Waiting Lists for Radiation Therapy: A Case Study

<p>Abstract</p> <p>Background</p> <p>Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions.</p> <p>Methods</p> <p>A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed.</p> <p>Results</p> <p>The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula.</p> <p>Conclusion</p> <p>Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.</p

Results, Old and New, in Computed Tomography

Introduction Computed tomography (CT) entails the reconstruction of a function f from line integrals of f . This mathematical problem is encountered in a growing number of diverse settings in medicine, science, and technology, ranging from the famous application in diagnostic radiology to recent research in quantum optics. As a consequence, many aspects of CT have been extensively studied and are now well understood, thus providing an interesting model case for the study of other inverse problems. Other aspects, notably three-dimensional reconstructions, still provide numerous open problems. The present article grew out of a series of tutorial talks given by the author at the IMA. In the spirit of such talks, it attempts to provide a brief introduction to the subject, highlight some aspects of general interest, sketch some recent developments, and point out references for further study. In practice only integrals over finitely many lines can b

TBP paralogs accommodate metazoan- and vertebrate-specific developmental gene regulation

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