Day: October 2, 2024

Categories : Medical IndustryTags : Leave a comment

Bonitas – Innovation, Life Stages and Quality Care

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Lee Callakoppen, Principal Officer, Bonitas Medical Fund

Lee Callakoppen, Principal Officer of Bonitas Medical Fund, talks about the year ahead for Bonitas Medical Aid and its members.

The medical scheme industry has faced turbulent conditions over the past 12 months with the debate over NHI, economic pressures and reserves coming under pressure.

Despite this, our value creation model stood us in good stead with over R1.4 billion in reserves given back to members through benefit enhancements and low and deferred increases in 2022 and 2023.

The Fund, which has a proud heritage spanning over four decades, today (October 2) announced its pricing and benefits strategy for 2025. These announcements are traditionally seen as ‘price hikes’ but our strategy also considered benefit hikes in response to member needs.  

Calculating the changes

The percentage increases are meticulously calculated by our actuaries, balancing the financial sustainability of the Scheme, while adhering to regulatory guidelines and requirements outlined by the Council for Medical (CMS).  And, while Bonitas has seen a positive performance, we’ve had to take measures to prevent instability in our environment in arriving at our weighted increase of 10.2% as of January 1, 2025.

Over the past few years, we kept our contribution increases well below the industry average, while maintaining a healthy financial position while ensuring benefits are not eroded.

The contribution increases range from 8.7% to 14.9% per plan, with the latter impacting only 1% of members. The increases and new benefits have been submitted to the CMS and are subject to their approval.

The Bonitas Board and Executive’s input considered: Market trends, including international healthcare protocols, industry analysis, benchmarking reports and benefit utilisation patterns. Integral to this process was independently commissioned research across core stakeholder groups including brokers, HR representatives, corporates and local government.

Membership profile

Our members are from across a diverse range of backgrounds – with corporate membership spanning over 65 industries and profiles varying from students and singles to families, established professionals and those enjoying their golden years.

A quintet of awards

One way of measuring and gaining insights on whether a brand is getting it right, is through independent surveys and audits from industry bodies and consumers themselves. Recently Bonitas was announced the winner of the ‘Medical Aid Category’ in the Ask Afrika Orange Index® Awards for 2024/2025. It is the 4th category win over the past seven years.  Principles such as trust, sustainability, reputation and care feature strongly in top customer need attributes. 

It is also the 5th accolade for the Scheme this year, others include: Two BHF Titanium Awards for’ Best Integrated Report’ and ‘Best Operational Performance’, Top 500’s ‘Leader for medical aid’ and a gold in the Daily Sun Reader’s Choice Awards.

The life stage model

Our new model is designed to revitalise our approach based on industry, life stage and various psychographic and behavioural science elements. This is supported by a diverse product range, tailored wellness and screening benefits, access to healthcare services and optimised member communication to drive education and improve benefit access.

We continue to make health risk assessments and preventative care screenings a core enabler for managed healthcare initiatives. After all, early detection and speedy intervention is critical to enhancing our member’s quality of life. For example, roughly half of our population have high blood pressure. The latest international treatment protocols, recommend self-monitoring to help individuals manage their blood pressure more effectively. In keeping with this, a blood pressure monitor will be funded over a two-year cycle per family.

So, what’s new?

Integrated chronic care family practitioner network

There is a direct correlation between chronic diseases and mental health. For 2025, we have added a mental health component into our GP network, to facilitate early disease detection, diagnosis and multi-disciplinary care-coordination, through the high-quality network of doctors. In addition, we will provide more personalised engagement and support through the enhanced maternity programme, to treat antenatal and postnatal depression.

Hearing Loss Management (Audiology)

This includes free online hearing screening for all South Africans. Members on selected plans will receive hearing aids, audiology services and hearing aid acoustic services of the highest quality by using a network provider.

Weight Management Programme

Obesity or being overweight, substantially increases the risk of morbidity from at least fifteen conditions, including: Hypertension, coronary artery disease, diabetes, strokes, sleep apnoea and respiratory problems and cancer.

The programme, led by a biokineticist registered with Biokinetic Association of South Africa, provides a holistic approach to weight loss that includes access to a dietician and psychologist for support on exercise, nutrition and mental health.

Female Health Programme  

We’re making a renewed commitment to the health and wellbeing of women and toddlers through the Mother and Child Care Benefit, including the Maternity Programme. Launched earlier this year in collaboration with CareWorks, the programme has an emphasis on preventative care and early detection of female-specific health issues, based on life stages.

Our enhanced Maternity Programme includes support for expecting mothers, including early identification and weekly engagement for high-risk pregnancies, post-childbirth care and associated mother mental health follow-up calls, given the prevalence of pre and postnatal depression.

