Thursday, October 29, 2009

Doctors at St. Joseph in Burbank hope the multi-leaf collimator will cause fewer side effects. Skeptics wonder about its $250,000 cost.

ED BOND
The Los Angeles Times
Sep 15, 1993. pg. 1

Copyright, The Times Mirror Company; Los Angeles Times

The mortal game cancer specialists have played for decades goes like this: blast the tumor, not the patient.

A group of doctors at St. Joseph Medical Center in Burbank are about to begin a new round in that confounding task, armed with a $250,000 device called a multi-leaf collimator.

The complicated-sounding machine has a simple purpose, to shape the beams of radiation so that most of the surrounding tissue is left untouched, sparing the patient nausea, diarrhea, discomfort or other side effects.

Doctors at St. Joseph plan to use its precision to test the effectiveness of higher doses of radiation on tumors. By better channeling the radiation, these doctors say, the machine will allow them to provide a level of care closer to that found in major medical institutions with multi-million-dollar equipment.

St. Joseph will be the first community hospital to use the device in California when patient treatment begins within two weeks, according to its manufacturers and members of the California Radiation Oncology Society. The machine will soon be in use at Northridge Hospital Medical Center, UCLA Medical Center, Cedars-Sinai Medical Center, and Sutter Memorial Hospital in Sacramento.

Some praise the machine as a breakthrough that finally gives the medical community a reliable tool for attacking a tumor. But others are more skeptical, saying that the machine is expensive and unnecessary.

"Right now we do a fairly good job of confining the radiation dose," said Dr. Donald Fuller, a San Diego radiation oncologist, who said most hospitals now use neither the multi-leaf nor its more expensive cousin. "If it is more expensive (to use the multi-leaf), can it be justified? These are the kinds of dilemmas we are wrestling with."

"This needs to be validated," acknowledged Dr. Christopher Rose, associate technical director at St. Joseph's radiation oncology department, who helped push for the technology to be developed in the mid-1980s. "It may be a $250,000 piece of junk."

The National Cancer Institute is planning a nationwide study next year on the effectiveness of multi-leaf collimators in fighting prostate cancer, said Dr. Dwight Kaufman, acting assistant director of the institute's radiation research program.

"Whether it translates into better control of cancer with less toxicity still remains to be seen," Kaufman said.

But supporters of the new procedure say they're betting it will prove an affordable way to focus radiation doses on tumors.

"This is the latest frontier in answering the question of how do we improve radiation treatment," said Dr. Michael Steinberg, of the Santa Monica Cancer Treatment Center, who is president of the California Radiation Oncology Society.

Here's how it works.

Until now, cancer specialists have had to protect the flesh around a tumor with blocks of a lead alloy, shaped to protect vital organs from a field of radiation.

The multi-leaf, however, protects healthy tissue by covering it with overlapping leaves of metal. Each leaf blocks out an area in the field of radiation, allowing only a shape approximately matching that of the tumor for the beam to pass through.

The multi-leaf also improves that way doctors can aim radiation at a tumor, supporters said. Instead of only being able to fire the radiation through the side or through the front, the new equipment uses a computer to continually change that shape of the beam as it rotates around the patient. This way, the tumor can be attacked from every angle.

The multi-leaf is not the only piece of equipment meant to sharpen the stream of radiation. Science has created far more precise tools, such as the equipment used for proton radiation treatment at the cancer center at Loma Linda University Medical Center. But that equipment cost $45 million, and it is one of only two in the United States.

Proton radiation hits only the tumor, said Dr. Jerry Slater, clinical director for the department of radiation medicine at Loma Linda. Radiation from the multi-leaf, by contrast, still must pass through some healthy tissue to get to the tumor.

Compared with conventional treatments, the multi-leaf collimator is expected to do the most good in reaching tumors in the deep, hard-to-access areas of the body, such as the pancreas or the prostate. Those organs are lodged between the bladder and the rectum, which are particularly susceptible to harm by radiation.

