Obama Offers Newtown 'Love and Prayers of a Nation'

President Obama told the grieving community of Newtown, Conn., that the nation has wept with them for the loss of 20 children and six teachers and school staff members killed in a senseless massacre.

Grim-faced, Obama took the stage at Newtown High School auditorium to speak at a memorial service for the first graders, teachers, principal and other school staff members killed Friday by 20-year-old Adam Lanza at the Sandy Hook Elementary School.

"I come to offer the love and prayers of a nation," the president said. "I am very mindful that mere words cannot match the depths of your sorrow nor can they heal your wounded hearts. I can only hope it helps to know you are not alone ... and that all across this land we have wept with you."

The memorial service had been delayed nearly an hour as Obama met with families of the victims -- 20 first graders and six adults -- in classrooms of the high school, but the audience sat patiently awaiting the service.

The president walked in shortly before 8 p.m., gave a brief wave to the room full of parents, friends and neighbors, before taking a seat in the first row.

He was greeted with a standing ovation as he the auditorium, and quickly took his seat in the first row to await his turn to speak in the interfaith memorial service.

Mandel Ngan/AFP/Getty Images

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"We needed this. We needed to be together, here in this room, in the gymnasium, outside the doors of this school, in living rooms around the world, we needed to be together to show that we are together and united," said Rev. Matt Crebbin, senior minister of the Newtown Congregational Church, who opened the ceremony.

CLICK HERE for full coverage of the tragedy at the elementary school.

"We gather in such a moment of heartbreak for all of us in Newtown," he said. "We gather esp mindful of family and friends and neighbors among us who have lost loved ones by an act of unfathomable violence and destruction.

"These darkest days of our community shall not be the final word heard from us," he said

Tragedy struck the small town Friday when Adam Lanza broke into the elementary school with a semiautomatic rifle and two handguns, and then killed 20 first graders and six school staff members before committing suicide as police arrived on the scene.

CLICK HERE to read about the 'hero teacher,' the principal and 20 children who lost their lives.

The audience showed no signs of impatience, despite the delayed start. They sat quietly until a group of state police arrived at the already packed high school auditorium, but then stood to give the police a standing ovation and hugs.

A short time later more police arrived, and were also greeted with applause and hugs.

Assuming a consoling role that has become all too familiar for this presidency, Obama will also privately meet with some of the families affected by the tragic shooting, as well as local first responders.

The president has witnessed five mass shootings since assuming office in 2009, his reaction to this most recent tragedy in New England being his most publicly emotional. On Friday, tears collected in his eyes as he addressed the nation after the tragedy.

"The majority of those who died today were children, beautiful little kids between the ages of 5 and 10 years old," the president said, pausing to collect himself. "They had their entire lives ahead of them -- birthdays, graduations, weddings, kids of their own."

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Violence flares in Cairo as Egyptians vote

CAIRO (Reuters) - Islamists attacked the offices of an Egyptian opposition party newspaper on Saturday, security sources said, as people voted on a new constitution intended to pull the country out of a growing political crisis.

The newspaper of the Wafd party in Cairo was targeted with petrol bombs and birdshot, the sources said, in the latest of a series of violent incidents surrounding a divisive referendum designed to pave the way to national elections next year.

The attack came as officials began counting votes after polling stations closed at 11 p.m. (1600 ET).

Official results will not come until after a second round of voting in remaining areas of the country next Saturday, but conflicting claims were already emerging from the rival camps.

A spokesman for the opposition National Salvation Front said it had indications that 60-65 percent of voters in Cairo and other cities had rejected the new constitution, while President Mohamed Mursi's Muslim Brotherhood allies said that after 1 million votes had been counted, 72.5 percent were in favor.

Mostafa Shafik, managing editor at Wafd's newspaper, which is located next to the party headquarters, said his offices had been damaged.

"The attackers used Molotov cocktails to enter, which left minor areas burned," he said.

A Reuters photographer saw a dozen or so cars damaged inside the Wafd headquarters' grounds, their windows broken. Glass was also broken in the headquarters, but he saw no immediate signs of fire damage. Two people appeared to have been injured.

Wafd blamed followers of Hazem Abu Ismail, a Salafist preacher, for the attack, but he used his Facebook page to deny involvement.

Violence in Cairo and other cities has marred the run-up to the referendum. Several party buildings belonging to the Muslim Brotherhood's Freedom and Justice party have been burned in protests.

