General Australian Population Research Articles

Clozapine Efficacy and Adverse Drug Reactions Among a Nationwide Study of 1021 Australians Prescribed Clozapine: The ClozaGene Study.

The ClozaGene Study is a nationwide cohort of adults who have been treated with clozapine. While clozapine is indicated in the management of treatment-resistant schizophrenia, it is associated with a considerable adverse drug reaction (ADR) burden, and not all patients achieve adequate symptomatic response. The current study focuses on self-reported experiences of clozapine use and response, clozapine-associated ADRs, and mental health comorbidity. A total of 1021 participants (41.0% female; aged 46.2 ± 10.6 years [range 18-66]) were recruited via a mail-out based on prescriptions for clozapine. Participants completed a self-report questionnaire. Most participants (90.1%, n = 912) were living with schizophrenia while 41.5% reported a lifetime diagnosis of depression, 15.6% bipolar disorder, and 8.1% schizoaffective disorder. Clozapine was currently prescribed to 944 (92.5%) participants and 37.8% of these participants self-reported currently taking additional antipsychotic medication. Nearly 3 quarters of participants living with schizophrenia reported that clozapine helped control their schizophrenia symptoms moderately to very well. The most commonly reported ADRs were sialorrhea (80.3%), weight gain (71.0%), constipation (56.9%), and sedation (52.8%). The prevalence of clozapine cessation due to clozapine-induced myocarditis and neutropenia was 1% and 0.4%, respectively. Our findings highlight the high rate of psychotic and metabolic symptoms and ADRs among adults prescribed clozapine in the general Australian population. Future genomic analyses will focus on identifying genetic variants influencing clozapine treatment response and side effects.

Consumer Preferences for a Healthcare Appointment Reminder in Australia: A Discrete Choice Experiment.

It is essential to consider the evidence of consumer preferences and their specific needs when determining which strategies to use to improve patient attendance at scheduled healthcare appointments. This study aimed to identify key attributes and elicit healthcare consumer preferences for a healthcare appointment reminder system. A discrete choice experiment was conducted in a general Australian population sample. The respondents were asked to choose between three options: their preferred reminder (A or B) or a 'neither' option. Attributes were developed through a literature review and an expert panel discussion. Reminder options were defined by four attributes: modality, timing, content and interactivity. Multinomial logit and mixed multinomial logit models were estimated to approximate individual preferences for these attributes. A scenario analysis was performed to estimate the likelihood of choosing different reminder systems. Respondents (n = 361) indicated a significant preference for an appointment reminder to be delivered via a text message (β = 2.42, p < 0.001) less than 3 days before the appointment (β = 0.99, p < 0.001), with basic details including the appointment cost (β = 0.13, p < 0.10), and where there is the ability to cancel or modify the appointment (β = 1.36, p < 0.001). A scenario analysis showed that the likelihood of choosing an appointment reminder system with these characteristics would be 97%. Our findings provide evidence on how healthcare consumers trade-off between different characteristics of reminder systems, which may be valuable to inform current or future systems. Future studies may focus on exploring the effectiveness of using patient-preferred reminders alongside other mitigation strategies used by providers.

Malignancy risk and mortality after lung transplantation: A single-institution experience over 31 years

BackgroundMalignancy is a long-term complication of lung transplantation (LTx); however, contemporary Australian data and detailed evaluation of non-reportable cancers are lacking. MethodsRetrospective review of LTx recipients’ medical records and registry data linkage were performed to identify histologically proven malignancies. Baseline clinico-demographic variables were collected, and cancer incidence was compared with reported data for the general Australian population. ResultsThere were 1,715 LTx in 1,631 patients between 1989-2021, with a follow-up of 9,696 person-years. 893 (54.8%) patients were male, and the median age at first LTx was 54.7 years. There were 886 deaths with a median overall survival of 7.5 years (95% CI 6.8-8.3 years). 1,774 separate invasive cancer events occurred across 407 patients, of which, 1,588 (89.5%) were non-melanoma skin cancers (NMSCs). This translated to a 9-fold increased incidence of NMSCs, and a 4-fold increased incidence of other cancers compared with the general population. Cancer mortality reached parity with chronic lung allograft dysfunction ten years post-first transplant, and was independently associated with age (HR per year increase in age 1.02 [95% CI 1.01-1.03], p=0.001), EBV primary mismatch (HR 3.24 [95% CI 1.68-6.25], versus non-mismatch, p=0.002) and cancer count (HR per cancer event 1.19 [95% CI 1.13-1.24], p<0.0001), but was not associated with a pre-transplant malignancy history. ConclusionsOur 31-year single-center experience demonstrates that malignancies are a significant mortality burden to long-term LTx survivors, dominated by NMSCs that are poorly reported in cancer datasets. A history of pre-transplant malignancy was associated with shorter time to post-transplant malignancy, but was not associated with cancer death.

