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Projects On View
Floating World:
Mercedes House
Manhattan, NY
Installed 2011
On view daily
Located in the South Lobby
Active Ecosystem (SMF):
Sacramento International Airport, Sacramento, CA
Installed 2011
On view daily
Located in Central Terminal B, Ticketing Hall
Shifting Time — San Jose:
The Norman Y. Mineta San Jose International Airport, San Jose, CA
Installed 2010
On view daily, 4pm - 10:30pm
Located in Terminal B, Ground Floor (near the Information Center, between Ticketing and Baggage Claim)
Aurora Organ:
The Shops at West End, St. Louis Park, MN
Installed 2009
On view daily during retail hours
Located in the Showplace Theater Lobby
Word Play:
The Fontana Children's Library, Fontana, CA
Installed 2008
Mon - Thur: 10am - 9pm, Fri/Sat: 10am - 6pm, Sun: 12pm - 5pm
Arc Tangent:
The Pittsburgh Children's Museum
Installed 2004
Mon - Sat: 10am - 5pm, Sun: 12pm - 5pm
Text Rain:
21c Museum Hotel, Louisville, KY
Installed 2000
On view daily 7am - 1am
The Pittsburgh Children's Museum
Installed 2004
News & Events
March 3, 2017 – May 13, 2017
Entangled at Emerson College Urban Arts' Media Art Gallery
Camille Utterback: Entangled Emerson Urban Arts: Media Art Gallery March 1 – May 13, 2017 Opening Reception: Friday March 3, 5-7pm Camille's dual screen interactive installation Entangled commissioned by the Contemporary Jewish Museum, San Francisco in 2015, will make its East Coast debut as part of the inaugural year programming for Emerson College's Urban Arts: New Media Arts Gallery.
January 24, 2017 – March 26, 2017
Sustaining Presence at The Stanford Art Gallery
The Department of Art & Art History at Stanford University presents Sustaining Presence, on view from January 24 to March 26, 2017 with a reception on Thursday, January 26, from 5-7 PM, at the Stanford Art Gallery. Continue reading →
October 22, 2016
Vital Current – Seeking the San Lorenzo Opens at the Santa Cruz MAH
For the past year Camille has been collaborating with Santa Cruz Museum of Art and History to create a site-specific artwork for the museum's lobby. The project is funded by a Creative Work Fund Grant received in 2015. The artwork opened to the public at the Glow Festival on October 22 and will be on [...]
August 10, 2016 6:30 pm – 9:00 pm
San Francisco Commonwealth Club Panel Discussion
Meet the Geniuses: Inside the MacArthur Foundation's Creative Thinking Awards Wed, Aug 10 2016 - 6:30pm More information can be found here. Maneesh Agrawala, Computer Vision Technologist; MacArthur Foundation "Genius" Grantee Camille Utterback, Digital Artist; MacArthur Foundation "Genius" Grantee Cecilia Conrad, Managing Director, John D. and Catherine T MacArthur Foundation; Former Vice President for Academic Affairs, Pomona College It's the 35th [...]
July 20, 2016 7:00 pm – 9:00 pm
Presentation at Grey Area Urban Prototyping Meetup
Urban Prototyping July Meetup July 20th, 2016 7:00 PM More information can be found here. Join us for the second public engagement Meetup for our Urban Prototyping Research Lab! Open to the public and cash bar for those 21 and older. 7:00pm-7:15pm: Doors/bar open 7:15pm-8:15pm: Public engagement with design teams begins 8:15pm-8:45pm: Public engagement with design teams ends and guest are invited into the [...]
January 4, 2016
Press for NEAT at the CJM & Digital Catalog
Closing January 17, 2015, NEAT: New Experiments in Art and Technology at the Contemporary Jewish Museum (CJM) featured Camille's work alongside nine other Bay Area digital artists. NEAT has had many great reviews and press, click through the links below to check them out: In San Francisco, Closing the Gap Between Art and Tech Hyperallergic, January 5, 2016 Where are [...]
September 23, 2015
Video Interview with Smithsonian Magazine
Camille discusses her practice and Text Rain, collaborative project with Romy Achituv, in a video interview depicting her working in the studio as well as visitors engaging with the piece at the Smithsonian American Art Museum. Follow this link to watch. Text Rain was recently acquired for the Smithsonian's permanent collection. The piece was on view in [...]
October 15, 2015 – January 17, 2016
NEAT: New Experiments in Art and Technology at the CJM
Camille will be participating in NEAT: New Experiments in Art and Technology at the Contemporary Jewish Museum (CJM) alongside eight other Bay Area digital artists. NEAT looks at the rapidly evolving relationship between artists and technology almost 50 years since the seminal 1960s Experiments in Art and Technology (E.A.T.) set out to break down barriers [...]
August 3, 2015
2015 Creative Work Fund Media Arts Grantee
Camille has been selected as a grantee for the 2015 Creative Work Fund in media arts! 14 grants were awarded supporting the creation of new works by San Francisco Bay Area artists who are working in collaboration with an array of nonprofit organizations to develop and present their work. The award will go towards a collaboration [...]
June 22, 2015 – July 3, 2015
Artist Residency at Pilchuck Glass School
Camille has been selected to serve as an Artist in Residence at Pilchuck Glass School in Stanwood, Washington this summer. From May through September every year, Pilchuck's program offers a series of courses as well as residencies for established artists in all media. Camille will reside for the third summer session alongside Irish musician Liam [...]
April 24, 2015 – September 7, 2015
Watch This! at The Smithsonian American Art Museum
Camille is participating in Watch This! Revelations in Media Art at the Smithsonian American Art Museum. This exhibition is organized by Michael Mansfield, curator of film and media arts and includes work by artists such as Cory Arcangel, Hans Breder, Takeshi Murata, Bruce Nauman, Raphael Montañez Ortiz, Nam June Paik, Martha Rosler, Eve Sussman, and [...]
May 23, 2015 3:25 pm – 4:05 pm
Navigating Creativity and Commerce Panel at The Gray Area Festival
Camille will serve as a panelist in a discussion on Navigating Creativity and Commerce at The Gray Area Festival in San Francisco. She will be speaking alongside Chris Delbuck, Michael Chang, Rachel Binx and Reza Ali. For artists / developers / entrepreneurs the line between creative pursuit and business can become blurred. How can artists [...]
April 30, 2015 6:00 pm
Film Screening and Panel Discussion: !Women Art Revolution
Through intimate interviews, art, and rarely seen archival film and video footage, Lynn Hershman Leeson's !Women Art Revolution reveals how the Feminist Art Movement fused free speech and politics into an art that radically transformed the art and culture of our times. Following the film will be a panel discussion featuring the filmmaker, Lynn Hershman Leeson; Moira [...]
April 24, 2015 6:00 pm
Artist Panel Discussion for Watch This! at The Smithsonian Institute
Camille will be participating in an artist panel discussion coinciding with the Watch This! Revelations in Media Art exhibition at the Smithsonian American Art Museum. Michael Mansfield, curator of film and media arts, will be leading the discussion featuring artists in the exhibition. Eve Sussman, David Behrman, and Camille will discuss how the manipulation of technology [...]
January 20, 2015 – April 17, 2015
Momentum: Women/Art/Technology at Rutgers University
Momentum: Women/Art/Technology features two exhibitions at the Rutgers University-New Brunswick campus. Camille will be participating in a group exhibition alongside Emilia Forstreuter, Jennifer Hall, Claudia Hart, Yael Kanarek, Jeannette Louie, Ranu Mukherjee, Mary Bates Neubauer, Marie Sivak, Adrianne Wortzel, and Janet Zweig, on view in Mary H. Women Artist Series Galleries. The 2015 Momentum: Women/Art/Technology exhibitions [...]
September 13, 2014 – September 21, 2014
Dances of the Sacred and Profane at the Cowell Theater
For Camille's debut creating interactive visuals for live performance, she teams up with choreographer Mark Foeringer, physicist David Glowacki, and sound designer Michael St. Clair to create Dances of the Sacred and Profane which premieres this September in San Francisco at the Cowell Theater in Fort Mason. This innovative performance, developed around a Claude Debussy score, [...]
June 26, 2014 – June 28, 2014
Americans for the Arts, Leadership Roundtable, The Arts + Technology Discussion Panel
Camille will be participating in the Americans for the Arts Leadership Roundtable taking place in Sun Valley, Idaho from June 26th-28th. She will be serving as a discussion panelist for Artists + Technology: Materials at Hand. The Arts Leadership Roundtable will bring together 30 artists, philanthropists, and corporate leaders in a proactive dialogue to explore how the arts [...]
