CT Image Electron Density Quantification in Regions with Metal Implants: Implications for Radiotherapy Treatment Planning

In radiotherapy planning, computed tomography (CT) images are used to quantify the electron density of tissues and provide spatial anatomical information. Treatment planning systems use these data to calculate the expected spatial distribution of absorbed dose in a patient. CT imaging is complicated by the presence of metal implants which cause increased image noise, produce artifacts throughout the image and can exceed the available range of CT number values within the implant, perturbing electron density estimates in the image. Furthermore, current dose calculation algorithms do not accurately model radiation transport at metal-tissue interfaces. Combined, these issues adversely affect the accuracy of dose calculations in the vicinity of metal implants. As the number of patients with orthopedic and dental implants grows, so does the need to deliver safe and effective radiotherapy treatments in the presence of implants. The Medical Physics group at the Cancer Centre of Southeastern Ontario and Queen's University has developed a Cobalt-60 CT system that is relatively insensitive to metal artifacts due to the high energy, nearly monoenergetic Cobalt-60 photon beam. Kilovoltage CT (kVCT) images, including images corrected using a commercial metal artifact reduction tool, were compared to Cobalt-60 CT images throughout the treatment planning process, from initial imaging through to dose calculation. An effective metal artifact reduction algorithm was also implemented for the Cobalt-60 CT system. Electron density maps derived from the same kVCT and Cobalt-60 CT images indicated the impact of image artifacts on estimates of photon attenuation for treatment planning applications. Measurements showed that truncation of CT number data in kVCT images produced significant mischaracterization of the electron density of metals. Dose measurements downstream of metal inserts in a water phantom were compared to dose data calculated using CT images from kVCT and Cobalt-60 systems with and without artifact correction. The superior accuracy of electron density data derived from Cobalt-60 images compared to kVCT images produced calculated dose with far better agreement with measured results. These results indicated that dose calculation errors from metal image artifacts are primarily due to misrepresentation of electron density within metals rather than artifacts surrounding the implants.

Patienters upplevelser av att vårdas på en akutmottagning : -en litteraturöversikt

Bakgrund: Vårdpersonalen på en akutmottagning har stora krav på sig, ansvar för många patienter och måste fatta många egna beslut, ibland med mycket kort betänketid. Vårdpersonalen möter många olika patienter med olika problem och personligheter, och måste bemöta varje patient så att denne känner sig bekräftad och sedd. Syfte: Syftet med litteraturöversikten är att undersöka patienters upplevelse av att vårdas på en akutmottagning. Metod: Artiklar till arbetet har söks i olika databaser. Aktuella artiklar har lästs och relevanta fynd har markerats, för att analyseras och sammanställa ett resultat. Resultat: Analysen resulterade i tre underrubriker: Information, Bemötande och Vårdmiljö, med uppdelning av positiva och negativa upplevelser. Många patienter var nöjda med vården, men hade låga förväntningar från början. Patienterna har förstående för personalens tuffa arbetsmiljö, men önskade att få bättre information om väntetid och undersökningar. De tyckte att väntetiden var för lång, och kände sig ofta ensamma och övergivna. Slutsats: Mycket behöver förändras för att patienterna ska få en mer positiv upplevelse av akuten. Detta arbeta kan hjälpa till att belysa vilka punkter som vården måste arbeta extra mycket med för att patienterna ska känna sig trygga, exempelvis bättre information om väntetider och ett bemötande där sjusköterskan ser hela patienten.

Sistema de informações para gestão ambiental

This Research Report presents the Environmental Management Information System, which has been planned for CEAMA - Center for Management and Environment. The System consists in the framework of data bases in the environment field, and the logic for information treatment. It has been developed to support current and future requirements of Center for Management and Environment in Escola de Administração de Empresas de São Paulo, Fundação Getulio Vargas (EAESP/FGV). The System was developed for Windows/Access environment and consists of a Main Data Base and a Thematic Data Base. The Main Data Base can store libraries, NGOs, Environmental Impact Reports, technical reports, companies and many other items. The Thematic one can contain several subjects related with environment, specifying the place or access form in which the data can be obtained. The Report also describes several environmental information systems, as a result of a survey that has been done as a part of the research project.