Rival factions armed with clubs, knives and swords fought in the streets of Alexandria on Friday. Opposition supporters trapped a Muslim preacher inside his mosque after he backed a "yes" vote in favor of the constitution.

ANGRY DEMONSTRATIONS

President Mursi provoked angry demonstrations when he issued a decree last month expanding his powers and then fast-tracked the draft constitution through an assembly dominated by his Muslim Brotherhood group and its allies. At least eight people were killed in clashes last week outside the presidential palace.

His liberal, secular and Christian opponents say the constitution is too Islamist and tramples on minority rights. Mursi's supporters say the charter is needed if progress is to be made towards democracy nearly two years after the fall of military-backed strongman Hosni Mubarak.

"The sheikhs (preachers) told us to say 'yes' and I have read the constitution and I liked it," said 53-year-old Adel Imam as he queued to vote in Cairo on Saturday. "The country will move on."

Turnout was high enough for voting to be extended by four hours in Cairo and some other cities.

In order to pass, the constitution must be approved by more than 50 percent of voters who cast ballots. A little more than half of Egypt's electorate of 51 million are eligible to vote in the first round in Cairo and other cities.

Rights groups reported some abuses, such as polling stations opening late, officials telling people to vote "yes", bribery and intimidation.

But Gamal Eid, head of the Arab Network for Human Rights Information, which is monitoring the vote, said nothing reported so far was serious enough to invalidate the referendum.

TRANSITION

Christians, making up about 10 percent of Egypt's 83 million people and who have long complained of discrimination, were among those waiting at a polling station in Alexandria to oppose the basic law. They fear Islamists, long repressed by Mubarak, will restrict social and other freedoms.

"I voted 'no' to the constitution out of patriotic duty," said Michael Nour, a 45-year-old Christian teacher in Alexandria. "The constitution does not represent all Egyptians."

Howaida Abdel Azeem, a post office employee, said: "I said 'yes' because I want the destruction the country is living through to be over and the crisis to pass."

Islamists are counting on their disciplined ranks of supporters and the many Egyptians who may fall into line in the hope of ending turmoil that has hammered the economy and sent Egypt's pound to eight-year lows against the dollar.

Mursi was among the early voters after polls opened at 8 a.m. (0600 GMT). He was shown on television casting his ballot shielded by a screen and then dipping his finger in ink - a measure to prevent people voting twice.

The second round will be held in other regions on December 22 because there are not enough judges willing to monitor all polling stations after some said they would boycott the vote.

Egyptians are being asked to accept or reject a constitution that must be in place before a parliamentary election can be held next year to replace an Islamist-led parliament dissolved in June. Many hope this will lead Egypt towards stability.

If the constitution is voted down, a new assembly will have to be formed to draft a revised version, a process that could take up to nine months.

The army has deployed about 120,000 troops and 6,000 tanks and armoured vehicles to protect polling stations and other government buildings. While the military backed Mubarak and his predecessors, it has not intervened in the present crisis.

(Writing by Edmund Blair and Giles Elgood; Editing by Tom Pfeiffer)

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Body found in Singapore River

SINGAPORE: A man was found dead in the Singapore River along Clarke Quay early Sunday morning.

The Singapore Civil Defence Force (SCDF) said it received a call at about 1.30am.

Someone was spotted jumping into the river near Block A.

SCDF officers arrived about four minutes later and conducted a search around the area.

Diving at a depth of about 3 metres, rescuers retrieved the body of a man about three-and-a-half hours later.

He was pronounced dead at the scene.

Police are investigating the unnatural death.

- CNA/ir

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Haryana residents prefer khaps over courts: Report

CHANDIGARH: A survey carried out by a sub-committee constituted by Haryana Backward Class Commission (HBCC) to ascertain possibility of reservation for jats and other communities has found out that rustic Haryanvis have more faith in social panchayats than judicial courts and prefer to approach khaps for remedial measures.

During the survey conducted on 49,870 households in rural areas, it was found that 66.6% families from 16 different castes said they preferred approaching khap panchayats than opting for judicial remedies for seeking justice whenever disputes arise. The survey was tasked to ascertain khaps' influence in Haryana and was conducted by a sub-committee headed by K S Sangwan, a former HoD of department of sociology at Maharishi Dayanand University, Rohtak.