May 16, 2014 11:30 am
ArtMarket San Francisco, Body of Work: Women Artists talk tech Panel Discussion
Camille will be a panelist for Body of Work: Artists talk tech, presented by ZERO1. The discussion will take place at ArtMarket San Francisco held at Fort Mason's Festival Pavilion May 15-18th. Join us for a multi-generational discussion featuring Camille as well as artists Paula Levine, Ranu Mukherjee, and Jenny Odell. This panel is moderated by [...]


text:
The Britannia
98 Grinstead Lane, Lancing, West Sussex, BN15 9DP
98 Grinstead Lane, Lancing, West Sussex, BN15 9DP
We love making new friends – especially if they're your friends. With our gift cards, you can treat friends and family to a Harvester here at Harvester The Britannia Harvester in Lancing any time they fancy.
Just choose your amount, from £5 to £100, and whether you want it to be delivered via email or text message. Then the lucky person just needs to show their mobile to spend it.
Gift cards received and redeemed by text message or email can be loaded with a value of up to £100.
Or you can buy our gift cards in person at any Harvester.
Buying for business? Call 0121 498 7098 to talk to someone in our gift-card team.

subset: commoncrawl


text:
Discussion in 'General Discussion' started by willowlove, Nov 4, 2014.
...the prank? hahahahaha I don't think I saw the right one
Hahahaha oh gosh legman you had me looking for an actual lion-sized dog for like 20 minutes....
Of course the best dog of all is....a bunny going doggy style!
As for dog breeds, I rescued a Vizsla... from Wikipedia...
The Vizsla is a dog breed originating in Hungary, which belongs under the FCI group 7 (Pointer group). The Hungarian or Magyar Vizsla are sporting dogs and loyal companions, in addition to being the smallest of the all-round pointer-retriever breeds. The Vizsla's medium size is one of the breed's most appealing characteristics as a hunter of fowl and upland game, and through the centuries the Vizsla has held a rare position among sporting dogs – that of household companion and family dog.
The Vizsla is a natural hunter endowed with an excellent nose and an outstanding trainability. Although they are lively, gentle mannered, demonstrably affectionate and sensitive, they are also fearless and possessed of a well-developed protective instinct.
That sounds like an awesome dog for you!!!
I just love your twisted sense of humor
Deer head chihuahuas are SOOOO beautiful to me!!
He's saying, Riley! Why haven't you stolen me away?! I gave you ALL of my heart! haha
Bull Mastiff.. I also love the intelligence of Domino's breed. St Bernard's are so cute as puppies.
I think he'd going to sneeze hahaha
I saw the cutest pug the other day, I think they're breeding them to have bigger and bigger eyes every time!
New favorite dog breed: Newfoundland
I was looking to see if anyone said Pitbull!
I have a chihuahua, a greyhound mix and had a pitbull
The best type, or at least the smartest haha
Greyhound and what mix
I have 3 dogs. A chihuahua. A pit bull. And a greyhound mix. I'm not 100% sure what else he is mixed with. He was rescued at the SPCA.
Half Chow with Half Rottweiler
My Dog "Snowball"
Snowball. is. ADORABLE!!!!!
My favorite breed is - Brittany!
Poodle (very intelligent dogs)
I know we already said pit bull but my baby is a pit bull mix and I just had to share her!
Separate names with a comma.


text:
£45,000 Offers over
Enjoying a fantastic town centre location this well placed traditional flat with flexible and generous accommodation which is on the third floor of a traditional town centre building.
The property accommodation comprises reception hallway, bright front facing lounge, double size bedroom, sizeable box room, family sized kitchen and bathroom.
There is good storage throughout the layout of the property which has been neutral decorated throughout, gas central heating and partially double glazing. View is recommended and this can be arranged with the selling agent.
Falkirk has a wide range of local amenities including excellent shopping arranging from boutiques to supermarket shopping as well as excellent access to both Glasgow and Edinburgh via train station which is literally local on your door step. There is also a wider selection of local pubs, clubs and restaurants.
Enjoying a town centre location this well placed and spacious traditional flat make an idea first time buyer or buy to let.
Lounge 15'3" x 11'5" (4.65m x 3.48m).
Kitchen 7'7" x 10'3" (2.31m x 3.12m).
Box Room 6'9" x 8'5" (2.06m x 2.57m).
Bathroom 7'8" x 5'10" (2.34m x 1.78m).
Bedroom 12'3" x 8'4" (3.73m x 2.54m).
This house description is based upon information supplied by the owner, or on behalf of the owner. These property particulars are produced in good faith and do not constitute or form part of any contract. s1homes do not take any responsibility for the accuracy of the information contained in this document.
If a property value displays '0', don't worry it just means no properties have been sold in that area during that time.
Sold house price data is supplied to us by the Registers of Scotland, a government department responsible for compiling and maintaining property registers, every month. There can be a delay of up to 3 months from when a property is sold to being recorded with Registers of Scotland. We provide house price data for your information only, we do not accept any liability for any errors. If you have noticed any incorrect information, please contact Registers of Scotland.


text:
|Publication number
|Publication type
|Application number
|Publication date
|Aug 1, 2006
|Filing date
|Jul 27, 2001
|Priority date
|Jul 27, 2001
|Fee status
|Also published as
|Publication number
|Abdalmajeid Musa Alyassin
|Original Assignee
|General Electric Company
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (12), Non-Patent Citations (1), Referenced by (13), Classifications (18), Legal Events (4)
|External Links: USPTO, USPTO Assignment, Espacenet
[The US Government may have certain rights in this invention pursuant to contract number MDA 905-00-1-0041 awarded by the United States Navy.]
This invention relates generally to volume rendering in medical imaging, and more particularly, to a method and system for readily generating transfer functions for visualization of rendered volumes.
Mammography is a low-dose x-ray procedure that creates one or more images of a patient's breasts desirable for detection of early stages of cancer.
A typical mammography procedure takes approximately thirty minutes. The procedure generally includes obtaining two images of each of the patient's breasts, one from above and one from the side. For example, separate images are obtained of each of the patient's breasts with x-ray tube 12 and digital detector 18 disposed in a vertically orientated arrangement along axis A (i.e., cranio-caudal) as shown in
During the procedure, the patient's breast is compressed between a compression paddle 22, e.g., a piece of radiographically transparent plastic, and digital detector cover 18 to flatten the breast, thereby decreasing the thickness and spreading the breast tissue, making the breast easier to be imaged. In obtaining the images, either from above or from the side, x-ray tube 12 is generally aligned perpendicular or normal to film plate or digital detector 18. A physician or radiologist then reviews the images of the breast, i.e., mammograms, to identify any breast cancer.
While the above described procedure is one of the best methods of detecting early forms of breast cancer, it is still possible for the breast cancer to be missed by a physician or radiologist reviewing the mammograms. For example, breast cancer may be missed by being obscured by radiographically dense, fibroglandular breast tissue, which is superimposed on the structures of interest in the mammogram.
Tomosynthesis breast imaging, in which a plurality of images or projection radiographs are acquired as the x-ray source is moved in an arc relative to the stationary breast and a stationary digital detector, has been studied in an effort to improve early detection of breast cancer. By shifting, scaling, and adding the plurality of projection radiographs, it is possible to reconstruct any plane in the breast being imaged that is parallel to the detector, thereby "removing" superimposed tissue from the structures of interest.
Visualizing micro-calcifications and masses, cysts, and other diagnostically relevant structures of the breast in a series of two-dimensional (2D) planes acquired from tomosynthesis breast imaging provides important diagnostic information. However, the volume of data is generally large and contains a considerable range of data content. Thus, radiologists essentially attempt to conceptually reconstruct these planes into a 3D structure by viewing approximately, for example, 60–80 images (usually 10 images for each cm of compressed breast thickness and each typically has a 2304�1800 matrix size) which makes this task difficult and time-consuming.
Volume rendering provides a three-dimensional (3D) visualization of an object volume. Volume rendering has proven to be particularly useful in medical imaging to screen or diagnose patients using 3D tomography data (e.g. computed tomography (CT), magnetic resonance (MR), and, most recently, 3D digital X-ray Mammography (3DDM)). One of the issues that hinders the usage of the volume rendering technique is the definition of initial transfer functions that would show content of the volumetric data that would be useful in diagnosis.
A transfer function is a mechanism for mapping the data values of individual voxels to colors and opacities. Typically, the transfer functions are generated based on prior knowledge of the 3D tomography data. For instance, in CT the range of the intensity values measured in CT Hounsfield numbers are approximately known and reproducible for a variety of tissue types. Using such prior knowledge enables a user to determine and manipulate transfer functions that are necessary to visualize the rendered volumes.
