Demonstration Program Research Articles

Impact of technological interventions of cluster front line demonstrations (CFLDs) on productivity and profitability of Pigeonpea (Cajanus cajan L.) in Sahibganj district of Jharkhand

Cluster Front Line Demonstrations (CFLDs) were conducted to evaluate the performance of improved varieties along with scientific package and practices on productivity and profitability of pigeonpea during 2016-17 to 2019-20. Pigeonpea is an important kharif pulse crop in Sahibganj district of Jhakhand covering over 8,945 ha with average productivity of 4.44 q/ha which is well below the state average (11.47 q/ha) and national average (9.60 q/ha). Unavailability of improved variety as well as non-adoption of scientific cultivation practices in the district is one of the possible reasons for lower average productivity of pigeonpea in the district. To enhance productivity of pigeonpea through improved variety and scientific cultivation practices cluster frontline demonstrations (CFLDs) were conducted during kharif season from 2016-17 to 2019-20. Performance of Pigeonpea varieties ICPL 87119 (Asha), Narendra Arhar 2 and Birsa Arhar-1 in 219 locations along with improved cultivation practices like line sowing, treatment of seed with fungicide and biofertilizer, balanced nutrition and weed management were evaluated in the district. It was observed that the yield of pigeonpea in CFLD under rainfed conditions ranged from 9.7 q to 11.2 q ha-1, whereas in FP it ranged between 6.4 to 7.1 q ha-1. The per cent increase in yield with improved practices (IP) over FP was recorded in the range of 48.5 to 61.5. The extension gap and technological index were ranging between 3.3 to 4.1 q ha-1 and 37.7 to 46.1 per cent, respectively. The trend of technology gap reflected the farmer’s cooperation in carrying out demonstrations with encouraging results in subsequent years. The benefit cost ratio varied from 2.18 to 2.48 under demonstration, while it was 1.77 to 1.87 under farmer’s practice. Therefore, the results clearly indicate that the use of improved variety and package of practice with scientific intervention under cluster frontline demonstration programme contribute to increase the productivity and profitability.

New CCBHC status to bolster Kentucky, Michigan service efforts

Michigan and Kentucky leaders and providers are hopeful and excited about opportunities for improved mental health, substance use and physical health care service access across their respective states following a federal announcement Aug. 5 that they are the newest participants in the Certified Community Behavioral Health Clinic (CCBHC) demonstration program.

Policy Recommendations to Promote Integrated Mental Health Care for Children and Youth.

Policy Recommendations to Promote Integrated Mental Health Care for Children and Youth.

How family crises may limit engagement of youth with disabilities in services to support successful transitions to postsecondary education and employment

Abstract Youth with disabilities receiving Supplemental Security Income (SSI) experience multiple barriers to successful transitions to postsecondary education and employment. To improve outcomes for this group, the PROMISE Initiative funded six demonstration programs across the US to test a set of evidence-based services linked to improved employment and educational outcomes, such as case management, benefits counseling, and financial literacy training. Unfortunately, study youth and families did not fully engage in program services, perhaps diminishing effectiveness of the intervention and opportunities for better outcomes. The aim of this descriptive qualitative study was to document family crises experienced by PROMISE participants and explore how these crises contributed to their lack of engagement from the perspectives of case managers who worked with young SSI beneficiaries and their families. Focus groups with nine case managers representing six states from one PROMISE program identified five types of family crises: financial, transportation, behavioral, legal/corrections, and family conflict. Findings suggest that case managers may need additional resources to effectively address the crises encountered. Strategies and future interventions to address crisis situations are suggested.

Addressing Consumer and Patients’ Preferences and Needs Whole Health System of Care Improves Health and Well‐Being and Reduces Opioid Use for Veterans with Chronic Pain

