Raising tobacco taxes to increase cigarette prices could reduce cigarette consumption and smoking-associated deaths (SADs) in all 28 EU countries, according to a new study. In higher income countries, raising tobacco taxes could increase revenues that could be spend on prevention and control programs, while in lower income countries tax revenues may be negatively affected, researchers suggest.
As prescription drug spending continues to rise in the United States, along with prices for new and well-established drugs, insurers, employers and patients are searching for ways to cut costs. A new study found that a policy called reference pricing is effective at encouraging patients to spend significantly less on prescription drugs by choosing cheaper drugs over name brand options.
Schools that provide prevention education, insecticide-treated nets and antimalarial treatment, in regions where malaria is highly seasonal, could reduce the risk of schoolchildren developing anaemia and improve their cognitive performance, according to new research published in BMJ Global Health.
The randomised study involved nearly 2,000 schoolchildren in Mali and was conducted by Save the Children in partnership with the London School of Hygiene & Tropical Medicine and the National Institute for Public Health Research in Mali.
It found schoolchildren who received a malaria control package delivered by teachers were more than 95%¹ less likely to be infected with malaria parasites than a control group (25/897 intervention schools, 737/951 control schools), and 44%² less likely to be anaemic (321/931 intervention schools, 418/930 control schools), with the benefits lasting until the end of the school year. The schoolchildren’s ability to pay attention for longer was also improved. There was no evidence of impact on other performance measures.
With governments increasingly recognising the importance of child health for educational achievement³, these findings support growing evidence that malaria control strategies in Africa should be formally introduced for schoolchildren, as well as the under five age group.
Malaria kills thousands of young children in Africa every year and there is growing evidence that the disease can also impair the development and educational performance of schoolchildren. Malaria infection is often more common in older children yet they are rarely targeted by malaria control methods. This is because by the time they start school they are likely to have acquired immunity through repeated infection with the malaria parasite, making them less likely to die.
However, many schoolchildren continue to harbour malaria parasites without displaying any symptoms of the disease. These asymptomatic infections frequently go unrecognised and untreated leading to anaemia, which may cause tiredness and decreased attention in class, potentially affecting school performance.
Children aged 6-14 years in 80 schools in southern Mali took part in the randomised study — the first to evaluate a malaria control package combining prevention methods and intermittent parasite clearance delivered by schools (IPCs) in an area where the disease is highly seasonal.
Prior to the start of the malaria transmission season, half the schools provided long-lasting insecticidal nets (LLINs) and taught children how to use them effectively. At the end of the transmission season they were then given one round of the antimalarial drug combination artesunate and sulfadoxine-pyrimethamine. The control schools just received LLINs as part of Mali’s national universal net distribution programme. Both groups were tested for Plasmodium malaria infection and anaemia, and a sample of older children aged 9-12 years undertook a series of cognitive tests.
Lead researcher Dr Sian Clarke from the London School of Hygiene & Tropical Medicine said: “Malaria transmission in the sub-Sahel is highly seasonal with new infections concentrated within a few months each year. Interventions delivered during this period will have maximum impact, however little evidence exists on the best malaria control strategies for schoolchildren, and how these might vary between different malaria transmission settings.
“This low-cost three-pronged approach delivered through schools had significant health benefits and could potentially improve educational performance through boosting a child’s ability to pay attention in class. Crucially, these benefits lasted until the beginning of the next transmission season, suggesting that a single annual dose of antimalarial drugs could help protect children in the sub-Sahel from anaemia throughout the entire school year. We also found schoolchildren who received education in malaria prevention used their nets more often and for longer. This will help protect them from acquiring new infections during the rainy season when schools are closed.”
The approach may have an additional role in overall malaria control by cutting infections in schoolchildren, an age group that makes-up a sizeable proportion of the African population.
Dr Clarke said: “Reducing the number of malaria parasites in schoolchildren also decreases the risk of infection for other people who live in the same community. Malaria control strategies should be an integral component of education and school health plans in countries where malaria is endemic.”
The study was conducted in primary schools in the Sikasso region, south-eastern Mali as part of Save the Children’s school health and nutrition programme which aims to address key health problems that prevent children from participating and learning in school. Since the study was completed, Save the Children, in partnership with the National Malaria Control Programme in Mali, has expanded the programme to reach over 400 schools in Sikasso region.
Natalie Roschnik, Senior Nutrition Advisor at Save the Children and a co-author of the study, said: “Save the Children has been implementing a school health and nutrition programme in Sikasso, Mali for nearly 20 years. Malaria and anaemia have been ongoing problems that we were unable to address until this study was conducted. Children were regularly dying of malaria, and anaemia rates remained at 50%, even after children were given iron supplements. We didn’t expect that just one malaria treatment a year, delivered by teachers with malaria prevention education, could have such a dramatic impact on children.
