Monthly Archives: July 2020

Losing Health Insurance Due to Job Interruption During Pandemic Could Jeopardize Cancer Care for Many Patients – Curetoday.com

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The results of the most recent survey showed that 46% of patients have experienced a decline in their financial security and ability to pay for their care, and nearly 25% worry that they may lose their insurance as a result of the pandemic.

BY Len Lichtenfeld, M.D.

Increased awareness, practicing precautions such as social distancing, keeping our hands clean and wearing masks represent a few of the measures many of us are taking to stay well. Yet, even as we follow these new rules for preserving our health, were finding that other crucial protections have been compromised. We have seen a dramatic decline during the pandemic in hospital and outpatient visits for screening and nonurgent cancer care. The delay of these procedures has led experts to raise concerns that an increase in deaths from cancer may be part of our future. Potentially adding to that trend will be the loss of health insurance that has accompanied job termination for many during the pandemic. The reality is that, without insurance, cancer care is not affordable.

The American Cancer Society Cancer Action Network recently completed surveysasking patients with cancer about the experiences and concerns they are confronting. The results of the most recent survey showed that 46% of patients have experienced a decline in their financial security and ability to pay for their care, and nearly 25% worry that they may lose their insurance as a result of the pandemic. Mental health is also affected: Because of the combined medical and financial stress, nearly half the respondents have perceived a major or moderate effect on their mental well-being.

These are not minor considerations. The reality is that most of us dont have an effective safety net when it comes to paying medical bills. One day you are employed and have health insurance, and the next you are unemployed and worried about whether you can afford food and rent, let alone an insurance extension from your employer if one is available. And lets not forget that even with insurance, cancer care is expensive, far beyond the means of many of us.

The pandemic has taught us a lot. It has shown us the weaknesses in our system at many levels. We need solutions that will protect us in times of need. Options could include reopening insurance exchanges or providing help with paying premiums. Inevitably, some will argue that the time has come for us to rethink how we as a nation pay for health care.

No matter the solutions, I suspect we can all agree on one thing: No one should have to forgo cancer care, particularly during an infectious pandemic and an economic disaster, because they cant afford it. If we can solve that dilemma, then perhaps something good will come out of a moment in time that has been so frightening for so many of us.

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Losing Health Insurance Due to Job Interruption During Pandemic Could Jeopardize Cancer Care for Many Patients - Curetoday.com

A physician’s thoughts on reopening school | Health Care | timesnews.net – Kingsport Times News

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Editors note: Emergency room physician Dr. Russell Hill is on the front lines locally of the fight against COVID-19. In the following column, he shares his thoughts about the decision to reopen schools this fall.

Back to school usually signals relief for parents, but dismay for teens and younger children. Traditionally, it marks the end of lazy summer days and the beginning of a more scheduled lifestyle. But not this year. This year, it is a time of significant uncertainty for parents and children, healthcare providers and policymakers, school administrators and teachers.

Like other activities and events, COVID-19 has upended seemingly simple and accepted practices, stirred more debates, and created quandaries for parents, physicians, and policymakers about whether reopening schools is the right thing to do.

Whats to be done? When adults need to work to provide for their families, they may have few options for either school or caregivers or worry that any option could put their children at risk. COVID-19, once thought to strike mostly those over 65 or persons with compromised health conditions, now seems to sicken young adults and children as well. And even if they are not ill themselves, asymptomatic children can be carriers who infect other unsuspecting parents, grandparents, or neighbors.

Parents, schools and communities are faced with seemingly impossible choices. Hastily constructed school distance learning plans were implemented in the spring with hopes that summer and fall COVID-19 infections would be controlled. Are their plans better today? Areas in the state and the country that appeared unscathed previously now face critical health threats. Have some locations become what infectious disease experts are calling superspreaders? Are schools likely to become superspreaders if reopened? The answer is we dont know. There is so much about this virus that we simply dont know at this point.

Given what is unknown about COVID-19 and its transmission and treatment, whats a reasonable course of action for schools and parents in East Tennessee to keep children safe and still meet educational goals?

First of all, as a physician, it remains unclear how staggered starts, small groups, and separation will limit transmission. For instance, recently a rural Missouri summer camp that took all of the expected precautions masks, social distancing, temperature checks still had 82 young campers become infected with COVID-19 after only a few days and the entire camp was soon closed.

Second, can we expect elementary school children to practice social distancing at all times, wear a mask at all times, and wash their hands each time they touch their face while at school? As a father of four children ages 4 to 10, this seems unlikely. Despite stressing these health habits, my kids forget. It only takes a few forgetful children for the virus to spread. Thankfully, children are the least likely to be affected severely by this infection. However, they may serve as a vector by increasing the risk to parents, grandparents, and neighbors.

The bigger questions of how this affects teachers and administrators at schools remain unanswered as well. The Centers for Disease Control has established some broad guidelines that advise schools not to reopen when infection rates in an area are in a red zone. Currently, Hawkins, Greene, Carter, Sullivan, and Washington counties are all in the red zone.

While some European countries have successfully implemented rules when sending children back to school, it is too soon to say how effective these rules actually are in preventing the spread of COVID-19. In Korea, despite strict social isolation policies, required masks, and available hand sanitizer, infection rates have recently surged and consequently delayed school reopenings.

A group of doctors, healthcare workers, and teachers in Tennessee recently formed a coalition called ProtectMy Care and cautioned against reopening schools too soon. Dr. Amy Gordon Bono, a primary care physician, spoke on behalf of the group at a July 22 press conference and offered this perspective: We should not rush to reopen our schools without a cautious and comprehensive community plan to reduce the spread of the coronavirus. More than half of Tennessee counties have an unacceptable rate of coronavirus transmission. Our state is now experiencing the worst we have experienced under the coronavirus crisis. ... To reopen schools is insane and irresponsible.

National and local leaders fearing economic losses should evaluate carefully their priorities. Public health guidelines should protect the innocent and most vulnerable, including our children, their teachers, and their caregivers. In medicine, our primary goal is to save lives and prevent or end illness. While it could be argued that at times doctors do this to a fault, it is the historic, prevailing public opinion. Lets not jettison it too soon or too quickly. While we would all like to get back to normal as soon as possible, reopening schools too soon is both bad medicine and risky public health policy.

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A physician's thoughts on reopening school | Health Care | timesnews.net - Kingsport Times News

Choose Candidate Who Supports Access to Affordable Health Care – Flathead Beacon

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Opinion | LetterDaines recently expressed his support for a lawsuit currently before the Supreme Court that seeks to invalidate the entire Affordable Care Act

By Lynn Stanley // Jul 24, 2020

Sen. Steve Daines has often been critical of federal judges who legislate from the bench, in his words, but apparently legislating from the bench is perfectly acceptable as long as it suits his ideological goals.

Daines recently expressed his support for a lawsuit currently before the Supreme Court that seeks to invalidate the entire Affordable Care Act. If the lawsuit were to succeed, Montanas Medicaid expansion (which Daines has voted to undermine) and protections for 152,000 Montanans with a pre-existing condition could be lost.

Of all the lawsuits Daines could be on board with in the middle of a global pandemic, he chooses the one that would rip health care coverage from the most vulnerable of our neighbors when they need it most. He didnt get his wish to repeal the Affordable Care Act in Congress, so now he wants the Supreme Court to do his work for him.

Im hopeful the Supreme Court will choose to protect the thousands of Montanans with pre-existing conditions and that are covered under the Medicaid expansion signed into law by Gov. Steve Bullock. But in the meantime, we should focus on choosing a new senator one who will work harder to expand access to affordable health care than he does to sabotage it.

Lynn StanleyKalispell

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Choose Candidate Who Supports Access to Affordable Health Care - Flathead Beacon

Here is how execs from Oscar Health, Intermountain and Cerner say the telehealth boom will change healthcare – FierceHealthcare

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The COVID-19 pandemic has accelerated the adoption of telehealth and there is a general consensus, including from White House leaders, that virtual care is here to stay.

In response to the COVID-19 pandemic, the Trump administration has opened up access to telehealth with sweepingbuttemporarychanges to reimbursement policies.

"Rather than just wholesale transformation, we have experienced an acceleration around transformations that were already underway," saidRyan Smith, chief information officer, Intermountain Healthcare, during a virtual event hosted by media company Protocol.

"With telehealth expansion we havetransitionedfrom it being adisruptive technology and care delivery model to overnightbeing almost a normal part of healthcare delivery," he said.

It's expected that an upcoming Medicare payment rule will include proposals outlining how the Trump administration plans to permanently expand reimbursement for telehealth services. Legislators also have taken steps topermanently open up access to telehealth services for Medicare patients.

It's understood that there are some healthcare visits that must be done in person and virtual care will not completely replace in-office care. What remains up in the air is where telehealth volume will land going forward.

So what will the future of virtual care look like in a post-pandemic healthcare industry? During several onlineevents in the past week, healthcare leaders weighed in onwhat's next for the industry's digital revolution.

RELATED:HHS official: 'Cat out of the bag' on telehealth but unclear what changes will stick

"Havingintegration between virtual care and in-office care makes each much more effective," said Kimber Lockhart, chief technology officer at tech-enabled primary care groupOne Medicalduring the event hosted by Protocol.

"I think well start seeing the connection between what was largely disparate provider groups providing either virtual care or in-office care and well start to see more blended models, where, depending on the needs of patients, care can move between virtual and in-person channels seamlessly," she said.

Mario Schlosser, co-founder and CEO ofhealthinsurance company Oscar Health, said patients seeking care for behavioral health issues as well as chronic conditions largely shifted to virtual services during the pandemic.

