Search

The school environment has been often identified as a prosperous venue for public health improvement. This study is a cluster randomized controlled trial evaluating the impact of a school-based helmet promotion program on knowledge, attitudes and practices of eligible adolescent drivers. Four public, four private and four vocational high schools situated in Attica, Greece, were sorted by type and randomly assigned to receive a 1-month intervention, based on the concepts of the Health Belief Model, or serve as controls. Self-report data were collected at baseline from 741 second grade students (16 years) and immediately after program completion. Linear mixed models with random student effects were used to estimate mean changes in scores for each treatment group and corresponding between groups differences of changes. Likelihood-based analysis showed that the intervention yielded a significant improvement in knowledge about helmet use. Yet, its impact on attitudes and practices appeared to vary across different school types. With current research offering ambiguous results on the appropriate timing of injury prevention efforts, this study suggests that educational programs targeting road safety can lead to positive changes if tailored to the needs of specific population groups and implemented during critical life periods, such as the transition to driving status.

Primary care settings seem to represent a unique opportunity for the early detection of Intimate Partner Violence (IPV), especially in rural areas, as they are more readily accessible to patients [...], The study explored the perceptions and practices of general practitioners (GPs) regarding the identification and management of victimized patients in primary care settings. A qualitative study was conducted employing three focus groups and a total of 18 GPs drawn from Greek General Practice Networks. Participants discussed issues of identification, assessment, recording, and referral of victimized patients at their clinical setting. Important points raised were the role ambiguity in the management of the victimized patients, the lack of confidence in diagnosing the problem, the discomfort in discussing Intimate Partner Violence (IPV) with their patients, the mistrust in the referral services, and the confidentiality issues affecting their recording practices. This preliminary information is expected to guide large-scale surveys and future interventions. Keywords Intimate partner violence * IPV * Primary care * General practitioners * Abuse * Perceptions * Practice

Introduction: A scoping review was conducted to understand which environmental factors are currently being discussed as candidates for inclusion in health technology assessments (HTAs). By mapping the current literature, the results of the scoping review will inform future work to assess the importance policymakers place on aspects of environmental concern. Methods: The scoping review involved literature searches across three electronic databases (MEDLINE, CINAHL, and PsycINFO), encompassing articles published up to the end of 2023, to identify a starting set of articles. Backward and forward citation searching of relevant studies was then employed to expand the scoping review, with inclusion criteria established to select studies based on the specific focus on HTA. Screening was conducted independently by two reviewers in two stages: title and abstract and then full-text screening. Data extraction involved a structured approach, collating relevant information for thematic analysis. Results: While the scoping review is ongoing, emerging issues included: methods for incorporating environmental pollution externalities into HTAs; the impact of climate change on health outcomes; intergenerational equity of health outcomes and definitions of sustainability; environmental epidemiology; and the potential for technologies to mitigate the impact of climate change. The ongoing thematic analysis will synthesize the results of the scoping review using mapping and categorization to identify knowledge gaps. Conclusions: The threat of climate change is the greatest issue faced by HTA in a generation, but this challenge is intersectoral and demands an intersectoral response. This paper identifies environmental concerns that might, in principle, be included within the HTA process. Ultimately, the HTA community must do its part to address the environmental crisis we face and move toward a more sustainable future. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion Social connections in the host country improve International Medical Graduates' (IMGs') well‐being, intercultural competence and performance at work but is an issue that has been largely overlooked in the academic literature and policy discussions. The aim of this study was to better understand the social connections that IMGs form by exploring this phenomenon in a UK context.IMGs and UK Medical Graduates (UKMGs) practising in Scotland were invited to participate. This was a qualitative study using online semi‐structured interviews for data collection and reflexive thematic analysis.Forty‐one participants were recruited (24 IMGs and 17 UKMGs), selected with maximum variation in terms of gender, ethnicity, speciality, grade and country of primary medical qualification. Twenty‐one (58%) of the participants had experience working in other parts of the UK.Five themes were identified: (i) overcoming early isolation, IMGs strove to overcome their initial social isolation which harmed their mental well‐being; (ii) where connections are made, IMGs form social connections mainly at work and within their religious communities; (iii) seeds of segregation, some IMGs found themselves outside tight UK native friendship groups. Alcohol was a socially exclusive activity for some IMGs, as were other host country cultural norms. Exclusion led IMGs to form social connections with other IMGs or other ‘outsider’ groups; (iv) degrees of Discrimination, discrimination and racism were experienced by some IMGs. Discrimination was individual, structural and institutional, and (v) “Open (ing) the door”, participants described interventions at organisational, departmental, and individual levels to improve IMGs' ability to form social connections.This study highlighted the challenges that IMGs face when trying to form social connections. More emphasis needs to be placed on promoting an environment where social connections, in particular between IMGs and host country natives, can flourish. [ABSTRACT FROM AUTHOR]

