CIA Nominee May Have 'Zero Dark Thirty' Problem


ap movie Zero Dark Thirty  thg 130103 wblog John Brennans Zero Dark Thirty Problem

Navy SEALs are seen fighting through a dust storm in the new thriller directed by Kathryn Bigelow, "Zero Dark Thirty." (Columbia Pictures/AP Photo)


There’s only one White House staffer portrayed in the new movie “Zero Dark Thirty,” and it is someone described in the credits as “National Security Advisor.”


It’s a position that’s possibly filled in real life by John Brennan, the president’s counterterrorism advisor, who President Obama nominated Jan. 7 to be director of C.I.A.. The character in the movie, with references to the C.I.A’s involvement in the flawed intelligence on weapons of mass destruction that led the U.S. into war in Iraq, explains to a frustrated agency representative the difficulty of the president’s decision in acting on partial intelligence.


Spoiler alert: The president does ultimately act on that partial intelligence and Osama bin Laden is nabbed.


The character in real life – Brennan – has been opposed by some for his work at the C.I.A. under President Bush and the “enhanced interrogation” policies like waterboarding that also play a prominent role in the movie.


President Obama makes a cameo in the movie in the form of a “60 Minutes” interview in which he declares that, “America doesn’t torture, and I’m gonna make sure that we don’t torture.”


That declaration is viewed, in the film, by a table full of CIA agents in Pakistan who have been involved in “enhanced” interrogations.


The U.S. used waterboarding on three al Qaeda detainees at secret prisons run by the CIA.  It  ended the practice of using secret prisons in September of 2006 under President Bush and in 2009 President Obama signed executive orders in his first days in office that banned of the use of waterboarding and other “enhanced interrogation” techniques.


But that was after the techniques had already scuttled Brennan’s first chance to head the CIA.  Brennan wasn’t nominated to be CIA director back in the early days of the Obama administration, but he was widely considered to be a front-runner for the job. ABC’s Jake Tapper reported at the time that Brennan withdrew his name for consideration and most of the opposition came as a result of his work at the C.I.A. when those techniques were in use.


And there is indication that they will make his nomination difficult this year.


“I appreciate John Brennan’s long record of service to our nation, but I have many questions and concerns about his nomination to be Director of the Central Intelligence Agency, especially what role he played in the so-called enhanced interrogation programs while serving at the CIA during the last administration, as well as his public defense of those programs,” said Sen. John McCain after Brennan was nominated Monday.  ”I plan to examine this aspect of Mr. Brennan’s record very closely as I consider his nomination.”


The movie has certainly brought “enhanced interrogation” – it’s critics call it torture – back into the conversation about the war on terror, as ABC’s Lee Ferran reported Monday:


Last week three high-powered senators, Intelligence Committee Chairman Dianne Feinstein (D.-Calif.), Armed Services Committee Chairman Carl Levin (D.-Mich.) and 2008 Presidential candidate John McCain (R.-Ariz.), revealed they had written two letters to Morell in December demanding to know what impact the CIA may have had on the depiction of enhanced interrogation in the film and whether the agency “misled” the filmmakers into thinking the tactic was effective.


“As you know, the film depicts CIA officers repeatedly torturing detainees. The film then credits CIA detainees subjected to coercive interrogation techniques as providing critical lead information on the courier that led to the [bin Laden] compound,” one letter says. “The CIA cannot be held accountable for how the Agency and its activities are portrayed in film, but we are nonetheless concerned, given the CIA’s cooperation with the filmmakers and the narrative’s consistency with past public misstatements by former senior CIA officials, that the filmmakers could have been misled by information they were provided by the CIA.”


Brennan, for his part, has said he opposed torture techniques, as Jake Tapper reported back in 2008 when Brennan removed his name from consideration for the C.I.A. job in 2008.


In a letter released to the media, apparently by Brennan or someone operating on Brennan’s behalf, the former CIA official wrote, “It has been immaterial to the critics that I have been a strong opponent of many of the policies of the Bush Administration such as the preemptive war in Iraq and coercive interrogation tactics, too include waterboarding. The fact that I was not involved in the decision making process for any of these controversial policies and actions has been ignored. Indeed, my criticism of these policies within government circles why I was twice considered for more senior-level positions in the current Administration only to be rebuffed by the White House.”


