Impacts of an interpretation fee on immigrants' access to healthcare: Evidence from a Danish survey study among newly arrived immigrants.

In 2018, a fee for healthcare interpretation was introduced for immigrants living in Denmark for more than 3 years to incentivize learning Danish faster. Little is known about who is affected and how immigrants experience impacts of the fee. Using survey data from 2021 (n = 486), we analysed prevalence and socio-demographic background of immigrants reporting interpretation needs, and self-reports about whether the fee had impacted their access to healthcare. In the study population, 19% (n = 95) reported interpretation needs. Refugees and their families (OR: 10.2) more often reported interpretation need compared with EU/EEA immigrants, as did immigrants with low education (OR: 1.86), low income (OR: 2.63) or poor self-perceived health (OR: 3.18), adjusted for gender, age, region of residence and length of stay. among immigrants needing interpretation, 42% (n = 69) reported having refrained from seeking healthcare due to the fee, 73% (n = 119) using ad hoc interpreters, and 77% (n = 126) trying to learn Danish faster. Findings suggest that the policy aim of incentivizing host country language acquisition is partly met, but that the fee has unintended consequences in terms of hampered access to healthcare and increased use of ad hoc interpreters, raising concerns about unmet health needs and poorer quality of care for a substantial group. Potential benefits of the policy should be carefully evaluated against severe negative impacts on immigrants' access to healthcare.

Status of snack behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To understand the current situation regarding snack food consumption among grade 4 and grade 5 primary school students in agricultural and pastoral areas of Qinghai Province, China, and to provide a scientific basis for nutrition education and intervention strategies.@*Methods@#Multistage stratified cluster random sampling was employed. The research included 969 fourth and fifth grade students were selected from 10 primary schools in four counties and districts of three cities in Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. The self report questionnaire method was used to investigate the current status regarding snack food consumption in this population.@*Results@#The proportion of students who consumed snack food at home, school and elsewhere were 98.2%, 88.5% and 75.4%, respectively. Male students reported a lower rate of snack consumption at school than female students ( χ 2=9.66). The fifth grade students reported a higher rate of snack consumption at home and other places than the fourth grade students ( χ 2=10.31, 6.77). The reported rate of snack consumption of students in the rural was higher than that in the county( χ 2=6.03,100.53, 24.77). The reported rate of snack consumption of boarding students at home was lower than that of non-boarding students ( χ 2=7.22), while the reported rate of snack consumption at school was higher than that of non-boarding students ( χ 2=9.04）（ P <0.01). The most popular snacks consumed at home included fruits and vegetables, cereals and nuts (76.9%, 67.2%, 63.7%), while the most popular snacks consumed at school were fruits and vegetables, cereals and candies (45.1%, 36.9%, 24.4%). The most popular snacks consumed in other settings included ice cream, candies and beverages(54.7%, 51.6%, 42.9%). The top three reasons for snacking were that snacks were regarded as delicious, healthy/nutritious and clean (76.9%, 65.5% and 59.0%, respectively).@*Conclusion@#Snacking is popular among students, although many snacks are unhealthy. Therefore, there is a need to improve food environments and nutrition education, so as to help students to choose healthy beverages and adopt healthy eating behaviors.

Is Hospital Hospice Service Associated with Efficient Healthcare Utilization in Deceased Lung Cancer Patients? Hospital Charges at Their End of Life.

In July 2015, South Korea began applying National Health Insurance reimbursement to inpatient hospice service. It is now appropriate and relevant to evaluate how hospice care is associated with healthcare utilization in terminal lung cancer patients. We used nationwide NHI claims data of lung cancer patients from 2008-2018 and identified a sample of patients deceased after July 2016. We transposed the dataset into a retrospective cohort design where a unit of analysis was each lung cancer patients' healthcare utilization. The differences in hospital charges per day were investigated depending on the patient's use of hospice service before death with the Generalized Linear Model (GLM) analysis. Additionally, subgroup analysis and the propensity score matching method were used to validate the model using the claims information of 25,099 patients. About 17.0% of patients used hospice services (N = 4260). With other variables adjusted, hospice service utilization by deceased lung cancer patients was associated with statistically significant lower hospital charges per day at the end of life (1 month, 3 months, and 6 months before death) compared to non-users. A similar trend was found in the propensity score matching model analysis. We found lower end-of-life hospital charges per day among lung cancer patients who received hospice services near death. The ever-expanding aging population requires health policymakers and the National Health Insurance program to expand hospice services for terminal cancer patients in underserved regions and hospitals that do not provide hospice.

