Academic literature on the topic 'Communication – Europe – History'

Over the past 30 years, researchers and practitioners have discussed the importance of risk communication in solving disputes ranging from the public outcry regarding importing GMO foods from the United States to Europe, the siting of waste incinerators in many parts of Europe to the building a permanent high level nuclear waste facility in the United States. In this paper the history of risk communication is discussed, focusing particularly on the importance of the social amplification of risk and trust. This is followed by a detailed discussion on trust as it relates to public perception of risk, where it is argued that trust is composed of three variables. The third section covers the theoretical debate of how to best deal with the decline in public trust. This is followed by a short analysis in which it is concluded that there is no simple solution to increasing public trust (and thereby assuring greater risk communication successes).

This article analyzes some of the social mechanisms and material processes involved in Jesuit global communication in the first decades of the Society’s history. The exchange of administrative correspondence, news-sheets (quadrimestres), and edifying letters from the overseas missions was coordinated by the Society’s Roman secretary, Juan Alfonso de Polanco. Communication made significant material demands on both Rome and key transmission nodes on the Jesuit network. In 1560, a decentralized system of scribal production of news and letters was established. Particular pressure was placed on Lisbon, a crucial communications hub for exchanges between Jesuits in Europe and the overseas missions. The last part of the article examines the experience of the Jesuit procurator in Lisbon, charged with managing the exchange of documents between Europe and Jesuits in Asia, Africa, and Brazil. The case of Lisbon, though exceptional, reflects many of the everyday realities of Jesuit communication during the Society’s formative period. Several documents are published in an appendix.

In most European countries, public relations is a flourishing industry, sometimes with a history of a least a century, and all over Europe young people like to become educated in the field. Nevertheless, little is known about crucial aspects of public relations in Europe and so far there is even lesser debate and knowledge exchange on these aspects. The research projects we have conducted so far show that public relations is a multi-dimensional concept. These different dimensions show that public relations is not just a professional function of managers and technicians. The question we want to raise in this article is what typifies European public relations in practice, education and research and what could be a unifying concept to develop practice, education and research.

The history of public communication of science in Spain is yet to be written. Few academic studies exist that have tackled this subject. The political and economic history of the country have marked out the evolution of this discipline, which burst into the country at the end of the 20th century with the proliferation of initiatives such as the creation of science museums, the building of the Spanish Science Foundation and the development of a public Scientific Information service. Despite these efforts, the level of scientific culture for Spanish people is one of the lowest in Europe [OECD, 2016].

In this paper, we identify some milestones in the construction process for mobile science museums and centres in Brazil. As background for presenting the Brazilian context, we initially address the records found on the earliest travelling museum exhibitions and mobile museums in Europe and North America. We then introduce the role of UNESCO in the promotion and implementation of travelling science exhibitions and museums in several countries. Finally, we document important events in the history of mobile science museum and centres in Brazil and outline three general and inter-related challenges currently faced by them.

This dissertation will examine evidence for communication and commerce between western Britain, Scotland, Ireland', their Continental and British neighbours, and the Mediterranean, in the period 400-800 AD. Parts of the terrain and subject of this enquiry have been covered in earlier, well-known studies by Heinrich Zimmer, Kuno Meyer and Joseph Vendryes, all of whom explored the evidence for 'direct' travel between Ireland and Gaul in this period, and by 0. G. S. Crawford and E. G. Bowen, who examined the early medieval evidence in wide-ranging studies of what they termed the 'western seaways'. Their sources and methods have figured more recently in studies of the 'Irish Sea Culture-Province' hypothesis4 and, most significantly, of the contacts indicated by imported ceramics identified on western British and Irish sites since the 1940s. Despite the considerable literature arising from these previous researches, however, a separate historical study integrating archaeological and textual sources to answer the basic question of who was coming and going from the western shores of Britain and Ireland in the period 400-800 AD, and by what means, is lacking. It has to a large degree been taken for granted that maritime exchange would have constantly flourished along the western seaboard, to be invoked whenever an explanation was required for the movement of ideas or objects between regions. The studies of Zimmer and Bowen, in particular, sought to identify communication models as the background to theses concerning the spread of culture to and from early medieval Britain and Ireland. Other investigations have discussed aspects of the subject with reference to Zimmer, sometimes adding new material in the case of Crawford, James and Thomas, but in other cases, such as studies by Boissonade, Vendryes and Lewis, chiefly repeating the core of references assembled by Zimmer. Accordingly, the desire of the cultural theorists to imagine constant trading links as a background to cultural exchange has been carried over into studies of economic history where, for example, Zimmer's 'Wine trade' model, a theory particular to his thesis of the spread of classical culture to Ireland, has cast a misleading spell over most subsequent studies, both historical and archaeological, and has deflected any questioning of the causal relationship between commerce and the travels of cultural practitioners such as scholars who travel on trading ships. In some cases, for example where monastic links may be involved in the formation of commercial links, possibly crucial relationships are obscured.

