Psychiatrists OK vast changes to diagnosis manual

CHICAGO (AP) — For the first time in almost two decades the nation's psychiatrists are changing the guidebook they use to diagnose mental disorders. Among the most controversial proposed changes: Dropping certain familiar terms like Asperger's disorder and dyslexia and calling frequent, severe temper tantrums a mental illness.

The board of trustees for the American Psychiatric Association voted Saturday in suburban Washington, D.C., on scores of revisions that have been in the works for several years. Details will come next May when the group's fifth diagnostic manual is published.

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

Board members were tightlipped about the update, but its impact will be huge, affecting millions of children and adults worldwide.

The manual "defines what constellations of symptoms health care professionals recognize as mental disorders and more importantly ... shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care," said Dr. Mark Olfson, a Columbia University psychiatry professor who was not involved in the revision process.

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.

The guidebook's official title is the Diagnostic and Statistical Manual of Mental Disorders. The new one is the fifth edition, known as the DSM-5. A 2000 edition made minor changes but the last major edition was published in 1994.

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," Olfson said.

Expected changes include formally adopting a term for children and adults with autism — "autism spectrum disorder," encompassing those with severe autism, who often don't talk or interact, and those with mild forms including Asperger's. Asperger's patients often have high intelligence and vast knowledge on quirky subjects but lack social skills.

Some Asperger's families opposed the change, fearing their kids would lose a diagnosis and no longer be eligible for special services. And some older Asperger's patients who embrace their quirkiness vowed to continue to use the label.

But experts say the change won't affect the special services available to this group.

Catherine Lord, an autism expert at Weill Cornell Medical College 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 recommended new diagnosis.

One reason for the recommended change is that in some states and some school systems, children and adults with Asperger's receive no services or fewer services than those given an autism diagnosis, she said.

Other proposed changes include:

—A new diagnosis — disruptive mood dysregulation disorder, which critics argued would medicalize kids' normal temper tantrums. Supporters said it would address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings from feeling sad and depressed to unusually happy or energetic. Affected children are sometimes very irritable or have explosive tantrums. The new diagnosis would be given to children and adults who can't control their emotions and have frequent temper outbursts in inappropriate situations.

—Eliminating the term "dyslexia," a reading disorder that causes difficulty understanding letters and recognizing written words. The term would be encompassed in a broader learning disorder category.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender — they dispute their normal biological anatomy. 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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Online:

Diagnostic manual: http://www.dsm5.org

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

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Cliff fight may knock out December rally

NEW YORK (Reuters) - In normal times, next week's slew of U.S. economic data could be a springboard for a December rally in the stock market.

December is historically a strong month for markets. The S&P 500 has risen 16 times in the past 20 years during the month.

But the market hasn't been operating under normal circumstances since November 7 when a day after the U.S. election, investors' focus shifted squarely to the looming "fiscal cliff."

Investors are increasingly nervous about the ability of lawmakers to undo the $600 billion in tax increases and spending cuts that are set to begin in January; those changes, if they go into effect, could send the U.S. economy into a recession.

A string of economic indicators next week, which includes a key reading of the manufacturing sector on Monday, culminates with the November jobs report on Friday.

But the impact of those economic reports could be muted. Distortions in the data caused by Superstorm Sandy are discounted.

The spotlight will be more firmly on signs from Washington that politicians can settle their differences on how to avoid the fiscal cliff.

"We have a week with a lot of economic data, and obviously most of the economic data is going to reflect the effects of Sandy, and that might be a little bit negative for the market next week, but most of that is already expected - the main focus remains the fiscal cliff," said Peter Cardillo, chief market economist at Rockwell Global Capital in New York.

Concerns about the cliff sent the S&P 500 <.spx> into a two-week decline after the elections, dropping as much as 5.3 percent, only to rally back nearly 4 percent as the initial tone of talks offered hope that a compromise could be reached and investors snapped up stocks that were viewed as undervalued.

On Wednesday, the S&P 500 gained more than 20 points from its intraday low after House Speaker John Boehner said he was optimistic that a budget deal to avoid big spending cuts and tax hikes could be worked out. The next day, more pessimistic comments from Boehner, an Ohio Republican, briefly wiped out the day's gains in stocks.

On Friday, the sharp divide between the Democrats and the Republicans on taxes and spending was evident in comments from President Barack Obama, who favors raising taxes on the wealthy, and Boehner, the top Republican in Congress, who said Obama's plan was the wrong approach and declared that the talks had reached a stalemate.

