UWE Experts Develop Skin Cancer Detection Tool

Engineering experts from the University of the West of England are working on the development of a skin analyser tool that will help enable doctors to diagnose malignant melanoma and other dermatological conditions such as burn severity. Recent sponsorship to the tune of ┬г650K has been awarded to the consortium composed of UWE, Frenchay Hospital and Astron Clinica Ltd. by the DTI Technology Programme to fund this project entitled 'PhotoDerm'.


Skin Cancer incidence has been growing since the 1930's with current figures showing 6,000 people diagnosed and 1,600 dying in the UK alone every year.


One of the problems facing primary health care practitioners is that most do not have the specialist expertise to enable an accurate diagnosis of skin cancer so most patients are referred to specialist units in hospitals. As the vast majority of referrals are found to be non-malignant the diagnosis of skin cancer is costly to the NHS as specialists spend significant time on diagnosis.


This could soon be set to change thanks to a novel application by experts in photometric stereo imaging or 3D imaging at UWE's Machine Vision Laboratory, part of the Centre for Innovative Manufacturing and Machine Vision Systems (CIMMS). Dr Melvyn Smith, Director of CIMMS at UWE explains, "We are collaborating with Astron Clinica and specialists at Frenchay Hospital in Bristol to produce a new low cost hand held skin analyser tool that will improve the vision of the clinician. We aim to make explicit the characteristics of the appearance of the skin that are not obvious to the naked eye. This will make it easier for a non specialist to make an early diagnosis.


"The skin analyser tool will also be useful in burns units as the 3D imaging will enable specialists to assess severity of burns through enabling clearer observation of burn depth. The tool builds on previous research by academics in CIMMS who developed a rather cumbersome tool some years ago. We aim to refine the principles adopted in the earlier model so that the imaging available to the practitioners is easier to observe.


"The 'Skin Analyser' prototype looks a little bit like a hair dryer which is positioned over the affected area of skin. A high resolution camera is directed at the skin and light shines from six different light sources surrounding the lense to give an illusion of 3 D when the image is observed on a computer screen via a USB link. This is called 6-light photometric stereo and we intend to develop this idea by fusing this information with a hand held spectrometer developed by Astron Clinica.


Skin cancer experts at Frenchay Hospital in Bristol have working with the UWE team to help ensure that the tool they develop fits the needs of practitioners. Mr Robert Warr, Consultant Plastic Surgeon specialising in malignant melanoma thinks that the skin analyser may have the potential to be very useful in assisting future diagnosis by non specialists, he said, "If successful, this tool will help both the general practitioner and the specialist in differentiating between benign and malignant lesions of the skin. Skin cancer is becoming increasingly common and any device aiding this often difficult diagnosis would certainly be extremely valuable.


Dr Smith concludes, "It is anticipated that the skin analyser may ultimately provide primary health care practitioners and hospitals with a low cost tool that will save lives as more health professionals will be able to assist in accurate diagnosis without unnecessary referral to specialist skin cancer units in hospitals."



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No-, Low-Cost Children's Health Insurance Programs Fill Gap In Care For Some Low-Income Families

Programs that provide low- and no-cost health insurance for children can bridge the gap between families that qualify for Medicaid and those who can afford private insurance or have employer-sponsored coverage, Reuters reports. About nine million children are uninsured but are in families whose incomes are too high to qualify for Medicaid. According to Al Rohling of the Alabama Child Caring Foundation, which provides no-cost coverage for children through BlueCross BlueShield of Alabama, "Health care for children really is a bridge to get out of poverty." Reuters reports that parents are more likely to forgo needed medical care for uninsured children because of cost issues, which can lead to missed work time for the parent if a child's illness worsens. Rohling, who helped form the foundation, said that people need annual incomes of about 300% of the federal poverty level to afford private insurance, but that many states provide coverage only to those with incomes up to 200% of the federal poverty level. According to Rohling, programs such as the one offered by the Child Caring Foundation "fill the void between affordability and eligibility." About 90% of foundation beneficiaries switch to private insurance within about 30 months, Reuters reports. Jennifer Tolbert, a principal analyst for the Kaiser Commission on Medicaid and the Uninsured, said the number of uninsured children in the U.S. has increased since 2004. Tolbert said it is possible that the federal government could expand state SCHIP programs to cover more children when Congress considers reauthorizing the program this year (Gates, Reuters, 1/3).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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Fatty Liver Disease May Raise Heart Disease Risk In Overweight, Obese Kids

A fatty liver disease that is not well-known in overweight and obese children may be a precursor of cardiovascular disease, researchers reported in Circulation: Journal of the American Heart Association.