The research was one of the 12 social indicators used by the sub-committee for determining social, educational and economical backwardness of various castes and communities of Haryana. While this part of the report has come as a shot in the arm for khap leaders, who claim khap panchayat to be legitimate dispute disputes platform, they have very conveniently chosen to trash the rest of the report.

"This is the only portion where the commission could not manipulate. We cannot rely on any other recommendations made in the report,'' said Sube Singh Samain, a spokesperson of Sarvjat Khap Panchayat.

Khaps in Haryana have been inviting criticism from various sections of the society as well as Punjab and Haryana High court for their diktats on barring same-village marriages and inter-caste marriages, which has led to incidents of honor killings in the state.

"Bhaichara (brotherhood) concept still exists in rural Haryana. Khaps have played important role in solving common problems. Villagers feel that in courts only one party wins the case. But when it comes to khap panchayats, it is a win-win situation for both the parties,'' said Sangwan.

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Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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Conn. Victim's Father Remembers 'Loving' Daughter

(Image credit: Emilie Parker Fund/Facebook)

Emilie Parker, the little girl with the blond hair and bright blue eyes, would have been one of the first to comfort her classmates at Sandy Hook Elementary School, had a gunman’s bullets not claimed her life, her father said.

“My daughter Emilie would be one of the first ones to be standing and giving support to all the victims because that’s the kind of kid she is,” her father, Robbie Parker said as he fought back tears, telling the world about his “bright, creative and loving” daughter who was one of the 20 young victims in the Newtown, Conn., shooting.

“She always had something kind to say about anybody,” her father said.  ”We find comfort reflecting on the incredible person Emilie was and how many lives she was able to touch.”

Emilie, 6, was helping teach her younger sisters to read and make things, and she was the little girls would go to for comfort, he said.

“They looked up to her,” Parker said.

READ: Complete List of Sandy Hook Victims

Parker moved his wife and three daughters to Newtown eight months ago after accepting a job as  a physician’s assistant at Danbury Hospital. He said Emilie, his oldest daughter, seemed to have adjusted well to her new school, and he was very happy with the school, too.

“I love the people at the school. I love Emilie’s teacher and the classmates we were able to get to know,” he said.

      (Image Credit: Alex von Kleydorff/AP Photo)

The family dealt with another tragic loss in October when Emilie lost her grandfather in an accident.

“[This] has been a topic that has been discussed in our family in the past couple of  months,” Parker said. “[My daughters ages 3 and 4] seem to get the idea that there’s somebody who they will miss very much.”

Emilie, a budding artist who carried her markers and pencils everywhere, paid tribute to her grandfather by slipping a special card she had drawn into his casket, Parker said.  It was something she frequently did to lift the spirits of others.

“I can’t count the number of times Emilie would find someone feeling sad or frustrated and would make people a card,” Parker said. “She was an exceptional artist.”

The girl who was remembered as “always willing to try new things, other than food” was learning Portuguese from her father, who speaks the language.

(Image Credit: Emilie Parker Fund/Facebook)

On Friday morning, Emilie woke up before her father left for his job and exchanged a few sentences with him in the language.

“She told me good morning and asked how I was doing,” Parker said. “She said she loved me, I gave her a kiss and I was out the door.”

Parker found out about the shooting while on lockdown in Danbury Hospital and found a television for the latest news.

“I didn’t think it was that big of deal at first,” he said. “With the first reports coming in, it didn’t sound like it was going to be as tragic as it was. That’s kind of what it was like for us.”

CLICK HERE for full coverage of the Sandy Hook shooting.

Parker said he knows that God can’t take away free will and would have been unable to stop the Sandy Hook shooting. While gunman Adam Lanza used his free agency to take innocent lives, Parker said he plans to use his in a positive way.

“I’m not mad because I have my  [free] agency to use this event to do whatever I can to make sure my family and my wife and my daughters are taken care [of],” he said. “And if there’s anything I can do to help to anyone at any time at anywhere, I’m free to do that.”

(Image credit: Emilie Parker Fund/Facebook)

Friday night, hours after he learned of his daughter’s death, Parker said he spoke at his church.

“I don’t know how to get through something like this. My wife and I don’t understand how to process all of this,” he said today. “We find strength in our religion and in our faith and in our family. ”

“It’s a horrific tragedy and I want everyone to know our hearts and prayers go out to them. This includes the family of the shooter. I can’t imagine how hard this experience must be for you and I want you to know our family … love and support goes out to you as well.”

