Venezuela postpones inauguration for cancer-stricken Chavez

CARACAS (Reuters) - Venezuela will postpone the inauguration of President Hugo Chavez for a new term due to health problems, the government said on Tuesday, another sign the socialist leader's cancer may be bringing an end to his 14 years in power.

The 58-year-old former soldier who has dominated the South American OPEC nation since 1999 has not been heard from since surgery on December 11 in Cuba - his fourth operation since he was diagnosed with an undisclosed type of cancer in June 2011.

The announcement outraged opposition leaders who insist that Chavez must be sworn in before the National Assembly on January 10 as laid out in the constitution, or temporarily step aside and leave an ally in power.

"The commander president wants us to inform that, based on his medical team's recommendations, the post-operative recovery should extend past January 10," said Vice President Nicolas Maduro, Chavez's chosen successor, in a letter read to the legislature.

"As a result, he will not be able to be present at the National Assembly on that date."

The letter said authorities would seek another date for the inauguration ceremony but did not say when it would take place or give a time frame for Chavez's return from Havana.

Rather than being sworn in by the legislature, he would take his oath at a later date before the Supreme Court, the letter said, as allowed by the constitution.

Government leaders insist Chavez is completely fulfilling his duties as head of state, even though official medical bulletins say he has a severe pulmonary infection and has had trouble breathing.

The government has called for a massive rally outside the presidential palace on Thursday, and allied presidents including Uruguay's Jose Mujica and Bolivia's Evo Morales have confirmed they will visit Venezuela this week despite Chavez's absence.

Argentine President Cristina Fernandez has announced plans to visit Chavez in Havana on Friday.

But the unprecedented silence by the president - famous for regularly speaking for hours in meandering broadcasts - has left many convinced he could be in his last days.

His resignation or death would upend politics in the oil-rich nation, where he enjoys a deity-like status among poor supporters thankful for his social largesse.

His critics call him a fledgling dictator who has squandered billions of dollars from crude sales while dashing the independence of state institutions.

CONSTITUTION DISPUTE

The constitution does not specify what happens if the president does not take office on January 10.

The Supreme Court, controlled by Chavez allies, called a news conference for Wednesday. It is widely expected to announce an interpretation of the constitution that will give Chavez leeway to take office when he is fit to do so.

If he dies or steps aside, new elections would be called within 30 days. Before leaving for Havana in December, the president instructed his supporters to back Maduro in that vote if he were unable to continue.

Opposition leaders argue that Congress chief and Chavez ally Diosdado Cabello should take over, as mandated by the constitution if the president's absence is formally declared.

Cabello has ruled that out, saying the president continues to be in charge.

"Who could have believed the opposition would be screaming for Diosdado Cabello to be given the presidency of the republic?" he said during a rambunctious session of Congress. "That's crazy, the opposition is losing it."

Meanwhile opposition deputies accused the Socialist Party of failing to follow Chavez's instructions - a scene that would have been unimaginable before Chavez's prolonged absence.

"President Chavez is the only one among you who has spoken clearly," said opposition leader Julio Borges.

He was drowned out by pro-Chavez deputies clapping and chanting the socialist leader's name and rebuffed by Cabello, who had long been considered a potential successor to Chavez until he was passed over for Maduro.

"It's not my fault you weren't chosen, don't take your frustration out on me," Borges quipped.

Another opposition deputy complained that during the debate a copy of the constitution was thrown across the chamber from the direction of the Socialist Party's deputies.

Chavez's supporters have held near-daily vigils for his recovery, while opposition activists accuse the president's allies of a Cuban-inspired manipulation of the situation.

Maduro has taken over the day-to-day running of the government and looks set to continue in the role past Thursday.

The mustachioed former bus driver lacks Chavez's charisma, but he has sought to imitate the president's style with vituperative attacks on the opposition and televised ribbon-cutting ceremonies.

With the micro-managing Chavez away, major policy decisions in Venezuela, such as a widely expected devaluation of the bolivar currency, appear to be on hold.

Venezuelan bond prices, which had soared in recent weeks on Chavez's health woes, dipped on Monday and Tuesday as investors' expectations of a quick government change apparently dimmed.

"The 'regime change' euphoria seems excessive taking into account the unclear legal transition and perhaps, more importantly, the risk that regime change does not allow for policy change," New York-based Jefferies' managing director Siobhan Morden said in a note on the bonds.

