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The purpose of this paper is to describe a jurisdiction-wide implementation and evaluation of intensity-modulated radiation therapy (IMRT) in Ontario, Canada, highlighting innovative strategies and lessons learned.

To obtain an accurate provincial representation, six cancer centres were chosen (based on their IMRT utilization, geography, population, academic affiliation and size) for an in-depth evaluation. At each cancer centre semi-structured, key informant interviews were conducted with senior administrators. An electronic survey, consisting of 40 questions, was also developed and distributed to all cancer centres in Ontario.

In total, 21 respondents participated in the interviews and a total of 266 electronic surveys were returned. Funding allocation, guidelines and utilization targets, expert coaching and educational activities were identified as effective implementation strategies. The implementation allowed for hands-on training, an exchange of knowledge and expertise and the sharing of responsibility. Future implementation initiatives could be improved by creating stronger avenues for clear, continuing and comprehensive communication at all stages to increase awareness, garner support and encourage participation and encouraging expert-based coaching. IMRT utilization for has increased without affecting wait times or safety (from fiscal year 2008/2009 to 2012/2013 absolute increased change: prostate 46, thyroid 36, head and neck 29, sarcoma 30, and CNS 32 per cent).

This multifaceted, jurisdiction-wide approach has been successful in implementing guideline recommended IMRT into standard practice. The expert based coaching initiative, in particular presents a novel training approach for those who are implementing complex techniques. This paper will be of interest to those exploring ways to fund, implement and sustain complex and evolving technologies.

The purpose of this paper is to continue studies previously reported with the primary focus of optimizing an inductor design. The potential benefits of hyperthermia for cancer therapy, particularly metastatic cancers of the prostate, may be realized by the use of targeted magnetic nanoparticles that are heated by alternating magnetic fields (AMFs).

To further explore the potential of this technology, a high‐throughput cell culture treatment system is needed. The AMF requirements for this research present challenges to the design and manufacture of an induction system because a high flux density field at high frequency must be created in a relatively large volume. Additional challenges are presented by the requirement that the inductor must maintain an operating temperature between 35 and 39°C with continuous duty operation for 1 h or longer. Results of simulation and design of two devices for culture samples and for in vitro tests of multiple samples in uniform field are described.

The inductor design chosen provides a uniform distribution of relatively high magnetic field strength while providing an optimal reduction in the voltage and power requirement. Through development of design and selection of magnetic concentrator, the exposure of the cell cultures to the heat generated by the inductor is minimized.

This method of generating uniform high AC magnetic fields in a large volume is beneficial for the study of hyperthermia in cells for a high throughput, necessary for cancer treatment research.

The purpose of this study is to investigate the motivational factors to work with cancer patients, their repercussions in job satisfaction among Portuguese healthcare professionals and to understand the role of sociodemographic and occupational variables in motivation and job satisfaction.

An instrument based on Maslow’s and Herzberg’s theories and developed by Paleologou et al. (2006) was applied to four categories of healthcare professionals. This instrument comprises four work-related motivators (remuneration, achievements, coworkers and job attributes) and a single-item question about job satisfaction. In total, 400 healthcare professionals in a Portuguese oncology hospital participated in this study.

Job satisfaction was positively and significantly associated with all motivational factors. Qualifications predicted all motivational factors, although the motivator “coworkers” was also influenced by age.

Motivation and job satisfaction are related, and some studies investigate the relation between them. However, these constructs are not sufficiently studied among healthcare professionals in oncology hospitals. This study shows that motivational factors to work in a cancer hospital are critical for job satisfaction among healthcare professionals. Moreover, qualifications predicted all motivational factors in this context.

The purpose of this paper is to evaluate the dosimetric properties of N-(3-methoxypropyl) acrylamide (NMPA) polymer gel dosimeter using UV-vis spectrophotometry as a simple and low-cost method.

The gel samples have been irradiated to various doses using a medical linear accelerator with 6 MV beam energy. The optical density of un-irradiated and irradiated NMPA polymer gel dosimeters in terms of absorbance at 500 nm was investigated by UV-vis spectrophotometry.