"What that shows you is that there is a big chunk of healthcare that you can virtualize and members want to see it virtualized," he said during an Axios virtual event.

"We need tomake sure that this shift to digital doesnt create more utilization, but shifts utilization that should not have otherwise happened," Schlosser said."I think there will be a blended approach and for as much care as possible it will be virtual first and then carefully orchestrated through the rest of the system for those things that need to happen in person," he said.

"From the time you arrive to the facility to conducting the encounter to being discharged, there is so much physical touch involved everywhere. I think that entire touchless experience is a highly valuable asset to work on to enable that consumer experience to make it safer. We have technology to do that today. Unlocking that touchless experience is a huge opportunity and were working to enable that," saidBharat Sutariya, Cerner's chief medical officer of population health, during the Protocol event.

Intermountain's Smith said the health system is thinking through how to redesign spaces for ambulatory care to leverage touchless technologies to minimize the number of people in waiting rooms.

RELATED:More than 300 organizations, physician groups push Congress to take action on telehealth policies

One Medical wants to use technology to direct patients to the right venue of care, whether it's virtual or in-person.

"We're working on using machine learningand other strategies to understand what patients needs are and route them to the right place to get care," Lockhart said.

In the next five years, healthcare will move from a transactional experience to a continuous experience where patients have an ongoing dialogue with providers, Cerner's Sutariya said.

"The technology around us, ambient technology and the Internet of Things, using that to positively impact lifestyle,create healthy behavior and take care of chronically ill, that will pick up significant momentum. We have the advantage of Big Data, machine learning and artificial intelligenceto help us with that and get it right," he said.

During the pandemic, the Centers for Medicare and Medicaid Services (CMS) has established payments for telehealth visits at the same rate as in-person visits.

Schlosser, for one, does not believe that payment parity is sustainable once the emergency period is over.

"I think this is going to be the battle to come.There is a huge opportunity to bending the cost curve in this shift toward digital and virtual, without a question. If we dont use that window then a big opportunity of bending the cost curve goes away," he said during theAxios event.

RELATED:Patients want to keep using virtual care after COVID-19 pandemic ends, survey finds

He added, "That will either mean that telemedicine will get reimbursed lower than in-person care, which would, unchecked, bankrupt a bunch of providers. Or it could mean that in the shift toward digital you also have a similar shift towards at-risk care delivery. So, providers who have been at-risk during the pandemic, their business has held up pretty well."

At the same time, health systems and hospitals have made significant investments in telehealth infrastructure during the pandemic and these organizations want to ensure a return on that investment, said Tom Leary, vice president of government affairsat the Healthcare Information and Management Systems Society (HIMSS) .

CMS and the Congressional Budget Office (CBO) will take a hard look at how the expansion of telehealth has impacted healthcare costs, industry leaders said.

"Clearly CMS doesnt want to increase their spend. They are going to dig intoto see what the current rate is going forward and the impact on outcomes and healthcare spend," saidDomenic Segalla, principal, healthcare advisory services at accounting firm Withum during a recent virtual event hosted by HIMSS.

RELATED:Tech experts: Widespread adoption of telemedicine, remote monitoring 'here to stay'

With the shift to virtual care, larger health care systems are concerned about what to do with their large brick-and-mortar footprints,Segalla said.

"Something weve been hearing from CFOs is we went through outpatient expansion and now with many of these E/Mlevel visits and the potential expansion of services that can be done virtually, what do we want to do with this large footprint or large amount of real estate that we have?," he said.

"With the shift towards virtual care, if we didnt pause to think about the role of physical space in our strategy that would be a mistake," One Medical's Lockhart said.

"As we are evaluating how we expand, we dobelieve in-person care is incredibly important and isnt going away. There are many things for which in-person care is the only way to provide the examination or care that a patientneeds," she said."On the other hand, we have discovered there are some things for which virtual care may in fact be better. There are some conversations that are best had in a situation where patients are in a comfortable setting, such as behavioral health conversations."

Telehealth is now poised to take a bigger share of the healthcare market, according to McKinsey and Company. Up to $250 billion, or 20%of all Medicare, Medicaid, and commercial outpatient, office, and home health spend could be done virtually, according to the company's analysis.

"I think we absolutely see telehealth staying," Intermountain's Smith said. "Will it continue at the current rate that it is? Alot of that depends on the continued relaxing of reimbursements and it's also going to be highly dependent on the stage of the individual health systems maturity, especially at it relates to value-based care."

The expansion of virtual care dovetails with trends around consumerization and transparency in healthcare, he noted.

"Everything is accelerated. Those organizations that havent evolved their models will be in peril. Certain provider organizations will fail. Were going to be back to broader mergers and expansions again by virtue of those not able to make that shift from fee-for-service to fee-for-value," he said.

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Here is how execs from Oscar Health, Intermountain and Cerner say the telehealth boom will change healthcare - FierceHealthcare

Health Care Worker Tests Positive For COVID-19, Quarantines, And Loses Job Only To Find Out Test Was Wrong – CBS Chicago

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CHICAGO (CBS) A COVID-19 test forced one woman into quarantine for weeks, and she lost her job.

But then she learned she never had the virus. The test was wrong.

CBS 2 Investigator Dave Savini reported Wednesday night on false COVID-19 test results and what went wrong. The health care worker, who did not want to be identified, wanted to tell her story to warn others about what happened to her.

So I had never been around any form of disease that hasnt had a cure before, said the woman. I have been in the medical field for quite some time.

She worked as a medical receptionist, wore a mask and gloves, and took all the precautions. Then one day, she started to cough and was concerned.

Like scores of other health care workers, she decided to play it safe and get tested for COVID-19.

She went for a free test at the Friend Health Center near 58th Street and Western Avenue in Chicago. Her samples were then shipped to a lab at Lurie Childrens Hospital.

Two days later, she got the result.

My primary physician called me. He told me I was positive, she said. I was in shock.

She called her family and her employer, and her worries intensified. Images she has seen while working, and all over the news, started to replay repeatedly in her head.

I thought of the ventilator, and I started to get my affairs in order, she said. I thought about the patients in the hospital how they cant see their loved ones. And I felt I would be one of them, and God knows Im praying for them.

She did what she was supposed to do and quarantined, which meant she also stopped going to work.

I was scared and I stayed in the house, she said, and I followed the instructions. You have to stay in quarantine for 14 days.

Then after 14 days of isolation, she sought her doctors approval to return to work. She missed a few more days of work waiting to get cleared.

And then she lost her job.

Then came another bombshell.

She got a letter from the lab at Lurie Childrens Hospital. It said she was never really COVID-19 positive it was all a big mistake.

The woman read part of the letter: We have learned that you received a false positive result. You did not have COVID-19.

The CBS 2 Investigators were told by a hospital official that they noticed an unusual pattern developing. So they retested the samples in question and found there was an equipment problem.

That is when they learned people who were told they were positive for COVID-19 were really negative.

I was devastated, said the health care worker about the impact of this bad test.

She says the hospital representative who called her would not tell her exactly how many others also spent weeks in quarantine for no reason.

Lurie Childrens also would not release to CBS 2 the number of false test results, only saying it was several.

We are sorry for the inconvenience, the health care worker said as she expressed her frustration that it took a month to get the accurate result. Thats all, thats all like a pat on the hand, Were sorry.'

A representative of Lurie Childrens Hospital told the CBS 2 Investigators they reported the false findings to the Illinois Department of Public Health (IDPH).

Our CBS 2 Investigators reached out to the IDPH to find out how many false positives they have received from all labs statewide. The IDPH has not yet responded.

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Health Care Worker Tests Positive For COVID-19, Quarantines, And Loses Job Only To Find Out Test Was Wrong - CBS Chicago

Letter: Thanks to health care heroes for their compassion – The Westerly Sun

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The family of Carol and Raymond Bedard would like to express their gratitude to the following health care heroes: Dunns Corners Fire Department, Charlestown & Westerly Ambulance, Westerly Hospital, HopeHealth Hospice and Palliative Care RI and especially the Westerly Health Center and Buckler-Johnston Funeral Home.

The year 2020 started with the anticipation of our Dads 85th birthday party on Jan 11. Our Dad (and Mom) were excited and surprised by the many friends and family members who attended. Looking back, it was such a bittersweet moment but we were able to capture the joy from that day in pictures.

Unfortunately, 2020 then took a quick turn. We lost both of our parents in a span of eight weeks from pneumonia just before COVID-19 testing started to be available. It was during this time that we saw a lot of the health care heroes mentioned above. They were so kind, understanding and compassionate for all that we were going through with both of our parents, in and out of ambulances, in and out of the hospital and rehab centers and then hospice.

Westerly Health Center was so caring, not only to our mother but to us also. They understood we never had time to grieve for our Dad prior to our Mom quickly getting sick, they did everything possible to allow us to be with her up until the end (pre-COVID). We will never forget their kindness and compassion.

Our parents were married almost 64 years. We always knew they would join each other quickly once the first one passed, but we never thought it would be that quick. With what is going on in the world, we are glad they are in heaven together and able to enjoy to walking and breathing freely on their own and enjoying the ever-after.

Lisa J. Bedard

Westerly

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Letter: Thanks to health care heroes for their compassion - The Westerly Sun

Twilio Moves Into Healthcare: What It Means for the Stock – The Motley Fool

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Twilio (NYSE:TWLO) stock has given shareholders an incredible ride, returning over 750% in the last three years. Its communication platform for generating text, voice, video, and email via software is now used by over 190,000 customers in 180 countries.

Data from the last three years through July 23, 2020. TWLO data by YCharts

It may not be a household name, but you've probably experienced Twilio's capabilities. If you've received a computer-generated text message saying your prescription is ready or an automated phone call reminder that your medical appointment is upcoming, these messages were likely created by its platform's tools.

