TA REACH, Cambodia (IRIN) – Cambodian efforts to contain the spread of malaria have been strengthened by a pilot project using text messaging and web-based technology.

“My work is definitely easier,” said Sophana Pich, 41, one of 184 village malaria workers (VMWs) now trained in three provinces (Kampot, Siem Reap and Kampong Cham) since the project launch earlier this year.

She typically diagnoses five to six cases of the often deadly virus each month during the rainy season between May and October.

“Before, it would take a month before this information was reported to the district health level. Now it’s instantaneous,” the mother-of-three said from her home in Ta Reach, a village of 200 households in Kampot Province, about 150km southwest of Phnom Penh.

There are close to 3,000 VMSs in 1,500 villages across Cambodia, described by many as the “foot soldiers” in the country’s fight against malaria.

As part of a larger US$22.5 million malaria containment effort launched by the government in 2009 and funded by the Bill & Melinda Gates Foundation , the volunteers receive three days of training in the early diagnosis of malaria and treatment.

In addition, they are given a bicycle, a pair of boots, a bag, a flashlight and a cooler box for medicines, as well as a small travel allowance.

Under the pilot scheme now under way, they are also given mobile phones.

Using FrontlineSMS – an open-source software enabling users to send and receive text messages with groups of people – VMSs can now report in real time all malaria cases in their villages to the Malaria Information and Alert System in Phnom Penh with a simple text message, including the patient’s name, age, location and type of virus.

That information is then disseminated to local, district and provincial health offices, with coordinates mapped on the country’s national malaria database using Google Earth.

Mobitel (Cambodia’s largest telecommunications company) provides free SIM cards and free SMSs, making the system cost-effective and easy to maintain.

“Without doubt, this is an important tool to quickly identify malaria cases and respond effectively,” explained Pengby Ngor, data manager for the Malaria Consortium , an NGO working closely with the government’s National Malaria Control Centre that helped develop the database.

“This is a pilot project which ultimately could be used throughout the country.”

That is good news for Cambodia, where malaria remains endemic; the government hopes to eliminate the disease over the next 15 years.

“We need a series of campaigns and activities so that malaria will go down towards the zero rate of malaria transmission by the year 2025,” Prime Minister Hun Sen told participants at this year’s 32nd National Health Conference in March.

Challenges

But while there is progress in that direction, including falling numbers of people getting sick or dying from malaria across much of the country, key challenges remain.

According to the Ministry of Health , the number of deaths from malaria fell by 53.8 percent in 2010 from the previous year.

At the same time, however, Cambodia has reported an increased incidence of multi-drug resistant falciparum malaria, one of four types of the disease, along parts of its 800km border with Thailand since 2009.

There health officials have expressed concern that the malaria causing parasite is becoming increasingly resistant to the most effective drug they have for treating it, Artemisinin.

“Here in Cambodia, we’ve found that the drug is less effective,” Najibullah Habib, malaria containment project manager for World Health Organization (WHO), confirmed in Phnom Penh, specifically in the area described as Zone 1.

In Cambodia, some 270,000 people live in Zone 1, comprised of Pailin Province, as well as parts of Battambang, Pursat and Kampot provinces.

Another 110,000 people live in the Thai border areas of Trat and Chanthaburi provinces.

“This is the epicentre of drug-resistant malaria,” Habib explained.

To counter that, Cambodian and international efforts are working on the ground to prevent the drug-resistant parasite from spreading elsewhere in the region, focusing on prevention, treatment and testing efforts at the village level.

“The VMWs are all over Zone 1,” the WHO official said. “They’re an essential tool.”

In 2008, prior to the distribution of more than half a million bed nets, as well as the VMW intervention, Zone 1 averaged more than 100 cases per month. Today that number is between 10 and 15.

According to WHO, in 2000, the number of treated malaria cases in Cambodia stood at 129,167 with 608 deaths. In 2010, that dropped to 56,217 and 135 deaths, down 78 percent.

About 3.3 billion people – half the world’s population – are at risk of malaria. Every year, this leads to about 250 million malaria cases and nearly one million deaths. People living in the poorest countries are the most vulnerable, the world health body says.

ds/mw

– Provided by Integrated Regional Information Networks.

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Traditional public school systems do not have a lock on the educational market. Affording college tuition or even high school tuition can be a factor in whether to choose public school or a private school, as private schools are far more expensive. However, there are so many grants and loans out there, that you shouldn’t let your dreams be thwarted over a lack of college funds. In addition, you may find many more choices for schooling that can fit into your budget without even having to take out loans.