Unlike CT data, the tissue intensity values are not generally reproducible in MR due to the lack of a corresponding concept to Hounsfield numbers. Generally, soft tissues in MR images have high contrast as well as high signal-to-noise ratio (SNR), particularly when data is acquired by high super-conducting magnets. Therefore, transfer functions may generally be set using a simple linear ramp between the minimum intensity value and the maximum intensity value from the 3D data set to sufficiently visualize the rendered volume. However, for data with low contrast and low SNR data (e.g. 3DDM), such a linear ramp may be unacceptable to volume render the data in a suitable manner. Attempting to manually manipulate the transfer functions is typically not practical as it is time consuming and clinically not feasible.
What is needed, therefore, is a method and system for readily determining transfer functions suitable for volume rendering 3D data that has low SNR and low contrast.
A method and system are provided for generating transfer functions for use in volume rendering of three-dimensional data of an object volume.
In a first aspect, the method comprises obtaining the three-dimensional data of the object volume, evaluating selected characteristics for a plurality of samples of the three-dimensional data and computing a transfer function range for volume rendering the three-dimensional data based on the selected characteristics.
In a second aspect, the system comprises an imaging device and an image processing device. The image processing device is adapted to generate at least one three-dimensional image data set of the object volume based on obtained image data and is further adapted to compute a transfer function range for use in volume rendering.
The features and advantages of the present invention will become apparent from the following detailed description of the invention when read with the accompanying drawings in which:
An apparatus 100 for obtaining x-ray projection radiographs used for generating tomosynthesis data of an object 102 such as a patient's breast for early detection of cancer is illustrated in
The actuator is operable to control movement of the radiation source so that the radiation source substantially stops at the plurality of positions and is operable to smoothly transition the radiation source between the plurality of positions. Desirably, the acceleration of the radiation source varies in general smoothly, e.g. sinusoidally, over time.
Alternatively, an arm having a first end portion is attached to the radiation source and a second end portion is pivotally attached to a support so that the radiation source is movable along an arc. A hydraulic system operably connectable to the arm controllably allows the radiation source to move under the influence of gravity from at least one elevated position to at least one lower position relative to the radiation detector, wherein radiation emitted from the radiation source at a plurality of positions between the at least one elevated position and the at least one lower position and passing through the object is detectable by the radiation detector. As used herein, "under the influence of gravity" and the like refers to gravity being the motive force for transitioning the x-ray source from one position to a next sequential position as the source is moved to obtained the desired tomosynthesis data. Further, as used herein, "operably connected" and the like refers to a coupling of components together to enable the components to provide a desired operation or movement; examples include, but are not limited to, mechanical coupling by means of fasteners (such as cotter pin couplings, spring release latches, and the like) that provide a detachable coupling between component parts.
A method for obtaining tomosynthesis data of an object comprises the steps of positioning a radiation source in an elevated position with the object disposed between the radiation source and a radiation detector, irradiating the object with radiation at a plurality of radiating positions as the radiation source is allowed to move under the influence of gravity from an elevated position to a lower position, and detecting radiation passing through the object at the plurality of positions with the radiation detector. The method further includes the step of generating, from projection radiographs derived by detecting radiation passing through the object at each of the plurality of positions, a plurality of spaced-apart planar images through the object.
Such an apparatus is simpler and more robust than, for example, a mammography machine with one or more servomotors, which are used to physically move and position the x-ray source relative to the digital detector. Such a motorized system imparts thrusting or jolting motions to the machine that affects the ability to maintain the detector and the patient's breast in a stationary or fixed position throughout the procedure. Advantageously, the apparatus limits abrupt thrusting or jolting motions throughout the apparatus, so that the detector and the patient's breast is better maintained in a stationary position throughout the procedure.
Exemplary apparatus 100 includes an x-ray source 110, a detector 120, and an actuator 130 for controllably allowing x-ray source 110 to move under the influence of gravity relative to detector 120. Actuator 130 includes a support 131, a first arm 132 (also referred to x-ray source arm) attached to support 131 and to x-ray source 110, a second arm 134 (also referred to as x-ray detector arm) attached to support 131 and to detector 120, and an actuating system 140.
X-ray source 110 is typically an x-ray tube and detector 120 is typically a digital x-ray detector. For example, detector 120 may be a solid state radiation imager, having e.g., a cesium iodide phosphor (scintillator) on an amorphous silicon transistor-photodiode array. Other suitable detectors may include one or more charge coupled devices (CCD) or a direct digital detector which converts x-rays directly to digital signals. While detector 120 is illustrated as being flat and defining a flat image plane, other configurations of digital x-ray detectors may be suitably employed, e.g., a curved-shaped digital x-ray detector having a curved image plane.
X-ray source 110 and detector 120 are separately movable relative to each other. For example, arm 132 has a first end 211 or portion attached to x-ray source 110 and a second end 212 or portion pivotally attached to support 131 so that x-ray source 110 is rotatable about a point or axis R in the directions indicated by curved double-headed arrow C. Similarly, arm 134 has a first end 221 or portion attached to detector 120 and a second end 222 or portion pivotally attached to support 131 so that detector 120 is rotatable about axis R in the directions indicated by double-headed arrow D.
X-ray source 110 and arm 132 are suitably weighted to provide a moment on the upper portion 211 of arm 132, i.e., the portion above axis R, which moment is greater than the moment of the lower portion 212 of arm 132, i.e., the portion below axis R. Desirably, when x-ray source 110 is positioned at a first or elevated upper position 201 (as shown in
In this exemplary embodiment, actuating system 140 comprises a hydraulic system having first and second hydraulic cylinders 142 and 144, respectively, a reservoir 160, a pump 170, and valves 172 and 174. Hydraulic cylinder 142 comprises a cylinder body 141 pivotally attached to support 131, and a piston 143 pivotally attachable at an upper end to one side of arm 132 for positioning x-ray source 110 relative to detector 120. Hydraulic cylinder 144 comprises a cylinder body 145 pivotally attached to support 1311, and a piston 147 pivotally attachable at an upper end to the other side of arm support 132 for positioning x-ray source 110 relative to detector 120 Reservoir 160, pump 170, and valves 172 and 174, are operably connected to hydraulic cylinders 142 and 144 so that fluid may be introduced into and removed from cylinder bodies 141 and 145 to position arm 132, and thus x-ray source 110 in an elevated position (e.g., position 201), relative to detector 120. Hydraulic cylinders 142 and 144 are suitably stabilized or maintained in a generally vertically disposed position when they are not attached to the respective sides of arm 132, or when apparatus 100 is operated to obtain standard cranial-caudal or medio-lateral oblique mammograms in which case, arm 132 and arm 134 may be suitably locked in a fixed position relative to support 131.
By way of example and not limitation, the x-ray source, the support, and the arms typically are of a type such as General Electric Medical Systems Model Senographe 2000D Digital Mammography System, and suitably modified as discussed above. It is to be appreciated by those skilled in the art that pneumatic cylinders may be suitably employed in place of the hydraulic cylinders. With pneumatic cylinders, a reservoir would not be necessary. It is also to be appreciated that various other mechanical components, e.g. ballscrew-drives, non-hydraulic systems and the like, may be used in apparatus 100 to effect the movement described above for obtaining images.
With reference to
An object volume to be imaged 102, such as a breast of a patient, is positioned between a compression paddle 122 and detector 120, and maintained in a stationary fixed position while x-ray source 110 is moved from the elevated position to a lower position 202 (shown in phantom) during which a plurality of images are obtained. The procedure is similar for obtaining images of the patient's other breast, but instead, hydraulic cylinder 144 is connected to arm 132 and motion of the arm is between the respective upper and lower positions 201 and 202 as illustrated in
In one aspect of obtaining the plurality of images, valve 172 may be opened to drain fluid from cylinder body 141 to reservoir 160 so that x-ray source 110 descends smoothly under the influence of gravity from the elevated position 201 to the lower position 202. As used herein, "smooth descent" and the like refer to the x-ray source moving between respective radiating positions without intermediate stops and in a fashion that does not involve abrupt changes in acceleration. During the descent of x-ray source 110, a plurality, desirably between eight and fifteen, images are obtained by the x-ray source emitting radiation towards the object to be imaged and the detector. For example, for a maximum angle of �24 degrees, use of six degree intervals, positions "a" through "i" shown in
Apparatus 100 desirably includes a processor 150 for controlling actuator system, and processing a plurality of images obtained at a plurality of positions of x-ray source 10 relative to detector 120 as further described below.
For example, a suitable inclinometer 180 having a sensitivity of about +/−0.1 degree may be attached to arm 132 and coupled to processor 150. Processor 150 typically also is interfaced with x-ray source 110 to supply a signal for energizing x-ray source 110 at the appropriate positions, e.g., positions "a–i", as x-ray source descends from the elevated position 201 to lower position 202. Advantageously, apparatus 100 includes suitable shock absorbers such as springs, or pressurized reservoirs to bring arm 132 to a gentle stop at position 202; alternatively processor 150 is programmed to slowly close valve 172 to decelerate x-ray source 110 as it approaches its position 202 at the end of the scan.