Cette thèse étudie la circulation internationale du folklore chilien pendant la seconde moitié du XXe siècle. On aborde le parcours de chanteurs et ensembles folkloriques liés à la gauche chilienne, ainsi que leurs pratiques artistiques, les espaces de diffusion musicale et les manières dont la musique folklorique est accueillie par le public général, les critiques de musique, les organisations politiques et les médias, notamment sur la presse de gauche et les maisons discographiques. L’espace géographique de cette circulation est constitué par les pays de l’Europe occidentale. La période d’étude est circonscrite par deux moments significatifs pour la circulation internationale du folklore chilien : le premier voyage en Europe de la chanteuse Violeta Parra le 1954 et la fin de l’exil des musiciens chiliens en 1988. Ce sont plus de 30 ans pendant lesquels les musiciens interagissent largement avec les divers contextes artistiques et politiques d’Europe. La première partie de la thèse aborde les activités que les musiciens chiliens ont réalisées en Europe entre l’année 1954 et le gouvernement de Salvador Allende (1970-1973), dans le contexte d’un fort regard exotique vers les musiques de l’Amérique latine. La deuxième partie s’occupe des activités artistiques ayant lieu entre les années 1968 et 1982, quand les événements politiques du Chili situent les manifestations culturelles, y compris le folklore, dans un lieu privilégié des circuits artistiques de la gauche européenne. Finalement, la troisième partie aborde les expériences artistiques développées entre les années 1978 et 1988, et analyse les répercussions que la vie en exil provoque sur la pratique du folklore chilien en Europe, notamment la mise en question de rôle de la politique
This thesis studies the international circulation of Chilean folk music’s during the second half of the 20th century. We discuss the international trajectory of singers and folk ensemble related to the Chilean Left, also their artistic practices, the space of musical circulation and the ways in which this folk music is welcomed by the general public, music critics, political organizations and media, including the left-wing press and labels. The geographical space of this circulation is constituted by the countries of Western Europe. The study period is circumscribed by two significant moments for the international circulation of Chilean folklore: the first trip to Europe of folk singer Violeta Parra in 1954 and the end of the exile of Chilean musicians in 1988. For more than 30 years, the musicians have been interacting extensively with the diverse artistic and political contexts of Europe. The first part of the thesis studies the activities that Chilean musicians performed in Europe between 1954 and the government of Salvador Allende (1970–1973), in a context of a strong exotic look towards the music of America Latin. The second part examines the artistic activities taking place between 1968 and 1982, when the political events of Chile locate the cultural manifestations, including the folklore, in a privileged place of the artistic circuits of the European left. Finally, the third part examines the artistic experiences developed between 1978 and 1988, and analyzes the repercussions that life in exile has on the practice of Chilean folklore in Europe, notably the questioning of the role of politics

