基于空间信息及灰度信息的塔型模糊聚类图像分割

对于二维灰度图像,基于灰度信息的图像信息熵分析法,由于没有考虑到图像的空间信息,存在着对图像信息描述不准确的问题。在进行图像分割时,若图像复杂到一定程度时,无法得到满意的效果。本文从空间信息和灰度信息出发,将图像的空间信息和灰度信息作为特征向量,对比较复杂的图像进行聚类分割,取得了满意的效果。经分析和实验验证,本文提出的基于空间信息和灰度信息的塔型模糊C-均值聚类（PFCM）图像分割方法与传统的非塔型聚类算法相比,具有收敛速度快、稳定性好等优点。同时,由于对初始聚类中心的合理初始化,消除了聚类分析中常见的死点问题。     

Family members' experiences, information needs and information seeking in relation to living with a patient with oesophageal cancer

A qualitative study was conducted with the aim to describe family members' experiences, information needs and information seeking in relation to living with a patient suffering from oesophageal cancer. Data were collected by means of semi-structured interviews with nine family members. A content analysis was used in order to organize data. It was found that family members were not aware of the severe diagnosis and the illness caused intrusions on the family. The time following diagnosis family members' information seeking was low. They used interpersonal as well as mass media sources to obtain knowledge about and handle the uncertainty related to the illness. Some family members did not actively seek information. In conclusion, healthcare professionals are expected to improve quality of cancer care. These improvements are unlikely to occur without an understanding of family members' needs. This study shows that the family members were unprepared of receiving a diagnosis of oesophageal cancer. They emphasized the importance of including the children in the care given. Moreover, the whole family was faced with uncertainty, which led to intrusion on everyday life. Therefore, family members used different strategies for managing the uncertainty, whereof one was searching for information. The primary source of information was the physician.     

Treating people with information: an analysis and review of approaches to communicating health risk information

The communication of risk information is a fundamental aspect of nearly all health promotion interventions. However, no consensus exists regarding the most effective way to provide people with risk information. We will review and evaluate the relative merits of two approaches to risk communication. One approach relies on the presentation of numerical information regarding the probability of a health problem occurring, whereas the other relies on the presentation of information about the antecedents and consequences of a health problem. Because people have considerable difficulty understanding and using quantitative information, the effectiveness of interventions that rely solely on numerical probability information has been limited. Interventions that provide people with a broader informational context in which to think about a health problem have had greater success systematically influencing perceptions of personal risk but have several important limitations. However, before any final conclusions can be drawn regarding the relative merits of different communication strategies, investigators must agree on the specific criteria that should be used to identify an effective intervention.     

Perceived need for information among patients with a haematological malignancy: associations with information satisfaction and treatment decision‐making preferences

For patients with haematological malignancies, information on disease, prognosis, treatment and impact on quality of life is of the utmost importance. To gain insight into the perceived need for information in relation to sociodemographic and clinical parameters, comorbidity, quality of life (QoL) and information satisfaction, we compiled a questionnaire based on existing validated questionnaires. A total of 458 patients diagnosed with a haematological malignancy participated. The perceived need for information was moderate to high (40–70%). Multivariate regression analyses showed that a higher need for information was related to younger age, worse QoL, being member of a patient society and moderate comorbidity. The need for disease and treatment‐related information was higher than the need for psychosocial information. A higher need for disease and treatment‐related information was associated to being diagnosed with multiple myeloma. A higher need for psychosocial information was related to a lower educational level. The information provision could be improved according to 41% of the patients. Higher satisfaction with provided information was associated with better QoL. Most patients (62%) reported that they wanted to be fully informed about their illness and actively involved in treatment decision‐making. The results contribute to improving patient‐tailored information provision and shared decision‐making in clinical practice. Copyright © 2014 John Wiley & Sons, Ltd.     