The Effect of Prospective Payment Systems on Health Care Providers' Behavior: A Case Study of Global Surgeries Payment System in Iran.

Background: Global payment system is a kind of case-based payment system which pays for 60 commonly surgical operations by the average cost for each specified surgery case in Iran. The aim of the study was to determine the effect of this payment system on the number of services provided for each global surgical case versus fee-for-service (FFS) for the same operation. Methods: This is a retrospective study based on data from a large referral teaching hospital in Iran in the period of 2012-2015. Information related to 46 surgeries was performed which both global and FFS documents were gathered (N=7672). Statistical analysis was done on variables including Length of stay (LOS), Blood test (BT), Radiology (RA) and a mixed variable named VC (visit and consult number). Data were analyzed by a zero-inflated negative binomial regression model using STATA 11. Results: Descriptive analysis showed the mean of each service was significantly (p<0.001) higher in the FFS document's group rather than the global payment group. Regression estimates showed the amounts of each service including LOS, BT, RA and VC were significantly (p<0.001) higher in FFS surgery than global documents for the 15 selected surgery. LOS and BT have shown a significantly higher amount in 100% of surgeries for FFS above global document. Same as for Radiology test and VC variables, there were significantly higher amounts in 93% of surgeries for FFS above global hospital documents. Conclusion: The findings can reinforce the presence of a relationship between providing more clinical services in FFS document form and providers' incentives to adjust profits against their Costs. The significantly higher service provision in FFS documents can be controlled with a prospective global payment mechanism.

Methods for estimating the cost of treat-and-release emergency department visits.

OBJECTIVE: To evaluate and compare approaches to estimating the service delivery cost of emergency department (ED) visits from total charge data only. DATA SOURCES: The 2013-2017 Healthcare Cost and Utilization Project's (HCUP) State Emergency Department Databases (SEDD) and the Centers for Medicare and Medicaid Services Healthcare Cost Report Information System (HCRIS) public use files. STUDY DESIGN: Compare a baseline approach (requiring cost-center-level charge detail) and four alternative methods (relying on total charges only) for estimating ED visit costs. Estimation errors are calculated after applying each method to a sample of ED visits, treating estimates from the baseline approach as the "true" cost. Performance metrics are calculated at the visit and hospital levels. DATA COLLECTION/EXTRACTION METHODS: The charges, revenue center codes, and patient/hospital characteristics were extracted from the SEDD. Detailed costs and charges were extracted from HCRIS public use files. PRINCIPAL FINDINGS: Baseline ("true") ED visit costs increased from $383 to $420 per visit between 2013 and 2017. Three methods performed comparatively well estimating mean cost per visit. The method using an overall cost-to-charge ratio (CCR) for all ancillary cost centers without regression adjustment (ANC-CCR) performed the worst, overestimating "true" costs by $63-$113 per visit. The other three methods, which used CCRs computed from selected cost centers, exhibited much smaller bias, with two of the methods yielding estimates within $2 of the "true" cost in 2017. Compared with ANC-CCR, the other three methods had more compact estimation error distributions. The estimated mean visit costs from all four methods have relatively small statistical variance, with 95% confidence intervals for mean cost in a hospital with 25,000 ED visits ranging between $4 and $7. CONCLUSIONS: When cost-center-level charge detail for ED visits is unavailable, alternative methods relying on total ED charges can estimate ED service costs for patient and hospital segments.

Research updates of international strategies to control sugar-sweetened beverages consumption in children and adolescents / 中国学校卫生

Abstract@#Excessive intake of sugar-sweetened beverages among children and adolescents could increase the risks of adverse health outcomes, including dental caries and obesity. This study reviewed the consumption of sugar-sweetened beverages among children and adolescents in China and the international strategies to reduce the consumption of sugar-sweetened beverage. The aim of the study was to provide a reference for the introduction of relevant policies to control the intake of sugar-sweetened beverages in children and adolescents in China. In summary, measures including a tax on sugar-sweetened beverages, implementing front-of-pack labelling system, restricting marketing and publicity and education have been adopted to control the consumption of sugar-sweetened beverages in some countries, while public publicity and education have been adopted in China. It is suggested that comprehensive policies and measures should be adopted to control the intake of sugar-sweetened beverage among Chinese children.

