Academic literature on the topic 'Museum attendance Psychological aspects'

While an increasing amount of literature highlights the psychological well-being benefits of musical participation, research focusing on electronic dance music (EDM) event contexts remains scarce. This exploratory mixed methods research draws influence from interdisciplinary research on EDM culture and psychological well-being research on music festivals that suggest EDM event attendance may have a positive influence on well-being. Two studies were implemented. Semistructured interviews with regular attendees of EDM events were undertaken and analyzed thematically (Study 1, n = 7). Four main themes were identified, namely the importance of social, musical, and emotional experiences, and shared values at EDM event. These themes were then used as a basis for developing a questionnaire which explored relationships between scores on facets of EDM event attendance and measures of subjective, social, and psychological well-being (Study 2, n = 103). Results showed that all four EDM event facets were positively associated with psychological and social well-being measures. Principal component analysis was utilized to elucidate nuanced aspects of the four themes and their links to well-being scores. A four-factor model (SMEV) that encapsulates the key psychological beneficial aspects of EDM event attendance has been suggested, and the implications of this model and findings are discussed within the context of future research avenues.

Modern ways of approach to arrangement of study in junior schoolchildren by means of museum pedagogy has been generalized. The psychological and pedagogical aspects of interaction and forms of study arrangement in junior schoolchildren within the museum environment have been analyzed, taking into account the peculiarities of their cognition and intercourse skills.

Background: Physical education may be thought of as a special form of education through one’s body which aims not only to fulfil biological purposes, but which also entails significant psychological and social issues. Starting from this point, the aim of the present study is to decrease the number of students exempted from physical education classes by asking them to fill in a survey before each class. Material and methods: The study was conducted in 4 schools from Oradea, over the course of 12 weeks of middle school classes. Results: A visible result was a decrease in the number of students exempted from physical education by 4 to 6 students. Surprisingly, the number of eighth graders exempted from physical education increased. Conclusions: Implementing surveys over a longer period of time would lead to significant results with regards to student attendance at physical education classes.

Considering the biopsychosocial benefits arising from human/nature interaction, we questioned how the biophilia hypothesis has been inserted into palliative care. The objective was to map, through integrative review, the historical and scientific conception of the theme, attesting to the contemplation of palliative care principles. Of 1,928 scientific texts, 71 covered the theme, being possible to identify at least one of the nine principles, with emphasis on the integration with psychological and spiritual aspects. Biophilia was applied, above all, to the emotional aspect, and zootherapy, to the relational. However, in view of the limitations imposed on the attendance of biosafety aspects and dependence on volunteers, the insertion of therapeutic horticulture in hospices and pet visits is proposed.

The article describes both historical aspects and modern approaches towards psychological and physical training of family for birth and also principles of management of normal birth and conditions of its providing in obstetric hospital. There is emphasized importance of attendance “School of family training for birth” by woman and her partner that permits to work out theoretical and practical skills of behavior during pregnancy, labour and postpartum period. Besides it is very important to teach the partner drug-free anaesthesis, who should not only be present in birthing room but be directly involved in labour. Also attention is paid to problems associated with training of family for birth when doctors are not sufficiently informed about psychological features of reproductive sphere, its psychosomatic nature and also forms and possibilities of psychological and psychotherapeutic assistance. Keywords: pregnancy, normal birth, training of family for birth, delivery with partner, drug-free anaesthesis.

Objectives: To assess the demographic and psychological mediators of gender differences in uptake of flexible sigmoidoscopy (FS) screening for colorectal cancer. Setting: A subsample ( n=5462) from a large community trial of FS in the UK. Methods: Menand women randomized to screening as part of the UK Flexible Sigmoidoscopy Trial were sent a postal questionnaire assessing demographic characteristics and attitudes to screening six months before their screening appointment. Attendance at screening was recorded by the screening centres. Results:More men than women attended screening (73% versus 67%). The higher male attendance was partially explained by their lower levels of socioeconomic deprivation, higher levels of marital status and lower perceived barriers to screening. Conclusions: Contrary to expectations, men weremore likely than women to attend FS screening. This was partially explained by socioeconomic and attitudinal differences to screening, but additional research is needed to understand the key aspects of FS screening that will maximize screening uptake in men and women.