Take a Look at Alternative Choices First

If you can’t afford a 4-year program, look for 2-year or certificate program to complete. Get skills that can put you in demand in the job market in your area. By targeting jobs that are hiring or due to expand in hiring, you have a better chance of putting your education to use. Think of going to a vocational training program or taking online classes. If you are in high school, you have the option to be home schooled, go to a magnet school, or a private school. Don’t assume that your only career path is a traditional 4-year college degree, unless that is something you’ve always dreamed of doing.

Find the Funding

Next, once you’ve narrowed down your choices, according to your lifestyles and dream, attempt to find your financing sources. You should do this early for college, like as soon as you enter your senior year in high school. Many programs do have funding, but application to get it is usually a lengthy process and needs to be completed by specific deadlines. Think ahead and look for funding at least one year, if not more, before you try to enter a program in any school. If the financing is first come/first served and you apply early, you will be the first in line if you qualify.

Washington, DC, United States (KaiserHealth) – What’s worse: Losing face or losing money?

Under laws in more than two dozen states and new Medicare rules that went into effect earlier this year, hospitals are required to report infections, risking their reputations as sterile sanctuaries, or pay a penalty. That’s left hospital administrators weighing the cost of ‘fessing up against the cost of fines.

For Clark Todd, CEO of Pacific Hospital in Long Beach, there’s only one way to go: “If we hide from the public then the tendency to keep the status quo is stronger than ever,” he said. “And that’s just not going to get the job done.”

It’s been more than a decade since a panel of top scientists declared hospital safety a national priority. Yet, about 90,000 patients still die each year from preventable infections resulting from routine surgeries and hospital care, according to the U.S. Centers for Disease Control and Prevention. Examples include infections resulting from contaminated tubes that deliver food and medications, and catheters that remove urine. Staph infections, which can be deadly, are a particularly serious problem.

Many more patients are irreparably harmed. Dave Meyer of Fair Oaks, Calif., a Sacramento suburb, was a general contractor before he broke his ankle in a motorcycle accident. Records indicate he contracted an infection at a local hospital that prevented his ankle from healing. He endured several surgeries and excruciating wound cleanings.

“Imagine taking an ice cream scoop and just taking half of your foot off. It looked like just this gaping hole,” said Meyer, adding: “I know that it would have been so much better if they used the proper hygiene in the hospital.”

Dr. Alfonso Torress-Cook of Pacific Hospital couldn’t agree more. “Hospitals are dirty,” he said. An epidemiologist and head of the hospital’s infection control program, Torress-Cook came to this for-profit teaching hospital five years ago with a clear goal: to sharply reduce the hospital’s infection rate.

Back then, the medical staff viewed infections at the 184-acute care bed facility as largely unavoidable and treated them with antibiotics, he said. The approach was costly: An infection can add $42,000 to a patient’s bill in the intensive care unit, according to the Leapfrog Group, an advocacy group that represents large employers like General Motors, Chrysler and Sprint.Now, hand washing at Pacific Hospital, especially in the ICU, is so routine nurses complain their hands are chapped. That’s just one of many changes. Nurses here wash patients every day. Janitors are given enough time to properly clean rooms. Even those coming in for surgery are asked to take a shower before showing up.Torress-Cook opened a closet to show off another weapon in the hospital’s anti-infection arsenal: an ultraviolet light, hooked up to the hospital’s air ventilation system, that kills airborne germs.At first the employees were skeptical, said Todd. But California’s new public reporting law, which went into effect in 2010, and Medicare’s decision to start withholding two percent of payments from hospitals that keep their rates secret, have helped his cause.”I think that gives administrators like me even more reason to get involved in this matter,” said Todd. “And more clout with our medical staff to work against some of these traditional behaviors.”Pacific Hospital is working to bring down bloodstream infections that result from tubes that deliver medication and nutrients, and has virtually eliminated methicillin-resistant Staphylococcus aureus (MRSA) and surgical infections.That has caught the attention of competitors and potential customers. And it’s become a source of pride for its employees.Indeed, researchers have found concern over a hospital’s public image is an even more powerful motivator than fear of losing market share.”Many hospitals will measure quality and voluntarily put it up, even without the government involved,” said Dr. Michael Rapp, director of the Quality Measurement and Health Assessment Group of the Centers for Medicare and Medicaid Services. “But certainly once it’s required for all hospitals to do that there’s the peer pressure and they’re going to be looking at how they do compared to others.” The fear of losing millions of dollars isn’t an idle threat either. Starting this year, hospitals have to reveal their catheter-associated blood stream infections if they want their Medicare bills paid in full. Next year, they’ll have to report surgical-site infections. The list will grow longer in the coming years. Rapp anticipates that nearly all U.S. hospitals will comply. Now, only half volunteer their data, he said. Still, the stigma of unclean wards and fear of lawsuits can make hospitals reluctant to report. When the law went into effect in California,’ hospitals out of 400 didn’t send in any data. State regulators, who acknowledge the first year of data collection was riddled with errors, are not imposing penalties. There are other concerns: Competitors may undercount, making more honest players look bad, and some hospitals simply do more surgeries or have sicker patients, said Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association. “The measures aren’t perfect and don’t adequately account for the differences among patients,” said Foster.For hospitals in cities like Long Beach or quieter, rural areas like Ukiah, keeping track of the frenetic activity in their facilities can be daunting.Ukiah is a verdant and woodsy town north of San Francisco, in Mendocino County. At the small, 78-bed nonprofit hospital, patients and staff all seem to know each other, trading warm hellos on a warm spring day. It’s not hard to imagine how quickly word of even one infection can spread.That’s something Sue Mason, a half-time nurse at Ukiah Valley Medical Center, worries about. “We have nothing to hide,” she said.Mason has a big job and only 20 hours a week to do it: She’s charged with tracking and preventing infections. Every morning, she checks the computerized lab tests and tries to chase down new cases. In the nationwide push for greater transparency of hospital performance, though, Mason is an overwhelmed foot soldier. She has little time to eliminate the very infections she’s charged with reporting.”I’d like to be out on the floor more with the nurses. I could monitor their hand hygiene compliance and educate them as I see them doing their job,” Mason said. Instead, she spends most her day in front of the computer crunching data.Mason must report not just the infections that occur, which are rare here, she said, but details of every surgery, every patient who tests positive or negative for gruesome antibiotic-resistant bugs, like MRSA.Even at Pacific Hospital, where infection rates are some of the lowest in the nation, hospital chief Todd preaches constant vigilance, “These initiatives have to be felt with some passion and they have to be implemented with consistency and strong will.”It will take some time before patients can know the full risk of entering their local hospital. At present, most states and Medicare publish just a short list of infections.In the coming years, though, as the federal health law continues to take effect, the noose will tighten even more. Starting in 2012, Medicare will reduce payments to hospitals with poor infection rates in their intensive care units.There is great hope, among researchers and hospital chiefs, that this double-barreled approach of public reporting and financial sanctions may be the best cure for what has proven to be a chronic condition in hospitals.