Snack consumption and the influencing factors of students participation in the Nutrition Improvement Program for Rural Compulsory Education in 2019 / 中国学校卫生

Objective@#To evaluate snack consumption and the influencing factors associated with student participation in the Nutrition Improvement Program, and to provide a scientific basis for improving the program.@*Methods@#Among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns (i.e., school, company, and mix). This study randomly selected one or two classes from each grade, which ranged from grade 3 to grade 9. A questionnaire, which addressed snack consumption and choice, was distributed to 27 374 students.@*Results@#The findings revealed that 14.0% of students from poor rural areas in central and western regions consumed snacks two or more times per day, and 21.6% of students spent 3 yuan or more on snacks each day. The top three choices of snacks included fruit and vegetables (50.6%), biscuits and bread (50.1%), and puffed food (40.0%). Students who had mothers who worked outside the home, parents who worked outside the home, who consumed corporate meals, and who had access to a small shop on campus were more likely to consume snacks one or more times per day(OR=1.35，1.19，1.11，1.51，P<0.05).@*Conclusion@#The phenomenon of snack consumption among primary and middle school students from poor rural areas in central and western regions is common, and the selection of unhealthy snacks was identified as a problem. A health education system with comprehensive support and guidance from individuals, families, schools, and society should be established to guide students to opt for healthier snacks.

Impact of antimicrobial stewardship fee on prescribing for Japanese pediatric patients with upper respiratory infections.

BACKGROUND: In 2018, the Japanese medical reimbursement system was revised to introduce a fee for the implementation of an antimicrobial stewardship (AS) fee for pediatric patients. The purpose of this study was to evaluate physicians' prescription behavior following this revision. METHODS: We conducted a retrospective observational study from January 1, 2017 to September 30, 2018 of pediatric (< 15 years) outpatients with upper respiratory tract infections (URIs). To assess the pattern of antibiotic prescription for the treatment of pediatric URIs before and after the introduction of the AS fee, we extracted data on pediatric URIs, diagnosed during the study period. Patients were divided based on whether medical facilities claimed AS fees. We defined antibiotic use as the number of antibiotics prescribed, and evaluated the proportion of each class to the total number of antibiotics prescribed. We also recorded the number of medical facilities that each patient visited during the study period. RESULTS: The frequency of antibiotic prescription decreased after AS fee implementation, regardless of whether the facility claimed the AS fee, but tended to be lower in facilities that claimed the fee. Additionally, the frequency of antibiotic prescription decreased in all age groups. Despite the reduced frequency of antibiotic prescription, consultation behavior did not change. CONCLUSIONS: The AS fee system, which compensates physicians for limiting antibiotic prescriptions, helped to reduce unnecessary antibiotic prescription and is thus a potentially effective measure against antimicrobial resistance.

Beverages consumption, sleep quality and depressive symptoms in Chinese university students: a latent variable mediation model / 中国学校卫生

Objective@#This study aimed to examine the mediating effects of sleep quality in the association between beverages consumption and depressive symptoms in Chinese university students, and to provide a theoretical reference for preventing and reducing depression symptoms.@*Methods@#This school-based cross-sectional survey was carried out among 4 624 university students from 2 universities in Anhui and Jiangxi provinces of China. The patient health questionnaire-9 items (PHQ-9) was used to assess depressive symptoms. The Pittsburgh sleep quality index（PSQI） was used to assess sleep quality, and a self-reported dietary frequency questionnaire was used to measure beverages consumption. The quantile regression model was used to association analysis, and the latent variable mediation model was used to analyze the mediation effect.@*Results@#The positive rates of mild, moderate, moderate to severe and severe depression in 4 624 university students were 31.4%, 7.5%, 4.1% and 2.0%, respectively. There was a significant association between the beverages consumption score, the PSQI score, and the PHQ-9 score( P <0.01). The higher the quantile of the beverage consumption and PSQI score, the greater the regression coefficient ( β ), and a significant dose-response relationship was observed( P <0.01). In the latent variable mediation model of beverages consumption associated with depressive symptoms in Chinese university students, the mediating effect value of sleep quality was 0.12, and the ratio of mediating effect to total effect was 71.3%.@*Conclusion@#Our study demonstrates that poor sleep quality partially mediates the association between beverages consumption and depressive symptoms in Chinese university students.

