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Issues of work-life balance are growing for doctors as more doctors ages 40-54 years face burnout or negative effects on health. Nearly half of doctors in the U.S. 40-54 years of age in a survey of 15,000 physicians report feeling burned out from work hours and administrative tasks. Younger doctors 25-39 years, and older ones 55-73 years also reported high rate of burnout at 38% and 39%. Overall for all physicians about half of all physicians said they would take a substantial pay cut to get a better work-life balance. What this survey and report by Medscape shows is that no age group, career stage, gender or specialty is immune to this problem, says Colin West, professor of Medicine and researcher on physician well being at the Mayo Clinic.

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A group of neurological expeorts in the UK help us with advice. Includes things like avoid hearing and vision loss that lead to not driving or isolating. Social interaction and learning are key so take up a hobby, find new interests , learn a new language, travel, and link this up with other people, new people you can meet. Get plenty of exercise, core building. Nature walks, hiking in the mountains, swimming, outdoor activity. Good sleep begins in the morning so that by the time it is 9.00- 9.30 pm one is ready to go to bed. It helps not to stay up late. Eating healthy, olive oil and Mediterranean diet instead of butter, and eating fruits and vegetables, nuts.  Mindfulness helps. There are four forms of mindfulness. On the leftside Menu for Lyrarc there is under Lyrarc Insights the section Mental Well-Being which gives a translation from the original Pali text of the Buddha describing the Four Forms of Mindfulness in the Sattipana Sutta. This spiritual training, a reading of the Bhagavad Gita or the Bible, nourishes brain health and gives clarity of mind. ...

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Speaker Johnson says "all of us 100 percent support the principle behind it." 100% support means killing the key part of the Kids bill on protecting mental health. Republican Senator from Tennessee Marsha Blackburn is leading the fight for the Kids Online Safety Act. It passed the US Senate in a 91-3 vote.  Donald Trump Jr. says  “It's time for House Republicans  to pass the Kids Online Safety Act ASAP.” House Republicans are trying to water down a bill on social media (Facebook and others) by taking out duty of care language that social media companies want taken out. Lobbying by social media companies means Speaker Johnson is holding out even when DJT and Elon Musk, have joined 35 states Attorney Generals, and the Biden Administration's Surgeon General in a bipartisan effort to get the House to pass the social media legislation. Speaker Johnson says "all of us 100 percent support the principle behind it." 100% support means killing the key part of the Kids bill on protecting mental health. Limiting it to physical harm defeats the purpose of the legislation as the WSJ did an extensive investigative report series documenting the harm to mental health and mental health is what needs protecting.   ...

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First disrupt the young people's attention and create effects on mental health of long hours spent on social media such as Tik Tok. This results in a loss of literacy on basic knowledge of civics and American history to lower and lower levels. Then let these young people decide who should run the country and its government for the next 4-8 years. The founders never intended this and never anticipated this threat. Congressmen Republican Gallagher of Wisconsin and Democrat Krisnamoorthi of Illinois introduced a bipartisan bill to ban TikTok in the US considering that it was foreign adversary application when its literacy effects are even more a concern. Byte Dance has appealed the law that goes into effect Jan 19, 2025. The appeal is now before a 3 person panel of the Columbia Circuit Court of Appeals of Sri Srinivasan, Neomi Rao, and Douglas Ginsburg. Does Byte Dance have recourse to the First Amendment rights in the US Constitution when the US sees Byte Dance as a foreign adversary controlled internet social media service, is the question before the Appeals Court and next before the US Supreme Court. The US government has shown the judges confidential classified data that shows why it thinks there is foreign adversary influence of some sort.  It is interesting to note that national literacy standards and the ability of average American young people to know enough about American history and civics that is in a dire state today and a key vulnerability for US democracy. This is gravely harmed by social media influence. Only negative effects on mental health of children and young girls has been put forward. Too many hours spent on social media is a negative influence which is why China and now Australia and UK have put restrictions on is use. US has none. India has banned Tik Tok for security reasons. In all situations there are negatives here yet it is an appalling thing that literacy is not the biggest one put forward when it should be for this Nation. ...