Cette thèse vise à démontrer que les travaux de l’historien d’art et d’architecture britannique d’origine allemande Nikolaus Pevsner (1902-1983) ont joué un rôle majeur dans l’accession de l’histoire de l’art et de l’architecture au statut de discipline universitaire au Royaume-Uni à partir des années 1930-1940. L’étude de ce cas particulier et des constellations et réseaux qui entrent en jeu durant son émigration vers l’Angleterre en 1933 apportent un éclairage différent sur le champ de l’histoire des migrants intellectuels en rappelant le conflit latent entre l’idéal d’universalisme de la science et les vecteurs socio- culturels nationaux qui président aux déplacements transnationaux.Notre recherche se concentre sur les transferts méthodologiques, institutionnels et historiographiques qui ont fait de la carrière de Pevsner un moment-clé de l’historiographie de l’art, de l’architecture et du design et aborde les domaines suivants : la question du Mouvement moderne, l’utilisation du concept d’espace dans le discours architectural d’après le principe de l’empathie (Einfühlung) ou encore dans l’exploration, à travers la méthodologie de la géographie de l’art, de la production artistique et du patrimoine architectural du pays d’accueil de Pevsner.Il s’agit de montrer que l’oeuvre de médiateur d’un historien d’art entre sa matière et la société se déploie aussi hors du seul cadre universitaire. Cette thèse expose comment Pevsner se fait une place dans la culture britannique en tant qu’éditeur, homme de radio, critique d’art, autant d’activités qui se basent sur des modèles allemands, mais qui font progressivement de l’historien déplacé, interprète de sa culture d’accueil, une véritable institution culturelle
This thesis demonstrates how the works of art and architectural historian Nikolaus Pevsner (1902-1983), a British scholar of German origin, played a major part in the accession of the history of art and architecture to the status of an academic discipline in the United Kingdom in the 1930s and 40s. This case study, along with the various networks that played a part in his displacement from Germany to Britain in 1933, sheds a different light on current research on the history of émigré intellectuals, as it seeks to show that there is a latent conflict between the ideal of universalism in science and the national socio-cultural vectors at play in transnational displacements.Our research focuses on methodological, institutional and historiographical transfers that made Pevsner’s career into a milestone in the historiography of art, architecture and design. It tackles the main aspects of his contribution, from the issue of the Modern movement, through the use of the concept of space in the architectural discourse based on the principle of empathy (Einfühlung), to the exploration of the artistic production and the architectural heritage of Pevsner’s country of adoption.Our contention is that the role of an art historian as a mediator between his subject and society goes beyond the realm of academia. This thesis shows how Pevsner found a place in British culture as editor, broadcaster and art critic, while basing these activities on German models, and how these activities gradually transformed an interpreter of culture into a cultural institution

Studies on historical representations of anarchists tend to focus on terrorist depictions and how they compare to the actual activities of the anarchist movement. Using British print media, this thesis explores other political, cultural, and social representations of anarchists in an effort to expand the field beyond a strict focus on terrorism. In addition, this thesis will also investigate the ways Cesare Lombroso and Havelock Ellis shaped discussions of anarchists in the British public sphere.

Les flux télégraphiques et postaux internationaux sont régulés à partir de la seconde moitié du XIXe siècle par le biais d’organisations internationales spécifiquement créées à cet effet : l’Union télégraphique internationale (1865 ; qui devient en 1932 Union internationale des télécommunications) et l’Union générale des postes (1874 ; qui devient en 1878 Union postale universelle). Ces rènes de coopération sont le lieu d’élaboration de normes tarifaires et techniques, assurant l’interconnexion des réseaux nationaux. L’objet de cette thèse est de retracer l’histoire de la politique de la France à leur égard. Ceci afin de mieux cerner la manière dont se construit et évolue un ordre international des communications du milieu du XIXe siècle au milieu du XXe siècle, autour d’institutions, de règles et de valeurs partagées par les partenaires de la coopération. La coopération technique est un objet d’histoire européen –à la fois international et transnational–, permettant d’aborder la question de l’articulation entre universalisme et régionalisme ainsi qu’entre ordre européen issu du XIXe siècle et construction européenne amorcée au lendemain de la Seconde Guerre mondiale
Since the middle of the XIXth Century, international connexions between national postal and telecommunication networks have been regulated through multilateral cooperation. This thesis aims at analysing the policy of France towards the International Telegraph Union (then renamed International Telecommunications Union) and the Universal Postal Union, from their creation to the foundation of the European Conference of Postal and Telecommunication Administrations in 1959. These institutions were arenas where international regulation (with both technical and commercial standards) was debated and cast by specific professional communities. The history of technical cooperation provides an international and transnational perspective for a history of European communication networks. It tackles the questions of the articulation between universalism and regionalism as well as between European order inherited from the XIXth Century and the European construction launched after the Second World War

Thesis (Ph.D.)--Indiana University, School of Journalism, 2008.
Title from home page (viewed on Jul 20, 2009). Source: Dissertation Abstracts International, Volume: 69-10, Section: A, page: 3789. Adviser: Owen V. Johnson.