(Editing by Daniel Wallis and Eric Beech)

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Malaysian manhunt on as escape drama spices up

KUALA LUMPUR: Seven Malaysians who escaped police custody this week did so by temporarily blinding a guard with chilli powder hidden in one of the escapee's underpants, police and press reports said Wednesday.

The escape Monday of the seven men -- whom police have called "dangerous criminals" -- has prompted a large-scale manhunt in the northern Malaysian state of Penang.

But the seven escapees remained at large after their daring break-out from a police van as they were being transported to a local court.

The detainees had staged a fight in the vehicle, prompting its driver to pull over, police said.

When the police opened the rear door to investigate, "they threw chilli powder on a policeman", Abdul Rahman Ibrahim, a local police official, told AFP, as other detainees attacked and injured his fellow guards.

Abdul Rahman declined to elaborate on the use of the spices, but press reports have said one of the men had concealed the chilli powder in his underwear.

Chilli powder is ubiquitous in Malaysia, which is known for its spicy cuisine.

The seven fugitives then sped off in the police van, which was later found abandoned in a nearby village, police have said.

Some 250 police officers aided by tracker dogs and a police helicopter were scouring the area near where the van was discarded, said Abdul Rahim Hanafi, Penang's state police chief.

"The escapees are dangerous criminals who have been charged with serious offences, including murder, gang robbery and causing grievous hurt," he was quoted as saying by The Star newspaper.

Police were investigating how the detainees had obtained the chilli powder.

The Star quoted an unnamed source saying the powder could have been from the spicy seasoning sachets found in instant noodle packets that are sometimes provided to detainees by family members during visits.

- AFP/al

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Guns fall silent on LoC

JAMMU: The Line of Control in Jammu and Kashmir was calm on Wednesday morning after overnight clashes between Indian and Pakistan troops, military officials said.

Pakistani guns fell silent in Krishnaghati sector in Poonch district, even as the Indian Army stepped up vigil all along the ​Line of Control (LoC) after Pakistani troops entered Indian territory and killed two Indian soldiers Tuesday.

On Tuesday evening, the Pakistani army opened fire on Indian posts in Krishnaghati sector, about 230 km from Jammu. The losses, if any, were not immediately known.

Indian officials accused the Pakistani soldiers of mutilating one of the two dead soldiers besides wounding a third Tuesday.

Islamabad says it was not involved in the attack, suggesting it could be the work of separatist militants.

Military sources said the Indian Army was prepared to give a "calibrated response" to any further provocation from Pakistan.

"There was heavy firing from the Pakistani side last night. We offered calibrated response and the guns fell silent by midnight," an army officer told IANS Wednesday morning.

"At the moment the LoC is calm," he added.

The LoC divides the Kashmir region between India and Pakistan. New Delhi controls the southern two-third of Kashmir and Islamabad the northern third.

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Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Meet Obama's Defense Secretary Nominee

President Obama nominated former Senator Chuck Hagel as the next U.S. secretary of defense. To those who haven't followed the Senate closely in the past decade, he's probably not a household name.

Hagel is a former GOP senator from Nebraska and Purple-Heart-decorated Vietnam veteran, but he wouldn't necessarily be a popular pick with Republicans in Congress.

At age 21, Hagel and his brother Tom became the next in the family to serve in the United States Army. They joined the masses of Americans fighting an unfamiliar enemy in Vietnam.

In his book, he describes finding himself "pinned down by Viet Cong rifle fire, badly burned, with my wounded brother in my arms."

"Mr. President, I'm grateful for this opportunity to serve our country again," Hagel said after Obama announced his nomination Monday.

In 1971, Hagel took his first job in politics as chief of staff to Congressman John Y. McCollister, a position he held for six years. After that, he moved to Washington for the first time, where he went on to work for a tire company's government affairs office, the 1982 World's Fair and in 1981, as Ronald Reagan's Deputy Administrator of the Veterans Administration.

Obama Taps Sen. Chuck Hagel for Defense Secretary Watch Video

Sen. Chuck Hagel's Defense Nomination Draws Criticism Watch Video

Obama's Defense Nominee Chuck Hagel Stirs Washington Lawmakers Watch Video

He worked in the private sector for most of the 80s and 90s before his first election to the Senate in 1997.
Since the turn of the century, Hagel has followed a curvy path of political alliances that puts his endorsements all over the map. Hagel's record of picking politically unpopular positions could be a large part of why Obama is naming him for the job, as Slate's Fred Kaplan surmises the next Defense secretary will be faced with tough choices.