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The U.S. Labor Department reports increase in payrolls by 215,000 for March 2016. Manufacturing continues to be a soft spot with loss of 29,000 jobs. Health care, leisure and hospitality, and retailing each added about 40,000 jobs. Jobs increased by 30,000 each in construction, and in professional/business services.

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This NYT editorial points out that the cuts to Medicaid amount to taking out a fourth of its budget and are sure to hurt low income Americans. The cuts are about $880 billion over 10 years for Medicaid. The $300 billion less in subsidies over ten years is likely to hurt the elderly. It also points out that removing the individual mandate will make it harder to reduce premiums as fewer healthy adults offset the costs of sick patients.

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Dr. Zhong Nanshan, China's leading epidemiologist and head of the Guangzhou Institute for Respiratory Health, talks to doctors in the U.S. at Temple University Hospital and Harvard University, about China's experience tackling the coronavirus. Other collaboration is happening between John Hopkins doctors and 80 other American doctors with Wang Jian-an president of the Second Affiliated Hospital at Zhejiang University. This hospital in China sent about 170 medical workers to Wuhan, the epicenter of the coronavirus in China.  Three areas of interest for American doctors are the clinical course of the virus, what treatments work and what does not work, treating pregnant infected women, and preventing infections among medical workers.

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Senator Manchin wants other countries or regions such as the European Union to go first with the global minimum tax of 15%. Holdouts Poland and Hungary have not agreed to the 15% tax in the EU. After that the US could follow. Mr. Manchin is a Democrat whose vote is needed for Congress to pass the legislation. Currently the tax is set at 10.5% after legislation passed by president Trump.

Much of the funding for HEIRS - for Health, Education, Infrastructure, Retirees and Society- has to come from better collection of taxes, so that everyone pays their fair portion of taxes which tech companies are not doing in the last decade. 

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Arwa Mahdawi writes in The Guardian about issues facing the Democratic party in the US, and Labour in the UK, of turning their backs on the working class. And to the roots of their parties in the working class and rising middle class under FDR, Truman and Clement Attlee in the 1930's 40's and 50's. Woman's issues are about men's issues and issues of the people as a whole, of fairness in the economy, about correcting grossly poor misallocation of capital away from education, health, infrastructure and children, when seen in this larger and very real context.

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The contrast between Carlos Tavares and Elon Musk can be seen in this exchange between Mr. Trump and Mr. Musk. Carlos Tavares plans a big manufacturing effort for Stellantis in electric cars- 75 models by 2030- with a very different culture than that of Mr. Trump and Mr. Musk, that builds on the dignity of each worker and family. Social media is used by Mr. Trump and Mr. Musk for their own benefit, by manipulating culture and beliefs including how capital of society should be allocated away from HEIRS (Health, Education, Infrastructure, Retirees, and Societal needs). Absent Mr. Musk America would still be producing electric cars as is evident from the intense competition between the major car companies and their complete switch to electric on a scale needed for tackling climate change. Who is the better role model for young people in the US or Europe? Carlos Tavares with his simplicity and caring for dignity of workers or Donald Trump, Elon Musk with their rancorous exchanges and comments, and extravagant behaviour.     ...

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A look at Israel at 70 by the Economist magazine shows a country that has combined early achievements of socialist governments such as free health care system and good education system with the addition of 1 million immigrants from the collapsing Soviet Union, to build a highly trained technically skilled workforce and international companies.  It says the Israeli Arabs are still poor and unable to integrate. With ultra Orthodox Jews they make up 30% of the population, and many of them who do not work. Infrastructure has suffered from lack of investment and public transport is in poor condition. About 4.5 million Palestinians in West Bank and Gaza remain a continuous source of tension with no settlement in sight. The shift of the capital to Jerusalem is recognized by the U.S. Trump administration, a win for Israel, but leaving the divisive politics of Mr. Netanyahu in place. So that with the growing economy, there are social problems and political division which need to be addressed as much as the economy. A problem left for another administration, another leader from possibly a revived Labor party and another day. ...

