Category Archives: Preventative Medicine

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As Canada continues to reopen, some grocery stores, salons and other businesses have implemented temperature screening an approach that uses a touchless scanner to measure a persons body temperature in an attempt to prevent the spread of the novel coronavirus.

The process was made mandatory for all air travellers in Canada in mid-June. Any passenger who shows a fever on two measurements, taken 10 minutes apart, will be asked to rebook after 14 days.

However, some experts wonder whether the step is effective given a person can shed the COVID-19 virus without having a fever or any change in body temperature. The tool often used to measure temperature has also been shown to be unreliable.

READ MORE: Temperature screening not always reliable to mitigate coronavirus risk, experts say

For those reasons, temperature screening has not been recommended by Canadas chief public health officer Theresa Tam. In fact, she quickly shut down the approach when more businesses began implementing the practice in May.

The more you actually understand this virus, the more you begin to know that temperature-taking is not effective at all, Tam said in a ministerial update that month.

Tam said the likelihood of screening someone who was symptomatic was relatively inefficient in comparison to those who were asymptomatic.

If we have a significant number of asymptomatic or pre-symptomatic people, that also even reduces the effectiveness even more.

Dr. Susy Hota, the medical director of the Infection Prevention and Control and Medical Device Reprocessing department at the University Health Network in Toronto, agrees.

"There really are a lot of limitations to temperature checks, and I'm not really convinced that they're worth investing in for this purpose," Hota said.

READ MORE: Canada to screen air travellers for fever amid coronavirus pandemic: Trudeau

There are also inaccuracies with the temperature probes used for this purpose, Hota said.

She worries they can give patrons and business owners a "false sense of security."

Temperature screening is typically not an effective way to detect COVID-19 when used on its own, and that's because of the way the virus spreads.

"When we talk about the issue of pre-symptomatic shedding and transmission, we're talking about people who have no symptoms yet so no fever," Hota said.

"Once you've developed the fever, we know what we're dealing with ... but in the pre-symptomatic phase, a temperature check won't help."

Problems can also arise from the touch-less temperature probes currently being used in airports, grocery stores and by other businesses.

"It's a variable that ... isn't infallible," said Dr. Leighanne Parkes, infectious disease specialist and microbiologist at the Jewish General Hospital in Montreal.

"It depends on the instrument that we're using, the ambient temperature, (if) the instrument is calibrated correctly, is the individual coming in from a hot outside or a cold outside?"

All these things come into play when a temperature probe is used, making true measures hard to come by.

READ MORE: You might be wearing your mask, gloves wrong. How to use PPE properly

There are also other reasons a person's body temperature could be elevated that don't have to do with COVID-19.

Medication, certain pre-existing conditions, weather and what you were doing immediately prior to having your temperature checked are all factors that can affect your body temperature, Hota said.

"It is possible that your ambient temperature and what you were doing before ... might register a higher temperature than you really would have otherwise," she said.

However, Parkes believes temperature screening could be helpful when it's "bundled" with other preventative health measures.

"If you have an adequately calibrated machine, you're [testing the person's temperature] indoors using appropriate techniques and ... you're also symptom-screening for things that are not fever, and risk factors including contact, those altogether can pick up some of the most high-risk cases," Parkes said.

Temperature screening should be considered just one layer in a "pyramid of prevention," she said.

"It's not a replacement for the other means that we have in place, such as social distancing, masking in public spaces, adequate ventilation, adequate environmental cleaning ... all those things combined."

Although temperature screening may not accurately detect COVID-19, it's still within the rights of a business to deny you service on the grounds of a high temperature.

This is because employers and employees have the right to a safe working environment.

"You can't be denied entry on grounds of race or religion ... because that's discrimination, but if your temperature is above some arbitrary scale, then you can be denied entry," said Bernard Dickens, professor emeritus of health law and policy in the faculty of law, faculty of medicine and Joint Centre for Bioethics at the University of Toronto.

READ MORE:Planes, salons and grocery stores: Companies that require masks in Canada

"It's a security ground ... to protect the staff who work in the facility. They have a right to a safe working environment, and the store is responsible for the safety of its employees."

Basically, any business can make conditions for who they serve as long as they don't discriminate [and they're not] in violation of the human rights code.

For this reason, you can refuse to take a temperature test, but the store can refuse your entry upon doing so.

"You have no right to go into the store ... because the store can set reasonable conditions [for protection]," Dickens said.

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.

In situations where you can't keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

For full COVID-19 coverage from Global News, click here.

With files from Global News' Emerald Bensadoun

Meghan.Collie@globalnews.ca

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Can I refuse a temperature check? What to know about the COVID-19 screening tool - MSN Canada

Amphibious assault ship USS Makin Island (LHD-8) underway in the eastern Pacific on April 20, 2020. US Navy Photo

When a COVID-19 outbreak hit USSKidd (DDG-100) last month, the Navy sent a medical team with specialized lab equipment to the guided-missile destroyer to test for novel coronavirus among the crew. An outbreak at sea could easily and quickly overwhelm a warships small medical department, in this case an independent-duty corpsman and two hospital corpsmen in a crew of about 330.

Fortunately forKidd, amphibious assault ship USSMakin Island(LHD-8) was training in the Southern California Operating Area when the Navy on April 23 ordered it to rendezvous withKiddand escort it to San Diego.