"It's unusual to end up with one variable in this industry, it's unusual to have a single bullet that is the causal factor effect, and you are sitting here for the next maybe two weeks or more, on that kind of condition," said Sandy Lincoln, chief market strategist at BMO Asset Management U.S. in Chicago.

"And that is what is grabbing the markets."

BE CONTRARY AND MAKE MERRY

But investor attitudes and seasonality could also help spur a rally for the final month of the year.

The most recent survey by the American Association of Individual Investors reflected investor caution about the cliff. Although bullish sentiment rose above 40 percent for the first time since August 23, bearish sentiment remained above its historical average of 30.5 percent for the 14th straight week.

December is a critical month for retailers such as Target Corp and Macy's Inc . They saw monthly retail sales results dented by Sandy, although the start of the holiday shopping season fared better.

With consumer spending making up roughly 70 percent of the U.S. economy, a solid showing for retailers during the holiday season could help fuel any gains.

Ryan Detrick, senior technical strategist at Schaeffer's Investment Research in Cincinnati, believes the recent drop after the election could be a market bottom, with sentiment leaving stocks poised for a December rally.

"The concerns on the fiscal cliff - as valid as they might be - could be overblown. When you look at a lot of the overriding sentiment, that has gotten extremely negative," said Detrick.

"From that contrarian point of view with the historically bullish time frame of December, we once again could be setting ourselves up for a pretty nice end-of-year rally, based on lowered expectations."

SOME FEEL THE BIG CHILL

Others view the fiscal cliff as such an unusual event that any historical comparisons should be thrown out the window, with a rally unlikely because of a lack of confidence in Washington to reach an agreement and the economic hit caused by Sandy.

"History doesn't matter. You're dealing with an extraordinary set of circumstances that could very well end up in the U.S. economy going into a recession," said Phil Orlando, chief equity market strategist at Federated Investors in New York.

"And the likelihood of that is exclusively in the hands of our elected officials in Washington. They could absolutely drag us into a completely voluntary recession."

(Wall St Week Ahead runs every Friday. Questions or comments on this column can be emailed to: charles.mikolajczak(at)thomsonreuters.com )

(Reporting by Chuck Mikolajczak; Editing by Jan Paschal)

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Israel Moves to Expand Settlements in East Jerusalem

Rina Castelnuovo for The New York Times

From his home in East Jerusalem last year, Haj Ibrahim Ahmad Hawa looked at the separation barrier surrounding Jerusalem with the Israeli settlement of Maale Adumim in the background. More Photos »

JERUSALEM — As the United Nations General Assembly voted overwhelmingly to upgrade the Palestinians’ status Thursday night, Israel took steps toward building housing in a controversial area of East Jerusalem known as E1, where Jewish settlements have long been seen as the death knell for a two-state solution to the Israeli-Palestinian conflict.

A senior Israeli official, speaking on the condition of anonymity, said on Friday that the decision was made late Thursday night to move forward on “preliminary zoning and planning preparations” for housing units in E1, which would connect the large settlement of Maale Adumim to Jerusalem and therefore make it impossible to connect the Palestinian cities of Ramallah and Bethlehem to Palestinian neighborhoods of East Jerusalem. Israel also authorized the construction of 3,000 housing units in other parts of East Jerusalem and the West Bank, the official said.

The prime minister’s office refused to comment on whether the settlement expansion — first reported on Twitter by a reporter for the Israeli daily Haaretz — was punishment for the Palestinians’ success in upgrading its status from nonmember observer entity to nonmember observer state at the United Nations, but it was widely seen as such. The United States, one of only eight countries that stood with Israel in voting against the Palestinians’ upgrade, has for two decades vigorously opposed construction in E1, a 3,000-acre expanse of hilly parkland where a police station was opened in 2008.

In Washington, a State Department official criticized the move. “We reiterate our longstanding opposition to settlements and East Jerusalem construction,” he said. “We believe it is counterproductive and makes it harder to resume direct negotiations and achieve a two-state outcome.”

Hagit Ofran, who runs the Settlement Watch project of Peace Now, called E1 a “deal breaker for the two-state solution” and denounced the decision as “disastrous.”

“Instead of punishing the Palestinians, they are actually punishing Israel,” Ms. Ofran, who is Israeli, said in an interview. “Instead of taking advantage of this bid in the U.N. and calling for negotiations to get to a two-state solution, this government is choosing to take actions that might prevent the possibility of a two-state solution.”

