The usual challenges of conducting primary care research, including randomized trials, have been exacerbated, and new ones identified, during the COVID-19 pandemic. HOMER (Home versus Office for Medication Enhanced Recovery; subsequently, Comparing Home, Office, and Telehealth Induction for Medication Enhanced Recovery) is a pragmatic, comparative-effectiveness research trial that aims to answer a key question from patients and clinicians: What is the best setting in which to start treatment with buprenorphine for opioid use disorder for this patient at this time? In this article, we describe the difficult journey to find the answer. The HOMER study began as a randomized trial comparing treatment outcomes in patients starting treatment with buprenorphine via induction at home (unobserved) vs in the office (observed, synchronous). The study aimed to enroll 1,000 participants from 100 diverse primary care practices associated with the State Networks of Colorado Ambulatory Practices and Partners and the American Academy of Family Physicians National Research Network. The research team faced unexpected challenges related to the COVID-19 pandemic and dramatic changes in the opioid epidemic. These challenges required changes to the study design, protocol, recruitment intensity, and funding conversations, as well as patience. As this is a participatory research study, we sought, documented, and responded to practice and patient requests for adaptations. Changes included adding a third study arm using telehealth induction (observed via telephone or video, synchronous) and switching to a comprehensive cohort design to answer meaningful patient-centered research questions. Using a narrative approach based on the Greek myth of Homer, we describe here the challenges and adaptations that have provided the opportunity for HOMER to thrive and find the way home. These clinical trial strategies may apply to other studies faced with similar cultural and extreme circumstances.

PURPOSE

HIV pre-exposure prophylaxis (PrEP) may increase rates of bacterial sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (GBM) through risk compensation (eg, an increase in condomless sex or number of partners); however, longitudinal studies exploring the time-dependent nature of PrEP uptake and bacterial STIs are limited. We used marginal structural models to estimate the effect of PrEP uptake on STI incidence.

METHODS

We analyzed data from the iCruise study, an online longitudinal study of 535 Ontarian GBM from July 2017 to April 2018, to estimate the effects of PrEP uptake on incidence of self-reported bacterial STIs (chlamydia, gonorrhea, and syphilis) collected with 12 weekly diaries. The incidence rate was calculated as the number of infections per 100 person-months, with evaluation of the STIs overall and individually. We used marginal structural models to account for time-varying confounding and quantitative bias analysis to evaluate the sensitivity of estimates to nondifferential outcome misclassification.

RESULTS

Participating GBM were followed up for a total of 1,623.5 person-months. Overall, 70 participants (13.1%) took PrEP during the study period. Relative to no uptake, PrEP uptake was associated with an increased incidence rate of gonorrhea (incidence rate ratio = 4.00; 95% CI, 1.67-9.58), but not of chlamydia or syphilis, and not of any bacterial STI overall. Accounting for misclassification, the median incidence rate ratio for gonorrhea was 2.36 (95% simulation interval, 1.08-5.06).

CONCLUSIONS

We observed an increased incidence rate of gonorrhea associated with PrEP uptake among Ontarian GBM that was robust to misclassification. Although our findings support current guidelines for integrating gonorrhea screening with PrEP services, additional research should consider the long-term impact of PrEP among this population.

Annals Early Access article

It will likely release in 2026 and feature Apple Intelligence, according to a reliable analyst.

In August, fellow reporter Jason Patinkin and I crossed on foot from northern Uganda into rebel-held South Sudan. Over the course of four days, we walked more than 40 miles through the bush, escorted by rebel soldiers, to shed light on one of the world’s most underreported conflicts.

Reporting on South Sudan’s war, which began in 2013, has always been a challenge due to the risk and logistical hurdles associated with accessing remote areas where fighting takes place. But over the past year, covering the war and its humanitarian fallout has become particularly difficult. Since the beginning of this year, South Sudan’s government has banned at least 20 foreign journalists in an apparent effort to silence reporters who had a track record of critically reporting on the government.

