Wall Street slips as earnings season gets under way

NEW YORK (Reuters) - Stocks fell on Tuesday, retreating from last week's rally on the "fiscal cliff" deal in Washington, as companies started to report results for the fourth quarter.

After a 4.3 percent jump in the two sessions around the close of the fiscal cliff negotiations, the S&P has declined a bit, with investors finding few catalysts to extend the rally that took the benchmark to five-year highs.

"We had a brief respite, courtesy of what happened on the fiscal cliff deal and the flip of the calendar with new money coming into the market," said Bucky Hellwig, senior vice president at BB&T Wealth Management in Birmingham, Alabama.

Shares of AT&T Inc dropped 1.7 percent to $34.35, making it one of the biggest drags on the S&P 500, after the company said it sold more than 10 million smartphones in the quarter.

This figure beat the same quarter in 2011, but also means increased costs for the wireless service provider. Providers like AT&T pay hefty subsidies to handset makers so that they can offer discounts to customers who commit to two-year contracts.

Fourth-quarter profits are expected to beat the previous quarter's lackluster results, but analyst estimates are down sharply from October. Quarterly earnings are expected to grow by 2.7 percent, according to Thomson Reuters data. Dow component Alcoa, the largest U.S. aluminum producer, reported results after the closing bell.

The Dow Jones industrial average <.dji> dropped 55.44 points, or 0.41 percent, to 13,328.85. The Standard & Poor's 500 Index <.spx> fell 4.74 points, or 0.32 percent, to 1,457.15. The Nasdaq Composite Index <.ixic> lost 7.01 points, or 0.23 percent, to 3,091.81.

"The stark reality of uncertainty with regard to earnings, plus the negotiations on the debt ceiling, are there and that doesn't give investors a lot of reason to take bets on the long side," Hellwig said.

With AT&T's fall, the S&P telecom services index <.gspl> was the worst performer of the 10 major S&P sectors, down 2.7 percent.

Sears Holdings shares dropped 6.4 percent to $40.16 a day after the company said Chairman Edward Lampert would take over as CEO from Louis D'Ambrosio, who is stepping down due to a family member's health issue. The U.S. retailer also reported a 1.8 percent decline in quarter-to-date sales at stores open at least a year.

Markets went lower as some of the first reported earnings were weak.

"It doesn't seem to be bouncing back, it might stay here or sell off a little further," said Stephen Carl, head of U.S. equity trading at The Williams Capital Group in New York.

Shares of restaurant-chain operator Yum Brands Inc fell 4.2 percent to $65.04 a day after the KFC parent warned sales in China, its largest market, shrank more than expected in the fourth quarter.

GameStop was one of the worst performers on the S&P 500 as shares slumped 6.3 percent to $23.19 after the video game retailer reported low customer traffic for the holiday season and cut its guidance.

Shares of Monsanto Co gained 2.5 percent to $98.42 after reaching a more than four-year high at $99.99. The world's largest seed company raised its earnings outlook for fiscal year 2013 and posted strong first-quarter results.

Volume was below the 2012 average of 6.42 billion shares traded per day, as 6.19 billion were traded on the New York Stock Exchange, NYSE MKT and Nasdaq.

Declining stocks outnumbered advancing ones on the NYSE by 1,495 to 1,458, while on the Nasdaq decliners beat advancers 1,305 to 1,158.

(Reporting by Gabriel Debenedetti; Editing by Kenneth Barry and Nick Zieminski)

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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 delay has 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," Vice President Nicolas Maduro said 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, nor give any time frame for Chavez's recovery or his 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 of supporters outside the presidential palace on Thursday, and allies including Uruguayan President Jose Mujica and Bolivian leader Evo Morales have confirmed they will visit Venezuela this week despite Chavez's absence.

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.

Opposition leaders argue that Congress chief Diosdado Cabello should take over as mandated by the constitution if the president's absence is formally declared. Cabello, a close Chavez ally, has ruled that out, saying the president continues to be in charge.