But Dani Dayan, leader of Israel’s settler movement, welcomed the news, saying it was “a very important Israeli interest to develop E1.”

He described the two-state solution as “an existential threat to Israel” and said the E1 development was “beneficial for peace because a two-state solution is a prologue for another bloody confrontation.”

“The fear to develop the communities is not rational,” Mr. Dayan said. “The opposition to the settlements has become a kind of religious dogma for the West.”

Even Mr. Dayan, however, said he did not like the idea of expanding settlements “as a sort of retaliatory or punitive step.”

“Under the circumstances that we understand the government operates, I think it’s O.K.,” Mr. Dayan added. “We have a legal and a political and a moral right to build. It’s strategic for Jerusalem; to strengthen Jerusalem is the only horizon. We don’t see it as an obstacle to peace.”

Michael R. Gordon contributed reporting from Washington.

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Jelly Bean update for DROID RAZR HD and MAXX HD set to roll out next week

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Powerball Winners Want to Go to the Beach, Set Up Scholarships with $300 Million

11/30/2012 at 04:35 PM EST

Cindy and Mark Hill

David Eulitt/Kansas City Star/Landov

Just in time for the holiday season the Hill family of Dearborn, Mo., got quite the gift: nearly $300 million, after winning half of the $587.5 million Powerball jackpot.

"We're still stunned by what's happened," Cindy Hill, 51, said during a press conference Friday alongside her family, according to an NBC News report. "People keep asking us, 'What are you going to buy with it?' I just want to go home and be back to normal."

Hill, who was an office manager until she was laid off in 2010, and her husband Mark, a mechanic, have three adult sons and a daughter, Jaiden, 6, whom they adopted from China.

On their list of possible purchases since their record win: a beach vacation for Jaiden (who has never visited the beach) and a red Camaro for Mark. The family has also spoken about possibly adopting again and setting up college funds for their extended family members, as well as a scholarship fund at their local high school.

As for their winning ticket, Cindy said she checked on Thursday morning after learning that one winning ticket was sold in Missouri.

"I didn't have my glasses, and I was thinking, is that the right number?" Cindy, who had bought five tickets, said, according to NBC.

The other winning ticket was sold in Arizona, and no winner has claimed the prize yet. On Thursday, however, a man in Upper Marlboro, Md., went into a gas station to check a handful of tickets (watch the CCTV video), reportedly presenting a ticket with the winning numbers (5-23-16-22-29-Powerball 6), CNN reports.

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Wall Street ends flat as "fiscal cliff" focus lingers

NEW YORK (Reuters) - The S&P 500 wrapped up its fifth positive month in the last six on Friday, although it ended the day flat as politicians remain at odds about how to avoid the so-called fiscal cliff.

Trading has been choppy in the last two weeks as investors react to statements from policymakers on the state of discussions on how to avert a series of tax hikes and spending cuts that could pull the economy back into recession.

The S&P 500 was up 0.29 percent in November even as it suffered a slide of more than 6 percent from the month's high to its low.

"Given the 'on again, off again' fiscal cliff (negotiations), it's rather surprising how resilient this market has been," said David Rolfe, chief investment officer at St. Louis-based Wedgewood Partners.

"Between now and the end of the year, there's going to be an information vacuum outside the fiscal cliff, and I believe that resiliency will be tested."

In contrast to the apparent calm in equities, the CBOE Volatility Index <.vix>, a gauge of market anxiety, jumped 5.4 percent, its largest daily gain in two weeks.

The VIX also rose for the week, but posted a whopping 14.7 percent decline for November.

On Friday, President Barack Obama accused a "handful of Republicans" in the U.S. House of Representatives of holding up legislation to extend tax cuts for middle-class Americans in order to try to preserve them for the wealthy.

Speaking shortly after the president, House Speaker John Boehner, an Ohio Republican, said: "There is a stalemate; let's not kid ourselves."

Despite the divisive language, many market participants are betting that a deal will be struck - if only at the eleventh hour.

Corporations continue to react to what is expected to be a harsher tax regime next year. Whole Foods Market was the latest to announce a special cash dividend - of $2.00 per share in this case - ahead of expected higher tax rates in 2013.

The Dow Jones industrial average <.dji> rose 3.76 points, or 0.03 percent, to 13,025.58 at the close. The S&P 500 <.spx> gained a mere 0.23 of a point, or 0.02 percent, to finish at 1,416.18. But the Nasdaq Composite Index <.ixic> dipped 1.79 points, or 0.06 percent, to end at 3,010.24.

