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NYT shows 17 year old Summer McKintosh of Etobicoke, Ontario, Canada, swimming with the greats such as her idol Ledecky in the 400 metres at Paris Olympics with use of breast, freestyle, back and butterfly strokes. The swimmers routine starts at 4.15 am and no matter how she feels she gets up goes to swim and tries the hardest for two hours 6.30 to 8.30 am then exercise training on land followed by 3-5 pm another two hours in the afternoon. She keeps at it steadily day after day. 

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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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Jonathan Martin of the NYT documents the many ways in which the current campaign for the U.S. presidential election sets alarming precedents- in the frequent use of untruths and inflammatory language, vulgar discourse. Republicans and Democrats alike are cited who say this has deteriorated the public discourse in the country. Martin documents the ways in which the Trump campaign has set a downward course. The language on television has deteriorated says Martin, and in some ways politics is catching up with it. The media has also failed to exercize proper scrutiny of candidates, and some experts say much soul searching may be needed in the future for the media and politicians if the country is to get back to dialogue based on facts.

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Lane Forsheim has this interview with tennis player Andre Agassi who won the Grand Slam in The Open era in 2003. Agassi suggests living in the present and avoiding future tripping thinking and solving problems for the future which may not exist. Agassi describes his daily routine. He says pickleball is a great way to exercise without thinking of exercise especially for over 50's. Agassi works for 3-4 hours a day and then plans his daily life around this. He loves the way Alcaraz, Sinner and Medvedev have brought new life into tennis as an exciting game to watch. Agassi talks about marraige- he is married to Steffani Graf, who also played tennis in the top ten. He says know yourself and you can't come into a relationship needing the other to be complete.  For breakfast he has oatmeal with protein or some granola and fruit. Less well known is that Andre Agassi is from Las Vegas, and has a thoughtful autobiography "Open" that is remarkably honest about his survival in the competitive world of tennis after many struggles with parental pressure to win. Yet he comes through having made his own choices. He started the preparatory Agassi Tennis academy for underprivileged children. When Sinner won the Australian Open yesterday he thanked his parents for not putting pressure on him for letting him try different sports. ...

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Sebastian Kniepp is Germany's barefoot walking guru. A German wellness expert from the period of the Hapsburg monarchy in Eastern Europe he came up with different ideas for wellness, including nutrition with home grown vegetables and fruits a big part of the diet. He turned to barefoot walking and storking using it as a form of exercise walking on one's toes in shallow water. This BBC report is from a Kniepp spa a short drive north of the Slovenian capital of Ljubljana, which shows these ideas popular today are not new.

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Three years of non stop mask wearing in Japan makes people's smile fade. Facial muscles no longer work the way they do. Exercizing facial muscles or doing yoga for the facial muscles can relieve the disuse. This is a problem not just for Japan. Key is to strengthen the muscles under the eyes and around the corners of the mouth by mild stretching using yoga or Japanese shiatsu exercizes.

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One commentator in Norway says "an entire state apparatus has played bankrupt" with Norway's international reputation. British and Norwegian Royals Sarah Ferguson divorced wife of Prince Andrew,  Princess Mette-Marit of Norway, and the Epstein Files showing messages exchanged with Epstein even after much of his history was known, show a lack of judgement that reflects badly on Britain's establishment, on Norway's establishment. There are media reports of Mandelson, Starmer's UK ambassador to US of having sent messages to Epstein on matters relating to confidential plans of the government to sell state assets and about policy influence under a previous Labour administration.This suggests to people in Britain that Labour has failed to appoint people of integrity to important positions. Before Rutte of the Netherlands took over as head of NATO, the head of NATO Stoltenberg for 10 years was from Norway. The total population of Norway of 5.5 million is less than the population of the Houston region. Should it exercise such an important role in the affairs of Europe much less of the world? It was under Stoltenberg's appointment in 2014 as head of NATO after losing an election in Norway, with Merkel and Obama's support, that gradually changed the perception of NATO as too close to Russia's borders so that by 2019 when Covid took place the situation deteriorated in Europe beyond recognition. Russia and China joined together and Russia invaded Ukraine in 2022 with Stoltenberg in a role in NATO that reflected more the British view of NATO than how DJT and other Republican leaders perceived NATO. As America turns this chapter of Bush-Clinton-Bush-Obama years of failed politics in which US lost control in its own backyard to drug trafficking gangs in Mexico and Venezuela, conducted wars in remote deserts and mountains in the Middle East, and lost its economic position to China, turned over NATO to  politicians who followed a British view of hostility to Russia that did not reflect the American view of working in cooperation with Russia, China and other major powers, this appointment of Stoltenberg a figure in the Norway establishment may be seen as another failure of the Merkel/Obama years. ...

