Your medical chart could include exercise minutes

CHICAGO (AP) — Roll up a sleeve for the blood pressure cuff. Stick out a wrist for the pulse-taking. Lift your tongue for the thermometer. Report how many minutes you are active or getting exercise.

Wait, what?

If the last item isn't part of the usual drill at your doctor's office, a movement is afoot to change that. One recent national survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.

Kaiser Permanente, one of the nation's largest nonprofit health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost 9 million patients are asked at every visit, and some other medical systems are doing it, too.

Here's how it works: During any routine check of vital signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it's among the first things the doctor sees.

"All we ask our physicians to do is to make a comment on it, like, 'Hey, good job,' or 'I noticed today that your blood pressure is too high and you're not doing any exercise. There's a connection there. We really need to start you walking 30 minutes a day,'" said Dr. Robert Sallis, a Kaiser family doctor. He hatched the vital sign idea as part of a larger initiative by doctors groups.

He said Kaiser doctors generally prescribe exercise first, instead of medication, and for many patients who follow through that's often all it takes.

It's a challenge to make progress. A study looking at the first year of Kaiser's effort showed more than a third of patients said they never exercise.

Sallis said some patients may not be aware that research shows physical inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November a government-led study concluded that people who routinely exercise live longer than others, even if they're overweight.

Zendi Solano, who works for Kaiser as a research assistant in Pasadena, Calif., says she always knew exercise was a good thing. But until about a year ago, when her Kaiser doctor started routinely measuring it, she "really didn't take it seriously."

She was obese, and in a family of diabetics, had elevated blood sugar. She sometimes did push-ups and other strength training but not anything very sustained or strenuous.

Solano, 34, decided to take up running and after a couple of months she was doing three miles. Then she began training for a half marathon — and ran that 13-mile race in May in less than three hours. She formed a running club with co-workers and now runs several miles a week. She also started eating smaller portions and buying more fruits and vegetables.

She is still overweight but has lost 30 pounds and her blood sugar is normal.

Her doctor praised the improvement at her last physical in June and Solano says the routine exercise checks are "a great reminder."

Kaiser began the program about three years ago after 2008 government guidelines recommended at least 2 1/2 hours of moderately vigorous exercise each week. That includes brisk walking, cycling, lawn-mowing — anything that gets you breathing a little harder than normal for at least 10 minutes at a time.

A recently published study of nearly 2 million people in Kaiser's southern California network found that less than a third met physical activity guidelines during the program's first year ending in March 2011. That's worse than results from national studies. But promoters of the vital signs effort think Kaiser's numbers are more realistic because people are more likely to tell their own doctors the truth.

Dr. Elizabeth Joy of Salt Lake City has created a nearly identical program and she expects 300 physicians in her Intermountain Healthcare network to be involved early this year.

"There are some real opportunities there to kind of shift patients' expectations about the value of physical activity on health," Joy said.

NorthShore University HealthSystem in Chicago's northern suburbs plans to start an exercise vital sign program this month, eventually involving about 200 primary care doctors.

Dr. Carrie Jaworski, a NorthShore family and sports medicine specialist, already asks patients about exercise. She said some of her diabetic patients have been able to cut back on their medicines after getting active.

Dr. William Dietz, an obesity expert who retired last year from the Centers for Disease Control and Prevention, said measuring a patient's exercise regardless of method is essential, but that "naming it as a vital sign kind of elevates it."

Figuring out how to get people to be more active is the important next step, he said, and could have a big effect in reducing medical costs.

___

Online:

Exercise: http://1.usa.gov/b6AkMa

___

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

Read More..

Hagel to Be Obama's Defense Secretary Nominee

Jan 6, 2013 4:52pm

(Junko Kimura/Getty Images)

WASHINGTON, D.C. — President Obama will nominate former senator Chuck Hagel to be his next Secretary of Defense tomorrow.