Recently the company has reached a key milestone that allows it to more fully serve the needs of the healthcare industry, and it's driving fast to capture new business. Let's check out what the company is up to on the healthcare front and what it means for investors.

After 18 months of development efforts, Twilio achieved HIPAA compliance on a set of its tools in February. HIPAA is short for the Health Insurance Portability and Accountability Act, passed in 1996, that protects personal healthcare information (PHI) and provides a standard for PHI transmitted or stored in electronic form. This milestone enables Twilio's network to handle PHI under a business associate agreement (BAA), which will allow healthcare entities to use its products and network for many new use cases.

This is not just a localized capability, but crosses a broad base of its products, including voice, text, video, and call center building blocks. This is a valuable service for healthcare entities, and a number of new customers have already jumped on board.

As the coronavirus started to spread, many healthcare providers looked to telehealth technology to perform non-critical or even COVID-19-related visits. The demand for these services skyrocketed in a short period of time, and Twilio's easy-to-implement and cloud-scalable tools were ready.

In the past few months, three large healthcare software platforms added Twilio's video capabilities to enhance their services. Epic, one of the largest healthcare record companies, implemented video to interact with patients, and allow virtual updates of clinical records. ZocDoc's medical appointment service was enhanced to allow the scheduled appointment to happen virtually over video chat. Doximity added video capability to its dialer service for its 100,000 physician customers to allow them to see the patient when calling.

Healthcare customers are using Twilio to power virtual doctor visits. Image source: Getty Images.

But it's not just video services that healthcare-related customers are using. New York City contracted with the company to help get their coronavirus contact tracing capabilities in place. The solution includes contact center software, voice communications, and text messaging capabilities. CipherHealth added COVID-19 interactive voice and text screening questions for its patients. Over 500 hospitals and healthcare systems using CipherHealth's platform have been issuing more than 430,000 outbound screenings per week.

This budding opportunity caused the company to add a key executive to its ranks.

In February, the company hired Susan Lucas Collins as its global head of healthcare services. Collins has been in healthcare-related roles her entire 33-year career and spent five years at Salesforce leading healthcare marketing efforts.

Andrew Zilli, vice president of investor relations, spoke about this role in a recent interview:

And so bringing somebody like Susan in who knows the healthcare world really, really well can really meaningfully up-level our ability to play a significant role there. And so it's kind of the first time that we've hired somebody in a role like that to really own a vertical, but I think it shows the importance of healthcare and what we think we can do with that.

Collins contributed to the recent customer wins and will be a great resource for the company to enhance its presence in this important industry.

Healthcare isn't a material part of Twilio's business yet, so these deals aren't going to cause the stock to move. But there have been some promising trends with this customer set. Since February, it's seen a doubling of healthcare customers' usage and a more than doubling of the number of healthcare customers utilizing the video services. Since its revenue is primarily usage-based, this is an encouraging development for investors. But the really exciting part is how these tools play a key role in helping this industry meet the challenge of reducing costs while also improving outcomes and increasing patient satisfaction. This capability could make the recent trend the start of something much bigger.

It may be a while until these new HIPAA-compliant capabilities make a meaningful difference in the company's topline, but shareholders should be comforted that this innovative tech company is continuing to expand its market opportunity.

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Twilio Moves Into Healthcare: What It Means for the Stock - The Motley Fool

Jordan to reopen to ‘low risk’ countries in August – Macau Business

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Jordan will reopen its airports to commercial flights next month after a near five-month shutdown imposed to stem the spread of the coronavirus, an official said Sunday.

The move comes as the country is trying to revive its economy which has been badly hit since the outbreak of the pandemic.

Civil aviation commission chief Haitham Misto told state television that flights from 22 low risk countries will be allowed from August 5.

The countries listed by the health ministry include Austria, Canada, China, Denmark, Georgia, Germany, Greenland, Iceland, Ireland, Italy, Malaysia, New Zealand, Switzerland and Thailand, he said.

Travellers from those countries will not need to isolate for 14 days when they reach Jordan but must be tested for the virus before arriving, Misto said, adding that the list would be updated every two weeks.

Transport Minister Khaled Saif however that those travellers must show proof of having spent two weeks in one of the countries on the list before arriving in Jordan.

Anyone providing false information will be fined 10,000 dinars ($14,000), he said.

The desert kingdom, which has recorded 1,154 cases of the virus including 11 deaths, imposed a tough curfew enforced with drones to curb the spread of COVID-19, before easing policies in early June.

Airports were closed in mid-March and international flights suspended.

The curbs hit cash-trapped Jordan hard. Its economy relies heavily on international aid, tourism revenues and expatriate remittances.

Before the coronavirus struck, Jordan hosted five million visitors a year and tourism accounts for 14 percent of the countrys GDP, employing about 100,000 people.

Tourism earned Jordan around $5.3 billion last year.

Around a quarter of a million people a year used to visit Jordan for medical treatmentbefore the pandemic broke out, bringing in some $1.5 billion.

The country was already in a precarious situation even before the new coronavirus, with unemployment at 19.3 percent in the first quarter of this year.

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Jordan to reopen to 'low risk' countries in August - Macau Business

‘Alarm’ at Poland’s plan to leave treaty protecting women – Macau Business

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The Council of Europe said Sunday it is alarmed that Polands right-wing government is moving to withdraw from a landmark international treaty combating violence against women.

Polish Justice Minister Zbigniew Ziobro said on the weekend that on Monday he will begin preparing the formal process to withdraw from the Istanbul Convention, the worlds first binding instrument to prevent and combat violence against women, from marital rape to female genital mutilation.

A previous centrist Polish government signed the treaty in 2012 and it was ratified in 2015, when Ziobro called it an invention, a feminist creation aimed at justifying gay ideology.

The treaty was spearheaded by the Council of Europe, the continents oldest human rights organisation, and its Secretary General Marija Pejcinovic Buric condemned the right-wing Law and Justice (PiS) governments plan to withdraw.

Leaving the Istanbul Convention would be highly regrettable and a major step backwards in the protection of women against violence in Europe, she said in a statement on Sunday.

If there are any misconceptions or misunderstandings about the convention, we are ready to clarify them in a constructive dialogue.

Around two thousand people marched in the Polish capital Warsaw on Friday to protest the governments withdrawal plan, some shouting stop violence against women.

There was also outrage from several members of the European Parliament, with Iratxe Garcia Perez, the Spanish leader of the Socialist group, calling the decision disgraceful.

I stand with Polish citizens taking (to) the streets to demand respect for womens rights, he tweeted.

The leader of the EU parliaments Renew Europe group, former Romanian prime minister Dacian Ciolos, tweeted: Using the fight against the Istanbul Convention as an instrument to display its conservatism is a new pitiful and pathetic move by some within the PiS government.

Fellow MEP and former Belgian premier Guy Verhofstadt said the decision was scandalous, adding that violence is not a traditional value.

The Council of Europe emphasised that the Istanbul Conventions sole objective is to combat violence against women and domestic violence.

The treaty does not explicitly mention gay marriage.

But that has not stopped the backlash to it in Hungary and Slovakia, where the parliament rejected the treaty insisting without proof that it is at odds with the countrys constitutional definition of marriage as a heterosexual union.

The Strasbourg-based Council of Europe, which is separate from the European Union, has no binding powers but brings together 47 member states to make recommendations on rights and democracy.

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'Alarm' at Poland's plan to leave treaty protecting women - Macau Business

The message behind golds rally: the world economy is in trouble – Macau Daily Times

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Its easy to forget now but there was a time early on in the pandemic when the price of gold was in freefall.It was a curious thing, what with the virus sparking a collapse in the global economy, and it would prove in time to be one of the great head-fakes in the recent history of financial markets. For the pandemic of 2020 would soon show itself to be the driving force behind one of the most ferocious rallies the gold market has ever seen. At the close of trading in New York on Friday, bullion had spiraled to $1,902.02 an ounce, some 30% higher than the low it hit in March and just 1% off a record high set back in 2011.The virus has unleashed a torrent of forces that are conspiring to fuel relentless demand for the perceived safety from turmoil that gold provides. Theres the fear of further government-ordered lockdowns; and politicians decision to push through unprecedented stimulus packages; and central bankers decision to print money faster than they ever have before to finance that spending; and the plunge in inflation-adjusted bond yields into negative territory in the U.S.; and the dollars sudden decline against the euro and yen; and rising U.S.-China tensions.All these things, when taken together, have even triggered concern in some financial circles that stagflation a rare combination of sluggish growth and rising inflation that erodes the value of fixed-income investments could take hold across parts of the developed world.In the U.S., where the virus is still raging and the economic recovery is stalling, this debate is growing louder. Investor expectations for annual inflation over the next decade, as measured by a bond-market metric known as breakevens, have moved higher the past four months after plunging in March. On Friday, they hit 1.5%. And while that remains below pre-pandemic levels and below the Federal Reserves own 2% target, it is almost a full percentage point higher than the 0.59% yield that benchmark 10-year Treasury bonds pay.The main driver behind golds latest rally has been real rates that continue to plummet and dont show signs of easing anytime soon, Edward Moya, a senior market analyst at Oanda Corp., said by phone. Gold is also drawing investors concerned that stagflation will win out and will likely warrant even further accommodation from the Fed.U.S. bond markets have been a driving force behind the rush to gold, which is serving as an attractive hedge as yields on Treasuries that strip out the effects of inflation fall below zero. Investors are looking for safe havens that wont lose value.The mania for gold right now has trickled down to Main Street. Retail investors have helped put ETF holdings backed by gold on track for an 18th straight weekly gain, the longest streak since 2006. Meanwhile, gold posted its seventh weekly gain on Friday, and analysts dont expect the increases to end anytime soon.When interest rates are zero or near zero, then gold is an attractive medium to have because you dont have to worry about not getting interest on your gold, Mark Mobius, co-founder at Mobius Capital Partners, said in a Bloomberg TV interview. I would be buying now and continue to buy.Analysts have been predicting huge upside for gold for several months. In April, Bank of America Corp. raised its 18-month gold-price target to $3,000 an ounce.The global pandemic is providing a sustained boost to gold, Francisco Blanch, BofAs head of commodities and derivatives research, said Friday, citing impacts including falling real rates, growing inequality and declining productivity. Moreover, as Chinas GDP quickly converges to U.S. levels helped by the widening gap in Covid-19 cases, a tectonic geopolitical shift could unfold, further supporting the case for our $3,000 target over the next 18 months.Bank of Americas bold prediction was made after gold prices initially dropped in March as investors sought cash to cover losses on riskier assets. Prices quickly recovered after a surprise cut to the Feds benchmark rate and signs that the economic toll of the coronavirus would lead to massive stimulus efforts from global governments and central banks.This isnt the first time gold has gotten help from central bank stimulus programs. From December 2008 to June 2011, the Fed bought $2.3 trillion of debt and held borrowing costs near zero percent in a bid to shore up growth, helping send bullion to a record $1,921.17 in September 2011.The crisis a decade ago was all about banks, said Afshin Nabavi, head of trading at Swiss refiner and dealer MKS PAMP Group, who nows sees gold pointing towards $2,000.This time, to be honest, I do not see the end of the tunnel, he said, at least until U.S. elections in November. Steven Frank, Vivien Lou Chen & Elena Mazneva, Bloomberg