This thesis questions a series of assumptions concerning the nineteenth- and early-twentieth-century modernization of European spaces. Current scholarship tends to concur with essayistic texts and images by contemporary intellectuals that technological and organizational developments increased the freedom of movement of those living in western-European societies, while at the same time alienating them from each other and from their environment. I assess this claim with the help of Dutch travel egodocuments such as travel diaries and letters. After a prosopographical investigation of all available northern-Netherlandish travel egodocuments created between 1500 and 1915, a selection of these documents is examined in greater detail. In these documents, travellers regarded the possession of identity documents, a correct appearance, and a fitting social identity along with their personal contacts, physical capabilities, and the weather as the most important factors influencing whether they managed to gain access to places. A discussion of these factors demonstrates that no linear increase, nor a decrease, occurred in the spatial power felt by travellers. The exclusion many travellers continued to experience was often overdetermined. The largest groups affected by this were women and less educated families. Yet travellers could also play out different access factors against each other. By paying attention to how practices matched hopes and expectations, it is possible to discover how gravely social inequities were really felt by travellers. Perhaps surprisingly, all social groups desired to visit the same types of places. Their main difference concerned the atmosphere of the places where the different groups felt at home. To a large degree this matched travellers' unequal opportunities. Therefore, although opportunities remained strongly unequal throughout the period, this was not always experienced as a problem. Also, in cases where it was, many travellers knew strategies to work around the obstacles created for them.

This paper examines how the development of the railway-telegraph technological complex impacted the tenuous relationship between the rulers and those they ruled; the British and the Indians. Through the experience of building and operating the railway, Indians came to understand the railway and telegraph as their own technologies well before the eventual handover of control over the networks from the British. The reasons behind the British desire to retain their grasp over the networks included profit, power, and orientalist notions of socially advancing Indians, all at the expense of Indian taxpayers. This arrangement was problematic and ultimately facilitated the Raj's undoing, while revealing certain realities of British imperial rule.

Abstract This chapter discusses the various forms of social communication and symbolism that framed the meanings of the spoken word, letters, and images in medieval East Central Europe. Focusing on elements of non-verbal communication, it examines the diverse communication capacities of particular regional groups, as well as the varying expectations in the region’s socio-cultural interactions. It is important not to put writing in radical opposition to oral and non-verbal communication; visual communication, for instance, combines crucial elements of these non-written forms by turning the sounds of the spoken word into a negotiated system of graphical signs. The ongoing investigation of the development of literacy in East Central Europe allows the conclusion that, despite some chronological delays, the implementation of writing in the region had a dynamic similar to that in many other parts of Europe. From the thirteenth century onwards, one can see both an apparent democratization and individualization in making, using, and keeping records in the ever-widening spectrum of pragmatic literacy, especially in urban environments.

Undoubtedly writing contributed to the perception of history from other perspectives. Starting from clay tablets from Summer or Tartaria and until so known editing programs for today’s format text , the writing was obviously the most important form of communication of ideas, concepts and theories. One of the most popular concepts to which we refer when we refer to writing, is the book. Books were for centuries the only means of passing on information, regardless of their(religious, scientific, etc..), reflecting their technological evolution of humankind. Therefore, long time, books were written by hand, and then they have multiplied copyists. But the invention of printing (in Europe around 1450, China and Korea it was known long before), the flow of information has been simplified and books have become an accessible element for public, more than hitherto. There was a long pause in the evolution of the concept book that has remained virtually unchanged, despite the fact that printing technology has changed radically. The so-called break ended a few years ago, because books have entered in a new stage of development -the electronic book or eBook. This is the digital version of a work (either already existing in print or broadcast only in digital format) the version whose content can be viewed either through a computer or through other devices that allow the compatibilization of the systems. Several centuries the printing on led to accelerating evolution of the process of social development. This required a rapid and massive development of paper-making industry which led to the emergence and overcome of serious environmental problems. In efforts to replace paper, the technique successfully identified substitutes: radio, television, teletext, fax, computers, Internet, magnetic or optical supports, microfilms and photographs.