Digital health access, uptake, literacy and trust in people with experience of homelessness.

Although digital health promises improved healthcare efficiency and equity, access and uptake might be low indisadvantaged populations. We measured access todigital health technology, the uptake of digital health, digital health literacy and COVID-19 vaccination intentions in an inner-city Australian population experiencing homelessness. An existing Australian survey, including a validated digitalhealth literacy measure (eHealth Literacy Scale [eHEALS]), was modified and distributed in three general practices specifically targeting the homeless population. Data analysis used appropriate descriptive statistics and correlation coefficients. Eighty-three respondents completed the survey in 2021. Digital health uptake was much lower than in the general Australian population in 2019-20, despite good access to working smart phones and connectivity. Digital health literacy was positively associated with uptake. Internet-sourced information was trusted less than information from a general practitioner. Further work is needed to understand the perceived usefulness and sociocultural compatibility of digital health in different subpopulations experiencing homelessness, including susceptibility to misinformation.

Excess Mortality in an Inception Cohort of Childhood Diabetes Diagnosed 1990–2010

Objective. Evaluate the mortality risk of childhood-onset type 1 diabetes compared to the general population. Research Design and Methods. The study population, identified from the Australasian Paediatric Endocrinology Group diabetes register, was diagnosed with type 1 diabetes at age &lt; 16 in New South Wales (NSW), Australia, from 1990 to 2010. The register was linked to National Death Index registrations to ascertain timing and cause of death up to 31/12/2022. Risk factors for mortality were assessed using multivariable Cox regression models and observed mortality rate compared to “expected” rates in the Australian general population using indirect-standardized mortality ratios (SMR), overall and by sex and age at diagnosis. Diabetes-related cause of death categories were identified. Results. Of 5,417 children diagnosed with type 1 diabetes, 157 subsequently died, with all-cause mortality of 1.37/1,000 person years. Increased mortality risk was associated with living in most disadvantaged areas (aHR 1.81 (1.05, 3.11)) but not living in a rural area. Overall SMR was 2.83 (95% CI 2.40, 3.33) with females having higher SMR than males (4.18 vs. 2.19). Most common causes of death recorded were acute diabetes complications (26%), including diabetes ketoacidosis, accident/misadventure (21%), and chronic diabetes complications (15%). Alcohol and/or drug use contributed to 17% of deaths. Conclusion. Compared to the general population, higher risk of mortality in people with type 1 diabetes was associated with female sex and living in area of socioeconomic disadvantage. Education about minimizing risk-taking behaviors should be communicated to young adults with type 1 diabetes.

Educators’ hands are tied: The impact of heteronormative and cisnormative discourses on students in faith-based schools in Australia

Australian religious conservatives continue to argue that religiously affiliated schools should be able to discriminate based on the sexuality and/or gender identity of students. We argue that this discussion fails to adequately consider the serious harms that discrimination against LGBTQ+ educators has on LGBTQ+ and questioning students. The article uses data from an Australian qualitative study examining the experience of LGBTQ+ educators in religiously affiliated organisations. We describe how heteronormative/cisnormative discourses and discriminatory practices toward LGBTQ+ educators have a direct negative impact on LGBTQ+ students. Even in relatively inclusive schools, the heteronormative and cisnormative climate of the schools is damaging, not only for educators but also for LGBTQ+ students. These serious harms need to be given greater consideration in evaluating the arguments for discriminatory practices in religiously affiliated schools funded by the government to provide education to the general Australian population.

