Holmes Played Childish Games After Aurora Carnage

As police confronted the movie theater carnage and a massive booby trap left behind by accused Aurora gunman James Holmes, the suspect loopily played with hand puppets, tried to stick a metal staple in an electrical socket and clamly flipped a styrofoam cup, according to court testimony today.

Holmes, 25, displayed the bizarre behavior once he was in custody and taken to Aurora police headquarters after the shooting that left 12 people dead and dozens injured, the lead investigator in the case testified today.

While being cross examined by Colorado public defender Daniel King, Police Detective Craig Appel was asked about the observations of two Aurora officers assigned to watch over Holmes in an interrogation room.

Appel said that to preserve possible gunshot residue, police had placed paper bags over Holmes' hands. One officer, King said, noted in a report that Holmes began moving his hands "in a talking puppet motion."

Click here for full coverage of the Aurora movie theater shooting.

King asked if Appel was also aware that the officer "observed Holmes take a staple out of the table and tried to stick it in an electrical socket?" Appel confirmed Holmes' actions.

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The officers also noted that they watched as Holmes began playing with an empty styrofoam cup, trying to "flip it" on the table.

While Holmes was carrying out his childish antics, police were puzzling over a complex booby trap Holmes had left behind in his apartment, according to testimony.

A gasoline-soaked carpet, loud music and a remote control car were part of Holmes' plan to trick someone into triggering a blast that would destroy his apartment and lure police to the explosion while he shot up a movie theater in Aurora, Colo., according to court testimony.

FBI agent Garrett Gumbinner told the court that he interviewed Holmes on July 20, hours after he killed 12 and wounded 58 during the midnight showing of "The Dark Knight Rises."

"He said he rigged the apartment to explode to get law enforcement to send resources to his apartment instead of the theater," Gumbinner said.

His plan failed to prompt someone into triggering the bombs.

Gumbinner said Holmes had created two traps that would have set off the blast.

The apartment was rigged with a tripwire at the front door connected to a mixture of chemicals that would create heat, sparks and flame. Holmes had soaked the carpet with a gasoline mixture that was designed to be ignited by the tripwire, Gumbinner said.

"It would have caused fire and sparks," the agent said, and "would have made the entire apartment explode or catch fire."

Holmes had set his computer to play 25 minutes of silence followed by loud music that he hoped would cause a disturbance loud enough that someone would call police, who would then respond and set off the explosion by entering the apartment.

Gumbinner said Holmes also told him he rigged a fuse between three glass jars that would explode. He filled the jars with a deadly homemade chemical mixture that would burn so hot it could not be extinguished with water.

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Ex-governor in North Korea with Google chief; seeks American's release

SEOUL (Reuters) - Former New Mexico Governor Bill Richardson and Google Executive Chairman Eric Schmidt began a controversial private mission to North Korea on Monday that will include an effort to secure the release of an imprisoned American.

The trip comes after North Korea carried out a long-range rocket test last month and as, according to satellite imagery, the reclusive state continues work on its nuclear testing facilities, potentially paving the way for a third nuclear bomb test.

Footage from North Korean state television showed Richardson and Schmidt at the Pyongyang airport on Monday evening.

"We are going to ask about the American who's been detained. A humanitarian private visit." Richardson said.

Richardson's efforts to seek the release of Kenneth Bae, a Korean-American tour guide who was detained last year will mark the latest in a series of high-profile visits over the years to free Americans detained by Pyongyang.

The delegation comprised Schmidt, his daughter, Richardson and Google executive Jared Cohen, according to South Korean news media and it arrived in Pyongyang on a flight from the Chinese capital, Beijing.

The mission has been criticized by the United States due to the sensitivity of the timing. The United States does not have diplomatic relations with North Korea and the isolated and impoverished state remains technically at war with U.S. ally South Korea.

"We continue to think the trip is ill-advised," U.S. State Department spokeswoman Victoria Nuland said in Washington. Last week she said the main U.S. objection was that the trip came so soon after North Korea's much-criticized December 12 rocket launch.

South Korea is in the midst of a transition to a new president who will take office in February, while Japan, another major U.S. ally in the region, has a new prime minister.

