Current Alberta radiation therapy care practices for patients with obesity and recommendations for improvement.

INTRODUCTION: Obesity has been associated with increased incidence of cancer thereby impacting the number of patients with obesity who may require radiation therapy (RT) treatment. Previous studies have detailed the impacts of obesity on RT treatment delivery including considerations when positioning, imaging, and communicating with patients. However, there is limited literature regarding best clinical practices used by Canadian RT departments when treating patients with obesity. This study aimed to answer the following question: How can the current standards of care (SOC) used by Alberta RT departments be improved to ensure safe and quality care of patients with obesity? METHODS: Semi-structured interviews were conducted with 19 practitioners including three RT managers, two medical physicists, two clinical educators, two radiation oncologists, a senior practice lead, and nine radiation therapists from five cancer centers across Alberta. Interviews were transcribed and analyzed independently by two researchers and used to inform recommendations for improvement to existing care practices. RESULTS: Four themes emerged as unique considerations for patients with obesity undergoing RT, which included technical factors, interpersonal interactions, patient care factors, and education and training. Recommendations to improve the current SOC in Alberta RT departments included the need for longer appointment times, sufficient staff, accessible mobility equipment, and additional education and training for HCPs tailored towards patients with obesity. CONCLUSION: SOC in Alberta could be improved for patients with obesity with modified appointment time, increased staff and resources, and more in depth and tailored education. Implementation of these considerations and recommendations for improvement to the current SOC used by Alberta RT departments has the potential to ensure safe and quality care of patients with obesity.

Understanding Indigenous peoples experiences to inform recommendations for improving cultural safety and care in radiation therapy centres in Alberta, Canada.

INTRODUCTION: Rates of common cancers are continuously increasing among Indigenous peoples and are above the incidence rates of non-Indigenous Canadians. When considering the intersecting social determinants of health such as culture, geography, funding, and access to basic health services, these all contribute to the unique cancer burden faced by Indigenous people. Indigenous patients sometimes feel alienated by the word "cancer", intimidated in the oncology setting and often avoid or delay seeking care, bypass screening and preventative care, and cease prescribed treatment before it is finished. Providing culturally competent, safe care to improve Indigenous health outcomes have been suggested and prioritized in health care systems across Canada. METHODS: Using an Indigenous methodology, sharing circles were held in Northern Alberta, Canada. Five Indigenous survivors of cancer and two Indigenous caregivers shared their experiences with oncology treatment in the radiation therapy centre. Results were transcribed verbatim and thematic analysis was conducted. RESULTS: This resulted in four main themes (1) historical and cultural understandings (2) reduce systemic harm by having dedicated Indigenous staff, cultural competency, and Indigenous specific supports (3) meaningful time commitment and relationship building (4) importance of kinship and Indigenous-centred, family-and-patient-centred care. These themes fed into the development of nine recommendations for policy and decision makers to improve cultural safety in the Alberta radiation therapy centres. CONCLUSION: Support for Indigenous patients and caregivers is essential to improve care in the radiation therapy centres. The findings from this work will support recommendations for health decision and policy makers within radiation therapy centres, which may be transferable to other centres within oncology and health.

A scoping review of patients as partners in undergraduate allied health curriculum: How are they involved?

INTRODUCTION: Patient participation in undergraduate education has been proven to contribute to student skills development complementing their didactic training. An increasing number of educational programs have implemented systematic patient engagement in curriculum to comply with the requirements of professional and regulatory bodies and to ensure greater focus on patient care. This scoping review aims to identify and summarize literature on the integration of patients and associated benefits in undergraduate allied health education programs. METHODS: This scoping review was conducted using a comprehensive literature search of the electronic databases MEDLINE, EMBASE and CINAHL. The study was carried out and reported using the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidance for Systematic reviews and Meta Analyses. Inclusion criteria included English language and allied health education. Exclusion criteria were outside the date range of 2011 to 2023, non-allied health programs, and clinical exposure during didactic courses. Literature reviews and commentaries were also excluded. RESULTS: A total of nineteen studies were included in the scoping review. The majority of these papers examined undergraduate programs that engaged patients in curriculum delivery while a few involved patients in feedback delivery and formal assessment. Other forms of patient involvement were through curriculum co-design. Across institutions, evidence suggested the benefits of patient involvement to students, patients, and educational programs for improved delivery of person-centred care. CONCLUSION: Patient involvement in curriculum delivery and student assessment provided valuable teaching and learning experiences for students and patients. Patient engagement also ensured that person-centered care principles were integrated into education programs. Summary of findings are provided to better prepare patients and facilitators for their role and to enhance the benefits to all participants.