"Venezuela is not a monarchy. Ours is not the Cuban system where power is passed around without an election," opposition leader Henrique Capriles, who lost to Chavez in the October presidential election, told reporters on Tuesday.

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

Vice President Maduro, who Chavez named last month as his successor, 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 rambunctious 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.

Opposition predictions of fighting within the ruling Socialist Party have not materialized, however, with Maduro and Cabello in particular pledging unity despite rumors of rivalry.

(Editing by Daniel Wallis and Eric Beech)

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Year-end Wii U sales steady, says Nintendo chief

KYOTO (Reuters) – Nintendo Co Ltd‘s year-end sales of its Wii U games console were steady, though not as strong as when its Wii predecessor was first launched, the Japanese game maker’s top executive told Reuters on Monday.

The company, which grew from making playing cards in the late 19th century into the blockbuster Super Mario video game series, is pinning its hopes on the Wii U after posting a first operating loss last year, as gamers ditch console games to play on smartphones and tablets.

“At the end of the Christmas season, it wasn’t as though stores in the U.S. had no Wii U left in stock, as it was when Wii was first sold in that popular boom. But sales are not bad, and I feel it’s selling steadily,” Nintendo President Satoru Iwata said in an interview.

Iwata gave no details on sales or forecasts, but said Nintendo needed to focus on developing attractive software for its 3DS handheld device to draw new users, and increase Wii U sales as it battles competition from popular mobile devices. The Wii U carries video content from Netflix Inc and Hulu, and has a dedicated social gaming network called Miiverse, which allows users to interact and share games tips.

Nintendo said in October it aimed to sell 5.5 million Wii U devices by end-March. Wii U, the successor to the blockbuster Wii machine, went on sale in the United States on November 18. The company later said it sold more than 400,000 of the video game consoles in the first week.

Nintendo sold 638,339 Wii U consoles in Japan between December 8 and 30, according to data from game magazine publisher Enterbrain. The company has sold nearly 100 million of the original Wii units since its launch in 2006.

Rival Microsoft Corp sold more than 750,000 of its Xbox 360 console during the Black Friday week in November – one of the busiest U.S. consumer shopping periods of the year, beating sales of both Sony Corp’s

DOUBLE CHALLENGE

Iwata acknowledged the challenge of producing two Wii U models at the same time, as most customers wanted the premium package, which sold out quickly in many places, while there was a glut of the slightly cheaper Wii U model on store shelves.

“It was the first time Nintendo released two models of the game console at the same time … and I believe there was a challenge with balancing this. Specifically, inventory levels for the premium, deluxe package was unbalanced as many people wanted that version and couldn’t find it,” he said.

Iwata noted a weaker yen would have little impact on Nintendo’s profits this fiscal year, but would positively impact its foreign denominated assets.

Nintendo’s Osaka-listed shares earlier ended down nearly 2.1 percent on Monday at 8,980 yen, and have fallen 15 percent since the Wii U was launched.

(Editing by Ian Geoghegan)

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Baby on the Way for Jensen Ackles

Mom & Babies
Celebrity Baby Blog

01/07/2013 at 06:15 PM ET

Mike Coppola/Getty

He’s hunted down demons, gone after ghosts and come face to face with ferocious monsters, but Jensen Ackles is diving into a whole new dimension: daddy duty.

The Supernatural star, 34, and his wife Danneel are expecting their first child later this year, his rep confirms to PEOPLE exclusively.

The actress, who most recently played Jenn on Retired at 35, will debut her baby bump when she accompanies Ackles — who plays Dean alongside new dad Jared Padalecki on the hit series — to the People’s Choice Awards Wednesday, where the dad-to-be is scheduled to present.

The couple tied the knot in 2010 in the actor’s hometown of Dallas, Texas.

– Anya Leon with reporting by Julie Jordan

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Organ donations fall in Germany after scandal

BERLIN (AP) — Organ donations have dropped sharply in Germany following a scandal over alleged corruption at several transplant clinics.