Extra medical help was on its way. AboardMakin Islandwere four members of Fleet Surgical Team 1, who were training with the ships medical staff during the at-sea operations.

Withindays, as both ships headed toward California,15Kiddcrew members suspected of being infected by the virus were flown toMakin Islandto be monitored for the virus.

The big-deck amphibious ships medical department is among the largest, most-advanced treatment facilities in the fleet, aside from the Navys two hospital ships operated by Military Sealift Command. It has large treatment spaces, including a 15-bed intensive-care unit and a 45-bed ward designed to treat combat-wounded Marines.

Along with the four members already embarked onMakin Island, the San Diego-based FST-1 sent an additional four a certified registered nurse anesthetist, critical-care registered nurse, respiratory therapy technician and laboratory technician to the ship to help treat theKiddsailors. When deployed, a Navy fleet surgical team generally has about 15 medical personnel and provides Role 2, or resuscitative damage control surgery and mental health, care to naval amphibious forces.

Navy Counselor 2nd Class Caileigh Almazo, assigned to the guided-missile destroyer USS Kidd (DDG-100) on April 28, 2020. US Navy Photo

Once we were notified that there was a possibility that we would be helping the USSKidd, we decided to bring onboard four additional team members, just based on the possibility of getting patients, Lt. Jose PonceVega, the FST-1 division officer and medical regulating control officer, told USNI News.

As soon as we heard that call, we decided we were going to bring those people, said PonceVega. So within an hour, we called our staff and said, Hey, pack your bags, youre coming with us, and they were onboard within four hours.

They arrived the same dayMakin Islandgot directed to assist. The team had two-and-a-half days to prepare before the 15 sailors arrived. They workedwith Makin Islands medical department to treat the patients and handle necessary laboratory work and X-rays en route to San Diego.Our goal was to provide basically observation on the patients, based on their medical condition and based on the symptoms they were displaying, he said. The patients remained aboard theBremerton, Wash.-based shipuntil San Diego.

FST-1 sent one of its independent-duty corpsmen, who have specialized training including in preventative medicine, to theKiddtoassist the destroyers crew, PonceVega said. He is very experienced and very knowledgeable, so him going to that ship really helped out the crew and their medical staff.

On the trek to San Diego,Kiddgot extra support including fuel, protective masks and other medical supplies fromMakin Islandin air deliveries flown by Navy Helicopter Sea Combat Squadron 23, according to an Expeditionary Strike Group 3 news story. A MH-60R from Helicopter Maritime Strike Squadron 75, embarked aboardKidd, transferred the patients fromKiddtoMakin Island, which instituted quarantine and decontamination measures to prevent the spread of any coronavirus.

We were standing by and able to bring those sailors toMakin Islandwhile still maintaining isolation and quarantine of them and the medical professionals that we have onboard who treated them, said Capt. Chris Westphal, the ships commander, said in the news story. We took every precaution to ensure the safety of bothMakin IslandandKiddsailors, and to ensureKiddreturned to San Diego safely, and we were proud to be able to help our fellow shipmates.

The emergent mission put FST-1 members to the test. This was definitely new for us. I think with the spirit of protecting our people, we had made some plans to care for COVID-positive patients at some point, PonceVega said. As soon as we got out of the pier and started doing normal operations in the SoCal area, we started making plans for that. But we didnt expect to employ those plans right away. So we planned for it, but we didnt think it would happen so soon. So we learned a lot through that process.

FST-1 leaned on the Naval Health Research Center and the Navy Environmental Preventative Medicine Unit for information and lessons learned from similar missions.

USS Kidd (DDG-100) arrives in San Diego on April 28, 2020. US Navy Photo

One thing that weve learned the most is about how to use our protective personnel equipment, our PPE, said PonceVega. When youre taking care of a patient, you dont typically wear a mask and face shield, so just getting used to using that and putting it on and taking it off appropriately is a learning experience itself. So they practiced in drills using the protective gear enroute to theKidd.

They took measures to limit interactions of medical staff with each patient, at least until they knew whether the sailor was infected with the coronavirus. You dont need everybody to have close contact with a positive patient right away, PonceVega explained. So you assess the patient and figure out what you need, then if you need additional staff to support the care that youre going to provide, then you bring them in.

That ability to scale your staff, based on the needs of the patient, was definitely something we learned, he said. Also from the perspective from the administrative requirements of moving the patient from one ship to the other and tracking them through the levels of care, that was something we paid close attention to to make sure we got it right.

We had developed plans what to do with patients if we ha positive patients onboard. Our initial plans were to get the patient to a medical facility to get the care they need. But in this situation obviously we had to keep the patient longer than expected, he said, so coordinating that care to make sure that once you get to a location that they get to the right facility for care.

The Navys primary mission is to protect our people, he added, so we pride ourselves on being able to provide care to our sailors and be ready to respond to whatever the needs are of the fleet.

Related

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How USS Makin Island, Fleet Medical Team Responded to COVID-19 Outbreak on USS Kidd - USNI News

(Reuters) Heres what you need to know about the coronavirus right now:

On the economy, medical metrics rule for now

U.S. Treasury Secretary Steven Mnuchin and Federal Reserve Chair Jerome Powell will testify on Tuesday before the Senate Banking Committee and face questions about their plans keep the worlds largest economy afloat and missteps in rolling out some $3 trillion in aid so far.