– Provided by Kaiser Health News.

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Because, I was wondering, and I thought you might be curious, too. Here is a screen, via FactSet, of the best-performing biotech and drug stocks over the year so far. I’ve taken some, but not many, efforts to screen out penny stocks.

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United States (KaiserHealth) – There’s no debating that the budget blueprint passed by the U.S. House of Representatives last month would make major changes to the Medicare program for the elderly and disabled.

What Republicans and Democrats don’t agree on, however, is whether those changes would actually save money or just shift costs now paid by the government to Medicare patients.

Rep. Paul Ryan (R-WI), who as chairman of the House Budget Committee wrote the plan that passed that chamber, says his plan would help bring down costs.

“We say, let 40 million seniors have choice, have power, and have those providers compete against each other for their business so they’re in charge of their Medicare,” he said during the House debate.

But Democrats – led by President Obama – say the GOP plan would merely let the government pay less by making Medicare patients pay more.

“I mean, it’s not hard to save the government money if you’re willing to just say, ‘Here, you pay for it,’ ” the president said at a town hall meeting in northern Virginia two weeks ago. “That’s not a solution.”

At the heart of Ryan’s plan for Medicare is a proposal to give everybody in the program a limited pot of money every year instead of the government-run health insurance they get now. But it’s not really a pot of money. Technically, it would be a subsidy they could only use to buy private health insurance.

Ryan says the plan would make Medicare work just like the health insurance he gets as a member of Congress.

“Look at all these plans we get to choose from,” he said, reading from the federal employees health plan handbook on the House floor during the debate. “Kaiser, Aetna, Blue Cross/Blue Shield, Coventry – pages and pages of choices and options. This is what we’re talking about for people [ages] 54 and below.”

Rising Costs, Inflation

Or not. “It’s not at all what you’ll have,” says Austin Frakt, a health economist at Boston University who co-authors a health blog called The Incidental Economist.

Frakt says one key advantage of the health plans available to members of Congress is that the subsidy they get to pay their health insurance premiums keeps up with rising health care costs.

“It keeps pace, it doesn’t erode over time,” he says.

That wouldn’t be the case with Ryan’s Medicare plan. It’s designed so that the amount seniors get to buy insurance would only go up as fast as inflation in the rest of the economy. Frakt says that could be a big problem. Health costs tend to rise much faster, sometimes twice as fast, as overall inflation.

“That difference means that the subsidy is kind of riding along, going up at a slow rate, and health care costs are going way up, and premiums reflect health care costs, so the entire difference is shifted to beneficiaries,” Frakt says.