O usuário e os sistemas de informatização: a utilização do sistema de controle de operações da delegacia legal pelos policiais civis do Estado do Rio De Janeiro.

Organizar racionalmente as informações e sistematizá-las tem sido essencial para o sucesso de diversas empresas. Quando estudamos as instituições destinadas à segurança pública percebemos que o uso de tecnologia e de sistemas de informação são comuns nos exemplos bem sucedidos de combate às práticas criminosas. O Programa Delegacia Legal, inaugurado no Estado do Rio de Janeiro em 1999, acompanha essa tendência e tem como um dos seus pilares a importância ao tratamento da informação. Os policiais que fazem os registros das ocorrências nas delegacias utilizando-se do Sistema de informação (SCO) têm então um papel fundamental porque através desses registros são investigadas as infrações, assim como é alimentado um banco de dados mais completo para ser aliado na elaboração de estatísticas e na aplicação de ações estratégicas. Considerando que esse tipo de registro, utilizando sistemas de informação, alterou a rotina institucional, o presente estudo verifica se existe ou não resistência ao uso do Sistema – SCO, fazendo uma abordagem sobre o sistema de informação, o Programa Delegacia Legal, a cultura organizacional e a opinião dos policiais.

Pedagogia etnomatemática : ações e reflexões em matemática do Ensino Fundamental com um grupo sócio cultural específico

mongst the trends in Mathematics Education, which have as their object a more significant and criticallearning, is the Ethnomathematics. This field of knowledge, still very recent amongst us, besides analyzing an externalist history of the sciences in a search for a relationship between the development of the scientific disciplines and the socio-cultural context, goes beyond this externalism, for it also approaches the intimate relationships betwe_n cognition and culture. In fact, the Ethnomathematics proposes an alternative epistemological approach associated with a wider historiography. It struggles to understand the reality and come to the pedagogical action by means of a cognitive approach with strong cultural basis. But the difficulty of inserting the Ethnomathematics into the educational context is met by resistance from some mathematics educators who seem indifferent to the influence of the culture on the understanding of the mathematics ideas. It was with such concerns in mind that I started this paper that had as object to develop a curricular reorientation pedagogical proposal in mathematics education, at the levei of the 5th grade of the Ensino Fundamental (Elementary School), built from the mathematical knowledge of a vegetable farmers community, 30 km away from the center of Natal/RN, but in accordance with the teaching dimensions of mathematics of the 1 st and 2nd cycles proposed by the Parâmetros Curriculares Nacionais - PCN: Numbers and Operations, Space and Form, Units and Measures, and Information Treatment. To achieve that, I developed pedagogical activities from the mathematical concepts of the vegetable farmers of that community, explained in my dissertation research in the period 2000 through 2002. The pedagogical process was developed from August through Oecember 2007 with 24 students of the 5th Grade of the Ensino Fundamental (Elementary School) of the school of that community. The qualitative analysis of the data was conducted taking into account three categories of students: one made up of students that helped their parents in the work with vegetables. Another one by students whose parents and relatives worked with vegetables, though they did not participate directly of this working process and one third category of students that never worked with vegetables, not to mention their parents, but lived adjacent to that community. From the analyses and results of the data gathered by these three distinct categories of students, I concluded that those students that assisted their parents with the daily work with vegetables solved the problem-situations with understanding, and, sometimes, with enriching contributions to the proposed problems. The other categories of students, in spite of the various field researches to the gardens of that community, before and during the pedagogical activities, did not show the same results as those students/vegetable farmers, but showed interest and motivation in ali activities of the pedagogical process in that period

Aspectos da representação temática pela indexação de livros: análise de Assunto e suas concepções na diversificação de áreas do conhecimento em bibliotecas dos Institutos Federais de Educação, Ciência e Tecnologia (IF's)