The article examines the modern approach in the pedagogical science of training future decorative and applied art artists, the search for new forms of practice, especially museum practice. The issue of forming future specialists’ professional competencies is always acute, but today, in connection with the issues of the pandemic and the partial transition to distance learning, it has become particularly relevant and topical, including the field of art education. The authors are tasked to analyze the effectiveness of the discipline «Museum Practice» in a remote form, the development of professional competencies by bachelors. In the standard situation, this practice is partially conducted in the city museums where the university is located and also off-premise, by personal attendance, but in the 2019-2020 academic year, changes were made to the curriculum of the field of education «Decorative and Applied Arts and Folk Crafts» at the Southern Federal University, and the practice was held in an online form. The article considers the issue of remote dialogue between teacher-student-museum, identifies the positive and negative aspects of this form of communication for the development of professional competencies by future applied artists. The use of interactive, multimedia and visual technologies in the synthesis with independent work of the student gives a positive effect for the development of the necessary professional skills, even in a non-standard situation of practical training.

Animal behaviorists have made extensive use of GPS technology since 1991. In contrast, psychological research has made little use of the technology, even though the technology is relatively inexpensive, familiar, and widespread. Hence, its potential for pure and applied psychological research remains untapped. We describe three methods psychologists could apply to individual differences research, clinical research, or spatial use research. In the context of individual differences research, GPS technology permits us to test hypotheses predicting specific relations among patterns of spatial use and individual differences variables. In a clinical context, GPS technology provides outcome measures that may relate to the outcome of interventions designed to treat psychological disorders that, for example, may leave a person homebound (e.g. Agoraphobia, PTSD, TBI). Finally, GPS technology provides natural measures of spatial use. We, for example, used GPS technology to quantify traffic flow and exhibit use at the Arizona Sonora Desert Museum. Interested parties could easily extend this methodology some aspects of urban planning or business usage. DOI:10.2458/azu_jmmss_v1i1_wolf

Animal behaviorists have made extensive use of GPS technology since 1991. In contrast, psychological research has made little use of the technology, even though the technology is relatively inexpensive, familiar, and widespread. Hence, its potential for pure and applied psychological research remains untapped. We describe three methods psychologists could apply to individual differences research, clinical research, or spatial use research. In the context of individual differences research, GPS technology permits us to test hypotheses predicting specific relations among patterns of spatial use and individual differences variables. In a clinical context, GPS technology provides outcome measures that may relate to the outcome of interventions designed to treat psychological disorders that, for example, may leave a person homebound (e.g. Agoraphobia, PTSD, TBI). Finally, GPS technology provides natural measures of spatial use. We, for example, used GPS technology to quantify traffic flow and exhibit use at the Arizona Sonora Desert Museum. Interested parties could easily extend this methodology some aspects of urban planning or business usage. DOI:10.2458/azu_jmmss_v1i1_wolf

Animal behaviorists have made extensive use of GPS technology since 1991. In contrast, psychological research has made little use of the technology, even though the technology is relatively inexpensive, familiar, and widespread. Hence, its potential for pure and applied psychological research remains untapped. We describe three methods psychologists could apply to individual differences research, clinical research, or spatial use research. In the context of individual differences research, GPS technology permits us to test hypotheses predicting specific relations among patterns of spatial use and individual differences variables. In a clinical context, GPS technology provides outcome measures that may relate to the outcome of interventions designed to treat psychological disorders that, for example, may leave a person homebound (e.g. Agoraphobia, PTSD, TBI). Finally, GPS technology provides natural measures of spatial use. We, for example, used GPS technology to quantify traffic flow and exhibit use at the Arizona Sonora Desert Museum. Interested parties could easily extend this methodology some aspects of urban planning or business usage. DOI:10.2458/azu_jmmss_v1i1_wolf