Application of information theory and extreme physical information to carcinogenesis

Cellular information dynamics during somatic evolution of the malignant phenotypes are complex and poorly understood. Accumulating, random genetic mutations and, therefore, loss of genomic information appears necessary for carcinogenesis. However, additional control parameters can be inferred because unconstrained mutagenesis would ultimately produce cellular information degradation incompatible with life. Similarly, the stability of some genomic segments, such as those controlling proliferation and metabolism, indicates the presence of selective mutational constraints. By applying Information Theory and Extreme Physical Information (EPI) analysis, we demonstrate that the phenotypic characteristics and growth pattern of cancer populations are emergent properties resulting from the nonlinear dynamics of accumulating, random genetic mutations and tissue selection factors. Maximum quantitative loss of transgenerational information is demonstrated in genomic segments encoding negative or neutral evolutionary properties. This is most evident in the progressive dedifferentiation observed during carcinogenesis and may terminate in a differentiation "information catastrophe" producing decoherent cellular morphology and function. In contrast, microenvironmental selection pressures preserve genomic information controlling properties that confer selective growth advantages even in the presence of a high background mutation rate. Thus, phenotypic traits characteristically retained by tumor populations can be identified as critical selection parameters favoring clonal proliferation. The information model of carcinogenesis is tested by applying EPI analysis to predict tumor growth dynamics. We found that cellular proliferation attributable to information degradation will produce power law tumor growth with an exponent of 1.62. Data from six published studies that use sequential mammograms to measure the volume of small, untreated human breast cancers demonstrate power law tumor growth with a mean exponent value of 1.73 +/- 0.23. Other predictions including exponential growth of tumor cells in vitro are also supported by experimental observations. The nonlinear dynamics of stochastic information loss constrained by somatic evolution indicate that carcinogenesis will not be associated with any predictable, fixed sequence of genomic alterations. Rather, sporadic clinical cancers are emergent structures produced by multiple, fundamentally nondeterministic genetic pathways.     

Use of information resources by patients with cancer and their companions

BACKGROUND: Use of the Internet is common among patients with cancer and their companions. However, little is known about patterns of use of print or telephone-based resources amidst growing Internet utilization, nor is it known whether different types of information are sought from electronic compared with print media. It is not clear as to whether patients and their companions differ in their patterns of content seeking. METHODS: A survey was developed to evaluate the use of electronic and nonelectronic informational resources by patients and their companions. During a 10-week period, this questionnaire was administered to 443 outpatients and 124 paired companions attending an urban academic cancer center. RESULTS: In this cohort, 64% of patients and 76% of companions were computer owners, with home Internet access indicated by 58% and 68%, respectively. Use of the Internet to obtain cancer-related information was reported by 44% of patients and 60% of companions. Print resources were used by 79% of patients and 83% of companions, with telephone resources used by 22% and 23%, respectively. The majority of Internet users also read print content (85%), whereas one-half of print users did not access data electronically (52%). Topic areas sought via print and the Internet were similar, with the exception of nutrition-related information, which was more commonly sought in print texts. There was a high rate of concordance between patient and companion use of both electronic and nonelectronic resources. CONCLUSIONS: Despite recent publicity and scrutiny focusing on the quality of Internet health care content, print products remain the most common source of information sought by patients with cancer. Future investigation should focus on the quality of print products used by patients.     

Health literacy and the provision of information to women with breast cancer

Aims

Health literacy and functional health literacy are important for patients with cancer, as key information regarding treatment complications and clinical trials is often imparted using written educational material. This study measured the health literacy and functional health literacy levels in a population of women with breast cancer and compared these with the level of written information provided.

Materials and methods

A cross-sectional survey of women with stage I-III breast cancer attending an outpatient clinic was conducted. Health literacy levels were assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM) score and functional health literacy was assessed using three validated screening questions. Patient education materials were assessed using the Simple Measure of Gobbledygook (SMOG) and Flesch Reading Ease (FRE) systems.

Results

One hundred and twenty-seven women were recruited. For patients, the mean REALM score was 64.3 (≥US 9th grade/reading age 14 years). The mean SMOG score of patient education materials was 80.5 (reading age 17 years). The mean FRE score of patient education materials was 55.7 (reading age 15-17 years). All patient information sheets assessed were written at ≥8th grade (reading age 13 years) and as a result up to 9% of patients would be unable to read them. Nineteen per cent of the population had inadequate functional health literacy.