It is already clear that the equipment will not be useful for all types of cancer. About 10% of the 700 cancer patients using radiation therapy at St. Joseph will be likely candidates for the new device, said Dr. Leslie Botnick, director of the Radiation Oncology Department at St. Joseph. Cancers such as lymphoma and Hodgkin's disease are not limited to a small area of the body, so patients with these illnesses would not benefit as much from the machine.

At Northridge Hospital Medical Center, it was the bottom line that encouraged hospital administrators to approve the purchase of their own multi-leaf collimator, which will be delivered in December, said Dr. Aaron Fingerhut, the hospital's director of the radiation oncology department at the Thomas and Dorothy Leavy Cancer Center.

"Right now we have a technician who manufactures these lead blocks, which is time-consuming, and then they have to be lifted up to shoulder height and mounted on the machine," Fingerhut said. A full-time technician earns more than $50,000 a year, so in a few years the hospital could recoup the cost on the device, he added.

With the multi-leaf collimator, treatments could eventually be made faster and more cost-effective, Fingerhut said. Some day, having the machine could increase a hospital's business, because insurance companies and health-maintenance organizations might send patients to the less-expensive program, he said.

One thing doctors at St. Joseph hope to do is use the machine to experiment with giving patients higher radiation doses. Researchers there say that if the machine really spares surrounding tissue, higher levels of radiation can be tried on tumors.

"St. Joseph's clearly wants to be a hitter in the high-dose studies," said Dr. Scotte Doggett, medical director of radiation oncology at Sutter Memorial Hospital in Sacramento, which also plans to use the device. The work at St. Joseph may encourage others, he said.

It is important to note, however, that despite high hopes, the multi-leaf might not be the answer for hospitals struggling to provide appropriate care for patients with cancer.

Loma Linda's Slater said that although he thinks the new machine represents a step forward, proton radiation treatment is "a magnitude ahead."

Buying a high-technology piece of equipment may be an unlikely step for a community hospital in a struggling economy, said Botnick, who came to St. Joseph along with Rose in the early 1980s from the Joint Center for Radiation Therapy at Harvard Medical School, which had begun the nation's first studies in shaping radiation beams.

The two came to St. Joseph to study ways to bring the same level of care found at a university hospital to a community hospital.

"I think if (hospital administrators) had to make the decision in 1992 economics, they wouldn't have done it," Botnick said. "This is not going to help us make more money."

Still, said Rose, the technology is too important to be ignored.

"The issue is, can it be done in a community hospital?" he said. "That's what we're going to try to find out."
[Illustration]
PHOTO: Radiation oncologist Dr. Arnold Malcolm and radiation therapist Carol Nemeth with multi-leaf collimator. Carlos Reyes poses as patient.; PHOTO: Display shows how a beam of radiation is aimed on the cross-section of a patient's body. / RICARDO DeARATANHA / Los Angeles Times

Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.
Section: Metro; PART-B; Zones Desk
ISSN/ISBN: 04583035
Text Word Count 1258

Science journalism

http://poynter.blogs.com/narrative/mistakes_in_reporting/

http://www.sciencejournalism.net/commentary_hype_and_spin.htm

Monday, October 19, 2009

How to keep the quality of your iMovie work when compressing

How to keep the quality of your iMovie work when compressing
(Using the 2006 Version on OS X)

Thanks to Katie Bataille for sending these in.

1. When finished editing your work, first save what you have, then go to:
• Share (at the top) QuickTime

2. On the QuickTime tab, go to the
• Pull-down menu Expert Settings Share (there’s one more step before it actually starts compressing)

3. In the window that pops up (“Save exported file as…), select where you’d like to save the file, and make sure “Export” says Movie to QuickTime Movie and “Use” says Most Recent Settings.