In another aspect of obtaining the plurality of images, x-ray source 110 may be moved to come to a rest or stop at each of the appropriate positions, e.g., positions "a–i", at which time (when no longer in motion) x-ray source is energized for generating an exposure. For example, processor 150 typically is interfaced with inclinometer 180 and valve 172 to control the descent of and cause x-ray source to come to a rest at each of the desired positions, as well as supply a signal for energizing x-ray source 110 while x-ray source is stopped or stationarily maintained at each of the desired positions.
From the present invention, it will be appreciated by those skilled in the art that instead of an inclinometer, a linear encoder or similar device can be attached to the hydraulic cylinder and calibrated for providing angular measurements. Similarly, the encoder can be interfaced with the computer and used to control the position of the x-ray source.
Desirably, as shown in
In an alternative embodiment of the actuator, an intermediate pair of variable sized reservoirs may be used in the drain line from each of the hydraulic cylinders so that the pair of reservoirs are alternately filled and emptied. The volume of each reservoir is desirably configured to contain an amount of fluid to be drained or removed from the hydraulic cylinder to permit x-ray source 110 to move from one position to the next. For example, when a reservoir is filled, the x-ray source can be energized to generate an exposure. The hydraulic cylinder would then be connected to the other reservoir to continue the scan, while the first would be emptied into the lower reservoir.
The hydraulic system and motion of the x-ray source allows for the acquisition of the tomosynthesis images in approximately three to five seconds which is sufficiently rapid to make the apparatus clinically applicable. The separate projection radiographs obtained during the imaging procedure typically are processed for use by the operator by processor 150 or other readout modalities coupled to the detector.
The plurality of separate projection radiographs generated by apparatus 100 (x-ray source 110 located at positions "a–i"), after preprocessing, are shifted, scaled, and added, e.g., transformed, to reconstruct one or more planes or slices S in the object imaged that are parallel to the plane of detector 120. It is to be appreciated that one skilled in the art would select from a variety of reconstruction techniques suitable for a given imaging application. As used herein, the plurality of planes or slices are referred to as tomosynthesis data. Tomosynthesis data describes the reconstructed data whereas projection radiographs refer to the x-ray shots. Tomosynthesis allows reconstruction of "in-focus" tomographic planes or slices S at any level within the imaged object, e.g., at about 1.0 mm spacing. Typically, equally spaced slices with a slice separation of about 1 mm are employed. However, other spacings and/or irregular spacings are alternative embodiments. The values in the tomosynthesis data set ideally have an obvious functional relationship with the linear attenuation values of the corresponding structures within the imaged object. Advantageously, the invention allows a physician or radiologist to see through "structured noise" of normal breast tissue to improve detection and characterization of breast cancer.
By way of example and not limitation, the generation of tomographic planes or slices S may alternatively be obtained by the processes disclosed in U.S. Pat. No. 5,872,828 to Niklason et al., or other suitable reconstruction algorithms known in the art.
After employing the tomographic imaging methods described above, the volume of the resultant tomographic data is generally large and the content of the data generally may contain a considerable dynamic range of voxel intensity values. In embodiments of the present invention, methods are provided to enable visualization, for example for diagnosis, of tomosynthesis data having considerable data volume and content. With respect to the volume, the plurality of spaced-apart images desirably have an in-plane image resolution of 100 micron (for breast imaging) or better and image spacing resolution of 1000 micron or better. Typically, each image represents a matrix size of approximately 2304�1800 voxels. As used herein, a voxel refers to a single data point within a data volume consisting of Nx by Ny by Nz data samples along the X, Y, and Z axes respectively. Typically, there are 10 images per cm of compressed thickness, with the compressed breast thickness typically ranging from about 4 cm to about 7 cm. Thus, tomographic imaging as described herein provides a large volume of data. With respect to the content of the data, the dynamic range of the data obtained by the techniques described above desirably utilizes 2 bytes of information (voxel intensity) to store the range difference in attenuation coefficients of imaged structures. There is a relationship between the voxel intensity value and the attenuation coefficients of the imaged structures. The output of the reconstruction technique can make this relationship either proportional or inversely proportional. For an inversely proportional relationship, the higher the attenuation coefficient of a structure within the breast, the lower its intensity value. For example, a micro-calcification has voxel values lower than voxel values associated with fibrous tissues. Other functional relationships between voxel intensity values and attenuation of the imaged structures are also possible.
A method for generating a three-dimensional image of an object volume, for example a patient's breast, comprises obtaining tomosynthesis data of the object volume as described above and generating the three-dimensional image by applying a 3D visualization technique to the tomosynthesis data. 3D visualization techniques, as used herein, refer to a variety of known volume rendering techniques such as maximum, minimum, composite, surface or averaged projections made at any arbitrary view angle in accordance with known techniques.
Volume rendering refers to various techniques to generate projected images onto various imaging planes in order to generate a three-dimensional rendering of the imaged object volume. The tomosynthesis data, i.e., the plurality of spaced-apart planar images, obtained by the methods described above collectively form a three-dimensional data volume representing the object volume. Referring to
In order to display and manipulate the three-dimensional rendered image for diagnosis purposes, two main parameters are desirably set for each voxel in the ray casting technique colors and opacity. Typically, there are two piecewise linear transfer functions that are used to set these parameters. One transfer function is used to set for colors (e.g. red, green and blue or RGB) and the other transfer function is used to set for opacity. Since, generally the rendered 3D image is shown in gray for most radiologists, all of the red, green and blue values are typically the same.
In the field of visualization, it is typical to refer to color monitors with RGBA colors (Red, Green, Blue, and Alpha). These colors refer to the electronic guns in the monitors. If only the red gun is turned on then the pixels on the screen would appear red, if the red and the green guns are turned on then the pixels would appear yellow, and if all of the guns are turned on then the pixels would appear white. The strength of the intensity of the guns generates different levels of shading. When the intensities of all the electronic guns are changed by the same amount and thus the same value, the pixels would have different gray scale values. Typically, radiologists have been trained to look at films which have gray scale values, and they prefer to look at digital images also in gray scale values, but this could change if the radiologists were to get trained on color images. The alpha value (opacity) refers to blending two planes. One plane refers to the colors generated from the screen and the other is opacity plane or alpha plane. Therefore, each pixel has an alpha value associated with it. Generally, in a monotonically increasing transfer function a value of 1 means the pixel on the screen is very opaque and a value of 0 means the pixel is very transparent.
Each transfer function maps the fully dynamic range of the original data into either 8 or more bits depending on the depth of the available display. Although the full dynamic range of the data is typically 15 bits, the necessary dynamic range to render a volume of interest (VOI) without a loss of depth of information requires generally a lesser number of bits. For instance, viewing only micro-calcification with full depth resolution requires a lesser number of bits than viewing both micro-calcifications and masses, cysts, or other lesions or soft tissue structures with full depth resolution. Thus, high resolution visualization of breast structures is possible utilizing embodiments of the present invention.
Note that, micro-calcifications have a distribution of intensity values that are more separated than the soft tissue structure intensity value distribution. Therefore, to map or scale the 15 bits depth resolution (all of the intensity values including the distributions for both micro-calcifications and soft tissue structures) to 8 bit depth resolution, there would be a loss of depth information. However, one intensity value distribution (e.g soft tissue structures) covers fewer than 15 bits, and therefore scaling one intensity value distribution to a 8 bits display leads to a lesser loss of depth information for that specific distribution.
In an embodiment of the present invention, a method for generating a transfer function comprises obtaining a three-dimensional (3D) data set corresponding to an object volume, sampling the 3D data set, measuring the mean and standard deviation of the intensity values for the samples, and computing an upper limit and a lower limit of a linear ramp transfer function.
In an exemplary embodiment, the three-dimensional data set is acquired by the methods described above relating to tomosynthesis and volume rendering. Thereafter, the 3D data set is randomly sampled with n number of samples, and then the mean and the standard deviation of the intensity values for those samples is measured. Afterwards, determine the lower limit and upper limit of a linear ramp transfer function based on the mean and standard deviation as shown the equation below:
Lower Limit=LL=μ−N�σ (1)
Upper Limit=UL=μ+N�σ
Where μ, σ, N are the mean, the standard deviation, and the number of standard deviations respectively. The corresponding opacity transfer function is as follows:
TF(x) is the transfer function, x is the voxel intensity value, A and B are the opacity values and they have values between 0 and 1. C is the y-intercept with opacity y-axis. This linear transfer function can be increasingly or decreasingly monotonic depending on the tissue intensity values. For instance, in 3DDM data, a value of one is assigned to the lower limit and a value of zero is assigned to the upper limit when a maximum intensity projection (MIP) is used for volume rendering. A less than one value (e.g. 0.5) is used if the other volume rendering technique is used (e.g. composite volume rendering). This is due to fact that denser tissues have lower intensity values than less dense tissue (e.g. micro-calcifications has low intensity values and are of great diagnostic importance for the radiologists).