Emergency Department Utilization for Substance Use-Related Disorders and Assessment of Treatment Facilities in New York State, 2011-2013.

BACKGROUND: Annually, 1.8 million New York (NY) residents experience substance use disorders (SUDs). Even though emergency departments (EDs) continue to experience high numbers of SUD-related visits, only 15% receive treatment. OBJECTIVES: This study estimates hospital-based EDs rates for SUDs in the State of New York. Also, the geographic distribution of substance use treatment centers and EDs are mapped to correlate utilization with access to care. METHODS: The 2011-2013 Healthcare Cost and Utilization Project's NY State Emergency Department Database provided information on utilization of services in EDs, charges, diagnoses, and discharge, as well as patient demographic variables. All patients within NY who had visited the ED for SUDs comprised the study population. Geographic mapping of EDs and substance abuse treatment centers at the county-level is based on data from the National Emergency Department Inventory and National Survey of Substance Abuse Treatment Services, respectively. RESULTS: A total of 492,419 ED visits for SUDs were reported through 2011-2013. Despite NY's Medicaid expansion in 2012, ED visits increased in 2013. About $856 million was spent in treating SUDs in EDs, with average charge of $1,764 per visit. Conclusions/Importance: Alcohol and drug-induced mental disorders are increasingly prevalent in New York's EDs. There is a need to develop health policies and programs to improve access to care for SUDs in urban states.

Comparison of the costs of different clinical treatment plans for children with acute promyelocytic leukemia / 白血病·淋巴瘤

Objective@#To explore the costs and other information of two different treatment plans for pediatric acute promyelocytic leukemia (APL): one is the traditional intravenous drip arsenic (arsenic trioxide) combined with chemotherapy treatment, and the other is a medication family treatment program based on oral arsenic (Realgar-Indigo naturalis formula), in order to provide a reference for the promotion of pediatric APL family treatment mode and the formulation of medical insurance policies.@*Methods@#The medical record homepage data and drug using of pediatric APL from 2010 to 2018 in Institute of Hematology & Blood Diseases Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively analyzed, and the newly diagnosed pediatric patients (≤14 years old) with APL were included. The hospitalization expenses and hospitalization time of two treatment options were compared. One treatment option was Chinese children APL treatment plan 2010 (CCAPL 2010), which was based on intravenous drip arsenic trioxide. The other was Chinese Children Cancer Group APL treatment plan 2017 (CCCG-APL 2017), which was based on oral Realgar-Indigo naturalis formula.@*Results@#A total of 79 pediatric APL patients were included and grouped according to the treatment plans, 56 patients were treated with CCAPL 2010 plan, and 23 patients were treated with CCCG-APL 2017 plan. The median costs of one single pediatric APL patient in CCAPL 2010 plan was 167 700 yuan (95 800-386 600 yuan), and the median hospital stay time of one single pediatric APL patient was 102 days (14-157 days). The median costs of one single pediatric APL patient in CCCG-APL 2017 plan group was 118 700 yuan(50 800-270 600 yuan), and the median hospital stay time of one single pediatric APL patient was 37 days(5-96 days). The costs and hospital stay time of one single pediatric APL patient with CCCG-APL 2017 plan were remarkably less than those of one single pediatric APL patient with CCAPL 2010 plan (U = 178, P < 0.01; U = 66, P < 0.01).@*Conclusions@#The CCCG-APL 2017 plan simplifies the treatment plan compared with the CCAPL 2010 plan and significantly reduces the patient's medical expenses and shortens the hospitalization days. The CCCG-APL 2017 plan is suitable for family therapy and has good social and economic benefits, which is worthy of clinical promotion.