Senior officials within the administration and Capitol Hill confirmed the pick to ABC News today after the Nebraska Republican had emerged as a frontrunner among potential candidates several weeks ago.

Hagel, 66, is a decorated Vietnam veteran and businessman who served in the senate from 1997 to 2009. After having sat on that chamber’s Foreign Relations and Intelligence Committees,  he has in recent years gathered praise from current and former diplomats for his work on Obama’s Intelligence Advisory Board as well as the policy board of the current Defense Secretary Leon Panetta.

But the former lawmaker faces an upscale battle in the coming confirmation hearings in Congress; critics on both sides of the aisle have taken aim at his record toward Israel and what some have called a lack of experience necessary to lead the sprawling Pentagon bureaucracy or its operations.

Progressives have also expressed concern about comments he made in 1998, questioning whether an “openly, aggressively gay” James Hormel could be nominated to an ambassador position by then-President Clinton. Hagel apologized for the comments last month, adding that he also supported gays in the military – a position he once opposed.

Who Is Chuck Hagel? Meet Obama’s Top Pentagon Pick

The friction with his former colleagues has left a degree of uncertainty in the air going into the hearings. Today on ABC’s “This Week,” Senate Republican Leader Mitch McConnell demurred when asked whether he would support the man who, in 2008, he had championed for his candidness and stature in foreign policy.

“I’m going to wait and see how the hearings go and see whether Chuck’s views square with the job he would be nominated to do,” he told George Stephanopoulos.

Senator Lindsey Graham was more blunt in his opposition to Hagel on CNN. The Georgia Republican called Hagel an “in your face nomination,” and said he “would be the most antagonistic secretary of defense towards the state of Israel in our nation’s history.”

If confirmed, Hagel will join a crop of new cabinet members expected to join the president in his second term, including Sen. John Kerry, D-Mass., who was nominated in December to replace Hillary Clinton as Secretary of State.

ABC’s Elizabeth Hartfield and Devin Dwyer contributed reporting.

SHOWS: Good Morning America This Week World News

Read More..

Venezuela lawmakers elect Chavez ally as Assembly chief

CARACAS (Reuters) - Venezuelan lawmakers re-elected a staunch ally of Hugo Chavez to head the National Assembly on Saturday, putting him in line to be caretaker president if the socialist leader does not recover from cancer surgery.

By choosing the incumbent, Diosdado Cabello, the "Chavista"-dominated legislature cemented the combative ex-soldier's position as the third most powerful figure in the government, after Chavez and Vice President Nicolas Maduro.

"As a patriot ... I swear to be supremely loyal in everything I do, to defend the fatherland, its institutions, and this beautiful revolution led by our Comandante Hugo Chavez," Cabello said as he took the oath, his hand on the constitution.

He had earlier warned opposition politicians against attempting to use the National Assembly to "conspire" against the people, saying they would be "destroyed" if they tried.

Thousands of the president's red-clad supporters gathered outside parliament hours before the vote, many chanting: "We are all Chavez! Our comandante will be well! He will return!"

If Chavez had to step down, or died, Cabello would take over the running of the country as Assembly president and a new election would be organized within 30 days. Chavez's heir apparent, Maduro, would be the ruling Socialist Party candidate.

Chavez, who was diagnosed with an undisclosed form of cancer in his pelvic area in mid-2011, has not been seen in public nor heard from in more than three weeks.

Officials say the 58-year-old is in delicate condition and has suffered multiple complications since the December 11 surgery, including unexpected bleeding and severe respiratory problems.

Late on Friday, Maduro gave the clearest indication yet that the government was preparing to delay Chavez's inauguration for a new six-year term, which is scheduled for Thursday.

'CHAVEZ IS PRESIDENT'

Maduro said the ceremony was a "formality" and that Chavez could be sworn in by the Supreme Court at a later date.

The opposition says Chavez's absence would be just the latest sign that he is no longer fit to govern, and that new elections should be held in the South American OPEC nation.