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NATO says Syrian Scuds hit "near" Turkey

BEIRUT (Reuters) - NATO accused Syrian President Bashar al-Assad's forces of firing Scud missiles that landed near to the Turkish border, in explaining why it was sending anti-missile batteries and troops to the bloc's frontier.

The Syrian government, which finds itself under attack from rebels in the capital Damascus and by a diplomatic alliance of Arab and Western powers, denies firing such long-range, Soviet-built rockets and had no immediate comment on the latest charge.

Admiral James Stavridis, the American who is NATO's military commander, wrote in a blog on Friday: "Over the past few days, a handful of Scud missiles were launched inside Syria, directed by the regime against opposition targets. Several landed fairly close to the Turkish border, which is very worrisome."

It was not clear how close they came. NATO member Turkey, once friendly toward Assad but now among the main allies of the rebels, has complained of occasional bullets and artillery fire, some of which has been fatal, for many months. It sought the installation of missile defenses on its border some weeks ago.

"Syria is clearly a chaotic and dangerous situation; but we have an absolute obligation to defend the borders of the alliance from any threat emanating from that troubled state," Stavridis wrote.

Batteries of U.S.-made Patriot missiles, designed to shoot down the likes of the Scuds popularly associated with Iraq's wars under Saddam Hussein in the 1990s, are about to be deployed by the U.S., German and Dutch armies, each of which is sending up to 400 troops to operate and protect the rocket systems.

The Syrian government has accused Western powers of backing what it portrays as a Sunni Islamist "terrorist" attack on it and says Washington and Europe have publicly voiced concerns of late that Assad's forces might resort to chemical weapons solely as a pretext for preparing a possible military intervention.

In contrast to NATO's air campaign in support of Libya's successful revolt last year against Muammar Gaddafi, Western powers have fought shy of intervention in Syria. They have cited the greater size and ethnic and religious complexity of a major Arab state at the heart of the Middle East - but have also lacked U.N. approval due to Russia's support for Assad.

Moscow reacted angrily on Friday to the way U.S. officials seized on comments by a top Kremlin envoy for the Middle East as evidence that Russia was giving up on Assad. Comments by Mikhail Bogdanov on Thursday in which he conceded Assad might be ousted did not reflect a change in policy, the Foreign Ministry said.

Assad's diplomatic isolation remains acute, however, as Arab and Western powers this week recognized a new, united coalition of opposition groups as Syria's legitimate leadership. Large parts of the country are no longer under the government's control and fighting has been raging around Damascus itself.

European Union leaders who met in Brussels on Friday said all options were on the table to support the Syrian opposition, raising the possibility that non-lethal military equipment or even arms could eventually be supplied.

In their strongest statement of support for the Syrian opposition since the uprising began 20 months ago, EU leaders instructed their foreign ministers to assess all possibilities to increase the pressure on Assad.

With rebels edging into the capital, a senior NATO official said that Assad is likely to fall and the Western military alliance should make plans to protect against the threat of his chemical arsenal falling into the wrong hands.

HUNGER SPREADS

Desperation for food is growing in parts of Syria and residents of the northern city of Aleppo say fist fights and dashes across the civil war front lines have become part of the daily struggle to secure a loaf of bread.

"I went out yesterday and could not get any bread. If only the problem was just lack of food - there is also a huge shortage of fuel, which the bakeries need to run," said Ahmed, a resident of the battle-scarred Salaheddine district.

He said people get into fist fights over flour and rebels regularly have to break up fights by firing into the air.

The World Food Programme (WFP) says as many as a million people may go hungry this winter, as worsening security conditions make it harder to reach conflict zones.

Forty thousand people have now been killed in the most enduring and destructive of the Arab revolts. The government severely limits press and humanitarian access to the country.

U.N. humanitarian chief Valerie Amos said on Friday the United Nations is committed to maintaining aid operations in Syria.

"NOTHING OFF THE TABLE"

At the EU summit, Britain's David Cameron pushed for an early review of the arms embargo against Syria to possibly open the way to supply equipment to rebels in the coming months. Germany and others were more reluctant and blocked any quick move. But there was widespread agreement that whatever action can be taken under current legislation should be pursued, and the arms embargo would still be reviewed at a later stage.

"I want a very clear message to go to President Assad that nothing is off the table," Cameron told reporters at the end of a two-day summit. "I want us to work with the opposition ... so that we can see the speediest possible transition in Syria.