This systematic crackdown on the foreign press (South Sudanese journalists have long risked imprisonment and death for doing their work) coincided with two important developments. In November 2016, the United Nations warned that the violence being committed against civilians in the southern region of Equatoria risked spiraling into genocide. Then, in February, the UN declared a man-made famine, warning that 100,000 people were at risk of starving to death as a result of civil war.

Journalists seeking to cover these events were left with two equally unsavory options: self-censorship or a risky trip to rebel-held parts of the country. Only a handful of journalists have attempted the latter since fighting escalated in July last year. For us, this was our second embed with the rebels this year.

We set off from a town in northern Uganda at five in the morning, bouncing along a bumpy dirt track towards the South Sudan border. Crammed into our four-wheel drive were rebel commander Martin Abucha, a dual American and South Sudanese citizen who we planned to profile for our PBS NewsHour Weekend segment, a couple of guides, and several duffle bags stuffed with our tents, sleeping bags, emergency medical kits and provisions to last us four days.

Just as the sun began to rise above a distant range of hills that we aimed to cross later that day, our car came to a halt in front of a stream. Because of the rainy reason, it carried more water than usual. It was time to disembark and start walking, or “footing,” as South Sudanese tend to call it.

We took off our shoes and waded through the stream’s chilly waters. This was the first of a many rivers we’d have to cross along the way, either on foot or in small flimsy canoes dug out from tree trunks. Each time, we dreaded the idea of falling in with our camera gear.

The first part of our journey in northern Uganda felt very much like a hike through a national park. Passing beautiful landscapes and idyllic farming villages, one could almost forget we were headed into a war zone — but we were about to get a reality check.

We had just crossed into South Sudan when out of nowhere, two dozen armed men popped out of the tall grass and surrounded us at gunpoint.

“Stop! Who are you and where are you going?” a soldier called out in Juba Arabic from his hideout no more than 20 yards away, pointing his AK47 at us. Another one next to him had a rocket-propelled grenade propped on his shoulder, also unequivocally aiming it in our direction.

Instinctively, we threw our hands in the air and exchanged a baffled glance. Had we accidentally bumped into government soldiers? Or perhaps we had come onto the “wrong” rebels? Abucha’s group, called the Sudan People’s Liberation Army In Opposition, is the biggest but not the only armed group in Equatoria, an area rife with rival militia and bandits who exploit the security vacuum left by war.

To our relief, and only after Abucha answered a series of questions, this routine security check quickly gave way to a warm welcome. The platoon would be our escort for the next four days as we trekked to their base and to Loa, Abucha’s hometown.

Keeping up with the rebels was no easy task. Given the country’s pervasive lack of basic infrastructure, South Sudanese grow up walking for dozens of miles just to go about their daily lives. For sedentary Westerners, keeping the target pace of “two meters per second” (around five miles an hour) proved challenging amid 90-degree temperatures, all while filming and plowing our way through dense, itchy elephant grass.

The upside of the cumbersome terrain was that it kept us safe. During our four-day trip, we didn’t cross a single road, instead walking along a dizzying network of narrow bush paths the rebels seemed to know like the backs of their hands. An unwanted encounter with government troops, who tended to stick to roads and move around in vehicles as opposed to on foot, was highly unlikely.

The closest we got to government-controlled area was a visit to Loa, located just two kilometers away from a main road frequently patrolled by government soldiers. We couldn’t stay long, but the hour we spent on the ground offered us a glimpse into what villages must look like in many parts of Equatoria: burned mud huts, looted schools and clinics, fallow fields and – most strikingly – no civilians.

The war has had a devastating impact on South Sudanese communities like the one in Loa, but much of it has remained out of the limelight of international media. Our four-day venture into rebel-held South Sudan offered us a rare opportunity to report ground truths, and we are thankful for that.