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The message behind golds rally: the world economy is in trouble - Macau Daily Times

Passion for purple revives ancient dye in Tunisia – Macau Business

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A Tunisian man has pieced together bits of a local secret linked to ancient emperors: how to make a prized purple dye using the guts of a sea snail.

At the beginning, I didnt know where to start, said Mohamed Ghassen Nouira, who heads a consulting firm.

I would crush the whole shell and try to understand how this small marine animal released such a precious colour.

Now, after years of trial and error and after getting used to the foul stench he uses a hammer and small stone mortar to carefully break open the spiny murex shells.

What happens next is part of a secret guarded so closely that it disappeared hundreds of years ago.

A symbol of power and prestige, the celebrated purple colour was traditionally used for royal and imperial robes.

Production of the dye was among the main sources of wealth for the ancient Phoenicians, and then for the Carthaginian and Roman empires, said Ali Drine, who heads the research division of Tunisias National Heritage Institute.

The industry was under the control of the emperors because it brought a lot of money to the imperial coffers, he said.

In August 2007 on a Tunisian beach, Nouira found a shell releasing a purplish red colour, reminding him of something hed learnt in history class at school.

He bought more shells from local fishermen and set out experimenting in an old outside kitchen at his fathers house that he still uses as a workshop.

Experts in dyeing, archaeology and history, as well as chemistry, helped and encouraged me, but nobody knew the technique, Nouira said.

No historical documents clearly detail the production methods for the purple pigment, Drine said.

Maybe because the artisans did not want to divulge the secrets of their know-how, or they were afraid to because the production of purple was directly associated with the emperors, who tolerated no rivalry, he said.

The only clues for unearthing the techniques lie in archaeological sites and artefacts in the Mediterranean, particularly in Tyre in southern Lebanon, and Meninx, on the coast of Tunisias Djerba island.

Phoenicians from Tyre set down the foundations of what would become the Carthaginian empire on the Tunisian coasts.

Also known as Tyrian purple, the pigment is still highly valued today and is produced by just a handful of people around the world.

They include a German painter and a Japanese enthusiast, each with their own secret techniques.

Among the buyers are collectors, artists and researchers.

The dye can cost $2,800 per gramme from some European traders, and prices can reach up to $4,000, Nouira said.

He said he had produced a total of several dozen grammes of the pure purple dye, which he sells internationally for more modest prices.

Nouira said that when he sought help from other dye-makers, one told him bluntly, its not a cooking recipe to be passed around.'

That made me even more determined. It drove me to read more and redouble my efforts.

In a wooden box where he keeps his stock, ranging from indigo blue to violet, Nouira carefully guards a dye sample from 2009 a dear memento of my first success.

I improved my methods until I found the right technique and mastered it from 2013-2014, he said.

To obtain one gramme of pure purple dye, Nouira said he had to shell 100 kilogrammes of murex, a task that takes him two weekends.

He washes the marine snails and sorts them by species and size, then carefully breaks the upper part of the shells to extract the gland that, after oxidisation, produces the purple colour.

Nouira said his greatest wish was to see his work exhibited in Tunisian museums.

Purple has great tourist potential, he added, expressing a desire to one day also conduct workshops.

But he lamented what he said was the authorities lack of interest in the craft.

In the meantime, he too is keeping his trade secrets close, and said he hoped to pass them on to his children.

Im very satisfied, and Im also proud to have revived something related to our Carthaginian ancestors.

by Kaouther Larbi

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Passion for purple revives ancient dye in Tunisia - Macau Business

Visitors fall 84% in the first half of the year – Macau News

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In the first half of 2020, the number of visitor arrivals decreased by 83.9 per cent year-on-year to 3,268,900, according to the Statistics and Census Service (DSEC).

Same-day visitors (1,723,218) and overnight visitors (1,545,682) declined by 84.0 per cent and 83.7 per cent respectively.

Visitors from mainland China (2,339,589), Hong Kong (652,522) and Taiwan (81,628) all recorded decreases of more than 80 per cent.

According to DSEC, Macao received 22,556 visitors in June, a decline of more than 90 per cent year-on-year.

In terms of the source of visitors, the number of mainland Chinese visitors fell by 99.0 per cent year-on-year to 21,067 (93.4 per cent of total), with 11,235 coming from the nine Pearl River Delta cities in the Greater Bay Area.

Macao received 1,142 visitors from Hong Kong and 326 from Taiwan.

Visitor arrivals by land totalled 22,443 in June, and 77.3 per cent of them arrived through the Border Gate (17,344). Besides, there were just 113 visitor arrivals by air.

Since February, the Macao government took drastic measures to cut the influx of visitors from mainland China, Hong Kong, Taiwan and other countries in order to contain the spread of COVID-19.

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Visitors fall 84% in the first half of the year - Macau News

Cries of cancel culture are a tantrum by the powerful – TRT World

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The moral panic is a reaction by cultural gatekeepers to the democratising nature of online platforms, who otherwise cannot fathom being held accountable for their speech.

It was just five years ago that New York Magazine writer Jonathan Chaitdeclared journalism to be besieged by a system of left-wing ideological repression. Political correctness, in Chaits parlance, was a style of politics in which the more radical members of the left attempt to regulate political discourse by defining opposing views as bigoted and illegitimate.

Previously confined to academia, according to Chait, political correctness had gradually made inroads on social media and subsequently attained an influence over mainstream journalism and commentary beyond that of the old.

The main complaint of the now infamousopen letter published by Harpers Magazine does not vary from Chaits denunciation of political correctness five years ago.

Much as Chait had bemoaned that debate had become irrelevant and frequently impossible due to political correctness, the letter decries that the very norms of open debate and toleration of differences are now threatened in favor of ideological conformity.

Nor are the stakes any different this time around.

Just as Chait warned that the growth of political correctness threatened democracy itself, the letter suggests that the new set of moral attitudes and political commitments make everyone less capable of democratic participation. Chait considered political correctness to be antithetical to liberalism and the letter maintains that the lifeblood of a liberal society is at risk.

It has now become common practice for prominent writers with access to platforms which reach millions to raise overwrought concerns that the very foundation of liberalism is crumbling.

What Chait called political correctness has increasingly come to be known as cancel culture: a supposedly censorious tendency which entails an intolerance of opposing views, a vogue for public shaming and ostracism, and the tendency to dissolve complex policy issues in a blinding moral certainty.

Ironically, what these writers and intellectuals consider to be a threat to free speech are in fact themselves acts of free speech.

Cancel culture, if one is to call it that, is merely an indication that free speech is alive and well. There is an audience which engages with the work of others and feels free to criticise what it does not like.

The responses can take many forms: criticism and shaming on social media, letters to the editor, or boycotts of publications, TV shows, and streaming platforms. These are all responses that an audience is entitled to and they are all well within the scope of free speech.

In their erstwhile desire to denounce the encroachment of the public on their turf, the guardians of our culture complain that they no longer feel as comfortable to share their opinions as before, due to how others may feel and react.

This is what the hand-wringing over and condemnations of cancel culture actually indicate. The immunity from criticism our cultural and political establishment enjoyed for so long has now been lost.

Access to liberal values has always been shaped by political contexts, material conditions, market incentives, cultural forces, and so on. This still remains true. What has changed is the growth of the internet as an open-forum.

Amplifying voices

The audience has access to tools which allow it to direct its ire at those who previously enjoyed unfettered access to traditional media and remained blissfully oblivious to the opinions of their readership.

Blogs in the early 2000s and social media, especially Twitter, since then have allowed and even amplified the voices of marginalised groups. It is these previously unheard voices which seem to be causing so much consternation to the cultural and political establishment.

The moral panic, thus, is merely an elite reaction to the democratising nature of engagement with traditional media which social media enables.

The gatekeepers can no longer control the terms of their engagement with their audience and are now treated to an unrelenting stream of criticism. They take this not just to be a personal affront but rather a significant cultural shift.