High COVID-19 vaccine uptake following initial hesitancy among people in Australia who inject drugs

BackgroundPrevious studies have reported high COVID-19 vaccine hesitancy among people who inject drugs. We aimed to examine COVID-19 vaccine coverage, motivations and barriers to vaccination, and factors associated with uptake among this population in Australia, 1.5 years after vaccine rollout commenced. MethodsIn June-July 2022, 868 people (66.0 % male, mean age 45.6 years) who regularly inject drugs and reside in an Australian capital city reported the number of COVID-19 vaccine doses they had received and their primary motivation (if vaccinated) or barrier (if unvaccinated) to receive the vaccine. We compared vaccine uptake to Australian population estimates and used logistic regression to identify factors associated with ≥ 2 dose and ≥ 3 dose uptake. ResultsOverall, 84.1 % (n = 730) had received at least one COVID-19 vaccine dose, 79.6 % (n = 691) had received ≥ 2 doses, and 46.1 % (n = 400) had received ≥ 3 doses. Participants were less likely to be vaccinated than the Australian general population (prevalence ratio: 0.82, 95 % confidence interval [CI]: 0.76–0.88). Key motivations to receive the vaccine were to protect oneself or others from COVID-19, while barriers pertained to vaccine or government distrust. Opioid agonist treatment (adjusted odds ratio [aOR]: 2.49, 95 % CI: 1.44–4.42), current seasonal influenza vaccine uptake (aOR: 6.76, 95 % CI: 3.18–16.75), and stable housing (aOR: 1.58, 95 % CI: 1.02–2.80) were associated with receipt of at least two vaccine doses. Participants aged ≥ 40 years (versus < 40 years; aOR: 1.66, 95 % CI: 1.10–2.53) or who reported a chronic health condition (aOR: 1.71, 95 % CI: 1.18–2.47) had higher odds of receiving at least three vaccine doses. ConclusionWe observed higher COVID-19 vaccine uptake than expected given previous studies of vaccine acceptability among people who inject drugs. However, it was lower than the general population. People who inject drugs and reside in unstable housing are a subpopulation that require support to increase vaccine uptake.

Exploring the Comparability Between EQ-5D and the EQ Health and Wellbeing in the General Australian Population

ObjectivesThe EQ Health and Wellbeing (EQ-HWB) is a novel measure that conceptually overlaps with the 5-level EQ-5D (EQ-5D-5L) while capturing broader dimensions of health and well-being. This study aimed to explore the extent to which the EQ-HWB and EQ-5D-5L capture overlapping or complementary constructs and to explore the discriminative ability of the EQ-HWB Short version (EQ-HWB-S) as a multiattribute utility instrument in the Australian setting. MethodsA secondary analysis of data from a nationally representative cross-sectional survey of 2002 Australian adults was performed. The survey included socioeconomic questions and health characteristics and the EQ-HWB and EQ-5D-5L instruments. Convergent and known-group validity were evaluated through Spearman rank correlation and multivariable regression analyses, respectively. An exploratory factor analysis was also performed to explore the underlying constructs of the 2 measures. ResultsCorrelation coefficients varied from moderate to strong (rs ≥ 0.40) between the EQ-5D-5L and the corresponding EQ-HWB dimensions (all P < .001). Based on the exploratory factor analysis, both instruments measure similar underlying constructs, with the EQ-HWB capturing broader aspects of well-being. The known-group analysis demonstrated the relative discriminative ability of the EQ-HWB-S in capturing broader aspects of health and well-being. ConclusionsThe EQ-HWB was at least moderately correlated with the EQ-5D-5L in overlapping domains/dimensions and demonstrated greater sensitivity in participants with mental health problems versus the EQ-5D-5L. Our findings support future research exploring the value of the EQ-HWB-S as a multiattribute utility instrument for the general Australian population.

