Parkview Community Hospital Medical Center in Riverside, Calif. and South Haven, Mich.-based South Haven Community hospital selected the Keane InSight healthcare information system by Keane Inc. of Boston.
HFMA President and CEO Richard L. Clarke, DHA, FHFMA, discussed the increase in the number of consumers who are using credit cards to pay for their medical expenses during a segment on “NBC Nightly News.” The segment aired Feb. 7, 2007, and also was published on the MSNBC web site.
A recent study by Demos and the Access Project linked high credit-card debt to medical expenses. In a survey of low- and middle-income households, 29 percent of those who cited medical expenses as a factor in their credit card debt had higher balance–46 percent higher, on average–than those who did not use credit cards to pay for health care. Low- and middle-income households who used credit cards to pay for medical expenses averaged credit card debt of $11,623, according to the study, while households that did not charge medical expenses averaged credit card debt of $7,964.
Clark told “NBC Nightly News” that hospitals, too, are in a tight spot, given the number of patients who are uninsured (47 million) or who have high-deductible plans and cannot afford their deductibles.
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“The high-deductible health plans are causing hospitals to have to collect more up front,” Clarke told NBC. “[Hospitals] are worried about the fact that patients will need treatment, yet they won’t have the money to pay up front.”
Clarke also discussed rising costs in two other recent television appearances. He recorded two interviews with “First Business Morning News” to discuss HFMA’s recent report Healthcare Finance Outlook 2007. To watch the videos, visit www.hfma.org/about/pressroom and click on “press releases.”
A new test for prostate cancer based on DiagnoCure’s PCA3 gene, which researchers believe is a much more precise indicator of prostate cancer than current diagnostics, has received CE Mark certification for use in Europe.
“I believe this is a significant moment for our company and for all those concerned with prostate cancer,” said John Schafer, President and Chief Executive Officer of DiagnoCure (TSX: CUR) “We are confident that clinicians and patients will share our excitement at the potential of this important new prostate cancer diagnostic tool.”
The CE Mark opens the ways for commercialization of the test in Europe. The Gen-Probe PCA3 test, which measures the expression of the prostate cancer-specific gene, PCA3, will be formally launched later this month at the meeting of the British Association of Urologic Surgeons (BAUS) in the UK. Gen-Probe is conducting studies at seven leading European institutions to validate with European patients the expected high clinical utility of the test. Four molecular pathology laboratories across Europe are in the process of setting up the assay for the reporting of clinical results.
At a European symposium in October, attended by many of the world’s key opinion leaders in the management of prostate cancer, Dr. Jack Schalken’s keynote presentation discussed data suggesting the importance of PCA3 in predicting the outcome of a prostate biopsy. This is an issue of major concern in the diagnosis of prostate cancer, as up to 80% of patients with an elevated Prostate Specific Antigen (PSA) level may have a negative prostate biopsy. Being able to predict whether a second biopsy is needed could potentially spare many patients the uncomfortable experience of a second procedure. Dr. Frans Debruyne, Emeritus Professor of Urology at UMCN called PCA3 the most important discovery in his over 20-years as head of the department.
About DiagnoCure
DiagnoCure specialises in the development, production and commercialisation of diagnostic tests for the early detection of cancers. DiagnoCure’s first product, ImmunoCyt(TM) /uCyt+(TM), is an important tool for the diagnosis and monitoring of bladder cancer. In 2003, the Company granted an exclusive worldwide license for the use of the PCA3 technology in prostate cancer diagnosis to Gen-Probe. Tests based on the PCA3 gene, believed to be the most accurate indicator of prostate cancer, are currently available in Analyte Specific Reagent format (ASR) in the United States. DiagnoCure is now exploring additional applications for the early detection of lung and kidney cancer. DiagnoCure is headquartered in Quebec City, Canada.
According to a report in last week’s Proceedings of the National Academy of Sciences on the identification of a new H5N1 virus sublineage in poultry, this new virus sublineage, called Fujian virus, appears to have become the dominant strain of the H5N1 avian influenza circulating in parts of Asia. If the report is confirmed, this does not come as a surprise, FAO and the World Organization for Animal Health (OIE) said today.
While there is a wide variety of avian influenza strains in animals, and influenza viruses in general have a high rate of change from season to season and from year to year, OIE Director-General Bernard Vallat and FAO’s Chief Veterinary Officer Joseph Domenech warn that with new antigens developing continually in avian influenza viruses, vaccines currently in use for poultry need to be assessed regularly.
The two organizations continue to recommend that vaccination control measures need to be accompanied by surveillance and post-vaccination monitoring. They also stressed the need to immediately report to veterinary authorities any unexpected poultry deaths.