But Brennan did defend the practice in news media interviews when he described the actions of C.I.A. director George Tenet. This is what Brennan told CBS’s Harry Smith about enhanced interrogation in 2007: “The CIA has acknowledged that it has detained about 100 terrorists since 9/11, and about a third of them have been subjected to what the CIA refers to as enhanced interrogation tactics, and only a small proportion of those have in fact been subjected to the most serious types of enhanced procedures….There have been a lot of information that has come out from these interrogation procedures that the agency has in fact used against the real hard-core terrorists. It has saved lives. And let’s not forget, these are hardened terrorists who have been responsible for 9/11, who have shown no remorse at all for the deaths of 3,000 innocents.”


Brennan has also spoken out in support of “rendition” – the practice where the U.S. government captures terror suspects in one country and relocates them to another. That’s a practice still employed by the Obama administration, according to a recent Washington Post investigation.


Related: Watch Martha Raddatz’s Nightline interview with ‘Zero Dark Thirty’ Director Kathryn Bigelow:





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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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Judge reduces possible sentence for WikiLeaks suspect






FORT MEADE: A US judge on Tuesday reduced the potential sentence for WikiLeaks suspect Bradley Manning by 112 days because of his harsh treatment at a military jail, where he was held in isolation despite advice from psychiatrists.

Judge Denise Lind said the US Army private's detention conditions were "excessive" and at times illegal, going beyond what was needed to ensure his safety and prevent the risk of suicide.

But the judge rejected a request by defence lawyers to dismiss all charges against Manning because of his nine-month detention at the US Marine Corps prison in Quantico, Virginia.

The ruling paves the way for a trial in March in which the army private is accused of "aiding the enemy" by passing a trove of secret government files to the WikiLeaks website.

Defence attorney David Coombs had argued the court should drop all charges against Manning on the grounds that he suffered illegal punishment at the Quantico jail, where he was held in a solitary cell 23 hours a day, kept under a strict suicide watch and often ordered to strip naked.

Prosecutors had said strict measures were necessary because Manning posed a suicide risk.

The judge concluded that the government had to ensure Manning did not take his life given his mental health history, as he had reported suicidal thoughts while detained in Kuwait.

"Preventing a detainee suicide is in the legitimate interest of the government," she said.

But she ruled prison authorities at Quantico should not have kept Manning under a "rigorous" super-strict suicide watch regime after military psychiatrists advised he was not suicidal.

Prison officers had no reason to take away Manning's underwear at one point as "no new threat" had emerged and it was "no longer reasonable to withhold the underwear," she said.

She cited a seven-day period in which Manning was assessed by psychiatrists as "no longer at risk" of suicide but was kept under strict isolation, saying it constituted "unlawful pre-trial punishment."

If convicted on 22 charges, Manning would receive credit for his time behind bars in Quantico, with his potential sentence reduced by 112 days, Lind said.

But the judge was not ready to call off the trial over Manning's treatment at the Quantico jail as "the charges are serious in this case," she said.

The 25-year-old private faces a slew of charges, including "aiding the enemy," for allegedly leaking hundreds of thousands of sensitive US military and diplomatic documents to Julian Assange's anti-secrecy site WikiLeaks.

He was arrested in May 2010 while serving as an intelligence analyst near Baghdad and subsequently charged over the largest leak of restricted documents in American history.

Manning was sent briefly to a US jail in neighbouring Kuwait, before being transferred to the Marine Corps jail in Quantico, Virginia in July 2010.

After nine months in the brig, he was moved in April 2011 to a US Army prison at Fort Leavenworth, Kansas, where he was allowed to interact with other detainees as detention conditions were eased.

If convicted, Manning could spend the rest of his life behind bars.

Before the ruling, the defence and prosecution clashed over whether the court should permit evidence in the trial on Manning's motive in leaking the classified files.

In leaking secret documents, Manning "selected information that could not be used to the harm of the United States or any foreign country," Coombs, the defence lawyer, told the court.

Coombs portrayed his client as a whistle-blower who was trying to inform the public instead of "aiding the enemy" as he is charged.

But prosecutors told the judge Manning's motives for the leak, the largest in US history, were irrelevant.

"The accused knew that he was dealing directly or indirectly with an enemy of the United States," prosecutor Captain Angel Overgaard said.

"He knew that the information would be published on the Internet and was accessible to the enemy," Overgaard said.

Coombs has argued that the case against Manning is virtually unprecedented as usually US authorities prosecute soldiers or government employees who pass secrets directly to an adversary -- and not those who leak information to a media outlet or website.