Research ObjectiveVHA is piloting the Whole Health System of Care (WHS) at 18 sites to shift care from a disease‐focused “find‐it, fix‐it” model to one driven by patients’ personal health goals, to foster patient self‐management, and to improve well‐being. As part of the Comprehensive Addiction and Recovery Act, VHA initiated a demonstration program in 18 VA Medical Centers to implement WHS. We report on its impact on Veterans.Study DesignA longitudinal survey of Veterans with chronic pain at the 18 flagship medical centers. Veterans were surveyed at baseline and 6 months using 12 patient‐reported outcome measures. Outcomes were compared between Veterans who did not use WHS services and Veterans with different levels of WHS service use, using standardized mean differences/Cohen’s D. We conducted a longitudinal cohort analysis of Veterans who started using WHS after April 2018. This analysis compared opioid dose levels using administrative pharmacy data (quarterly morphine equivalents) for the 6‐month period before using WHS to opioid levels one year later. This analysis included Veterans from the same time periods who did not use WHS services.Population StudiedSurvey: a random sample of Veterans with chronic musculoskeletal pain at 18 VA medical centers; we report on 3622 patients who completed baseline and 6‐month surveys (response rate: 49.3% baseline; 74.2% follow‐up). Administrative cohort analysis: 112 202 Veterans with chronic pain who received continuous VA care between October 2017 and March 2019 and used >2 WHS (without WHS services prior to April 2018) or no WHS throughout the evaluation period.Principal Findings46% of survey respondents and 5.9% of the administrative cohort used >2 WHS services. Effect sizes for survey measures were small overall; however, those who used WHS services reported greater improvements in perceptions of care, engagement in health care and self‐care, life meaning and purpose, pain, and perceived stress. Opioid use among Veterans using WHS decreased 23% compared with 11% decrease among those with no WHS use.ConclusionsWHS use, especially high levels of WHS use, was positively associated with improvements in several patient‐reported health and well‐being outcomes. While effect sizes were small for survey measures over this 6‐month period, they are promising for the future impact of VHA’s WHS initiative. Administrative data identified meaningful reductions in opioid use among WHS users.Implications for Policy or PracticeThe use of WHS services among Veterans with chronic pain has important implications for pain management, and Veteran health and well‐being. Implementing a system of care that is designed to provide these services to patients presents an opportunity to radically change the way health care is delivered and impact patients’ lives and not just fix their diseases.Primary Funding SourceDepartment of Veterans Affairs.

"It's Not Just About a Paycheck": Perspectives on Employment Preparation of Students With Intellectual Disability in Federally Funded Higher Education Programs.

Students with intellectual disability (ID) are increasingly attending postsecondary education institutions and acquiring work experiences while completing their studies. One of the main motivations for students with ID to seek higher education is to broaden and increase their chance for finding fulfilling, paid employment in their communities. Findings from a qualitative study on staff perspectives regarding career development and employment supports and services provided to students attending Transition and Postsecondary Education Programs for Students With Intellectual Disability (TPSID) model demonstration programs in the United States are presented. Results reflect consensus across program staff regarding the goals and expectations for employment of TPSID students. Programs vary considerably in their institutional context, their partnership with other entities, and the structure of employment services, as well as the emphasis placed on paid versus unpaid employment. Some of the key strategies shared by staff regarding successful student employment practices involved outreach and engagement, visibility on campus, improving access to career services, and cultivating partnerships. As higher education continues to expand its offerings to students with ID, postsecondary education programs need to continue to emphasize and honor the importance of paid employment, and continue to seek the best methods to achieve this outcome for students with ID.

Senate bill would authorize grants to expand rural telemental health

Residents of rural communities always have struggled to gain access to effective mental health services, and the COVID‐19 crisis has only added to the urgency of the problem. A bipartisan group of U.S. senators is responding with proposed legislation that would establish a telemental health care demonstration program targeting three key industry groups prominent in rural areas.

A System-of-Systems Approach to the Strategic Feasibility of Modular Vehicle Fleets

The value proposition for ground vehicle modularity in the U.S. Army and other services has been a topic of continuing debate. Studies to date have largely focused on individual system elements such as manufacturing or maintenance, lacking a holistic perspective of the implications of modularity for the entire fleet operation and life-cycle. The U.S. Army Science and Technology community has demonstrated the technical feasibility of large-scale, transformative ground vehicle modularity, but the business case for modularity remains incomplete. There are multiple criteria tradeoffs between modular and mission-specific (conventional) vehicle platforms, such as total life-cycle cost, mission utility, personnel requirements, and fleet adaptability. This paper presents a system-of-systems framework to address these tradeoffs to support high-level decisions on the strategic feasibility of ground vehicle modularity. We demonstrate this framework with a notional example and an application to the Joint Tactical Transport System (JTTS), a U.S. Army Tank Automotive Research, Development and Engineering Center demonstrator program. Under certain modeling assumptions with regards to the operation of a modular fleet, results for the JTTS study indicate that modularity can lead to significant cost savings at the expense of increased personnel requirements.