4. BEFORE HITTING SAVE, select the Options button. A box called “Movie Settings” will pop up.

5. Check all boxes: Video, Sound, Prepare for Internet Streaming.

6. The list under VIDEO should be as follows (use the buttons on the left to adjust if necessary:
• Compression: H.264
• Quality: High
• Key frame rate: 24
• Frame recording: yes
• Encoding mode: multi-pass
• Dimensions: 720x480

7. The list under SOUND should be as follows (again, adjust with the settings button to the left)
• Format: Integer (Little Endian)
• Sample rate: 48.000 kHz
• Sample size: 16-bit
• Channels: Stereo (L R)

8. Under PREPARE FOR INTERNET STREAMING, the pull-down menu should be on
“Fast Start” (again, change with settings button to the right)

9. Click OK, the box should disappear. Click Save.
• Your work should automatically begin compressing with a progress bar.
• It should take much longer to compress (a two minute video on these settings takes about 10 minutes) than it would for CD-ROM or e-mail pre-set compression settings.

Cicero family watches house burn

http://www.syracuse.com/news/index.ssf/2009/10/cicero_family_watches_house_bu.html

For young mom, new CPR beat back death

http://www.cnn.com/2009/HEALTH/10/14/cheating.death.harden.cpr/index.html

New Science Journalism

http://www.newsciencejournalism.net/#

Solar Decathalon

http://www.cnn.com/2009/TECH/science/10/08/eco.solar.decathlon/index.html

http://www.cnn.com/2009/TECH/science/10/16/eco.solar.decathlon/index.html

Sandra Blakeslee

http://sandrablakeslee.com/articles2.php#

Digital journalist

http://www.digitaljournalist.org/

Making Sense of Science Reporting

http://www.washingtonpost.com/wp-dyn/content/article/2008/12/05/AR2008120502959.html

Blood Test, Statin Afford Potent Shield, Study Says

http://www.washingtonpost.com/wp-dyn/content/article/2008/11/09/AR2008110900852.html

Sheriff: Balloon hoax a publicity stunt

http://www.usatoday.com/news/nation/2009-10-17-balloon-boy_N.htm

Saturday, October 17, 2009

Mahala Gaylord videos

Some more examples of online/video journalism:

http://mahalagaylord.blogspot.com/2009/10/newsday-cranking-out-daily-video.html

Wednesday, October 14, 2009

Park Service Maps the Great Plains Fire History

Washington library destroyed by fire

Fire season strikes early in California

Selling Sickness: How Drug Ads Changed Health Care

Soda Tax Could Shake Up Industry

N.Y. Mandates Flu Shots For Health Care Workers

About press releases and e-mails

I need to talk about press releases and e-mails.

1) You need to understand that a press release represents only the first layer of reporting, gathering information that has been handed you. To accept what has been given to you without challenging it, without questioning it, is not journalism. To simply take what comes from a press release and regurgitate it into your story is lazy and deceptive to the public. They are counting on you to establish the facts for yourself, not to just be a secretary or a relay service for the public official. You need to ask questions. You need to find areas within the press release that must be challenged. And you need to attribute the facts given as coming from the press release.

2) The quotes included in a press release are not reliable quotes. You should be skeptical about using such quotes as if they came out of the mouth of the person that the press release says they came from. Why? Because usually they don't. What often happens is that an assistant, a PR rep or someone within the official's office is asked to generate a press release. They come up with quotes to put in the press release, and then ask the official to review it. The official looks at it, says, "That's fine with me," and the press release goes out without the words actually coming out of their mouth.

Some operations may be a little more ethical, where the assistant asks the official for a quote and the assistant writes it down. But the quote is still one that is sanitized and carefully crafted to express a safe point of view. You are not there in the room to challenge it or ask any kind of follow-up questions.

If you do get a press release that includes quotes, I would use them only in the rare case when you could not reach the person directly. And if you do use the quote, don't use the simple attribution: said. As in "This grant will be a boost to the economy of our fair and noble city," Mayor Joseph Jenkins said.