For MIP 3D visualization, the color transfer function may have the same shape as the opacity transfer function or may even have just a constant one value. For other volume rendering techniques (e.g. composite volume rendering), the color transfer function may have the same linear ramp characteristics, however, the lowest value should be zero and highest value should be 1 in order to leverage the maximum possible color range.
Note that the higher the number of samples taken from the volume, the more reproducible the transfer functions are. However the price would be increasing processing time. Therefore, the tradeoff is reproducibility versus speed.
In 3DDM data, the SNR is low. Therefore, it is desirable to use six standard deviations in Equation 1 to provide an adequate estimate of the transfer functions.
Processor 150 is typically a digital computer that is programmed to process imaging signals received from detector 120 during the x-ray procedure. In an embodiment of present invention, processor 150 is further adapted to generate 3D images based on tomosynthesis data, as described in greater detail above. As used herein, adapted to, configured and the like refer to operation capabilities of electrical elements such as analog or digital computers or application specific devices (such as an application specific integrated circuit (ASIC)) that are programmed to perform a sequel to provide an output in response to given input signals. An exemplary processor 150 may include a suitable computer (e.g., SPARC 20 workstation from Sun Microsystems PENTIUM based computer, etc. having a hard, drive, input devices such as a keyboard, a mouse, magnetic storage media (e.g., tape cartridges or disks), optical storage media (e.g., CD-ROMs), and output devices such as a display and a printer. Suitable programming to perform the transformations as explained in greater detail above, is installed or embedded in processor 150.
In a further embodiment, a system for generating three-dimensional images of an object volume is provided. The system comprises an imaging device and an image processing device. The imaging device, as described above, irradiates the volume with radiation at a plurality of radiating positions and further generates a plurality of spaced-apart planar images through the object volume derived by detecting radiation at the plurality of radiating positions. The image processing device, such as processor 150 of
The 3D image is available for display to a user of the system (a display device is not shown). In further embodiments, the image processing device is adapted to respond interactively to inputs from a user of the system for a desired display format. For example, a user such as a radiologist may select a specific region or view angle of the rendered 3D volume or, alternatively, may want to review the 3D image based on parameters such as intensity. It is to be appreciated that with suitable programming processor 150 is adapted to respond to user input for a desired display of the rendered 3D image. In another further embodiment, processor 150 is adapted to provide an animated video display of the rendered 3D image.
From the present description, it will be appreciated the apparatus may be configured to image a variety of objects, and is not limited to breast imaging. It will also be appreciated by those skilled in the art that the computation of transfer functions may also be applicable to any 3D application for which volume rendering is used and may also be applicable to any of the various medical imaging modalities (e.g. ultrasound).
While the preferred embodiments of the present invention have been shown and described herein, it will be obvious that such embodiments are provided by way of example only. Numerous variations, changes and substitutions will occur to those of skill in the art without departing from the invention herein. Accordingly, it is intended that the invention be limited only by the spirit and scope of the appended claims.
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text:
Julie Mccabe Permanent Brain Damage
November 23, 2011 by staff
Julie Mccabe Permanent Brain Damage, A woman from West Yorkshire has been left brain-damaged and in a coma, apparently after suffering a severe reaction while dyeing her hair.
Julie McCabe, 38, from Keighley, is on a life-support machine following the incident at her home on 30 October.
Her family believe she collapsed because of an allergic reaction to a chemical widely used in hair dyes.
Her father Keith Miller said she was struggling to breathe and was taken to Airedale General Hospital.
Mr Miller, 63, from Shipley, said: "She dyed her hair. She couldn't breathe so we'd rushed her down to the hospital and her heart stopped during that journey.
"So they revived her in hospital but the damage had been done by then."
He believes the chemical para-phenylenediamine (PPD) in her hair dye caused his daughter's condition.
'Unlikely to recover'
In 2007, an article in the British Medical Journal by St John's Institute of Dermatology in London warned PPD could trigger allergic reactions.
However there is not yet any proven link between the chemical in the dye and Mrs McCabe's illness.
Doctors believe Mrs McCabe is unlikely to recover.
Mr Miller has instructed a lawyer to highlight the dangers of the chemical.
Lawyer Greg Almond said: "We would encourage people to carry out a test absolutely every time they dye their hair and that's probably the best way to prevent it at the minute.
"But we would call on the government to take a much stronger line with this and to introduce either an outright ban on this particular chemical or to force restriction on sale."
L'Oreal 'concerned'
Mr Miller said: "Knowing my daughter she's a strong little character and if anyone can [recover] she can."
Mrs McCabe was using a L'Oreal Preferences hair dye.
Mr Miller said his daughter had dyed her hair regularly for several years and had used the L'Oreal product in the past. He believes she did a skin test before using the dye.
In a statement, the cosmetics company said: "L'Oreal was extremely concerned to hear about this serious situation.
"We do not know the details of the case so it would be inappropriate for us to comment further, however we will do everything we can to assist this lady's family and medical team with information they might need to establish what happened."
Please feel free to send if you have any questions regarding this post , you can contact on
Disclaimer: The views expressed on this site are that of the authors and not necessarily that of U.S.S.POST.


text:
Coulson and Brooks face new charges
The Crown Prosecution Service said five people are to face action as part of the inquiry, called Operation Elveden. They include Coulson and former News of the World royal correspondent Clive Goodman, who are to be charged with two conspiracies relating to the request and authorisation of alleged payments to public officials in exchange for information, including a royal phone directory known as the "Green Book". It contained contact details for the royal family and members of the household.


text:
New Delhi, June 1: The Indian telecom watchdog on Wednesday launched a mobile application to file complaints about unsolicited commercial communications.
"It is called DND Services. It is available in Google App Store and Mobile Seva App Store now and soon will be available in Apple iOS," Telecom Regulatory Authority of India (TRAI) Chairman R.S. Sharma told reporters in a press meet.
"It is done keeping in mind consumer interest. It will make the complaining process easier," he added.


text:
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An NHS tax is needed to keep the NHS free to all at the point of need
This is the first in a series of guest blogs that we'll be publishing in the run-up to the launch of the final report from the Commission on the Future of Health and Social Care in England.
Each blog will focus on one of the possible options for funding future health and social care considered in the commission's interim report. Here, Nick Pearce of IPPR discusses how a dedicated NHS tax might work.
The commission will make its final recommendations on 4 September.
This is a guest blog post. The views expressed are the author's own and do not necessarily represent the views of The King's Fund.
The NHS is facing a serious funding gap if demand continues to increase and budgets remain frozen – up to £30 billion by 2021 according to NHS England. The independent Commission on the Future of Health and Social Care in England, set up by The King's Fund, is a timely contribution to determining how to address the financial challenge.
As our population ages and increasing numbers of people have multiple long-term chronic conditions, pressure on our services increases. This government has more or less maintained the NHS budget in real terms, but this contrasts with the historical 4 per cent annual increases that until now have made the NHS able to respond to growing demand.
If we are to avoid a financial crisis in health in the next few years, the NHS needs a cash injection to accelerate innovation and reform.
Health consistently comes out top in people's priorities for extra government spending. But it is unrealistic to think extra funding could be found by cutting other Whitehall budgets more deeply – the ring-fencing of NHS funding has already meant disproportionately large cuts to unprotected departments.
A dedicated NHS tax or National Insurance increase would boost NHS revenue while not affecting other departments' budgets. The public may be sceptical about tax increases in general, but is likely to be more supportive of those used to finance the NHS. A one percentage point increase in one of the National Insurance rates, ring-fenced for the NHS, would raise £4 billion and could be popular.
The government would, of course, need to be transparent that this funding was additional, not just filling gaps created elsewhere. It would also need to show that the new funding was having a measurable effect and not simply disappearing without trace into the NHS budget.
Other approaches also need to be considered, as the commission's interim report set out.
For instance, we should look for more productivity gains in the way services are delivered. However, the NHS has already had to make fairly substantial efficiency savings over the past few years and there may be limited scope to do much more in the short term while maintaining quality of care. Also, not all of these savings will be cashable.