P619 Sleep disruption is associated with reduced quality of life in inflammatory bowel disease through its interaction with pain

Abstract Background Quality of life is reduced in people with inflammatory bowel disease. Poor sleep is prevalent in people with inflammatory bowel disease. This study aimed to investigate the influence of sleep on quality of life in people with inflammatory bowel disease. Methods An online questionnaire was administered through three tertiary IBD centres, social media and through Crohn’s Colitis Australia. The questionnaire included the EQ-5D-5L measures of health-related quality of including EQ-5D utility score, EQVAS – visual analogue scale from 0-100 of quality of life and domains mobility, selfcare, activities, pain and depression and anxiety. Measures of sleep included the insomnia severity index (ISI), and the Pittsburgh sleep quality index (PSQI). IBD activity was assessed using validated patient reported scores. Demographic data and mental health scores were also obtained. Results Quality of life was lower in people IBD than the general South Australian population (utility score mean (SD) 0.79 (0.15) v 0.91(0.14)). Poor sleep and clinically significant insomnia were associated with lower quality of life (utility score 0.77 (0.15) and 0.71 (0.16) respectively, cohort 0.79 (0.15), p&amp;lt;0.0001). Sleep quality scores moderately correlated with EQ-5D domains pain (Ro=0.35), usual activities (Ro=0.32), and depression-anxiety (Ro=0.37) but not domains self-care or mobility. After adjusting for demographic variables, IBD anxiety, depression, and anxiety the pain domain continued to be influenced by sleep quality, sleep disturbance and sleep duration, and the usual activities domain continued to be influenced by daytime dysfunction (see table 1). Clinically significant insomnia was associated with a reduction of 13.6 (10.42-16.91) (univariate regression) in quality of life measured by EQVAS. Following introduction of demographic and IBD activity the reduction in EQVAS for clinically significant insomnia remained significant (10.11 (6.96-13.27)). Health related quality of life scores (EQVAS) were significantly worse in those with clinically significant insomnia and active IBD than with active IBD alone (see Figure 1). Conclusion Health related quality of life in IBD is influenced by aspects of sleep quality irrespective of IBD activity and mental health conditions. The presence of insomnia is associated with a significant decline health related quality of life. Consideration should be given to sleep targeting interventional studies in an IBD population.

Estimating the Prevalence of Dementia in a sample of Australian Prisoners: The Cohort Study Design, Results and Implications for Public Health and Prison Sectors

AbstractBackgroundThe number of older prisoners within our prison system is increasing. The health challenges faced by prisoners in general contribute to prisoners being considered ‘old’ within the prison system once they reach the age of 50. The prison lifestyle, combined with the risk factor profiles of those incarcerated (higher rates of low educational attainment, smoking, substance use, head injury, psychiatric illness, unmet chronic health needs) suggests that older prisoners are likely to be at significantly higher risk of developing dementia than those of similar ages in the general population.Surprisingly, however, we know very little about the prevalence of dementia within prison systems both internationally and locally, with no Australian data being available. This study aimed to estimate the prevalence of dementia among older prisoners within prisons in Victoria, Australia. Cognitive screening was conducted on a large sample of older prisoners housed within 3 correctional facilities in Victoria, such that the overall prevalence of dementia within this vulnerable group could be ascertained, as a first step towards appropriate service planning.MethodDementia assessments of over 100 prisoners aged over 50 years, were conducted across three prison sites in Victoria, Australia. Each assessment included a demographic interview to capture the presence of risk factors and an Addenbrooke’s Cognitive Examination 3rd edition. All assessment data were reviewed by a psychogeriatrician for quality and to identify false positive dementia screens.ResultThe total sample of prisoners 114 reported higher rates of risk factors than those seen in the general population. Conservative dementia prevalence rates based on psychogeriatrician review of self‐reported medical history and patterns of responding on the ACE‐III suggest that dementia is more prevalent in prison populations than in the Australian general population. The overall sample of 95 included assessments suggested prisoners were up to eight times more likely to have dementia than population estimates of 1.1%.ConclusionDementia is likely to be more prevalent in prison systems due to increased risk factors profiles. This poses a significant challenge for corrective services as the ageing prisoner population continues to increase. This study provides rationale for review of planning and service provision to older prisoners.

Quality of life in south-eastern Australia: normative values for the WHOQOL-BREF in a population-based sample of adults

ObjectivesThe abbreviated World Health Organisation Quality of Life tool (WHOQOL-BREF) is a short-form quality of life (QoL) assessment commonly used worldwide in both healthy and ill populations. Normative data for...