Two months into the pandemic, many analysts have concluded that U.S. policy has at best fought back worst-case outcomes on both the health and economic front.

Powell has said he sees the likely need for up to six more months of government financial help for firms and families. With regular data on the economy at best volatile and at worst outdated when it comes out, he said medical metrics were the most important signs to watch right now.

The presidential pill

Donald Trump surprised many on Monday by revealing that he is taking hydroxychloroquine as a preventative medicine against the coronavirus despite warnings about the malaria drug.

Ive been taking it for the last week and a half. A pill every day, he told reporters. All I can tell you is so far I seem to be OK.

Weeks ago Trump had promoted the drug as a potential treatment based on a positive report about its use against the virus, but subsequent studies found it was not helpful. The Food and Drug Administration issued a warning about it.

Glimmer of hope

That overshadowed news that an experimental COVID-19 vaccine made by Moderna Inc produced protective antibodies in a small group of healthy volunteers, according to very early data released by the biotech company on Monday.

The vaccine has the green light to start the second stage of human testing. In this Phase II trial to test effectiveness and find the optimal dose, Moderna said it will drop plans to test a 250 mcg dose and test a 50 mcg dose instead.

Reducing the dose required to produce immunity could help spare the amount of vaccine required in each shot, meaning the company could produce more of the vaccine.

Eating with your mask on

Israeli inventors have developed a mask with a remote control mouth that lets diners eat without taking it off, which they say could make a visit to a restaurant less risky.

A squeeze of a lever opens a slot in the front of the mask so food can pass through.

The process could get messy with ice cream or sauces, but more solid morsels can be gobbled up a la Pac-Man in the arcade game.

(Compiled by Karishma Singh and Mark John; Editing by Giles Elgood)

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What you need to know about the coronavirus right now - Physician's Weekly

YOUTUBE ORIGINALS DEBUTS NEW LEARNING SERIES "SLEEPING WITH FRIENDS"

REALITY SLEEP COMPETITION SERIES AIMS TO PROMOTE WELLNESS AS PART OF MENTAL HEALTH AWARENESS MONTH

Watch FOR FREE Now at YouTube.com/BrainCraft

WHAT:

Today, YouTube Originals unveiled "Sleeping with Friends," an all-new reality competition series about sleep hosted by BrainCraft's Vanessa Hill, which is now available to stream for free only on YouTube.

The series arrives for Mental Health Awareness Month, which coincides with one of the most challenging periods our world has ever faced with the current pandemic. There is no health without mental health, and it's important to take notice and care of our emotional, psychological and social well-being. One major factor that contributes to mental health? SLEEP.

In this three part special, EduTubers will go head to head to see who can improve their own sleep using the latest techniques and products. Featuring Mitch and Greg from ASAPScience, Donna Yatz of PsychIRL, Melissa Maribel, judges and mental health professional Kati Morton, Dr. Ali Mattu, Trace Dominguez, and hosted by Vanessa Hill. The series is produced by 96 Next.

Sleep is the ultimate performance enhancer and best preventative medicine. Yet, a 2018 CDC study revealed that every night, 35% of Americans don't get enough. We're in a cultural shift where more people are trying to reclaim sleep - and using YouTube for on-demand sleep aids and information. BrainCraft presents the world's first sleep competition series with "Sleeping with Friends!"

Speaking of sleep, YouTube recently rolled out its Bedtime Reminders feature where you can set reminders at specific times to stop watching videos and (you guessed it!) go to bed. You can set this up through Settings, and you'll even have the option to dismiss or snooze the reminder. This feature is available on Android and iPhone devices and will roll out to all users in the next few days.

This month, YouTube will also be highlighting Well Being and Mindfulness content on the platform's Spotlight channel. Playlists on the channel will feature content from creators like Kati Morton who can speak to why getting support can help, and Jay Shetty on meditation.

# # #

ABOUT YOUTUBE ORIGINALS

YouTube Originals are award-winning, creative and engaging scripted and unscripted series and films across music, personalities and learning for fans all over the world. Spotlighting both YouTube creators alongside Hollywood's biggest stars, YouTube Originals provide an experience that only YouTube can offer. By tapping into the platform's growing global community, fan engagement product capabilities, and innovative content mixed with pioneering live-streamed specials, there is truly something for everybody. Fans experience YouTube Original content through ad-supported YouTube as well as YouTube Premium, a subscription service that offers access to YouTube Original series and movies, a streaming music platform, and an uninterrupted, ad-free experience across all of YouTube. YouTube Originals are available in nearly 80 countries worldwide.

ABOUT BRAINCRAFT

BrainCraft is a popular educational YouTube channel that shares self-improvement tips and advice based in psychology and neuroscience. With more than 500,000 subscribers and 30 million views to date, BrainCraft was created by Australian science journalist and producer Vanessa Hill to bridge the gap between scientific research and people's daily well-being. Along with BrainCraft's success on YouTube, BrainCraft ran for five seasons as a PBS web-series and has received nods from both the Webby and Telly Awards. Vanessa's work on YouTube and in collaboration with public broadcasters in the US and Australia has helped make her one of the leading female voices in science media.

ABOUT 96 NEXT

96 Next is a Primetime Emmy(R) and Peabody award winning multi-platform production studio. The company is founded by interactive storyteller, creator, and showrunner Bernie Su. His YouTube work includes, The Lizzie Bennet Diaries and Emma Approved, which were awarded the first and second Primetime Emmys ever won by a YouTube distributed series.