There is also the potential to reduce the predicted pressure on NHS spending by reducing demand for services, or at least stemming the increase. In health care this is surely an uncontroversial aim – we all want people to stay healthier for longer, which will in turn lead to lower demand on services. However, many of the possible solutions – integrating budgets and services, providing whole-person care, making greater use of community-based settings, encouraging healthier lifestyles, supporting patients to have greater control and so on – may take time to have a major financial impact.
Crucially, some of the measures to increase productivity and reduce demand would benefit from an upfront investment in cash. Using the invest-to-save principle, an NHS tax could be the catalyst that's needed.
An NHS tax or increased National Insurance contribution would not generate the full £30 billion but it would be a significant contribution towards it. It could have a near-immediate effect in kick-starting a programme of innovation and reform to redesign health and social care services to better meet patient needs and reduce demand over time.
An NHS tax could play a significant – and immediate – role in reducing the funding gap while maintaining quality of care and keeping the NHS free at the point of need.
- Latest on the Commission on the Future of Health and Social Care in England
- Download the interim report: A new settlement for health and social care
- The commission's final report will be published on 4 September 2014
Nick Pearce is Director of IPPR. He rejoined the institute in September 2010 after two years as Head of the Policy Unit at No 10. An author and regular commentator on public policy in broadcast and print media, Nick writes on a wide range of issues, from social justice, public service reform and identity politics to the future of social democracy.
This is a guest blog post. The views expressed are the author's own and do not necessarily represent the views of The King's Fund.
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There are two ideas in this blog I think are dangerous.
The first is the assumption, common among health economists who think about the NHS top-down, that there is no scope for significant improvement in productivity. Those who look at the problem bottom-up (that is they look at how the daily operations and processes of the NHS actually work) would beg to differ. There is a great deal about the NHS that could be done more efficiently if the way it worked was reformed significantly. Some of they change requires investment, but the major barrier is cultural: the NHS default assumption is that management just doesn't matter (which is why the system is so extraordinarily under managed). Politicians share this belief and have imposed management cuts to generate populist headlines about their "war on bureaucracy". But it is not hard to show that management (not perhaps traditional NHS management but good operational management) makes a big difference to the quality and cost-effectiveness of care.
The second is that the best way to raise more for the NHS is a hypothecated increase in national insurance. The problem here is broader. The UK tax system is already an ineffective, inconsistent and badly designed mess. NI contributions are used by politicians to raise tax without admitting it. The notional income tax doesn't change, but the real amount of money taken out of salaries does. That's just dishonest and moreover complicates the tax system and makes it more costly to administer and less effective as the wealthy find more loopholes to avoid paying. It would be both more honest and more effective to put income tax up. Or, better, to completely redesign the system so it is simpler, fairer and more effective. we might find that the government's capacity to raise money would go up and the public's tolerance of taxation would improve. That would be a better solution for the NHS (and other public services) than a sneaky, complexity-inducing and potentially ineffective increase in NI.
The best way to raise money is via general taxation.
The problem is stopping politicians spending it on sexier projects.
The only way is to increase the pain for misapplying resources.
That means making it easier for patients to sue, whistleblowers to blow, and for heads to roll when things go wrong.
Patients cannot be treated as passive recipients of care. If patients were given access to their records and had some notion of how much it costs to provide care in various settings, then the vested interests would have much tougher job convincing that extra days in hospital is in patients interests or blame others for not providing the care needed.
We use the most expensive resource hospital care in a non transparent way. even the Commissioners do not really know what they are paying for. The quality of data provided by hospitals in the age of instant records is dismal. I was really taken back when I found that the discharge summary was audio recorded for someone to type a letter that was then sent to the GP, arriving 7 days after the discharge and then another person who keyed in the information on the GP system and there were significant errors.
Even though we talk about NHS, it is a fragmented system with some really perverse incentives so when people say increased tax will fund the NHS, we need to be mindful what transparency is there in terms of where the funding goes. The GP system which is what majority of people access is at breaking point and not funded properly.
Increasing taxation further either through income tax, NIC or VAT is counter productive and leads to diminihing tax revenues. The way to raise more money for the NHS is to charge those who can afford it. Charging £ 10 a day for hospital meals would bring in a vaste amount, and charging £ 5 a visit to a GP would bring in more, exempting those on income support. If we charge for prescriptions, why not for these? Free at the point of need is an out-dated concept.
There is nothing free about the NHS. Saying things like "free at the point of care" simply dis-intermediates payment from the service. Clinging to this notion, while politically convenient and makes for rocking good speeches, obscures the real issue which is to answer two questions: (1) How can we pay for the healthcare we want (re-introduce some responsibility for paying for services vs thinking they are free); and, (2) Is the NHS delivering services cost effectively and will appropriate clinical efficacy?
There is no free and economist understand the principle of the rationing behavior of price, although they seem loath to remind us that "price" has its place in the discussion. To say it another way, people will consume all of "free" they can get - and they will not value it.
The commission should address these points and I daresay they would get to a much more enlightened (and interesting) set of findings!
Hear, hear to Mr Stephen Black. I too work in front line services and can attest to the huge amount of inefficiency and lack of incentives, even suspicion, to work differently. We are still paying Band 7 staff to type letters, for heavens sake!
The proposed solution avoids the problem, as others have noted. There is a sense of deja-vu about it all.
If there are any hints as to what the future of healthcare and social care might look like, we likely need a system that is better integrated around the patient, uses clinical expertise better, and responds to patient preferences, is nimble, able to change and evolve locally better, deploy expertise and services that can changed quickly
So what funding model or options give us something that is flexible and sustainable for everyone? We know there will never be enough money so creating models to increase the pot of money is a deadend and seems to be the blog author's fantasy. If we briefly consider the impact of taxation funding on health system behaviours, what do we see: failure of financial discipline, failure of clinical quality, leadership failure to be tough on poor performance, inability to create and implement creative solutions, and we see a system that struggles (in the behaviourally relevant sense) to get patients to be more involved and responsible for their health and care.
For my part, I would be looking at how might supplementary insurance be used to part-fund some of the rationed care/medicines that are becoming increasingly evidence (think how we'll fund future oncology treatments if you think the current medicines are expensive). How to use co-payments effectively and when they don't work (US and France as examples). How co-payments enable pooled funding to integrate health and social care without the necessity of means-testing and enable patients to directly commission their needs (e.g. Korea). Why removing the hospital-based monopoly control of access to consultant specialists would be a good, rather than a bad, thing (think access to oncologists, neurologists and cardiologists, for instance where UK outcomes suffer and patient access is significantly delayed). Indeed, is the gatekeeper model fit for purpose, and is it possible that primary care seems to be now part of the problem. I think in part it is because of its inability to pull resources away from hospital monopolists.
Critical to future system flexibility and sustainability will be the need to rethink the current system of controlling access to training in the health professions (why does the UK have, e.g. so few neurologists, compared to other countries). Future healthcare requires greater flexibility in how clinical expertise is trained and deployed.
In my blogging, I've wondered why creative solutions fall on barren ground when transported to the UK from elsewhere -- think Evercare. Why haven't hospital managers addressed the challenges they face creatively on their own; that Virginia Mason, or InterMountain in the US (as breathlessly reported by the King's Fund) have successfully innovated and why haven't people here thought these thoughts independently?
From a policy perspective, the weakness in policy has always been the disconnect with implementation. There is the purity of the policy ideas (much loved by policy folk) and nonsense such as extra taxes (check out whether a similar tax in Ontario, Canada achieved its objectives or just made it easier to run over budget). Meanwhile the gritty real world remains.
For many of the range of interesting opinions expressed in response to this piece, there are alternative but I would suggest equally valid viewpoints for instance
1. It is absolutely the case that there are inefficiencices and unwarranted variations in the NHS (not least those caused by endless structural reorganisations), but we spend proportionately a lower percentage of GDP on healthcare than Canada, Australia, Germany, France, New Zealand, Holland, Nordic Countries etc and yet the Commonwealth fund comparison (and yes i know there are other comparisons out there) ranks our system highest on several indices - including value for money. So the assumption that underfunding isnt an issue is at least contestable
2. Co-payment based on ability to pay can work (notably in Singapore for instance). However, in my clinical job i frequently see the effects of means testing for social care - older people who would really benefit from home care are so scared of the means testing or the payment that they often end up refusing care which could help keep them at home. Given that the most intensive service users are frail older people with complex comorbidities, dementia etc or younger people with multiple long term conditions, social disadvantage and often chaotic lifestyles linked to drug or alchohol problems - do we reallly want to be asking the most needy groups of service users to be paying and thereby making them less likely to use services. Where its at these days isnt health literate educated professionals with a big interest in self care, contrary to the zeitgeist.