Vegan burger, no thanks! Juicy American burger, yes please! The effect of restaurant meal names on affective appeal

Reducing meat consumption could materially reduce global greenhouse gas emissions. Yet, meat consumption habits are exceptionally difficult to break, even more so when plant-based meals are described using unappealing names. Past interventions that attempted to alter consumer choice by changing meal names at restaurants reported only modest effects. We propose that interventions aimed at increasing demand for plant-based meals may be more effective if: (1) meal naming is informed by theory; (2) the affective appeal of meal names is tested before deployment; (3) meat-based meal names are deliberately kept basic; and (4) heterogeneity of different meat-eater segments is accounted for. We conduct three studies. Study 1 evaluates the appeal of several alternative theory-informed names of plant-based meals, highlighting taste, provenience, and/or texture. Study 2 assesses the effectiveness of appealing names on stated plant-based choices across the general Australian population, and Study 3 for market segments of meat-eaters. Results indicate that highlighting flavour, provenience, and texture can impact the appeal of plant-based meals. Increased appeal does not translate to increased plant-based meal choices across all consumers but does have a potential impact for a specific group of more flexible meat-eaters. We conclude that using appealing names for plant-based dishes on restaurant menus may represent a cost-effective way to entice specific market segments of consumers to choose plant-based rather than meat-based dishes when dining. With food contributing nearly 25% to global emissions, changing meal choices for even the smallest of market segments can make a meaningful contribution to climate change mitigation.

Understanding suicidal transitions in Australian adults: protocol for the LifeTrack prospective longitudinal cohort study

BackgroundThe factors that influence transition from suicidal ideation to a suicide attempt or remission of suicidal thoughts are poorly understood. Despite an abundance of research on risk factors for suicidal ideation, no large-scale longitudinal population-based studies have specifically recruited people with suicidal ideation to examine the mechanisms underlying critical transitions to either suicide attempt or recovery from suicidal ideation. Without longitudinal data on the psychological, behavioural, and social determinants of suicide attempt and the remission of suicidal ideation, we are unlikely to see major gains in the prevention of suicide.AimThe LifeTrack Project is a population-based longitudinal cohort study that aims to identify key modifiable risk and protective factors that predict the transition from suicidal ideation to suicide attempt or remission of suicidal ideation. We will assess theory-informed risk and protective factors using validated and efficient measures to identify distinct trajectories reflecting changes in severity of suicidal ideation and transition to suicide attempt over three years.MethodsA three-year prospective population-based longitudinal cohort study will be conducted with adults from the general Australian population who initially report suicidal ideation (n = 842). Eligibility criteria include recent suicidal ideation (past 30 days), aged 18 years or older, living in Australia and fluent in English. Those with a suicide attempt in past 30 days or who are unable to participate in a long-term study will be excluded. Participants will be asked to complete online assessments related to psychopathology, cognition, psychological factors, social factors, mental health treatment use, and environmental exposures at baseline and every six months during this three-year period. One week of daily measurement bursts (ecological momentary assessments) at yearly intervals will also capture short-term fluctuations in suicidal ideation, perceived burdensomeness, thwarted belongingness, capability for suicide, and distress.ConclusionThis study is intended to identify potential targets for novel and tailored therapies for people experiencing suicidal ideation and improve targeting of suicide prevention programs. Even modest improvements in current treatments may lead to important reductions in suicide attempts and deaths.Study RegistrationAustralian New Zealand Clinical Trials Registry identifier: ACTRN12623000433606.

Exploring the cost-effectiveness of EBV vaccination to prevent multiple sclerosis in an Australian setting

BackgroundIncreasing evidence suggests the potential of Epstein-Barr virus (EBV) vaccination in preventing multiple sclerosis (MS). We aimed to explore the cost-effectiveness of a hypothetical EBV vaccination to prevent MS in...