- AFP/jc



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Absconding Himachal MLA surrenders

PANCHKULA/DHARAMSHALA: In a face-saving exercise, the Himachal Pradesh Congress on Tuesday forced its on-the-run MLA from Doon constituency Ram Kumar Chaudhary, wanted in a murder case of a dalit woman, to surrender before a Panchkula magistrate hours before the party's newly-elected legislators took oath at Dharamshala.

A police team had been camping in Dharamshala for the past few days to nab the MLA if he arrives for the swearing-in ceremony. The Panchkula police on Monday had announced a reward of Rs 2 lakh for any information on Chaudhary.

Anticipating an embarrassing situation in the HP assembly as the Opposition BJP was planning to target the Congress for protecting a MLA accused of murder, the ruling party apparently asked Chaudhary to surrender before the start of the session on Tuesday morning.

The 42-year-old MLA, who is one of the four accused in the murder of 24-year-old Jyoti Devi, arrived in the court of chief judicial magistrate Bhavna Jain around 10.30am. He was accompanied by his lawyer. Soon, a police team reached there and took the MLA into custody with the permission of the court.

Later in the afternoon, the cops brought him to the court seeking police remand. However, the MLA's attempt to avoid media drew the court's flak this time as Chaudhary, was brought to the courtroom through the backdoor which is normally used by the judges. After hearing the arguments of both the sides, the court remanded Chaudhary in police custody for six days.

The body of Jyoti, a resident of Hoshiarpur, was found in Sector 21 in Panchkula on November 22. A Panchkula court had issued arrest warrants against Chaudhary and his three associates - Dharampal, Paramjeet and Gurmeet - on December 20, 2012.

When asked about Chaudhary's expulsion from the party following his surrender before the court, chief minister Virbhadra Singh said in Dharamshala that law will take its course.

"This case has affected the party's image but it will not have any impact on the stability of the government. He can take oath later, even in the room of the Speaker, but it would have been better had he surrendered earlier," he said after the oath-taking ceremony of new MLAs.

Leader of the Opposition Prem Kumar Dhumal said, "We will not say anything about the Congress party's stand over the accused legislature. But it is not proper for a sitting legislature to go against the law."

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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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Cops Break Down as They Describe Aurora Horror













Two veteran police officers broke down on the stand today during a preliminary hearing for accused movie theater gunman James Holmes, with one officer choking up when he described finding the body of a 6-year-old girl inside the theater.


Sgt. Gerald Jonsgaard needed a moment to compose himself as he described finding the little girl, Veronica Moser Sullivan, in the blood splattered theater in Aurora, Colo.


An officer felt for a pulse and thought Veronica was still alive, Jonsgaard said, but the officer then realized he was feeling his own pulse.


A preliminary hearing for Holmes began today in Colorado, with victims and families present. He is accused of killing 12 people and wounded dozens more in the movie theater massacre. One of Veronica's relatives likened attending the hearing to having to "face the devil."


The officers wiped away tears as they described the horror they found inside of theater nine.


Officer Justin Grizzle recounted seeing bodies lying motionless on the floor, surrounded by so much blood he nearly slipped and fell.


Grizzle, a former paramedic, says ambulances had not yet made it to the theater, so he began loading victims into his patrol car and driving to the hospital.


"I knew I needed to get them to the hospital now, " Grizzle said, tearing up. "I didn't want anyone else to die."






Arapahoe County Sheriff/AP Photo











James Holmes Tries to Harm Himself, Sources Say Watch Video









Aurora, Colorado Gunman: Neuroscience PhD Student Watch Video







Grizzle drove six victims in four trips, saying that by the end there was so much blood in his patrol car he could hear it "sloshing around."


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


An officer who took the stand earlier today described Holmes as "relaxed" and "detached" when police confronted him just moments after the shooting stopped.


The first two officers to testify today described responding to the theater and spotting Holmes standing by his car at the rear of the theater on July 20, 2012. He allegedly opened fire in the crowded theater during the midnight showing of "The Dark Knight Rises."


Officer Jason Oviatt said he first thought Holmes was a cop because he was wearing a gas mask and helmet, but as he got closer realized he was not an officer and held Holmes at gunpoint.


Throughout the search and arrest, Holes was extremely compliant, the officer said.


"He was very, very relaxed," Oviatt said. "These were not normal reactions to anything. He seemed very detached from it all."