3. Central control of workforce planning. I totally understand that per capita we have a low number of neurologists or medical oncologists and that this could affect outcomes. However, in many other western countries, because a cardiologist or orthopaedic surgeon can earn 10 times what a GP or geriatrician or acute hospitalist can earn, medical graduated are drawn disproportionately into these high paying specialities partly to pay down debts for their courses which dwarf any similar debts here. What the population increasingly needs is good generalists in primary care and for hospitals, doctors specialising in acute medicine, geriatric medicine and general medicine - this is the biggest need. At least in the UK we are able to match workforce planning with need and because we have national salary scales for hospital doctors and GPs can earn similar money to hospital specialists, we dont have perverse incentives drawing too many doctors into single organ specialities, with big private practice earnings. Older people with complex co-morbidities dont want to be bounced around between lots of different docs based on organs - they want continuity of care and expert generalism.
4. With regard to the Gatekeeper role played by primary care, it is a powerful bulwark against people "doctor shopping" and going straight ot secondary care experts even if in many cases they dont require this input - in turn under a more marketised model, those same specialistss are perversely incentivised to over-investigate and over-treat and people end up with fragmented, poorly co-ordinated care with too many cooks involved. Even now, it seems to be the case that people want quick access to a familiar GP and if they are actually able to get that they often wont default to hospital at all, but primary and communty health services are underfunded.
5. We have to stop recycling the myth that there is no clinically led innovation and quality improvement coming from within the NHS and our "cultural cringe" to all things coming from overseas - yes of course we should be open minded and receptive to good practice examples, but there are examples of innovation in the UK (across the whole service and not just among selected provider chains who can pick and choose which population they look after) which when i speak about overseas, people wish they could import from us. Check out for instance the work of the national hip fracture database, hip fracture best practice tariff etc on driving up quality and improving outcomes for people with hip fracture across the whole NHS - not just in one or two rolls royce providers. Oh and the reason Evercare didnt work isnt because of some kind of resistance to quality improvement in the NHS - its that the politicians of that time tried to drop in a model into a very different context, railroad through a report on effectiveness before it had a chance to bed in and actually the intervention bore little resemblance to the Evercare model.
I could go on, but i think its a perfectly defensible proposition that we need to increase NHS funding to c 11% of GDP and to do this out of general taxation (though the draconian cuts in social care which impact so much on individuals and on the use of health services) need to be reversed and we do need to move towards more integrated care models and a greater focus on prevention.
The US service is designed to enable world class provision and choice to a few service users in a few services who can decide which business line to be in. The NHS is designed to provide universal coverage to whole populations at a half decent standard at a low cost - and this is what it generally does despite all the caveats
David Oliver
As a semi-retired, lower-middle level tax payer with a significant career in the NHS, I agree wholeheartedly with Nick Pearce's view. It's clear that the demand for and expectation of the health care sytem is not being matched by the amount of money put into the system. Apart from the wholesale privatisation of the NHS, which I abhor as 1) it's unethical to make a profit out of people who are sick and needy, and 2) it's just not profitable anyway (look at the problems Circle et al have experienced trying to run health care privately), the only way is to fund it through income tax. Whilst no politician will accept this as it will lose them votes, the 'sweetener' will be matching this to a rise in the taxability threshold so that only people who can afford to will pay the extra tax to ensure sustainability of the service - Simples!
I do not see why there should be a debate at all & I reject the notion.
If tax was collected as it ought to befrom the tax dodgers there would be no need to even consider increasing taxes for the rest of us.
There is an long-standing intransigence to address the establishment in the NHS put there by a whole managerial class of two govermments - managerial posts which hugely, and daily suck revenue out of patient care without great benefit to anybody but themselves.
Whistleblowers are constantly, and in the absence of undertakings to the contrary, put out of a workable discussion for improvement of the system: all those I talk to identify managers as being at the heart of the problem against an atmosphere where the lack of transparency means we cannot know how much of the NHS is being sweated in contracts to Virgin Healthcare and other wholly shadowed contractors with the worst possible record in healthcare when brought under a proper spotlight . It is now obvious why.
The entire austerity narrative by Hunt and Osborne is being used as a blind to the multifarious vested interests, over 35 MPs from the Conservative benches alone are invested or represent these, and the hideous veil of 'non-speech', and outrageous disregard of the reality of what is going on behind the scenes should fool no acerbic or perspicacious observer of the piecemeal trashing of this vastly popular mainstay of British civilisation.
It is now incumbent, as never before, for people to gather round and defend the principle as well as the practice of the NHS. Social engineering has gone so far. We will stop it going further together.
what if solar pannels were fitted on all hospital roofs that could have them a social club that i belong to from jan to june 2014 was paid over £4,000 from an energy company for the power that we gave to the grid


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November 10, 2011
On Wednesday, November 16, Dr. Thomas S. Kidd, Associate Professor of History and Senior Fellow at Baylor University's Studies of Religion, will speak at Hampden-Sydney College. This is the 11th annual Governor Henry lecture and is entitled Henry, Madison, Jefferson, and the Contest for Religious Liberty in Revolutionary Virginia.
Kidd's most recent book is Patrick Henry: First Among Patriots. His other books include God of Liberty: A ReligiousHistory of the American Revolution, The Protestant Interest: New England after Puritanism and The Great Awakening: The Roots of Evangelical Christianity in Colonial America.
Kidd received a 2010 Baylor University Outstanding Professor Award, a 2006-07 NEH Fellowship to support The Great Awakening, and a 2004 NEH Summer Stipend and was selected for the 2004-05 Young Scholars in American Religion program.
He earned a B.A. and M.A. at Clemson University and joined Baylor University in 2002 after completing a Ph.D. in history at the University of Notre Dame.
This event begins at 7 PM in Crawley Forum and is free and open to the community. It is sponsored by the Patrick Henry Memorial Foundation, Library of Virginia, and Hampden-Sydney College with support from the Society of the Cincinnati of the State of Virginia.


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The first significant milestone of their nascent reign, the dismissal of Roy Hodgson and the return of Kenny Dalglish, may look like it was made as a sop to their new supporters, an attempt to ingratiate their reign with the paying public.
This is no democracy, though. Anfield is in the grip of an elective dictatorship. Power still resides in the boardroom, not in the stands.
Everything Fenway Sports Group, Henry's and Werner's investment vehicle and the club's parent company, has done in its four months on Merseyside has served to make the club's supporters, so distant from and discordant with the previous regime, feel enfranchised.
They promised to help Liverpool succeed by living within their means. They promised to review the possibility of remaining at Anfield. They promised to reinvigorate a stagnant club with vibrant youth. They offered discounted tickets, and they have engaged with supporters' groups.
And now, after weeks of growing calls for change from the Kop, they have deposed the impostor and crowned the king.
It would be easy to characterise FSG's ownership thus far as one of style over substance. It is yet to increase Liverpool's commercial riches, already boosted substantially by Tom Hicks and George Gillett. It has replaced a 63-year-old manager with a 59 year-old.
There still seems to be no long-term plan, no vision. FSG admits it is still learning about football. Its actions suggest as much.
That sentiment, though, will seem far-fetched come the summer, when the next big decision is made. FSG see sDalglish as a caretaker. He will not last beyond the end of the season, even if he returns Liverpool to Europe and wins the Europa League. FSG may have reinstated royalty, but remains set on revolution.
The process that returned Dalglish to Anfield proves as much. Hodgson, put simply, never fitted FSG's hopes for its investment, its Liverpool. Too old, too set in his ways. A dignified, honourable man, but not the thrusting, ambitious visionary to revitalise the club.
From the off, FSG viewed him as an interim appointment. It has long been examining the credentials of other candidates, their identities and ages illustrative of how unlikely it would have been to see Hodgson complete his three-year contract.
Andre Villas Boas, Jose Mourinho's erstwhile assistant, unbeaten in his first season at Porto at the age of just 33. Jurgen Klopp, 43, the man credited with turning Borussia Dortmund into a force once more. Didier Deschamps, only 42, but with a track record of success at each of his three clubs.
FSG had hoped to make the first appointment of its reign a permanent one, to show the club's fans the scale of its ambitions and the way it would attempt to fulfil them. It would stick by Hodgson for the season, proof that the image it has projected as serious, intelligent, considered owners is not a false one.
That it has acted so decisively — with such little regard for timing — is evidence, though, that its patience is not unlimited. Henry and Werner are successful, hardened businessmen. They expect their investments to perform. If they do not, they will act. Ruthlessly.
"We are grateful for Roy's efforts over the past six months, but both parties thought it in the best interests of the club that he stand down from his position as team manager," said Henry of FSG's decision.
It is the best interests of the club, rather than rose-tinted sentimentality, which have returned Dalglish to the post he last occupied in February 1991. Hodgson's failure to remedy his ills was threatening to turn a task FSG viewed as a touch-up job into a write-off. It had to act, and it did.