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Bars and restaurants filled with people just increases the risk. Consider that on one day June 20, 500,000 people went to bars in Los Angeles county the day after they reopened, as reported in the WSJ. This is similar to what happened in soccer stadiums in Lombardy, Italy, spreading the virus like wildfire. Experts say social distancing is easier to do in office locations and at work, than at bars, restaurants inside, and at soccer stadiums, or large gatherings of any sort. In just one situation 138 new cases were traced to a bar in East Lansing. Michigan.

Most of the restlessness about the lockdown was about not being able to get to work after weeks inside. And getting outside to a park for exercize was always safer because it was easier to keep social distancing in these places.

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Lessons that can be learned from the Shackleton mission to the North Pole for the exercize of leadership.

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U.S. healthcare spending of about $3 trillion comes with poor results. The cost per person is about three times that of countries such as France, Britain, yet the results show U.S. doing extremely poorly. The author points out that less spending on healthcare and more on social services in areas such as education, nutrition, housing and other services would improve the outcomes and results. It is this missing factor that is helping other countries in Europe, Japan and China achieve better outcomes and returns per dollar spent.  Social spending can affect such things as nutrition, exercize levels, lifestyles, housing and result in dramatic improvements in obesity levels for instance, or inflammation levels in the population that play a role in many diseases. The idea is prevention. This is not happening because higher health dollar spending has lobbies to support it. Social spending also is a dollar expense that shows up immediately whereas results are spread out into the future as a longer term benefit with healthier populations that need to consume less healthcare and treatment. Elizabeth Bradley, president of Vassar College is an expert on this subject. She says social services spending gives more bang for buck  in health outcomes.  The point is relevant also for countries in South Asia and Africa that have taken some on some aspects of the U.S. health system resulting in health care spending that does not deliver the most for the dollar spent, and ignores the critical role of prevention.  The solution lies in moving these health care dollars out of the health care spending and into education for health outcomes, lifestyles, exercize habits education, and into social services that enable prevention and better health. ...

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This report in the WSJ shows how Amy Barrett, the new Supreme Court nominee, has managed to combine parenting with her career as a Notre Dame professor and judge on the Seventh U.S. Circuit Court of Appeals. A lot of help from her husband, a flexible workplace, living in a smaller town South Bend, Indiana, and a willingness to go with nonconformity, make it possible. She is up at 4 or 5 am to exercize. Blending different worlds is part of this. She can go from work to run an activity for the children. She also views raising children as the activity that has the "greatest impact on the world," so that her career is seen in a bigger context of life.

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Pope Francis outlines his views on gay marraige and divorce in this document in April 2016, and calling on pastors to exercize tolerance and broadmindedness.

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Comparative effectiveness research will be conducted to evaluate what is the best treatment for any ailment or disease or health problem under the $1.1 billion allocated for this in the Stimulus Plan. What are the alternative methods of treatment, what is the effectiveness of each treatment, what are the comparative costs and so on. Is it better to treat neck pain with surgery or acombination ofphysical therapy, exercize and medications? If there is ablockage of arteries in the lower leg and leg pain, how does drugs and watchful waiting compare with surgery? For chronic heart failure how does home monitoring of blood pressure and weight and exercise in addition to medications provide an alternative route as opposed to just medications. Dr Fisher of Dartmouth Medical School cites these as examples of questions that can be asked in comparitive effectiveness research. The money will be available to the Health and Human Services Department and will be used over several years. About 15 federal employees will form a council to coordinate the research and advise President Obama and Congress on how to use the money. In 2007 the US spent $2.2 trillion, or 16% of GDP, on health care, and the Congressional Budget Office says it will grow to 25% of GDP at the rate its growing by 2025 if left to its own devices. ...

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Typically one spouse is healthier than the other. As one ages, kids and other things are less in the foreground, health matters more. This is when the conversation if carried on the right way, nudging in the right way can get results.

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What is the one thing experts say is most beneficial for health? Improving our minds by building self-awareness. Understanding your feelings, motivations and behaviours in more depth, enables us to make better choices. To do this try journaling, meditating, practicing mindfulness or simply making time for self-reflection at the end of the day.

In doing this also pay attention to diversity in eating plant based foods for as many as 30 plant based foods, incorporating different exercize routines that get you motivated and happy, and get a good seven or eight hours of sleep, say these experts in health and nutrition.

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The 65,000 tonne vessel aircraft carrier HMS Queen Elizabeth joins the British fleet at Portsmouth. Queen Elizabeth says at the opening ceremony- "she will in the years and decades ahead represent the country's resolve on the global stage."  The Queen has a special connection with the Royal Navy- "As the daughter, wife, and mother of naval officers I recognize the unique demands our nation asks of you. I will always value my special link with HMS Queen Elizabeth, her ship's company, and her families."