Children in upper primary school who have not made progress along the Swimming and Water Safety Continuum may be at a greater risk in an aquatic environment because they have not developed the swimming competency, endurance and skills needed for survival in threatening aquatic situations. Three groups representing different socio-economic and geographical areas were selected to explore the relationships between psycho-social factors and the development of swimming ability among year seven students. Two groups from lower socio-economic areas were chosen. The first group was directly on the coast with easy access to the beach, while the second group was inland in the foothills of Perth. As higher socio-economic areas in Perth are generally not far from the coast only one group from a higher socio-economic coastal area was chosen. The participants were 540 year seven students, 282 of whom were males and 258 of whom were females. The primary variable of interest was the current swimming stage of year seven participants, and the differences between genders and/or locality groups. The primary research questions investigated differences between locality groups and/or genders for; a) perceived athletic competence and global self-worth, b) perceived swimming competency, confidence in deep water and importance placed on learning to swim well. c) perceived social support for sport and swimming activities and d) attendance at Interm, Vacswim and other swimming programs and aquatic venue experience. Relationships between swimming stage and the above variables were analysed. The secondary research questions investigated the most frequent reasons given by the students for not attending or discontinuing participation inVacswim, and whether there were differences between locality groups or genders. Findings indicated that the lower socio-economic groups had a significantly lower swimming stage and lower perceived self-worth than the higher socioeconomic group. Students from the lower socio-economic inland area had the lowest mean swimming stage as well as lower perceived social support for sport and swimming than either of the other two groups in the study. The two lower socioeconomic groups also attended less swimming instruction and placed less emphasis on the importance of learning to swim well than the higher socio-economic group. Despite these findings, the lower socio-economic groups did not view themselves as any less able in terms of athletic and swimming competence. However, as the two lower socio-economic groups have not progressed along the Swimming and Water Safety Continuum to the 'desirable standards' of the RLSSA (1999), these groups could be viewed as at-risk in an aquatic environment. At the same time, there was evidence that attendance at Interm along with attendance at another swimming program enabled participants to reach the 'desirable standards' of the RLSSA (1999). Girls generally had a higher swimming stage than boys in the lower socio-economic areas, attended year seven Interm and Vacswim more than boys, reported more social support for sport and swimming, and placed more emphasis on the importance of learning to swim well than boys. While many of these relationships between swimming stage and psycho-social factors have been intuitively accepted within the swimming teaching industry, we now have a better understanding of the strength and direction of these relationships.

As many as a quarter of undergraduate college students are placed on academic probation at least once during their college career. In addition, first-generation college students are even more at-risk for stopping out or dropping out due to being less academically prepared than their non-first-generation peers. In order to examine factors that influence first generation student academic risk and success, this exploratory study examined the intersection of academic standing and four primary conceptual contributors: academic integration, personal adjustment, family and social adjustment, and psychological factors. Survey data were collected from first generation undergraduate students at an urban research university who were placed on academic probation and those who returned to good standing. Six overarching themes emerged that demonstrate critical importance in first generation student academic success: 1) overall study skills, 2) class attendance 3) health-related issues, 4) financial difficulties, 5) family and personal issues, and 6) physiological symptoms. In addition, these factors appear to have additive and multiplier affects for students. First generation students may be able to overcome one set of factors but each new dimension can further inhibit academic good standing. Recommendations include mandatory advising and college success classes.

