Wall Street falls after five-year high, earnings in focus

NEW YORK (Reuters) - Stocks fell on Monday as traders cashed in recent gains that lifted the S&P 500 to a five-year high on Friday and awaited Tuesday's start of the fourth-quarter earnings season.


Last week was the best for U.S. stocks in more than a year as a budget deal and economic data boosted investor confidence.


Investors will likely turn their attention to the fourth-quarter earnings season that kicks off this week. Earnings are expected to be only slightly better than the third-quarter's lackluster results and analysts' current estimates are down sharply from what they were in October.


"We have a cautious market entering fourth-quarter earnings season," said Peter Cardillo, chief market economist at Rockwell Global Capital in New York. "I think it's going to be a disappointing one this time around."


Financial shares will be in focus a day after global regulators known as the Basel Committee gave banks four more years and greater flexibility to build up cash buffers, scaling back moves that aimed to help prevent another financial crisis.


"Basel giving banks four more years to get their act together will be good" for stocks, Cardillo said.


Bank of America shares rose 0.5 percent to $12.17 after hitting their highest since May 2011 as it reached a settlement with Fannie Mae worth roughly $11.6 billion to resolve agency mortgage repurchase claims.


The bank also entered into agreements with Nationstar Mortgage Holdings and Walter Investment Management to sell about $306 billion of residential mortgage servicing rights.


Nationstar rose 16.8 percent to $38.80 and Walter Investment added 7 percent to $47.13.


The Dow Jones industrial average <.dji> fell 63.59 points, or 0.47 percent, to 13,371.62. The S&P 500 <.spx> dropped 6.53 points, or 0.45 percent, to 1,459.94. The Nasdaq Composite <.ixic> lost 12.56 points, or 0.41 percent, to 3,089.09.


Walt Disney Co started an internal cost cutting review several weeks ago that may include layoffs at its studio and other units, three people with knowledge of the effort told Reuters. Disney shares fell 1.4 percent to $51.46.


Video-streaming service Netflix Inc shares gained 4 percent to $99.78 after it said it will carry previous seasons of some popular shows produced by Time Warner's Warner Bros Television.


Amazon.com shares hit their highest price ever at $269.22 after Morgan Stanley raised its rating on the stock. Shares were up 3.6 percent at $268.50.


Roche's chairman was quoted as saying the Swiss pharmaceutical group is no longer considering a bid for the U.S. gene-sequencing company Illumina . Illumina shares were off 8 percent at $50.20.


Major U.S. technology companies could miss estimates for fourth-quarter earnings as budget worries likely led some corporate clients to tighten their belts last month.


(Reporting by Rodrigo Campos; Editing by Kenneth Barry)



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Court in Bahrain Confirms Jail Terms for 13 Dissidents





CAIRO — A court in Bahrain on Monday upheld prison sentences for 13 of the country’s most prominent dissidents, in a decision that government opponents offered as evidence that the monarchy was ignoring calls to negotiate a political solution that could quiet a nearly two-year-old uprising.




The decision ends all appeals for the dissidents, who were sentenced to between five years and life in prison for their leadership roles in the revolt that began in February 2011, according to a colleague of one of the jailed opposition members. The 13 are part of a group of 20 opposition leaders who were sentenced by a military tribunal on charges that included trying to overthrow the government. Other dissidents were sentenced in absentia.


Since pledging to accept reform recommendations made by an independent panel that investigated the uprising — including to commute sentences of those charged with “political expression” — the government has continued to silence its critics. In November, the government stripped 31 people, including former opposition members of Parliament and exiled dissidents, of their citizenship.


Last month, a judge upheld a prison sentence for a popular human rights advocate, Nabeel Rajab, who was convicted of inciting protests. As the security forces have moved to contain street protests, the contest over freedom in Bahrain has moved to the judiciary. Activists accuse the courts of being little more than arms of the government that endorse charges for political crimes.


On Monday, in an apparent reaction to such allegations, Bahrain’s state news agency carried a statement affirming what it said was the judiciary’s independence and condemning “false defamatory statements.”


The dissidents who lost their appeal on Monday include human rights activists and opposition leaders. Some of the detainees have advocated the creation of a constitutional monarchy in Bahrain, while others have called for the fall of the government. They were arrested as part of a government crackdown on a pro-democracy uprising in 2011 led by members of Bahrain’s Shiite majority, who have protested against what they say is discriminatory rule at the hands of the Sunni monarchs.