Comparison of the costs of different clinical treatment plans for children with acute promyelocytic leukemia / 白血病·淋巴瘤

Objective To explore the costs and other information of two different treatment plans for pediatric acute promyelocytic leukemia (APL): one is the traditional intravenous drip arsenic (arsenic trioxide) combined with chemotherapy treatment, and the other is a medication family treatment program based on oral arsenic (Realgar-Indigo naturalis formula), in order to provide a reference for the promotion of pediatric APL family treatment mode and the formulation of medical insurance policies. Methods The medical record homepage data and drug using of pediatric APL from 2010 to 2018 in Institute of Hematology & Blood Diseases Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively analyzed, and the newly diagnosed pediatric patients (≤14 years old) with APL were included. The hospitalization expenses and hospitalization time of two treatment options were compared. One treatment option was Chinese children APL treatment plan 2010 (CCAPL 2010), which was based on intravenous drip arsenic trioxide. The other was Chinese Children Cancer Group APL treatment plan 2017 (CCCG-APL 2017), which was based on oral Realgar-Indigo naturalis formula. Results A total of 79 pediatric APL patients were included and grouped according to the treatment plans, 56 patients were treated with CCAPL 2010 plan, and 23 patients were treated with CCCG-APL 2017 plan. The median costs of one single pediatric APL patient in CCAPL 2010 plan was 167 700 yuan (95 800-386 600 yuan), and the median hospital stay time of one single pediatric APL patient was 102 days (14-157 days). The median costs of one single pediatric APL patient in CCCG-APL 2017 plan group was 118 700 yuan(50 800-270 600 yuan), and the median hospital stay time of one single pediatric APL patient was 37 days (5-96 days). The costs and hospital stay time of one single pediatric APL patient with CCCG-APL 2017 plan were remarkably less than those of one single pediatric APL patient with CCAPL 2010 plan (U ＝ 178, P < 0.01; U ＝ 66, P< 0.01). Conclusions The CCCG-APL 2017 plan simplifies the treatment plan compared with the CCAPL 2010 plan and significantly reduces the patient's medical expenses and shortens the hospitalization days. The CCCG-APL 2017 plan is suitable for family therapy and has good social and economic benefits, which is worthy of clinical promotion.

Analysis of the current situation and related factors of beverage consumption in college sports specialty / 中国学校卫生

Objective@#To study the consumption status of sports drinks in colleges and universitiesand its influencing factors,so as to provide the scientific basis for conducting nutrition education and making interventional measures.@*Methods@#2 610 college students from arts school, PE school and Chemistry and Environmental Science Institute of a university in Shangrao city, Jiangxi Province were randomly selected by random cluster sampling method to investigate the frequency and types of drinking beverages.@*Results@#In terms of gender, apart from lactic acid drinks, there was significant statistical significance in whether men and women regularly consumed beverages (fruit and vegetable juice drinks, χ2=24.20;Tea beverage, χ2=45.58;Carbonated beverage, χ2=57.27;Energy drink χ2=86.68, P<0.01).In addition to lactic acid drinks, there was statistically significant difference in whether the college regularly consumed beverages (fruit and vegetable juice drinks, χ2=54.72;Tea beverage, χ2=25.97;Carbonated beverages, χ2=46.64;Energy drinks χ2=74.81, P<0.01).In terms of family residence, only tea beverage (χ2=25.97) and carbonated beverage (χ2=46.64) had statistical significance（P<0.01）. In terms of monthly living expenses, all beverage types had statistical significance (milk beverage, χ2=11.69;Fruit and vegetable juice beverage, χ2=18.92;Tea beverage, χ2=20.09;Carbonated beverages,χ2=29.98;Energy drink χ2=17.71, P<0.01). Logistic regression analysis showed that apart from lactic beverages, male students were more likely to consume fruit and vegetable juice, tea beverage, carbonated drinks and functional drinks than female students(OR=1.60, 2.38, 2.50, 4.95, P<0.01); The students in PE school were more likely to consume lactic beverages and functional drinks than those in Arts school, while the students in Chemistry and environmental science institute were less likely to consume fruit and vegetable juice, tea beverage, carbonated drinks and functional drinks than those in Art school (OR=1.29, 2.19, 0.43, 0.50, 0.42, 0.42, P<0.05); The students who spent >1 500 yuan monthly were more likely to consume lactic beverages, fruit and vegetable juice, tea beverage, carbonated drinks than those spent <1000 yuan monthly, and they consumed more functional than those spent<1 000 yuan monthly(OR=1.68, 1.75, 1.73, 2.15, 1.69, P<0.05).@*Conclusion@#The students of different characters have different kinds of beverages. Therefore, health education should focus on male students who spend <1 500 monthly, and targeted measures should be taken to help college students build up a reasonable concept of beverage consumption so as to promote the formation of a scientific behavior of beverage consumption.