Oviatt said Holmes had extremely dilated pupils and smelled badly when he was arrested.


Officer Aaron Blue testified that Holmes volunteered that he had four guns and that there were "improvised explosive devices" in his apartment and that they would go off if the police triggered them.


Holmes was dressed for the court hearing in a red jumpsuit and has brown hair and a full beard. He did not show any reaction when the officers pointed him out in the courtroom.


This is the most important court hearing in the case so far, essentially a mini-trial as prosecutors present witness testimony and evidence—some never before heard—to outline their case against the former neuroscience student.


The hearing at the Arapahoe County District Court in Centennial, Colo., could last all week. At the end, Judge William Sylvester will decide whether the case will go to trial.






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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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US Dollar falls ahead of ECB meeting






NEW YORK: The US dollar retreated Monday against the euro and other major currencies as financial markets girded for a meeting later this week of the European Central Bank.

The euro was valued at US$1.3115 dollars at 22H00 GMT Monday, up from Friday's value of US$1.3067 at the same time.

The US dollar was also lower against the Japanese yen, trading at 87.89 Monday instead of the 88.15 level on Friday night.

The quarterly earnings season unofficially kicks off Tuesday with the report from aluminium producer Alcoa. Several US Federal Reserve officials have public appearances this week.

Given the lack of US economic data to be released this week, "we believe that the US dollar will take its cue from earnings and comments from the Fed officials," said Kathy Lien of BK Asset Management.

After focusing heavily on the US due to the much-touted debate on the fiscal cliff, financial markets were beginning to turn to the euro again with Thursday's meeting of the ECB.

That said, Thursday's ECB meeting "offers little reason to be bullish (about) the euro," said Christopher Vecchio, currency analyst at DailyFX.

Vecchio noted that the euro had fallen after the November and December ECB meetings, which followed a September announcement by ECB President Mario Draghi of a program to keep Italian and Spanish borrowing costs down.

The euro did, however, pick up support on news that former Italian prime minister Silvio Berlusconi would not seek election during the Italian elections next month.

Watchers of the Federal Reserve will be looking for signs later this week in public appearances by the presidents of the Fed banks of Kansas City, Philadelphia and Richmond.

Minutes released by the Federal Reserve last week showed that the US central bank is considering ending its aggressive stimulus plan more quickly than expected. But some market watchers say the Fed will be unlikely to pull the plug on the program given last week's weak jobs report.

"The confusion created by the FOMC minutes makes this week's comments from Fed presidents extremely important because investors want to know how serious the central bank is about phasing out" its stimulus program, Lien said.

The US dollar fell against the Swiss currency, to 0.9212 francs from 0.9246 francs late Friday, while the pound rose to US$1.6114 from US$1.6068.

- AFP/jc



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Abu Jundal's bail plea dismissed

NEW DELHI: A trial court has dismissed the bail plea of LeT terrorist and 26/11 Mumbai attack key handler Abu Jundal, arrested for his alleged role in conspiring to launch terror strikes across the country. It also gave NIA up to 180 days time to complete its probe into the case.

In an in court proceeding, District Judge (DJ) I S Mehta allowed the application of National Investigation Agency (NIA), which sought extension of probe time up to 180 days, saying the articles alleged to have been recovered from Jundal is sensitive to "the issue of national security," the court sources said.

"Looking into the facts and circumstances and the articles alleged to be recovered from respondent/accused (Abu Jundal)... I allow the application of NIA and the accused is remanded to judicial custody for further period of 13 days and Jundal's application under section 167(2) of the CrPC is dismissed," the court said, while fixing the matter for further proceeding on January 17.

During the hearing, Jundal's counsel M S Khan moved the court for bail saying the NIA is delaying the filing of the charge sheet in the case and this does not entitle it to seek more time to complete the probe.

The NIA had also sought extension of Jundal's judicial custody saying its investigation is in progress and it could not disclose its details due to security reasons and the court could see the same in the case diary.

The NIA had lodged an FIR against Jundal following the unearthing of a Lashkar-e-Toiba's (LeT) conspiracy for terror strikes across the country.

During the hearing, Jundal's counsel Khan opposed the NIA's plea for extension of judicial custody saying no efforts have been made by the agency to collect evidence from Pakistan and Saudi Arabia against his client.

Khan argued that there was no circumstance under which the extension of time could be granted to the NIA and Jundal was entitled to be released on bail.

The NIA, however, told the court that its probe into the case is going on.

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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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