As the dissidents have disappeared into jail or exile, their likenesses, in spray paint, have started to fill the walls of Shiite villages, where clashes between youths and the riot police have become the principal interaction between the state and its opponents.


The government has accused many of the dissidents of colluding with Iran to topple the state and has blamed the violence of some protesters for the absence of dialogue. Critics of the monarchy argue that by sidelining the most influential opposition members, government officials are making negotiation impossible.


“They are trying to pull us toward a security solution,” said Radhi Mohsen al-Mosawi, the acting secretary general of the National Democratic Action Society, a leftist opposition group whose leader, Ibrahim Sharif, was among the dissidents who lost his appeal on Monday. Mr. Sharif is serving a five-year sentence.


“They have made things so difficult for them, and for us,” said Mr. Mosawi, who added that his group still favored negotiations for a constitutional monarchy. “Our demand is a peaceful demand. It is a minimum demand.”


This article has been revised to reflect the following correction:

Correction: January 7, 2013

An earlier version of this article incorrectly stated the name of the leader of the National Democratic Action Society. He is Ibrahim Sharif, not Ibrahim Hussein.



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Kuwaiti journalist jailed for Twitter ‘insults’






KUWAIT CITY (AP) — A Kuwait newspaper says an online journalist has been sentenced to two years in prison for posts deemed “insulting” to the Gulf nation’s ruler — the second such ruling this week.


The decision reflects a widening social media crackdown across the Gulf Arab states to quell perceived political dissent.






Kuwait’s pro-government Al Watan newspaper reported Monday that Ayyad al-Harbi, a journalist at news website Sabr, was charged with posting Twitter messages considered offensive to the nation’s Western-allied emir. No other details were given.


Kuwait, which hosts thousands of U.S. troops, has been gripped by months of political unrest led by anti-government groups, including Islamist factions.


On Sunday, Kuwaiti media said a social media activist also has received a two-year prison term for Twitter posts that allegedly insulted the emir.


Social Media News Headlines – Yahoo! News





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Brad Pitt Hints at Return to China - Despite Being Banned















01/07/2013 at 11:35 AM EST







Brad Pitt as Austrian mountaineer in Seven Years in Tibet


David Appleby/AP


Looks like Brad Pitt is about to say "Ni hao" to China ... in person.

The actor – who was reportedly banned from China following the government's disapproval of his 1997 film Seven Years in Tibet, which portrayed harsh Chinese rule in Tibet – has hinted at a return to the country. And he took to social media to do it.

Via China's version of Twitter, called Sina Weibo, the actor posted from his verified account, "It is the truth. Yup, I'm coming ..."

The surprising statement is the actor's only "Tweet" on the social network, but it generated more than 24,000 comments from his nearly 160,000 followers.

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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


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"Cliff" concerns give way to earnings focus

NEW YORK (Reuters) - Investors' "fiscal cliff" worries are likely to give way to more fundamental concerns, like earnings, as fourth-quarter reports get under way next week.


Financial results, which begin after the market closes on Tuesday with aluminum company Alcoa , are expected to be only slightly better than the third-quarter's lackluster results. As a warning sign, analyst current estimates are down sharply from what they were in October.


That could set stocks up for more volatility following a week of sharp gains that put the Standard & Poor's 500 index <.spx> on Friday at the highest close since December 31, 2007. The index also registered its biggest weekly percentage gain in more than a year.


Based on a Reuters analysis, Europe ranks among the chief concerns cited by companies that warned on fourth-quarter results. Uncertainty about the region and its weak economic outlook were cited by more than half of the 25 largest S&P 500 companies that issued warnings.


In the most recent earnings conference calls, macroeconomic worries were cited by 10 companies while the U.S. "fiscal cliff" was cited by at least nine as reasons for their earnings warnings.


"The number of things that could go wrong isn't so high, but the magnitude of how wrong they could go is what's worrisome," said Kurt Winters, senior portfolio manager for Whitebox Mutual Funds in Minneapolis.


Negative-to-positive guidance by S&P 500 companies for the fourth quarter was 3.6 to 1, the second worst since the third quarter of 2001, according to Thomson Reuters data.


U.S. lawmakers narrowly averted the "fiscal cliff" by coming to a last-minute agreement on a bill to avoid steep tax hikes this weeks -- driving the rally in stocks -- but the battle over further spending cuts is expected to resume in two months.