The Opaque Fight Against Price Transparency.

For those who doubt the importance of transparency in price and quality to free the market, you just have to look behind the public curtain and observe the fierceness with which the opponents of transparency are trying to keep consumers in the dark.

HDHPs: Cost Shift But No Swing to High-Value Care.

Employers and health insurers are asking consumers to put "more skin in the game" with high deductible health plans, but don't provide incentives for them to choose high-value care. A recent study in the American Journal of Managed Care found no change in spending on 26 commonly used, low-profile services.

Direct Primary Care: Applying Theory to Potential Changes in Delivery and Outcomes.

Direct Primary Care (DPC), where patients pay a fee to a primary care provider to obtain access to services, is a delivery model that has received notable attention and enthusiasm from some providers. Proponents of DPC believe that the model increases accessibility, reduces overhead, and ultimately improves care for patients; however, there is little evidence in the peer-reviewed literature to support these claims. The objective of this analysis was to apply Starfield's adaptation of Donabedian's Structure-Process-Outcome conceptual model to evaluate primary care to formally display the links between potential changes in clinical structure and processes from DPC adoption. Based on existing literature on the constructs in Starfield's model, expectations of DPC's impact at the patient, clinic, and system levels were defined. DPC uses changes to financing and the population eligible to trigger potential gains in continuity and accessibility to subsequently improve care processes. There is evidence to support DPC as a theoretically sound approach to improve attributes of primary care, such as first contact care and longitudinality at the clinic level for participating patients. At the health system level, DPC has low-construct validity that would suggest a positive impact on the potentially eligible population's health due to membership fees that exclude patients who are more likely to be vulnerable and complex than patients who are willing and able to stay in the practice. Descriptive and comparative research of included and excluded patients is needed to inform providers, patients, and policy makers of the DPC's ability to attain the attributes of primary care and ultimately achieve better outcomes over alternative primary care delivery and financing models. Meanwhile, theoretic application informed by years of research on primary care provide insight as to what changes to expect and to monitor as practices consider DPC adoption.

Free Children's Visits and General Practice Attendance.

PURPOSE: In July 2015, all children aged younger than 6 years gained free access to daytime and out-of-hours general practice services in the Republic of Ireland. Although 30% previously had free access, 70% did not. METHODS: To examine subsequent changes in service use, we retrospectively analyzed anonymized visitation data from 8 general practices in North Dublin providing daytime service and their local out-of-hours service, comparing the 1 year before and the 1 year after introduction of free care. RESULTS: In the year after granting of free general practice care for children younger than 6 years, 9.4% more children attended the daytime services and 20.1% more children were seen in the out-of-hours services. Annual number of visits by patients increased by 28.7% for daytime services and by 25.7% for out-of-hours services, translating to 6,682 more visits overall. Average visitation rate for children this age increased from 2.77 visits per year to 3.25 visits per year for daytime services, but changed little for out-of-hours services, from 1.52 visits per year to 1.59 visits per year. CONCLUSIONS: Offering free childhood general practice services led to a dramatic increase in visits. This increase has implications for future health care service planning in mixed public and privately funded systems.

Effect of a financial incentive on the acceptance of a smoking cessation programme with service charge: a cluster-controlled trial.