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Breaking News - YouTube Originals Debuts New Learning Series "Sleeping with Friends" - The Futon Critic

Many residents are doing their part to help flatten the curve by sheltering in place and reducing visits to local businesses during the COIVD-19 pandemic. But when they dont got to an emergency department because of an illness or injury, the delay could be life threatening.

Bunch

At Riverview Health, Lynne Bunch, the program director of the Fishers and Hazel Dell ER/Urgent Care facilities, said she worries daily that people are waiting too long to see a doctor for fear of coronavirus exposure.

People are afraid to come out to the ER, and it leads to a much higher acuity level, or sickness, with people who dont have a choice and have to come, and thats dangerous for all kinds of reasons, Bunch said.

Delays in seeking care can make otherwise treatable medical conditions worse.

Preventative medicine is shut down, too, right now, so thats an issue in delaying diagnosis, Bunch said. I have several examples of people waiting, and our acuity is much higher than it has been because when they do come in, they are much sicker than they would be.

Bunch said if someone is second-guessing whether or not to seek care, the answer is to seek it.

If you have an acute illness, go to an emergency department. Our facility is a unique model because if you are urgent level care, you are billed urgent level care and you will still see an ER physician and ER-trained staff, Bunch said. If you do need to be an ER patient based on what ails you, we can do that right there, too, and you wont have to be transferred.

Fry

Ascension St. Vincent is noticing a similar downturn in its non-COVID-19 patients.

Our experience has been same as pretty much everywhere around country. The number of patients presenting with stroke and heart attack are down significantly, said Dr. Edward Fry, chair of cardiology atAscensionSt. Vincent. Initially, people were embracing that as a good thing, a silver lining to isolation. Maybe people were not stressed and sleeping more, exercising and eating better, but what we are really finding out is people are fearful.

We are seeing the same phenomenon where people are deferring care and staying home.

Fry said a recent patient had a prolonged episode of chest pain and eventually visited the hospital a week later, where it was discovered he had had a heart attack.

He was lucky enough to survive, Fry said. There are a lot of examples of that. We are trying, through many different ways, to connect to patients to reassure them that every precaution to keep them safe is being put in place and to not forget their original health problem they had in the first place, especially for things like heart attack and stroke where time is of the essence in terms of treatment. If someone presents in a short timeframe of having a stroke, they can often be treated and reverse the effects of that stroke. Otherwise, it can be disabling lifelong. Thats similar with a heart attack.

Fry said heart attack cases are down by approximately 50 percent as of early March, but he doesnt believe that means heart attacks arent happening.

Hoeppner

IU Health has seen similar examples of patients delaying treatment and is taking steps to ensure patients feel safe enough to visit the ER.

We are separating folks based on screening in the emergency department, Director of the Medicine Service Line Christen Hoeppner said. If people are worried about sitting next to somebody who possibly has COVID, we are physically separating them with a wall.

There are two areas of the department, two entrances, all of that.

IU Health Emergency Dept. Physician Megan Crittendon said IU Healths emergency department when the pandemic began but has slowed since then.

Crittendon

I would say the evolution of this thing has been really interesting, she said. Initially, people were coming in just like regular when it first started, and people were concerned they had COVID, and so we were very busy because of it. It then reached this steady state where people started dropping off and not coming in except only for COVID, and we were seeing people in the extremes of illness. They were waiting until they reached the extremis. It has kind of become apparent that people were concerned that they were going to get coronavirus or have exposure or use valuable resources, so we werent seeing a lot of minor stuff, but we also werent seeing serious stuff, stuff people get admitted for. People were coming in extremely sick because they waited such a long time, so we have mitigated that risk by dividing the emergency department and waiting rooms into a cold side and hot side, as we call it, a side for COVID-exposed or concerned and a side of not concerned.

We still treat everybody with the upmost precaution. We mask everybody to mitigate the risk of spread.

Like other hospitals, Community Health has seen a steep downturn in patients.

Ross

Statistics have indicated overall numbers (of non-COVID-19 patients) are down significantly, and those illnesses obviously dont wait for the COVID-19 pandemic to go away. They happen, regardless, said Dr. Chris Ross, a Community Health emergency medicine physician. The overall emergency department volumes (that are) down significantly makes me concerned patients arent seeking care when they need help.

Ross said delaying a visit can result in serious health problems, including death.

We have seen people who have had pretty significant permanent injury because of the wait and also people who have had deaths, he said. We see that directly attributed to waiting to be seen because of coronavirus. Family members are afraid to come to the emergency department because they are concerned of getting the coronavirus, but unfortunately that (non-COVID) illness (and waiting to seek treatment) made them pass away.

Read more here:
The extremes of illness: Delaying a visit to the emergency room could be life-threatening for non-COVID-19 patients - Current in Carmel

Maayan Ora, originally from Montreal, is a vegan who uses her love of art to create delicious and vibrant recipes.

She is in her second year of blogging online about healing foods and plans to open a restaurant in Jerusalem next year.

Her motto, she says, has always been revealing the light within the truth. She believes there is more than an appealing exterior to food and works to highlight the beauty inside in her recipes.

Plant-based shakshuka with a chickpea-flour omelet.Photo courtesy of Maayan Ora

My name is a big part of my healing journey, she says.My name in Hebrew means Wellspring of Light. We are all given names which are a lot more powerful than we know. I believe our parents name us for what they saw in us, a garment of our soul, a power that we will shine through one day, its very deep and very real to me.