Researchers performed a case-controlled study of 150 overweight children with biopsy-proven non-alcoholic fatty liver disease (NAFLD) and 150 overweight children without NAFLD. Participants were well matched in age (average 12.7 years), sex and severity of obesity. More than half of the children in each group were in the 99th percentile for body mass index.



The overweight children with NAFLD had significant cardiovascular risk including higher levels of fasting glucose, insulin, total cholesterol, low-density lipoprotein (LDL, "bad" cholesterol), triglycerides and higher systolic and diastolic blood pressure than the control group. The children with NAFLD also had significantly lower levels of high-density lipoprotein (HDL, "good" cholesterol) than the control group.



Researchers found the distribution of the disease by race and ethnicity was also significantly different, with more Hispanic and Asian children in the fatty liver group and more white and black children in the control group. They also found that children with metabolic syndrome were five times more likely to have NAFLD as overweight and obese children without metabolic syndrome.



"Our results demonstrate that obese children and adolescents with a definitive diagnosis of NAFLD have a more severe cardiovascular risk profile than their age, sex and BMI-matched peers," said Jeffrey Schwimmer, M.D., lead author of the study and associate professor of pediatrics at the University of California, San Diego. "These collective data illustrate that fat accumulation in the liver may play a more important role than obesity itself in determining the risk for 'weight-related' metabolic co-morbidities. Thus, in children and adolescents, NAFLD may serve as a marker to stratify the cardiovascular risk of overweight and obese patients."



NAFLD is the most common cause of liver disease in children and is associated with metabolic syndrome, a clustering of risk factors for the development of cardiovascular disease and type 2 diabetes. NAFLD is characterized by the presence of oily droplets of triglycerides in liver cells. More than 6 million children in the United States are affected.



Strengths of the study included the large series of biopsy-proven pediatric NAFLD and the use of a well-matched control group, said Schwimmer, who is also director of the Fatty Liver Clinic at Rady Children's Hospital San Diego.



Other observations include:
NAFLD in overweight children is strongly associated with metabolic syndrome. The association is independent of both body mass index and insulin sensitivity.


All study children were overweight, with 96 percent classified as obese.


More than half of the subjects in each group (NAFLD 57 percent, controls 54 percent) had a BMI ВЎГќ 99th percentile.

Fatty liver disease often has no outward symptoms, which contributes to it going undetected. Although some children will have symptoms such as abdominal pain or fatigue, the majority remain symptom-free until the disease is in very advanced stages. Long-term studies are ongoing to determine the causes and consequences of fatty liver disease, researchers said.



"Roughly 25 percent of children with fatty liver will develop hepatitis as children or by their 20s," Schwimmer said. "Of these, approximately 20 percent may go on to develop cirrhosis as young adults, with a subsequent life expectancy of seven years.



"Overweight children age 8 or older and especially those with symptoms of metabolic syndrome should be screened for NAFLD," Schwimmer said. "I think many parents have not ever heard of NAFLD, and many physicians are not aware of its prevalence and severity in children. Identification of NAFLD in a child should prompt counseling that addresses nutrition, physical activity and avoidance of smoking."







Co-authors are: Perrie E. Pardee, B.S.; Joel E. Lavine, M.D., Ph.D.; Aaron K. Blumkin, M.S.; and Stephen Cook, M.D.



The study was partially funded by the Rest Haven Foundation; the National Institute of Diabetes, Digestive and Kidney Diseases; the National Center for Research Resources of the National Institutes of Health for the General Clinical Research Center at UCSD; and the National Heart, Lung, and Blood Institute. Disclosures for individual authors are available on the manuscript.



To combat the growing epidemic of childhood obesity, the American Heart Association and the William J. Clinton Foundation joined forces in 2005 to create the Alliance for a Healthier Generation. The alliance is working to stop the nationwide increase in childhood obesity by 2010 and is taking bold, innovative steps to help all children live longer and healthier lives. The alliance is positively affecting the places that can make a difference to a child's health: homes, schools, restaurants, doctors' offices and the community. For more information, please visit healthiergeneration/.



Statements and conclusions of study authors published in the American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.



Source: Karen Astle


American Heart Association


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House Members Introduce Companion To Universal Health Insurance Bill Sponsored By Sen. Wyden

Reps. Debbie Wasserman Schultz (D-Fla.) and Jo Ann Emerson (R-Mo.) on Wednesday introduced a companion bill (HR 6444) to Senate legislation (S 334) that would establish a universal health insurance system in the U.S., the Salt Lake Tribune reports (Canham, Salt Lake Tribune, 7/10).