It includes milestone reminders for children under three, immunisation reminders and online screenings for infant and toddler health and screening by an ophthalmologist for premature neonates, on all options except BonCap. This allows for early intervention and, where possible, prevents blindness. We’ve also opted to cover antenatal vitamins on all plans through savings or the Benefit Booster.

Bonitas Geriatric Care  

This is a personalised range of screening, prevention and wellness benefits which can be performed in the comfort of their own homes and includes: Wellness screenings, vaccines for flu and pneumonia, age-appropriate screening for prostate, breast and cervical cancer, osteoarthritis screenings, coordination of care with a nominated GP, chronic care management and support and fall-risk assessments to allow seniors to live independently. All covered from Risk.

Diabetic retinopathy screenings

In partnership with PPN, our members can access cutting edge, AI driven diabetic retinopathy screenings. The screening also detects several other conditions that could affect the eyes.

Benefit Booster

The Benefit Booster remains the only benefit in the market which provides members with access to up to R5 000 as an additional benefit to use for out-of-hospital expenses, at no extra cost. For 2025, we’ve opted to bolster the Benefit Booster on seven plans, to offer even more value for money while providing access to additional benefits.

Despite the challenges in the healthcare industry, we continue to run a tight ship, staying on course to meet the diverse needs of our members with innovative benefits, a life stage model and a commitment to quality care.

Because we know health is not just a plan, it’s a lifelong journey.’

Categories : Lab Tests and Imaging Respiratory DiseasesTags : Leave a comment

New Images of RSV may Expose Weak Points in the Stubborn Virus

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Photo by Andrea Piacquadio on Pexels

The complex shape of respiratory syncytial virus is one hurdle limiting the development of treatments for an infection that leads to hospitalisation or worse. New images of the virus published in Nature from researchers at the University of Wisconsin–Madison may hold the key to preventing or slowing RSV infections.

RSV is of greatest concern in young children, the elderly and adults at high risk for respiratory complications. Yet unlike the flu and other common, communicable respiratory illnesses that annually sweep through schools, there are few options for fighting RSV. In the US, prophylactic treatments are available for young children, and existing vaccines are approved only for pregnant women and the elderly.

The virus’s structure, which consists of tiny, bending filaments, have eluded researchers. This has made it difficult to identify key drug targets, including viral components that are conserved across related viruses.

RSV F proteins, shown in this image created by University of Wisconsin–Madison researchers using a technique called cryo-electron tomography, may make RSV more potent by keeping it from infecting cells prematurely. Image by Wright Lab, UW–Madison

“There are a number of viruses related to RSV that are also significant human pathogens, including measles,” says Elizabeth Wright, a UW–Madison biochemistry professor. “What we know about related viruses gives us clues about RSV protein structures, but to identify drug targets we need a closer look at RSV proteins that are intimately associated with the membranes of host cells.”

Using an imaging technique called cryo-electron tomography, Wright and her team have now revealed details of molecules and structures essential to RSV’s form and function. They published their findings recently in Nature.

Cryo-ET freezes viral particles or other molecules at ultracold temperatures, stopping biological processes in action. This allows researchers to examine the structures of organisms, cells and organelles, and viruses and capture small-scale images of structures frozen in time. Flash-freeze many RSV particles, and cryo-ET imaging will capture (nearly) all the virus’s possible configurations from many different angles. These 2D images are combined to produce a representation of the virus’s 3D structures at high resolutions – even at the level of individual atoms.

Wright’s recent study produced high-resolution images detailing the structure of two RSV proteins, RSV M protein and RSV F protein, that are crucial to the interaction between the virus and the host cell membrane. Both proteins are also present in related viruses.

RSV M protein interacts with host cell membranes, holding together the virus’s filamentous structure and coordinating viral components and other proteins – including RSV F proteins. RSV F proteins sit on the viral surface, ready to engage with host cell receptors and regulate the virus’s fusion and entry into the host cell. The scientists’ images reveal that in RSV, two F proteins come together to form a more stable unit. Wright says that this association may prevent the F proteins from prematurely infecting the host cell.

“Our primary findings reveal structural details that allow us to better understand not only how the protein regulates assembly of viral particles, but also the coordination of proteins that enable the virus to be infectious,” says Wright.

The scientists believe that F protein pairs may be a key to destabilising the virus before it is ready to infect its next host, making pairs of F proteins a possible target for future drug development. They will continue to explore how RSV proteins interact with each other to cause infection.

Source: University of Wisconsin-Madison

Categories : Endocrinology Environmental EffectsTags : Leave a comment

Airborne Levels of Chemicals Released by Plastics Shock Researchers

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Photo by Ryan Zazueta on Unsplash

A new study documents how people in California are chronically being exposed to toxic airborne chemicals called plasticisers, including one banned from children’s items and beauty products. 

