated by Christian Yorubas. More than a decade ago, when word came from the capital that all children must swallow pink drops to protect them against paralysis, Muslim Hausas in the far-off north could be forgiven for reacting the way the fundamentalist Americans of the John Birch Society did in the 1960s when the government in far-off Washington decreed that, for the sake of children’s teeth, all drinking water should have fluoride.

The northerners already had grievances. In 1996, the drug company Pfizer tested its new antibiotic, Trovan, during a meningitis outbreak there. Eleven children died. Although Pfizer still says it was not to blame, the trial had irregularities, and last year the company began making payments to victims.

Other rumors also spring from real events.

In Pakistan, resistance to vaccination, low over all, is concentrated in Pashtun territory along the Afghan border and in Pashtun slums in large cities. Pashtuns are the dominant tribe in Afghanistan but a minority in Pakistan among Punjabis, Sindhis, Baluchis and other ethnic groups. Many are Afghan refugees and are often poor and dismissed as medieval and lawless.

Pakistan’s government is friendly with the United States while the Pashtuns’ territory in border areas has been heavily hit by American Taliban-hunting drones, which sometimes kill whole families.

So, when the Central Intelligence Agency admitted sponsoring a hepatitis vaccination campaign as a ruse to get into a compound in Pakistan to confirm that Osama bin Laden was there, and the White House said it had contemplated wiping out the residence with a drone missile, it was not far-fetched for Taliban leaders to assume that other vaccinators worked for the drone pilots.

Even in friendly areas, the vaccine teams have protocols that look plenty suspicious. If a stranger knocked on a door in Brooklyn, asked how many children under age 5 were at home, offered to medicate them, and then scribbled in chalk on the door how many had accepted and how many refused — well, a parent might worry.

In modern medical surveys — though not necessarily on polio campaigns — teams carry GPS devices so they can find houses again. Drones use GPS coordinates.

The warlords of Waziristan made the connection specific, barring all vaccination there until Predator drones disappeared from the skies.

Dr. Bruce Aylward, a Canadian who is chief of polio eradication for the World Health Organization, expressed his frustration at the time, saying, “They know we don’t have any control over drone strikes.”

The campaign went on elsewhere in Pakistan — until last week.

The fight against polio has been hampered by rumors that the vaccine contains pork or the virus that causes AIDS, or is a plot to sterilize Muslim girls. Even the craziest-sounding rumors have roots in reality.

The AIDS rumor is a direct descendant of Edward Hooper’s 1999 book, “The River,” which posited the theory — since discredited — that H.I.V. emerged when an early polio vaccine supposedly grown in chimpanzee kidney cells contaminated with the simian immunodeficiency virus was tested in the Belgian Congo.

The sterilization claim was allegedly first made on a Nigerian radio station by a Muslim doctor upset that he had been passed over for a government job. The “proof” was supposed to be lab tests showing it contained estrogen, a birth control hormone.

The vaccine virus is grown in a broth of live cells; fetal calf cells are typical. They may be treated with a minute amount of a digestive enzyme, trypsin — one source of which is pig pancreas, which could account for the pork rumor.

In theory, a polio eradicator explained, if a good enough lab tested the vaccine used at the time the rumor started, it might have detected estrogen from the calf’s mother, but it would have been far less estrogen than is in mother’s milk, which is not accused of sterilizing anyone. The trypsin is supposed to be washed out.

In any case, polio vaccine is now bought only from Muslim countries like Indonesia, and Muslim scholars have ruled it halal — the Islamic equivalent of kosher.

Reviving the campaign will mean quelling many rumors. It may also require adding other medical “inducements,” like deworming medicine, mosquito nets or vitamin A, whose immediate benefits are usually more obvious.

But changing mind-sets will be a crucial step, said Dr. Aylward, who likened the shootings of the girls to those of the schoolchildren in Newtown, Conn.

More police involvement — what he called a “bunkerized approach” — would not solve either America’s problem or Pakistan’s, he argued. Instead, average citizens in both countries needed to rise up, reject the twisted thinking of the killers and “generate an understanding in the community that this kind of behavior is not acceptable.”

