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.


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Online:


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


___


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


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Pastor Accused of Killing Wives Faces Trial













Jury selection is scheduled to begin Monday for Pastor Arthur Schirmer, who is accused of killing his second wife and then staging a car accident to hide it.


Schirmer, 64, also faces a second trial at a later date for the death of his first wife. He has said he is innocent of all charges.


In 2008, the pastor and his wife, Betty, were involved in what appeared at the time to be a car crash. Schirmer told police at the time that he had been driving 55 mph and swerved to miss a deer, causing him to drive off the road, according to a police affidavit obtained by ABC News.


Schirmer also said at the time that his wife's head had come forward and struck the windshield, according to the affidavit. Betty died a day later and her body was cremated at the request of Schirmer.


It wasn't until a grisly suicide in 2010 inside Schirmer's office that authorities decided to revisit the case of Betty Schirmer's death and arrest the pastor.


The man who broke in and shot himself at the desk in Schirmer's office at the Reeders United Methodist Church, Joseph Mustante, was the husband of the pastor's secretary, Cynthia Mustante, Poconos Township Police Detective James Wagner said.






Pocono Record, David Kidwell/AP Photo











Mustante's suicide was prompted by the discovery that his wife and the pastor had apparently been having an affair, Wagner said. He was alone at the time of his death.


Investigators looking into the suicide say that several church parishioners had concerns about the deaths of Schirmer's two wives.


"That suicide eventually exposed the affair publicly and subsequent to that, questions arose about the loss of [Schirmer's] wives and his character became questionable," Wagner said.


Relaunching the investigation into the two deaths, Wagner said he quickly suspected that "foul play existed, and the car crash was staged," allegedly, by Schirmer. Wagner said investigators also believed there was something "suspicious" about the first wife's death, a marriage that investigators had not known about prior to the suicide.

Investigators Look Into Deaths of Rev. Arthur Schirmer's Wives



Schirmer's first wife, Jewel, died in April 1999 from a traumatic brain injury after she purportedly fell down a flight of stairs in Lebanon, Pa., Wagner said.


Lebanon is about 100 miles southwest of Reeders, where Schrimer later moved with his second wife.


At the time of Jewel's death, Wagner said, a relative told police that he suspected Schirmer may have had a hand in his wife's death but that the investigation was "never completed."


On Dec. 11, 2012 -- more than 13 years after Jewel died, a Lebanon County judge ruled Schirmer would be tried for her murder.


When investigators looked at the death of Betty Schirmer, they saw inconsistencies, Wagner said.


"There was no airbag deployment and it simply looked like a car that had driven off the road at a very low speed," Wagner said. "It didn't match the injuries to [Betty's head].


"I know there are people out there who probably know him and feel like there is absolutely no way he would be capable of doing this," Wagner of Schirmer. "But they clearly don't know him."



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13 killed in Philippine shootout: police






MANILA: Police in the Philippines killed 13 members of a criminal gang in a shootout on Sunday, the third violent incident within days amid widespread calls for stricter gun controls.

The battle erupted after the gunmen in two vehicles tried to smash through a police checkpoint near the town of Atimonan, according to the national police headquarters' operations centre.

A police statement said one senior police officer was wounded and taken to hospital. It said 10 firearms were recovered from the gang members, including an M16 assault rifle.

No other details of the incident in the town 173 km (108 miles) southeast of Manila were available.

The incident occurred two days after a drug-crazed former village official went on a shooting rampage, killing seven people and wounding 12 others, some of whom have life-treatening injuries.

Rolando Bae was himself killed in a subsequent shootout with police.

Also last week two children aged seven and four were killed by stray bullets fired during celebratory gunfire to welcome the New Year.

The incidents triggered public condemnation and calls for stricter controls on gun ownership, with official statistics estimating nearly 600,000 unlicensed guns across the Philippines.

Some 1.2 million licensed firearms were on the registry as of 2012.

Various civic groups as well as the influential Catholic church have called for a total ban on guns on the streets. President Benigno Aquino -- himself a gun aficionado -- has yet to respond to the demand.

Other groups called for the return of capital punishment, which the government banned in 2006.

- AFP/xq



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Lot to be done to strengthen Indo-Pak bilateral ties: Salman Khurshid

AMRITSAR: India and Pakistan government took some bold initiatives to further strengthen the bilateral ties between the two which includes easing out the visa regime and opening of Integrated Check Post at Attari (India)-Wagha (Pakistan) border but still lot was to be done and hopefully it would be achieved in the near future with sincere and relentless efforts, said Union external affairs minister Salman Khurshid in his opening remarks after inauguration of the 8th South Asian Free Media (SAFMA) Conference-2013 organized for the first time in Punjab.

On the occasion Salman assured the members of SAFMA that he would soon take up the matter with his ministry to sort out the issue of multiple visa to the journalists of SAARC countries.