In other words, Ryan’s plan allows the government to spend less on Medicare by making patients pay more – potentially a lot more.

To see exactly how much more, we did a little math experiment.

The most popular federal worker health plan is the standard option Blue Cross/Blue Shield Plan. Its total annual premium this year is just under $7,000.

The government (the employer in this case) pays just under 70 percent of that amount, and the workers (including members of Congress) pay 30 percent.

This year, those amounts would be roughly $4,900 and $2,100.

Say next year the plan’s total premium rises to $7,500; that would be a fairly modest increase of about 7 percent. Under the federal plan, the government still pays that 70 percent. So, Frakt says, using the new total, “70 percent of that is $5,250, and the difference would be what enrollees pay … $2,250.”

That’s a total annual premium increase for federal workers of $150.

Now let’s try the same exercise under the Ryan Medicare plan.

Assume, just for comparison’s sake, the first year the government provided the same $7,000 for an individual. (The subsidy would likely be considerably higher, since seniors tend to have more health problems, and their health care costs more). And assume that the first year that subsidy would be enough to cover the full cost of a low-cost insurance plan.

What happens to the subsidy, then, when that plan’s cost rises to $7,500 the next year?

“It depends on the inflation rate,” Frakt says. “But say inflation was essentially zero, the subsidy would stay the same. So that increase in $500 in the premium would be entirely paid by the beneficiary.”

In other words, the increase for the Medicare patient would be more than three times higher than the one for the federal employee. And each year, the Medicare enrollee would be responsible for that difference between overall inflation and health inflation.

‘Cost-Conscious Consumers’

Now, Ryan and his supporters dispute that exercise. They say their plan has elements that actually would reduce health care spending.

For example, Michael Cannon of the libertarian Cato Institute says having people spend their own money, rather than the government’s, helps.

“They’ll be cost-conscious consumers, they’ll choose economical health plans, they’ll put downward pressure on prices, because they will get to see the savings,” he says.

At the same time, Cannon adds, more competition within the health care industry will also help hold down prices.

“Because in order to capture the business of those cost-conscious consumers, health plans, providers, will have to find ways to cut costs while improving quality,” he says.

So far the Ryan plan is barely more than an outline. And it’s going nowhere in the Democratic-led Senate. But it’s an important marker in the emerging Medicare debate.

And that debate comes with more than a few political perils. Medicare clearly needs some kind of fix to withstand the onslaught of 78 million baby boomers.

But so far, public opinion polls show that neither Republican nor Democratic voters favor any big changes to the program.

– Provided by Kaiser Health News.

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North Yorkshire, England, United Kingdom (AHN) – British Prime Minister David Cameron criticized Oxford University Monday for its alleged racially discriminatory admission policies. Cameron claimed the educational institution admitted only one black student in the last academic year.

The prime minister also hit other elite institutions for discriminating against high school graduates of state schools.

However, senior Oxford officials denied Cameron’s allegation. They said Oxford admitted 42 black students last year – 27 were black Africans, one was a black Caribbean and 14 of mixed race. The sole black student that Cameron referred to was the one from the Caribbean.

The university explained only 452 black students across Britain met the A-level results required by Oxford’s tough minimum entry standards for the 2009-10 academic year.

The Conservative chairman of the Commons Education Select Committee, Graham Stuart, said the reason behind the low acceptance rate by elite universities in Britain of minority group members is the lack of good education at the basic level. He said the problem could not be solved by forcing universities with higher benchmarks to lower the bar, but by improving the standards of state education.

Of 16,591 students enrolled last year at Oxford who disclosed their ethnicity, 12,671 or 76 percent were white, 1,477 (9 percent) were Asian, 1,098 (7 percent) were Chinese, 254 (1.5 percent) were of other ethnicities and 253 (1.5 percent) were black.

Downing Street eventually admitted Cameron was not precise in his wording, but just wanted to emphasize that it is not acceptable for elite universities such as Oxford to have very few students from black and minority ethnic groups.

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U.S. TB rates last year fell to an all-time low since national reporting began in 1953, but the disease is proving difficult to target among specific populations, especially among foreign-born individuals, blacks and people infected with HIV.

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Every year the tobacco industry spends literally, billions of dollars on promotion, sponsorship and advertising. Tobacco advertising increases tobacco consumption which in turn kills people. Teens are at especially high risk of starting to smoke product advertisements and viewing such ads alone is guaranteed to start more youths on this deadly habit…

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shingles vaccine can prevent tens of thousands of cases of the painful, blistering condition each year, but only reaches roughly 11 percent of those who could benefit, according to a Kaiser Permanente

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flu season approaches, a survey of 525 nurses from America’s leading hospitals reveals that 93 percent of nurses are confident that hospitals are “far better prepared” to handle a poten

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