The post Column: Why reporting from South Sudan is so difficult — and critically needed appeared first on PBS NewsHour.

Secretary of State Rex Tillerson speaks at the Center for Strategic and International Studies on Wednesday.

WASHINGTON — Secretary of State Rex Tillerson is condemning reported atrocities committed against Rohingya Muslims in Myanmar, and he says those responsible — perhaps the country’s military — will be held accountable.

Tillerson says accounts of the suffering of the Rohingya are “heartbreaking” — and that if those reports are true, then “someone is going to be held to account for that.”

Tillerson — who’s set to visit South Asia next week — is urging the Myanmar government to improve humanitarian access to the population in western Rakhine state.

Amnesty International has accused Myanmar’s security forces of killing hundreds of men, women and children during a systematic campaign to expel the Rohingya. More than 580,000 refugees have fled to neighboring Bangladesh since late August.

“We really hold the military leadership accountable for what’s happening,” Tillerson said at the Center for Strategic and International Studies, a Washington think tank. “What’s most important to us is that the world can’t just stand idly by and be witness to the atrocities that are being reported in that area.”

He also called Wednesday for the U.S. and India to expand strategic ties. He pointedly criticized China, which he accused of challenging international norms needed for global stability.

He said the world needed the U.S. and India to have a strong partnership. The two nations share goals of security, free navigation, free trade and fighting terrorism in the Indo-Pacific, and serve as “the eastern and western beacons” for an international rules-based order which is increasingly under strain, he said.

Both India and China had benefited from that order, but Tillerson said India had done so while respecting rules and norms, while China had “at times” undermined them. To make his point, he alluded to China’s island building and expansive territorial claims in seas where Beijing has long-running disputes with Southeast Asian neighbors.

“China’s provocative actions in the South China Sea directly challenge the international law and norms that the United States and India both stand for,” Tillerson said in an address at the Center for Strategic and International Studies, a Washington think tank.

He added that the U.S. seeks constructive relations with China but “won’t shrink” from the challenges it poses when it “subverts the sovereignty of neighboring countries, and disadvantages the U.S. and our friends.”

U.S.-India relations have generally prospered in the past decade, in part because of their shared concerns about the rise of China. While President Donald Trump has looked to deepen cooperation with China on addressing the nuclear threat from North Korea, he’s also sought a closer relationship with India, which shares U.S. worries on Islamic extremism.

“In this period of uncertainty and angst, India needs a reliable partner on the world stage. I want to make clear: with our shared values and vision for global stability, peace and prosperity, the United States is that partner,” Tillerson said.

Tillerson said the U.S. wants to help improve India’s military capabilities, and also improve security cooperation among the region’s major democracies, which included Japan and Australia.

Tillerson said the U.S. and India were leading regional efforts on counterterrorism. He called for India’s archrival Pakistan “to take decisive action against terrorist groups based within their own borders that threaten its own people and the broader region.”

The post Tillerson: ‘Heartbreaking’ reports of suffering in Myanmar appeared first on PBS NewsHour.

A national review of social work in Scotland has been launched in a bid to address ‘systemic racism’ within the sector.

BioWare currently has no plans for Dragon Age: The Veilguard expansions, according to reports. Instead the studio will support the fantasy RPG with smaller updates and otherwise turn their full attention towards Mass Effect 5.

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A new report by OpenTheBooks reveals that the Health and Human Services Department (HHS) employs 294 people in diversity-focused positions, with 182 of them earning six-figure salaries.

According to a report Tuesday, the league deliberately decided not to impose an immediate fine on San Francisco 49ers defensive end Nick Bosa for wearing a "Make America Great Again" hat during a postgame television interview.

The Italian is reportedly set to leave Stamford Bridge at the end of his contract..