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Acer’s $99 Android tablet might not launch in the U.S.

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Jack Klugman, Odd Couple and Quincy, M.E. Star, Dies

By Stephen M. Silverman

12/24/2012 at 07:35 PM EST

Jack Klugman, The Odd Couple and Quincy, M.E. star beloved by TV, movie and theater audiences for five decades, died in Los Angeles on Monday, one of his sons told the Associated Press. He was 90.

"He had a great life and he enjoyed every moment of it and he would encourage others to do the same," son Adam Klugman said of his father, who had lost his voice to throat cancer in 1980 and then taught himself to speak again through breath control.

With Tony Randall on ABC's adaptation of the smash Neil Simon play and movie of the '60s, Klugman played sloppy Oscar Madison from 1970 to 1975 to Randall's Felix Unger, and though they really were an odd couple, offscreen they were adoring friends. Randall died in 2004.

Born in Philadelphia, Klugman started acting in college, and his film credits included the all-star courtroom drama 12 Angry Men. On Broadway he starred as the love interest Herbie in the original production of the quintessential backstage musical, Gypsy, with the legendary Ethel Merman.

Klugman's wife, actress-comedian Brett Somers, costarred on The Odd Couple as his ex-wife Blanche. According to the AP, they married in 1953 and had two sons, Adam and David, and had been estranged for years at the time of her death in 2007.

Besides their sons, Klugman is survived by Peggy Crosby, whom he married in February 2008.

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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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Yen on defensive on U.S. fiscal worry, helps Nikkei

TOKYO (Reuters) - Uncertainty over whether U.S. lawmakers will strike a deal by an end-of-year deadline to avert a severe fiscal retrenchment undermined the yen and bolstered Japanese shares on Tuesday in low volume, with many participants away on Christmas holiday.

The dollar rose to a 20-month high of 84.965 yen early on Tuesday in Asia, as Japanese markets caught up with global investors who had reacted overnight to incoming Japanese Prime Minister Shinzo Abe's weekend comments that raised the pressure on the Bank of Japan.

During a meeting on Tuesday with officials from Japan's major business lobby, Keidanren, Abe reiterated calls on the BOJ to conduct bold monetary easing to beat deflation by setting an inflation target of 2 percent.

The head of Abe's coalition partner said on Tuesday the coalition party and Abe had agreed to set a 2 percent inflation target and compile a large stimulus budget to help the economy return to growth and overcome deflation.

The yen has come under pressure as a result of expectations that the BOJ will be compelled to adopt more drastic monetary stimulus measures next year.

The dollar was expected to stay firm this week as investors repatriate dollars, and as the U.S. fiscal impasse is likely to continue to sap investor appetite for risky assets and raise the dollar's safe-haven appeal.

"The dollar is seen relatively well bid, with all focus on the fiscal cliff," said Yuji Saito, director of foreign exchange at Credit Agricole in Tokyo.

"Negotiations may be carried over the weekend, but markets still expect a deal to be struck by December 31. It is unthinkable that the U.S. will risk driving its economic growth sharply lower by not agreeing to avoid it."

U.S. lawmakers and President Barack Obama were on Christmas holiday and talks were unlikely to resume until later in the week.

House of Representatives Speaker John Boehner failed to gain support for a tax plan at the end of last week, raising fears that the United States may face the "fiscal cliff" of some $600 billion in automatic spending cuts and tax increases set to start on January 1.

Japan's Nikkei stock average <.n225> resumed trading after a three-day weekend with a 1.1 percent gain, recapturing the key 10,000 mark it ceded on Friday after Boehner's failure sparked a broad market sell-off and the Tokyo benchmark closed down 1 percent. The Nikkei was likely to be supported as long as the yen stayed weak. <.t/>

"Ongoing optimism about the weak yen is lifting hopes that exporters' earnings will be better than expected," said Hiroichi Nishi, general manager at SMBC Nikko Securities.