Investors also have seen a revival of worries about Europe's sovereign debt problems, with Moody's in November downgrading France's credit rating and debt crises looming for Spain and other countries.


"You have a recession in Europe as a base case. Europe is still the biggest trading partner with a lot of U.S. companies, and it's still a big chunk of global capital spending," said Adam Parker, chief U.S. equity strategist at Morgan Stanley in New York.


Among companies citing worries about Europe was eBay , whose chief financial officer, Bob Swan, spoke of "macro pressures from Europe" in the company's October earnings conference call.


REVENUE WORRIES


One of the biggest worries voiced about earnings has been whether companies will be able to continue to boost profit growth despite relatively weak revenue growth.


S&P 500 revenue fell 0.8 percent in the third quarter for the first decline since the third quarter of 2009, Thomson Reuters data showed. Earnings growth for the quarter was a paltry 0.1 percent after briefly dipping into negative territory.


On top of that, just 40 percent of S&P 500 companies beat revenue expectations in the third quarter, while 64.2 percent beat earnings estimates, the Thomson Reuters data showed.


For the fourth quarter, estimates are slightly better but are well off estimates for the quarter from just a few months earlier. S&P 500 earnings are expected to have risen 2.8 percent while revenue is expected to have gone up 1.9 percent.


Back in October, earnings growth for the fourth quarter was forecast up 9.9 percent.


In spite of the cautious outlooks, some analysts still see a good chance for earnings beats this reporting period.


"The thinking is you need top line growth for earnings to continue to expand, and we've seen the market defy that," said Mike Jackson, founder of Denver-based investment firm T3 Equity Labs.


Based on his analysis, energy, industrials and consumer discretionary are the S&P sectors most likely to beat earnings expectations in the upcoming season, while consumer staples, materials and utilities are the least likely to beat, Jackson said.


Sounding a positive note on Friday, drugmaker Eli Lilly and Co said it expects profit in 2013 to increase by more than Wall Street had been forecasting, primarily due to cost controls and improved productivity.


(Reporting By Caroline Valetkevitch; Editing by Kenneth Barry)



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Letter From Washington: U.S. Fiscal Talks Made No One Look Good







WASHINGTON — A grand fiscal bargain, with perhaps $2 trillion more in deficit reduction over 10 years — more than a quarter of which would be additional revenue, with much of the rest obtained through well-crafted, significant cutbacks in big-ticket entitlements — could have been a win-win for Republicans and Democrats.




Along with terminating the high-end Bush tax cuts, this would have earned lawmakers public approbation for working together and given investor and business confidence a boost.


The corollary is the small-bore deal cobbled together to avoid the so-called fiscal cliff, which may be a lose-lose for both sides. Defying political physics, the White House and congressional Republicans emerged politically weaker and facing more trouble ahead.


President Barack Obama, who Republicans acknowledged had all the leverage in the latest round, could have hung tough and persevered with one goal: the bigger deal. Indisputably, Democrats got much more than Republicans. Yet even with this unusual leverage — without a deal, taxes would have increased for everyone — the Democrats got only about 60 percent of what the House speaker, John A. Boehner, had once been willing to give on taxes.


Republicans reinforced their image as protectors of the privileged. In the House of Representatives, which they control, they displayed dysfunction remarkable even by Washington standards. With bigger fights ahead over the debt ceiling and indiscriminate across-the-board spending cuts, the problems outweigh the possibilities for both sides.


The estate tax epitomizes this state of affairs. It is assessed on fewer than 1 percent of the wealthiest estates. Michael J. Graetz, a former Treasury official in the administration of President George H.W. Bush who has written a book on the subject, says that with huge deficits and worsening income inequality, “it is amazing that our political system cannot maintain an estate tax that contributes less than 1 percent of federal revenues from those Americans best able to afford it.”


Lawrence H. Summers, a former Treasury secretary, once observed, “There is no case other than selfishness” for cutting the estate tax.


There are legitimate debates about the effect on economic growth of tax rates on capital gains, dividends or corporate income. It’s tough to find a serious economist who makes that case for the estate tax; years ago, the conservative economist Irwin M. Stelzer described a low tax as “affirmative action” for wealthy heirs.


Still, reducing or eliminating the estate tax was a top priority for Republicans in this latest round. The White House essentially caved to a measure that will cost about $100 billion over 10 years and will benefit fewer than 5,000 wealthy estates.