"There is no single simple answer, but inaction and indifference are not options."

Among factors holding Western powers back from arming the rebels is the presence in their ranks of anti-Western Islamist radicals. Following a U.S. decision this week to blacklist one such group, Jabhat al-Nusra, a "terrorist" group, thousands of Syrians demonstrated on Friday against ostracizing the movement.

The latest, weekly Friday protests in rebel-held areas were held under the slogan: "The only terrorism in Syria is Assad's".

Inspired by Arab uprisings across the region, Syrian protesters were met with gunfire by Assad's security forces in March 2011. Armed revolt overtook the movement, which has become increasingly sectarian - waged by majority Sunni Muslims against forces loyal to Assad, who is from the minority Alawite sect, an offshoot of the Shi'ite Islam practiced in Assad's ally Iran.

A video posted on the Internet showed dozens of Sunni rebels dressed in camouflage gear congratulating and kissing each other outside a burning Shi'ite shrine.

A fighter holding a rifle said the group was destroying the "dens of the Shi'ites". Reuters could not independently verify the video, which was posted on YouTube on Wednesday and purports to be filmed in the northern town of Jisr al-Shughur.

(Writing by Oliver Holmes and Alastair Macdonald; Editing by Michael Roddy)

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Police hunt man who threatened shooting at US mosque

LOS ANGELES: Police in California are looking for a man who reportedly walked into a California mosque saying he had a gun and threatened to kill everyone, a spokeswoman said Friday.

The man entered the Ibrahim Khalilullah Islamic Center in Fremont, south of San Francisco, during afternoon prayer Wednesday, said mosque leaders, urging official action to track down the man.

According to witnesses, a "white male in his thirties entered the IKI Center Mosque during prayer, and shouted that he had a gun and wanted to kill everyone. When confronted, the male left," said a police spokeswoman.

"We are a little worried because of the situation that happened in Oregon," said Fareed Wardak, a member of the center's board of directors, referring to a shooting in the western US state that left three dead on Tuesday.

"We don't want the same thing to happen," he told KTVU television, in comments made before Friday's shooting at an elementary school in the eastern state of Connecticut that killed 20 children and six adults.

The man left without taking out a gun. Fremont Police Department spokeswoman Geneva Bosques told AFP: "He never displayed a gun, kept his hands in his pockets. We are following up in an attempt to look at video surveillance."

The man possibly drove a 1990s gray Toyota Camry, and officers will be carrying out extra patrols looking for anything suspicious, KTVU reported.

"We do have surveillance cameras. We'll be getting pictures out of that system," said Wardak, adding: "We're not sure what kind of person" the man was.

"It's Christmas, people are going back and forth," said Mohammed Zarabi, president of the board of directors. "Maybe he needs some money. I can't say what his intention was. I just hope it doesn't happen again."

The center has some 500 members, mostly of Afghan descent, and has been in the city for two decades.

This week's shootings in Oregon and Connecticut have revived the perennial debate about gun control in the United States, a country that regularly has to cope with such apparently random killings.

Friday's massacre at the Sandy Hook Elementary School in Newtown, Connecticut was the second deadliest US school shooting, after the 2007 campus shootings at Virginia Tech University, which left 32 dead.

- AFP/ck

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HC allows auction of 25 quarries in Punjab

CHANDIGARH: Around four months after banning all mining activities, the Punjab and Haryana high court on Friday allowed auction of 25 quarries in various districts of Punjab.

While permitting the state to initiate the process of auctioning the mining quarries under a close and strict monitoring mechanism, the court of Justice Rajive Bhalla observed that the system of issuing manual slips for lifting minerals from the quarries was being misused.

The court also issued directions to instal weighing machines at the quarries to keep a tab on each vehicle's weight to prevent contractors from extracting material in addition to the prescribed limit by over-digging and thereby harming the ecology.

In August this year, the HC had imposed complete and immediate ban on mining in the state without environmental clearance in operational quarries of up to five hectares in the state.

The court also directed that environment impact assessment committee would grant permission in each case so that there was no ecological degradation. The HC has also told the trial courts to avoid releasing vehicles and equipment used for illegal mining.

The division bench also made it clear that the HC's endeavour was only to ensure the undertaking of mining after obtaining requisite permission and following the rules, which was not being done.

Justice Bhalla was miffed over the recent statements made by the state governments that rates of building material have reached all time high because of stay on mining by the Punjab and Haryana high court.

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Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

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Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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