The ship is part of a carrier group that includes US Marine aircraft that is headed for the Indian Ocean and Japan for joint exercizes.

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This WSJ report shows how retirement looks in America from the financial and lifestyle aspects. The median net worth for people 65-74 years is about $266,000 compared to an average net worth of 5 times that of $1.2 million for this group. This means wealth is highly skewed in America today with a small percentage of high wealth group pushing the average up this much- a result of neglect of American manufacturing that sharply reduced income and savings security of working families, and the impact of laissez faire policies of the administrations since the 1970's with financial crises hurting workers and families. The impact of wars was also borne heavily by workers and families with the neglect of infrastructure and public services in a misallocation of the nation's wealth.  Other points of note are the way time is spent today in retirement with less educational activity or volunteer work than one would imagine, and not enough time for exercize. Only a miniscule amount of time goes to volunteer work (.17 hours) or reading (.57 hours) compared to watching television (4.50 hours) for retirees. Exercize that keeps people healthy one would expect it to go up in retirement only shows .29 hours. Arts and entertainment or cultural activities only 0.05 hours, people are lonelier spending less time with each other with 0.57 hours for socializing and communicating. All showing how Americans in retirement can do better and live better lives by increasing the amount of time they spend in these healthy activities and less on television. Television which is also a sedentary activity takes up 3 times all the other activities essential for healthy living just mentioned combined. Little or no time is spent in meditation, mindfulness or mental wellness, as this grouped under prayer shows only .07 hours or just a few minutes a day.  Small changes that are made in the right direction would do much good for the quality of living for all Americans. Combined with an effort for the renewal of infrastructure and public services this would be an effort in the right direction, contributing to the well being of America.   ...

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Isaacson's new book on Musk says Musk's story is a cautionary tale. The compulsion to be drama magnet or mean are not prized traits, say others.  More sinister (the hell) is celebrating a culture that does not respect the need for worklife balance, of respect for nutrition and exercize for good health. Musk's methods which he calls "algorithm", a word known more for obscurity than meaning, are nothing new. For years as the US, Japan and China, now India have innovated there is a focus on simplifying things, and to do this questioning the existing way of doing things by breaking down the existing method into pieces and reorganizing the pieces of the puzzle leaving out unneeded pieces. What is the key to his success as it was for Jobs at Apple is creating a culture in which people would invest in and take risks for innovation at the high end of the price spectrum. Jobs used design and new stuff like the iPod and iPad, iPhone to do this. Musk does this through playing the role of a social media icon but a dangerous one that does not respect worklife balance and good health habits of nutrition, exercize and mindfulness. In processes this can give you a process that takes less time and money- how India's moon mission and rover Chandrayan 3 was done for $78 million showing these work practices of Musk are nothing new, and universally adopted by successful companies and nations. Newer ask your employees to do what you would not do, is also adopted by the best managers. By turning it into a mantra it obscures the fact that America today is a country of massive inequalities where two thirds of 4th graders cannot pass ACT reading test and half of retirees have zero savings, working people and families face a cost of living and health crisis and are badly neglected. How does it help to role model as an icon and popularize a culture that tolerates and accepts such conditions that would leave men deeply troubled, including America's leaders Washington, Lincoln and FDR if they were alive today. ...

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On CBS "Face the Nation" last weekend both Mark Warner and Senator Rubio expressed concern about unknown algorithms targeting 150 million young users in America. The problem extends beyond that into the effects of TikTok and other social media that is harmful to children taking so much of their time that basic civics, reading, sports and exercise, outdoor activities, suffers enormously. No other generation has faced this and the US Congress and the White House have fallen far behind the curve of setting the rules and regulating use of the new information technologies. 