Brandishing a copy of the constitution after his win in the Assembly, Cabello slammed opposition leaders for writing a letter to foreign embassies in which they accused the government of employing a "twisted reading" of the charter.

"Get this into your heads: Hugo Chavez was elected president and he will continue to be president beyond January 10. No one should have any doubt ... this is the constitutional route," he said as fellow Socialist Party lawmakers cheered.

The opposition sat stony-faced. One of their legislators had earlier told the session that it was not just the head of state who was ill, "the republic is sick."

Last year, Chavez staged what appeared to be a remarkable comeback from the disease to win re-election in October, despite being weakened by radiation therapy. He returned to Cuba for more treatment within weeks of his victory.

Should the president have to step down after 14 years in office, a new vote would probably pit Maduro, a 50-year-old former bus driver and union leader, against opposition leader Henrique Capriles, the 40-year-old governor of Miranda state.

Capriles lost to Chavez in October's presidential election.

"I don't think Maduro would last many rounds in a presidential race. He's not fit for the responsibility they have given him," Capriles said after the vice president's appearance on state television.

Chavez's condition is being watched closely by leftist allies around Latin American who have benefited from his oil-funded generosity, as well as investors attracted by Venezuela's lucrative and widely traded debt.

The country boasts the world's biggest crude reserves. Despite the huge political upheaval Chavez's exit would cause, the oil industry is not likely to be affected much in the short term, with an extension of "Chavismo" keeping projects on track, while a change in parties could usher in more foreign capital.

(Additional reporting by Deisy Buitrago; Editing by Vicki Allen)

Read More..

Football: Wolves sack Solbakken after FA Cup exit

LONDON: Stale Solbakken was sacked as manager of Championship side Wolves on Saturday, just hours after the club had been dumped out of the FA Cup by non-league Luton.

The struggling side, who were relegated from the Premier League last season, also terminated the contracts of assistant manager Johan Lange and Patrick Weiser, the first team coach.

Wolves are currently 18th in the Championship, having won just three out of their last 16 league games and a disappointing run of results culminated in Saturday's FA Cup third round 1-0 defeat to Luton Town.

Solbakken had only been in charge at Molineux for six months.

"Kevin Thelwell, head of football development and recruitment, will take charge of first team training until a new manager is appointed, assisted by development coach, Steve Weaver," said a club statement.

"The club would like to offer their thanks and best wishes to Stale, Johan and Patrick."

The 44-year-old Solbakken, who had previously been in charge of German side Cologne, replaced Terry Connor in the Wolves hotseat last summer.

He becomes the 10th Championship manager to leave his club this season while Wolves now search for their fourth boss in under a year.

Speaking after Saturday's match, the Norwegian had said he was not "embarrassed" by the defeat.

"There will be a lot of questions over me but that is normal, that's football and I have to take that, it's no problem," he said.

"I can put it right. I'm not embarrassed by the result, I can't fault the players' effort. First half we did well, but second half we didn't because our physical presence in the box was not enough."

- AFP/de

Read More..

Mamata breathes fire in Jangalmahal

MIDNAPORE: Chief minister Mamata Banerjee on Saturday threatened to launch an agitation against the Centre and take it to New Delhi, if necessary, to demand an interest waiver on the state's over Rs 2 lakh crore debt. Mamata held out the threat while addressing youngsters from Jangalmahal at the Midnapore College Ground.

On April 21 last year, Mamata had served a 15-day ultimatum to the centre for a three-year moratorium on interest payable on debt. Though the Trinamool was in UPA II then, the centre refused to yield to that threat despite the chief minister's "enough is enough" warning. So the result of her latest threat, that too sans the three-year time-frame, isn't likely to be any different after Trinamool's exit from the alliance.

Mamata again gave the same justification for her demand—that the debt had been incurred by the Left Front government and passed on to her. "Bengal can't be ignored," said Mamata while giving a call for an anti-centre stir in Delhi. Mamata had earlier agitated in the capital on the FDI issue with NDA ally Sharad Yadav in tow.