The German Foundation for Organ Transplantation says the number of organs donated fell almost 13 percent to 3,917 last year, the lowest figure in a decade.

Several German clinics are being investigated over allegations that doctors manipulated waiting lists to help some patients appear sicker than they were and so receive transplants sooner.

The foundation said Monday that the scandal had "massively shaken" the public's faith in the transplant system.

Some 12,000 people in Germany require organ transplants each year.

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Wall Street edges off five-year high, awaits earnings

NEW YORK (Reuters) - Stocks lost ground on Monday, as investors drew back from recent gains that lifted the S&P 500 to a five-year high, in anticipation of sluggish growth in corporate profits.

Shares of financial companies dipped after a group of major U.S. banks agreed to pay a total of $8.5 billion to end a government inquiry into faulty mortgage foreclosures. The KBW bank index <.bkx>, a gauge of U.S. bank stocks, was down 0.3 percent.

Other sectors were hit as well, most notably energy and utilities. The S&P 500 energy sector index <.gspe> fell 0.8 percent and the utilities sector <.gspu> was off 1.1 percent.

The day's decline came a session after the S&P 500 finished at a five-year high, boosted by a budget deal and strong economic data. The S&P 500 rose 4.6 percent last week, the best weekly gain in more than a year.

"It's a little bit of taking some risk off the table ahead of profit season, you're not going to see anything all that great" on earnings, said Larry Peruzzi, senior equity trader at Cabrera Capital Markets Inc in Boston.

Earnings are expected to be only slightly better than the third-quarter's lackluster results, and analysts' current estimates are down sharply from where they were in October. Fourth-quarter earnings growth is expected to come in at 2.8 percent, according to Thomson Reuters data.

Aluminum company Alcoa Inc begins the reporting season by announcing its results after Tuesday's market close. Alcoa shares fell 1.7 percent at $9.10.

The Dow Jones industrial average <.dji> dropped 50.92 points, or 0.38 percent, to 13,384.29. The Standard & Poor's 500 Index <.spx> fell 4.58 points, or 0.31 percent, to 1,461.89. The Nasdaq Composite Index <.ixic> lost 2.84 points, or 0.09 percent, to 3,098.81.

Ten mortgage servicers - including Bank of America , Citigroup , JPMorgan , and Wells Fargo - agreed on Monday to pay $8.5 billion to end a case-by-case review of foreclosures required by U.S. regulators.

In a separate case, Bank of America also announced roughly $11.6 billion of settlements with mortgage finance company Fannie Mae and a $1.8 billion sale of collection rights on home loans.

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

Bank of America shares lost 0.2 percent at $12.09 while Nationstar Mortgage Holdings jumped 16.8 percent to $38.83.

Citigroup shares were up 0.09 percent to $42.47, and Wells Fargo shares fell 0.5 percent to $34.77.

"The financials probably have the wind behind them now with a lot of the regulations coming out ... the market has to absorb a lot of the gains, and for that reason there's a pullback from this level," said Warren West, principal at Greentree Brokerage Services in Philadelphia.

Shares of U.S. jet maker Boeing Co dropped 2 percent after a Boeing 787 Dreamliner aircraft with no passengers on board caught fire at Boston's Logan International Airport on Monday morning.

Amazon.com shares hit their highest price ever at $269.22 after Morgan Stanley raised is rating on the stock. Shares were up 3.6 percent at $268.46.

Video-streaming service Netflix Inc shares gained 3.4 percent to $99.20 after it said it will carry previous seasons of some popular shows produced by Time Warner's Warner Bros Television.

Walt Disney Co stock fell 2.3 percent to $50.97. The company 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.

Volume was lower than average, as 4.78 billion shares were traded on the New York Stock Exchange, NYSE MKT and Nasdaq. This is well below the 2012 average of 6.42 billion per session.