Pós-graduação em Ciência da Informação - FFC

Proposta de formação em serviço como prática de educação continuada para bibliotecários catalogadores da Rede de Bibliotecas da UNESP

Pós-graduação em Ciência da Informação - FFC

Política de indexação na catalogação de assunto em bibliotecas universitárias: a visão sociocognitiva da atuação profissional com protocolo verbal

The indexing policy must be represented by means of a philosophy that reflects the system's aims. One of the aspects concerning the indexing policy is relating to the data retrospective conversion. The general aim is to discuss and make a profound study on indexing policy guidelines and to analyze the elements to set up an indexing policy, that should direct the indexing procedures carried out in university libraries using the methodology of verbal protocol. The results demonstrate that the indexing policy serves as a support for the knowledge organization in the catalog, acting as a guide for the librarian when determining the subjects of the documents described in the records. It is concluded that the indexing only will be carried out in the university library during the documentary information treatment by means of a well determined policy.

Recognizing and tagging temporal expressions in Spanish

This paper shows a system about the recognition of temporal expressions in Spanish and the resolution of their temporal reference. For the identification and recognition of temporal expressions we have based on a temporal expression grammar and for the resolution on an inference engine, where we have the information necessary to do the date operation based on the recognized expressions. For further information treatment, the output is proposed by means of XML tags in order to add standard information of the resolution obtained. Different kinds of annotation of temporal expressions are explained in another articles [WILSON2001][KATZ2001]. In the evaluation of our proposal we have obtained successful results.

Nutritional status and information needs of medical oncology patients receiving treatment at an Australian public hospital

This study aimed to identify: i) the prevalence of malnutrition according to the scored Patient Generated-Subjective Global Assessment (PG-SGA); ii) utilization of available nutrition resources; iii) patient nutrition information needs; and iv) external sources of nutrition information. An observational, cross-sectional study was undertaken at an Australian public hospital on 191 patients receiving oncology services. According to PG-SGA, 49% of patients were malnourished and 46% required improved symptom management and/or nutrition intervention. Commonly reported nutrition-impact symptoms included: peculiar tastes (31%), no appetite (24%) and nausea (24%). External sources of nutrition information were accessed by 37%, with popular choices being media/internet (n=19) and family/friends (n=13). In a sub-sample (n=65), 32 patients were aware of the available nutrition resources, 23 thought the information sufficient and 19 patients had actually read them. Additional information on supplements and modifying side effects was requested by 26 patients. Malnutrition is common in oncology patients receiving treatment at an Australian public hospital and almost half require improved symptom management and/or nutrition intervention. Patients who read the available nutrition information found it useful, however awareness of these nutrition resources and the provision of information on supplementation and managing symptoms requires attention.

Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs : results from a randomised, controlled trial

Background: High levels of distress and need for self-care information by patients commencing chemotherapy suggest that current prechemotherapy education is suboptimal. We conducted a randomised, controlled trial of a prechemotherapy education intervention (ChemoEd) to assess impact on patient distress, treatment-related concerns, and the prevalence and severity of and bother caused by six chemotherapy side-effects. Patients and methods: One hundred and ninety-two breast, gastrointestinal, and haematologic cancer patients were recruited before the trial closing prematurely (original target 352). ChemoEd patients received a DVD, question-prompt list, self-care information, an education consultation ≥24 h before first treatment (intervention 1), telephone follow-up 48 h after first treatment (intervention 2), and a face-to-face review immediately before second treatment (intervention 3). Patient outcomes were measured at baseline (T1: pre-education) and immediately preceding treatment cycles 1 (T2) and 3 (T3). Results: ChemoEd did not significantly reduce patient distress. However, a significant decrease in sensory/psychological (P = 0.027) and procedural (P = 0.03) concerns, as well as prevalence and severity of and bother due to vomiting (all P = 0.001), were observed at T3. In addition, subgroup analysis of patients with elevated distress at T1 indicated a significant decrease (P = 0.035) at T2 but not at T3 (P = 0.055) in ChemoEd patients. Conclusions: ChemoEd holds promise to improve patient treatment-related concerns and some physical/psychological outcomes; however, further research is required on more diverse patient populations to ensure generalisability.

