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Amazon is tackling the Indian market by addressing the need of rural shoppers in all parts of India- home to nearly 800 million people. Here WSJ shows how this works with a customer in Dhowachal, in the northeastern state of Assam, who had no access to stores except by travelling for hours to the nearest town.  The customer is a teacher who received an Amazon delivery of pairs of jeans, socks, curtains, glasses and other items. Rural shoppers in India spent about $400 billion in 2017. Barclays estimates Amazon had $7 billion in gross merchandise sales volume in India in 2017, about 2% of what it does worldwide. More than 80% of customers in 2018 are from outside India's largest cities.  To do this Amazon has changed its app to work on cheaper smartphones and patchy cellular networks, added hundreds of thousands of Indian language descriptions of products and videos. It has also opened physical Amazon stores to teach people how to order online. Tens of thousands of distributors were added to deliver packages and take cash or digital payment. Amazon is spending $5 billion in India to set up a logistics network and warehouses, including staff and content development for Amazon Prime. In doing this Amazon has learned from China where Alibaba and other online retailers have grown seven fold by reaching rural areas. Amazon could not compete with Alibaba in China. In India Amazon has no strong local competitors like Alibaba. It is learning how to operate in India. The app offer tips on how to order, no email is needed, only a phone number, machine learning translates all descriptions into Hindi. Icons work well. A digital wallet lets customers without bank accounts or cards to pay or get money back. Amazon is investing aggressively using an advertising campaign and discounts to pass Flipkart which WalMart bought for $16 billion in 2018. Amazon is trying new ideas in India's situation where small stores often closet sized sell a limited number of products often going through multiple middlemen resulting in high prices. Amazon is now enlisting these small stores as package depots in its own unique distribution network. The small store gets an 8-10% commission on sales for helping guide shoppers make a purchase. In Amazon's unique "I Have Space" program 20,000 mom and pop stores in remote areas of India offer to take packages and deliver in neighborhoods for a commission. They get a uniform, a bag and a week of training. Many of these store owners know the addresses in their neighborhood having lived there a long time. The entire effort shows Amazon has adapted its delivery effort, logistics and payment systems to Indian conditions in a well planned way. Compare this to the failed effort by Apple in India, with high management turnover and lack of understanding of Indian conditions and pricing, and no real plan to tackle the Indian market.     ...

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Keller says that Fox News has contributed to the corrosiveness that has affected public dialogue in the U.S. He admits that the prestigious urban newspapers like the Washington Post and the New York Times can be condescending and too open to consider points of view that do not have merit. Yet, he says, they are different from Fox News in that they are self-critical and take up different points of view outside their own, an openness that Fox News lacks. A little research shows another side of the Times- during its early years the Times with a scoop of its own helped put the boss of Tammany Hall, which dominated New York politics in the late twentieth century, in jail. The journalists of the Times, even though they have their own screwups, always must carry the added responsibility of living up to a long heritage.

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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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The use of fast track procedures under 510 K, for approval of Ren-Gen's Menaflex product to treat knee injuries. Under 510K rules for fast track no clinical trials are required, because the product is similiar to already existing products. Menaflex does not have asimiliar product, yet the FDA allowed Menaflex to be treated as fast track. The closest is orthopedic surgical operation, which is quite different. Menaflex is a C shaped pad used to repair a torn meniscus, a rubbery substance made from cow collagen that that acts like ashock absorber between the knee bones. Their is a booming market for meniscus repair among sports athletes. In fact originally Ren-Gen did not even apply as fast track, but only afte its clinical trials ran into trouble, did it try for fast track, which was turned down several times. At which point Ren-Gen got Democrats Senator Robert Menendez, Rep Frank Pallone, Chairman of the Health Subcommittee of the House Energy and Commerce Committee, Rep Rothman of Hackensack where Ren-Gen is based, and Senator Frank Lautenberg to intervene. At this point Senator Menendez and the others wrote to the FDA Commisssioner Dr Von Eschenbach, and Menendez spoke to the Commisssioner personally on the phone. After this intervention things started moving in Ren-Gen's dirtection, bypassing the FDA staffers who had reservations, and a special panel was appointed that again excluded anyone that had reservations, in an unusual procedure, which approved Menaflex. Now Congress and the Obama administration are being asked to review the whole process the FDA uses for medical devices because of the controversy this has caused about what is seen as unfair influence of companies in FDA approval process. Menaflex say those who had reservatoions faces alot of pounding and wear and tear between the knee bones and its safety and effectiveness needs to be proven before approval. It has been approved in Europe for afew years, but only 2800 patients have used it in Europe, only a small proportion of patients, and not enough is known about its effectiveness and any issues. ...

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Nokia's new phones which allow music to be downloaded wirelessly compete with the Apple iPod. The new phones can download songs wirelessly which the iPod cannot, but have a limited range and music selection compared to the iPod. Nokia hopes o enhance its margins with the higher priced phones. It is also giving Nokia an opportunity to take the lead in innovation.

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Ways to know when social media use is unhealthy are shown here. It includes compulsive checking of feeds, and being anxious without one's phone. Better still do away with social media use altogether. The world did just fine in the time upto the year 2000. Social media is a relatively recent phenomenon and around for a short time to be thought of just as a fad that came and passed like so many fads before this. News media is best done by those with the accumulated experience of generations and not by social media or tech companies. Life could return to a better state of affairs that existed before all the turmoil from social media and so called tech in news that almost ditched the greatest democracy in the world. And provided the distractions from the dangers that now threaten the Free World in America, Latin America, Europe, Asia and Africa from pandemics, food security, dependence on foreign manufacturing, high inflation, mental health, and threats from Russia and China. ...

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David Segal takes a detailed look inside Apple's retail stores in the U.S. and talks with employees at different stores to find out what its like working as an hourly employee at an Apple store. World wide Apple's 327 global stores sold $16 billion in Apple products. Per employee the sales are about $473,000, but at an hourly rate of about $12 the average employee makes about $25,000 per year. After recent wage raises this could be up to about $36,000. The National Retail Federation says electronics stores have about an average of $206,000 in sales per employee. Contrary to what most people may think most of Apple's employees are not engineers and other professionals, about 30,000 of the 43,000 Apple employees in the U.S. work as hourly employees in the retail stores. Most are young people in the early 20's, single, with health insurance provided by Apple not costing as much for that age group. There is no career path and most leave after a couple of years. Because of the Apple mystique and the drive to create new user friendly products there are many young people looking for this kind of temporary work, especially now with high unemployment. ...

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HP's Apotheker emphasized in an earnings call "the tablet effect is real and sales of the TouchPad are not meeting our expectations. The velocity of change in the personal device marketplace continues to increase as the competitive landscape is growing increasingly more complex especially around the personal computing area." By the tablet effect Apotheker means the Apple iPad. The tablet is becoming popular but not the other tablets from Samsung, HP and other makers. It is the iPad that is the product customers turn to and the tablets of competitors are not accepted as a substitute. As a result CEO Apotheker plans to exit the tablet and PC business.