MBSE Methodology Applied for a Technology Demonstrator in the Space Transportation Sector

AbstractOver the last 40 years, NASA has sponsored many technology development programs for composite cryogenic tanks (CCT) in order to improve space launchers’ performance. However, they have learned certain lessons in terms of risk mitigation, design failures, lack of technology maturation and time constraints during development phases that push to reinforce the systems engineering perspective given the number of new functions, components and subsystems involved in these CCTs performance.The present paper suggests a Model‐Based Systems Engineering (MBSE) methodology to reduce the challenges that CCTs entail in a technology demonstrator program currently in a conceptual phase for the Ariane 6 upper stage. Topics such as a strong operational analysis; project instability; a Fully Integrated Operational System (FIOS) model combined with a Manufacturing, Assembly, Integration & Test (MAIT) model; requirements traceability; and model navigability issues are studied throughout the modelling process. Results from this approach show and ease the way to obtain information in a complex and large model intended to simulate our System of Interest (SoI)/CCTs life cycle. Consequently, CCTs can face NASA's aforementioned lessons learned from an early phase of the project in order to prevent similar adverse situations.

A National Measurement Framework to Assess and Improve Sickle Cell Care in 4 US Regions.

Coordinated measurement strategies are needed to inform collaborative approaches to improve access to and quality of care for persons with sickle cell disease (SCD). The objective of our study was to develop a multilevel measurement strategy to assess improvements in access to and quality of care for persons with SCD in 4 US regions. From 2014 through 2017, regional grantees in the Sickle Cell Disease Treatment Demonstration Program collected administrative and patient-level electronic health record (EHR) data to assess quality improvement initiatives. Four grantees-covering 29 US states and territories and an SCD population of 56 720-used a collective impact model to organize their work. The grantees collected administrative data from state Medicaid and Medicaid managed care organizations (MCOs) at multiple points during 2014-2017 to assess improvements at the population level, and local patient-level data were abstracted from site-level EHRs at regular intervals to track improvements over time. Administrative data were an important source of understanding population-level improvements but were delayed, whereas patient-level data were more sensitive to small-scale quality improvements. We established a shared measurement approach in partnership with Medicaid and Medicaid MCO stakeholders that can be leveraged to effectively support quality improvement initiatives for persons with SCD in the United States.

Transit infrastructure, rolling stock condition assessment demonstration program (DOT)

Federal Grants & ContractsVolume 44, Issue 14 p. 5-5 Grant Alerts Transit infrastructure, rolling stock condition assessment demonstration program (DOT) First published: 16 June 2020 https://doi.org/10.1002/fgc.31142Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume44, Issue1418 June 2020Pages 5-5 RelatedInformation

Participation in a Nutrition Education and Demonstration Program in Rural Senegal Is Associated with Higher Household Dietary Diversity

Abstract Objectives We conducted a non-randomized evaluation of a nutrition education program delivered by Soins de Santé Primaire in rural Senegal to identify the impact of participation on household dietary diversity scores (HDDS). We also sought to understand participant's perceptions of program strengths and weaknesses. Women participated in a single education session that emphasized hygiene, selecting from a variety of food groups, risk awareness of diet-related non-communicable diseases, and a recipe demonstration of a locally-sourced, balanced meal. We hypothesized that program participation would be associated with increased HDDS. Methods We surveyed 20 female program participants sampled from two communities and compared their responses with 20 women sampled from two non-intervention communities (n = 40). Surveys collected 24-hour dietary recall to calculate a dietary diversity score using the 12-point HDDS scale. The mean difference in HDDS was evaluated between post-program and comparison groups using linear regression. Models controlled for household size, employment, education, marital status, and the Food Insecurity Experience Scale. We conducted key informant interviews with post-program participants (n = 19) to understand message recall, reported behavior change, and feedback for future sessions. Results Women in intervention households reported higher HDDS than comparison households [Mean (SE) = 9.0 (0.39) vs. 7.65 (0.24), P = .003]. In the adjusted model, program participation was positively associated with HDDS (β = 1.16, P = .041). Household food insecurity was associated with lower HDDS (β = −0.52, P = .024). Program participants recalled the importance of reducing bouillon cube usage and eating from each food group. Participants reported changes in food preparation and hygiene routines, such as adding more beans or vegetables and changing dirty dishwater often. The key improvement suggestion was to increase session frequency and expand education on hygiene and sanitation. Conclusions Low intensity nutrition education programs that include meal demonstrations may be a low-cost, effective method for improving dietary diversity among a population with moderate food insecurity in rural Senegal. Funding Sources World Renew, Services Luthériens pour le Developpement au Sénégal, and the Wheaton Human Needs and Global Resources Program.