Ora says that before diving into any food or therapy, one should look at the name and the meaning of it and they will understand a lot more.

Avo Toast with sourdough bread, cashew spread and quinoa patties. Photo courtesy of Maayan Ora

Vegan Indian Thali. Photo courtesy of Maayan Ora

Truffle mushroom burger on sourdough bun. Photo courtesy of Maayan Ora

After immigrating to Israel three years ago, she saw how the vegan movement boomed in Israel.

Whats special about Israel is that a lot of people are looking for something deeper. Maybe because they live in their soul country or because of the way the culture is. I think Israelis are talented and lucky to be in a space where they can spread the healing of the body.

Ora was not always vegan, but later in life she saw the way food affected her body. Veganism means healing and preventative medicine to her.

Loaded Veggie Bowl topped with vegan sour cream. Photo courtesy of Maayan Ora

While she loves animals and the environment, health is her main reason for promoting veganism.

I feel that before anything else we need to save our own body. Our body is our walking vehicle in this world. One must take very good care of it.

Loaded Veggie Bowls and tahini. Photo courtesy of Maayan Ora

Q: What is the philosophy of the restaurant you are planning to open?

A: Healing. Our whole beings are solely created from a seed. And from there we grow. When I look at real food plant based I see seeds. Seeds waiting to be treated and cooked with love. The idea is that our bodies cant handle much. We grow up with different illnesses or later in life it hits us. The food we put into our mouths has a lot to do with chronic illnesses. All we have to do is get to know the nutrients and see what our bodies really need in order to not just survive, but live.

Barbecue Jackfruit Nachos with a side of artichoke guac and cashew cheese. Photo courtesy of Maayan Ora

Q: Why do you want to open a vegan restaurant?

A: Plant based has always been an eye catcher for me. The things you can create with simple foods, its endless. I also wanted to use the experience to acquire more knowledge about food interactions in the body.

Maayan Oras Healing Mushroom Coconut Curry Soup

Go crazy on the spices because they are flavor and because they are medicine, Ora says.

Saut in a little oil:

Add in:

Cook until soft.

Add:

Bring to a boil briefly. Add salt and pepper. Blend, eat and enjoy.

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Art-inspired vegan recipes for health and healing - ISRAEL21c

Ground-breaking new study shows the efficacy of a long-acting injectable to prevent HIV

GENEVA, 19 May 2020UNAIDS warmly welcomes the announcement that the long-acting injectable cabotegravir is safe and effective in preventing HIV among gay men and other men who have sex with men and transgender women. The HIV Prevention Trials Network (HPTN) 083 study enrolled almost 4600 HIV-negative people from across more than 40 sites in North and South America, Asia and Africa.

This is a breakthrough that will have a significant impact on the lives of gay men and other men who have sex with men and transgender women when they are at higher risk of HIV infection. said Shannon Hader, UNAIDS Deputy Executive Director, Programme. We are particularly pleased that the study met its targets to recruit substantial numbers of younger black men who have sex with men and transgender women, the very people for whom accessing effective HIV prevention still remains a huge challenge.

In 2018, UNAIDS estimates that there were 1.7 million new HIV infections, 54% of which were among key populations and their partners, including gay men and other men who have sex with men, transgender women, sex workers, people who inject drugs, people in prison, clients of sex workers and sex partners of other key populations.

Pre-exposure prophylaxis (PrEP)HIV-negative people using antiretroviral medicine to prevent HIV infectionis an important element in the HIV combination prevention toolkit. PrEP allows people to reduce their risk of becoming infected with HIV, particularly during periods of increased risk in their lives. It may also provide reassurance and reduce anxieties when the risks are uncertain.

Once it has passed regulatory approval, and when production of affordable cabotegravir can be scaled up, gay men and other men who have sex with men will have the choice of three highly effective ways to use PrEP to prevent HIV infection: daily pills, pills taken before and after sexual activity (event-driven PrEP) or an injection every two months. Transgender women will be able to choose between injections or daily pills, since the World Health Organization does not recommend event-driven PrEP because of possible drug interactions with some hormones. Injections of cabotegravir every two months are an important option for people who find it hard to take a pill every day, yet remain vulnerable to HIV infection.

The trial was scheduled to continue for at least another year, but the first interim analysis of the data was brought forward a few weeks because of the potential disruption that the COVID-19 pandemic might cause to high-quality clinical trial procedures. The Data and Safety Monitoring Board (DSMB) in the United States of America reviewed the data up to March 2020 and found that there was already clear evidence that cabotegravir was highly effective and not inferior to the currently recommended oral PrEP regimen.

Half of the study group were given oral PrEP and were injected with a placebo; the other half were given a cabotegravir injection and took a placebo pill. The study found a total of 12 HIV infections in the group using the injectable compared to 38 in the group taking the daily pill. The side-effects of both treatments were relatively mild, with only 2.2% of people in the injection group choosing to stop having the injections because of painful reactions. The DSMB therefore recommended that the study be halted and that all participants be notified of the result. The participants will be able to choose which regimen they wish to continue on.

Despite good adherence in the oral group and very few discontinuations in the injection group, the overall incidence of HIV infection in the study was 0.79 per 100 person-years. Planned analyses will explore why those 50 infections occurred among the 4565 trial participants.

