Does context matter? A discrete choice experiment investigating the impact of palliative context on EQ-5D-5L health state valuation.

PURPOSE: Ensuring the values applied in health technology assessment of palliative care accurately reflect the palliative context is crucial for informed and effective resource allocation. The aim of this study is to examine whether the valuation of EQ-5D health states varies when framed within a palliative care needs context: limited life expectancy and availability of supports. METHODS: This study was a multinational cross-sectional discrete choice experiment (DCE) with respondents from the general populations of Australia (n = 2,082), Ireland (n = 1,280), and the UK (n = 2,009). Each participant was presented with a series of 20 choice sets, in which they were asked to choose between two EQ-5D-5L health states and immediate death. Half of the choice sets were accompanied by a "context vignette" while the remaining half were "context-free". The context vignettes, developed through a four-stage iterative process, described four distinct levels of palliative care needs. A D-efficient DCE design was developed, and the data were analysed using multinomial logit regression models. RESULTS: The study found inconsistencies in the EQ-5D-5L health state valuations in palliative contexts compared with context free valuation. Both life expectancy and level of support impacted health state valuation, with life expectancy having the larger effect. The inclusion of the palliative care vignettes substantially increased the number of health states that were given values worse than dead. This increase was more pronounced in Australia and the UK than in Ireland. CONCLUSION: These results imply that EQ-5D value sets that are context free require careful interpretation, especially when applied in settings such as palliative care

Effect of high temperature and cooling method on compression and fracture properties of geopolymer-based ultra-high performance concrete

High-temperature damage to concrete is one of the most common hazards to be experienced during its service life. In this study, the mechanical properties of geopolymer-based ultra-high performance concrete (GUHPC) after high temperature exposure using different cooling methods were investigated. The specimens were heated to 200 °C, 400 °C, 600 °C, 800 °C and 1000 °C, followed by air and water cooling. Then the quasi-static tests were conducted with the assistance of a digital image correlation (DIC) device to examine the compressive and flexural strength, elastic modulus, fracture performance, and failure patterns. In addition, the microstructural change of GUHPC after high temperature exposure was analysed utilizing X-ray Diffraction (XRD) and Scanning Electron Microscope (SEM) methods. Test results revealed that GUHPC demonstrated different degrees of thermal damage at high temperatures ranging between 200 °C and 1000 °C but exhibited superior thermal spalling resistance. The reduction in strength, elastic modulus and fracture properties after high temperature exposure can be divided into three stages, i.e., 25–200 °C, 400–600 °C and 800–1000 °C, respectively. These three stages defined the mild, moderate, and severe damage. Compared to air cooling, water cooling caused thermal shock to specimens, resulting in a greater loss of strength. The microstructural analysis indicated that the damage to steel fibres along with the formation of new substances due to phase transition at high temperatures led to variations in the internal structure, consequently affecting the mechanical performance of the studied GUHPC

Designing for Performance and Real-Time Interaction with Media Multiplicities: Collaborative Multimedia Artwork Creation Using Networked Devices

University of Technology Sydney. Faculty of Engineering and Information Technology.This thesis explores the collaborative development of performances and real-time interaction scenarios with multimedia art installations. The art installations in question are assembled using large arrays of distributed, wirelessly networked computers, in a form known as a media multiplicity. A media multiplicity is characterised by the use of networked devices to coordinate digital media into larger perceivable wholes, for example drone shows, speaker arrays, or LED walls. This research aims to advance the understanding of interaction design in media multiplicities and to conceptualise the interdisciplinary collaboration within the teams who make them. To achieve this, the design process for creating media multiplicities was researched and explored across multiple art and design projects, culminating in four research phases and creative works that are investigated. Through these research projects, the collaborative process of developing performances with media multiplicities is conceptualised using a novel design framework. This framework is the overarching contribution of the thesis, describing the ways a reconfigurable chain of software and hardware tools can be used to integrate performance with multimedia art installations that make use of networked computers

Milk from the farm, the factory and the future: An ecofeminist reflection on Aotearoa New Zealand's dairy sector

In this article, I explore the topic of dairy transitions in Aotearoa New Zealand through an ecofeminist lens. This perspective challenges existing power dynamics and calls for greater consideration of ethical and political dimensions for food system transitions. I draw from reflections from doctoral fieldwork conducted in the South Island of Aotearoa New Zealand in 2022, which included visits to 13 dairy farms, a milk processing facility, and a precision fermentation laboratory. Guided by ecofeminist ethics and critiques of feminised protein production, the paper advocates for more ethical engagement with the complex relations within dairy food systems and explores the cultural and the material realities of shifting away from animal-based dairy towards abstracted protein production. These reflections highlight the importance of critical place-based inquiry, researcher reflexivity, and situated knowledges in shaping understandings of just and sustainable agri-food transitions more broadly

Future-oriented capabilities impact framework: measuring transdisciplinary higher education programmes’ contribution to societal transitions