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Princes MBZ of the UAE and MBS of Saudi Arabia were seen as close with MBZ the mentor of Prince Salman of Saudi Arabia (MBS). Saudis and UAE differ on how high oil prices should go. Both MBZ MBS wider mindsets are close based on modernization of the Arab world. Oil price increases mean hardship for most of the world's population, a shift of wealth from more populous countries such as Turkey and India to countries with very small numbers of people as the UAE (9 million) and Saudi Arabia 35 million). It poses hardship in cost of living for people in Asia, Africa and in EU, the US. This calls for a vigorous effort to make the switch to solar energy to reduce inequality and wide disparities of wealth in Asia and the Middle East.

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Obama ACA subsidies to go directly to the people through Health Savings Accounts proposed by Republican Senators Graham, Scott and Cassidy in 2017, and again in 2025, and not to Insurance companies. In a post on his social media site DJT tells Congress that the ACA subsidies given directly to people rather than money sucking insurance companies would lead to a better result of people getting their own and better coverage for less money than under Obama type subsidies sent to insurance companies.  Much of Obamacare was done under a campaign from insurance companies and other health vested interests that undermined the original objectives so that however good the original objectives the watered down, disincentivising of reducing unproductive costs, led to a hotch potch band aid result. A common sense approach with the courage to get the right result that works for the people of the Nation to get good health care similar to Japan and other nations in Europe at reasonable cost is not a goal that an advanced nation like the US should see as unreachable or beyond our efforts, skills and wisdom. Obama and Bush failed, Bush in a major error to remove the negotiating power of government Medicare agency with pharmaceutical companies that Democrats failed to push back. ...

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Rate of diabetes is rapidly going up in India. In addition scientists have shown that Indians are more prone to diabetes if they are obese to the same extent as someone from Canada or the U.S. This is called thin-fat diabetes- a higher impaired glucose intolerance- and comes from centuries of body changes following famine in parts of the country from failure of monsoon rains. The obesity rate is going up dramatically and with it diabetes is up significantly.  From 6.4% obese or overweight in 1990, by 2017 18.8% are obese or overweight, according to Health Metrics and Evaluation Institute of the University of Washington. The International Diabetes Federation now predicts 123 million with diabetes in India by 2040. By 2017 diabetes rates went up from 1990- from 5.5% to 7.7% or 63 million people. The major problem in South Asian countries and in China is the growing use of packaged and processed foods, fast food and carbonated drinks. Efforts to prevent the sale of junk foods is a battle being fought between private citizens and the large processed foods companies such as Coca Cola, Pepsi and Nestle. This is the subject of this article with Mr. Verma taking the case to the Delhi High Court facing large opposition. Mr. Verma left his job as a marketing executive as he took care of his sick child. He filed a case in the Delhi High Court in 2010, and faces the opposition of the India Food Processors Association- so far there is little progress.   ...

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French youth are an important part of the protests in France in extending the retirement age from 62 to 64 years. A neuropsychologist at a Paris hospital says "are there any social benefits they haven't rolled back," in this report in FR24. Youth feel that the reform asking workers to work longer in the current situation in France is basically unfair at a time when workers are facing a cost of living crisis and are just coming out of a once in a century pandemic. And with the stress on schools, hospitals and older people, the shrinking savings of workers and families as pandemic period benefits are being phased out. In the US and Germany there is support for working families during the cost of living crisis, much less so in France, and even less in Britain. France is facing protests and possible strikes, Britain has strikes across health, transport and education. 

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Of NYT's decades old indifference, an almost Churchill like distance and indifference to the aspirations of the people of South Asia it can be said- indifference to the aspirations of 1.4 billion people to modernize the country with the same infrastructure that Europe and the US, Japan, and now China take for granted. Indifference to the problems in creating a nation  with 13 languages and 1.4 billion people that has a freely elected parliament never before done in history, one which also delivers on banking accounts, health care, infrastructure, for all its  people, of all races and religions. This indifference runs counter to everything that Indians admire about America. And a lack of awareness of what Indians admire today about the Biden administration's promise to make the words of Jefferson true in America as the Modi administration does in India- "We hold these truths to be self-evident that all men are created equal, (created equal) and that they are endowed by their Creator with certain inalienable rights, among these are life, liberty and the pursuit of happiness." The NYT's indifference to this inequality both in the US and in India run counter to the founding principles of Jefferson and of India's saint from Wardha, Mohandas Gandhi, who both fought the British empire at the height of its prominence.  ...