Analysts say a near-term correction may be possible as the index is now in "overbought" territory after gaining 16.2 percent over the last six weeks, hitting a nine-month high last Friday. Its 14-day relative strength index was at 72.34, above the 70 level that signals an overbought condition.

MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> nudged up 0.1 percent, driven higher by surging Shanghai shares, as most Asian bourses were shut for Christmas.

The Shanghai Composite Index <.ssec> soared over 2 percent to five-month highs as investors bought property stocks on mounting optimism about the sector. Taiwan shares <.twii> jumped 1.3 percent on gains in technology and financial shares.

Asset performance in 2012: http://link.reuters.com/muc46s

2012 commodities returns: http://link.reuters.com/faz36s

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^>

U.S. HOLDS 2013 KEY

Goro Ohwada, president and CEO at Japan-based fund of hedge funds Aino Investment Corp, said investors were likely to focus on economic fundamentals and the United States for cues on investment direction in 2013.

"There is a feeling that an investment strategy based on economic fundamentals may finally work next year, with asset prices more closely reflecting fair value. The problem is, we don't know yet which asset is a better bet than others," Ohwada said, adding that oil and gold appeared to be near their highs.

Naohiro Niimura, a partner at research and consulting firm Market Risk Advisory, said commodities and energy prices will likely move in tight ranges in 2013, with investors eyeing political events, including the U.S. fiscal cliff outlook, Italian parliamentary election set for February 24-25, and Germany's elections in September.

"The macroeconomic policies taken this year around the world to support growth are expected to result in a moderate recovery in 2013 to reduce an excessive downside risk to prices. This will likely keep commodities, gold and energy prices near their highs," Niimura said.

(Additional reporting by Ayai Tomisawa in Tokyo; Editing by Edmund Klamann and Daniel Magnowski)

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IHT Rendezvous: An Education City Takes Shape

HONG KONG — Malaysia is working on turning an area of gritty industrial towns and villages into EduCity, a massive new education complex that will include the branches of 10 foreign schools, including several universities, business and sports institutes, and two private prep schools.

Kristiano Ang visited the dusty construction sites that are expected to become immaculately planned campuses housing 16,000 students. Currently, only a few EduCity schools are operational; but if all goes according to plan, the full project will be open by 2017.

Western institutions have been weighing the pros and cons of expanding East: Costs are relatively low, local governments are supportive, and the potential for growth is huge. But there can be cultural or political differences to overcome. There is also no way to predict if Asian campuses will give students the same quality of education, and the same freedoms, as in these schools’ home campuses.

Some EduCity educators, accustomed to working with relative independence in the West, now have to check with the government on everything from staffing to fees and admissions.

While at EduCity, Kristiano toured the new Marlborough College Malaysia, an extension of an elite British boarding school, complete with wooden desks, checkered uniforms and the master’s house overlooking the cricket ground.

He and Yenni Kwok in Hong Kong look at the rise of elite prep schools opening branches in the region. Harrow, the British institution founded in the 16th century, added to its Beijing and Bangkok branches with a new school in Hong Kong in September. Also this autumn, Branksome Hall, a century-old private girls’ school in Toronto, opened a campus on Jeju, a resort island in South Korea.

All three got support from local governments, either in terms of land use, interest-free loans or preferential tax treatment.

There are several reasons Asian states are opening their doors to foreign institutions: They want to minimize brain drain as more students head to the West. They are also catering to the wishes of a rising upper class, who are enamored with Western brand names, whether they are attached to designer purses or high schools.

Should Asian governments help foreign private institutions when poor local schools in the region lack basic resources? Can you replicate a Western education in Asia?

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Saudi website editor could face death for apostasy-rights group

RIYADH (Reuters) – The editor of a Saudi Arabian website could be sentenced to death after a judge cited him for apostasy and moved his case to a higher court, the monitoring group Human Rights Watch said on Saturday.

Raif Badawi, who started the Free Saudi Liberals website to discuss the role of religion in Saudi Arabia, was arrested in June, Human Rights Watch said.

