Factors affecting the implementation of complex and evolving technologies: multiple case study of intensity-modulated radiation therapy (IMRT) in Ontario, Canada

<p>Abstract</p> <p>Background</p> <p>Research regarding the decision to adopt and implement technological innovations in radiation oncology is lacking. This is particularly problematic since these technologies are often complex and rapidly evolving, requiring ongoing revisiting of decisions regarding which technologies are the most appropriate to support. Variations in adoption and implementation decisions for new radiation technologies across cancer centres can impact patients' access to appropriate and innovative forms of radiation therapy. This study examines the key steps in the process of adopting and implementing intensity modulated radiation therapy (IMRT) in publicly funded cancer centres and identifies facilitating or impeding factors.</p> <p>Methods</p> <p>A multiple case study design, utilizing document analysis and key informant interviews was employed. Four cancer centres in Ontario, Canada were selected and interviews were conducted with radiation oncologists, medical physicists, radiation therapists, and senior administrative leaders.</p> <p>Results</p> <p>Eighteen key informants were interviewed. Overall, three centres made fair to excellent progress in the implementation of IMRT, while one centre achieved only limited implementation as of 2009. Key factors that influenced the extent of IMRT implementation were categorized as: 1) leadership, 2) training, expertise and standardization, 3) collaboration, 4) resources, and 5) resistance to change.</p> <p>Conclusion</p> <p>A framework for the adoption and implementation of complex and evolving technologies is presented. It identifies the key factors that should be addressed by decision-makers at specific stages of the adoption/implementation process.</p

Contextualizing students' alcohol use perceptions and practices within French culture: an analysis of gender and drinking among sport-science college students

Although research has examined alcohol consumption and sport in a variety of contexts, there is a paucity of research on gender and gender dynamics among French college students. The present study addresses this gap in the literature by examining alcohol use practices by men and women among a non-probability sample of French sport science students from five different universities in Northern France. We utilized both survey data (N = 534) and in-depth qualitative interviews (n = 16) to provide empirical and theoretical insight into a relatively ubiquitous health concern: the culture of intoxication. Qualitative data were based on students’ perceptions of their own alcohol use; analysis were framed by theoretical conceptions of gender. Survey results indicate gender differences in alcohol consumption wherein men reported a substantially higher frequency and quantity of alcohol use compared to their female peers. Qualitative findings confirm that male privilege and women’s concern for safety, masculine embodiment via alcohol use, gendering of alcohol type, and gender conformity pressures shape gender disparities in alcohol use behavior. Our findings also suggest that health education policy and educational programs focused on alcohol-related health risks need to be designed to take into account gender category and gender orientation

No Homo: Gendered Dimensions of Homophobic Epithets Online

We examine a case of homophobic language online, specifically the deployment of the phrase “no homo,” shorthand for “I’m not a homosexual.” An analysis of 396 instances (comprising 1061 individual tweets) of the use of the phrase “no homo” on the social media platform Twitter suggests that the phrase is a gendered epithet that conveys cultural norms about masculinity. The first finding is that the phrase is used more often by male tweeters than by female tweeters. The second, as predicted by the literature on homophobia, is that the phrase is used in a negative emotional context to convey disapproval for men’s homosexuality or behavior that is not gender normative. The third finding is that the modal use of the phrase “no homo” is in a positive emotional context, accompanying expressions of men’s pleasure, desire, affection, attachment, and friendship. Our analysis suggests that the phrase “no homo” is a gendered one, primarily used by men to facilitate a particularly masculinized construction of positive emotional expression. Our research adds to and complicates findings on the relationship between homophobia and masculinity that suggests that homophobia is an organizing principal of masculinity in western cultures