A U.S. official said the trip's timing was particularly bad from the Obama administration's point of view because it comes as the U.N. Security Council ponders how to respond to the North Korean missile launch.

"We are in kind of a classical provocation period with North Korea. Usually, their missile launches are followed by nuclear tests," said the official, who spoke on condition of anonymity.

"During these periods, it's very important that the international community come together, certainly at the level of the U.N. Security Council, to demonstrate to North Korea that they pay a price for not living up to their obligations."

Richardson, a former ambassador to the United Nations, has made numerous trips to North Korea in the past that have included efforts to free detained Americans. The reasons for Schmidt's involvement in the trip are not clear, though Google characterized it as "personal" travel.

Schmidt did not respond to requests for comment.

Richardson told CBS television last Friday that he had been contacted by Bae's family and that he would raise the issue while in North Korea.

Pyongyang's most notable success was securing a visit from former President Bill Clinton in 2009 to win the release of two American journalists.

Last year, Jared and Schmidt met defectors from North Korea, a state that ranks bottom in an annual survey of Internet and press freedom by Reporters Without Borders.

Media reports and think tanks say that officials from the North Korean government went to Google's headquarters in 2011, something the U.S. technology giant declined to comment on.

(Additional reporting by Cho Meeyoung and WASHINGTON Bureau; Editing by Michael Perry, Ron Popeski and David Brunnstrom)

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Hagel draws fire as Obama's Pentagon pick

WASHINGTON: US President Barack Obama named Chuck Hagel on Monday to lead the Pentagon, setting up an ugly confirmation battle as Republican opponents said he was too hard on Israel and too soft on Iran.

Obama's choice of John Brennan to replace scandal-tainted David Petraeus as CIA chief was seen as more straightforward despite the counter-terrorism czar's defense of "enhanced interrogation techniques" and the US drone war.

The second term revamp of the president's national security team was expected to win ultimate approval but several leading Republicans signaled they would make it tough for Hagel even though he is one of their own.

Obama paid particular tribute to retiring Pentagon chief Leon Panetta before giving ringing endorsements to the "outstanding" Hagel and Brennan and urging the Senate not to dally in confirming their important appointments.

"Chuck Hagel is the leader that our troops deserve. He is an American patriot," the president said, heaping praise on a war hero who was awarded two Purple Heart medals for his bravery as a soldier in Vietnam.

"When Chuck was hit by shrapnel, his brother saved him. When his brother was injured by a mine, Chuck risked his life to pull him to safety. To this day, Chuck bears the scars -- and the shrapnel -- from the battles he fought in our name," Obama said.

Some Republicans have never forgiven him for his outspoken criticism of ex-president George W. Bush's handling of the Iraq war, and his closeness to the Democratic president sees him regarded by others as a traitor.

But Obama, who wants to be remembered as a leader who ended wars abroad to set about the tricky task of nation-building at home following a crippling recession, described Hagel as someone perfectly fitted to that mold.

"Maybe most importantly, Chuck knows that war is not an abstraction. He understands that sending young Americans to fight and bleed in the dirt and mud, that's something we only do when it's absolutely necessary," he said.

Administration appointments are often tense affairs in the United States as confirmation hearings provide senators with opportunities to turn away unwanted candidates or score cheap political points, or both.

Hagel, 66, known for a fiercely independent streak and a tendency to speak bluntly, is expected to get particularly rough treatment due to his criticism of America's "Jewish lobby" and opposition to some Iran sanctions.

Republican Senator Lindsey Graham said Hagel would be "the most antagonistic defense secretary towards the state of Israel in our nation's history."

Another Republican senator, John Cornyn of Texas, said he would oppose the nomination, charging it would be the "worst possible message we could send to our friend Israel and the rest of our allies in the Middle East."

But in an interview with The Lincoln Journal Star, a newspaper in his home state of Nebraska, Hagel hit back at his critics.

There is "not one shred of evidence that I'm anti-Israeli, not one vote (of mine) that matters that hurt Israel," he said.

If confirmed by the Senate, Hagel will have to manage major cuts to military spending while wrapping up the US war effort in Afghanistan and preparing for worst-case scenarios in Iran or Syria.