In the 2010 year-end tax-cut deal, the Obama administration insisted on extending the refundable tax credits for the poor; resistant Republicans said they would go along only if the White House accepted two years of lower estate-tax rates. Agreed. This time, however, the refundable credits for the poor were extended only temporarily, while the more generous estate-tax provision is permanent.


The political appeal here is to reward big campaign contributors; that matters to Democrats as well as Republicans. When Vice President Joseph R. Biden Jr., in the private bargaining, argued for a tougher provision, the Senate Republican leader, Mitch McConnell, asked that it be put to a vote. The vice president knew that Democrats like Senators Max Baucus of Montana and Mary Landrieu of Louisiana would side with the rich heirs.


Lawmakers are braced for a tougher battle in the next two months over the debt ceiling and across-the-board spending cuts that neither side likes. Republicans contend that, unlike with the fiscal cliff — the package of tax increases and spending cuts that had been set to take effect with the new year — this time they have the leverage to force the president to accept big spending cuts, particularly of big-ticket entitlements.


House Republicans insist on the “Boehner rule,” that any increase in the debt ceiling be matched by a comparable reduction in spending. That isn’t realistic: The debt ceiling will have to be increased by almost $2 trillion over the next two years, and spending cuts of that order would be politically and economically disastrous. The speaker’s ability to maneuver may be limited, though. On the fiscal deal, his own majority leader and whip deserted him, as did seven current committee chairmen and almost two-thirds of his caucus.


Tougher still is the substance. House Republicans are all for big spending cuts, though other than some easy ones, including going after programs for the poor, they duck specifics.


They are fierce deficit hawks in principle, yet when specific cuts to Medicare, a health insurance program for the elderly, or Social Security, a retirement fund, are raised, they turn into pacifists.


And the president, who wouldn’t play for keeps when he had the leverage, vows this time will be different. He won’t negotiate over the debt ceiling; that would be tantamount, he proclaims, to negotiating with terrorists.


Mr. Obama demands that any spending cuts be accompanied by revenue increases.


He correctly notes that there already has been more than twice as much in spending cuts as in tax increases and that any subsequent action that involves only cuts would run counter to the recommendations of bipartisan panels like the 2010 commission headed by Alan K. Simpson, a former Republican senator, and Erskine Bowles, a former White House chief of staff under Bill Clinton. Republicans dismiss that as a nonstarter.


The bottom lines: The White House believes Republican leaders privately realize that holding the nation’s full faith and credit hostage to cutting popular programs is a loser. Congressional Republicans dismiss Mr. Obama’s lines in the sand, saying that he invariably backs down and that any economic fallout ultimately hurts his presidency.


Both points are persuasive.


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RIM unveils a new BlackBerry phone! (But it’s only a Curve for T-Mobile running BlackBerry 7)






Research In Motion (RIMM) on Thursday took the wraps off a brand new BlackBerry smartphone — but it’s not the kind of smartphone BlackBerry fans have been waiting more than a year for. Instead, it’s a low-end BlackBerry Curve 9315 that will launch later this month on T-Mobile. The phone features the BlackBerry 7.1 operating system, a 3.2-megapixel camera, microSD memory expansion and a full QWERTY keyboard, and it will launch on January 23rd… just seven days before RIM unveils its first BlackBerry 10 phones. Pre-sales for the Curve 9315 begin on January 16th and the phone will cost $ 49.99 out of pocket plus a $ 10 payment each month as part of Equipment Installment Plan. T-Mobile’s full press release follows below.


[More from BGR: ‘iPhone 5S’ to reportedly launch by June with multiple color options and two different display sizes]







BlackBerry Curve 9315 Smartphone Introduced By T-Mobile and RIM


[More from BGR: RIM teases BlackBerry 10 launch with image of first BB10 smartphone]


T-Mobile’s most affordable BlackBerry smartphone provides productivity tools and features to keep customers connected


BELLEVUE, Wash. and WATERLOO, ON – Jan. 3, 2013 – T-Mobile USA, Inc. and Research In Motion (RIM) (NASDAQ: RIMM; TSX: RIM) today announced the most affordable BlackBerry® smartphone on T-Mobile’s nationwide network – the BlackBerry® Curve 9315. Powered by the BlackBerry® 7.1 operating system with 3G connectivity, the sleek new smartphone is easy-to-use and provides tools that enable customers to stay connected to the people and information that matter most.