INTRODUCTION: Frontline health care professionals in Hong Kong may encounter high refusal rates for the Hospital Authority's Smoking Counselling and Cessation Programme (SCCP) when smokers know it is subject to a service charge. We compared SCCP booking and attendance rates among smokers with or without a financial incentive. METHODS: In this multicentre non-randomised cluster-controlled trial, adult smokers who attended one of six general out-patient clinics between November 2015 and April 2016 were invited to join an SCCP. Attendees in the three intervention-group centres but not the three control-group centres received a supermarket coupon to offset the service charge. RESULTS: A total of 173 smokers aged 18 years or older (92 in the intervention group and 81 in the control group) were recruited into the study. In the intervention group, 47 smokers (51%) agreed via a questionnaire that they would join the SCCP, compared with only 23 smokers in the control group (28%). The booking rates were 83% (n=39) in the intervention group and 83% (n=19) in the control group. Among those who had booked a place, 19 (49%) intervention-group participants and 11 (58%) control-group participants attended an SCCP session. Multivariable logistic regression revealed that offering a coupon was associated with agreeing to join an SCCP (odds ratio=4.963, 95% confidence interval=2.173-11.334; P<0.001) and booking an SCCP place (odds ratio=4.244, 95% confidence interval=1.838-9.799; P<0.001). CONCLUSION: Provision of a financial incentive was positively associated with agreement to join an SCCP and booking an SCCP place. Budget holders should consider providing the SCCP free of charge to increase smokers' access to the service.

Perícias trabalhistas em odontologia legal: credenciamento e honorários do perito judicial no Brasil / Expert routine in labor lawsuits: forensic odontologist role, accreditation, and fees in Brazil

A figura do perito nos processos judiciais é de suma importância, pois o esclarecimento em casos cujo assunto da lide ultrapassa o conhecimento do Juiz é indispensável para uma decisão devidamente fundamentada. A Lei 5.081/66, que regula o exercício da Odontologia no Brasil, diz ser a perícia nas mais diversas áreas, uma das competências do cirurgião-dentista. Nesse sentido, no âmbito trabalhista, a perícia judicial envolve casos dos chamados infortúnios do trabalho ou doenças relacionadas à atividade laborativa e quando estes processos demandam conhecimentos acerca da Odontologia, o cirurgião-dentista é o profissional mais indicado para elaborar o laudo pericial. O objetivo deste estudo foi levantar os procedimentos referentes ao credenciamento para atuação pericial junto aos Tribunais Regionais do Trabalho (TRTs) em suas 24 regiões, bem como questões referentes aos honorários quando no contexto da justiça gratuita. Por meio de pesquisa documental, buscou-se encontrar os procedimentos de cadastro como também os valores dos honorários, através de pesquisa nos sítios eletrônicos dos TRTs e contatos com suas ouvidorias. Concluiu-se que os TRTs possuem, em sua totalidade, procedimentos próprios para cadastros de peritos, sendo uma parte por meios eletrônicos e outra por meios físicos ou presenciais, regulados por intermédio de normativas específicas. Quanto aos honorários periciais, a maior parte dos TRTs segue a Resolução nº 66/2010, do Conselho Superior da Justiça do Trabalho (CSTJ), porém algumas regiões extrapolam os valores definidos e outras desfalcam o montante gratificado ao perito.

The presence of an expert in legal proceedings is of the utmost importance, since most lawsuits demands a technical or scientifical elucidation, as this might surpass the knowledge of the Judge responsible for the case. The expert's role is indispensable for a correctly substantiated decision on the case. The Law 5.081/66, which regulates the practice of Dentistry in Brazil, embeds expertise in several legal fields as one of the dentist's skills. Among these fields, in the labor scope, the judicial expertise involves cases of so-called labor misfortunes or accidents, or labor-related diseases. When the aforementioned harm oral or dental structures and for that, call for odontological knowledge, the dentist is the most appropriate professional to produce a report for the Judge. The aim of this study was to bring forth the procedures involved in the accreditation of Brazilian dentists to the Regional Labor Courts (RLCs) in its 24 sub-divisions, as well as issues related to expert fees when the losing part is granted by free costs on legal proceedings. Through documentary research, we sought to find the registration procedures, coupled with the fees granted to the experts, via research in the Courts websites and contact with their ombudsmen. We conclude that the entirety of the RLCs have their own procedures for experts' accreditation, some by electronic means and others by physical means, all of them regulated by individual legal resolutions. Regarding the expert fees, most of the RLCs follow the Superior Council of Labor Justice Resolution 66/2010; however, some regions exceed the defined Resolution values while other ones pay lower amounts to the expert.