Serving as an enlisted man who never joined the officer ranks, Hagel carries a particular empathy for the unheralded infantry "grunts" in the field.

As he grapples with budget pressures, the former sergeant will likely try to shield frontline troops from the effect of spending cuts.

In his typical straight-shooting fashion, Hagel has called the Defense Department "bloated" and said that "the Pentagon needs to be pared down."

Obama, smarting from watching Susan Rice -- reportedly his first choice to succeed Hillary Clinton as secretary of state -- fold her bid in the face of Republican opposition, pressed hard for the Senate to approve Hagel.

"He would be the first person of enlisted rank to serve as secretary of defense. One of the few secretaries who had been wounded in war and the first Vietnam veteran to lead the department," Obama said, calling his appointment "historic."

Brennan, 57, may get an easier ride but is sure to face questions over his support for the use of certain "enhanced interrogation techniques" under the Bush administration and for his staunch defense of the US drone program.

The 25-year Central Intelligence Agency veteran, an Arabic-speaking Middle East expert, replaces Petraeus, who resigned in November after confessing to an extramarital affair with his biographer Paula Broadwell.

Obama highlighted what he called Brennan's incredible work ethic, saying "John is legendary even in the White House" and reminding everyone of a now-famous quote from August 2010.

Asked if he got any down time or was all work and no play, Brennan replied: "I don't do down time."

In a moment of levity at the White House event, the avuncular 74-year-old Panetta drew loud laughs when he said he would be retiring to his walnut farm and "dealing with a different set of nuts."

- AFP/ac

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Better drive safe, wife's watching

NEW DELHI: Drivers of Andhra Pradesh's 23,000 public transport buses are a lot more responsible now, a transformation that has happened in the past six months. That's because buses they're assigned to have photographs of their children and wife stuck on the dashboard. This step coupled with random mandatory breath analyser tests, have had a salutary effect and accidents are significantly down.

Also, the December 16 Delhi gang rape has spurred the Andhra Pradesh State Transport Corporation (APSRTC) to make state bus travel safer for women. It has started martial arts training for its 7,000-odd women conductors so that they can help prevent attacks on passengers.

On Monday, APSRTC that ferries at least 1.4 crore passengers every year, received a trophy for its impressive accident-control record from highways minister CP Joshi. In the last two years, the corporation has recorded only 0.13 and 0.11 accidents per 1lakh km. "Ever since we started the two recent initiatives to put brake on accidents, our record has improved to 0.09," APSRTC vice- chairman and managing director A K Khan, an IPS officer, said.

The idea of putting a driver's family photograph on the dashboard was implemented last July in view of the psychological impact it has on the man behind the wheel. "Every driver leaves home promising his family that he will return home safe. A soft reminder of his family motivates him to be alert. This has gone down well with the drivers," Khan said.

Booze test for Andhra drivers must

To ensure drivers aren't drunk, the Andhra Pradesh State Transport Corporation (APSRTC) has procured 300 advanced breath analyzers and tests are mandatory.

Last July, 25 drivers were sacked after they were found drunk.

"This strong message of zero tolerance to drink driving has worked," APSRTC vice-chairman and managing director A K Khan said.

APSRTC transports at least 1.2 crore passengers per day and covers 82 lakh km. It won the trophy in the mofussil category. "Over 1.47 lakh state transport undertaking buses carry about 7 crore passengers across the country. They need to ensure high levels of passenger safety," said executive director of association of STRUs U Sudhakara Rao.

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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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Poisoned Lottery Winner's Body to Be Exhumed

The body of a $1 million lottery jackpot winner will likely be exhumed from Rosehill Cemetery in Chicago, according to the Cook County medical examiner, who determined that the winner died of cyanide poisoning.

Last June Urooj Khan, 46, won $1 million in a scratch-off lottery game, or $425,000 after taxes, but he died unexpectedly on July 20. Since there were no signs of foul play or any cause for suspicion, his death was attributed to arteriosclerotic cardiovascular disease, which covers heart attacks, stroke or ruptured aneurysm.

But a few days after the death certificate was issued, a family member called the medical examiner's office and asked that the death be investigated, said Dr. Stephen Cina, Cook County's chief medical examiner. Cina said he could not disclose the identity of the family member because of the ongoing investigation.