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What is the difference between South Korea and the U.S., Europe in the handling of coronavirus? It is tracking and testing.  President Trump and health adviser Dr. Fauci, see South Korea as the successful model to be followed in controlling the coronavirus. What has happened till now it is accepted with shortage of basic medical supplies and equipment, stress on hospital systems, are merely mitigation actions. South Korea was prepared for the coronavirus crisis because of the MERS and other epidemics, and failures resulting in corrective actions. Labs were centralized and better equipped for testing and tracking the infected. One of the key tools is testing. President Trump says the goal is for the U.S. to exceed and far surpass tests per capita in South Korea. Five million tests are planned by the end of April in the U.S. Where the U.S. falls short is in use of multipronged digital tracking using data from people's use of mobile phones, credit card usage, and use of apps designed to separate infected people from others. South Korea is a democracy with a population of 52 million people, about the size of France. People who were student activists in the democratization era in South Korea say the use of digital technology is a need today. We have to adapt in emergency situation they say. Ki Mo-ran, epidemiologist, and adviser to South Korean government says this is a key part lacking in the European and U.S. efforts to control coronavirus. She says in South Korea we know the patient's contacts, where he goes and stays, so we don't have to lock down everybody. Without digital tracking one cannot know which place is contaminated, which place is clean, so that there can be a lockdown of just that area and not the whole country, says Ki Mo-ran. She asks the question- is one person's privacy more important than the lives of a family or other people who are affected. Is it OK to lockdown every child in the country in a home as in Spain for over a month so that particular people's privacy is respected? These are serious questions for western society, are they exceptions or is democracy not just a western idea but equally cherished in Asian societies, people talk about Confucianism in China and the Asian culture forgetting that the biggest democracies are quite large and functioning well in India in addition to South Korea, Taiwan Indonesia, Malaysia, Bangladesh and Japan, far larger in area and population than China. The French government has chosen the app TraceTogether as the least intrusive one adaptable to France for use there. The U.S. is having Google and Apple develop one of its own. India will be developing one of its own. The NYT raises the question will it be watered down so much in France or in the U.S. and UK to be less effective than the  dire need for an alternative to lockdowns? ...

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Massachusetts governor Charlie Baker gets an order in with a number of Chinese manufacturers for supply of over a million N95 masks. The hard hit east coast states of the U.S. face a critical shortage of N95 masks for health care workers in hospitals. The problem is getting them shipped from Shenzen, China to to Boston's Logan airport. Someone suggested using the Patriots football team's Boeing 767 jet. Robert Kraft, Patriot's owner agreed and the passenger plane was converted to carry cargo. The Chinese consulate in New York stays open over the weekend to process the flight crew's visas. Approval for landing without the crew being asked to quarantine for 14 days was another hurdle. Chinese authorites agreed to permit the landing for about 3 hours to pick up cargo only, with the flight crew staying on the plane. Chinese internet company Tencent sent some of its employees to help prepare the shipment and send it to Shenzen airport. The Boeing 767 makes a stop in Alaska before flying to Shenzen and completes the flight back to Logan airport in Boston. Governor Baker and the Patriot's Mr. Kraft send 300,000 of the masks to New York. ...

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Trump at 77 has serious issues of age for the US presidency says Frank Bruni, professor of journalism and public policy at Duke University. Age is a very personal journey, says one expert, and it depends on how good you are taking care of yourself. On this score Trump has serious drawbacks. Nutrition matters, exercise matters. Bruni says Trump's diet is garbage, and he is overweight. Biden is only 3 years older than Trump, and he is known for healthy eating habits and regular exercise. This is a serious difference that the press has paid little attention to. Another factor in aging is doing something for a purpose in life that extends beyond one's self. Trump's obsessive attention to himself means there is a lack of purpose beyond one's own egoistic pursuit of office which acts as a negative factor in aging.