When South Africa became a democracy, many of its cultural institutions were tainted by the stigma of having been tools for the production and propagation of apartheid ideology. This thesis examines two key facets of post-apartheid museums and memorials. Firstly, how they have repositioned themselves as institutions of cultural and social standing. Secondly, their role as tools of nation building, social change, and creators of national collective memory within the new democratic South Africa. Through an analysis of cultural memory theory pertaining to museology, this study elaborates on the methods employed by museums to incorporate memory into their narratives and in turn, transfer collective memory to their viewers. This thesis provides a comparative study of the architectural, memorial and museological strategies of two post-apartheid museums; the Red Location Museum and the Apartbeid Museum. It examines the contributions of both museums to the introduction of new museological strategies for the successful creation and transmission of South African collective memory. Through this analysis, both the invaluable contributions and the drawbacks of post-apartheid museums as tools for the promotion of new democratic ideologies and philosophies are considered. This thesis does not resolve the arguments and questions which have surfaced regarding cultural institutions as tools for the promotion of reconciliation and the construction of national collective memory within South Africa. As the current climate of memorialisation is one of change and paradox, it is presently impossible to fully quantify post-apartheid museums' roles within South Africa's move toward reconciliation and social change. However, the examination of both the Red Location Museum and the Apartheid Museum reveals the extraordinary change that South African cultural institutions have undergone in addition to their potential to become institutions which facilitate active reconciliation as well as social and cultural growth.

Gender equity has been a national and global aim for over half a century (Ceci & Williams, 2007; National Center for Education Statistics, 2003; National Science Board, 2008). While gains have been made, one area where inequity remains is spatial reasoning ability, where a large gender gap in favor of males has persisted over the years (Else-Quest, Linn, & Shibley Hyde, 2010; National Science Board, 2008; Ruble, Martin, & Berenbaum, 2006). This gender gap in spatial reasoning has had substantial societal impact on the career interests of females in areas of Science, Technology, Engineering, and Math (STEM), contributing to the larger societal need to engage non-dominant groups in these fields to reduce outsourcing (Ceci & Williams, 2007; Jaschik, 2007; Wai, Lubinski, & Benbow, 2009; White, 1992). Both spatial reasoning ability and STEM career interest have been related to science museum visits (Hamilton, Nussbaum, Kupermintz, Kerkhoven, & Snow, 1995; Salmi, 2001, 2002). However, researchers have also found a gender gap in favor of males in regard to science museum attendance and experiences once at the museum (Borun, 1999; Crowley, 2000). There are many suggestions for increasing female engagement at science museums and creating equitable experiences, but few have been systematically studied (Kekelis, Heber, & Countryman, 2005; Koke, 2005; Maher, 2005; Taylor, 2005). This research investigated gender equitable exhibit development by enhancing a geometry exhibit with several female-friendly design features and analyzing video data to determine the effects on girls' engagement and social interactions with their caregivers. The findings suggest that incorporating several female-friendly design features leads to significantly higher engagement for girls (evidenced by greater attraction and time spent). This study also looked for any unanticipated negative effects for boys after incorporating the female-friendly design features. It is encouraging that this study was unable to detect any unintended negative effects for boys; however, such non-significant results are inconclusive and should not dissuade future research and design teams from continuing to check for unanticipated ill effects of female-friendly design features for boys. While the positive effects for girls were significant, it is important to note that they were not significantly more positive for girls than for boys; further research is needed to determine whether the female-friendly design features create a more equitable experience for girls, or a more positive experience for everyone. This study did not identify any significant differences in parent-child verbal social interactions between the two versions of the exhibit; however, the pattern of results suggests that gender discrepant parent explanations, as found by Crowley, 2001 in a children's museum, may be less of a concern for girls in science centers, providing an interesting area for future study. This research presents evidence to support incorporating female-friendly design features in future science exhibit development projects, and indicates areas where future studies are still needed to gain a deeper understanding of their effects.