An additional study (HPTN 084) is ongoing to establish the efficacy of the long-lasting injectable in non-transgender women. To date, more than 3000 sexually active women in seven African countries have enrolled in the study. Those results are expected in November.

We are eagerly awaiting the results of the ongoing HPTN 084 study among African women, said Dr Hader. We hope that by the end of this year there will be equally good news for women around the world.

HTPN 083 was conducted by the HPTN and funded by ViiV Healthcare and the United States National Institute of Allergy and Infectious Diseases. Cabotegravir has not yet been approved for the treatment or prevention of HIV as a single agent by regulatory authorities anywhere in the world. ViiV Healthcare plans to use the data from HPTN 083 for future regulatory submissions.

UNAIDS congratulates the research teams and urges continued investment in research and development for HIV vaccines, diagnostics, preventative medicines, treatment and a cure.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizationsUNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bankand works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

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UNAIDS welcomes new tool for HIV prevention for gay men and other men who have sex with men and transgender women - UNAIDS

Eighteen members of the Class of 2020 will enter a Campbell University Affiliate Residency Program in July bringing the total number of Campbell Medicine Alumni to continue their trainingover the past four years in a Campbell Residency to sixty-one including Emergency Medicine Chief Residents at Cape Fear Valley Health and Southeastern Health. Four membersof the Class of 2020 share their reflections on why they chose to continue their physician training with Campbell University.

What brought you to medicine?I started off in undergrad wanting to go to medical school, and then got away from that idea and began my career working in an agriculture-biotech laboratory in RTP after graduation. But, it didnt take long for me to realize I missed interacting with people and having a direct outcome and impact. So, I started looking back at medicine and started doing some shadowing and volunteering at a clinic in Raleigh to build my resume up for applying to medical school.

Why Campbell?Location all of my family is in North Carolina, and it was new school with a new facility in a non-urban setting. That really appealed to me.

Why Emergency Medicine?Coming in you dont know that much and dont know exactly what you want to do. I had the picturesque rural, family physician in my mind; that was my plan until I started doing rotations and realized I really enjoyed the Emergency Department. I was fortunate to do a rotation in the ED at Cape Fear Valley during my third year and got a taste of it. I really liked EM because you get a little bit of everything people coming in with boo-boos and heart attacks. People come in as kind of a blank slate they come in with complaints, but its kind of a mystery is it really bad or something minor? Traumas were exciting as a student, but, now facing the added layer of responsibility as a resident physician, Im really hoping we dont have many of those days.

Im excited! Being around emergency medicine doctors and residents, you know they have a good handle on what they are doing, and its good to know they were in my shoes not long ago. You dont know how steep the learning curve is how hard it is to get that point, but, it is doable. I know I will be with strong physicians and residents who know what they are doing. In the ED, there is always the element of the unknown you never know what someone is going to come in with, and we dont know everything that is one of my bigger anxieties.

Why Southeastern Health?They were high on my match rank list based on location. I liked some programs farther away, but being out of state and in an urban setting isnt attractive to me. In larger hospitals massive places you dont know whos-who and who you are handing your patients off to. I did an audition rotation at Southeastern, and everyone was very friendly, helpful and open. At other programs, they definitely didnt have that sense of comradery. It is a pretty busy ED, but it is a smaller environment not as hectic all the time. All of the staff and hospitalists know each other; everyone is very cordial and have a since of community. In Lumberton, I just got a good feeling, and Ben McMichael (DO 17) is chief resident there now, so Im looking forward to working under his leadership.

What experience during medical school was the most meaningful?

I went on the Armenia mission trip and that was a good, meaningful experience. We were a small group Dr. Kaprielian, Dr. Paolini, myself and three other students. We learned a lot and got a lot of one-on-one attention with attendings. It was interesting to be in another country, to see health care there the differences, and getting to go into small villages and provide health care. That was really nice.

What lead you to the dermatology residency at Sampson Regional?

I did a lot of away rotations 4th year; you need to for dermatology. Show your face to other programs and give them an idea of who you are as an applicant. Its a bigger

thing in the DO world than the MD world, but still very important. I did a rotation with Dr. Crane at Wilmington and Sampson, and absolutely loved it. The comradery of the residents there was truly incredible. It felt like they were a big family. They gathered together almost every morning especially on didactic days. They all respect and want to help one another which was really awesome to see because not all residency programs have that team-based atmosphere. Also, being close to home for me was really important. Im from the area, and I would love to be close to my family if I can. It was a well rounded picture the training is amazing, Dr. Crane, all the resident comradery, and being close to home all those things together.It worked out amazingly, and I couldnt be happier.

Staying with Campbell, that has supported me all along, is also a huge plus. Working in a small community based hospital, Im excited about that because I will get a lot of hands-on training and be with the attending a lot, so Im looking forward to that aspect of the program as well.

Why Dermatology?

During third year, I had my eye on ENT or surgical sub-specialty, but I realized in Dermatology you get to do a lot of hands-on procedures which is something I was looking for, but you dont have the craziness of being a surgeon on call and in the OR all the time. You negate some of the negative aspects of being a surgeon while still getting to do the hands-on procedures that I really want to do. So, hands-on was big for me, and I like creative things. Medicine in generally is algorithmic and in a lot of specialties you follow a treatment algorithm. However, in dermatology you have to have good visual identification of various things, and this creative component most specialties do not have. For example, in Mohs surgery, a big skin cancer surgery, people have giant defects on their face or another part of their body. You have to figure out an artistic way to close it up and make it look like it never happened. Dermatology has a plastics component to it without being plastic surgery; you are removing skin cancer and figuring out a way to make it look sound.