Free speech, and liberalism generally, face no threat from a sheltered cultural and political establishment finally being challenged or exposed to contrary views. In its classical liberal formulation, free speech guarantees protection from government persecution but not necessarily a platform to broadcast your views.

No one is entitled to a Netflix special or access to the opinion pages of the New York Times and no ones freedom of speech is challenged when that access is cancelled. Never mind that many of those who are ostensibly cancelled actually go on to enjoy their lives and careers in much the same way as before.

As US House Representative Alexandria Ocasio-Cortezpointed out, no one has the right to a large, captive audience and does not become a victim if people choose to tune them out. The odds are, she continued, youre not actually cancelled, youre just being challenged, held accountable, or unliked.

It is telling that the Harpers Magazine letter contains no concrete examples of how free speech is being threatened. The consequences for dissenting and marginalised voices have always been far more severe than disagreements and social media shaming.

Advocates of Palestinian self-determination arefired from their jobs and have their lives destroyed, Muslims are thrown in prison fortranslation work, Black Lives Matter (BLM) activists arethreatened by intelligence agencies, and so on.

The cancellation of unnamed individuals from marginalised groups looks very different from the cancellation of a famous writer who may have to think twice before firing off another anti-trans tweet.

What the Harpers letter, and denunciations of cancel culture generally, represent is an attempt to weaponise free speech to further constrict free speech: a list ditch effort by the self-appointed guardians of culture to ensure access remains limited to the select few.

Disclaimer: The viewpoints expressed by the authors do not necessarily reflect the opinions, viewpoints and editorial policies of TRT World.

We welcome all pitches and submissions to TRT World Opinion please send them via email, to opinion.editorial@trtworld.com

Source: TRT World

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Cries of cancel culture are a tantrum by the powerful - TRT World

Charlie Kaufman’s debut novel, ‘Antkind,’ is just as loopy and clever as his movies – theday.com

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Antkind

By Charlie Kaufman

Random House. 720 pp. $30

---

B. Rosenberger Rosenberg does not think much of filmmaker Charlie Kaufman or his work. "He sticks in my craw like no other," Rosenberg says, and it's one of the milder insults he lobs at the screenwriter and director responsible for such celebrated, mind-bending films as "Being John Malkovich," "Anomalisa" and "Synecdoche, New York." That Rosenberg correctly suspects Kaufman of being his creator and the decider of his fate has no moderating effect on his attacks. Kaufman, he says, is "a third-rate talent who no doubt despises me as much as I do him."

Rosenberg is easy to dislike. A self-described "older, intellectual writer" who reviews movies for obscure publications, Rosenberg is deeply envious of his fellow critics. He loathes most other writers and believes his essays are well known when, in fact, they may not even exist (sample title: "Swedish Hsi Dews," about Swedish palindromists). He tries so hard to prove that he's woke, "as the children today say," that he comes off as anything but. Disagreeable, arrogant and clueless, Rosenberg is no one's idea of a quarantine companion. He is, in short, an ass.

All of which makes him the ideal protagonist for "Antkind," Kaufman's loopy, loony, 720-page raspberry of a first novel. A dyspeptic satire that owes much to Kurt Vonnegut and Thomas Pynchon, "Antkind" has in Rosenberg a contrarian whose tomatoes are always rotten. "Starbucks is the smart coffee for dumb people. It's the Christopher Nolan of coffee," he offers during one discursive rant. About the only things Rosenberg approves of are sex (which he seldom has) and Judd Apatow ("the Great Exception").

Why spend a minute, let alone 720 pages, with this guy? For starters, he can be outrageously funny, often without meaning to be. "Imagine a holy synthesis of Brandon Cruz from 'The Courtship of Eddie's Father' and Mayim Bialik of 'Blossom' fame and you're imagining me as a boy," Rosenberg says, totally serious. "I am the Marilu Henner of men," he brags of the extraordinary memory he claims to possess and certainly does not. His chronic misspelling of famous names (Jake Gillibrand, Tarrantinoo) is the novel's best running joke.

Kaufman, of course, is the clever one here, and he has a blast tweaking toxic masculinity, celebrity worship, political correctness, filmmaking, therapy, high art, low art and much more. Themes that have long preoccupied the writer, particularly in the films "Adaptation" and "Eternal Sunshine of the Spotless Mind," reappear in "Antkind." Humanity's ever competing perceptions of reality, the unreliability of memory, the question of God's existence and the malleable nature of storytelling are measured again and again in this novel that is long but never dull.

"We are all of us victims of the illusion of constancy," a filmmaker named Ingo Cutbirth tells Rosenberg during a visit to St. Augustine, where he is researching a book about gender and cinema. Cutbirth, who claims to be 119 years old, has spent nine decades creating a stop motion-animation film that is three months long and features thousands of handmade puppets. Rosenberg agrees to watch the film in one stretch, pausing only for bathroom, food and sleep breaks determined by Cutbirth. It is, Rosenberg decides, "the greatest single piece of art ever created."

As Rosenberg watches the film, Cutbirth dies, and the critic dedicates his life to making sure the movie is "properly disseminated, appreciated, celebrated." He packs decades' worth of boxes filled with film reels and puppets into a rental truck and heads home to New York. But while he's inside a fast-food restaurant, the truck catches fire. Only one frame of Cutbirth's film survives. For the next 500-plus pages, Rosenberg attempts to recreate the movie through a variety of self-invented memory techniques and hypnotherapy. Soon, he can no longer tell the difference between the real world and that of the film, and he's traveling back and forth through time, pausing frequently to complain about this and that. He becomes Billy Pilgrim as played by Larry David.

Keeping up with the story is near impossible, particularly when Rosenberg finds himself embroiled in a war between a million Donald Trump robots with nuclear bombs inside their heads and an army formed by the Slammy's fast-food chain. But for all the absurd digressions and circuitous detours, "Antkind" remains propelled by Kaufman's deep imagination, considerable writing ability and bull's-eye wit.

Increasingly among the mayhem, the promise of Rosenberg's redemption also surfaces. "Perhaps this would have been the work of art that would do what no other work of art has ever been able to achieve: unite us, show us the best in ourselves, lead us on a collective journey toward compassion," Rosenberg says of Cutbirth's lost film. "I know it led me toward compassion, at least one-seventh of the way."

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Charlie Kaufman's debut novel, 'Antkind,' is just as loopy and clever as his movies - theday.com

With a Funded Internship, Griffin Marshall ’21 Seeks An Alternative Treatment for Aquaculture – Bowdoin News

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Griffin Marshall, on a Zoom call.

While this summer he is working in a lab running experiments and bioassays, last summer he spent a lot of time in swamps.

That's because Prospective Research is searching for the next great medicine in dirt. "Dirt prospecting," Marshall calls it.

"My job last year was field work and dirt dilutions. I'd go out with waders and sterile vials, scoop up dirt, and go back to the lab," he said. After diluting the samples and putting them in an incubator, he would watch what grewsometimes blooms of rainbow-colored bacteria colonies.

Prospective Research's team is smalltwo founders, two interns, and a scientist with a background in drug development. Now that they've collected some promising bacteria strains, they're developing them in the lab to see whether they can effectively fight against bacterial, fungal, or parasiticpathogens in aquaculturespecies like shrimp, salmon, and oysters.

This summer, Marshall has a Scott and Anne Perper Internship Fund from Bowdoin to support his summer internship. The fund is one of 102 grants that Bowdoin Career Exploration and Development awarded to students this year to pursue unpaid summer internships.

Marshall is working in an emerging area of discovery: the development of antibiotic alternatives that can control the spread of disease in marine organisms. "The implications are massive," he said. "In aquaculture, density is the key. If you can increase density, you get more food. But the biggest hindrance is disease."

Antibiotics in aquacultureare problematic, mainly for the resistance that might build up to them, and countries have placed strict regulations on their use. So Prospective Research is looking for a bacteria that will act like a probiotic and outcompete pathogens in farmed fish or shellfish populations.

"It works the same way as in your gut," Marshall said. "It will decrease the overall density of the pathogenic species. Pathogens are always present, but they only become a problem when there are a lot of them."

Marshall spends his days in a small laboratory in Beverly, Massachusetts, experimenting with different ways to grow the bacteria colonies he's collected from the environment. The promising ones that can be successfully cultivated are tested with live marine species in a lab in Arizona.

As a biology major and environmentalstudies minor, Marshall said he's interested in the intersections of science and environmentalism. "This is a really cool spot, because we're looking at aquaculture, which gets at the ecology aspect, but it also has microbiology," he said.

Working in a commercial lab has also been exciting, he said. "It's been a valuable experience, because it feels like what I am doing is not just for the sake of learning but for the sake of building a business, and I'm building more connections in the science world."

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With a Funded Internship, Griffin Marshall '21 Seeks An Alternative Treatment for Aquaculture - Bowdoin News

Complementary and Alternative Medicine Market Is Expected To Grow At A Fast Pace During Forecast 2020 To 2025 | Report Including COVID-19 Impact…

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Global Complementary and Alternative Medicine Market 2020

The Complementary and Alternative Medicine Market 2020 report includes the market strategy, market orientation, expert opinion and knowledgeable information. The Complementary and Alternative Medicine Industry Report is an in-depth study analyzing the current state of the Complementary and Alternative Medicine Market. It provides a brief overview of the market focusing on definitions, classifications, product specifications, manufacturing processes, cost structures, market segmentation, end-use applications and industry chain analysis. The study on Complementary and Alternative Medicine Market provides analysis of market covering the industry trends, recent developments in the market and competitive landscape.