Kaseya, a provider of unified IT management and security software for managed service providers (MSPs) and small to midsize business (SMBs), today released its 2024 MSP Benchmark Report, which surveyed close to 1,000 MSPs from the Americas, EMEA (Europe, Middle East and Africa) and APAC (Asia Pacific) regions and includes responses from both IT professionals […]

The post Cybersecurity top revenue driver for bulk of MSPs, Kaseya report finds first appeared on ITBusiness.ca.

U.S.-based startup company Heliospect Genomics reportedly is offering wealthy couples embryo screening for IQ and other traits at $50,000 for 100 embryos.

Trump would face little to no resistance in confirming his picks for Supreme Court justices in the majority-GOP Congress, but Alito has no plans to step down.

In its annual report, the Food Safety Authority of Ireland (FSAI) warned that food incidents are becoming more complex and often serious. FSAI marked its 25th anniversary in 2023. External challenges impacting food safety include the potential for supply disruption due to political unrest in the Middle East and the... Continue Reading

Senator-elect Jim Justice's office has clarified reports that his famous pooch Babydog was banned from the Senate floor, saying Justice never intended to bring the dog onto the floor.

Xbox hardware sales dropped 29 percent, but that barely made a dent.

The world's first wooden satellite arrived at the International Space Station this week.

The office of the U.S. Special Inspector General for Afghanistan Reconstruction (SIGAR), a federal watchdog agency, revealed in its regular report that China has held more than 200 meetings with Taliban terrorists since their return to power, Afghanistan's Tolo News reported this weekend.

The post U.S. Watchdog Report: China Holds More Meetings with Taliban than Any Other Country appeared first on Breitbart.

The California-based Middlebury Institute of International Studies published research this week that showed China has constructed a prototype nuclear reactor that could fit aboard a large surface vessel - a sign that China is making progress toward building a nuclear-powered aircraft carrier.

The post Report: China Builds ‘Prototype’ Nuclear Reactor for Aircraft Carrier appeared first on Breitbart.

Liberal women are stockpiling abortion pills and "morning after" pills and men are scheduling vasectomies at greater rates.

The post Report: Women Stockpile Abortion Pills, Men Schedule Vasectomies After Election appeared first on Breitbart.

Sen. John Fetterman (D-PA) weighed in on reports regarding President-elect Donald Trump's choice for secretary of state.

The post Fetterman Calls Rubio ‘Strong Choice’ as Trump Reportedly Considers Him for Secretary of State appeared first on Breitbart.

1. RG Kar rape case: Bengal governor seeks report from CM after Sanjay Roy made big allegation against ex-Kolkata top cop  Hindustan Times
2. RG Kar rape case: Bengal Guv seeks report from Mamata govt after accused Sanjay Roy claims ‘Vineet Goel is threatening…’  Mint
3. Video | RG Kar Case News | Kolkata Horror: Prime Accused Sanjay Roy's 'Shocking Revelation' On Camera  NDTV
4. RG Kar rape-murder victim’s dad deposes on day 1 of trial  The Times of India
5. RG Kar case: CM Mamata asked to submit report on prime accused's claim  CNBCTV18

Can’t do global work if the White House is forcing sale of US business, Mayer said.

Amazon is reportedly developing smart glasses for its delivery drivers, according to sources who spoke to Reuters. These glasses are intended to cut “seconds” from each delivery because, well, productivity or whatever. Sources say that they are an extension of the pre-existing Echo Frames smart glasses and are known by the internal code Amelia.

These seconds will be shaved off in a couple of ways. First of all, the glasses reportedly include an embedded display to guide delivery drivers around and within buildings. They will allegedly also provide drivers with “turn-by-turn navigation” instructions while driving. Finally, wearing AR glasses means that drivers won’t have to carry a handheld GPS device. You know what that means. They’ll be able to carry more packages at once. It’s a real mitzvah.

I’m being snarky, and for good reason, but there could be some actual benefit here. I’ve been a delivery driver before and often the biggest time-sink is wandering around labyrinthine building complexes like a lost puppy. I wouldn’t have minded a device that told me where the elevator was. However, I would not have liked being forced to wear cumbersome AR glasses to make that happen.