Declining stocks outnumbered advancing ones on the NYSE by 1,629 to 1,363, while on the Nasdaq decliners beat advancers 1,438 to 1,066.

(Reporting By Gabriel Debenedetti; Editing by Kenneth Barry and Nick Zieminski)

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Five accused in India rape case charged in court

NEW DELHI (Reuters) - Five men accused of raping and murdering an Indian student were read the charges in a near-empty courtroom on Monday after the judge cleared out lawyers for bickering over whether the men deserved a defense.

The 23-year-old physiotherapy student died two weeks after being gang-raped and beaten on a moving bus in New Delhi, then thrown bleeding onto the street. Protests followed, along with a fierce public debate over police failure to stem rampant violence against women.

With popular anger simmering against the five men and a teenager accused in the case, most lawyers in the district where the trial will be held refuse to represent them.

Before the men arrived for a pre-trial hearing on Monday, heckling broke out in a chamber packed with jostling lawyers, journalists and members of the public after two of the lawyers, Manohar Lal Sharma and V. K. Anand, offered to defend the men.

"We are living in a modern society," declared Lal Sharma, defending his decision. "We all are educated. Every accused, including those in brutal offences like this, has the legal right ... to defend themselves."

One woman lawyer prodded V. K. Anand in the chest, saying: "I'll see how you can represent the accused."

Unable to restore order, presiding magistrate Namrita Aggarwal ordered everyone to leave except the prosecution, and set police to guard the entrance.

She said the trial would now be held behind closed doors because of the sensitivity of the case.

FACES COVERED

Reuters video images showed the men stepping out of a blue police van that brought them from Tihar jail and walking, their faces covered, through a metal detector into the South Delhi court building.

The court was across the street from the cinema where the victim watched a film before she was attacked on her way home.

Aggarwal gave the men copies of the charges, which include murder, rape and abduction, a prosecutor in the case told Reuters.

Police have conducted extensive interrogations and say they have recorded confessions, even though the men have no lawyers.

If the men, most of them from a slum neighborhood, cannot arrange a defense, the court will offer them legal aid before the trial begins.

Two of them, Vinay Sharma and Pawan Gupta, have offered to give evidence against the others - Mukesh Kumar, Ram Singh and Akshay Thakura - possibly in return for a lighter sentence.

Mohan, describing what he called a heinous crime, said: "The five accused persons deserve not less than the death penalty."

The case has sharpened long-standing anger against the government and police for a perceived failure to protect women.

A male friend who was assaulted with the woman on December 16 said on Friday that passers-by left her unclothed and bleeding in the street for almost an hour and that, when police arrived, they spent a long time arguing about where to take them.

The woman lived for two weeks after her attack, dying in a Singapore hospital where she had been taken for treatment.

FAST-TRACK COURT

Aggarwal said the next hearing would be on January 10. The case is due to move later to another, fast-track court set up since the woman was attacked to help reduce a backlog of sex crime cases in Delhi.

Legal experts say the lack of representation for the five men may give grounds for appeal if they are found guilty. Convictions in similar cases have often been overturned years later.

Some legal experts have also warned that previous attempts to fast-track justice in India in some cases led to imperfect convictions that were later challenged.

The sixth member of the group alleged to have lured the student and a male friend into the private bus is under 18 and will be tried in a separate juvenile court.

The government is aiming to lower the age at which teenagers can be tried as adults, acknowledging public anger that the boy will face a maximum three-year sentence.

The victim was identified by a British newspaper at the weekend but Reuters has opted not to name her.

Indian law generally prohibits the identification of victims of sex crimes. The law is intended to protect victims' privacy and keep them out of the glare of media in a country where the social stigma associated with rape can be devastating.

The dead woman's father repeated on Monday that he wanted her identified and said he would be happy to release a photograph of her.

"We don't want to hide her identity. There is no reason for that. The only condition is it should not be misused," he told Reuters.

He said he was confident the trial would be quick and reiterated a call that the perpetrators be hanged.