It takes into account the CAGR, value, volume, revenue, production, consumption, sales, manufacturing cost, prices, and other key factors related to the global Complementary and Alternative Medicine market. All findings and data on the global Complementary and Alternative Medicine market provided in the report are calculated, gathered, and verified using advanced and reliable primary and secondary research sources. The regional analysis offered in the report will help you to identify key opportunities of the global Complementary and Alternative Medicine market available in different regions and countries.

Some of The Companies Competing in The Complementary and Alternative Medicine Market are: Columbia Nutritional, Herb Pharm, Herbal Hills, Helio USA, Deepure Plus, Nordic Naturals, Pure encapsulations, Iyengar Yoga Institute, John Schumachers Unity Woods Yoga Center, Yoga Tree, The Healing Company, and Quantum Touch

The final report will add the analysis of the Impact of Covid-19 in this report Complementary and Alternative Medicine industry.

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The report scrutinizes different business approaches and frameworks that pave the way for success in businesses. The report used Porters five techniques for analyzing the Complementary and Alternative Medicine Market; it also offers the examination of the global market. To make the report more potent and easy to understand, it consists of info graphics and diagrams. Furthermore, it has different policies and improvement plans which are presented in summary. It analyzes the technical barriers, other issues, and cost-effectiveness affecting the market.

Global Complementary and Alternative Medicine Market Research Report 2020 carries in-depth case studies on the various countries which are involved in the Complementary and Alternative Medicine market. The report is segmented according to usage wherever applicable and the report offers all this information for all major countries and associations. It offers an analysis of the technical barriers, other issues, and cost-effectiveness affecting the market. Important contents analyzed and discussed in the report include market size, operation situation, and current & future development trends of the market, market segments, business development, and consumption tendencies. Moreover, the report includes the list of major companies/competitors and their competition data that helps the user to determine their current position in the market and take corrective measures to maintain or increase their share holds.

What questions does the Complementary and Alternative Medicine market report answer pertaining to the regional reach of the industry?

The report claims to split the regional scope of the Complementary and Alternative Medicine market into North America, Europe, Asia-Pacific, South America & Middle East and Africa. Which among these regions has been touted to amass the largest market share over the anticipated duration

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Considering the present scenario, how much revenue will each region attain by the end of the forecast period?

How much is the market share that each of these regions has accumulated presently

How much is the growth rate that each topography will depict over the predicted timeline

A short overview of the Complementary and Alternative Medicine market scope:

Global market remuneration

Overall projected growth rate

Industry trends

Competitive scope

Product range

Application landscape

Supplier analysis

Marketing channel trends Now and later

Sales channel evaluation

Market Competition Trend

Market Concentration Rate

Reasons to Read this Report

This report provides pin-point analysis for changing competitive dynamics

It provides a forward looking perspective on different factors driving or restraining market growth

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It helps in making informed business decisions by having complete insights of market and by making in-depth analysis of market segments

TABLE OF CONTENT:

Chapter 1: Complementary and Alternative Medicine Market Overview

Chapter 2: Global Economic Impact on Industry

Chapter 3: Complementary and Alternative Medicine Market Competition by Manufacturers

Chapter 4: Global Production, Revenue (Value) by Region

Chapter 5: Global Supply (Production), Consumption, Export, Import by Regions

Chapter 6: Global Production, Revenue (Value), Price Trend by Type

Chapter 7: Global Market Analysis by Application

Chapter 8: Manufacturing Cost Analysis

Chapter 9: Industrial Chain, Sourcing Strategy and Downstream Buyers

Chapter 10: Marketing Strategy Analysis, Distributors/Traders

Chapter 11: Complementary and Alternative Medicine Market Effect Factors Analysis

Chapter 12: Global Complementary and Alternative Medicine Market Forecast to 2027

Get Complete Report @ https://www.reportsandmarkets.com/enquiry/covid-19-impact-on-global-complementary-and-alternative-medicine-market-size-status-and-forecast-2020-2026?utm_source=bulletinline&utm_medium=36

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Complementary and Alternative Medicine Market Is Expected To Grow At A Fast Pace During Forecast 2020 To 2025 | Report Including COVID-19 Impact...

RHOC: Shannon Beador and her three daughters have Coronavirus – Champagne and Shade

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THE REAL HOUSEWIVES OF ORANGE COUNTY, Tamra Judge, Braunwyn Windham-Burke, Shannon Storms Beador, Gina Kirschenheiter, Emily Simpson (Photo by:Casey Durkin/Bravo)

While filming was shut down in many places for extended periods of time, The Real Housewives of Orange County was one of the first franchises to start back up again. Shannon Beador had the ladies over to her house, and just last week, Gina Kirschenheiter said the group was going on a trip together while quarantining.

But on Saturday, Shannon took to her Instagram to say that she and all three of her daughters, Sophie, Stella, andAdeline had all tested positive for the Coronavirus. Ginas post about the RHOC trip was only ten days ago, so it isnt clear when exactly Shannon got sick but hopefully, no one else in the group contracted the virus. It was speculated that Shannon and Emily Simpson opted out of going on the trip toLake Arrowhead.

Shannon said that she and the girls are all staying in the same house, but in separate rooms. She also thanked those medical professionals who helped them.

Braunwyn Windham-Burke left some hearts in the comments, and her mother, Dr. Deb, offered to bring them food if needed. The comments were mostly positive, besides some others that criticized Shannon and the other ladies for being reckless.

Shannon has always been a bit obsessed with health, including her alternative medicine doctor, Dr. Moon. Dr. Moon and his energy medicine center were frequently featured on the show in Shannons earlier seasons.

Meanwhile, Kelly Dodd said that the coronavirus was Gods way of thinning the herd.I wonder how Shannon feels about those comments now?

This season of RHOCis certainly going to be different, and inevitably choppy with the timeline of things. Perhaps Bravo will acknowledge the virus and show how the ladies spent their time in quarantine. Or, perhaps, theyll just ignore it altogether. Only time will tell!

Get well soon, Shannon, Sophia, Stella, andAdeline!

For more information about COVID-19, visittheCDCs websiteor the website for your states Department of Health.

The Real Housewives of Orange Countywill be back later this year.

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RHOC: Shannon Beador and her three daughters have Coronavirus - Champagne and Shade

Is this the end of Turkish secularism? – Al-Monitor

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Jul 24, 2020

The Hagia Sophia opened for Muslim prayer on July 24. As the world grapples with Turkish President Recep Tayyip Erdogans abrupt decision, many opposition figures have fallen in line to congratulate the decision.

One can understand the enthusiasm of the Islamist Felicity Party or Erdogans coalition partner Nationalist Movement Party, whose bases share strong feelings about the museum turning into a mosque. However, other parties reactions are more surprising.

Recent polls indicate only 20% of Good Party voters and 21.8% of left-leaning Republican Peoples Party (CHP) voters approve of the decision, along with 33% of the voter base of the pro-Kurdish Peoples Democratic Partys (HDP). The HDPs elected officials are the only ones who dared speak words of caution as the ruling Justice and Development Party (AKP) promotes a monolithic expression of identity.

Muharrem Ince, a 2018 CHP presidential candidate, announced he would join the first Friday prayers if he is invited.

Timur Kuran, a professor of economics and political science at Duke University, told Al-Monitor, We are observing rising preference falsification in Turkey on a host of matters. The reactions to Hagia Sophia offer a salient example. The opposition has applauded the decision not because it approves it. Rather, it is afraid to be labeled as anti-Muslim and to be tied to Kemalisms assertive secularism.

A few intellectuals have voiced criticism of the decision, to harsh treatment by pro-government media outlets.

One of the most striking comments came from author Orhan Pamuk, a Nobel laureate. Pamuk said, There are millions of secular Turks like me who are crying against this but their voices are not heard.

Political Islam has produced several red lines that no political figure dares to cross. The fear of offending Muslim sensitivities has crippled the opposition while giving free rein for Erdogan, who gleefully grabs more power. This timidity has led to serious policy consequences in the last two decades.

For example, the Turkish government has invested unreported sums of money into alternative medicine against the advice of the medical establishment. Traditional cures are touted as having been used and recommended by the Prophet Muhammad.

Another example is womens rights, the first and worst victim of political Islam. After seeking the right to wear their headscarves in the public domain, women are being gradually pushed back into the house. Femicide has skyrocketed, while womens presence in education, workspaces and parliament has declined.

A recent International Social Survey Program poll documented a spike in the number of those who support Sharia law. The figures, which stood at 14-19% 2009, increased to 27-32% in 2019.

Diyanet, Turkeys official religious body, has an exponentially growing budget and number of personnel have become beacons of political Islam. Religious sects have gained sufficient power within the state, many argue, to form a parallel state that led to a coup attempt in 2016. While the Fethullah Gulen movement was only one of them, the others mounting reach is an open secret in Turkey.

Law professor emeritus Levent Koker told Al-Monitor, Over time the AKP became entrenched as the political instrument of the Turkish nationalist establishment, now politically using religion more efficiently and visibly, turning the Diyanet into an overt instrument of political hegemony. This does not mean that the AKP, as an Islamist party, is changing the foundational characteristics of the Turkish Republic to turn it into an Islamic polity. To the contrary, what seems to be happening now is the rise of authoritarian rule with a strong reference to religion in a historical-political context in which Islam has been institutionalized as a mechanism of state control over society. It is an open-ended question whether this authoritarian formation could be reversed or will advance to turn Turkey into a Sharia-based state. The historical background says the latter option is very remote, while the former is possible but very difficult under the current national and international climate dominated by nationalist/populist authoritarians.

Birol Baskan, a non-resident scholar at the Middle East Institute, told Al-Monitor, For now, political Islam has fallen short of legislating on matters of everyday life, but has been quite successful reaching in its main goal. For years now, discussions with titles such as Islam and democracy, Islamic economy, Islam and ecology, Islam and women and others have been based on the assumption that Islam is relevant and involved in all areas.