He said he would also take up the issue of opening up of the corridor between Dera Baba Nanak (India) and Kartarpur Sahib (Pakistan) with the home ministry.

Chief minister Parkash Singh Badal had taken up the issues of opening of corridor and another trade route through Hussainiwala border.

In his inaugural address, Badal said it was the need of the hour to eliminate all the physical barriers for the promotion of people to people contact to foster goodwill, friendship and amity in the South Asian Region.

He said that this could only be achieved by the sincere and concerted efforts of both the national governments of India and Pakistan.

Badal also urged SAFMA to take up the issue of opening of corridor with both the central governments of India and Pakistan.

Badal also supported the issue of unrestricted multiple visa to the media persons for their free movement across Asia and asked the ministry of external affairs to concede this long pending demand of media fraternity.

He sought the cooperation from SAFMA in setting up of the South Asian economic and parliamentary union which could lead to the formation of 'Asian Economic Union' on the lines of European Economic Union.

He said that in this context India and Pakistan could play a leading role as some remarkable progress had already been made in this directions by these two countries by opening the Attari-Wagha border for trade, although the scale of trade there was needed to be increased.

On the occasion, the president of Indian chapter of SAFMA, Vinod Sharma, gave a brief account of the activities of SAFMA in the country in general and in creating awareness of 'Asian Unity' by organizing a series of media events like conferences and media submits to promote peace, understanding and international cooperation especially amongst the SAARC countries.

Later, Salman Khurshid accompanied by Badal visited the Golden Temple to pay obeisance.

Badal presented a 'Siropa' (robe of honour), shawl, portrait of the Golden Temple and a set of religious books to Salman.

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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.


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Gun Show Near Newtown Goes on Despite Anger













A little more than 40 miles from Sandy Hook Elementary School, where last month 20 first graders and six staff members were massacred, gun dealers and collectors alike ignored calls to cancel a gun show, and gathered for business in Stamford, Conn.


Four other gun shows with an hour of Newtown, Conn., recently cancelled their events in the wake of the shootings, when 20-year-old Adam Lanza broke in to the elementary school with a semi-automatic assault rifle and three other guns.


The organizers in Stamford emphasized their show only displayed antique and collectible guns, not military style assault weapons like the one used by Lanza in Sandy Hook.


Still, Stamford Mayor Michael Pavia had called for the show to close its doors, calling it "insensitive" to hold so close to the murders.


Gun show participant Sandy Batchelor said he wasn't sure about whether going ahead with the show was "insensitive," but said the shooter should be blamed, not the weapons he used.


"I don't have a solid opinion on [whether it is insensitive]," Batchelor said. "I'm not for or against it. I would defend it by saying it wasnt the gun."


In nearby Waterbury, the community cancelled a show scheduled for this weekend.


"I felt that the timing of the gun show so close to that tragic event would be in bad taste," Waterbury Police Chief Chief Michael J. Gugliotti said.












National Rifle Association News Conference Interrupted by Protesters Watch Video





Gugliotti has halted permits for gun shows, saying he was concerned about firearms changing hands that might one day be used in a mass shooting.


Across the state line in White Plains, N.Y, Executive Rob Astorino also canceled a show, three years after ending a had that had been in place since the 1999 Columbine High School shooting in Colorado. He said he felt the show would be inappropriate now.


But across the country, farther away from Connecticut, attendance at gun shows is spiking, and some stores report they can hardly keep weapons on their shelves with some buyers fearful of that the federal government will soon increase restrictions on gun sales and possibly ban assault weapons altogether.


"We sold 50-some rifles in days," said Jonathan O'Connor, store manager of Gun Envy in Minnesota.


President Obama said after the Sandy Hook shooting that addressing gun violence would be one of his priorities and Rep. Nancy Pelosi, D-Calif., said she would introduce an assault weapons ban this month.


But it is not just traditional advocates of gun control that have said their need to be changes in gun laws since the horrific school shooting.


Republican Sen. Kay Bailey Hutchison of Texas and Virginia Sen. Mark Warner, a Democrat but a long-time opponent of gun control who like Hutchison has received an A rating from the NRA, have both come out in support of strengthening gun laws.


In Stamford, gun dealer Stuart English said participants at the gun show there are doing nothing wrong.


"I have to make a living. Life goes on," gun dealer Stuart English said.


ABC News asked English, what he thought about the mayor of Stamford calling the show "insensitive."


"He's wrong," English said. "This is a private thing he shouldn't be expressing his opinion on."


If you have a comment on this story or have a story idea, you can tweet this correspondent @greenblattmark.


The Associated Press contributed to this report.



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Chavez swearing-in can be delayed: Venezuelan VP


CARACAS (Reuters) - President Hugo Chavez's formal swearing-in for a new six-year term scheduled for January 10 can be postponed if he is unable to attend due to his battle to recover from cancer surgery, Venezuela's vice president said on Friday.