Web Based System for Program Analysis and Transformation in Optimizing Parallelizing System

Experience of designing different variants for web-based development environment (IDE) for Optimizing parallelizing system and compiler for reconfigurable architecture is described. Designed system is based on existing tools and frameworks such as Jupyter Notebook and Eclipse Che. Set of requirements for Optimizing parallelizing system components is developed to make it possible to integrate them into web-based development environment accessible through the Internet. Designing portable environment for compiler development, compiler technology demonstration and teaching parallel program development is also described. Examples of performing newly developed program transformations are shown to be used during program optimizations for FPGA inside the designed web environment. Means of program transformation visualization are described for use with Jupyter Notebook. The work shown demonstrates possibility to organize remote access to library of instruments and tools for program optimizations currently under development that would be convenient for application developers.

Optimalisasi Produktivitas Lahan Sempit di Desa Sigerongan Lingsar Lombok Barat melalui Penerapan Tumpangsari Sayuran Okra dan Beberapa Genotipe Kacang Tanah

This extension activity aimed to help Farmer Group partner of the "Sumber Hidup" in Sigerongan Village to increased the productivity of narrow land through the application of intercropping technology between okra crop and peanut genotypes. The program that implemented were the application of science and technology with stages of activities, namely: 1) dissemination activities "optimization of productivity of narrow land through the application of intercropping okra and peanuts and the application of technology to increased production of okra and peanut”. This activity was carried out with a lecture and discussion system between the Extension Team and the Farmer Group, and 2) plot demonstration program. Farmers directly participated in planing, planting, crop maintaining, comparing and evaluating whether the implemented program will benefit or not. The results of the activity showed that the farmers participating in the extension were very responsive to the dissemination of intercropping okra-peanut. This was reflected in the participants' enthusiasm in asking questions and having discussions between participants with Team. In addition, participants were also active in participating in each stage of activities such as selecting seed quality, making demonstration plots, planting, growing, weeding, controlling pests and diseases, and harvesting activities. The transformation process of the okra-peanut intercropping technology in the narrow land of Sigerongan Village has implemented, with the hope that farmers will be able to take advantage the narrow land by planting intercropping. Cultivation of okra-peanut intercropping was more productive with an LER value of 2.28 compared to peanut monoculture and 1.35 compared to okra monoculture

Quantifying yield and economics of improved rice (Oryza sativa L.) varieties through frontline demonstrations (FLDs) in Manipur

The study aimed at quantifying yield and economics of the performance of frontline demonstrations (FLDs) in terms of grain yield, extension gap, technological gap and economic gains in six improved varieties of rice in 9 districts of Manipur during 2016-17 to 2018-19. The data on selected parameters of demonstration plots as well as control plots were collected through experimental designs (‘Control-Treatment’) of social research. The results revealed that the average grain yield in demonstration plots of all the selected varieties of rice was higher than farmers practice with highest percent increase over the local check was recorded in var. RC Maniphou-7 (32.67%). The lowest extension gap and technology gap were observed in var. RC Maniphou-11 (7.5q/ha) and CAU-R1 (5q/ha). While the highest technology index was seen in RC Maniphou-7 (14.87%) variety of rice with respect to its potential yield. The study also shown that the highest additional income of Rs. 27325/ha in demonstration over local check was recorded in cultivation of var. RC Maniphou-13 with B:C ratio of 2.38. This was followed by var. RC Maniphou-10 (Rs. 27033/ha), RC Maniphou- 12 (Rs. 23550/ha) and CAU-R1 (Rs. 22153/ha). The results clearly indicate that the adoption of improved varieties of rice and recommended package of cultivation practices with scientific intervention by KVKs under frontline demonstration (FLD) programme contributes to increase the productivity and profitability of rice cultivation at farmers’ fields in Manipur, which may be further improved by reducing the cost of cultivation, extension gap and technology gap.

Dissemination of improved bottle gourd variety and its production technology through front line demonstrations

The present study was carried out the evaluating the performance of improved cultivars with scientific package and practices on production, productivity and profitability of Bottle gourd. Frontline demonstrations were conducted during 2015-16 and 2017-18 with evaluation the performance of Narendra Shankar Lauki-4 variety of Bottle gourd in Sattarkattaiya blocks of the district and record the feedback information of farmer’s. The results revealed that average yield of Bottle gourd under frontline Demonstrations were 297 and 311 q/ ha as compare to 256 and 260 q/ ha recorded in farmer’s practice and average yield increase of 16.01 and 19.61 per cent, respectively. It was observed that the benefit cost ratio (B: C) of recommended practice (FLD’s) were 2.10 and 2.15 as compared to 1.88 and 1.87 in farmer’s practice during consecutive years of study blocks. The average extension gap 46 q/ ha and average technology gap 61 q/ ha was recorded. Therefore, the results clearly indicates that the use of improved varieties and package and practices with scientific intervention under frontline demonstration programme contribute to increase the productivity and profitability of pulses in Bihar state.

