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The substantial public health benefits of autonomous vehicles will be optimised once all vehicles operate in autonomous mode. This form of disruptive technology will need to be widely accepted by the community to facilitate the regulatory and behavioural adjustments required to achieve rapid adoption. The aim of this study was to assess: i) receptiveness to autonomous vehicles; ii) the salience of various health benefits (e.g. crash prevention, emission reduction, driving stress reduction, cyclist safety, increased mobility for those unable to drive); and iii) prompted awareness of these health benefits. Quantitative and qualitative data were generated via a national online survey of a broad range of Australians aged 16 years and over (n=1,624). There were neutral levels of receptiveness and very low salience of health benefits, but more substantial levels of prompted awareness of positive health outcomes. These results suggest that the public may be interested in information relating to the individual and societal health benefits of autonomous vehicles, which in turn may increase overall support for this innovation. Australians are likely to be receptive to autonomous vehicles when provided with information relating to their public health benefits.

In Australia, telehealth is not new, with several telehealth specialist services being available for those living in rural and remote communities. However, prior to the COVID-19 pandemic, telehealth was not routinely available for primary care or urban specialist appointments. There has been an increased focus in the use of telehealth within primary care, and particularly general practice, but overall, there has been limited research to date to guide telehealth best-practice based on consumer experiences and preferences within these settings. We aimed to capture the consumer experience of telehealth during the COVID-19 pandemic, through a novel Kitchen Table Discussion (KTD) method. This increases access to a broader community consumer cohort, with consumer hosts leading discussions in a safe environment. The KTDs were conducted in May 2021, with 10 community members each hosting a group of up to 10 participants. A total of 90 participants took part from across Australia, with the majority living in major cities, although a significant proportion lived in inner and outer regional areas of Australia, or had experience living in rural, regional or remote areas. Seventy percent of participants reported using telehealth in the past. Data were analysed sequentially using thematic analysis and identified key themes: modality, convenience, access, wait time, existing relationship, communication, connectivity, cost, and privacy. Overall, the future of telehealth looks hopeful from the perspective of the consumer, but significant improvements are required to improve consumer engagement and experience. It is evident that ‘one size does not fit all’, with results suggesting consumers value the availability of telehealth and having choice and flexibility to use telehealth when appropriate, but do not want to see telehealth replacing face-to-face delivery. Participants tended to agree that telehealth was not a preferred method when physical examination was required but would suit certain points of the patient journey.

يتناول كتاب (نهاية الشر : كيفية الانتصار على الإرهاب) والذي قام بتأليفه (ديفيد فروم) في حوالي (268) صفحة من القطع المتوسط موضوع (الإرهاب في الولايات المتحدة الأمريكية) مستعرضا المحتويات التالية : ماذا الآن، نهاية البداية، المحور الجديد، الحرب في الوطن، الحرب في الخارج، حرب الأفكار، التنظيم من أجل النصر، الأعداء والأصدقاء، حرب في سبيل الحرية.

The opportunity to assess cochlear implant outcomes remotely provides the potential to streamline delivery of care for cochlear implant users. However, the conditions required for its implementation into clinic systems must be fully understood to ensure success and sustainability. The objectives of this study were to (i) use a discrete choice experiment quantify the preferences of cochlear implant users when considering use of Cochlear Remote CheckTM, a remote assessment service, and (ii) explore the perceptions, insights and attitudes of CI users that may influence utilisation of a remote service. A discrete choice experiment was administrated to Australian adult cochlear implant users via an online survey. Participants chose between pairs of hypothetical clinical service options for three different clinical scenarios (acute care, troubleshooting and long-term review). Participants answered a series of questions focusing on how and when remote services should be discussed and offered within their hearing journey. A total of 124 adult cochlear implant users completed the survey. Conditional logit analysis revealed the strongest participant preference was clinician continuity for assessment review, followed by low service costs. They preferred to receive assessment results within one week of completion, but not by videoconference/call in the acute care scenario. Only 12% of participants preferred in-clinic visits for all scenarios. Notably, 100% of participants felt that cochlear implant users should be made aware of remote service opportunities available to them. Study participants placed high importance on clinician continuity, but preferences for timing and delivery of results were less pronounced. This information can help to inform customisation of remote services by individual clinics. Costs and payment infrastructure for providing remote care require careful consideration. Whilst there is an appetite for use of Remote CheckTM alongside clinic visits, it is not suitable for, nor preferred by, all cochlear implant users.