Aims: The IATPAD (Improvement in Access to Treatment for People with Alcohol and Drug Related Problems) study explored barriers and facilitators to accessing alcohol and drug treatment services in eight European countries. Methods: Results from individual interviews and focus group discussions with 246 service users who had experienced alcohol and drug treatment in Bulgaria, Greece, Italy, Poland, Slovakia, Slovenia, Spain and Scotland are described. Thematic analysis was used to interpret the data. Results: The study identified a number of consistent facilitating factors and barriers across all eight European countries, despite different health care systems. The results suggest that five main factors were implicated in the help-seeking behaviour of the service users interviewed. These were: information, service organisation, staff attitudes, significant others and personal disposition. All these factors could be viewed as both facilitators and barriers. Conclusions: To enhance access to alcohol and drug treatment, local, non-stigmatising and available services are required alongside support from significant others which should increase motivation and skills of potential service users. [ABSTRACT FROM AUTHOR]

Objectives: The roles and potential value of patient preference (PP) data in health technology assessment (HTA) remain to be fully realized despite an expanding literature and various efforts to establish their utility. This article reports lessons learned through a series of collaborative workshops with HTA representatives, organized by the Health Technology Assessment International's Patient Preferences Project Subcommittee., Methods: Five online workshops were conducted between June 2022 and June 2023, seeking to facilitate collaborative learning and reflection on ways that PP data can be integrated into HTA. Participants included nine HTA representatives from the United States, Canada, Australia, England, and the Netherlands. Workshops were recorded, transcribed, and thematically analyzed., Results: Despite appreciating the value of PP data, participants were ambivalent about their use in HTA. Some felt that they were already getting the information they needed from the cost-effectiveness analysis or existing patient involvement processes. Others thought that PP data would be very helpful at the initial and final stage of the decision-making process and, particularly, in the following cases: (a) when technology has important non-health benefits; (b) when the clinical and/or cost-effectiveness evidence is marginal; and (c) when treatment is indicated for a large and heterogeneous population. Issues related to the validity and reliability of PP studies were frequently raised, with preference heterogeneity at the core of these concerns., Conclusions: Collaborating with HTA representatives in the "co-creation" of PP research can help address their concerns and facilitate mutual learning about how PP data can be used in HTA.

Introduction: Diagnosing and treating lung cancer in early stages is essential for survival outcomes. The chest X-ray (CXR) remains the primary screening tool to identify lung cancers in the UK; however, there is a shortfall of radiologists, while demand continues to increase. Image analysis by machine-learning software has the potential to support radiology workflows with a focus on immediate triage of suspicious X-rays. The RADICAL study will evaluate Qure.ai's 'qXR' software in reducing reporting time for suspicious X-rays in NHS Greater Glasgow & Clyde., Methods and Analysis: This is a stepped-wedge cluster-randomised study consisting of a retrospective technical evaluation and prospective clinical effectiveness study alongside the assessment of acceptability via qualitative work and evaluation of cost-effectiveness via a cost utility analysis. The primary objective is to assess the clinical effectiveness of qXR to prioritise patients suspected with lung cancer on CXR for follow-up CT. Secondary objectives will look at the utility, safety, technical performance, health economics and acceptability of the intervention. The study period is 24 months, consisting of an initial 12 month data collection period and a 12 month follow-up period. All the standard care CXRs from outpatient and primary care requests will be securely transmitted to Qure.ai software 'qXR' for interpretation. Images with features of cancer will be flagged as 'Urgent Suspicion of Cancer' and be prioritised for radiologist review within the existing reporting workflow., Ethics and Dissemination: The study will follow the principles of Good Clinical Practice. The protocol was granted REC approval in August 2023 from North West-Greater Manchester West Research Ethics Committee (REC 23/NW/0211). This study was registered on clinicaltrials.gov (NCT06044454). An interim report will be produced for use by the Scottish Government. The results from this study will be presented at artificial intelligence, radiology and respiratory meetings and published in peer-reviewed journals., Trial Registration Number: NCT06044454., Competing Interests: Competing interests: We note that we have received funding from Qure.ai to support the service implementation; however, the Scottish Government has funded the evaluation by the University of Glasgow. Qure.ai employees are also listed as authors in this study., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)