 diagnostic testing or treatment is best for that patient. Many clinical physicians feel that in order to have a financially viable practice, it is necessary to have income streams derived from patient testing.
The risk to the physician-owner of such a venture is minimal, since the physician-owner has it in his power to increase the volume of scans to any point necessary to insure profitability.
Defense of the practice of self referral is often rationalized and cloaked in a single word, "convenience". The self-referring physician claims that he or she performs the examination in the office strictly for the convenience of the patient. This is the primary explanation for self referral. However, the convenience argument does not justify unnecessary exams, increasing medical costs to society, or the absence of peer-reviewed quality imaging performed for the sake of profit. Often, the patient cannot be seen by the physician on the same day the study is performed, negating the argument.
**From the Dept. of Health & Human Services concerning tests covered under Stark law:
:
physical therapy;
occupational therapy;
radiology services;
radiation therapy services and supplies;
durable medical equipment and supplies;
parenteral and enteral nutrients, equipment and supplies;
orthotics, prosthetics, and prosthetic devices and supplies;
home health services;
outpatient prescription drugs; and
inpatient and outpatient hospital services."Inkline creates a beautiful adventure platformer with Ayo: A Rain Tale (Ayo), which sets out to increase awareness about the harsh and dangerous conditions girls and women in Africa face everyday when fetching water for survival. You play as Ayo, a girl who is sent on the perilous journey of H2O retrieval, and the many challenges you face underway are metaphorical for the real challenges that millions of people face every day in the real world.
As beautiful as the message behind Ayo is — that something should be done to help ease or eliminate the daily struggles people face to retrieve water — it is also equally beautiful on the surface. I love the style of the vibrantly colored objects in the forefront contrasting with the scenic, desert landscapes in the background. Each level has its own distinctive elements, so there is a pleasant amount of variation. I found myself looking forward to advancing to the next level partly just to see what it would look like.
One way the player experience could be improved is how the camera zooms in and out without any way to control it: if you move your character into a small space, the camera sometimes zooms in super close, only to zoom back out once you move back out into a larger space. The constant zooming in and out was irksome and it and even made me a little queasy. The camera is otherwise stable, though, so I was able to pull through.
Still, I would much prefer if there was a way to zoom yourself, or if the camera stayed at a constant distance the whole way through. There were times when it was inconvenient to have the view zoom in close, because I couldn’t see where the next platform was to jump to, or keep an eye out for monsters to evade. A few times, the zooming caused me to die, which was frustrating because it was outside of my control.
A seemingly impossible task… by design?
One great aspect of the game is that it constantly changes as you advance, unlocking special powers such as digging or jumping super high. These new tricks change how you play, so you likely won’t feel like you’re so used to the mechanics that it gets boring.
There are some weirdly difficult maneuvers you are expected to pull off occasionally. Difficult obstacles pop up after easy ones seemingly at random, which can be confusing. I spent quite a bit of time simply thinking there was no possible way to make progress in the third level and feeling very confused, until I finally pulled off an extremely tricky move that I wasn’t even sure was possible. Perhaps this is intentional and metaphorical, as it requires that you persevere in the face of a seemingly impossible task — but if that is the case, I think it is still too difficult as it hinders enjoyment of the game.
I played Ayo for three hours and reached roughly the halfway point. In each level there are water droplets for you to collect that can be easy to overlook or difficult to obtain, so there’s material for several playthroughs. Indeed, you might have to replay some levels multiple times anyway if you want to achieve the perfect score by collecting all of the water.
Ayo shares with its audience a sincere message encapsulated by game, and continues the progression we have seen recently of video games used as a vehicle beyond the immediate capacity for ‘interactive entertainment.’ Despite a clunky camera and some problematic puzzles, this platformer boasts a solid foundation, with promise of several hours of enlightening fun.London Journal - Day 18 -???
London Journal - Day 18 - Shrines and Casket Casts
Leicester Square again this morning. Score: Stalls, row H seat 5 for Cabaret! I’ve been needing a musical, after all of the heavy dramas I’ve seen of late. Not something too light, mind you. No, some singing Nazis ought to do the trick.
Then back onto the Piccadilly line to South Kennsington to visit the Andipa gallery for a rare exhibit of Banksy. South Kennsington is posh territory. A detached home in Kennsington just sold for £80million if the papers are to be believed, making it the most expensive home sale in the world up till now (not for long, we are assured, there’s a £95m offer in the works nearby). The streets from the tube stop to the gallery are lined with exclusive shops and galleries. The odd piece in all of this is the Michelin House and Beidendum (below). It is a lovely building, but as if someone erected a grand McDonalds museum on Park Avenue in the 50’s in Manhattan.
This shrine to the bulbous rubberman is charming, in its own way, and the Art Nouveau style is right up my alley. Out of place here, though.
From that shrine to commercial success of a century ago I went to a shrine to commercial success just as unlikely, in setting and style. Banksy is a street artist, a graffiti talent who can do with a stencil, paintcan and boundless wit what few other artists in the contemporary realm can. He can engage a larger public, as Warhol did, but he can provoke them to think and talk about larger issues, something Warhol I don’t think ever really tried to do.
The comparison with Warhol is not incidental, I think Banksy seeks this comparison. He has even cribbed from Warhol in pursuit of his own mark on the world of Pop Art. Where Warhol sought out and craved attention, however, Banksy is so elusive that there is no documentation on who he even really is — no name, no confirmed sightings, and no retail chain of evidence connecting him to the sales of his works.
The show was marvellous, there were about 20 or so works in all, none of them direct from the artist but instead from the secondary market. Some are literally pieces of walls removed from buildings. The prices ranged from £10,000 to £250,000 each, and ¾ of the show was sold already, even though it had opened just an hour before I arrived. The piece above (not a photo from the show, but this piece was in the show) was tagged at £25,000 or so. All told there was about $10 million worth of work sold in a few hours, if the gallery folk are to be believed. I heard one on the phone with a reporter, which conversation leaves me in some doubt as to his veracity, however.
Ah yes, shrines. They are fungible things, as my next stop revealed. The Victoria & Albert Museum has two entire galleries devoted to the Cast Courts, which are an oddity in that they are collections of plaster castings of burial crypts, statuary, etc. from various royal courts. So, if you want to admire the replicas of actual historic artefacts, now made historic themselves by dint of their being displayed for so long at the V&A, have at it. This kind of reflected significance is lost on me. Unfortunately, the ceramics, musical instrument and several other galleries were closed for various reasons, leaving the V&A a disappointment for me. Onward!
Oh, but first, here is a passage that struck me, from a replica of a monument for Emily Georgiana Countess of Winchilsea and Nottingham:
I
When the knell rung for the dying
soundeth for me
and my corse coldly is lying
neath the green tree
II
When the turf strangers are heaping
covers my breast
Come not to gaze on me weeping
I am at rest
III
All my life coldly and sadly
The days have gone by
I who dreamed wildly and madly
am happy to die
IV
Long since my heart has been breaking
Its pain is past
A time has been set to its aching
Peace comes at last
E.G.W.& N.
Call me sentimental (big surprise there) I like it. The countess died young, just 39 years, and had suffered the last of them. So, this was her parting gift to her husband. The beautifully sculpted monument by Lawrence Macdonald was his gift to her.
The next stop was the Science Museum and the new Listening Post exhibit. This is a wonderful piece, a visionary synthesis of technology into art. It is an enveloping