Careful monitoring of vaccination campaigns recommended
Vaccination remains part of the FAO-OIE strategy to contain avian influenza and both organizations say that vaccination campaigns should be applied appropriately and carefully monitored according to FAO and OIE technical guidelines, including the use of a cold chain in order to protect the vaccine. Vaccination must be carried out along with other disease control measures, such as improved hygiene on the farm, animal movement management or market inspection and culling in case of outbreaks, said Dr. Domenech.
According to Dr. Vallat, “Commitment is needed from all governments to implement prevention and control programs such as surveillance of virus circulation and, where appropriate, vaccination programs in countries where the virus is endemic or where there is a high risk of introduction of the virus.”
FAO and OIE are already supporting such programs in key countries where the virus is still circulating. But, they say more information on control programs based on vaccination is needed and urge more research be funded to better understand the epidemiology and genetic changes of the H5N1 virus.
Giving anti-HIV drugs to HIV-negative people who are at high risk of HIV infection (pre-exposure prophylaxis or “PREP”) may become an important tool in curbing the HIV pandemic, says a group of researchers in a policy paper in PLoS Medicine.
Inge Derdelinckx (University Medical Center, Utrecht) and colleagues formulate criteria for what would be the optimal drug to test as a PREP candidate in clinical trials. They then evaluate existing antiviral drugs to see which of these would best fit these criteria.
Based on their analysis, they conclude that lamivudine (3TC) would be a good PREP candidate to test, “given its relative safety, ease of use, mode of action and pharmacology, antiviral profile, and cost-effectiveness.” Whether its use would be optimal as monotherapy or in combination with another antiviral, they say, is still unknown.
“Randomised clinical trials to evaluate 3TC’s efficacy in preventing new HIV infections are the only way forward,” say the authors.
All works published in PLoS Medicine are open access. Everything is immediately available without cost to anyone, anywhere–to read, download, redistribute, include in databases, and otherwise use–subject only to the condition that the original authorship is properly attributed. Copyright is retained by the authors. The Public Library of Science uses the Creative Commons Attribution License.
Eisai has introduced a Rx-to-OTC switch product for allergic-related rhinitis and skin problems, available from November 1.
The product, ‘Higuard’, is the first Rx-to-OTC switch product of azelastine hydrochloride, an anti-allergy compound originally approved for prescription use. It is also effective in alleviating allergyc symptoms including rhinitis caused by pollens or house dusts and skin problems such as utricaria and eczema.
The active ingredient of Higuard azelastine hydrochloride exhibits anti-allergic effects by inhibiting and releasing leukotriens and histamine that cause allergy, relieving allergic symptoms including rhinitis (sneezing, runny and stuffy nose) and skin problems (urticaria, eczema, etc).
It is recommended that patients with seasonal allergic diseases be started on Higuard immediately before the beginning of the season to maximize the effect.
According to an Eisai survey, more than 50 percent of the people who suffer from pollen allergy answered that they constantly feel itching of skin, and 70 percent said that they experience allergic problems all year. Higuard is expected to serve the needs of such people acting on both rhinitis and skin problems.
As part of the major nationwide educational campaign Diabetes & You: Step It Up to Get It Down, life and fitness coach Bob Harper will visit Los Angeles to encourage local residents with type 2 diabetes to better manage their disease. Harper and a panel of diabetes experts convened by the American Association of Clinical Endocrinologists (AACE) developed the easy-to-understand and motivational 6.5 Steps Toward Better Blood Sugar Control. The 6.5 Steps underscore the importance of reaching the AACE target A1C goal of 6.5% or less for most patients through the cornerstones of effective diabetes management — eating healthy, being physically active, monitoring blood sugar, seeing a doctor or other healthcare professional, and, when appropriate, taking one or more medicines. To encourage area residents to “Step It Up,” Mayor Antonio Villaraigosa has declared the week of October 30, 2006 “Diabetes Control Week” in Los Angeles, dedicated to improving blood sugar control for people with type 2 diabetes.
“Type 2 diabetes affects millions of Americans and is an epidemic,” said Bob Harper. “Through my years of coaching and training, I’ve worked with many people with type 2 diabetes and seen how hard it can be to live with this condition. But I learned that anyone can change their life. It’s all about finding the right tools and motivation. I’m challenging people with type 2 diabetes to step it up and use the 6.5 Steps Toward Better Blood Sugar Control. It’s your body — take charge today!”
The Diabetes & You: Step It Up to Get It Down campaign was developed in response to a first-of-its-kind report issued last year by AACE showing that two out of three Americans with type 2 diabetes analyzed in a study were not in control of their blood sugar — failing to meet the AACE-recommended A1C goal of 6.5% or less for most patients. According to the report, in California alone, more than one-third of people with type 2 diabetes who were analyzed in the study were not in control of their blood sugar. The A1C test measures a person’s average blood sugar levels over the previous two to three months. The A1C test complements blood sugar monitoring that patients do on their own, which shows a blood sugar level at the time the test is taken.