In 2000, he was one of few Republican senators to back Sen. John McCain over then-presidential-candidate George W. Bush.

After that election, Hagel fiercely criticized Bush for adding 30,000 surge troops to Iraq, in place of the bipartisan Iraq Study Group's proposal of a draw-down and regional diplomacy, which Hagel preferred. When Bush instead announced that more troops would go to Iraq, Hagel co-sponsored a nonbinding resolution to oppose it, along with then-Sen. Joe Biden, D-Del.

"The president says, 'I don't care.' He's not accountable anymore," Hagel told Esquire in June 2007. "He's not accountable anymore, which isn't totally true. You can impeach him, and before this is over, you might see calls for his impeachment. I don't know. It depends how this goes."

Hagel's fierce opposition to America's involvement in Iraq – he called it one of the five monumental blunders of history, on par with the Trojan War – will be of substantial importance as the Obama administration charts our course out of Afghanistan, deciding how to withdraw the last of the troops in 2014 and how much of a presence to leave behind.

Hagel's support for McCain, which was substantial in his competition against Bush, disappeared in the 2008 election. Hagel toured Iraq and Afghanistan with Obama during his first campaign for the presidency.

In October 2008, Hagel's wife, Lillibet, announced her support for the Obama team, after the Washington Post reported on her donations to his campaign. She donated again in 2012.

Before the 2008 election, Hagel wrote: "The next president of the United States will face one of the most difficult national security decisions of modern times: what to do about an Iran that may be at the threshold of acquiring nuclear weapons."

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In India, questions over decision to treat rape victim overseas

NEW DELHI (Reuters) - The decision to fly the victim of a gang rape that outraged India for treatment in Singapore made little medical sense as the woman was so severely injured that her death was all but inevitable, doctors say.

The government, on the back foot after furious street protests and stinging criticism of authorities over the December 16 rape in the capital, New Delhi, has struggled to defend its decision to send the 23-year-old physiotherapy student overseas. She died 48 hours later.

With a deadly infection seeping into her blood from damage done to her intestines during the assault, complicated by a cardiac arrest and damage to the brain, she was just clinging to life when she was flown 2,500 miles from New Delhi to Singapore late on December 26, doctors said.

"It was ethically and morally wrong to have taken her out, given that she was sinking and her chances of survival were next to zero at that stage," said a doctor at New Delhi's All India Institute of Medical Sciences (AIIMS), which was advising the team treating the woman at a sister hospital across the street.

"Such a thing raises false hopes in the minds of the family, the community. No doctor in his right mind would do this, unless you want to get the patient off your back," said the doctor, who declined to be identified, saying colleagues at the government-run hospital who had spoken out had been warned of consequences in what has become a politically explosive case.

The woman, who was assaulted by five men and a teenager on a moving bus after a male companion was beaten unconscious, cannot be named under an Indian law that prohibits identifying victims of rape.

Another doctor who was consulted during the woman's care at New Delhi's Safdarjang hospital, where she was taken following the assault, said she had been getting the best possible treatment in India and the question of why she was shifted should be answered by the government.

Many security officials have said they feared the protests would escalate if the woman had died in New Delhi, but the government has said the only consideration was her wellbeing.

"The idea was to give her the best possible treatment," said Harish Rawat, a government minister who attended a cabinet meeting on the woman's condition and the efforts to save her.

"I don't think the idea was to run away from the problem. Death here or death abroad would still have the same impact," he said. "We felt if there was a chance to save her, it should be tried. Take her to a transplant facility abroad."

At the time of the transfer, authorities at Safdarjang said her condition was critical which was why they decided to move her to Singapore's Mount Elizabeth Hospital, which specialized in multi-organ transplant.

But a transplant for her damaged intestine, if at all possible, was months away, doctors said. At the time of her transfer, the woman, unconscious since a heart attack the previous night, was in no condition to go through such an operation.

"One cannot think about intestinal transplant at this moment," Samiran Nundy, the head of surgical gastroenterology and organ transplantation at the Ganga Ram Hospital in New Delhi, was quoted as saying in newspapers.