Baskan observed that the opposition was a tacit or open accomplice in this process. He pointed out that many mayors and CHP officials have avoided using the term corruption and instead speak of economic waste a concept with stronger resonance in the conservative circles. All these are evidence of the success of political Islam, not its demise, he added.

Aykan Erdemir, senior director of the Turkey Program at the Foundation for Defense of Democracies and a former member of the Turkish Parliament, told Al-Monitor, A majority of Turkeys pro-secular figures have unknowingly internalized the Sunni hegemonic worldview and cannot imagine a future without the Turkish states direct control over the religious domain through the Directorate of Religious Affairs.

On Al-Quds Day, the speeches by the left-leaning CHP leadership and right-wing politicians were almost identical. One of the crucial consequences of this skewed understanding of secularism, Erdemir said, is that it has made the opposition apathetic to the persecution of and discrimination against Turkeys religious minorities." He went on, "We now witness that even a tame and timid version of secularism is no longer welcome in Turkey as an emboldened Erdogan pushes a more assertive sectarian agenda.

Kuran said secularism is not dead, however. It has gone underground, where it is expanding but also metamorphosing. When it reemerges, it will probably be a more tolerant variety. What emerges will probably be a form of passive secularism rather than the assertive secularism of the 1930s and 1940s, he explained.

With limited political accountability and a struggling economy, Turkish politics is becoming increasingly volatile. Secularism is on life support and those who do not fit into the ideal Sunni Muslim mold are quietly paying the price.

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Chipping Away at the Surface of Melanoma Treatment: Narrowing Down Therapies – Targeted Oncology

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With many systemic therapy options available for the treatment of patients with melanoma, the American Society of Clinical Oncology (ASCO) gathered together an expert panel to create guideline recommendations for choosing the optimal agent at multiple stages of the disease (FIGURE).1 They covered 1 systematic review, 1 meta-analysis, and 34 randomized trials to compile the new set of recommendations for treating patients with various stages of melanoma.1

When asked how treatment options have changed in the last 5 years, Rahul Seth, DO, lead author of the guideline, said, Melanoma is a field that has undergone a revolution in terms of treatment options and treatment outcomes. With so many therapies available and new ones being tested every day, deciding on a treatment regimen can be difficult.

Targeted Therapies in Oncology asked Seth, an assistant professor of medicine at State University of New York Upstate Medical University in Syracuse, if there were any therapy regimens not listed in the expert recommendations that he felt had merit. The short answer is no, the ASCO guideline [was] pretty exhaustive in all aspects, he said.

The guideline addresses 4 clinical questions regarding approaches to systemic treatment for different types and stages of melanoma, in addition to summarizing the trials on which the recommendations were based.

The evidence supporting the panels advice regarding systemic therapy in patients with melanoma who are ineligible for surgical resection was primarily based on a 2018 Cochrane Review, which included data from 122 randomized clinical trials through October 2017.1,2

The guideline indicates that patients with BRAF wild-type unresectable/metastatic cutaneous melanoma should be offered, in no significant order, combination ipilimumab plus nivolumab followed by nivolumab, single-agent nivolumab, or single-agent pembrolizumab.

Historically, patients in this population received chemotherapy with or without interferon and/or interleukin-2 (IL-2), but therapy success was limited and toxicity incidence was high. When introduced, the CTLA-4 inhibitor ipilimumab induced better progression-free survival (PFS) but also greater toxicity. Phase 3 results from trials comparing experimental regimens of ipilimumab (Yervoy) versus nivolumab (Opdivo; CheckMate 067, NCT01844505) or pembrolizumab (Keytruda; KEYNOTE-006, NCT01866319) showed significantly improved overall survival (OS) compared with the control arm of single-agent ipilimumab in both cases.

For patients with BRAF V600 unresectable/ metastatic cutaneous melanoma, the panel said the above regimens can be considered, in addition to BRAF/MEK inhibitor combinations of dabrafenib (Tafinlar) plus trametinib (Mekinist), encorafenib (Braftovi) plus binimetinib (Mektovi), or vemurafenib (Zelboraf) plus cobimetinib (Cotellic).

I do believe that gene mapping is necessary for patients, for there are possibilities to get targeted therapies which may benefit patients, Seth said. Efficacy can be increased, and we do recommend FoundationOne [CDx] testing if one has no options left.

Each BRAF/MEK inhibitor combination may produce different toxicity profiles; therefore, switching between regimens may be beneficial for patients experiencing unmanageable toxicities. However, there are no data regarding the effects on efficacy of such a switch.

When compared with chemotherapy, single-agent BRAF and MEK inhibitors have produced superior OS and PFS in randomized clinical trials. But when both types of agent are combined, OS and PFS are superior to those with BRAF inhibitors alone. Phase 3 trials with results supporting these recommendations include the CoBRIM trial (NCT01689519) of vemurafenib and cobimetinib, the COM-BI-v trial (NCT01597908) of dabrafenib and trametinib, and the COLUMBUS trial (NCT01909453) of encorafenib and binime-tinib, all with a control arm of single-agent vemurafenib. At this time, no head-to-head data are available to inform clinicians as to the best combination therapy.

Treating patients and handling their expectations and understanding of possible adverse effects is a huge part of practice, Seth said. I have found with more patient education [there are] better outcomes and a better quality of life.

Recommendations for second-line treatment depend on the patients BRAF biomarker status and type of first-line agent. Patients with BRAF wild-type tumors who progressed on PD-1 inhibitors may receive ipilimumab or ipilimumab- based therapy; those with injectable lesions are eligible for talimogene laherparepvec (T-VEC) therapy. Evidence for second-line ipilimumab is based on a single previous trial that investigated this agent following IL-2 or chemotherapy. However, because that studys first-line treatment was not a PD-1 inhibitor, the panel questioned its relevance and only weakly recommended this option.

Second-line recommendations for patients with BRAF V600 mutations include the BRAF/MEK inhibitor combinations discussed above following frontline PD-1 inhibition; conversely, PD-1 inhibitors may be considered following frontline BRAF/MEK inhibition. For either group, ipilimumab or ipilimumab-containing regimens are a suggested alternative.

Second-line therapies are chosen based on factors [related to] how the patient is doing with the current treatment, Seth said. There [are] no absolute criteria, but the clinicians decide based on the treatment options [that are out there].

Patients who are ineligible or unwilling to receive systemic therapy or participate in clinical trials may be given T-VEC as an alternative primary therapy. Evidence from the phase 3 OPTiM trial (NCT00769704) demonstrated mixed results for T-VEC versus granulocyte macrophage colony-stimulating factor, with a significant improvement in median time to treatment failure (HR, 0.42; 95% CI, 0.32-0.54) but not in OS (HR, 0.79; 95% CI, 0.62-1.00). Additionally, grade 3/4 toxicity was somewhat increased in the T-VEC arm.

The most recent FDA approval for a systemic melanoma treatment occurred in 2019, when the agency designated the PD-1 inhibitor pembrolizumab as an acceptable adjuvant treatment for patients with melanoma with lymph node involvement following complete resection.3

The panel investigated different adjuvant systemic therapy options, alone or in combination, to determine the best options for use in adults with resected stage II to IV cutaneous melanoma.

Nineteen randomized trials were reviewed in this section of the guideline, most of which were found to have a low risk of bias. The panel primarily examined the recurrence-free survival (RFS) and OS rates. Recommendation 2.1 advises against adjuvant nivolumab, pembrolizumab, or combination therapy with dabrafenib and trametinib for patients with stage II disease due to the lack of positive trial data. The panel suggested that patients seek to enroll in a clinical trial instead.1

However, the panel determined that for patients with resected stage IIIA to IIID disease and BRAF wild-type tumors, a year of systemic therapy with a PD-1 inhibitor, either nivolumab or pembrolizumab should be offered. The recommendations advised against the routine use of interferon and ipilimumab in adjuvant therapy. Patients with BRAF V600E/Kmutant disease may consider the same therapies in addition to the targeted BRAF/MEK inhibitor combination of dabrafenib plus trametinib.1

It was determined that patients with resected stage III disease with minimal lymph node involvement have a lower risk of relapse, thereby making individualized therapy after shared decision-making talks with the patient preferred over a broad recommendation.1

The phase 3 CheckMate 238 trial (NCT02388906) in patients with stage IIIB/C or IV melanoma found nivolumab superior to ipilimumab in terms of RFS (HR, 0.65; 97.56% CI, 0.51-0.83; P <.001) and toxicity. A similar RFS advantage was seen with the use of pembrolizumab versus placebo in patients with high-risk stage III melanoma (HR, 0.57; 98.4% CI, 0.43-0.74; P <.001) in the phase 3 KEYNOTE-054 trial (NCT02362594).1

With no head-to-head studies available to compare nivolumab and pembrolizumab, the panel determined that either treatment plan would be an acceptable option for these patients.

Efficacy of the combination of dabrafenib and trametinib was explored in the phase 3 COMBI-AD trial (NCT01682083) in patients with high-risk BRAF V600E/Kpositive melanoma following surgical resection. With a minimum follow-up of 3 years, the targeted therapy regimen had significant improvements in RFS (HR, 0.47; 95% CI, 0.39-0.58; P <.001) and OS (HR, 0.57; 95% CI, 0.42-0.79; P = .0006) versus placebo.

Randomized data testing the efficacy of interferon showed a significant benefit compared with observation. However, this was outweighed by the greater benefits demonstrated with more recently available agents coupled with the known toxicity of interferon, which led the expert panel to determine that interferon could not be recommended.

