Assessing the feasibility, acceptability and impacts of an education program on hepatitis B testing uptake among ethnic Chinese in Australia: results of a randomised controlled pilot study

Background In Australia, Chinese migrants are among the populations most affected by hepatitis B virus (HBV) infection but often experience late diagnosis or access to clinical care. This study aims to explore approaches to increase HBV testing in Australia’s Chinese community and inform evaluation planning, specifically to i) assess the feasibility and acceptability of HBV educational programs, and ii) compare HBV testing uptake in people receiving a tailored education resource focussing on liver cancer prevention compared with a standard HBV education package. Methods This is a pre-post mixed-methods pilot and feasibility study. People of Chinese ethnicity and unsure of their HBV infection or immunity status were recruited from ten community sites in Melbourne, Australia in 2019–2020. Participants were randomised to receive an education package (comprised of a leaflet and in-person one-on-one educational session) with a focus on either 1) standard HBV-related information, or 2) liver cancer prevention. Participants completed a baseline questionnaire prior to receiving the intervention and were followed up at 6 months’ time for a questionnaire and an opt-in semi-structured interview. Primary study outcomes included feasibility of study procedures, measured by recruitment, participation, and retention rates; acceptability of the education program assessed by acceptability scores; and HBV testing uptake rate in each arm. Secondary outcomes include HBV-related knowledge change, assessed by pre-post comparison; and factors affecting participants’ testing behaviour analysed using qualitative data. Results Fifty-four participants received an education package; baseline and follow-up data from 33 (61%) were available. The study procedures of recruitment and retention were feasible; the acceptability of the education program was moderate with improved HBV-related knowledge observed. Four participants self-reported being tested: one (1/15, 7%) in the standard HBV information group and three (3/18, 17%) in the liver cancer prevention information group. Factors identified as affecting testing included perceived relevance and seriousness of HBV, healthcare access and costs of testing, and perceptions of the role of primary care providers in HBV-related care. Conclusion A tailored education program targeting ethnic Chinese in Australia was feasible with moderate acceptability. A larger study is required to determine if a liver cancer prevention message would improve HBV testing uptake in Chinese community than standard HBV education message. Supports from healthcare providers, community-based testing programs, and public health education programs are likely needed to motivate diagnostic testing among Chinese people at risk of HBV infection.

KELOMPOK INFORMASI MASYARAKAT DAN MASYARAKAT INFORMASI (Studi Kasus Kontribusi Kelompok Informasi Masyarakat Dalam Mewujudkan Masyarakat Informasi di Kota Magelang)

This paper aims to describe the contribution of Community Information Group in the development of the information society. The development of an information technology based service city, needs to be supported by community readiness. They are entities who have high information needs, able to apply information technology in various fields, and able to exchange digital data quickly over long distances. Currently, the Magelang City Government is committed to implementing a Smart City, supported by Magelang Cerdas Application, that makes it easier for the public to access local information and public services. However, community response is still low, so community information groups need support in encouraging the success of local government programs. The problem is studied descriptively qualitatively, by taking the location in Magelang City. Informants are officials of the Communication Informatics dan Statictics Agency and also management of Community Information Group who were chosen purposively. Research findings state that Community Information Group contributes in disseminating government programs to the community. However, the efforts made were less than optimal due to coordination factors, lack of human resources commpetence, priority issue, and budget issue.

Youtube English videos as a source of information on shoulder exercise after breast cancer surgery

Purpose To examine the content, quality and reliability of YouTube videos on exercises that can be performed after breast cancer surgery. Methods Videos selected from YouTube using the search terms “shoulder exercise and breast cancer surgery”, “arm exercise and breast cancer surgery”, and “physiotherapy/physical therapy and breast cancer surgery” were categorized as useful or misleading by a doctor and a physiotherapist. The videos were analyzed using the five-point DISCERN scale for reliability, the five-point Global Quality Scale (GQS) for quality, and a 10-item scale for comprehensiveness. Results Of the 180 videos initially analyzed, 82 were included in the study, and 42 (51.2%) were classified as having misleading information and 40 (48.8%) as having useful information. The reliability, content and quality scores of the videos containing useful information were higher (p<0.001). Most of the videos in the useful information group (80%) were uploaded by universities/professional organizations/physicians/physiotherapists, while the majority of those in the misleading information group (47.6%) were uploaded by websites providing independent healthcare information. The total and daily views of the videos were higher in the useful information group than in the misleading information group (p<0.001 and p=0.004, respectively). When the video parameters were evaluated between the two groups, no significant difference was found in the number of likes and comments and video length. Conclusion YouTube can be an important instrument to protect patients from musculoskeletal system complications after breast cancer surgery and improve existing complications. Universities, physicians, and physiotherapists should be encouraged to prepare more videos containing full and accurate information on this subject.