"First, the infection spreading in her should be stopped, then one can think about transplant."

Within 40 hours of her arrival in Singapore, doctors called her family and told them the end was near, even as millions prayed at home in the hope that she would pull through.

"Sepsis followed by cardiac arrest is a terminal event in 99 percent of cases," said the doctor at AIIMS, referring to blood infection.

"Doctors will have anecdotal evidence about one or two cases in their whole career of somebody who survived. I had one case, a woman, but she too died within a month. Yes, miracles happen, but you were not looking at one in this case. It was clear to everyone, especially after the cardiac arrest."

PROTESTS AND PANIC

Piecing together the events leading up to her death tells a tale of authorities in Delhi trying to defuse public anger over the attack by initially insisting that she was getting the best possible treatment, and then, as things began to go wrong, getting increasingly worried that the protests that tapped a deep vein of frustration, could spin out of control.

The alarm bells for the government rang late on Christmas night when the woman suffered the cardiac arrest. That was nine days after she was brought in to Safdarjang hospital in a life-threatening condition after the brutal assault - she was assessed then as 5 on a scale in which 6 is rated as no chance of survival.

After the heart attack, her pulse rate became critically low. Doctors resuscitated her after three to four minutes but by then she had become unconscious, caused by lack of blood to the brain. She never regained consciousness from that point on.

Equally worrisome, the infection from her injured intestines had seeped into her blood and was spreading to her vital organs.

For the government, shaken by the scale and intensity of the protests that focused on the lack of safety in the capital for women, the deterioration in her health was cause for concern.

Even as the federal cabinet met the next morning, arrangements to fly the woman for treatment in Singapore were being put in place.

One official said the public mood was so fragile that the government felt that if she died in India, some people would have blamed the government for not sending her abroad for treatment.

"You can argue this the other way. They would have said 'if Sonia can go abroad, why not this girl'," the official said, referring to the head of the ruling Congress party, Sonia Gandhi, who travels abroad for treatment of an undisclosed condition.

Outside the prime minister's office where the cabinet met, thousands of baton-wielding police including crack members of Rapid Action Force kept the area under a lockdown. Days earlier, pitched battles broke out between hundreds of protesters and police at the scene, in which a policeman was killed.

Protesters had climbed the walls of South and North Block, the high-security seat of government, while others swarmed towards the iron gates of the presidential palace. They carried placards such as "The only two women safe in Delhi are Sonia Gandhi and Sheila Dikshit". Dikshit is the chief minister, the top elected official of the local government of Delhi.

A government official privy to the handling of the protests said the administration had not anticipated that so many students would come out onto the streets and that the protests would last for so many days.

But when protesters showed up at the presidential palace, the line had been crossed in the security agencies' mind.

"It was a near-breach of security at the presidential palace. The officials tasked with security didn't know how to control the protesters, if they had jumped over its gates. Would you fire at the students, the housewives?" the official asked.

The Intelligence Bureau, which coordinates all domestic intelligence, had been warning that the public mood may turn uglier, the official said.

NO PASSPORTS

At Safdarjung on the morning of December 26, a team of doctors arrived from Medanta Medicity, a private medical centre which runs an air ambulance service. Their mandate was to assess whether she could survive the airlift, said Dr Yatin Mehta, head of critical care at Medicity.

"The decision was to take her out of the country. Our job was to determine whether she could take the airlift, not whether she should be going or not," said Mehta, who accompanied the woman on the flight.

He said the option of sending her to Cambridge in Britain to a hospital that specializes in transplants, was considered but dropped because it would have involved a refueling stop for the aircraft and a two-hour road trip upon landing in London.

Flying her to the Canadian city of Toronto, which also has a specialized organ transplant centre, was also vetoed. They zeroed in on Singapore, six hours flying time away.

It is highly unusual for someone to be flown out of India for critical care. If anything, the traffic is the reverse, with people travelling to the country for treatment.

In the event, the transfer to Singapore was successful, Mehta said, although the woman suffered a drop in blood pressure during the flight. "We were prepared for that. We handed her over to Mount E in the same condition she left the hospital in Delhi," he said, referring to the Singapore hospital.

The woman's family first got wind of the plan to transfer her at hospital in Delhi, when her brother noticed a flurry of activity and a staff member said that doctors were considering moving her.