In the phase 3 ECOG-E1609 trial of ipilimumab at doses of 3 mg/kg and 10 mg/kg (NCT01274338), the CTLA-4 inhibitor had similar efficacy to interferon in terms of RFS and only showed improvement in OS at the lower dose (HR, 0.78; 95.6% CI, 0.61-1.00; P = .044). This result, coupled with data showing the superiority of nivolumab over ipilimumab, led the panel to determine that ipilimumab can no longer be recommended as a preferred agent.

For patients who have resected stage IV melanoma, the panel formed a consensus regarding single-agent nivolumab as the preferred agent based on evidence from CheckMate 238. The panel determined that pembrolizumab may be offered as an alternative to nivolumab, despite an absence of clinical data, based on similar efficacy of the 2 PD-1 inhibitors seen in key clinical trials. Dabrafenib plus trametinib may also be offered to patients with BRAF V600E/K mutations, particularly those who cannot receive or who cannot tolerate nivolumab.

Because noncutaneous forms of melanoma such as mucosal and uveal melanomaare less common than cutaneous forms, trial-based evidence is difficult to obtain due to small sample sizes. However, the panel did address a few specific studies in making recommendations for treating these patients.

Several clinical trials included subgroups of patients with mucosal melanoma but had insuff icient numbers of patients for the panel to draw conclusions. One phase 2 trial of patients with mucosal melanoma found improved RFS and OS with temozolomide plus cisplatin chemotherapy versus interferon and observation, with similar grade 3/4 toxicities between the 2 nonobservation arms. However, the panel considered those results as artifactual given the small sample size; therefore, it recommended that patients with mucosal melanoma follow the guidance given for unresectable cutaneous melanoma.

In uveal melanoma, selumetinib (Koselugo) compared with either temozolomide or dacarbazine demonstrated an improvement in PFS that was statistically significant (HR, 0.46; 95% CI, 0.30-0.71) but not clinically meaningful, and there was no difference in OS. The follow-up phase 3 SUMIT trial (NCT01974752) failed to produce improvement in either OS or PFS with selumetinib plus dacarbazine versus dacarbazine alone.

Uveal melanoma is commonly included in the exclusion criteria for studies of new therapies, making it difficult to find useful data to make treatment recommendations. The panel concluded that no specific recommendation could be made regarding patients with uveal melanoma and indicated that patients should be referred to clinical trials when possible.

No specific recommendation could be made for or against neoadjuvant therapy for resectable cutaneous melanoma. Current evidence suggests that the best option for these patients is referral to a clinical trial.

In forming this conclusion, the expert panel reviewed 4 trials. Two small trials led by Rodabe N. Amaria, MD, were terminated early and failed to produce results sufficient for drawing a conclusion regarding efficacy. The first trial (NCT02231775), which looked at neoadjuvant and adjuvant dabrafenib plus trametinib versus contemporary standard of care in 21 patients, was stopped early due to significant event-free survival improvement in the experimental arm (HR, 0.016; 95% CI, 0.00012-0.1; P <.0001). The second trial (NCT02519322) consisted of 23 patients treated with neoadjuvant ipilimumab and nivolumab versus single-agent nivolumab, both followed by adjuvant nivolumab. This trial was stopped early because patients had high toxicity rates and early disease progression.

Two other trials of different combinations of nivolumab and ipilimumab as neoadjuvant therapy failed to demonstrate a clear benefit at dose levels that did not lead to a significant increase in toxicity.

The panel concluded that potential benefit with neoadjuvant therapy may exist, and clinical trials are the best option for these patients.

There are many studies open, Seth said. I think studies looking at the BRAF[/MEK] combinations and immunotherapy will be the ones to help us in the future.

When asked about his current treatment preferences, Seth said, in the time of COVID-19 [coronavirus disease 2019], I am using immunotherapies for patients [who] are unable to get surgery.

I truly believe melanoma will become a treatable [disease], Seth concluded. The next 5 years are unknown, but we are bound to be better and more efficient in treatment.

References:

1. Seth R, Messersmith H, Kaur V, et al. Systemic therapy for melanoma: ASCO guideline. J Clin Oncol. Published online March 31, 2020.doi:10.1200/JCO.20.00198

2. Pasquali S, Hadjinicolaou AV, Chiarion Sileni V, Rossi CR, Mocellin S. Systemic treatments for metastatic cutaneous melanoma. Cochrane Database Syst Rev. 2018;2(2):CD011123. doi:10.1002/14651858. CD011123.pub2

3. FDA approves pembrolizumab for adjuvant treatment of melanoma. FDA. Updated March 18, 2019. Accessed May 22, 2020. bit.ly/3btFOiG

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Chipping Away at the Surface of Melanoma Treatment: Narrowing Down Therapies - Targeted Oncology

The real face of Reading’s Christopher Columbus statue was a pioneer of a different sort – Reading Eagle

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When Monica Krick and her brother, Butch Parenti, look at the Christopher Columbus statue in City Park, they see the face and figure of their father's friend, Dr. Jesse Mercer Gehman.

The statue has generated protests in the racial justice period that followed the death of George Floyd in police custody in late May in Minneapolis. The protests expanded beyond the Floyd death.

Dr. Jesse Gehman, a native of Elverson, Chester County, grew up in Reading and was a pioneer in the field of natural health. Gehman was the model used in sculpting the Christopher Columbus statue in Reading's City Park.

Gehman, who grew up in Reading, was the model for the statue, sculpted in 1925 by Vincenzo Miserendino.

Whenever we went by the park, my dad would point out the statue and say Jesse posed for that, said Krick of Blandon.

She and Parenti of Reading credit Gehman, a pioneer in the fields of alternative medicine and naturopathy, for their father's longevity.

Their father, Nick, the well-known owner of the Keystone Meat Market at 857 Penn St., was91 when he died in 2008.

The elder Parenti, a lifelong disciple of Gehman, largely followed the naturopaths protocols for more than 70 years.

My dad listened to Jesse and was a good pupil, Krick said.

She remembers when her father developed a cyst that grew into his middle ear and bulged beneath his jaw.

Nicky, you have been a bad boy, she recalled Gehman said when consulted.

He blamed the growth on lapses in Nick's healthy diet and ordered a strict regimen of raw vegetables and fruits. After several weeks, the cyst drained and healed, she said.

Jesse had pretty much a cure for everything, Krick said. He advocated daily exercise and a vegetarian diet.

The naturopath favored eating a diet low in starchy and fatty foods, limiting consumption of meats, alcohol and caffeine and getting plenty of daily sunshine, fresh air and exercise. Outspokenly against smoking, he penned Smoke Across America, a treatise on the dangers of tobacco use, in 1943.

He also drew criticism from the established medical community due to what were seen as his unscientific methods and his anti-vaccination stance.

"Jesse could look at someone and diagnose their health problems," Krick said, noting the doctor could detect potential diseases and health conditions by examining a patient's eyes, skin and fingernails.

Dr. Jesse Gehman, a native of Elverson, Chester County, grew up in Reading and was a pioneer in the field of natural health. Gehman was the model used in sculpting the Christopher Columbus statue in Reading's City Park.

Gehman's interest in the health and strength-training movement, then known as physical culture, began during his teen years.

Typical exercise routines used by the movement often included the use of wooden clubs, dumbbells and medicine balls, equipment popular in the gymnasiums of Olivet Boys Club and Reading YMCA, where Gehman worked out.

After attending preparatory school in Massachusetts, he enrolled in the American College of Naturopathy and Chiropractic, graduating in 1925 with degrees in nutrition, naturopathy and chiropractic medicine.

The chiropractic school was established in New York in 1901, the same year Gehman was born.

He went on to complete a doctorate in natural philosophy in 1931.

Jesse Mercer Gehman poses as artist Vincenzo Miserendino puts the finishing touches on the wax sculpture to be used in casting the bronze figure of Christopher Columbus in Reading City Park.

While in his early 20s, Gehman settled outside New York, where he worked as a model, sometimes posing for Miserendino, according to an article in theReading Times, May 12, 1925. He also boxed and wrestled professionally under the name Jim Mercer.

His much younger brother, Marvin K. Gehman, later wrestled as Atomic Marvin Mercer. A World Junior Heavyweight wrestling champion, Marvin won 1,887 of his 2,327 professional matches with 368 others ending in a draw, according to the Reading Eagle, June 28, 1992.

The younger Gehman excelled in sports, particularly swimming during his years at Reading High School in the 1930s, and in the 1940s wrestled in matches at the Reading Armory.

About that time, he met the slightly younger Parenti, also a practitioner of physical culture and a wrestler. Marvin introduced Nick to Jesse, leading to a lifelong friendship, Krick said.

Krick, Parenti and their sister, Sandra Sikora, sometimes accompanied their father and stepmother their mother died in 1965 on visits to Gehman, his wife, Agnes, and their children. The Gehmans had moved to a farm inDuncannon, Perry County, where they founded a health spa and natural healing center,called the Natural Living Foundation.

Gehman served as president of the American Naturopathic Association and was in demand as a lecturer at the meetings of natural health organizations. He was honored in October 1975, by the International Vegetarian Union for his efforts in advancing vegetarianism.

Gehman died at age 75 the following year.

In addition to his second wife, Agnes Stone Gehman, he was survived by their two adult children and three children from his first marriage, according to his obituary in The News of Paterson, N.J.

Krick said she kept in touch with Gehman's family for many years and still follows many of the doctor's precepts, which she calls "Jesse-isms."

"He recognized the benefits of a healthy diet and exercise," Parenti said. He really was ahead of his time."

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The real face of Reading's Christopher Columbus statue was a pioneer of a different sort - Reading Eagle