Plasticizers are chemical compounds that make materials more flexible. They are used in a wide variety of products ranging from lunchboxes and shower curtains to garden hoses and upholstery. 

“It’s not just for drinking straws and grocery bags,” said David Volz, environmental sciences professor at UC Riverside, and corresponding author of the study published in the journal Environmental Research. 

Previous California monitoring programs focused on plasticisers called ortho-phthalates, some of which were phased out of manufacturing processes due to health and environmental concerns. Less research has focused on the health effects of their replacements, called non-ortho-phthalates. This study revealed the presence of both types of plasticisers in the air throughout Southern California.

“The levels of these compounds are through the roof,” Volz said. “We weren’t expecting that. As a result, we felt it was important for people to learn about this study.”

The National Institute of Environmental Health Sciences also wants to increase the visibility of this study, one of only a few to document the phthalates’ presence in the air of urban environments. The institute’s monthly newsletter, Environmental Factor, highlights the study in their October 2024 issue.  

The researchers tracked two groups of UCR undergraduate students commuting from different parts of Southern California. Both groups wore silicone wristbands designed to collect data on chemical exposures in the air. 

The first group wore their wristbands for five days in 2019, and the second group wore two different wristbands for five days each in 2020. Both groups wore the bands continuously, all day, as they went about their activities. At the end of the data collection period, the researchers chopped the wristbands into pieces, then analysed the chemicals they contained. 

In a previous paper, the team focused on TDCIPP, a flame-retardant and known carcinogen, picked up in the wristbands. They saw that the longer a student’s commute, the higher their exposure to TDCIPP. 

Unlike TDCIPP, which most likely migrates out of commuters’ car seats into dust, the team cannot pinpoint the origin of the plasticisers. Because they are airborne, rather than bound to dust, the wristbands could have picked them up anywhere, even outside the students’ cars.

For every gram of chopped-up wristband, the team found between 100 000 and 1 million nanograms of three phthalates, DiNP, DEHP, and DEHT. Ten total plasticizers were measured, but the levels of these three stood out.

Both DiNP and DEHP are included on California’s Proposition 65 list, which contains chemicals known to cause cancer, birth defects, or other reproductive harm. DEHT was introduced as an alternative, but its effects on human health have not been well studied. 

This study suggests that introducing DEHT also has not done much to reduce the public’s level of exposure to DiNP or DEHP. Levels of all three chemicals found by Volz and his team were similar to those found by researchers in unrelated studies conducted on the East Coast. 

Despite differences in climate, the air on both coasts is likely carrying similar levels of phthalates.

“No matter who you are, or where you are, your daily level of exposure to these plasticizer chemicals is high and persistent,” Volz said. “They are ubiquitous.”

To Volz, studies like this one amplify the need to find alternatives to plastic. As plastics degrade, these compounds and others like them are leaching out into the environment and into the body. 

“The only way to decrease the concentration of plasticisers in the air is to decrease our production and consumption of materials containing plasticisers,” he said. 

Source: University of California – Riverside

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Antigens in Foods Suppress Gut Tumours by Activating Immune Cells

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Photo by Pixabay on Pexels

Researchers led by Hiroshi Ohno at the RIKEN Center for Integrative medical sciences (IMS) in Japan have discovered that food antigens like milk proteins help keep tumours from growing in our guts, specifically the small intestines. Experiments revealed how these proteins trigger the intestinal immune system, allowing it to effectively stop the birth of new tumours. The study was published in the scientific journal Frontiers in Immunology.

Food antigens get a lot of negative press because they are the source of allergic reactions to foods such as peanuts, shellfish, bread, eggs, and milk. Even if not allergenic, these antigens, along with the many others found in plants and beans, are still considered foreign objects that need to be checked out by the immune system. Ohno and his team have previously reported that food antigens activate immune cells in the small intestines, but not the large intestines. At the same time, some immune cells activated by gut bacteria are known to suppress tumours in the gut. In the new study, the RIKEN IMS researchers bring these two lines of thought together and tested whether food antigens suppress tumours in the small intestines.

The team began with a mouse model with a mutated tumour-suppression gene. Like people with familial adenomatous polyposis, when this gene malfunctions, the mice develop tumours throughout the small and large intestines. The first experiment was fairly simple. They fed these mice normal food or antigen-free food and found that the ones that got normal food had fewer tumours in the small intestines, but the same amount in the large intestines.

Next, they added a common representative antigen called albumin – which can be found in meat and was not in the normal food – to the antigen-free diet, making sure that the total amount of the protein equalled the amount of protein in the normal diet. When the mice were given this diet, tumours in the small intestine were suppressed just as they has been with normal food. This means that tumour suppression was directly related to the presence of antigen, not the nutritional value of the food or any specific antigen.