Mind the gap: Gender disparities in authorship in the Journal of Medical Imaging and Radiation Sciences.

INTRODUCTION: Research studies tracking gender and academic publication productivity in healthcare find gender disparities in research activity, publication, and authorship. Article authorship is one of the important metrics to track when seeking to understand gender inequality in academic career advancement. Research on gender disparities in publication productivity in the field of Medical Radiation Science (MRS) is very limited thus this study analyses and explains potential gender differences in article authorship and acceptance for publication in the Journal of Medical Imaging and Radiation Sciences (JMIRS) for a 5-year period (2017-2021). METHODS: Gender was inferred based on the author's first name or title (e.g., Mr, Mrs or Ms). For those who left the title blank or reported as 'Dr' or 'Prof,' a series of steps were taken to identify their gender. Where gender was impossible to ascribe, these authors were excluded. Descriptive and inferential statistics are reported for the study population. Descriptive and inferential statistics are used. Percentages of females are reported, and males constitute the other portion. Chi-square, slope analysis and z-tests were used to test hypotheses. RESULTS: Results show that female authorship overall and in all categories of authorship placement (i.e., first, last and corresponding) increased over the timeframe reviewed. The percentage gain in the increase was higher than that for male authorship. However, male authorship started from a higher baseline in 2017 and has also increased year on year and overall, as well as in each placement category examined. More female authors were in the MRS sub-specialism Radiation Therapy (RT) than in the other MRS sub-specialisms. Analysis of the acceptance rate of articles with female authors shows a weak downward trend, and this may be related to higher submission and acceptance rates of articles by male authors during the same period. CONCLUSION: Male authors are overrepresented in all categories, which raises questions about the persistence of gender disparities in JMIRS authorship and article acceptance. Positive trends in female authorship indicate progress, yet there is the persistence of the significant under-representation of women in the Medical Radiation Sciences workforce in academic publishing. Recruiting more males to address the gender imbalance in the profession should not be at the expense of females' career progression.

Social accountability and improving care for sexual and gender diverse patients.

Social Accountability (SA) in healthcare includes understanding and responding to how social determinants affect patient health. Altruistic healthcare professionals can improve socially accountable patient care at the individual patient or family level (micro), the population or community level (meso), and/or provincial, federal, or international levels (macro). There is a well-established healthcare equity gap for Sexual and Gender Diverse (SGD) people affected by cancer. In this article, I discuss how SA has played a role in my career. As a SGD healthcare professional, I offer some personal examples of SA in action that have made a difference. For socially accountable healthcare professionals, there is almost always something to contribute to improve care, from the patient to the policy level.

Narratives in the Journal of Medical Imaging and Radiation Sciences: Publishing stories in an academic journal.

Healthcare narratives can be used for education to elicit an emotional or affective response, develop critical thinking, and gain perspective on individuals' experiences with life and illness to cultivate person-centered care. This editorial describes the recent experience of the Journal of Medical Imaging and Radiation Sciences (JMIRS) in developing a new narrative submission format. The processes of engaging and supporting patient authors as well as creating a more accessible submission and review process are presented. Finally, the paper discusses the emerging impact of published narratives and the benefit of working with patients as experts and authors.

Letter in response to Laing et al., "An evaluation of radiation therapy patient body mass index trends and potential impact on departmental resource planning".

"An evaluation of radiation therapy patient body mass index trends and potential impact on departmental resource planning" by Laing et al. The authors' comment that research into the experiences of larger bodied patients should focus on compassionately improving care for this patient population rather than framing large-bodied patients as a burden or problem, and should include commentary on the effects of weight-bias in the healthcare system.