For the month of November, the S&P 500 rose 0.29 percent, its smallest monthly variation since March 2011. The Dow fell 0.5 percent and the Nasdaq gained 1.1 percent.

For the week, though, all three major U.S. stock indexes advanced, with the Dow up 0.1 percent, the S&P 500 up 0.5 percent and the Nasdaq up 1.5 percent.

VeriSign shares dropped 13.2 percent to $34.15 after the company said the U.S. Department of Commerce approved its agreement with ICANN to run the .com internet registry, but VeriSign won't be able to raise prices as it did before.

Yum Brands slid 9.9 percent to $67.08 a day after the parent of the KFC, Taco Bell and Pizza Hut chains said it expects a drop in fourth-quarter sales at established restaurants in China.

After a close relationship for several years, Facebook and Zynga revised terms of a partnership agreement, according to regulatory filings on Thursday. Under the new pact, Zynga, creator of the "Farmville" game, will have limited ability to promote its site on Facebook.

Zynga's stock fell 6.1 percent to $2.46. Facebook's stock gained 2.5 percent to $28.

Apple Inc's latest iPhone received final clearance from Chinese regulators, paving the way for a December debut in a highly competitive market where the lack of a new model had severely eroded its share of product sales. Apple's stock fell 0.7 percent to $585.28.

The markets' reaction to data on Friday was muted.

U.S. consumer spending fell in October for the first time in five months and income growth stalled, leading some economists to cut already weak estimates of fourth-quarter economic growth.

Slightly more than 7 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, more than the daily average so far this year of about 6.48 billion shares and the largest in two weeks.

On the NYSE, roughly six issues rose for every five that fell, while on Nasdaq, the ratio was nearly 1 to 1.

(Reporting by Rodrigo Campos; Editing by Jan Paschal)

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U.N. Will Vote on Status for Palestinians, Defying U.S.

Chang W. Lee/The New York Times

President Mahmoud Abbas of the Palestinian Authority spoke at the United Nations before the General Assembly voted on Palestine's status as a “nonmember observer state” on Thursday.

UNITED NATIONS — An overwhelming majority of countries are expected on Thursday to vote to recognize Palestine as a “nonmember observer state” at the United Nations. Palestinian leaders say the step advances a two-state solution with Israel, but Israeli and American officials condemn it as detrimental to peaceful coexistence.

President Mahmoud Abbas of the Palestinian Authority, speaking to the United Nations General Assembly before the vote, called the moment a “last chance” to save the two-state solution and said that the window of opportunity was narrowing.

“The General Assembly is called upon today to issue a birth certificate of the reality of the State of Palestine,” he said just before the vote was scheduled to take place.

The resolution is expected to win backing from a number of European countries, among them France, Spain and Switzerland — a rebuff to intense American and Israeli diplomacy. Others, like Germany, say they will abstain, and a tiny handful of countries are expected to join Israel and the United States in voting no.

The resolution comes shortly after an eight-day Israeli military assault on Gaza that Israel described as a response to stepped-up rocket fire into Israel. The operation killed scores of Palestinians and was aimed at reducing the arsenal of Hamas, the militant group that controls Gaza, a part of the territory that the United Nations resolution expects to make up a future state of Palestine.

Mr. Abbas directed harsh criticism toward Israel, saying that the “aggression against our people in the Gaza Strip has confirmed once again the urgent and pressing need to end the Israeli occupation and for our people to gain their freedom and independence.”

“This aggression also confirms the Israeli Government’s adherence to the policy of occupation, brute force and war, which in turn obliges the international community to shoulder its responsibilities toward the Palestinian people and toward peace,” Mr. Abbas said early in his speech.

The Palestinian Authority, based in the West Bank city of Ramallah, was politically weakened by the Gaza fighting, with its rivals in Hamas seen by many Palestinians as more willing to stand up to Israel and fight back. That shift in sentiment is one reason that some Western countries give for backing the United Nations resolution, to strengthen Mr. Abbas and his more moderate colleagues in their contest with Hamas.

“We have not heard one word from any Israeli official expressing any sincere concern to save the peace process,” Mr. Abbas said.