"We are in discussion with the state attorney about whether we are going to do an exhumation. Right now, we are leaning in that direction. We have a cause and matter of death on the books, and we're comfortable with that," Cina told ABCNews.com. "If or when this goes to court, it would be nice to have all the data possible."

Illinois Lottery/AP Photo

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Cina said the final toxicology results came back in late November showing a lethal level of cyanide, which led to the homicide investigation. Melissa Stratton, a spokeswoman for the Chicago Police Department, confirmed a murder investigation had been "under way," and that the police department had been working closely with the medical examiner's office.

Khan is survived by his wife, Shabana Ansari, 32, and teenage daughter. The family owned three dry-cleaning businesses in Chicago.

Ansari told the Chicago Tribune that Khan was "the best husband on the entire planet" and "extraordinary, nice, kind and lovable."

Ansari could not be reached by ABC News for comment.

The police are not confirming whether Khan's lottery winnings played a part in the homicide.

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When asked why cyanide, a chemical asphyxiant that binds to red blood cells and prevents the entry of oxygen, was not found in the initial examination of Khan's body, Cina said, "Quite frankly, it's unusual as a cause of death, so it's not at the top of your mind."

He said about 50 percent of people can smell cyanide, but it is more noticeable when the body is opened up.

Sometimes the coloring of blood changes with cyanide poisoning after death, becoming "more reddish than purple," he said.

"In this case that wasn't particularly striking," Cina said, describing the first examination of Khan's body.

"It strangles your red blood cells at a biochemical level," he said.

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Activists wary as India rushes to justice after gang rape

NEW DELHI (Reuters) - It's no surprise the Indian street wants faster, harsher justice for sexual crimes after a horrific gang rape that rocked the nation, but some activists worry the government will trample fundamental rights in its rush to be in tune with popular rage.

Last month's rape of a physiotherapy student on a moving bus and her death on December 28 in hospital triggered a national debate about how to better protect women in India, where official data shows one rape is reported on average every 20 minutes.

Many women's rights groups are cautiously hopeful the protests and outrage that followed the crime can be channeled into real change - fast-track courts for sexual offences and a plan to hire 2,500 new women police in Delhi are measures already in the works.

But legal experts and some feminists are worried that calls to make rape punishable with death and other draconian penalties will cramp civil liberties and are unconstitutional. They say India needs better policing and prosecutions, not new laws.

"If there are not enough convictions, it is not because of an insufficiency of law, but it is the insufficiency of material to base the conviction on," said retired Delhi High Court judge R.S. Sodhi.

Five men have been charged with the student's rape and murder and will appear before a New Delhi court later on Monday. They are due to be tried in a newly formed fast-track court in the next few weeks. A teenager also accused will likely be tried in a juvenile court.

Ahead of Monday's court appearance the five still had no defense lawyers - despite extensive interrogations by the police, who have said they have recorded confessions - after members of the bar association in the South Delhi district where the case is being heard vowed not to represent them.

GROUNDS FOR APPEAL

The men will be assigned lawyers by the court before the trial begins, but their lack of representation so far could give grounds for appeal later should they be found guilty - similar cases have resulted in acquittals years after convictions.

"The accused has a right to a lawyer from point of arrest - the investigations are going on, statements being taken, it is totally illegal," said Colin Gonsalves, a senior Supreme Court advocate and director of Delhi's Human Rights Law Network.

Senior leaders of most states on Friday came out in support of a plan to lower to 16 the age that minors can be tried as adults - in response to fury that the maximum penalty the accused youth could face is three years detention.

A government panel is considering suggestions to make the death penalty mandatory for rape and introducing forms of chemical castration for the guilty. It is due to make its recommendations by January 23.

"The more you strengthen the powers of the state against the people, the more the possibility you create a draconian regime," said Sehjo Singh, Programme and Policy Director with ActionAid in India and an expert on Indian women's social movements.

"We want to raise the bar of human rights in India, we want to raise the standards, not lower them."

The Indian Express newspaper warned against "knee-jerk" reaction and said any change to the juvenile law "must come after rigorous and considered debate. It cannot be a reaction to a fraught moment".