I always enjoyed art my dad went to art school, so I feel like I take after his creative edge. I love art as an outlet acrylic painting, pencil drawing and glass sculpture work. I started making sculptures out of glass with flame working at NC State, and I can still go there as an alum to the Craft Center. I used to teach a class there. I didnt get there much during first and second year, but the past two years Ive gone more, and it has definitely been a stress reliever.

What was your journey to medical school?

I graduated in 2013 started engineering and then switch to pre-med. When I graduated, I wasnt ready to apply to medical school and my older brother (6 years older than me) was in med school at the time. We had a conversation where he told me do not go into medicine you will not like your life. But, my mom is a nurse, and she was an inspiration for us to pursue health care. So, I went to chiropractic school in Florida for a term, but realized it was not for me. Then, I started applying to medical schools, and I like the DO philosophy a preventative and holistic approach to medicine. Campbell being brand new that was exciting. I remember when I got the call telling me I was accepted I was in the grocery store, and I just sat down in the aisle. Im sure people wondered what was wrong with me! So, it was definitely a journey and evolving goal. My brother is now in a foot and ankle fellowship at the University of Virginia, and he is coming back to Raleigh to practice, so we are looking forward to being in medicine in the same state together.

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Merck Foundation (www.Merck-Foundation.com), the philanthropic arm of Merck KGaA Germany in partnership with African First Ladies and Ministries of Health, continue their strategy to provide one-year diploma and two-year master degree in both Preventive Cardiovascular Medicine and Diabetes for medical postgraduates from more than 35 African and Asian countries.

Dr. Rasha Kelej, CEO of Merck Foundation and One of 100 Most Influential Africans emphasized, Amidst the pandemic that has rocked the world, we must not forget people living with other health conditions such as Diabetes and Hypertension because they are the Coronavirus risk groups therefore Merck Foundation continues to buildHypertension and Diabetes care training to doctors, in partnership with African First Ladies, Ministries of Health and Academia. Moreover, we also provide training to doctors from Asian countries.

Merck Foundation has so far enrolled and trained over 183 Medical postgraduates from over 35 countries. As a part of their efforts to build hypertension and diabetes care capacity, Merck Foundation enroll medical postgraduates for One Year Online Diploma and Two Year online master degree in Preventive Cardiovascular Medicine and Diabetes from reputable university in UK. Additionally, they also enroll doctors for a three-month Diabetes Master course from English, French and Portuguese speaking African countries to advance their clinical knowledge in tackling these non-communicable conditions.

Merck Foundation started capacity building of Coronavirus healthcare through providing online one-year diplomas and two year master degree in both Respiratory Medicine and Acute Medicine from UK University, for African doctors.

Dr. Sofia Jarombwereni Natshikare Nepembe, Merck Foundation alumnus from Namibia says, I feel fortunate to be a part of this program and receive the Postgraduate one-year Diploma in Preventative Cardiovascular Medicine as part of Merck Foundation capacity advancement program. The course has enabled me to learn the advanced scientific developments for prevention and treatment of cardiovascular diseases. The course has helped me to serve my patients better. Merck Foundation is doing a great job by providing postgraduate degrees for doctors like me who are eager to specialize to better serve their communities.

We are committed to enroll more doctors for these courses to be able to build a platform of hypertension and diabetes experts in underserved communities. These online courses is the right strategy to scale up our efforts to improve access to quality healthcare solutions widely and effectively especially during Coronavirus lockdown, explained Dr. Rasha Kelej.

The program started in 35 countries such as: Bangladesh, Botswana, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad, DR Congo, Ethiopia, Gabon, The Gambia, Ghana, Indonesia, Kenya, Liberia, Malaysia, Mauritius, Mozambique, Myanmar, Namibia, Nepal, Niger, Nigeria, Philippines, Rwanda, Senegal, Sierra Leone, South Africa, Sri Lanka, Tanzania, United Arab Emirates, Uganda, Zambia and Zimbabwe.

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About Merck Foundation:The Merck Foundation (www.Merck-Foundation.com), established in 2017, is the philanthropic arm of Merck KGaA Germany, aims to improve the health and wellbeing of people and advance their lives through science and technology. Our efforts are primarily focused on improving access to quality & equitable healthcare solutions in underserved communities, building healthcare and scientific research capacity and empowering people in STEM (Science, Technology, Engineering, and Mathematics) with a special focus on women and youth. All Merck Foundation press releases are distributed by e-mail at the same time they become available on the Merck Foundation Website. Please visitwww.Merck-Foundation.comto read more. To know more, reach out to our social media:Merck Foundation(www.Merck-Foundation.com);Facebook(bit.ly/347DsTd),Twitter(bit.ly/2REHwaK),Instagram(bit.ly/2t3E0fX),YouTube(bit.ly/2E05GVg) andFlicker(bit.ly/2RJjWtH).

About Merck:Merck (www.MerckGroup.com) is a leading science and technology company in healthcare, life science and performance materials. Almost 52,000 employees work to further develop technologies that improve and enhance life from biopharmaceutical therapies to treat cancer or multiple sclerosis, cutting-edge systems for scientific research and production, to liquid crystals for smartphones and LCD televisions.