"We accepted the decision. We were not interfering in the treatment. The doctors said it was in the best interest of our sister, we accepted it. Our only condition was to save her," the brother told Reuters.

Shortly afterwards, officials from the foreign ministry arrived and issued the family travel documents, since none of them had a passport. Their pictures were taken at the hospital.

Three ambulances arrived at the hospital. One of the ambulances headed into the interior of the city and another took the route to the Medanta centre, followed by a convoy of television crews.

A third, carrying the woman, sped away to a special section of Delhi airport, giving everyone the slip.

After she was taken to Singapore, authorities in the city-state's Mount Elizabeth Hospital were frank about her bleak chances for survival.

"The patient is currently struggling against the odds, and fighting for her life," Chief Executive Officer Kelvin Loh said in a statement a day after she was admitted.

"Our medical team's investigations upon her arrival at the hospital yesterday showed that in addition to her prior cardiac arrest, she also had infection of her lungs and abdomen as well as significant brain injury."

Later that day, Soh said her condition was deteriorating.

Her family was told the end was near.

"We didn't expect her to go so quickly," said her brother, who was with her when she died. "At 9:30 p.m., the doctors called us in and said they were sorry, they couldn't do anything more. Her vital organs were failing."

"We went inside and stayed with her the whole night. We saw her heart beat slowing down on the machine. It kept dropping and then dropped to zero. The time was 4:05 a.m."

(Additional reporting by Rajesh Kumar Singh in New Delhi and Kevin Lim in Singapore; Editing by Robert Birsel and Raju Gopalakrishnan)

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Private newspapers in Myanmar gearing up for the daily grind

YANGON: Private newspapers in Myanmar are gearing up to publish dailies for the first time, after authorities indicated they would begin issuing such licences in April.

Currently, only state-owned newspapers are allowed to publish dailies -- private ones are restricted to weeklies.

But observers caution that the still under-developed Myanmar economy might prove a challenge for private dailies.

There was a time when journalists from private newspapers like The Myanmar Times had to subject their reports to government censorship before the papers could be sent to the printers. But that changed last August, when authorities began reforming Myanmar's media regulations.

Geoffrey Goddard, senior editor of The Myanmar Times, said: "It was the curse of our professional lives and there was much celebration in the fourth estate when the decision was made by the government as part of the reform process to end pre-publication censorship."

Now, the government has indicated it will further liberalise the media sector -- by allowing applications for private daily licences as early as next month.

Mr Goddard added: "What we are eagerly looking forward to is the granting of licences to publish daily. That's the next big challenge for us and other newspapers in Myanmar."

The Myanmar Times has shown an interest in getting the license. But as with the rest of the world, the dailies have to contend with the onslaught of the online media. Currently, the Myanmar internet infrastructure might still be in the 90s, but it is expected to get up to speed soon.

There are more than 300 private weekly journals currently being published in Myanmar -- less than five are in English.

While many are excited at the prospect of publishing daily, observers doubt the viability of private dailies, given the country's under-developed economy.

Myo Aung, managing director of Success International Distributor, said: "Compared to neighbouring countries, our advertising budget is not very big. Most are local products. They advertise in magazines, journals and newspapers.

"But we hope that the government allows foreign investors to invest here. If foreign investors, and foreign firms and foreign expertise are here, I think our advertising scenario will also change very soon."

The government has already allowed foreign dailies to be distributed in the country.

And with the three state-controlled dailies currently having a circulation of 2.5 million copies a day, it will be a tough environment for upcoming private ones to compete in.

-CNA/ac

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Jharkhand cabinet recommends dissolution of assembly

RANCHI: The Jharkhand cabinet on Tuesday recommended the dissolution of the state assembly a day after Jharkhand Mukti Morcha (JMM) withdrew its support to the BJP-led government, said an official.

The cabinet meeting was attended by ministers from the BJP, All Jharkhand Students Union and Janata Dal-United. JMM ministers did not attend the meeting, said the official in the chief minister's office.

The cabinet's decision comes ahead of JMM presenting the letter of withdrawal of support to the governor.

The withdrawal of support on Monday has reduced the state government to a minority in the 82-member assembly.

Relations between JMM and BJP have been strained ever since chief minister Arjun Munda denied there was an agreement between the two parties on sharing the chief minister's post.

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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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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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