La arquitectura puede introducirnos en la experiencia de la memoria; memoria como reflexión, y arquitectura como dispositivo para la experiencia memorial a la vez que contenedor de la información. Cada objeto es definido en un proceso en el que considerar diversos actores, sus voluntades, opciones y experiencias. Es el caso de las obras que aborda este trabajo, en las que evidenciar e interrogarnos sobre el gesto arquitectónico, la memoria evocada y su interpretación social. Obras que han alcanzado notoriedad por diferentes motivos: como la Sala del Recuerdo, de Arieh Elhanani, Arieh Sharon y Benjamin Idelson (1961) en Yad Vashem, Jerusalén; por su significado científico e histórico, como el Museo de Historia del Holocausto, también en Yad Vashem, de Moshé Safdie (2005); por su relevancia cultural o arquitectónica, como el Museo Judío (Ampliación del Museo de Berlín con el Departamento del Museo Judío) de Daniel Libeskind en Berlín (1999); e incluso por la controversia que han suscitado, como el Monumento en Memoria de los Judíos Asesinados de Europa, también en Berlín, conocido como el Monumento del Holocausto, de Peter Eisenman (2004).***Architecture can introduce us to the experience of memory; memory as reflection, and architecture as a drive for the experience of remembering as well as a container of information. Each object is de ned in a process in which different actors, their wills, options and experiences, are taken into account. This is the case of the artworks addressed by the present communication, in which we reveal and ask ourselves about the architectural gesture, the evoked memory and its social interpretation. Artworks that have achieved prominence for different reasons, such as the Hall of Remembrance, of Arieh Elhanani, Arieh Sharon and Benjamin Idelson (1961) in Yad Vashem, Jerusalem; for its scientific and historical significance, such as the Holocaust History Museum, also in Yad Vashem, by Moshe Safdie (2005); for its cultural or architectural relevance, such as the Jewish Museum (Extension of the Berlin Museum with the Department of the Jewish Museum) by Daniel Libeskind in Berlin (1999); and even because of the controversy they have raised, such as the Memorial to the Murdered Jews of Europe, also in Berlin, known as the Holocaust Memorial, by Peter Eisenman (2004).

The Japanese criminal justice system has gone through transformations in its modern history, adopting the models of European Continental Law systems in the 19th century as part of Japan’s modernisation process, and then the Anglo-American Common Law orientation after WWII. More recently, citizen judges have been introduced to the criminal justice process, a further move towards an adversarial orientation with increased focus on orality and courtroom discourse strategies. Yet, the actual legal process does not necessarily represent the adversarial orientation found in Common Law jurisdictions. While previous research from cultural and socio-historical perspectives has offered valuable insights into the Japanese criminal court procedures, there is hardly any research examining how adversarial (or non-adversarial) orientation is realised through language in Japanese trials. Drawing on an ethnographic study of communication in Japanese trials, this paper discusses a ‘hybrid’ orientation to the legal process realised through courtroom discourse. Based on courtroom observation notes, interaction data, lawyer interviews and other relevant materials collected in Japan, trial participants’ discourse strategies contributing to both adversarial and inquisitorial orientations are identified. In particular, the paper highlights how accusation, defence and morality are performed and interwoven in the trial as a genre. The overall genre structure scaffolds competing narratives, with prosecution and defence counsel utilising a range of discourse strategies for highlighting culpability and mitigating factors. However, the communicative practice at the micro genre level shows an orientation to finding the ‘truth,’ rehabilitation of offenders and maintaining social order. The analysis of courtroom communication, contextualised in the socio-historical development of the Japanese justice system and in the ideologies about courtroom communicative practice, suggests a gap between the practice and official/public discourses of the justice process in Japan. At the same time, the findings raise some questions regarding the powerful role that language plays in different ways in varying approaches to delivery of justice.