Background Australia has a well-established health technology assessment process and there is extensive use of generic health related quality of life (HRQoL) instruments in evidence presented to it. However, there are gaps in tools and evidence available to support evaluation of paediatric health. The aim of this paper is to produce an Australian EQ-5D-Y-3L (Y-3L) value set. Methods The methods follow the international Y-3L valuation protocol, but with an expanded design. Data were collected using Composite Time Trade Off (cTTO) and Discrete Choice Experiment (DCE) data from two independent samples of adult members of the Australian general public. In total, 52 Y-3L health states, assigned into four blocks of 14 health states each containing health state 33333, were valued using cTTO. cTTO data were collected via videoconferencing interview and each respondent valued 14 health states. Mean observed cTTO values were adjusted for censoring at -1 using a Tobit model. For the DCE component, 150 latent scale DCE choice pairs were collected via an online survey with each participant completing 15 pairs. DCE data were modelled using a garbage class mixed logit model. Two approaches to anchor DCE data to the Quality Adjusted Life Years (QALYs) scale were explored: anchoring on the value for the worst health state (33333); and mapping DCE data onto the mean cTTO values using all 52 health states. Two evaluation criteria were used to select the final value set: (1) coefficient significance and logical consistency; (2) prediction accuracy of the mean observed cTTO values. Results In total, 268 individuals participated in the cTTO interviews, and 1002 completed the DCE. The linear mapping without intercept performed best and was selected as the final value set. Health state values ranged between 0.142 and 1. The relative importance of domains by level 3 coefficients (ordered from most to least important) was: pain/discomfort, then feeling worried, sad or unhappy, usual activities, looking after myself, and mobility. Conclusion This study reports an Australian value set for the Y-3L, which enables the calculation of QALYs for use in the economic evaluation of paediatric interventions and can support evidence development and decision making. Key points Employing the international EQ-5D-Y-3L (Y-3L) valuation protocol, this study developed an Australian Y-3 L value set, which enables the calculation of QALYs for use in the economic evaluation of paediatric interventions and can support evidence development and decision making. Pain/discomfort was considered as the most important domain, followed by feeling worried, sad or unhappy, usual activities, looking after myself, and mobility. In the value set, the worst health state is valued as being better than being dead, which is not the case for most other Y-3L value sets and adult EQ-5D-3L value sets. This reflects the unwillingness of adults to trade off life years in cTTO when considering children’s health states.

One prominent barrier faced by healthcare consumers when accessing health services is a common requirement to complete repetitive, inefficient paper-based documentation at multiple registration sites. Digital innovation has a potential role to reduce the burden in this area, through the collection and sharing of data between healthcare providers. While there is growing evidence for digital innovations to potentially improve the effectiveness and efficiency of health systems, there is less information on the willingness of healthcare consumers to embrace and utilise technology to provide data. The study aims to improve understanding of consumers' preference for utilising a digital health administration mobile app. The online study used a stated preference experiment design to explore aspects of consumers' preference for a mobile health administration app and its impact on the likelihood of using the app. The survey was answered by a representative sample (by age and gender) of Australian adults, and sociodemographic factors were also recorded for analysis. Each participant answered eight choice sets in which a hypothetical app (defined by a set of dimensions and levels) was presented and the respondent was asked if they would be willing to provide data using that app. Analysis was conducted using bivariate logistic regression. For the average respondent, the two most important dimensions were the time it took to register on the app and the electronic governance arrangements around their personal information. Willingness to use any app was found to differ based on respondent characteristics: people with higher education, and women, were relatively more willing to utilise the mobile health app. This study investigated consumers' willingness to utilise a digital health administration mobile app. The identification of key characteristics of more acceptable apps provide valuable insight and recommendations for developers of similar digital health administration technologies. This would increase the likelihood of achieving successful acceptance and utilisation by consumers. The results from this study provide evidence-based recommendations for future research and policy development, planning and implementation of digital health administration mobile applications in Australia.

Objective Myasthenia gravis is a chronic neuromuscular disease that causes weakness. It’s uncertain whether generic health instruments can adequately capture its impact. This study aimed to develop a scoring system to generate utility values for all health states defined by the myasthenia gravis quality of life 6-dimension (MGQoL-6D) classification in Chinese patients with myasthenia gravis (MG). Methods The data used in this study were obtained from a web-based cross-sectional study conducted in China. Patients with MG were invited to complete an online discrete choice experiment (DCE) survey. Each participant completed 10 randomly assigned choice pairs from a set of 40 choice pairs, with each pair comprising two health states and a duration attribute. Conditional logistic regression analysis was employed to analyse the data, which included responses from 300 patients. Results Utility decrements estimated by conditional logit regression were generally monotonic, with the largest decrements observed for emotion (− 0.419), social activity (− 0.323), and hobbies and fun activities (− 0.323). The MGQoL-6D utility scores ranged between − 0.559 and 1. Conclusion This study established utility weights for the MGQoL-6D that can facilitate cost-utility analyses related to MG-related health interventions and technologies.

Background Discrete-choice experiments (DCEs) are used in the development of preference-based measure (PBM) value sets. There is considerable variation in the methodological approaches used to elicit preferences. Objective Our objective was to carry out a structured review of DCE methods used for health state valuation. Methods PubMed was searched until 31 May 2018 for published literature using DCEs for health state valuation. Search terms to describe DCEs, the process of valuation and preference-based instruments were developed. English language papers with any study population were included if they used DCEs to develop or directly inform the production of value sets for generic or condition-specific PBMs. Assessment of paper quality was guided by the recently developed Checklist for Reporting Valuation Studies. Data were extracted under six categories: general study information, choice task and study design, type of designed experiment, modelling and analysis methods, results and discussion. Results The literature search identified 1132 published papers, and 63 papers were included in the review. Paper quality was generally high. The study design and choice task formats varied considerably, and a wide range of modelling methods were employed to estimate value sets. Conclusions This review of DCE methods used for developing value sets suggests some recurring limitations, areas of consensus and areas where further research is required. Methodological diversity means that the values should be seen as experimental, and users should understand the features of the value sets produced before applying them in decision making.