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The increased use of C-arm fluoroscopy in interventional pain management has led to higher radiation exposure for pain physicians. This study investigated whether or not real-time radiation dose feedback with coaching can reduce the scatter dose received by pain physicians. Firstly, phantom measurements were made to create a scatter dose profile, which visualizes the average scatter radiation for different C-arm positions at 3 levels of height. Secondly, in the clinical part, the radiation dose received by pain physicians during pain treatment procedures was measured real-time to evaluate (1) the effect of real-time dose feedback on the received scatter dose, and (2) the effect of knowledge of the scatter dose profile and active coaching, on the scatter dose received by the pain physician. The clinical study included 330 interventional pain procedures. The results showed that real-time feedback of the received dose did not lead to a reduction in scatter radiation. However, visualization of the scatter dose in a scatter dose profile and active coaching on optimal positions did reduce the scatter radiation received by pain physicians during interventional pain procedures by 46.4% (P = 0.05). Knowledge of and real-time coaching with the scatter dose profile reduced the dose of pain physicians by half, caused by their increased awareness for scatter radiation and their insight into strategic positioning.

This article explores the use of design thinking as a method to develop scenario for the future of hotels. Using a Dutch case study, this article shows how a new concept for hotels -the Lifestyle Hub -was created using design thinking as methodology. The Lifestyle Hub concept provides ingredients to hotel owners as well as public policymakers to help understand how future guests may expect to make use of individually tailored hospitable facilities in destinations around the world. Moreover, design thinking allows researchers and businesses to generate highly differentiated customer-centred, experiencebased business concepts, thus adding to the toolkit of futures researchers. We conclude that design thinking provides new insights for hospitality and tourism and presents a valuable alternative to current future scenarios approaches.

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