Higher education institutions play a vital role in fostering societal transitions towards sustainable and equitable futures, primarily, by equipping university graduates with future-oriented capabilities to address complex contemporary challenges. Despite their efforts, higher education institutions often lack consistent practices in assessing the impact of their educational programmes towards these goals. This paper introduces a framework designed to guide higher education institutions in evaluating the impact of their education programmes. The framework is based on a theory of change and applies an ecological perspective to articulate change mechanisms, including direct and indirect outcomes at individual, organisational, and societal levels over time. It elucidates the often-implicit assumptions about education programmes’ contributions to societal transitions. The study aims to inspire action, inviting educators to consider the impact of their programmes in fostering long-term social and environmental sustainability beyond the boundaries of education institutions

Cognitive behaviour therapy for social anxiety disorder: a systematic review and meta-analysis investigating different treatment formats

Objective: Cognitive behaviour therapy (CBT) for social anxiety disorder (SAD) can be delivered through several modalities, including individually-administered CBT (ICBT), group-based CBT (GCBT), and CBT delivered remotely (RCBT). We synthesised the current literature on ICBT, GCBT, and RCBT approaches in adults with SAD, and compared their relative effectiveness using a meta-analytic approach. Method: This review included randomised controlled trials comparing a disorder specific CBT monotherapy (ICBT, GCBT, or RCBT) to a non-active control group in adults with diagnosed SAD. Eligible studies were searched through PsycINFO, Scopus, and EMBASE databases to April 2023. A total of 37 studies met the inclusion criteria (with 55 between-group comparisons; N = 3234). Between-group effect sizes were conducted using random effects models. Results: Analyses indicated that RCBT (k = 23; g = 0.90; 95% CI = 0.74–1.06) and ICBT (k = 17; g = 0.95; 95% CI = 0.66–1.23) demonstrated large effects, while GCBT demonstrated medium effects (k = 15; g = 0.71; 95% CI = 0.49–0.94). The groups, however, did not differ significantly (Q2 = 2.17, p >.05). Conclusions: This study builds on the existing literature demonstrating the efficacy of these treatment approaches

Authors' Reply: "Adolescent Cocreation in Digital Health: From Passive Subjects to Active Stakeholders".

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Restoring Children From Out-of-Home Care: Insights From an Aboriginal-Led Community Forum

Restoring children from out-of-home care (OOHC) to their families is the preferred outcome for all children removed by child protection services, yet little is known about how restoration processes are experienced by families and services supporting them. This paper provides important insights about Aboriginal child restoration from 40 practitioners and stakeholders at a community forum led by Aboriginal Community Controlled Organisations in regional New South Wales (NSW), Australia. This is one component of larger Aboriginal-led research, which investigates child protection experiences and pathways to successful restoration in NSW and the data source for this paper. The community forum explored the issues for families navigating family preservation, OOHC and restoration within child protection and legal systems. Findings include the need for a continuum of support for families throughout their engagement with child protection systems and crucially following the removal of their children. Barriers to effective restoration practice included a lack of access to meaningful and ongoing preservation services, insufficient cultural care planning and family finding efforts that are often too late, the pressure on services to support families without adequate capabilities or enough resourcing, the lack of transparency and the complexities in navigating the restoration process, and the lack of culturally informed support for children and their families while children are in care. Implications for policy and practice are discussed. This paper contributes to understanding practice, processes and barriers for restoration, particularly focused on the perspectives of Aboriginal families and communities, with potential insights for practice within Australia and internationally

Evolution of pore structure and flow properties in particle segregation

The Brazil Nut Effect is widely observed in both everyday life and industrial processes. Although extensive research on segregation behaviour, the resulting changes in pore structure and flow properties remain inadequately explored. During particle segregation, the granular system evolves continuously, forming a complex porous media. Understanding the impact of this evolving porous media on fluid transport is crucial across various disciplines. In this study, the Discrete Element Method (DEM) is proposed to analyse the segregation process of granular materials, and the Lattice Boltzmann Method (LBM) is employed to investigate the influence of segregation on macroscopic and microscopic flow properties. The results indicate that particle segregation initially develops rapidly and gradually stabilises, with the evolving contact information illustrating the anisotropy of the granular system. Energy analysis reveals that segregation primarily occurs when the granular material contacts the base. Pore structure analysis shows that pore diameters follow a lognormal distribution, while throat diameters exhibit a bimodal distribution, and sphericity displays a trimodal distribution. As the degree of segregation increases, the top layer experiences a rise in large particles, resulting in higher sphericity and a reduction in pore spaces. Conversely, in the bottom layer, the aggregation of small particles results in lower sphericity and a greater number of pores. Particle segregation induces anisotropic behaviour in the permeability of porous media, with a significant increase in the horizontal direction and a slight decrease in the vertical direction. The tortuosity of the porous media decreases noticeably in the horizontal direction, while exhibiting minimal variation in the vertical direction. These findings underscore the influence of segregation on the pore structure and flow properties of porous media, highlighting the necessity of understanding particle segregation in granular mechanics