“At T-Mobile, our goal is to delight customers. The new BlackBerry Curve 9315 will delight customers with unprecedented value while also allowing them to combine their mobile business and personal use in one great device,” said Brad Duea, senior vice president of product management at T-Mobile. “The Curve 9315 is the most affordable BlackBerry smartphone on our nationwide network and provides our customers with a wide variety of productivity and social features to keep them connected and make their mobile lives easier.”


“We’re pleased to work with T-Mobile to bring the BlackBerry Curve 9315 to customers,” said Richard Piasentin, managing director for the U.S. at Research In Motion. “The Curve 9315 is designed to make it incredibly easy to stay connected with friends, family and coworkers and will be popular with customers upgrading to a smartphone for the first time, as well as existing Curve customers looking for a step up in speed and functionality.”


Combining an intuitive interface with a QWERTY keyboard, the BlackBerry Curve 9315 features built-in Wi-Fi® connectivity for voice and data, enabling customers to access the information they need when and where they need it, and Wi-Fi calling, allowing calls and messages over an available Wi-Fi network. With a dedicated BlackBerry® Messenger (BBM™) key, preloaded apps for Facebook® and Twitter® and the Social Feeds 2.0 app, customers can easily interact with their friends, coworkers and social networks whether it’s instant messaging, posting or tweeting.


The new BlackBerry Curve 9315 offers a 3.2-megapixel camera with LED flash and digital zoom as well as video recording capabilities. Customers also have the ability to geo-tag the location of their pictures by utilizing the smartphone’s built-in GPS. In addition, the smartphone features a microSD card slot for up to 32GB of additional media storage and a built-in FM radio letting customers tune in to local FM stations. With the BlackBerry App World™ storefront, customers have exclusive access to a wide range of apps, allowing them to enhance their smartphone experience with entertainment, personalization and productivity apps of their choosing.


The BlackBerry Curve 9315 will be available in an exclusive pre-sale for T-Mobile business customers beginning January 16 and is expected to be available in T-Mobile retail stores, via http://www.T-Mobile.com, and with select dealers and national retailers beginning January 23, 2013. For well-qualified customers, the Curve 9315 will require a $ 49.99 out-of-pocket down payment and 20 equal monthly payments of $ 10 per month via T-Mobile’s Equipment Installment Plan (EIP)1, with a two-year service agreement and qualifying T-Mobile Value voice and data plan. Customers may also purchase the Curve 9315 for $ 49.99 after a $ 50 mail-in rebate card, with a two-year service agreement and qualifying T-Mobile Classic voice and data plan.2



This article was originally published by BGR


Gadgets News Headlines – Yahoo! News




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Lady Mary Set to Wed as Third Season of Downton Abbey Premieres (Photo)















01/06/2013 at 11:00 AM EST







Lady Mary (Michelle Dockery) on her wedding day from Downton Abbey season 3


Carnival Films and Television Limited for Masterpiece


It looks like Lady Mary will finally make a fetching and stylish bride.

New photos posted by EW.com show Mary in her wedding gown as she is set to marry distant cousin – and heir to the family's fortune – Matthew Crawley (Dan Stevens) in the third season of Downton Abbey, which returns to American television on Sunday night (9 p.m. ET) on PBS.

The show's costume designer, Caroline McCall, went all out for the bride's period wedding ensemble, making it what EW says is the show's most expensive outfit to date. A vintage veil will be anchored on Mary's head by a 45-carat floral diamond tiara, valued at $200,000, from U.K. jeweler Bentley & Skinner.

"I wanted her wedding dress to have a bit of softness," said McCall. "I wanted her to look really romantic, really elegant."

The crème long-sleeved wedding gown features rice pearls and Swarovski crystals, and took eight-weeks to create. Mary, played by British actress Michelle Dockery, carries a presentation bouquet of white Calla lilies to complete her nuptial look.

Season 3 will also feature Shirley MacLaine, who plays Lady Cora's mother Martha Levinson and arrives from America to add a bit of Yankee spark to the cast.

The show has been nominated for a Golden Globe award for outstanding performance by an ensemble in a drama series.

Lady Mary Set to Wed as Third Season of Downton Abbey Premieres (Photo)| Weddings, Downton Abbey, Downton Abbey, TV News, Dan Stevens, Elizabeth McGovern, Michelle Dockery

From left: Lady Mary (Michelle Dockery), Lady Grantham (Elizabeth McGovern), Lady Edith (Laura Carmichael) and Lady Sybil (Jessica Brown-Findlay)

Carnival Films and Television Limited for Masterpiece

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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..