Bengal's annual interest liability is Rs 22,000 crore and its revenue generation is 21,000 crore. Mamata has consistently raised the state's poor fiscal health since coming to power, citing that she had inherited an empty coffer from the Left. Debt and interest apart, Mamata reiterated that during Left Front rule, West Midnapore's villages were turned into killing fields by CPM harmads. "Even today, you just have to dig a little and you will find skeletons in different villages of Midnapore," the CM said from the dais of the Jangalmahal Vivek Chhatra Yuba Utsab.

Read More..

FDA: New rules will make food safer

WASHINGTON (AP) — The Food and Drug Administration says its new guidelines would make the food Americans eat safer and help prevent the kinds of foodborne disease outbreaks that sicken or kill thousands of consumers each year.

The rules, the most sweeping food safety guidelines in decades, would require farmers to take new precautions against contamination, to include making sure workers' hands are washed, irrigation water is clean, and that animals stay out of fields. Food manufacturers will have to submit food safety plans to the government to show they are keeping their operations clean.

The long-overdue regulations could cost businesses close to half a billion dollars a year to implement, but are expected to reduce the estimated 3,000 deaths a year from foodborne illness. The new guidelines were announced Friday.

Just since last summer, outbreaks of listeria in cheese and salmonella in peanut butter, mangoes and cantaloupe have been linked to more than 400 illnesses and as many as seven deaths, according to the federal Centers for Disease Control and Prevention. The actual number of those sickened is likely much higher.

Many responsible food companies and farmers are already following the steps that the FDA would now require them to take. But officials say the requirements could have saved lives and prevented illnesses in several of the large-scale outbreaks that have hit the country in recent years.

In a 2011 outbreak of listeria in cantaloupe that claimed 33 lives, for example, FDA inspectors found pools of dirty water on the floor and old, dirty processing equipment at Jensen Farms in Colorado where the cantaloupes were grown. In a peanut butter outbreak this year linked to 42 salmonella illnesses, inspectors found samples of salmonella throughout Sunland Inc.'s peanut processing plant in New Mexico and multiple obvious safety problems, such as birds flying over uncovered trailers of peanuts and employees not washing their hands.

Under the new rules, companies would have to lay out plans for preventing those sorts of problems, monitor their own progress and explain to the FDA how they would correct them.

"The rules go very directly to preventing the types of outbreaks we have seen," said Michael Taylor, FDA's deputy commissioner for foods.

The FDA estimates the new rules could prevent almost 2 million illnesses annually, but it could be several years before the rules are actually preventing outbreaks. Taylor said it could take the agency another year to craft the rules after a four-month comment period, and farms would have at least two years to comply — meaning the farm rules are at least three years away from taking effect. Smaller farms would have even longer to comply.

The new rules, which come exactly two years to the day President Barack Obama's signed food safety legislation passed by Congress, were already delayed. The 2011 law required the agency to propose a first installment of the rules a year ago, but the Obama administration held them until after the election. Food safety advocates sued the administration to win their release.

The produce rule would mark the first time the FDA has had real authority to regulate food on farms. In an effort to stave off protests from farmers, the farm rules are tailored to apply only to certain fruits and vegetables that pose the greatest risk, like berries, melons, leafy greens and other foods that are usually eaten raw. A farm that produces green beans that will be canned and cooked, for example, would not be regulated.

Such flexibility, along with the growing realization that outbreaks are bad for business, has brought the produce industry and much of the rest of the food industry on board as Congress and FDA has worked to make food safer.

In a statement Friday, Pamela Bailey, president of the Grocery Manufacturers Association, which represents the country's biggest food companies, said the food safety law "can serve as a role model for what can be achieved when the private and public sectors work together to achieve a common goal."

The new rules could cost large farms $30,000 a year, according to the FDA. The agency did not break down the costs for individual processing plants, but said the rules could cost manufacturers up to $475 million annually.