M.Ed. (Psychology of Education)
Truancy is such a problem that there is a need to investigate it. The act of truancy has both psychological and social consequences. It affects not only the individual truant adversely but also the people in his social environment. The ultimate purpose of the research is essentially practical: to help teachers, parents and others to address issues of non-attendance. The present research focuses on the possible role of parents in the incidence of truancy, since the family is basically a community of love. The present research displays a two-pronged approach. Firstly, a literature study is carried out on truancy as a phenomenon and on the role of parents in children's development. This serves as the substructure for the second component, namely the empirical investigation. Secondly, an empirical investigation is done. The empirical investigation in Mamelodi high schools, is part of a group project that utilizes a criterion-group-comparative-group research design with a nomothetic strategy, comparing truants' data with those of non-truants.

M.Ed.
The problem of truancy is causing a great deal of concern for the communities, for the state, for the family and for the school. The number of students who deliberately stay away from school on certain occasions is on the increase. The fact that absenteeism and truancy have become significant predictors of problem behaviour, troublesomeness and sometimes delinquency in secondary schools, makes it even more vital that the problem of truancy needs to be addressed with the urgency that it deserves. Up to now, very little is known about the contribution made by the curriculum content towards truancy. The structure of the curriculum, methods of instruction, the timetable, examination pressures and extramural activities are some of the possible causes of truancy. School rules, teacher attitude and teacher expectations are also among some of the contributing factors to absenteeism. The purpose of this research, therefore, is to attempt to find out if the curriculum content plays any part in curbing the problem of truancy, and to ascertain if there is a possible contribution of the curriculum content towards truancy. It is also one of the fundamental aims of this survey to learn more about the value orientations of children who do not attend school regularly and to establish curriculum changes that might be needed to alleviate the problem of truancy. In order to investigate the possible contributions made by the curriculum content, and the perceptions of black truants of their schooling, a two-part methodology was devised. In the first place, a questionnaire was formulated and a pilot study was conducted at a school that was not part of the target group. A survey was subsequently carried out at three Mamelodi high schools. The data from the questionnaire were analysed using the first and second order factor analyses, and even a discriminate analysis was applied on the data. The following format has been used in the presentation of the results. First, the findings from the literature study are discussed, and then results obtained from the empirical study are also outlined. From the literature study it was found that the content of the curriculum does not satisfy the needs of the individual student and can therefore lead to truancy. The schools' system such as school rules, timetables, language and methods of instruction sometimes demotivate students from attending school regularly. Teachers and family members also play a role in discouraging students from seeing any value in attending school. The following statistically significant differences were found after the analysis of the respondents' estimates of the applicability of the statements in the literature study as reflected in the questionnaire. If students had a choice, more truants than non-truants would stay away from school. More truants find school and school activities less interesting and most do not know what they want to do with their lives after completing school. More truants than nontruants find school irrelevant and school subjects less important and of less value to their future aspirations. It is against this background that one can conclude that indeed the school curriculum content does not help much in curbing the problem of truancy.