Founded in 1668, Merck is the world's oldest pharmaceutical and chemical company. The founding family remains the majority owner of the publicly listed corporate group. Merck holds the global rights to the Merck name and brand. The only exceptions are the United States and Canada, where the company operates as EMD Serono, MilliporeSigma.

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Merck Foundation together with African First Ladies continue their strategy to provide specialty training for African doctors to better manage...

As one of the most destructive business sectors, the fashion industry is poised for change, and COVID-19 might just be the catalyst it needs to become a more sustainable and ethical industry.

The COVID-19 pandemic has shed light on bad practices and unsustainable business models across industries, but one sector in particular has found itself at the forefront of this exposurethe fashion industry.

As one of the worlds most destructive business sectors, fashion is the worlds second worst offender when it comes to water pollution, according to the 2019 Global Wellness Trends Report, and is responsible for approximately 10 percent of all carbon emissions. Not to mention, with overproduction running 30 to 40 percent each season, more than 70 percent of clothes end up in a landfill and an estimated $500 billion value is lost every year due to clothing being barely worn and rarely recycled, The Business of Fashion reports.

As weve seen the crisis unfold, the issues of resilience, or lack thereof, and various aspects of the supply chain have come to the fore within both the fashion and apparel space, said Niall Murphy, CEO and cofounder of EVRYTHING, a tech platform providing digital identities for the worlds consumer products and a pioneer in bringing transparency to the fashion industry. And in other categories, weve seen businesses called out, actually, with dependencies in their source materials, their raw materials, their components within their supply chain that they didnt realize that they had because they dont have sufficient level of visibility across the supply chain.

Last week, Murphy was joined by Vanessa Barboni Hallik, founder and CEO of sustainable fashion brand Another Tomorrow; e-commerce pioneer Julie Wainwright, founder and CEO of The RealReal; and Kathleen Entwistle, private wealth advisor at UBS, for a discussion with Worth CEO Juliet Scott-Croxford about how the business of fashion is changing amidst COVID-19 and how sustainability, brand values and innovative technology will play a larger role in how consumers choose their apparel in a post-pandemic world.

Weve had challenge after challenge in both going fromwe couldnt hire fast enough to now we have to lay people off, Wainwright said. Weve boarded up all of our stores. Hopefully, we can start doing curbside pickup at some point, but its been tough. On the flip side, the company and the team have shown tremendous innovation. The management team, the directors, the entire company has innovated beyond scope. And so, were going to end up in a really unique position when we pull out of this, which were starting to see some light.

But as supply chains have globalized over the last several years, the issues facing the fashion and apparel industry cut much deeper than just the current crisis. I think fashion and sustainability has been a hard sell historically, Barboni Hallik said, noting that this unique moment could be seen as a test for the fashion industry because it really has allowed so many people in so many critically vital areas of the economy to become seen in a way and create that empathy.

All of the panelists agree that consumer education is critical. I do think the first thing is understanding and having the information out there and available to people, UBS Entwistle said.

One of the things that I think is challenging, in terms of getting consumers to think about clothing as an asset, is this really disruptive sales cycle that the industry is in, Barboni Hallik added. And I think its really positive to see that some of the world is changing, but its very difficult to train a customer to think about clothing as an asset, when the retail price is only the retail price for a month, two months at best. And then its 40, 50, 60 percent off. So, I think thats really challenging. I do think that the education piece and the communication piece is so important to actually enable customers to make better decisions. It was one of the major reasons why I started Another Tomorrow, because I found it just so incredibly frustrating to actually get any level of procurement information about how a product was made. Youre pretty much lucky to know what country its manufactured in, let alone how it was made.

But even more important than education alone is that education, at least according to Wainwright, is turned into policy.

Until laws change, even COVID isnt going to change some of the practices, Wainwright explained. So, laws have to change. We cant continue to produce so many goods that end up in landfill. Theres a truckload a second going into landfill as we speak; 50 percent of whats made doesnt sell. A lot of the luxury brands are still burning their bags because they can. Theyre still burning their things because they can. Burberry stopped. Burberry partnered with The RealReal. Were in conversations with other large brands. But until the governments really force it, COVID is not going to force sustainability. We view this as a serious issue.

Look, consumers, its going to be tough, Wainwright continued. Were at this pivotal point where what governments do to help their people get back to work and also their focus on getting a vaccination and preventative medicine, how much effort is going to determine every countrys economy, and thats a weird thing to say. As an entrepreneur, you like to think you chart your own destiny, but this is bigger than whatever any of us are doing here. Governments are going to help get people back on their feet. Theyre also going to help science help give us some form of living with this horrible situation.

I do think that Julies point is right, that theres a macro situation thats much bigger than any of us, Murphy added. And weve got to keep our eyes on how those things affect us. But I am tremendously motivated by the degree of collaboration, and just conversations like this, thats going on every day across industries where people are trying to work out how to find paths to solution. And that bodes well, thats what you want to see in humanity, is collaboration and working out how we solve each others problems together. And Im pretty optimistic about the fact that were going to dig ourselves out of this hole. Were going to dig ourselves out of this hole well.

Watch the full discussion from The Next Normal: Why Sustainability Is the Future of Fashion here:

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How the Current Crisis Could Impact the Future of Fashion Forever - Worth