To that end, the sources tell Reuters that this project is not an absolute certainty. The glasses could be shelved if they don’t live up to the initial promise or if they’re too expensive to manufacture. Even if things go smoothly, it’ll likely be years before Amazon drivers are mandated to wear the glasses. The company is reportedly having trouble integrating a battery that can last a full eight-hour shift and settling on a design that doesn’t cause fatigue during use. There’s also the matter of collecting all of that building and neighborhood data, which is no small feat.

Amazon told Reuters that it is “continuously innovating to create an even safer and better delivery experience for drivers” but refused to comment on the existence of these AR glasses. "We otherwise don’t comment on our product roadmap,” a spokesperson said.

The Echo Frames have turned out to be a pretty big misfire for Amazon. The same report indicates that the company has sold only 10,000 units since the third-gen glasses came out last year.

This article originally appeared on Engadget at https://www.engadget.com/big-tech/amazon-reportedly-wants-drivers-to-wear-ar-glasses-for-improved-efficiency-until-robots-can-take-over-174910167.html?src=rss

Total greenhouse gas emissions from Alberta's oilsands have remained relatively flat for the last few years but could climb yet again in 2024 as the industry ratchets up oil production, according to a new report released Thursday.

An internal report on workplace racism and harassment at the highest levels of the federal public service shows that not even the federal government’s top executives are immune from the problem.

A Canada Border Services Agency superintendent is speaking out after being targeted by the Indian government with allegations of murder and terrorism — allegations Canadian authorities say are not backed by any evidence.

On October 8, 2024, Drug Channels Institute will release our 2024-25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. This report—our fifteenth edition—remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry.

9 chapters, 350+ pages, 178 exhibits, 750+ endnotes: There is nothing else available that comes close to this valuable resource.

We are providing you with the opportunity to preorder this thoroughly updated, revised, and expanded 2024-25 edition at special discounted prices. This means that you can be among the first to access our new report. Those who preorder will receive a download link before October 8.

• Review pricing/license options and place a preorder

• Download a free pre-publication report overview (including key industry trends, What's New in this edition, the Table of Contents, and a List of Exhibits)

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to contact us if you would like to pay by corporate check or ACH.

Special preorder and launch pricing discounts will be valid through October 23, 2024.

Read on for more details.
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I am pleased to announce Drug Channels Institute's new 2024–25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.

• Download a free report overview (including key industry trends, the Table of Contents, and a List of Exhibits)

• Review pricing/license options and download the full 2024-25 report

We’re offering special discounted pricing if you order before October 23, 2024.

2024–25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our 15th edition--remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry. This 2024-25 edition includes substantial new material—outlined on page vii of the report overview.

9 chapters, 380+ pages, 178 exhibits, more than 750 endnotes: There is nothing else available that comes close to this valuable resource.

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to contact us if you would like to pay by corporate check or ACH.

Email Paula Fein (paula@drugchannels.net) if you’d like to bundle your report purchase with access to DCI’s video webinars.

If you preordered the report, you should have already received an email with download instructions last week. Please contact us if you did not receive your email.

Read on for some additional details.
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An AllTrials report for the House of Commons Science and Technology Select Committee this week has found that 33 NHS trust sponsors and six UK universities are reporting none of their clinical trial results, while others have gone from 0% to 100% following an announcement from the Select Committee in January that universities and NHS […]

New research has shown that the majority of clinical trials which should be following the US law on reporting results aren’t. Less than half (41%) of clinical trial results were reported on time and 1 in 3 trials (36%) remain unreported. The research also found that clinical trials sponsored by companies are the most likely […]

LONDON — The world's biggest food and beverage companies on average sell products in low-income countries that are less healthy than what they sell in high-income countries, according to a new report. Products sold by companies including Nestle, Pepsico and Unilever were assessed as part of a global index published by the Access to Nutrition Initiative (ATNI), its first since 2021. The non-profit group found that across 30 companies, the products sold in low-income countries scored lower on a star rating system developed in Australia and New Zealand than those sold in high-income countries. In the Health Star Rating system, products are ranked out of five on their healthiness, with five the best, and a score above 3.5 considered to be a healthier choice.