M.Ed.
Truancy, which according to Thompson and Rudolph (1992:513), is a deliberate absence from school without a valid reason, is a problem that probably dates back to the initial institution of large scale formal schooling. Although it may seem obvious that the reason for truancy is related to the fact that the truant prefers to be elsewhere, or that he finds the school an unpleasant place to be, the underlying reasons for truancy are more difficult to pinpoint. Research conducted in 1991 and 1992 in the United Kingdom (O'Keefe, 1994:48), and which included 150 schools, revealed that a significant number of pupils of compulsory school—going age become involved in truancy. Statistics reported by the research team themselves, based on a survey which involved questionnaires, suggested that if the results of their survey could be extrapolated to all schools, then a 95 per cent confidence interval for the mean truancy level in schools, is between 29.7 per cent and 32.4 per cent. About two thirds (68%), of all schools should have truancy levels between 22.7 per cent and 39.3 per cent, and 96 per cent of all schools should have levels between 14.4 per cent and 47.4 per cent. If these statistics could be used as a guide to estimate an average of truants per school, the enormity of the prevalence of truancy becomes evident. According to McWhirter and McWhirter (1993:58), truants tend to have what is termed a "dropouts perspective". They claim that dropouts inter alia tend to leave school for the following reasons: * a dislike for school, with the opinion that school is boring and not relevant to their needs * low academic achievement and poor grades * poverty, a desire to work full-time, and a need for money, and * a lack of belonging and a sense that nobody cares about them Some of these attributes might thus also obtain for many truants. Paterson (Wardaugh, 1990: 744), proposes two broad categories of truants, namely the "endangered" truant (also termed the delinquent or morally endangered truant), and the "fearful" truant (also termed the school phobic or abused truant). The "endangered" truant is prone to falling into trouble when absent from school, while the "fearful" truant wishes to go to school, but is afraid to do so. Truancy is also listed by Kapp (1990:119) as one of the behaviours manifested by juvenile delinquents along with various other delinquencies such as theft, running away from home, use and distribution of drugs, burglary, vandalism, assault and robbery, thus suggesting that truancy is associated with these misdemeanours. Healy (Tyerman, 1968:10), notes that truancy is the root of all these misbehaviours, and he described truancy as "the kindergarten of crime". In 1944 Burt (1944:455) already referred to truancy as "the first step on the downward stair to crime". According to Hersov and Berg (1980:67), truancy is a reliable predictor of difficulties in later life. They also report that school truancy significantly predicts four subsequent child events: being held back in elementary school, dropping out of high school,leaving the parental home before the age of 18, and marriage before the age of 18. Thus, it would appear that the prognosis for truants in terms of completing their schooling, securing stable employment and fulfilling responsible citizenship, without being a burden to their future spouses, families, communities and the state, is rather uncertain. Against this background, there can be little argument that the phenomenon of truancy is serious enough to warrant a counseling programme that will be effective in treating truants in the light of their problems in such a way that they will obtain a balanced perspective of the value of regular school attendance. In South Africa, the incidence of truancy, in the old racially biased provincial education schooling system of the House of Assembly (HOA), could be measured quite accurately, simply by consulting the class register over a period of time. Through investigating the circumstances surrounding the absenteeism the teacher could quite easily determine whether such circumstances met the criteria for classification of such absentees as truants. Unfortunately, the same cannot be said for the schools which were under the jurisdiction of the former Department of Education and Training (DET), of which the researcher was an employee for a number of years. Not only were records of attendance not kept properly in many instances to be able to determine how often a pupil was absent, but even if attendance records had been kept properly, the possible reasons for staying away from school, such as political violence, intimidation, and caring for younger siblings, do also not meet the criteria for classifying such an absentee as a truant. What is however also true, is that large numbers of former DET pupils could have exploited the prevailing situation at the time and could have stayed away from school for reasons that may well have qualified them as truants. Many schools served by the former House of Delegates (HOD), and the former House of Representatives (HOR), were, maybe, just as seriously affected by the political climate as the DET schools. The level of absenteeism related to unrest situations in the former HOD and HOR schools makes it just as difficult to distinguish between the "truants" and the "bona fide" absentees during those turbulent times. For this reason it was decided to restrict the scope of the present study to truants in schools which traditionally fell under the provincial education system of the former House of Assembly.

M.Ed. (Educational Guidance)
Truancy is a grave problem because truants are wasting their opportunities and are in danger of not becoming productive members of society. Teachers, parents, peers, psychologists, psychiatrists and other important people (see Chapter 5) can play a decisive role in preventing truancy. The literature study states that peer group pressure is one of the main causes of truancy (see Chapter 2) . An empirical research study has been done at Mamelodi high schools. Certain criteria were followed in order to identify truants (see Appendix B). Chapter 4 shows clearly the results of the research project. The significant findings are as follows : more truants are among std 9 than std 8 more truants than non-truants have failed three times or more more truants than non-truants expect to obtain lower marks in the coming examination ; more friends of truants than those of non- truants expect them to obtain lower marks in the coming examination ; truants have less friends than non-truants who are at school ; truants have less friends than those of non-truants who think they are good in their school work.

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.