The absorbance values of the gel samples were increased linearly with increasing dose in the dose range between 2 and 20 Gy. A remarkable improvement in the dose response was noticed after the addition of various concentrations of glycerol. The impact of dose rate, beam energy and the post-stability of the exposed gels was studied and found consistent with the previous study using nuclear magnetic resonance results (energy independent and dose rate independent, stable up to one week).

The results of the independent experimental spectrophotometry and nuclear magnetic resonance analyses indicate that the NMPA polymer gel dosimeter has good and consistent dosimetric features for radiotherapy dosimetry.

The ionizing radiation-induced polymerization of gel samples leads to a change in the absorbance of the irradiated gel samples. This study introduces the first characterization of NMPA gel dosimeter by means of UV-vis spectrophotometer.

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

This paper aims to explore gender differences in payments made to physicians by the pharmaceutical and medical device industries via the performance of a systematic review of articles based on the Open Payments Database (OPD).

Three databases (Scopus, Web of Science and PubMed) were searched for articles published from September 30, 2014 to May 10, 2019, using two search terms: “Sunshine Act” and “Open Payments.” The systematic review is reported according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.

The search identified 359 abstracts. Thirty-nine articles were selected for full review, and 17 of these met the inclusion criteria. Although the articles considered are based on the same database, they adopt diverse approaches and analyses are conducted in different ways. A substantial proportion of the studies show total payments from the two industries to be higher for male physicians than for female physicians. However, a few exceptions exist, higher female mean or median values occurring for payments involving research, ownership, honoraria, grants, royalties/licenses and travel/lodgings. Also, in the case of obstetric–gynecological specializations, a higher proportion of women than men are shown to cooperate with the industries.

There is gender inequality in terms of industries’ funding for doctors. While analyses of secondary OPD data show that a gender inequality exists, they do not provide an understanding of why this occurs. However, from the exceptions identified, it can be speculated that this phenomenon is connected with greater adherence to ethical standards on the part of female physicians and/or the likelihood that fewer opportunities for industrial cooperation are extended to them.

Globally, cancer represents an increasing proportion of child mortality as progress against infectious causes is made. Approximately 400,000 children will develop cancer, each year, around the world. Only about half of these cancers will ever be diagnosed. In high-resource settings, 80% of children will survive, but only about 30% will survive in low-resource settings. Digital solutions have a valuable role in increasing health professional knowledge, skills and empowerment to diagnose, treat and otherwise care for children and adolescents with cancer. This review sought to identify digital resources that support the training and development of the paediatric oncology workforce in resource -poor settings.

This paper presents a narrative descriptive review of peer-reviewed publications and digital platforms that contribute to health professionals' education and training regarding paediatric oncology, particularly in rural and other low-resource settings.

Digital solutions were identified for building communities of practice, facilitating access to information and support and providing access to training, education and supervision specifically for paediatric oncology health professionals. A total of 33 resources are discussed in depth. A quality assessment of the digital resources is provided using the Currency, Relevance, Authority, Accuracy and Purpose (CRAAP) tool and suggestions to improve the quality of resources are discussed.

The authors anticipate that this summary of digital resources for the global paediatric oncology professional community will inform digital health investments and design of digital innovations to meet emerging needs and will have an impact on the workforce in the real world. Ultimately, this work will contribute to an improvement in the diagnosis and treatment of children and adolescents with cancer in resource-poor settings.

This is the first discussion and summary of digital education platforms which educate, train and offer support to health professionals with respect to paediatric oncology. These digital platforms are often aimed at, and are essential for, health professionals in rural and other low-resource settings.

Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem. Additionally, a considerable number of studies have introduced the ‘healing environment concept’ as a substantial input for healthcare buildings. The purpose of this paper is to present a design guide for cancer treatment services that is compatible with the healing environment concept.

In this context, studies on the healing environment have been analyzed, and the legislation of some selected countries has been assessed. Then, all the filtered data are used to form the design guideline for chemotherapy department, radiation oncology department and inpatient care services under a new series of analysis criteria.

The resulting principles are revealed according to the criteria of general settlement principles, internal function relations, medical necessities, user experience, interior design, social interaction/privacy, safety, landscape design and outdoor relations by the help of proposed plans, diagrams and schematic drawings.

This research constitutes the first and yet only study in its field that aims to increase efficiency and user satisfaction and provide better patient-centered care while providing a design guide on health-care architecture.