From Helicopters to Hearing Aids

You have accessThe ASHA LeaderIn the Limelight1 Mar 2020From Helicopters to Hearing AidsAn audiologist uses his military experience to support legislation allowing people with hearing loss to serve. Shelley D. Hutchins Shelley D. Hutchins Google Scholar More articles by this author https://doi.org/10.1044/leader.LML.25032020.26 SectionsAboutPDF ToolsAdd to favorites ShareFacebookTwitterLinked In David Alexander knew as a boy he wanted to serve his country. The son of a Marine also wanted to be a pediatrician. In high school, he discovered the Armed Services’ Reserve Officers’ Training Corps (ROTC) program would pay for college. Shortly after starting Loyola University Maryland as pre-med, Alexander realized that path wasn’t for him. “I still wanted to do something related,” he says. “So I literally read through the course catalog and picked communication sciences and disorders (CSD).” Alexander graduated in 2002 as an Army officer headed to helicopter flight training. Although he enjoyed piloting Blackhawks, he couldn’t shake the “medical itch.” In 2009, he met a University of South Dakota audiology professor while giving CSD undergrads his ROTC pitch. The professor encouraged Alexander to complete his audiology degree. Now an audiologist at Virginia Head and Neck Surgeons and serving in the Army Reserves, Alexander applies his piloting skills and experience to his current work. Applying military skills Many skills Alexander used as a pilot enhance his audiology work. Close attention to detail is an obvious overlap. Less so is his willingness to ask others for support. This helped when performing newborn hearing screenings at Maryland School for the Deaf (MSD), where he began in 2015. “Counseling parents was tough, and some parents would get quite emotional,” Alexander says. “I tapped into my ability to ask a more experienced audiologist when I didn’t know how to do something.“ Proving a point Alexander worked with MSD students in a junior cadet program. “We taught leadership training and drill work, which is all about communication,” he says. “In the military this is all verbal command, but we developed hand and arm signs with American Sign Language to do the same marching formations. Our cadets were invited to Fort Jackson in South Carolina to participate in boot camp for a few days. Our students did everything. And they figured out ways to communicate with each other and work together as one big group. The Army mantra happened in front of our eyes— ‘One team, one fight.’” Changing his mind Keith Nolan, a teacher, approached Alexander shortly after he started at MSD. “He is deaf and wanted to join the military,” Alexander says. “He asked what I thought about deaf people serving in the military. I gave a non-answer, but thought to myself it was impossible. But Keith showed me research he’d done on deaf soldiers in the Israeli Defense Force. I then thought—why haven’t we done this already?!” Advocating for change After Keith Nolan convinced Alexander that people who are deaf can serve in the military, the two worked together. “I helped Keith almost pass a bill allowing for a demonstration program of about 20 soldiers who are deaf to serve in the Air Force. It got close last year ... it made it out of the House Armed Services Committee and passed in the House as part of the National Defense Authorization Act (NDAA), but never made it into the Senate version. It was positive progress, really positive.” Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 25Issue 2March 2020 Get Permissions Add to your Mendeley library History Published in print: Feb 28, 2020 Metrics Downloaded 483 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2020 American Speech-Language-Hearing AssociationLoading ...

Trend in Age-Specific Cancer Mortality and Cancer-Free Life Expectancy in China, 2008-2017: An Analysis of Nationwide Data