“The treatment therefore supports the goals of three sectors all at once; malaria, nutrition and education. Preventing anaemia in schoolgirls is particularly important in Mali because teenage marriage and pregnancy is so common. A girl who is anaemic when pregnant is more likely to have a low birth weight child with developmental delays and is at greater risk of dying too. This is a highly cost-effective intervention that we hope will be taken to scale by the government soon.”
The authors acknowledge limitations of the study including that they could not separate the effects of each component of the intervention.
When I first heard about, a website that helps men and women connect with sugar babies (people who are paid to provide some sort of relationship service) and sugar daddies (people who pay to receive the relationship service), I was skeptical. A girlfriend of mine was already on the site as a sugar baby, and she was getting all these lavish gifts — extravagant dinners with a $1,000+ bill, exotic getaways, designer handbags — but I had no idea what she, or other girls on the site, were doing in exchange for these things. Plus, who were these people that she was meeting? Were they nice guys? Creeps? Were they even who they said they were?
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The gifts obviously seemed nice, but when I heard that she was making money on top of that, that’s what really persuaded me. Because I didn’t care about the material things I could have — I just wanted to provide for my son.
I’m a single mom to six-year-old Carter*, who lost his dad when he died from a heart attack five years ago. We obviously weren’t expecting it, and losing a second income, especially in Los Angeles — one of the most expensive cities to live in — made it very difficult for me to provide for Carter. I could afford the basics on my salary working as a customer service representative, but I was never really able to give him the things I thought he should have — a nicer backpack for school, a fun day at the amusement park, or the latest video game that all his friends were playing. I would do anything for my son, and I want him to be happy. That doesn’t mean he needs material things to be happy, of course. But there’s a lot of pressure, especially on social media, to have a picture-perfect life. And at the end of the day, I just couldn’t provide in the way that I wanted to.
So with my friend’s encouragement, I decided to give this sugar baby business a try. Most people assume that everyone who’s a sugar baby has sex with their clients, but that’s not true. You can set whatever ground rules you’d like, decide who you see, and how often you want to “work” with them. When I signed up, I went in knowing that I wasn’t going to have sex with anyone. That’s just not me, and it isn’t something I’m comfortable with. I was here to provide for my child, yes, but I wasn’t at the point that I felt the need to sell my body to do so.
When I first set up my page, I thought letting guys know right away that I wouldn’t be offering sex, and that I had a child, was the best course of action. I figured, ‘Tell them right up front because if that’s what they want, they know to not waste their time.’ So I literally had that information on my page. And, of course, I heard crickets those first few weeks. I barely heard from any sugar daddies, and when I did, as soon as I started talking about my son I wouldn’t hear from them anymore. It started to get frustrating — I wasn’t in this for anything but to provide for my son, but if they knew about him, I got shut down. I thought, ‘Do I really have to keep him a secret?’
I was here to provide for my child, yes, but I wasn’t at the point that I felt the need to sell my body to do so
I started looking at other girls’ pages, including my friend’s, and one thing was clear: Regardless of what services they were or weren’t wiling to provide, their pages were more inviting than mine. I realized that laying it all out there like that wasn’t doing anyone any favors — it was too harsh; kind of like when you go on a first date and someone word vomits their entire life story and outlines their marriage checklist. It’s an immediate red flag and turns most people off. It’s the same thing here — nobody was looking for a relationship or marriage, per se, but that didn’t mean I needed to be so abrupt about it. ‘Guys like the chase,’ I reminded myself.
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I edited my page so that I seemed like a nicer girl to talk to, and shortly after I did, I met O*. Other men had messaged me as well, and while we talked a bit online, I never wanted to meet up in person. But there was something about O that intrigued me. He was handsome, kind, and had a gentle demeanor that came off as very attractive. And he was older — in his late 60s, while I’m in my 30s. I had never dated a man that much older than me before, but I reminded myself that this wasn’t dating. So why shouldn’t I explore the opportunity?
I decided to go for it, and I’m so glad I did. O and I got together for dinner a few times, and he was a complete gentleman — never pressuring me for sexual favors and always respecting my boundaries. I slowly became more comfortable around him, and as I did, I stopped talked to other potential sugar daddies online. When I told him I had a son — news that made other potential suitors drop me before I could blink — he didn’t bat an eyelash. He asked questions about Carter, but didn’t ask to meet him. And when I told him one of my hard rules was that this would be a completely separate part of my life, O respected that. I didn’t feel like I was putting myself or my son in danger.