Genetic Risk Assessment of Degenerative Eye Disease (GRADE): study protocol of a prospective assessment of polygenic risk scores to predict diagnosis of glaucoma and age-related macular degeneration

BackgroundGlaucoma and age-related macular degeneration (AMD) account for a substantial portion of global blindness. Both conditions are highly heritable, with recognised monogenic and polygenic inheritance patterns. Current screening guidelines lack decisive recommendations. Polygenic risk scores (PRS) allow for cost-effective broad population risk stratification for these conditions. The predictive potential of PRS could facilitate earlier diagnosis and treatment, and prevent unnecessary vision loss.MethodsThe Genetic Risk Assessment of Degenerative Eye disease (GRADE) study is a prospective study designed to generate high-quality evidence about the feasibility of PRS to stratify individuals from the general population, enabling identification of those at highest risk of developing glaucoma or AMD. The targeted recruitment is 1000 individuals aged over 50 years, from which blood or saliva samples will be used for genotyping and an individual PRS for glaucoma and AMD will be derived. Individuals with PRS values in the bottom decile (n = 100), top decile (n = 100) and middle 80% (n = 100) for both glaucoma and AMD will undergo a detailed eye examination for glaucoma and/or AMD.DiscussionThe primary objective will be to compare the prevalence of glaucoma and AMD cases between low, intermediate, and high PRS risk groups. We expect to find a higher prevalence of both diseases in the high PRS risk group, as compared to the middle and low risk groups. This prospective study will assess the clinical validity of a PRS for glaucoma and AMD in the general Australian population. Positive findings will support the implementation of PRS into clinical practice.

Validation of the Consumer Health Activation Index (CHAI) in general population samples of older Australians

ObjectiveTo validate the 10-item Consumer Health Activation Index (CHAI), developed in the United States, as an activation measure for interventions targeted at the Australian older general population. MethodsThe study was a cross sectional design. Exploratory factor analysis (EFA) was conducted on survey data from a community sample of participants (n = 250), aged 55–75 years. Confirmatory factor analysis (CFA) was used to evaluate dimensionality among a second sample of participants randomly sampled from the electoral roll (n = 571), aged 50–75 years. Associations between the CHAI and self-reported health behaviours were examined. ResultsEFA revealed a 7-item, two-factor structure (‘Health self-management’ and ‘Patient-provider engagement’). CFA indicated optimum model fit was obtained with this structure. Subscale reliability and validity were confirmed, with significant correlation to age, functional health literacy and health screening. ConclusionIn contrast to the original structure, optimum model fit was obtained with a two-factor solution and retention of seven items. The subscales have utility as a measure of health activation for tailoring of information in this group. InnovationA freely-available, unidimensional health activation measure has demonstrated an underlying two-scale structure that will enable tailored approaches toward the enhancement and maintenance of self- and externally-managed health behaviours in an Australian population.

Perceived Discrimination in Australia During the COVID-19 Pandemic: a Longitudinal Study.

There have been global reports of increased discrimination during the COVID-19 pandemic relative to the pre-pandemic era, though this has not been well explored within Australia. The aim of the study was to characterise discriminatory behaviour experienced by groups previously identified as most at risk of experiencing discrimination (i.e. those of Asian descent or healthcare workers) both from pre-pandemic to pandemic and during the pandemic era in Australia. From April 2020 to September 2021, 1479 Australian adults completed the everyday discrimination scale (EDS). Initially, participants were asked to retrospectively consider discrimination experienced pre-COVID-19 pandemic and then to consider experiences in the past month during the pandemic. Participants were invited to repeat the latter every 2 months. Collectively, there was a reduction in EDS scores from pre-pandemic to pandemic. Within the pandemic era, mean trajectory graphs across time revealed that changes in EDS scores in the 'non-Asian healthcare workers' and 'Asian healthcare workers' subgroups tended to mirror onto fluctuations in Australian COVID-19 case numbers. Our findings suggest social solidarity amongst the general Australian population during the pandemic, but still highlight a need to dedicate resources towards groups with heightened risk of experiencing discrimination during future public health threats.