“On the contrary, our people have witnessed, and continue to witness, an unprecedented intensification of military assaults, the blockade, settlement activities and ethnic cleansing, particularly in Occupied East Jerusalem, and mass arrests, attacks by settlers and other practices by which this Israeli occupation is becoming synonymous with an apartheid system of colonial occupation, which institutionalizes the plague of racism and entrenches hatred and incitement.”

“The moment has arrived for the world to say clearly: Enough of aggression, settlements and occupation,” he said.

The vote is taking place exactly 65 years after the General Assembly voted to divide the former British Mandate of Palestine into two states, one Jewish and the other Arab — a vote that Israel considers the international seal of approval for its birth.

At the time, Arabs rejected the division of the land and the creation of Israel. But since the late 1980s, the Palestine Liberation Organization has officially endorsed two states, with the state of Palestine defined as comprising the West Bank, East Jerusalem and Gaza — areas beyond Israel’s pre-1967 borders that it captured in the 1967 Middle East war.

Mr. Abbas said the Palestinians wanted to breathe new life into the negotiations. He said the Palestinians would accept “no less than the independence of the State of Palestine, with East Jerusalem as its capital, on all the Palestinian territory occupied in 1967, to live in peace and security alongside the State of Israel,” adding they were also seeking a solution to the refugee issue based on the resolutions.

Reporting was contributed by Michael R. Gordon and Mark Landler from Washington, Isabel Kershner from Jerusalem, and Nicholas Kulish from Berlin.

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Stephen Fishbach Blogs: Abi-Maria Gomes Has 'Subtlety of a Wounded Walrus' on Survivor

TV Watch

Survivor

By Stephen Fishbach

11/29/2012 at 04:45 PM EST

Abi-Maria Gomes (left) and Lisa Whelchel

Monty Brinton/CBS (2)

Stephen Fishbach was the runner-up on Survivor: Tocantins and has been blogging about Survivor strategy for PEOPLE.com since 2009. Follow him on Twitter @stephenfishbach.

"You need to pick one side or the other. You can't keep flipping."
– Amanda Kimmel, Survivor: Micronesia

Hey guys – I have a secret. It's a really, really big secret. You'll never discover it. Not even if you follow me around all day. Look – just follow me a little. Please? For your sake. This secret is frickin' huge. It's going to change everything.

Okay, here's a hint. Starts I. Ends with DOL.

It's an immunity idol, alright?! And I have this secret paper here, which proves it. But I'm going to rip it up into little pieces. Because it's soooo secret.

Poor Abi. Is there anything more heartbreaking in this broken world than someone pretending that they have a secret? The dreamy Malcolm said it best on Survivor: she's like a wounded ex-girlfriend.

As much as Abi is playing at strategy, she really craves attention. Everyone wants to feel wanted. Who hasn't done the whole "I have a secret immunity idol in my pocket, so you'd better be my friend" trick?

Abi's "hints" reminded me of Heroes vs. Villains, when Amanda "hinted" to Parvati about 18 times that she was a target. At the time, I said that Amanda "clobbered Parvati with the Amanda bat."

Okay, so she has the subtlety of a wounded walrus. Nevertheless, Abi wins her first Fishy Award for showing impressive discipline at the food auction. While Denise and Skupin blow their cash on cheap carbs, Abi saves up for that special something. She buys a valuable advantage in the immunity challenge, and wins three more days on the island. In Survivor, three days can change everything.

On Wednesday's episode, Abi also lost her title as the season's most annoying player. Lisa Whelchel turned in another weepy, woe-is-me performance – and let me be the first to say, "Enough!" I threw up a little in my mouth when Lisa went sobbing to Penner ... that she had to vote out Penner. Tears might win you Emmys, Lisa, but on Survivor they only win you enemies.

She's even starting to repeat the same lines. Did you notice she trotted out her old remark about how "Survivor is bigger than I am?" I get that she was a sitcom star, but that doesn't mean she needs a catch phrase. Moreover, the remark basically makes no sense, since Survivor is an abstract concept and Lisa is a physical being. It's just a lazy excuse for not having the will to play the game.

The real victim of Lisa's hemming and hawing is poor Jonathan Penner. With only a couple episodes left, I already miss the lovable goon. What makes Penner such a great player is that, at every moment, he's willing to do whatever it takes to advance himself.

He makes mistakes; he misjudges people's motivations; he fails to make alliances when he needs to most. But he is always scheming, always evaluating. He is always ready to completely rewrite the rulebook of the entire game, so long as it advances Jonathan Penner one space further on the board.