(Writing by Frank Jack Daniel; Editing by Robert Birsel and Tom Pfeiffer)

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Handset makers scurry to join Year of the Phablet

SINGAPORE/HONG KONG (Reuters) – Call it phablet, phonelet, tweener or super smartphone, but the clunky mobile phone – closer in size to a tablet than the smartphone of a couple of years back – is here to stay.

A surprise hit of 2012, it is drawing in more users, more handset makers and is shaping the way we consume content.

“We expect 2013 to be the year of the phablet,” said Neil Mawston, UK-based executive director of Strategy Analytics‘ global wireless practice.

While Samsung Electronics Co Ltd has blazed a trail with its once-mocked Galaxy Note devices, now other manufacturers are scurrying to catch up.

At this week’s Consumer Electronics Show in Las Vegas, Chinese telecommunications giants ZTE Corp and Huawei Technologies Co Ltd will launch their own.

ZTE, which collaborated with Italy’s designer Stefano Giovannoni for the Nubia phablet, is scheduled to launch its 5-inch Grand S, while Huawei brings out the Ascend Mate, sporting a whopping 6.1-inch screen, making it only slightly smaller than Amazon’s Kindle Fire tablet.

“Users have realized that a nearly 5-inch screen smartphone isn’t such a cumbersome device,” said Joshua Flood, senior analyst at ABI Research in Britain.

Driving the phablet’s shift to the mainstream is a confluence of trends. Users prefer larger screens because they are consuming more visual content on mobile devices than before, and using them less for voice calls – the phablet’s weak spot.

And as WiFi-only tablets become more popular, so has interest among commuters in devices that combine the best of both, while on the move.

According to the latest Ericsson Mobility Report, the monthly data traffic for every smartphone will rise fourfold between now and 2018 to 1,900 megabytes.

The upshot is a market for phablets that will quadruple in value to $ 135 billion in three years, according to Barclays. Shipments of gadgets that are 5 inches or bigger in screen size will surge by nearly nine-fold to 228 million during the same period, though estimates vary because no one can agree on where smartphones stop and phablets start.

But that’s the point, some say.

“I think phone size was a preconceived notion based on voice usage,” said John Berns, a Singapore-based executive who works in the information technology industry. He recently upgraded his Note for the newer Note 2 and bought another for his girlfriend for Christmas. “Smaller was better until phones got smart, became visual.”

Samsung has been both the engine and beneficiary. While other players shipped devices with larger screens earlier – Dell Inc launched its Streak in 2010 – it was only when the Korean behemoth launched the Galaxy Note in late 2011, with its 5.3-inch screen, that users took an interest.

“The Streak was launched at a time when 3-inch smartphones were standard and the leap to a 5-inch Streak was a jump too far for consumers,” says Strategy Analytics’ Mawston.

“The Galaxy Note was launched when 4-inch smartphones had become commonplace, and the leap to 5-inch was no longer such a chasm.”

THE BIGGER, THE BETTER

Since then Samsung has bet big on bigger: its updated Note has a 5.5-inch screen and its flagship Galaxy S3 – the best-selling smartphone in the third quarter of 2012 – has a screen that puts it in the phablet category for some analysts.

Samsung accounted for around three quarters of all phablets shipped last year, according to Barclays’ Taipei-based analyst Dale Gai.

Samsung’s marketing heft has paved the way for others. LG Electronics Inc accounted for 14 percent of shipments in the third quarter of last year, according to Strategy Analytics.

HTC Corp’s 5-inch Butterfly – called the Droid DNA in the United States – has been selling well in places where Samsung is less dominant, according to Taipei-based Yuanta Securities analyst Dennis Chan. The first batch sold out soon after its December launch in Taiwan.

“I don’t think we can say that Samsung invented phablets,” said Lv Qianhao, head of handset strategy at ZTE. “But it did do a lot to promote this product category, which helped create tremendous demand.”

Phablets are also proving popular in emerging markets.