BAKU — Global carbon dioxide emissions, including those from burning fossil fuels, are set to hit a record high this year, pulling the world further off course from averting more destructive climate extremes, scientists said on Wednesday (Nov 13). The Global Carbon Budget report, published during the UN's COP29 climate summit in Azerbaijan, said global CO2 emissions are set to total 41.6 billion metric tons in 2024, up from 40.6 billion tons last year. The bulk of these emissions are from burning coal, oil and gas. Those emissions would total 37.4 billion tons in 2024, up by 0.8 per cent in 2023, the report said. The rest are from land use, a category that includes deforestation and forest fires. The report by more than 80 institutions was led by the University of Exeter in UK. "We don't see a sign of fossil fuel emissions peaking in 2024," said lead author Pierre Friedlingstein, a climate scientist at the University of Exeter. Without immediate and steep emissions cuts worldwide, "we will just go straight into the 1.5C target, we'll just pass it and continue," he said.

Polling was held on December 4 and the results were announced on Wednesday.

2015 Sodexo Workplace Trends Overview

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West and HealthPrize are collaborating to provide an end to end connected health solution for pharmaceutical companies and the patients they serve.

March of Dimes volunteer ambassador and world famous photographer Anne Geddes is featured in a PSA to raise awareness about preventing preterm birth and give more babies a healthy start in life.

Brad & Jenny Lost 400 lbs. Together

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Download CA Final Financial Reporting FR Question Papers New Course Nov 2024 in PDF. For older question papers of CA final May 2024, Nov 2023, May 2023, Nov 2022, May 2022, Dec 2021, Nov 2020, May 2019, Nov 2018,CA final May 2018, Nov 2017, May 2017, CA final may 2016, CA final Nov 2016 check similar section. Previous years CA final Financial Reporting FR question papers can also be downloaded using Search. You can also search and download may 2015 IPCC & IPC question papers here. We are providing ca final question papers of may 2016 for Financial Reporting FR, Advanced Financial Management AFM, Advanced Auditing, Assurance And Professional Ethics, Direct Tax Laws DT, Indirect Tax Laws IDT, Integrated Business Solutions (Multidisciplinary Case Study with Strategic Management) and IPCC/IPC Nov 2023 question papers for Accounting , Business, Law, Ethics & Communications , Cost Accounting & Financial Management CAFM, Taxation, Advanced Accounting , Auditing & Assurance, Information Technology & Strategic Management ITSM.

Check out Waze’s latest updates, including Conversational Reporting.

Southeast Asia’s economy has rapidly expanded over recent years — and there’s no sign of slowing down. In fact, the GDP growth of Southeast Asia is projected to outpace …

Daisy Ridley‘s Rey Skywalker is viewed as one of the most valuable cinematic assets in the Star Wars universe, and could play a key role in several movies in the future, according to a new report. In a new report on the ongoing state of the Star Wars universe and what its future holds for […]

The post Report: Daisy Ridley’s Rey Skywalker to Star in Multiple New Star Wars Movies appeared first on ComingSoon.net - Movie Trailers, TV & Streaming News, and More.

We speak with The Nation's John Nichols in Wisconsin, where Kamala Harris and Donald Trump are spending a lot of their time in the closing days of the election in a tight battle for the state's 10 Electoral College votes. Nichols also discusses the battle for the Senate, with key races in Wisconsin and Nebraska; how New York races could tip control of the House to Democrats; and why Kamala Harris needs to expand her message beyond the threat of Trump’s authoritarianism. “At the doors, people want to talk about economics,” says Nichols.