Mice that got the plain antigen-free diet had many fewer T cells than those that got the normal food or the antigen-free food with milk protein. Further experiments revealed the biological process that makes this possible.

These findings have clinical implications. Similar to antigen-free diets, clinical elemental diets include simple amino acids, but not proteins. This reduces digestive work and can help people with severe gastrointestinal conditions, such as Crohn’s disease or irritable bowel syndrome. According to Ohno, “small intestinal tumours are much rarer than those in the colon, but the risk is higher in cases of familial adenomatous polyposis, and therefore the clinical use of elemental diets to treat inflammatory bowel disease or other gastrointestinal conditions in these patients should be considered very carefully.”

Elemental diets are sometimes adopted by people without severe gastrointestinal conditions or allergies as a healthy way to lose weight or reduce bloating and inflammation. The new findings suggest that this could be risky and emphasises that these kinds of diets should not be used without a doctor’s recommendation.

Source: RIKEN

Categories : Cardiovascular DiseaseTags : Leave a comment

A New Heart Failure Treatment Targets Abnormal Hormone Activity

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Right side heart failure. Credit: Scientific Animations CC4.0

Scientists have discovered a potential new treatment for heart failure with preserved ejection fraction (HFpEF), a type of heart disease that is notoriously difficult to treat. The diseased heart cells were found to have high levels of glucagon activity, a pancreatic hormone that raises blood glucose levels. The scientists then demonstrated that a drug that blocks the hormone’s activity can significantly improve heart function.

In heart failure, which is considered a global pandemic, the heart can no longer pump blood effectively. Globally, an estimated 64 million people live with this condition with HFpEF accounting for around half of the cases.

In HFpEF, the heart can pump normally but its muscles are too stiff to relax to re-fill the chambers with blood properly. It is often seen in older adults and people with multiple risk factors including high blood pressure (hypertension), obesity and diabetes. They typically have symptoms such as shortness of breath, fatigue and reduced ability to exercise. This is unlike heart failure with reduced ejection fraction (HFrEF), where heart muscle is weakened and pumping volume reduced.

There have been studies on how the heart is stressed by hypertension and metabolic diseases associated with obesity, such as diabetes, but these have been done in isolation of each other. This latest study, which was published in Circulation Research, addresses this gap by taking into account both stressors, revealing for the first time, the molecular pathway that contributes to HFpEF progression.

In pre-clinical studies, the team of scientists, which included collaborators from the University of Cincinnati College of Medicine, University of California Los Angeles, University of Toronto and University of North Carolina School of Medicine, investigated how stress from hypertension affected lean hearts versus diabetic/obese ones. In their findings, the lean models developed heart failure with reduced ejection fraction (HFrEF), typically observed in hypertensive patients. The obese models however, developed heart failure with preserved ejection fraction (HFpEF), proving that a combination of stressors give rise to the disease and providing a good model for further studies.

Using advanced single-cell RNA-sequencing technologies, the scientists were then able to study the expression of every detected gene in every single heart cell, allowing them to uncover specific genetic variations in cells associated with HFpEF. The scientists found that in the obese models, the most active genes were the ones driving the activity of glucagon.

Professor Wang Yibin, Director of the Cardiovascular & Metabolic Disorders Programme at Duke-NUS and senior author of the study, said:

“Under stress conditions such as high blood pressure and metabolic disorders like obesity and diabetes, we found that glucagon signalling becomes excessively active in heart cells. This heightened activity contributes to the development of heart failure with preserved ejection fraction (HFpEF) by increasing heart stiffness and impairing its ability to relax and fill with blood.”

The team then tested a drug that blocks the glucagon receptor in a pre-clinical model of HFpEF and found significant improvements in heart function, including reduced heart stiffness, enhanced relaxation, improved blood filling capacity and overall better heart performance.

Assistant Professor Chen Gao from the Department of Pharmacology, Physiology and Neurobiology at the University of Cincinnati College of Medicine; and the study’s first author, said:

“Our study shows strong evidence that a glucagon receptor blocker could work well to treat HFpEF. Repurposing this drug, which is already being tested in clinical trials for diabetes, could bypass the lengthy drug development process and provide quicker and more effective relief to millions of heart patients.”

Professor Patrick Tan, Senior Vice-Dean for Research at Duke-NUS, commented:

“With our ageing population, there will likely be more patients with multiple conditions, including heart failure, diabetes and hypertension, presenting a significant challenge to health systems. Uncovering the synergistic impact of such illnesses and their underlying mechanisms is key to better understanding the complex process of heart failure and developing an effective treatment for the disease.”  

The researchers hope to work with clinical partners to conduct clinical trials to test the glucagon receptor blocker in humans with HFpEF. If these succeed, it could become one of the first effective treatments for this challenging condition, significantly improving the quality of life for millions worldwide.

Source: Duke University