FDA Commissioner Margaret Hamburg said the success of the rules will also depend on how much money Congress gives the chronically underfunded agency to put them in place. "Resources remain an ongoing concern," she said.

The farm and manufacturing rules are only one part of the food safety law. The bill also authorized more surprise inspections by the FDA and gave the agency additional powers to shut down food facilities. In addition, the law required stricter standards on imported foods. The agency said it will soon propose other overdue rules to ensure that importers verify overseas food is safe and to improve food safety audits overseas.

Food safety advocates frustrated over the last year as the rules stalled praised the proposed action.

"The new law should transform the FDA from an agency that tracks down outbreaks after the fact, to an agency focused on preventing food contamination in the first place," said Caroline Smith DeWaal of the Center for Science in the Public Interest.

Read More..

City Answers Gang-Rape Cover-Up Allegations

As Steubenville, Ohio, prepares for the high-profile rape trial of two high school football players, officials, battling allegations of a cover-up, announced the creation of a new website today to debunk rumors and create what they said would be a transparent resource for the community.

"This site is not designed to be a forum for how the Juvenile Court ought to rule in this matter," the website, called Steubenville Facts, said.

A timeline of the case, beginning with the alleged gang rape of a 16-year-old girl at a party on Aug. 11-12, 2012, is posted on the site. Summaries of Ohio law relating to the case and facts about the local police force including statistics on how many graduated from Steubenville schools, is included.

The case gained national attention last week when hacking collective Anonymous leaked a video of Steubenville high school athletes mocking the 16-year-old female victim and making crude references to the alleged rape.

Steubenville Herald-Star, Michael D. McElwain/AP Photo

"It's disgusting, and I've had people calling, numerous people call here, upset, they have seen it, one woman, two women were crying, because of what they witnessed," Jefferson County Sheriff Fred Abdalla said. "It really is disgusting to watch that video."

Anonymous has called for more arrests, however Steubenville Police have said their hands are tied.

"Steubenville Police investigators are caring humans who recoil and are repulsed by many of the things they observe during an investigation," the website said, addressing the video. "Like detectives in every part of America and the world, they are often frustrated when they emotionally want to hold people accountable for certain detestable behavior but realize that there is no statute that allows a criminal charge to be made."

Occupy Steubenville, a grassroots group, estimated 1,300 people attended a rally today outside the Jefferson County Courthouse, where rape victims and their loved ones gathered to share their stories.

The father of a teenage rape victim was met with applause when he shared his outrage.

"I've tried to show my girl that not all men are like this, but only a despicable few," he said. "And their mothers that ignore the truth that they gave birth to a monster."

Authorities investigated the case and charged two Steubenville high school athletes on Aug. 22, 2012.

The teenagers face trial on Feb. 13, 2013 in juvenile court before a visiting judge.

Attorneys for the boys have denied charges in court.

Read More..

Abbas sees Palestinian unity as Fatah rallies in Gaza

GAZA (Reuters) - President Mahmoud Abbas predicted the end of a five-year split between the two big Palestinian factions as his Fatah movement staged its first mass rally in Gaza with the blessing of Hamas Islamists who rule the enclave.

"Soon we will regain our unity," Abbas, whose authority has been limited to the Israeli-occupied West Bank since the 2007 civil war between the two factions, said in a televised address to hundreds of thousands of followers marching in Gaza on Friday, with yellow Fatah flags instead of the green of Hamas.

The hardline Hamas movement, which does not recognize Israel's right to exist, expelled secular Fatah from Gaza during the war. It gave permission for the rally after the deadlock in peace talks between Abbas's administration and Israel narrowed the two factions' ideological differences.

The Palestinian rivals have drawn closer since Israel's assault on Gaza assault in November, in which Hamas, though battered, claimed victory.

Egypt has long tried to broker Hamas-Fatah reconciliation, but past efforts have foundered over questions of power-sharing, control of weaponry, and to what extent Israel and other powers would accept a Palestinian administration including Hamas.