Conclusions

Health literacy levels were high in the population studied. However, the reading level of written patient information was also high, meaning that up to 9% of patients would be unable to read the information provided. Functional health literacy levels were lower, with 19% of patients having inadequate ability. This means that although most patients are able read the information sheets provided, there is a larger proportion that would be unable to understand and act upon this information. Patient education materials should be written at an appropriate level and different modalities of communication should be used to ensure adequate comprehension.     

多技术集成的放疗信息系统开发与应用

目的 根据科室在多院区发展的需要设计开发简易的放疗信息系统。方法 采用C/S+B/S双技术架构,编程工具选择Visual Studio 2015+C#+HTML5+JavaScript+PostgreSQL9.5进行开发,将二维条码、智能IC卡、身份证识别、人脸识别、语音合成等技术集成并应用于放疗流程管理中,对正常业务流程都设计了默认自动处理,将往常需要多步的操作简化为一键操作。结果 2017年底系统开发完成并实施,连接南、北两个院区,不仅解决了医生查阅患者资料需要人工输送或者打电话的难题,而且实现科室业务流程的无纸化,突出优势是在智能和优化方面做得细致,约95%的正常流程都一键自动处理,另外5%的特殊操作(例如修改或删除等)做了提示和权限限制,确保了数据安全和系统稳定。结论 系统的应用提升了科室信息化管理水平,节约了耗材资金和人力资源成本。     

Adjustment to cancer and the information needs of people with lung cancer

Objective: Although typically high, the need for information varies between cancer patients. Few studies, however, have examined the factors that predict patient information needs. This study investigated the influence of different styles of adjustment to cancer on information needs. It was proposed that adjustment styles can be defined in terms of goal pursuit and that adjustment influences information needs as these also arise from goal pursuit. Method: Seventy‐three lung cancer patients were recruited at their first appointment with their radiation oncologist. Participants completed the Patient Information Needs Questionnaire measuring Disease Orientated (DO) information and Action Orientated (AO) information, the Mini‐Mental Adjustment to Cancer Scale, and a purpose‐built measure of cancer‐related personal goals. Results: High levels of the adjustment styles, Fighting Spirit and Anxious Preoccupation, were related to a high need for DO information (p=0.042 and 0.023, respectively). Conversely, high levels of the adjustment style Cognitive Avoidance was related to a low need for DO information (p=0.041). High levels of Anxious Preoccupation were also positively related to a high need for AO information (p=0.018). Support for the proposed theoretical model was also found: information goals predicted information needs and mediated the relationship between Fighting Spirit and DO information need. Conclusions: These findings suggest that information needs vary as a function of adjustment to cancer. Consequently information provision to cancer patients could be more appropriately tailored by attending to how a patient is adjusting to their diagnosis of cancer. Copyright © 2010 John Wiley & Sons, Ltd.     

Inaccurate diagnosis information in patients with cancer: quality and associated factors

Purpose

The objective of this study is to determinate the relationship between the accurate information related to the diagnosis and the information that the patients know about it

Methods

Three questions were asked to the patients:a. What kind of disease do you have?b. Who told you the diagnosis?, andc. Where did they give you the information? We have analyzed the presence of associated factors to an inaccurate information in 150 patients with cancer attended for the first time in a medical oncology department referred from clinical and surgical departments. The quality of information has been defined as the relationship between the patients information about their diagnosis and the accurate information about it, being the incorrect and unspecific information the inaccurate information.

Results

There were 50.7% of men, with a range of 23 to 82 years old; 102 (68%) patients had an inaccurate information about their diagnosis. Logistic regression analysis showed that older patients (odds ratio = 1.07; p = 0.001; 95% Confidence Interval = 1.02-1.11) and patients with ovarian cancer (odds ratio = 7.08; p = 0.033; 95% Confidence Interval = 1.17-42.71) were more likely to have an inaccurate information.

Conclusion

Then, the sociodemographic characteristics of the patients and the type of cancer affect the information given to the patients by the physicians. These results indicate that the patients referred to the medical oncology department have an incomplete information about their diagnosis.