Sheffield Shield Cricketers Live Longer than the Age-Matched General Australian Male Population

Background/objectivesPrevious studies have shown a trend that elite athletes tend to live longer than the general population, which has been attributed to the “healthy worker hire effect” and the health benefits of exercise. There have not been any previous studies looking at survival of elite cricketers with the general population as a reference cohort. This study aimed to compare the annual mortality rates of current and retired elite male Australian cricket players to that of the age-matched general Australian male population.MethodsAnalysis of publicly accessible dates of birth, death, and cricket debut data for male Australian Sheffield Shield cricket players who played before 2022 and had not died before 1971. Included persons were Sheffield Shield players who lived primarily in Australia during and after their cricket careers. Death rates from 1971 to 2021 (inclusive) were compared to the general Australian male population.Results1824 Sheffield Shield players had not died prior to 1971 (798 had played before the 1971 season, 1026 debuting subsequently). There were 586 deaths in the 51 years of observations, compared to 825 expected deaths, giving a Standardized Mortality Ratio of 0.71 (95% CI 0.63–0.80).ConclusionElite Australian male Sheffield Shield cricket players outlive the general male population with lower death rates. This is probably due to a combination of the healthy worker hire effect and the health benefits of exercise. This study provides evidence that in terms of longevity, it is safe to play elite-level cricket in Australia.Graphical

Valuing the Dental Caries Utility Index in Australia.

The Dental Caries Utility Index (DCUI) is a new oral health-specific health state classification system for adolescents, consisting of 5 domains: pain/discomfort, difficulty eating food/drinking, worried, ability to participate in activities, and appearance. Each domain has 4 response levels. This study aims to generate an Australian-specific utility algorithm for the DCUI. An online survey was conducted using a representative sample of the adult Australian general population. The discrete choice experiment (DCE) was used to elicit the preferences on 5 domains. Then, the latent utilities were anchored onto the full health-dead scale using the visual analogue scale (VAS). DCE data were modeled using conditional logit, and 2 anchoring procedures were considered: anchor based on the worst health state and a mapping approach. The optimal anchoring procedure was selected based on the model parsimony and the mean absolute error (MAE). A total of 995 adults from the Australian general population completed the survey. The conditional logit estimates on 5 dimensions and levels were monotonic and statistically significant, except for the second level of the "worried" and "appearance" domains. The mapping approach was selected based on a smaller MAE between the 2 anchoring procedures. The Australian-specific tariff of DCUI ranges from 0.1681 to 1. This study developed a utility algorithm for the DCUI. This value set will facilitate utility value calculations from the participants' responses for DCUI in economic evaluations of dental caries interventions targeted for adolescents. Preference-based quality-of-life measures (PBMs), which consist of a health state classification system and a set of utility values (a scoring algorithm), are used to generate utility weights for economic evaluations.This study is the first to develop an Australian utility value set for the Dental Caries Utility Index (DCUI), a new oral health-specific classification system for adolescents.The availability of a utility value set will enable using DCUI in economic evaluations of oral health interventions targeted for adolescents and may ultimately lead to more effective and efficient planning of oral health care services.

Areas of Concern and Support among the Austrian General Population: A Qualitative Content Analytic Mapping of the Shift between Winter 2020/21 and Spring 2022.

This study aimed to analyze areas of concern and support of the Austrian general population two years into the COVID-19 pandemic. A representative sample (N = 1031) of the Austrian general population was surveyed online between 19 April 2022 and 26 April 2022. A qualitative study design was used to explore the factors of most considerable current concern (Question 1) and the most important sources of support (Question 2). The responses to the two open-ended questions were evaluated using a conventional content analysis, and categories were formed according to the frequency of the answers. The analysis revealed that inflation and finances (30% of participants) and the war in Ukraine (22%) were the greatest sources of concern, followed by mental health (11%), and physical health (11%). Factors such as social contacts within and outside the family were mentioned most frequently as sources of support (36% of participants), followed by recreational activities (23%) and attitudes and abilities (22%). Compared to data collected at the end of the first year of the pandemic (between 23 December 2020 and 4 January 2021), concern about one's financial situation was now mentioned more frequently (30% vs. 8,5%). On the other hand, different types of pandemic-related concerns were mentioned less often. Social contacts and recreation were mentioned as the most important sources of support at both time points (46% and 36% of the participants). The results suggest that the economic concerns are lagging behind the restrictions imposed by the pandemic. In addition, the impending war in Ukraine seems to have a relevant impact on mental health in Austria. Further nuanced qualitative research, particularly involving vulnerable groups such as low-income individuals and the unemployed, is crucial.