The main recommendations of the panel report can be summarised under four headings: 1. From Source to Sea: River systems, from their source to the sea and beyond, should form the focus for research projects, allowing the integration of all archaeological work carried out along their course. Future research should take a holistic view of the marine and maritime historic environment, from inland lakes that feed freshwater river routes, to tidal estuaries and out to the open sea. This view of the landscape/seascape encompasses a very broad range of archaeology and enables connections to be made without the restrictions of geographical or political boundaries. Research strategies, programmes From Source to Sea: ScARF Marine and Maritime Panel Report iii and projects can adopt this approach at multiple levels; from national to site-specific, with the aim of remaining holistic and cross-cutting. 2. Submerged Landscapes: The rising research profile of submerged landscapes has recently been embodied into a European Cooperation in Science and Technology (COST) Action; Submerged Prehistoric Archaeology and Landscapes of the Continental Shelf (SPLASHCOS), with exciting proposals for future research. Future work needs to be integrated with wider initiatives such as this on an international scale. Recent projects have begun to demonstrate the research potential for submerged landscapes in and beyond Scotland, as well as the need to collaborate with industrial partners, in order that commercially-created datasets can be accessed and used. More data is required in order to fully model the changing coastline around Scotland and develop predictive models of site survival. Such work is crucial to understanding life in early prehistoric Scotland, and how the earliest communities responded to a changing environment. 3. Marine & Maritime Historic Landscapes: Scotland’s coastal and intertidal zones and maritime hinterland encompass in-shore islands, trans-continental shipping lanes, ports and harbours, and transport infrastructure to intertidal fish-traps, and define understanding and conceptualisation of the liminal zone between the land and the sea. Due to the pervasive nature of the Marine and Maritime historic landscape, a holistic approach should be taken that incorporates evidence from a variety of sources including commercial and research archaeology, local and national societies, off-shore and onshore commercial development; and including studies derived from, but not limited to history, ethnology, cultural studies, folklore and architecture and involving a wide range of recording techniques ranging from photography, laser imaging, and sonar survey through to more orthodox drawn survey and excavation. 4. Collaboration: As is implicit in all the above, multi-disciplinary, collaborative, and cross-sector approaches are essential in order to ensure the capacity to meet the research challenges of the marine and maritime historic environment. There is a need for collaboration across the heritage sector and beyond, into specific areas of industry, science and the arts. Methods of communication amongst the constituent research individuals, institutions and networks should be developed, and dissemination of research results promoted. The formation of research communities, especially virtual centres of excellence, should be encouraged in order to build capacity.

The main recommendations of the panel report can be summarised under five key headings:  Building the Scottish Bronze Age: Narratives should be developed to account for the regional and chronological trends and diversity within Scotland at this time. A chronology Bronze Age Scotland: ScARF Panel Report iv based upon Scottish as well as external evidence, combining absolute dating (and the statistical modelling thereof) with re-examined typologies based on a variety of sources – material cultural, funerary, settlement, and environmental evidence – is required to construct a robust and up to date framework for advancing research.  Bronze Age people: How society was structured and demographic questions need to be imaginatively addressed including the degree of mobility (both short and long-distance communication), hierarchy, and the nature of the ‘family’ and the ‘individual’. A range of data and methodologies need to be employed in answering these questions, including harnessing experimental archaeology systematically to inform archaeologists of the practicalities of daily life, work and craft practices.  Environmental evidence and climate impact: The opportunity to study the effects of climatic and environmental change on past society is an important feature of this period, as both palaeoenvironmental and archaeological data can be of suitable chronological and spatial resolution to be compared. Palaeoenvironmental work should be more effectively integrated within Bronze Age research, and inter-disciplinary approaches promoted at all stages of research and project design. This should be a two-way process, with environmental science contributing to interpretation of prehistoric societies, and in turn, the value of archaeological data to broader palaeoenvironmental debates emphasised. Through effective collaboration questions such as the nature of settlement and land-use and how people coped with environmental and climate change can be addressed.  Artefacts in Context: The Scottish Chalcolithic and Bronze Age provide good evidence for resource exploitation and the use, manufacture and development of technology, with particularly rich evidence for manufacture. Research into these topics requires the application of innovative approaches in combination. This could include biographical approaches to artefacts or places, ethnographic perspectives, and scientific analysis of artefact composition. In order to achieve this there is a need for data collation, robust and sustainable databases and a review of the categories of data.  Wider Worlds: Research into the Scottish Bronze Age has a considerable amount to offer other European pasts, with a rich archaeological data set that includes intact settlement deposits, burials and metalwork of every stage of development that has been the subject of a long history of study. Research should operate over different scales of analysis, tracing connections and developments from the local and regional, to the international context. In this way, Scottish Bronze Age studies can contribute to broader questions relating both to the Bronze Age and to human society in general.

Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.