Report on the 2014 UKONS Annual Conference Belfast, 14–15 November 2014: focus on living with and beyond cancer, patient information and support, and innovations in treatment and care

The UK Oncology Nursing Society’s (UKONS) annual conference focused on three major themes. These were ‘Living With and Beyond Cancer’, ‘Patient Information and Support’, and ‘Innovations in Treatment and Care’. It featured a wide range of presentations, industry satellites, exhibitions, poster discussions. and workshops. Presenters ranged from those eminent in their particular field to those gracing the speaker’s podium for the first time. The rich variety of presentations covered policy, cancer trends, clinical developments, care initiatives, personal development, and advances in practice. There was a strong emphasis on skills, knowledge, values, and attitudes, with the most junior and novice nurses mixing with experienced and highly esteemed practitioners.

Patients' information-seeking activity is associated with treatment compliance in inflammatory bowel disease patients.

Background. Despite the chronic and relapsing nature of inflammatory bowel diseases (IBD), at least 30% to 45% of the patients are noncompliant to treatment. IBD patients often seek information about their disease. Aim. To examine the association between information-seeking activity and treatment compliance among IBD patients. To compare information sources and concerns between compliant and noncompliant patients. Methods. We used data from the Swiss IBD cohort study, and from a qualitative survey conducted to assess information sources and concerns. Crude and adjusted odds ratios (OR) for noncompliance were calculated. Differences in the proportions of information sources and concerns were compared between compliant and noncompliant patients. Results. A total of 512 patients were included. About 18% (n = 99) of patients were reported to be noncompliant to drug treatment and two-thirds (n = 353) were information seekers. The OR for noncompliance among information seekers was 2.44 (95%CI: 1.34-4.41) after adjustment for confounders and major risk factors. General practitioners were 15.2% more often consulted (p = 0.019) among compliant patients, as were books and television (+13.1%; p = 0.048), whereas no difference in proportions was observed for sources such as internet or gastroenterologists. Information on tips for disease management were 14.2% more often sought among noncompliant patients (p = 0.028). No difference was observed for concerns on research and development on IBD or therapies. Conclusion. In Switzerland, IBD patients noncompliant to treatment were more often seeking disease-related information than compliant patients. Daily management of symptoms and disease seemed to be an important concern of those patients.

A comparison of methods for treatment selection in seamless phase II/III clinical trials incorporating information on short-term endpoints

In an adaptive seamless phase II/III clinical trial interim analysis, data are used for treatment selection, enabling resources to be focused on comparison of more effective treatment(s) with a control. In this paper, we compare two methods recently proposed to enable use of short-term endpoint data for decision-making at the interim analysis. The comparison focuses on the power and the probability of correctly identifying the most promising treatment. We show that the choice of method depends on how well short-term data predict the best treatment, which may be measured by the correlation between treatment effects on short- and long-term endpoints.

Flexible selection of a single treatment incorporating short-term endpoint information in a phase II/III clinical trial

Seamless phase II/III clinical trials in which an experimental treatment is selected at an interim analysis have been the focus of much recent research interest. Many of the methods proposed are based on the group sequential approach. This paper considers designs of this type in which the treatment selection can be based on short-term endpoint information for more patients than have primary endpoint data available. We show that in such a case, the familywise type I error rate may be inflated if previously proposed group sequential methods are used and the treatment selection rule is not specified in advance. A method is proposed to avoid this inflation by considering the treatment selection that maximises the conditional error given the data available at the interim analysis. A simulation study is reported that illustrates the type I error rate inflation and compares the power of the new approach with two other methods: a combination testing approach and a group sequential method that does not use the short-term endpoint data, both of which also strongly control the type I error rate. The new method is also illustrated through application to a study in Alzheimer's disease. © 2015 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.