Nicolas Maduro's comments were the clearest indication yet that the Venezuelan government is preparing to delay the swearing-in while avoiding naming a replacement for Chavez or calling a new election in the South American OPEC nation.


In power since 1999, the 58-year-old socialist leader has not been seen in public for more than three weeks. Allies say he is in delicate condition after a fourth operation in two years for an undisclosed form of cancer in his pelvic area.


The political opposition argues that Chavez's presence on January 10 in Cuba - where there are rumors he may be dying - is tantamount to the president's stepping down.


But Maduro, waving a copy of the constitution during an interview with state TV, said there was no problem if Chavez was sworn in at a later date by the nation's top court.


"The interpretation being given is that the 2013-2019 constitutional period starts on January 10. In the case of President Chavez, he is a re-elected president and continues in his functions," he said.


"The formality of his swearing-in can be resolved in the Supreme Court at the time the court deems appropriate in coordination with the head of state."


In the increasing "Kremlinology"-style analysis of Venezuela's extraordinary political situation, that could be interpreted in different ways: that Maduro and other allies trust Chavez will recover eventually, or that they are buying time to cement succession plans before going into an election.


Despite his serious medical condition, there was no reason to declare Chavez's "complete absence" from office, Maduro said. Such a declaration would trigger a new vote within 30 days, according to Venezuela's charter.


RECOVERY POSSIBLE?


Chavez was conscious and fighting to recover, said Maduro, who traveled to Havana to see his boss this week.


"We will have the Commander well again," he said.


Maduro, 50, whom Chavez named as his preferred successor should he be forced to leave office, said Venezuela's opposition had no right to go against the will of the people as expressed in the October 7 vote to re-elect the president.


"The president right now is president ... Don't mess with the people. Respect democracy."


Despite insisting Chavez remains president and there is hope for recovery, the government has acknowledged the gravity of his condition, saying he is having trouble breathing due to a "severe" respiratory infection.


Social networks are abuzz with rumors he is on life support or facing uncontrollable metastasis of his cancer.


Chavez's abrupt exit from the political scene would be a huge shock for Venezuela. His oil-financed socialism has made him a hero to the poor, while critics call him a dictator seeking to impose Cuban-style communism on Venezuelans.


Should Chavez leave office, a new election is likely to pitch former bus driver and union activist Maduro against opposition leader Henrique Capriles, the 40-year-old governor of Miranda state.


Capriles lost to Chavez in the October presidential election, but won an impressive 44 percent of the vote. Though past polls have shown him to be more popular than all of Chavez's allies, the equation is now different given Maduro has received the president's personal blessing - a factor likely to fire up Chavez's fanatical supporters.


His condition is being watched closely by Latin American allies that have benefited from his help, as well as investors attracted by Venezuela's lucrative and widely traded debt.


"The odds are growing that the country will soon undergo a possibly tumultuous transition," the U.S.-based think tank Stratfor said this week.


(Additional reporting by Marianna Parraga; editing by Christopher Wilson)



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Tennis: Williams races to Brisbane title win






BRISBANE, Australia: American superstar Serena Williams demolished Russia's Anastasia Pavlyuchenkova 6-2, 6-1 in just 50 minutes to win the Brisbane International on Saturday.

Third-seeded Williams served notice that she will be the one to beat at this month's Australian Open with a ruthless display against Pavlyuchenkova, the world number 36.

She took control at 2-2 in the first set when she went on a run of seven straight games and never looked like losing against an increasingly demoralised opponent, who had no answer to Williams' power and aggression.

Williams sent down nine aces and won 91 per cent of her first serves, blasting 24 winners past Pavlyuchenkova, who looked shell-shocked at times with the pace of the American's groundstrokes.

Williams, 31, has now won 47 titles on the WTA tour and lost only once since the French Open last year, winning 35 of her past 36 matches.

Although ranked third in the world, Williams is a firm favourite for the Australian Open on the strength of her efforts in the second half of 2012, when she won Wimbledon, the US Open, the WTA Championship and the Olympics.

- AFP/xq



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Centre waives off bill for ITBP deployment to guard Kasab

MUMBAI: Union home minister Sushilkumar Shinde today said the Centre had decided not to recover from Maharashtra government Rs 21 crore on account of deployment of Indo-Tibetan Border Police at Arthur Road Central Jail here to guard 26/11 terrorist Ajmal Amir Kasab.

Kasab was lodged in Arthur Road jail, where the trial of 26/11 case also took place, for four years, before he was shifted to Pune's Yerawada jail for execution last November.

Shinde today visited the Arthur Road jail and reviewed the security.

He said the state should spend the money — otherwise payable to the Centre — for prison reforms.

Maharashtra home minister R R Patil had written to the Centre saying that state alone should not bear the financial burden for Kasab's security.

Shinde today said he would be visiting all the major jails in the metro cities to review the security, and his next stop would be Tihar in New Delhi.

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