Can patient decision aids reduce decisional conflict in a de-escalation of breast radiotherapy clinical trial? The PRIMETIME Study Within a Trial implemented using a cluster stepped-wedge trial design

Background For patients with early breast cancer considered at very-low risk of local relapse, risks of radiotherapy may outweigh the benefits. Decisions regarding treatment omission can lead to patient uncertainty (decisional conflict), which may be lessened with patient decision aids (PDA). PRIMETIME (ISRCTN 41579286) is a UK-led biomarker-directed study evaluating omission of adjuvant radiotherapy in breast cancer; an embedded Study Within A Trial (SWAT) investigated whether PDA reduces decisional conflict using a cluster stepped-wedge trial design. Methods PDA diagrams and a video explaining risks and benefits of radiotherapy were developed in close collaboration between patient advocates and PRIMETIME trialists. The SWAT used a cluster stepped-wedge trial design, where each cluster represented the radiotherapy centre and referring peripheral centres. All clusters began in the standard information group (patient information and diagrams) and were randomised to cross-over to the enhanced information group (standard information plus video) at 2, 4 or 6 months. Primary endpoint was the decisional conflict scale (0–100, higher scores indicating greater conflict) which was assessed on an individual participant level. Multilevel mixed effects models used a random effect for cluster and a fixed effect for each step to adjust for calendar time and clustering. Robust standard errors were also adjusted for the clustering effect. Results Five hundred twenty-one evaluable questionnaires were returned from 809 eligible patients (64%) in 24 clusters between April 2018 and October 2019. Mean decisional conflict scores in the standard group (N = 184) were 10.88 (SD 11.82) and 8.99 (SD 11.82) in the enhanced group (N = 337), with no statistically significant difference [mean difference − 1.78, 95%CI − 3.82–0.25, p = 0.09]. Compliance with patient information and diagrams was high in both groups although in the enhanced group only 121/337 (36%) reported watching the video. Conclusion The low levels of decisional conflict in PRIMETIME are reassuring and may reflect the high-quality information provision, such that not everyone required the video. This reinforces the importance of working with patients as partners in clinical trials especially in the development of patient-centred information and decision aids.

Improving the management of menopause in women with serious mental illness

AimsTo improve the diagnosis and management of menopause in women with a serious mental illness in psychiatric services. This will be achieved by developing a questionnaire to systematically assess symptoms related to the menopause, based on NICE guidelines. Women will be offered information and advice, according to these guidelines. Barriers to the assessment or management of the menopause will be identified by piloting the questionnaire on an inpatient female ward.MethodWomen aged 40 years and over, admitted to an acute female in-patient ward in South London and Maudsley NHS Foundation Trust, were interviewed using a structured questionnaire.ResultIn total, 23 eligible women were approached of whom 17 (74%) agreed to take part with mean age 53 years (range 40–67 years). Nine women reported that they had undergone the menopause and four women reported experiencing perimenopausal symptoms. Fifteen women had not previously received information about the menopause. Of the 13 women who had undergone the menopause or were experiencing irregular periods, 7 reported experiencing hot flushes, night sweats and a general change in physical and mental health and four reported a change in mood. Seven women reported that the changes noted may have been related to the menopause over the previous 12 months. Eight women requested further information either in written format or in the form of an information group about the menopause.ConclusionWe identified women who were admitted to a psychiatric ward who had experienced symptoms related to the menopause that had impacted on their mental and physical health. It was evident that the majority of these women with severe mental illness had not had the opportunity to discuss their symptoms with a healthcare professional in the past and a significant proportion welcomed further information to help make sense of their symptoms. We intend to implement the questionnaire trust-wide with the eventual aim of developing a local guideline to inform the assessment and management of the menopause within our services.

Identification of Gene Markers for Survival Prediction of Lung Adenocarcinoma Patients Based on Integrated Multibody Data Analysis

We constructed a prognostic-related risk prediction for patients with lung adenocarcinoma by integrating multiple omics information of lung adenocarcinoma clinical information group and genome and transcriptome. Blood samples and cancer and paracancerous lung tissue samples were collected from 480 patients with lung adenocarcinoma. DNA and RNA sequencing was performed on DNA samples and RNA samples. The first follow-up was carried out 3 months after discharge. Clinical information of patients including age, gender, smoking history, and TNM stage was collected. The Cox proportional hazard model evaluated more than 600 potential SNPs related to the prognosis of lung adenocarcinoma. After LASSO analysis, we obtained 4 SNPs related to the prognosis of lung adenocarcinoma (including rs1059292, rs995343, rs2013335, and rs8078328). Through the Cox proportional hazard model, 260 candidate genes related to the prognosis of lung adenocarcinoma were evaluated. After subsequent analysis, 3 genes related to the prognosis of lung adenocarcinoma (LDHA, SDHC, and TYMS) were obtained. All survived patients were spilt into a high-risk group ( n = 170 ) and a low-risk group ( n = 170 ) according to 4 SNPs and 3 genes related to the prognosis of lung adenocarcinoma. The overall survival rate of patients in the high-risk group was lower than that in the low-risk group. The prognostic risk prediction index constructed by combining clinical information group and genomic and transcriptome characteristics of multiomics information can effectively distinguish the prognosis of patients with lung adenocarcinoma, which will provide effective support for the precise treatment of patients with lung adenocarcinoma.

Research on the Ways of People’s Participation in Anti-terrorism from the Perspective of National Anti-terrorism

Anti-terrorism by the whole people is inseparable from the extensive participation of the people. Historical experience has shown that the people are the true source of strength and the deepest source of war’s might. The anti-terrorist struggle is a fundamental contradiction between the enemy and ours. It is a long-lasting and long-term struggle. It requires the implementation of the fundamental strategy of "combination of prevention and combat, and the focus on prevention" and the extensive participation of the people. At present, the situation in the domestic fight against terrorism is still severe and complex, and there are still many problems in intelligence and information, group defense and group governance, and emergency rescue. To win the final victory in the fight against terrorism, we must create new ways for the people to participate in the fight against terrorism.