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Inflation in China and rising wages are pushing up costs for American manufacturers. The pressure on China, most recently in Congress, is helping to push up the value of the yuan. This combined trend is making it attractive for some manufacturers to bring factories home to the U.S. A trend in the U.S. towards non-unionized labor and the new trend to a two-tier wage level- with lower wages for entry level workers- and the shedding of legacy health care costs, is creating a more cost competitive labor force in the U.S. This extends from older industries such as furniture and auto components to newer industries and technology. The new factories setup in the U.S. use technologies that require a smaller number of workers, in most cases less than half the number of workers that were employed earlier. This adds another element in cost efficiency, though it means fewer jobs are created with new plants.

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Rachel Reeves is Shadow Chancellor in Britain, that is a way of saying Finance Minister when Labor currently in the Opposition forms a new government. Speaking at the Peterson Institute for International Economics in Washington DC she says how Labour will bring about a transformation of Britain's economy with ambitions that borrows from and matches what Biden is doing in the US, and Scholz in Germany. This is very different from anything Britain has seen in its history. The Labour government of Clement Attlee made some institutional changes such as setting up the Bank of England as Britain's central bank in 1946, creating the structures that would help workers and families and the British economy recover from the war, and declaring in parliament that Britain would leave India by June 1948. Blair's response to the Thatcher government did not rival the changes brought by Attlee by any comparison. What Britain following the US is facing today is an FDR or Attlee moment because of the scale of changes needed to create an American or British economy that matches the aspirations of the people, and creating a meaningful role in the world economy and supply chains. Investments have to be made in public goods such as renewable energy, health, education and transportation infrastructure that have no parallel in history including that of FDR or Attlee. Biden is investing on a scale that is designed to overcome two decades of neglect of infrastructure and public goods such as education, health care, and public services. The same is true for Britain. The same is true for Germany and for the European Union.   ...

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The title may not reflect the content of this report on Admiral Giroir who heads the U.S. coronavirus testing effort. He is a pediatrician who worked for hospitals in Texas before heading a vaccine project at Texas A&M University.  Internal politics led to his resigning from the effort to build a vaccine development capability with pharmaceutical companies at Texas A&M. Most of the rest of this report shows a physician who is determined to pursue big projects such as the one he is tackling today. President Trump appointed him to lead FDA, and to be the Assistant Secretary of the Department of Health and Human Services. With the missteps of Secretary Azar testing suffered in the early months of the crisis as reported in the WSJ. Adm. Giroir has taken a leading role since  this period. He also heads the U.S. Public Health Service Commissioned Corps of 6200 staff playing a vital role. On March 13 he was asked to lead the effort in testing.  He comes to this role with experience in the field of vaccines realizing that "the challenges are not just biological but engineering." New technology would be needed to make massive amounts of vaccine. His idea is that transformational efforts are needed. His idea for a billion dose per month facility in Texas did not work, yet he worked on it for about 5 years from 2010 to 2015 at Texas A&M University, at one point being the vice chancellor. He was selected by Texas Governor Perry as chairman of the task force in Texas in 2014 to oversee the effort to fight the Ebola virus. He now is in a position to bring all his experience and aspirations to tackle the coronavirus, cutting through much of the red tape and bureaucracy, and pulling together the effort combining science of pharmaceutical companies with the technology of manufacturing billions of vaccine doses in a record time. Today he sees capacity for testing reaching 40-50 million tests a month by September 2020.   ...

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The UK government's chief scientific adviser, Sir Patrick Vallance, says coronavirus testing has not been scaled quickly enough. Public health experts warn that Downing Street is in the position to face "an unforgiving reckoning." The UK has done 5400 tests per million population, the U.S. 8894 tests per million, and Germany 15,700 per million, according to data from Worldometer website. UK got off to a slow start.  Experts at Imperial College, London, say a major problem is the lack of contact trace, test, isolate. Contact tracing having fallen behind. The government is relying too much they say on an app from Google and Apple to do the tracing because for this kind of work humans are needed, "boots on the ground" are needed. South Korea and Taiwan have successfully used people to do the contact tracing by using access to cellphone carrier data that was made possible from protocols established in earlier MERS crisis. ...