“Making the decision to take control of the disease is one of the most important things a person with type 2 diabetes can do to properly manage the condition and ultimately reduce the risk of long-term complications associated with the disease,” said Dr. Michael Bush, Past Clinical Chief, Division of Endocrinology, Cedars-Sinai Medical Center. “The 6.5 Steps Toward Better Blood Sugar Control provide patients with recommendations that they can realistically incorporate into their daily routine. It’s a great tool to motivate patients to partner with their doctor or other healthcare professional to make better health choices and bring their blood sugar levels under control.”
Approximately 1,769,850 people in California are diagnosed with diabetes, and over 18 million people in the United States have type 2 diabetes, the most common form of diabetes. Type 2 diabetes occurs when the body does not produce enough insulin or does not respond properly to its own natural insulin, a condition called insulin resistance. Insulin helps the cells convert blood sugar to energy. When sugar builds up in the blood instead of going into the cells, it can starve the cells of energy and, over time, high blood sugar levels can cause diabetes-related complications, affecting the eyes, kidneys, nerves or heart.
The South African government has shifted its response to the HIV/AIDS epidemic to focus more on expanding access to antiretroviral treatment, HIV testing and prevention, the Washington Post reports. The shift has come about with the appointment of Deputy President Phumzile Mlambo-Ngcuka as head of the national AIDS commission, according to the Post. Although President Thabo Mbeki in the past has questioned the link between HIV and AIDS, Mlambo-Ngcuka over the past six weeks has emphasized that the government believes HIV causes AIDS, the Post reports. Mlambo-Ngcuka also has said the government needs to focus on antiretrovirals to treat HIV/AIDS. Health Minister Manto Tshabalala-Msimang has been known to promote dietary recommendations, such as beetroot and lemons, to treat the disease, the Post reports (Timberg, Washington Post, 10/27). The government on Thursday endorsed a revised draft of its AIDS control policy. Government spokesperson Themba Maseko said the plan is being finalized (Roelf, Reuters Health, 10/26). Maseko said the government has decided to set goals in the country’s five-year plan, scheduled to be released on World AIDS Day on Dec. 1., aimed at widening HIV prevention programs and the availability of antiretrovirals. South Africa’s antiretroviral treatment program currently reaches about 200,000 people — approximately one-quarter of HIV-positive people estimated to need access to the drugs. Activists are calling on the government to provide one million people with access to antiretrovirals, expand HIV testing and reduce the number of new infections. In addition, some activists have said the tone of the dialogue with the government has shifted significantly since Mlambo-Ngcuka’s appointment. The Treatment Action Campaign says its members now are discussing long-term targets with the government “after years of hostility and legal battles,” according to the Post. TAC leader Zackie Achmat said, “There’s clearly a shift taking place.” The government’s change in stance was spurred by the “growing realization of the severity” of HIV/AIDS in South Africa — where 5.4 million of the country’s 47 million residents are estimated to be HIV-positive — as well as concerns over the impact that the government’s response to the disease is having on the country’s reputation, according to the Post (Washington Post, 10/27).
HIV/AIDS Might Hamper Economic Growth
In related news, the HIV/AIDS epidemic in South Africa might undermine the country’s gains in productivity and increase health care and training costs, according to economists, USA Today reports. The disease by 2010 is expected to cut annual economic growth by 1.5 percentage points, according to Christo Luus — chief economist for Absa, the country’s largest bank. Although the Bureau for Economic Research in 2005 said HIV/AIDS would reduce economic growth rates by no more than half a point annually, Luus said that previous studies have been less comprehensive (Lynch, USA Today, 10/27).
Parents should listen to their instincts and pick up their newborn babies when they cry, Queensland University of Technology researcher Professor Karen Thorpe said.
A joint study with QUT and the Riverton Early Parenting Centre has found many parents of infants up to 12 weeks, were uncertain about how best to settle their crying baby and whether or not it was “right” to pick them up.
“A lot of parents are unsure if they should pick up their baby when their baby cries,” Professor Thorpe from QUT’s Faculty of Education said.
“The answer is: you should. Babies in the first 12 weeks of their life need highly responsive parents. They want and need a parent that is responsive to their cries.”
Professor Thorpe said the study was initiated by concerns by clinical nurses from the Riverton centre that parents were choosing to ignore their crying newborn for fear it would “spoil” their baby to pick them up.
Riverton clinical nurse and co-researcher Claire Halle said parents felt picking up their crying baby would create “bad habits” which would impact negatively on their child’s behaviour in the future.