Background: Cancer is the main chronic disease that affects the health of Chinese residents, however, less systematic study on cancer-free life expectancy in China. We aimed to explore age-specific cancer mortality and changes in population lifespan after removal of cancer to provide important insights and a basic reference on the development of relevant health policies such as cancer control or elderly care. Methods: We use the available data to produce estimates of the number of deaths from 2008 to 2017 for 18 age groups, both sexes, urban areas and rural areas, cancer and the three high-incidence cancers. Data used include the population data from the National Bureau of Statistics and cancer mortality from China Health Statistics Yearbook. We analyzed the change in mortality over the years, and at the same time input the population and deaths into the life table system to calculate life expectancy for all ages and cancer-free. Findings: From 2008 to 2017, the total mortality rate of cancers in China decreased at a steady trend per year in urban areas and increased in rural areas. The mortality rate of the different age groups decreased during the 10-year period while the overall mortality rate increased. The lung cancer in rural areas increased by 2.8% per year, and liver cancer and stomach cancer significantly decrease by 2.1-2.2% per year (P<0.05). Life expectancy of the entire population from 74.6 years in 2008 to 75.6 years in 2017, nearly increases about 1 year. Life expectancy in female is higher than male, urban areas are higher than rural areas. After removing the effects of cancer, life expectancy of the population increases by about 3 years. Lung cancer has a greater impact on life expectancy of the population, mainly concentrated in the male population under 54 years old. If the cancer is effectively controlled, life expectancy of population in 50-84 years will be significantly improved. Interpretation: Cancer is a seriously disease harms the health of the population in China. The development of medical is the main reason for the rapid increase in life expectancy in rural areas. Increasing smoking and obesity are the main factors affecting life expectancy of people, meanwhile, the development of new drugs and some new vaccines can effectively control cancer deaths. The study on life expectancy and healthy life expectancy are important trends in the future. Funding Statement: National High-tech R&D Program (863 Program) for High-end Electronic Medical Record Technology Development and System Application Demonstration (2012AA02A607) Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Missing.

ESR/ERS statement paper on lung cancer screening.

In Europe, lung cancer ranks third among the most common cancers, remaining the biggest killer. Since the publication of the first European Society of Radiology and European Respiratory Society joint white paper on lung cancer screening (LCS) in 2015, many new findings have been published and discussions have increased considerably. Thus, this updated expert opinion represents a narrative, non-systematic review of the evidence from LCS trials and description of the current practice of LCS as well as aspects that have not received adequate attention until now. Reaching out to the potential participants (persons at high risk), optimal communication and shared decision-making will be key starting points. Furthermore, standards for infrastructure, pathways and quality assurance are pivotal, including promoting tobacco cessation, benefits and harms, overdiagnosis, quality, minimum radiation exposure, definition of management of positive screen results and incidental findings linked to respective actions as well as cost-effectiveness. This requires a multidisciplinary team with experts from pulmonology and radiology as well as thoracic oncologists, thoracic surgeons, pathologists, family doctors, patient representatives and others. The ESR and ERS agree that Europe's health systems need to adapt to allow citizens to benefit from organised pathways, rather than unsupervised initiatives, to allow early diagnosis of lung cancer and reduce the mortality rate. Now is the time to set up and conduct demonstration programmes focusing, among other points, on methodology, standardisation, tobacco cessation, education on healthy lifestyle, cost-effectiveness and a central registry.Key Points• Pulmonologists and radiologists both have key roles in the set up of multidisciplinary LCS teams with experts from many other fields.• Pulmonologists identify people eligible for LCS, reach out to family doctors, share the decision-making process and promote tobacco cessation.• Radiologists ensure appropriate image quality, minimum dose and a standardised reading/reporting algorithm, together with a clear definition of a "positive screen".• Strict algorithms define the exact management of screen-detected nodules and incidental findings.• For LCS to be (cost-)effective, it has to target a population defined by risk prediction models.

ESR/ERS statement paper on lung cancer screening.

In Europe, lung cancer ranks third among the most common cancers, remaining the biggest killer. Since the publication of the first European Society of Radiology and European Respiratory Society joint white paper on lung cancer screening (LCS) in 2015, many new findings have been published and discussions have increased considerably. Thus, this updated expert opinion represents a narrative, non-systematic review of the evidence from LCS trials and description of the current practice of LCS as well as aspects that have not received adequate attention until now. Reaching out to the potential participants (persons at high risk), optimal communication and shared decision-making will be key starting points. Furthermore, standards for infrastructure, pathways and quality assurance are pivotal, including promoting tobacco cessation, benefits and harms, overdiagnosis, quality, minimum radiation exposure, definition of management of positive screen results and incidental findings linked to respective actions as well as cost-effectiveness. This requires a multidisciplinary team with experts from pulmonology and radiology as well as thoracic oncologists, thoracic surgeons, pathologists, family doctors, patient representatives and others. The ESR and ERS agree that Europe's health systems need to adapt to allow citizens to benefit from organised pathways, rather than unsupervised initiatives, to allow early diagnosis of lung cancer and reduce the mortality rate. Now is the time to set up and conduct demonstration programmes focusing, among other points, on methodology, standardisation, tobacco cessation, education on healthy lifestyle, cost-effectiveness and a central registry.