An Egyptian official told Reuters Cairo was preparing to invite the factions for new negotiations within two weeks.

Israel fears grassroots support for Hamas could eventually topple Abbas's Palestinian Authority (PA) in the West Bank.

"Hamas could seize control of the PA any day," Israeli Prime Minister Benjamin Netanyahu said on Thursday.

The demonstration marked 48 years since Fatah's founding as the spearhead of the Palestinians' fight against Israel. Its longtime leader Yasser Arafat signed an interim 1993 peace accord that won Palestinians a measure of self rule.

Hamas, which rejected the 1993 deal, fought and won a Palestinian parliamentary election in 2006. It formed an uneasy coalition with Fatah until their violent split a year later.

Though shunned by the West, Hamas feels bolstered by electoral gains for Islamist movements in neighboring Egypt and elsewhere in the region - a confidence reflected in the fact Friday's Fatah demonstration was allowed to take place.

"The success of the rally is a success for Fatah, and for Hamas too," said Hamas spokesman Sami Abu Zuhri. "The positive atmosphere is a step on the way to regain national unity."

Fatah, meanwhile, has been riven by dissent about the credibility of Abbas's statesmanship, especially given Israel's continued settlement-building on West Bank land. The Israelis quit Gaza unilaterally in 2005 after 38 years of occupation.

"The message today is that Fatah cannot be wiped out," said Amal Hamad, a member of the group's ruling body, referring to the demonstration attended by several Abbas advisers. "Fatah lives, no one can exclude it and it seeks to end the division."

In his speech, Abbas promised to return to Gaza soon and said Palestinian unification would be "a step on the way to ending the (Israeli) occupation".

(Editing by Dan Williams, Alistair Lyon and Jason Webb)

Read More..

Tennis: Tsonga withdraws from Sydney event with injury

SYDNEY: French tennis star Jo-Wilfried Tsonga has withdrawn from next week's Sydney International with a hamstring injury, tournament organisers said on Saturday.

The world number eight pulled out of the last major leadup event to this month's Australian Open after suffering the injury playing for France in the mixed teams Hopman Cup in Perth on Friday.

"Unfortunately Jo-Wilfried Tsonga sustained an injury in Perth and has been forced to pull out of the Apia International Sydney with a left hamstring injury," tournament director Craig Watson said.

"We wish him a speedy recovery and all the best for a successful Australian Open."

Tsonga, the 2008 Australian Open finalist, would have been top seed for the Sydney International and compatriot Richard Gasquet, the world number 10, is expected to become the top seed for the men's draw to be made later Saturday.

- AFP/jc

Read More..

Stop helping black money hoarders: Kejriwal to govt

NEW DELHI: Aam Aadmi Party convener Arvind Kejriwal on Friday accused the government of protecting Indians who laundered black money asking it to take a cue from the United States. The renewed offensive comes after reports that a Swiss bank had been forced to shut down after it pleaded guilty to helping Amercians evade taxes. The US government has also charged the bank $57.8 million as fine.

News reports said that Wegelin & Co will pull down shutters permanently following its guilty plea to charges of helping wealthy Americans evade taxes of USD 1.2 billion for nearly a decade. Wegelin agreed to pay USD 57.8 million to the United States in restitution and fines.

AAP convener Arvind Kejriwal tweeted, "The Swiss bank, which allowed 100 American citizens to hide $1.2bn for 10 years, forced to close operations in US and pay heavy penalties. In contrast, India protects both the guilty Swiss bank and those who stashed their money abroad."

His colleague and AAP member Manish Sisodia added: "Oldest Swiss bank is to close permanently for allowing US black money, also fined $57.8m. Do we have any courageous leadership to Act?"

The political group had raised the issue of black money being laundered with the assistance of Swiss banks in November 2012. Kejriwal had alleged that HSBC helped several Indians including Ambanis with money stashed abroad. The allegations were denied by the Ambanis and the bank.

Read More..