Courts are swamped with a backlog of cases in the country of 1.2 billion people and trials often take more than five years to complete, so the launch by Chief Justice Altamas Kabir of six fast-track courts in the capital to deal with sexual offences was widely greeted as a welcome move.

Several other states including Tamil Nadu and Maharashtra are now looking at following Delhi's example.

But Gonsalves says while the courts are a good idea on paper, similar tribunals in the past delivered dubious verdicts and put financial pressure on the rest of the justice system.

FAST TRACK COURTS

India set up 1,700 fast-track courts in 2004, but stopped funding them last year because they turned out to be costly. The courts typically work six days a week and try to reduce adjournments that lead to long delays in cases.

"The record of the fast-track courts is mixed," Gonsalves said. Conviction rates rose, he said, but due process was sometimes rushed, leading to convictions being overturned.

"Fast-track courts were in many ways were fast-track injustice," he said.

The real problem lie with bad policing and a shortage of judges, Gonsalves said. India has about a fifth of the number of judges per capita that the United States has.

Indian police are often poorly trained and underpaid, and have sometimes been implicated in organized crime. Rights groups complain the mostly male officers are insensitive to victims of sexual crimes.

Resources for, and expertise in, forensic science is limited in most of the country's police forces and confessions are often extracted under duress. The judiciary complains it is hard to convict offenders because of faulty evidence.

Human Rights Watch said reforms to laws and procedures covering rape and other sexual crimes should focus on protection of witnesses and modernizing support for victims at police stations and hospitals.

The rights organization has documented the continued use of archaic practices such as the "finger test" used by some doctors on rape victims to allegedly determine if they had regular sex.

"Reforms in the rape laws - these are needed. But not in terms of enhancing punishment," said Meenakshi Ganguly, South Asia Director of Human Rights Watch.

"Why they are not investigated, why there are not enough convictions, those are the things that need to be addressed."

(Additional reporting by Satarupa Bhattacharjya, Shashank Chouhan and Annie Banerji; Editing by Alex Richardson)

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Korean sports star's suicide echoes death of actress-wife

SEOUL: Police confirmed Monday that a former baseball star and ex-husband of a top South Korean actress, whose 2008 suicide shocked the country, took his own life over the weekend.

Cho Sung-Min, a former pitcher for Japanese baseball team Yomiuri Giants, was found dead early Sunday with a belt around his neck by his girlfriend in the bathroom of her Seoul apartment.

"The autopsy result showed death due to hanging," Yonhap news agency quoted a senior police officer as saying, "We've concluded the case as suicide."

In a final text to his girlfriend, Cho had written: "Thank you for everything. Hang tough even after I am gone."

The 39-year-old was the former husband of the hugely popular actress Choi Jin-Sil, who took her own life in similar fashion in 2008, four years after their marriage ended.

Choi, who had two children with Cho, was found hanging from a length of elastic at her Seoul home.

Relatives and friends said she had been depressed since her divorce and troubled by rumours circulating on the Internet that she had caused another actor's suicide by demanding repayment of debts he owed her.

Her death shocked the country and prompted a police crackdown on cyber-bullying.

In 2010 Choi's younger brother, singer Choi Jin-Young, also hanged himself while suffering from severe depression.

Suicide is the most common cause of death among those in their 20s and 30s in South Korea, which has the highest suicide rate among member nations of the Organisation for Economic Cooperation and Development.

-AFP/fl

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Pak soldier killed, India says fired in retaliation

SRINAGAR: Pakistani troops violated ceasefire on Sunday by firing mortar shells towards Indian army posts at Hajipir area in Uri sector near the Line of Control.

"They started firing mortar shells towards our posts in Uri sector around 3.15am," an army spokesman said. He said that some shells landed close to civilian habitation though no damage was done.

The spokesman added that Indian troops responded with light weapons which stopped the Pakistani shelling.

On the other hand, Pakistan's army has accused India of crossing the LoC and raiding its check post in Bagh area on Sunday. It said Indian troops raided a military post in the Hajipir sector of Bagh area, killing a soldier and injuring another.

(With inputs from Omer Farooq from Islamabad)

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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.

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Online:

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

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

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