Instead, you need to write: "This grant will be a boost to the economy of our fair and noble city," Mayor Joseph Jenkins said in a press release. ... or said in a statement.

Let the public know that you did not talk to Joseph Jenkins personally.

The same goes for e-mails.

When you get an e-mail from a lawmaker's office, you are essentially getting a press release and you need to acknowledge that you did not gather this information yourself. Apply the same skepticism I've discussed above. You need to say it came from a press release or prepared statement.

Now, you may actually develop a reliable e-mail relationship with a source or official. Probably you established an in-person contact first, and then for efficiency sake, most of your contact is through e-mail.

You may be confident that the source wrote the e-mail themselves, but you still need to acknowledge that it came from an e-mail. Give the attribute as: "said in an e-mail" or "wrote in an e-mail."

Notes about the beat notes

By now, I have met with most of you about your beat notes. These are a critical tool for a journalist setting out to learn a new community. When you turn in your notes at the end of the semester, your beat notes will reflect how well you have learned this community of Ithaca.

In broad strokes, Ithaca is described as a hippie town or as a college town. The phrase I’ve often heard is “Ten square miles, surrounded by reality.”

There is much truth to that, but what I’ve tried to get across in our individual sessions is that the complexity of a community can’t be expressed in a bumper sticker.

So, in developing your beat notes, I’m asking that you work beyond the stories that you might have in front of you, to look for people to talk to who will help you understand the city and community of Ithaca and what makes it tick.

Everyone in this class needs to make an effort to get off campus and meet contacts who will help them understand the city more. If you are limited by a lack of transportation, my advice is to get out and ride the TCAT around the city. Don’t take it just to get to a destination. Ride it to get an overview and understanding of what the city is about. Look around and ask yourself: “Why is that like that?”

Then, can you find the people who can answer the question?

Above all -- BE CURIOUS!

Talk to the people on the bus. Find a conversation starter and start asking questions about what Ithaca is about. You’ll find there are people out there who live large parts of their lives without even thinking about the colleges or the hippie community.

Now, for the women in the class, you should exercise some caution. Unfortunately, the world is a more dangerous place for a woman than a man. My wife, who teaches self-defense for women, has explained that to me. You need to develop your instincts for danger. But at the same time, to function as a journalist, you need to get out and meet people. So, I would recommend a book called “The Gift of Fear” by Gavin DeBecker. Actually, both men and women need to read this book. More thoughts.

The book is very helpful for journalists and writers because it teaches you about reading body language and other cues that can give you insight into what someone is about to do. Noticing and gathering those details can also enrich your writing.

But, getting back to the beat notes, I would encourage that with everyone you talk to for the rest of this semester, try to find opportunities to ask about Ithaca. What do they think of it? What are the major issues in town? Then are there other people who would know more about those issues who you should talk to? Find an opportunity to ask about this in each interview, if that is practical.

By doing this, you should come up with excellent ideas for final projects.

But ultimately, you will develop the skills needed to learn a community.

This had been my strategy when I set out to cover Burbank, Calif., for the Los Angeles Times. I filled sheets of paper with typewritten and handwritten notes as I drove around the city, making contacts. (Later, I put them all in a computer file.) But I knew I had done enough when I started getting the same names recommended to me. I still kept collecting contacts, but by then I knew the major players, and I knew who I needed to call when a story broke. I also knew who I needed to call to check in with on a regular basis.

Later, I also covered parts of the east San Fernando Valley, and the heavily Latino populations there. I used the same strategy, and I also reached a moment when I knew I had worked the beat effectively.

I received a letter at the L.A. Times that told me how accepted I had become in this community. Not that acceptance is what you drive for as a journalist. Your goal is not to make everyone like you. (That typically fails, anyway.) You want to maintain a professional, respectful relationship with your sources. However, this letter let me know what this source thought of me. But it was not what was in the letter, actually. It was what was on the envelope.

It was addressed to “Ed Bondilla.”

“Wow! I’ve made it,” I said to myself.