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Increasing Lung Cancer Screening Uptake Among High-Risk Emergency Department Patients
PROJECT SUMMARY/ABSTRACT Lung cancer is the leading cause of cancer death in the US. Although lung cancer screening (LCS), using low- dose CT scan, decreases lung cancer mortality through early disease identification, fewer than 1 in 6 eligible individuals get screened, with significant differences based on demographic and socio-economic factors. LCS is a process, not just a test. The critical first steps in this process are (1) identification of high-risk individuals who are eligible for LCS, and (2) recruitment of these individuals into an LCS program. The Emergency Department (ED) setting is optimal for an intervention to promote LCS by accomplishing these steps. Individuals at high risk for lung cancer are over-represented in the ED population, including: individuals that smoke, non-White individuals, patients with lower education levels, and the under-insured. In fact, over 2.3 million high-risk people pass through EDs every year who are eligible for LCS but have never been screened. The investigators’ long-term goal is to develop a low-cost, scalable intervention that increases LCS uptake among ED patients and is deployable in any ED with a regionally referrable LCS program. The objective of the proposed randomized clinical trial is to test the efficacies of text messaging and a facilitated referral strategy to promote uptake of LCS in order to achieve this goal. Step 1 of the approach is to identify participants that are eligible for LCS. Step 2 is to randomize eligible participants, using a 2x2 design, among four study arms: (1) basic referral for LCS (i.e. verbal referral with written materials; comprising an enhanced control arm), (2) basic referral plus a subsequent series of text messages, grounded in behavioral change theory, aimed at generating intention and motivation to get screened, (3) facilitated referral for LCS (i.e. submission of a requisition to LCS program by staff), and (4) facilitated referral plus text messages. The investigators’ pilot work demonstrated the feasibility and efficacy of the proposed approach. A total of 1036 individuals eligible for LCS will be recruited from a high-volume urban ED and a low-volume rural ED, randomized among study arms, and followed-up at 120 days to assess interval LCS uptake. The Specific Aims of the proposed project are, (1) Compare LCS program uptake among study arms that receive text messages to study arms that do not, (2) Compare LCS program uptake among study arms with basic referral to study arms with facilitated referral, (3) Investigate the interaction between receipt of text messages (yes/no) and referral type (basic/facilitated), and (4) Evaluate participant feedback on (a) differential barriers to LCS across sub-groups and (b) acceptability and appropriateness of ED-based promotion of LCS. The study team is at the forefront of developing ED-based interventions to promote cancer screening. This project leverages the universal access setting of the ED to identify individuals at greatest risk for lung cancer and get them screened. A scalable ED-based intervention that increases LCS uptake would save lives.
NeurotechEU Summit
Our first NeurotechEU Summit will be fully digital and will take place on November 22th from 09:00 to 17:00 (CET). The final programme can be downloaded here. Hosted by the Karolinska Institutet, the summit will provide you an overview of our actions and achievements from the last year and introduce the priorities for the next year. You will also have the opportunity to attend the finals of the 3 minute thesis competition (3MT) organized by the Synapses Student Society, the student charter of NeurotechEU. Good luck to all the finalists: Lynn Le, Robin Noordhof, Adriana Gea González, Juan Carranza Valencia, Lea van Husen, Guoming (Tony) Man, Lilly Pitshaporn Leelaarporn, Cemre Su, Kaya Keleş, Ramazan Tarık Türksoy, Cristiana Tisca, Sara Bandiera, Irina Maria Vlad, Iulia Vadan, Borbála László, and David Papp! Don’t miss our keynote lecture, success stories and interactive discussions with Ms Vanessa Debiais Sainton (Head of Higher Education Unit, European Commission), Prof. Staffan Holmin (Karolinska Institutet), Dr Mohsen Kaboli (BMW Group, member of the NeurotechEU Associates Advisory Committee), and Prof. Peter Hagoort (Max Planck Institute for Psycholinguistics, Donders Institute). Would you like to use this opportunity to network? Please join our informal breakout sessions on Wonder.me at 11:40 CET. You will be able to move from one discussion group to another within 3 sessions: NeurotechEU ecosystem - The Associates Advisory Committee: Synergies in cross-sectoral initiatives Education next: Trans-European education and the European Universities Initiatives - Lessons learned thus far. Equality, diversity and inclusion at NeurotechEU: removing access barriers to education and developing a working, learning, and social environment where everyone is respected and valued. You can register for this free event at www.crowdcast.io/e/neurotecheu-summit
Hughlings Jackson Lecture: Making Progress in Progressive MS – the Ultimate Challenge!
On April 22, 2021, Dr. Alan J Thompson of the University College London and the UCL Institute of Neurology, London, UK will deliver the Hughlings Jackson Lecture entitled, “Making Progress in Progressive MS – the Ultimate Challenge!” Established in 1935, the Hughlings Jackson Lecture is The Neuro’s premier scientific lecture. It honors the legacy of British neurologist John Hughlings Jackson (1835-1911) who pioneered the development of neurology as a medical specialty. Talk Abstract : The international focus on progressive MS, driven by the Progressive MS Alliance amongst others, together with recent encouraging results from clinical trials have raised the profile and emphasised the importance of understanding, treating and ultimately preventing progression in MS. Effective treatment for Progressive MS is now regarded as the single most important issue facing the MS community. There are several important challenges to developing new treatments for progressive MS. Fundamental to any development in treatment is a better understanding of the mechanisms of tissue injury underpinning progression which will in turn allow the identification of new targets against which treatments can be directed. There are additional complications in determining when progression actually starts, determining the impact of aging and defining the progressive clinical phenotypes – an area which has become increasingly complex in recent months. Evaluating potential new treatments in progressive MS also poses particular challenges including trial design and the selection of appropriate clinical and imaging outcomes - in particular, identifying an imaging biomarker for phase II trials of progressive MS. Despite these challenges, considerable progress is being made in developing new treatments targeting the innate immune system and exploring neuroprotective strategies. Further advances are being driven by a number of international networks, funded by the Progressive MS Alliance. Overall we are seeing encouraging progress as a result of co-ordinated global collaboration which offers real possibilities for truly effective treatment of progression.
Burnout syndrome in the staff of different institutions correlated with EEG-EKG and cortisol post-COVID 19 pandemic
FENS Forum 2024
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