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This excellent article by Peta Bee looks at how we can do anti-ageing efforts to keep our immune systems strong as we become older. She looks at work by an expert in immune cell biology, Janet Lord, who is head of the Institute for Inflammation and Ageing at Birmingham University. It is now proven that the link between ageing and immune systems can be guided in constructive ways. At sixty and seventy years age one can have the immune system of a 30 year old by doing a couple of simple things which are covered here from taking 10,000 steps a day, high intensity interval training on some days each month, occasional fasting on some days, high fibre diet and vitamin D. Walking, running or other forms of exercize affect a particular form of immune function called neutrophil movement in positive ways. Neutrophil movement because these cells are the main defense against the forms of bacteria that cause pneumonia. Neutrophils in older adults behaved in ways similar to that found in 30 year olds when doing 10,000 steps a day of exercize. Dr. Lord and other researchers have found. Dr. Jenna Macciochi, a lecturer in immunology at the University of Sussex, says about 70% of our immune system resides in our gut, making gut health very important for our immunity. Macciochi is the author of Immunity: The Science of Staying Well. Important for gut or gastrointestinal health is the eating of food that has prebiotic and probiotic effect. This helps reverse the decline of immunity coming with ageing.When we chew down on fibre in vegetables, fruit, beans or lentils we have beneficial byproducts called postbiotics that act as an interface between diet and immunity, that change the personalities of cells and circulate in our blood for regulation of immune system, says Dr. Macciochi. Postbiotics from eating dietary fibre tune up specific virus fighting cells that help us fight infections from flu and viruses, studies show says this report in The Times. Women in the UK get only 17g per day, men 20 mg per day of fibre. We need 30 mg per day of fibre and to do this we need to increase our intake of vegetables, fruits, whole grains, nuts, seeds and pulses. Also important is avoiding the inflammation that comes with ageing called inflammageing, says Dr. Macciochi. To do this do resistance training, weights, or using body weight such as lunges, push ups, squats. When our muscles move we produce hormones called myokines that help our immune cells function and keep inflammation down. She believes strength work is an absolute essential to rejuvenate our immune age. ...

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US life expectancy dropped by 1.5 years to 77.3 years, the largest drop since 1943. This takes life expectancy back to the level in 2003. During the pandemic of 1918 the drop was 11.5 years, showing how much difference vaccines and modern medicine can make. The drop is a result of coronavirus, and added to this are the complications for people with other diseases including chronic liver disease, which is connected to use of alcohol. There was a decline in asthma and cancer related diseases. Delayed treatment for health conditions because of lockdowns and homicide increase were other causes of the drop.

Isolation, stress and disruption of normal diet and exercise will have effects still to be seen, say experts. 

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Will AI reduce the curiosity that drives the creation of new knowledge and the curiosity for new discoveries that powered science and technology since 1600? Will it affect the human tendency and habit of asking questions, seeking out novel answers that is intrinsically human that AI cannot do? Scientific inventions that led to Europe leading the way and Asia falling behind after 1600 and new inventions taking place for 300 years with old theories discarded and new knowledge created are impossible under an AI arrangement. If AI existed in 1600 few new discoveries would have happened because they involve asking new questions and finding answers to these questions that take many years sometimes a lifetime of discovery and invention. Other weaknesses of AI are for example that it is fast but it cannot think- it is pieces of knowledge pinned together in different ways that come up from billions of pieces of information pieced together. It gives the appearance of thinking if one is not careful to look at it's process diligently. Its main source is using the public knowledge base built by Wikipedia, with other additions piled on top. Wikipedia may be wrong there are biases and tendencies to overlook facts in Wikipedia inherent in any knowledge exercise. These are then transferred to AI without anyone knowing about it openly, making it more dangerous in that it precludes creative thinking and finding solutions that never existed before to problems or questions, which can only be done by the human mind through its curiosity and stubborn dogged desire to find solutions to a problem.  ...

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Fortunately even here there is room for optimism as male life expectancy declined by only 0.2 years from 79.2 years to 79.0 years the level in 2014. Considering the scale and intensity of this pandemic this is a sign or resilience of the UK with the work of NHS at the forefront. Female life expectancy has remained unchanged in 2020 at 82.9 years, about three years more than men.

With more consciousness about the risks of obesity, importance of nutrition and exercise habits information given wide attention, there may be some positive signs from this period that will lead to a healthier population.

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Prime minister Boris Johnson says he will proceed with "maximum caution" as he plans reopening of the economy. The reproduction R ratio for the virus is just below 1.0 and may have gone up recently, say public health officials. Britain faces a problem of deaths in care homes that is not under control.

Prime minister Johnson will announce Sunday new moves which will be limited- allowing people to go out to take as much outdoor exercize as they like, and restart activities such as tennis, golf and fishing. Businesses will get guidance to prepare places for social distancing when people return to work. Restrictions on limiting people contact to those within their household will remain.

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This report about 996, referring to nine am to nine pm 6 workdays a week, shows it is becoming highly unpopular among tech workers in China, as tech companies slash jobs and workers work longer hours. A campaign on GitHub a code sharing platform is called 996/ICU speaks of such gruelling hours as the way to end up in the ICU. It got 250,000 positive user comments.

This type of work at tech companies is leading to fatigue, chronic illness, stress and lack of any free time to think or even exercize, leading to health problems. Yet some company CEO's push 996 against the mounting evidence that this is not the best for employees and can lead to por producivity. Recent studies about the cities such as Mumbai, India, or Tokyo, Japan, show productivity is a fraction of the productivity in many European countries working normal hours. Mumbai vs. Dublin for example. Dublin has a lot higher productivity.