Badawi had initially been charged with the less serious offence of insulting Islam through electronic channels, but at a December 17 hearing a judge referred him to a more senior court and recommended he be tried for apostasy, the monitoring group said.

Apostasy, the act of changing religious affiliation, carries an automatic death sentence in Saudi Arabia, along with crimes including blasphemy.

Badawi’s website included articles that were critical of senior religious figures, the monitoring group said.

A spokesman for Saudi Arabia’s Justice Ministry was not available to comment.

The world’s top oil exporter follows the strict Wahhabi school of Islam and applies Islamic law, or sharia.

Judges base their decisions on their own interpretation of religious law rather than on a written legal code or on precedent.

King Abdullah, Saudi Arabia’s ruler, has pushed for reforms to the legal system, including improved training for judges and the introduction of precedent to standardize verdicts and make courts more transparent.

However, Saudi lawyers say that conservatives in the Justice Ministry and the judiciary have resisted implementing many of the changes that he announced in 2007. (Reporting By Angus McDowall; Editing by Kevin Liffey)

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Sandy Hook Shootings: How to Cope

By Howard Breuer

12/23/2012 at 06:00 PM EST

State police personnel lead children to safety away from the Sandy Hook Elementary School

Shannon Hicks/Newtown Bee/Reuters/Landov

The Sandy Hook massacre, in which 20 innocent children and six heroic elementary school faculty members were gunned down last Friday, is particularly difficult for people – even those thousands of miles away from Newtown, Conn. – to process, according to mental health experts.

"This tragedy is so deeply affecting the national psyche, reminding us of 9/11, because of its assault on Norman Rockwell's vision of America," psychiatrist Carole Lieberman tells PEOPLE.

Friday was proclaimed a national day of mourning for those lost a week ago, with a moment of silence called for at 9:30 a.m. Eastern time, as 26 churchbells rang in Newtown and elsewhere. In addition, First Lady Michelle Obama sent an open letter of condolence to the town, saying the entire nation "is holding you in our hearts."

But how do those directly involved with the tragedy find the strength to cope?

To do that, family members who lost loved ones need immediate counseling and to maintain their normal routines. They also need to draw support from other affected families who can relate to what they're going through, says Dr. Stephanie N. Marcy, a psychologist at Children's Hospital Los Angeles.

"I think the people on the ground are feeling a sense of hopelessness because there is no way to justify what happened," Marcy says. "They need to be around other people who have experienced and understand it. If you were all involved together, you can empathize and grieve together."

In many of these families, the remaining children might have survivor's guilt, she adds.

"They rethink what they did that day and wonder if they in some way contributed to the death of a sibling, or they wonder, why did I survive?" Marcy says.

Therapists will need to explain to kids who lost a sibling that their "false belief that they should have been able to prevent it is not correct," adds Marcy.

Children at Sandy Hook may also have Post-Traumatic Stress Disorder and will need therapy, Lieberman says.

What to Tell Children

And what do parents whose children were not involved in the tragedy tell their own youngsters about what happened? That, Marcy says, depends on how old they are and how much they know already.

"Kindergarteners and first graders don't need to be told about it unless you think they will hear it somewhere else. For older kids, you have to get to know what they know, answer any questions they might have, and be truthful – but don't say too much," Marcy says. "Say that a person who was having problems, that was sick, went into a school and injured some people for no particular reason. Tell them it would never happen at their school."

"Yes," she adds, "it could happen anywhere. But there's no point in letting your child think that, [because] they may be flooded with fear."

For the adults and children across the country who have been vicariously traumatized, Marcy says, "We need to regain our sense of control, because this type of event makes us feel completely helpless."

Lieberman adds that Americans "are also feeling a generalized anxiety, a fear that no place is safe anymore. They need to talk to friends and family, get involved in championing causes that make society better, to volunteer for charities, and to get psychotherapy if the sadness and anxiety persist."

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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.

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Online:

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

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

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