The Senate bill, sponsored by Sens. Ron Wyden (D-Ore.) and Bob Bennett (R-Utah), would effectively replace the employer-sponsored health care system with a system in which individuals would purchase private health insurance through state-administered purchasing pools. The legislation would require all residents to obtain health insurance. Wyden in April modified the bill to allow employers to continue to provide health insurance (Kaiser Daily Health Policy Report, 7/9). The employer provision also was added to the House measure on Wednesday.

The House bill has 19 supporters, two of whom are Republicans; the Senate legislation has 14 co-sponsors, seven of whom are Republicans. Bennett at a news conference said, "The heavy lifting is still ahead, but the fact that there are so many people here willing to participate in this gives me hope that we can get it done" (Salt Lake Tribune, 7/10).


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.


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Commentary Discusses Improving Patient Safety; Reports Examine State Efforts To Expand Coverage

"Improving Patient Safety by Taking Systems Seriously," Journal of the American Medical Association: In the JAMA commentary, Stephen Shortell and Sara Singer, both of the University of California-Berkeley School of Public Health, examine the challenges to improving patient safety and discuss how improvement must be achieved through a systems-based approach rather than a patient or condition-specific-based approach. According to the authors, the greatest barrier to patient safety is the fragmentation of the U.S. health care system (Shortell/Singer, JAMA, 1/30).


New reports, Kaiser Family Foundation's Commission on Medicaid and the Uninsured: New reports released by KCMU describe aggressive efforts by states over the past year-and-a-half to expand coverage to low-income children and their families. However, the reports note that a downturn in the economy, federal failure to reauthorize SCHIP and new federal rules affecting Medicaid and SCHIP eligibility suggest that the recent period of coverage expansion may be over. The studies are based on a 50-state survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in 10 states representing all regions of the country and recent studies of enrollment in Medicaid and SCHIP (Kaiser Family Foundation release, 1/28).


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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Los Angeles County Health Officials Discuss Strategies for Fighting Hepatitis C at Third Annual Summit

Los Angeles County, the state of California and the US government have not done enough to fight hepatitis C, Stephen Simon, AIDS coordinator for the city of Los Angeles, told health officials gathered for the Third Annual Los Angeles County Hepatitis C Summit on Thursday, KPCC's "KPCC News" reports. Simon said one in 50 U.S. adults and as many as 650,000 California residents are infected with the virus, which is the leading cause of liver transplants in the U.S. According to a study published in 2000 in the American Journal of Public Health, if a more effective strategy is not adopted to fight hepatitis C, the virus could cause 193,000 deaths, $11 billion in health care costs and up to $54 billion in societal costs in the U.S. between 2010 and 2019, KPCC reports. Health officials at the summit discussed logistical problems involved in providing treatment to incarcerated populations and the homeless, such as poor prison health care infrastructures and hepatitis C medications requiring refrigeration. The segment includes comments from Neva Chauppette, project director of a mobile medical clinic that provides free hepatitis, HIV and STD services, and state Assembly member Paul Koretz (D), who is sponsoring legislation that would allow residents with hepatitis C or HIV to receive liver transplants from the national registry (Rabe, "KPCC News," KPCC, 11/21). The complete segment is available online in RealPlayer. Complete audio of a lecture presented at the summit by Chauppette is also available online in RealPlayer.

In addition, KPCC's "Talk of the City" on Monday included an interview with Peter Anderson, a nurse practitioner at the University of Southern California Medical Center, and Alberto Mendoza, co-chair of the Hepatitis C Task Force for Los Angeles County and director of the Southern California office of the Drug Policy Alliance, about what is being done to fight hepatitis C in the state (Beaupre, "Talk of the City," KPCC, 11/21). The complete segment is available online in RealPlayer.


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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Pain In People With Dementia Often Undiagnosed

The elderly who suffer from dementia aren't able to say when something hurts or is sore. They may demonstrate their pain through behaviours like rocking or striking out, and we often dismiss these actions as symptoms of the dementia instead of pain, which is usually from a different problem. Arthritis, diabetic neuropathy, fractures, muscular contractures, bruises, abdominal pain and mouth ulcers are among the list of common ailments that go undetected. It is important for those who live or work with persons with dementia to know how to identify when an elderly person is experiencing pain - and receive treatment sooner rather than later.



The University of Alberta's Cary Brown, PhD, has a new tool to help. She has developed an online workshop and toolkit for caregivers, health-care providers, family members and friends of people with dementia.



The researcher from the Faculty of Rehabilitation Medicine created an evidence-based website with a narrated presentation on pain and dementia, a downloadable resource pack for family members, a downloadable pain log and a facilitator's toolkit with background material, a planning guide, promotional material and supplemental information for organizations who wish to put on a workshop.



The online workshop and toolkit are available at: painanddementia.ualberta



Source:
Laurie Wang


University of Alberta

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