“Parent’s felt torn between what they thought and what they felt was the right thing to do, and this uncertainty seemed to heighten their stress levels,” Ms Halle said.
The study found about 20 per cent of first time parents and 30 per cent of experienced parents admitted they were uncertain about picking up their crying baby. It also revealed that almost 25 per cent of first time parents and just over 10 per cent of experienced parents believed picking up a crying baby would spoil them.
“One parent said ‘I feel guilty for not picking him up when he cries’,” Ms Halle said. “Another said ‘frequent and sudden changes in baby’s behaviour make it hard to judge; too much attention may spoil them’.”
But Professor Thorpe said in the first three month’s of a baby’s life, having responsive parents was very important to the child’s emotional and neurological development.
She said the study highlighted there was a problem because parents were getting mixed messages about how best to settle their newborn baby.
“We need to ensure nurses, educators and health professionals are providing parents with consistent and appropriate guidelines for caring for their baby,” Professor Thorpe said.
“It is also important for parents to have the confidence to trust their instincts when it comes to caring for their baby.”
The experience of racial discrimination may be a key factor in explaining why African Americans have higher rates of obesity and suffer at higher rates from such diseases as diabetes and cardiovascular disorders, according to UCLA researchers.
Repeated responses to such discrimination — which include elevated blood pressure and heart rate — can cause enormous stress on a person’s mental and physical health, according to research scheduled to be published in Volume 58 of the Annual Review of Psychology.
Race-based discrimination may help explain why African Americans, despite gains in civil rights and targeted health programs, continue to have the highest rates of diabetes, cardiovascular heart disease, hypertension and stroke as compared to all other racial or ethnic groups in the United States.
“This is not to say that every African American has poor health,” said Vickie Mays, the report’s lead author, a UCLA professor of psychology and health services and director of the Center for Research, Education, Training and Strategic Communication on Minority Health Disparities. “However, African Americans — as a group of people — have not been able to gain as much ground as other ethnic groups. That’s when you need to worry and look at missing factors that can explain these health disparities.”
When a person experiences discrimination, the body develops a cognitive response in which it recognizes the discrimination as something that is bad and should be defended against, Mays said. She said this response occurs for the most part even if the person merely perceives that discrimination is a possibility.
Starting with the brain’s recognition of discrimination, the body sets into motion a series of physiological responses to protect itself from these stressful negative experiences, Mays said. These physiological responses include biochemical reactions, hyper-vigilance and elevated blood pressure and heart rate. With many African Americans, these responses may occur so frequently that they eventually result in the physiological system not working correctly.
According to Mays, the experience of race-based discrimination for some African Americans is akin to the response a person’s body mounts when it experiences significant life-threatening danger, such as fear for a person’s life or of a possible attack. She said that if the body mounts a response to protect itself against a “life-threatening” experience on a regular basis, after awhile it is strained and overworked. Many of the chemicals that come to its rescue can damage systems in the body that are associated with disease and obesity.
According to the report’s authors, there has been much focus on the emotional impact of discrimination. But other critical factors — such as identifying how the brain recognizes and determines what racial discrimination is and how the body responds biochemically — may help researchers understand why African Americans are not benefiting from protections against negative health outcomes in the same manner as whites.
Health disparities in African Americans may even be passed down from one generation to the next. For example, even middle- and upper-class African American women are at a higher risk of delivering pre-term babies as compared to other ethnic minority and white women of the same social class.
“What may be occurring is that despite having a great education and prenatal care, your body may be programmed to deliver early because of the stresses experienced by your mother during her pregnancy,” Mays said. Research suggests that African American women produce a hormone activated in response to stress that is often associated as a time-clock for birth.
“This results in the placenta separating itself a little bit early and, that may be one of the reasons for a preterm delivery,” Mays said.
Another key factor is that African Americans faced with constant discrimination may experience high levels of stress that cause an “allostatic load.” The term refers to the cumulative wear and tear of stress as the body responds to an overload of challenges and demands.
When the stress challenge to the cardiovascular system is prolonged and excessive to the point of allostasis, the immune system is suppressed, blood pressure increases and, over time, atherosclerosis can develop, resulting in coronary vascular disease.
UCLA researchers will conduct further research on the link between race-based discrimination and health problems, including searching for possible solutions and coping methods for individuals.
“As we deal with skyrocketing rates of obesity and rising rates of diabetes in African Americans and other racial and ethnic minority groups, we need to think about the impact of race-based discrimination and how they respond to that stress,” Mays said. “It may not be just a matter of telling a person to eat better or exercise. We may need to take a look at the person’s environment and the race-based discrimination that that person is experiencing.”