A poll of nearly 5,000 readers of Yahoo’s Indonesian website chose Samsung’s Galaxy Note 2 as their favorite mobile phone of 2012, ahead of the iPhone 5.

Kristian Tjahjono, a technology journalist who posted the poll, said phablets were a natural fit for Indonesians who liked tablets but also liked making phone calls.

But while those in such markets who can afford them are going for the high-end devices, the door is opening for cheaper models. Tjahjono pointed to Lenovo’s 5-inch S880, which has a lower resolution screen and sells for about $ 250, which is around a third of the price of Galaxy Note 2.

SWEET SPOT

Falling component prices will add to demand. The total cost of an upper-end phablet, its bill of materials, will likely fall to 2,000 yuan ($ 323) this year, says Gai from Barclays, and will halve within two years.

“One thousand yuan is a very sweet spot for China,” he said.

India is also a fan.

Vivek Deshpande, who manages global strategy for Shenzhen-based mobile phone maker Zopo, says that while the Indian and Chinese markets are different, they both share a common appetite for aspirational devices: phones big enough for their owners to show off. This is changing the direction of lower end players.

“Zopo’s primary focus is now on phablets,” said Deshpande.

Even Samsung is pushing its own creation downmarket: In Las Vegas it will unveil the Galaxy Grand, a 5-inch device that lacks some of the resolution and muscle of its bigger brethren but will be aimed at markets like India. There is a version offering a dual SIM slot, a popular feature for those wanting to arbitrage cheaper call and data plans.

As phablets slide into the mainstream, handset makers are trying to find ways of differentiating.

As well as hiring Italian designer Giovannoni better known for his minimalist, sleek bathrooms, ZTE also came up with an onscreen keypad that inclines to one side of the screen, depending on whether the user is left- or right-handed.

Samsung, however, not only has first mover advantage, it can also build on its expertise in display.

Barclay’s Gai says Samsung is expected to introduce a thinner, unbreakable AMOLED screen which will leave room for bigger batteries.

“That will put Samsung in good stead to still dominate the market,” he said. Despite pressure in China, Gai estimates Samsung’s share of smartphones with 5-inch or larger screens to fall only from 73 percent in 2012 to 58 percent in 2016, which is still the lion’s share.

By then consumers will see the phablet for what it is, says Horace Dediu, a Finnish analyst who runs a technology blog asymco.com. Its rise is part of a wider march of computing power into wherever we reside – the living room, the train, bed or work.

“It makes sense that we’re moving towards a time where we are served not by a computer or a netbook or a phone, but rather that we have these screens scattered around and available for us to play with,” he said. “In a way the phablet is not a bulky phone but a very delicate computer.”

(Editing by Emily Kaiser)

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Jordana Brewster Is 'Enamored' with the Idea of Having Twins

01/06/2013 at 05:00 PM EST

Jordana Brewster has babies on the brain – yes, you read that right: plural.

The Dallas star, 32, who has been married to movie producer Andrew Form since 2007, tells Latina she "definitely" wants two kids and is "enamored" by the idea of having twins.

"My dad was a twin, so it runs in the family," she explains. "Fingers crossed. We're thinking about having kids but I don't know when it'll happen. I feel very ready now."

When the couple does eventually expand their family, the children will be raised in a loving home.

"We FaceTime all of the time," Brewster says, of keeping the romance alive long distance. "We love that. There are times when I just say, 'I need to see you now.' And so we FaceTime a lot, or I surprise him and visit him or he does the same. It's super important … Couples shouldn't be apart for too long. We've been married for five years now and we know how important that is because otherwise you just lose touch with each other."

A big part of their bond has come from the way Form inspires his wife on a professional level.

"It's so amazing to have a husband in the business who can challenge me and we can talk about his work and my work and understand each other in that way," Brewster says. "I love getting his feedback and he likes getting mine. And of course, that has pushed me more to consider producing in the future."

And she's not just talking about babies!

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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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