And he always engages his fellow contestants. I loved Penner's brief conversation with Abi after the auction. Abi was feeling petulant and abused. Penner didn't placate her, but by simply representing his intentions, he managed to foster a bond with the outcast Brazilian.

I can't think of many contestants who are better talkers than Penner. Even when he's making mistakes and uttering nonsense, he sounds brilliant.

And is there any more perfect summation of the experience of Survivor than Penner's closing remarks? "It's been fun – and extremely painful," he says. I'm sorry for his pain, but watching him has been a real pleasure.

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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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Wall Street ends higher after swings on 'fiscal cliff'

NEW YORK (Reuters) - Stocks finished higher on Thursday as investors bought on sporadic dips in a market roiled by conflicting comments from Washington about negotiations on an agreement to avoid the "fiscal cliff."

Tech shares, including Research In Motion and Advanced Micro Devices , helped the Nasdaq outperform the broader market. Telecommunications and health-care stocks were the day's best-performing sectors.

Reflecting the uncertainty surrounding U.S. budget talks, trading was choppy. Wall Street reversed early gains and fell shortly after House Speaker John Boehner, the top Republican in Congress, dashed hopes that lawmakers were getting closer to a budget deal that would avert automatic tax increases and spending cuts set for early 2013 - the fiscal cliff - that could push the U.S. economy into a recession next year. But the market rebounded by afternoon and the three major U.S. stock indexes rebounded to near their session highs.

"There is an emotional part in buying on the small dips here. Investors are more worried about missing the rally than losing money as they believe that the 'fiscal cliff' will be solved eventually," said James Dailey, portfolio manager at TEAM Asset Strategy Fund in Harrisburg, Pennsylvania.

"Until the fiscal cliff is solved, the madness of the crowd will not subside."

Discussions on Capitol Hill are aimed at avoiding big automatic spending cuts and tax hikes, known as the fiscal cliff, that will start taking effect beginning in January.

Boehner's comment about a lack of progress in talks with the White House was one of a series of contrary pronouncements by lawmakers and the Obama administration over whether Washington will finally cut a deal.

There have been some signs that leaders are moving closer to a fiscal agreement. The S&P 500 has gained about 5 percent recently after a sell-off that took it down almost 8 percent following the U.S. election on November 6. But investors remain wary that politicians' ad hoc statements can spark quick reversals in the market.

U.S.-listed shares of BlackBerry maker Research In Motion rose 4 percent to $11.54 after Goldman Sachs upgraded the stock to "buy" from "neutral" on optimism ahead of the launch of the BlackBerry 10 smartphone.

Advanced Micro Devices Inc shares gained 4.1 percent to $2.04 on plans to sell and lease back its campus in Austin, Texas. The sale and lease-back will raise cash and fund its chipmaking business as Advanced Micro Devices diversifies beyond the struggling PC industry into new markets.

The Dow Jones industrial average <.dji> rose 36.71 points, or 0.28 percent, to 13,021.82 at the close. The Standard & Poor's 500 Index <.spx> gained 6.02 points, or 0.43 percent, to 1,415.95. The Nasdaq Composite Index <.ixic> advanced 20.25 points, or 0.68 percent, to close at 3,012.03.

So far this week, the Dow is up 0.1 percent, the S&P 500 is up 0.5 percent and the Nasdaq is up 1.5 percent.

But shares of top retailers retreated in the wake of data showing a weak start to November sales after Superstorm Sandy. Kohl's Corp fell 12 percent to $45.02.

Tiffany shares dropped 6.2 percent to $59.80 after the upscale jeweler reported quarterly results and cut its full-year sales and profit forecasts.

Supervalu shares sank 18.6 percent to $2.28 after a report that Cerberus Capital Management was having difficulty obtaining financing to buy out the troubled grocery chain.

Data showed the U.S. economy grew faster than initially thought in the third quarter as businesses restocked, but consumer and business spending were revised lower in a sobering reminder of the economic recovery's underlying weakness.

Contracts to buy previously owned U.S. homes rose more than expected in October, a sign the housing market recovery advanced into the fourth quarter despite a mammoth storm and concerns over looming tax hikes. Homebuilders' shares rose. The PHLX housing index <.hgx> rose 0.8 percent.

About 6.15 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, below the daily average so far this year of about 6.48 billion shares.

On both the NYSE and the Nasdaq, roughly three stocks rose for every one that fell.

(Editing by Kenneth Barry and Jan Paschal)

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