It was no knee-jerk decision made after defeat to Wolves or embarrassment at Blackburn. It was simply a matter of expediting a plan that was already in action. Hodgson had to go, so go he would.
Even then, FSG clung to the hope that a permanent replacement could be found. It would be sensible to assume that discreet inquiries into possible candidates suggested January was no time to appoint a man to carve a future. Time to turn to Dalglish.
The Scot, of course, comes with the additional benefit of uniting the supporters and inspiring the players. That is, though, in FSG's eyes, simply a happy accident. The past does not define its vision of the future. This is FSG's club now. The company will do what it wants, to win.


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Thank you for voting Yes on Prop 8, now may we also have your votes on Prop 19, which is of even higher importance to our fellow californinians?
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Thank you for voting Yes on Prop 8, now may we also have your votes on Prop 19, which is of even higher importance to our fellow californinians?
Last edited by DOOM!; 09-25-2010 at 12:23 PM. Reason: Forgot to add the 'Yes'
what's propeller 19 when its at home?
Can't vote, sorry. >_>
Sorry Doom, I don't condone smoking in any form.
Sadly I don't live in Cali either.
oh right it's the smoking one. yeah, GO SMOKING BAN!!!!!!
I don't smoke, but i wouldn't have a problem if prop 19 passed in Cali.
Man that is whack!
Token Black Guy
I hate drugs. Sorry yo I be trippin' sometimes.
No, it's just how I feel at the moment.
I don't really care, but sure. Pass it, the only problem is that people will abuse the drugs and get messed up. On the other hand, it'll reduce the criminal activity such as smuggling the drugs and whatnot. ;/
Its up to the people to make their own choices to abuse Prop 19 or not.
Now how will they be doing that? o_o
Its so funny, like earlier today I was watching some documentary about marijuana. I mean, I stay neutral to these kind of issues like this. I look to the good things and bad things that marijuana can do, but then, when I think about it as I watched it its considered "bad" because a lot of people are abusing the substance. Long ago, it was no illegal drug. They don't use the plant to make them all high and happy, it was more for medical uses. Its also the same with other drugs besides that.
>_> So, if over-the-counter cough medicine become an addicition, expect that to be an illegal drug. Theres no more limitations. And besides medicine and drugs, that goes with other things as well. Just in my opinion, people needs limits. Otherwise there will be no problem.
I sort of see this as a way to help California's economy. They are in a big massive empty money hole. If they legalize pot all the pot heads will move there so they can smoke without worry. Thus bringing in more money into California once again. But I don't know this may be just me. But thats how I see the reason behind bringing this up.
I started up a website called Dango News for anime, game, and Japanese news & current events.
Dango News | Twitter | Facebook | Instagram
And just where, might you ask, goes the money generated through the illegal trade of illicit drugs?
Why the trails lead all the way back to war lords and terrorists who in-turn use said money to train/recruit more people, create plots of destruction, and buy weapons that are then used to wreak havoc.
I hate drugs, and I wish to see them all one day whipped clean of the face of the planet. But as a matter of security, this is a necessary 'lesser-of-the-two evils'.
Last edited by Skylar1; 09-27-2010 at 02:44 PM.
The Brighter the Light the Darker the Shadow
As much as i despise the idea of drugs being legalized we are in a hole and the taxes on marijuana would really help right now. I see marijuana going through the same thing that happened to alcohol, of course alcohol didn't have a medical phase as far as i know but this prop will more than likely pass.
Set made by me
"Do you know who I am? I'm the man who's going to burn your house down! With the lemons! I'm going to get my engineers to invent a combustible lemon that burns your house down!"
I sense a great deal more controversy about how to handle drivers who are high > .>
Back, by popular demand! Now with new avy.
Vote NO, and all come to Holland for your pot! :'D
Decriminalisation has the capacity to work wonders (supposing it's gone about the right way).
You're screwing over the very source of drug crimes and when you think about it, most druggies are going to find a way to get a hit anyway be it legal or illegal.
victoria aut mors
They should legalize it. Not only should they legalize it, but they might as well just legalize it. Half the people in my P.E. class spent half the class talking about how they'd be as high a kite once the week ended. It's a lost battle.
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ACT Meteors coach Andrew Dawson says there is no reason to panic despite his side crashing to another heavy defeat to competition heavyweight NSW at Blacktown on Saturday.
After losing their season-opening Twenty20 fixture by nine wickets on Friday the Meteors' 50-over campaign began with a seven-wicket defeat.
Batting first, the Meteors began well on a flat deck at 1-90 off 18 overs with skipper Kris Britt (74) again leading the way.
But the middle order was torn apart by off-spinner Lauren Smith (4-35), ensuring the Meteors were bowled out for 224 in the final over.
The Breakers cruised to victory in the 39th over, with Australia regulars Alyssa Healy (90 off 95 balls), Rachel Haynes (36 off 38 balls) and Alex Blackwell (42 off 47 balls) doing the damage.
ACT used eight bowlers but could not find a way to stem the avalance of runs.
NSW have been the competition's clear standouts for years, and Dawson said his side is still working out how to balance aggression with occupying the crease.
"We're trying to promote positive play and be attacking but it's probably that realisation of game sense [we're missing]," he said.
"It's finding that balance, but I'm not too stressed about it.
"Especially with our bowling, the girls have admitted they're bowling one or two bad balls an over.
"Our batters lost their way in the middle, we didn't play their spinner very well and overthought the situation, which was disappointing."
The two sides take on each other again in a second Twenty20 fixture at Blacktown on Sunday.


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Contest? How Often? When Is The Next One?
Decorating By fluffball Updated 15 Jun 2010 , 5:40am by wjbowden3
I'm new to the site and was just wondering how often the contests are run. Are they monthly? or just randomly done?
when can we expect the next one?
Fairies and Dragons cake contest:
agreed would like to know that to since its june 14.2010,beginner but wouldlove to try a contest LOL
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With fears of carbon dioxide causing global warming and diminishing supplies of fossil fuels, a looming energy crisis is affecting all countries. As a consequence, a great deal of world-wide effort is going into the development of alternative energy technologies. At present, wind, hydro and geothermal are becoming well established with more niche roles for tidal and solar. The latter ...
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- alpaca
- noun Etymology: Spanish, from Aymara allpaqa Date: 1811 1. a domesticated mammal (Lama pacos) especially of Peru that is probably descended from the guanaco 2. a. wool of the alpaca b. (1) a thin cloth made of or containing this wool (2) a rayon or cotton imitation of this cloth
New Collegiate Dictionary. 2001.


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An Island Of Hope - by Pankaj Butalia
Partners PSBT FILMS SKU: An Island of Hope-1
Ready stock. It can be delivered within 3-5 days. Returns accepted
|Duration/ Language
00:26:00 (hh:mm) , English
|Trailer/ Excerpt Link
|Filmmaker/s Bio Note/s
|Pankaj has made eight documentaries and one fiction film. Many of his documentaries have been screened extensively throughout the world and one of them, Moksha, won four major international awards and one national award in 1993-94. His first feature film Karvaan, got a Special Mention at Amiens, France, and has been screened at film festivals in Venice, Toronto, Rotterdam, Belgium, Hong Kong, Turkey, New Delhi and Calcutta.
|Synopsis/ Description
The Chakmas are a tribal group that went to Pakistan when the Chittagong Hilly Tracts became part of what was then known as East Pakistan. In 1964, the setting up of the Kaptal Hydel Project uprooted 50,000 Chakmas from their traditional homelands. Most of them then crossed over to India where they were buffeted from one state to another. They ended up living in and around Changlang, a small part of Eastern Arunachal Pradesh. A few years ago, a small school was started in Diyun, Changlang, by a few young Chakma men. This school suddenly transformed the local environment and led to the local communities grudgingly accepting this 'outsider' immigrant community.
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Catering Director843-953-5669Jennifer has been with College of Charleston Catering Services since March 2013. She has over 15 years of experience in the hospitality industry and brings a high level of expertise to the department.
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Catering Manager843-953-5669Originally from Grand Rapids, MI, and a 2009 graduate from Michigan State University with a degree in Hospitality Business, Michelle has been a part of the CofC Catering team since 2012. With over 10 years of hospitality experience, Michelle ensures that every College of Charleston event receives the dedicated attention necessary to exceed expectations!
Catering Manager843-953-5669Claire relocated to Charleston in 2013 from Washington, DC for a 'change of pace'. She joined out staff in the Fall Semester of 2014 originally as our Supervisor and has recently transitioned to her new role as one of our Catering Manager. She has worked in hospitality for over ten years with experience in many facets from restaurants, to hotel sales, and of course, catering and events!
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