Multimorbidity and health-related quality of life amongst Indigenous Australians: A longitudinal analysis.

BACKGROUND: The burden of multimorbidity has been observed worldwide and it has significant consequences on health outcomes. In Australia, health-related quality of life (HRQoL) is comparatively low amongst Aboriginal and/or Torres Strait Islanders, yet no studies have examined the effect of multimorbidity on HRQoL within this at-risk population. This study seeks to fill that gap by employing a longitudinal research design. METHODS: Longitudinal data were derived from three waves (9, 13, and 17) of the household, income and labour dynamics in Australia (HILDA) Survey. A total of 1007 person-year observations from 592 Aboriginal and/or Torres Strait Islander individuals aged 15 years and above were included. HRQoL was captured using the 36-item Short-Form Health Survey (SF-36), and multimorbidity was defined using self-reports of having been diagnosed with two or more chronic health conditions. Symmetric fixed-effects linear regression models were used to assess how intraindividual changes in multimorbidity were associated with intraindividual changes in HRQoL. RESULTS: Approximately 21% of Indigenous Australians were classified as experiencing multimorbidity. Respondents had statistically significantly lower HRQoL on the SF-36 sub-scales, summary measures, and health-utility index in those observations in which they experienced multimorbidity. Among others, multimorbidity was associated with lower scores on the SF-36 physical-component scale (ß = - 6.527; Standard Error [SE] = 1.579), mental-component scale (ß = - 3.765; SE = 1.590) and short-form six-dimension utility index (ß = - 0.075; SE = 0.017). CONCLUSION: This study demonstrates that having multiple chronic conditions is statistically significantly associated with lower HRQoL amongst Indigenous Australians. These findings suggest that comprehensive and culturally sensitive health strategies addressing the complex needs of individuals with multimorbidity should be implemented to improve the HRQoL of Indigenous Australians.

Disability, physical activity, and health-related quality of life in Australian adults: An investigation using 19 waves of a longitudinal cohort.

BACKGROUND: Any form of long-term physical or mental impairment might negatively influence health-related quality of life (HRQoL). HRQoL, as an independent concept, covers a wide range of characteristics that includes physical, mental, social, and spiritual functions. People with disabilities are continuously exposed to multiple barriers that deteriorate their HRQoL. It also creates impairment in performing physical activities. However, experts opine regular physical exercise as an intervention to help disabled people. This research aims to investigate the association between disability and physical activity with HRQoL among the adult population in Australia. DESIGN: A retrospective cohort study. METHODS: This study utilized the most recent 19 waves of data (2002-2020) from the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey. Component summary scores such as physical component summary (PCS) and mental component summary (MCS), and SF-6D utility scores were utilized to measure HRQoL. Random-effects GLS regression technique was fitted to estimate the association between disability and physical activity with HRQoL, after adjusting for a range of socio-demographic and health-related characteristics. RESULTS: Disability was negatively associated with the PCS (-5.95), MCS (-2.70) and SF-6D (-0.060) compared with non-disabled counterparts. However, respondents engaged in the recommended level of physical activity had substantial gain in PCS (b = 0.96), MCS (1.57), and SF-6D (0.021) scores. Besides, the results showed that performing the recommended level of physical activity in the presence of disability has lessen the negative effect of disability/ positive moderating effect of physical activity on PCS, MCS, and SF-6D scores by 1.84 points, 0.82 points, and 0.013 percentage points, respectively. CONCLUSION: This study found an inverse association between disability and HRQoL among Australian adults. However, physical activity was associated with improved HRQoL. Therefore, public health interventions, such as the orientation of physical activities, have a higher potential to dwindle the burden regarding HRQoL.

Effectiveness of COVID-19 Vaccines against Delta Variant (B.1.617.2): A Meta-Analysis.

Objectives: The highly transmissible COVID-19 Delta variant (DV) has contributed to a surge in cases and exacerbated the worldwide public health crisis. Several COVID-19 vaccines play a significant role in a high degree of protection against the DV. The primary purpose of this meta-analysis is to estimate the pooled effectiveness of the COVID-19 vaccines against the DV in terms of risk ratio (RR) among fully vaccinated, compared to unvaccinated populations. Methods: We carried out a systematic review, with meta-analysis of original studies focused on COVID-19 vaccines effectiveness against a DV clinical perspective among fully COVID-19 vaccinated populations, compared to placebo (unvaccinated populations), published between 1 May 2021 and 30 September 2021. Eleven studies containing the data of 17.2 million participants were identified and included in our study. Pooled estimates of COVID-19 vaccines effectiveness (i.e., risk ratio, RR) against the DV with 95% confidence intervals were assessed using random-effect models. Publication bias was assessed using Egger's regression test and funnel plot to investigate potential sources of heterogeneity and identify any differences in study design. Results: A total population of 17.2 million (17,200,341 people) were screened for the COVID-19 vaccines' effectiveness against the DV. We found that 61.13% of the study population were fully vaccinated with two doses of COVID-19 vaccines. The weighted pooled incidence of COVID-19 infection was more than double (20.07%) among the unvaccinated population, compared to the fully vaccinated population (8.16%). Overall, the effectiveness of the COVID-19 vaccine against the DV was 85% (RR = 0.15, 95% CI: 0.07-0.31). The effectiveness of COVID-19 vaccines varied slidably by study designs, 87% (RR = 0.13, 95% CI: 0.06-0.30) and 84% (RR = 0.16, 95% CI: 0.02, 1.64) for cohort and case-control studies, respectively. Conclusions: The effectiveness of COVID-19 vaccines were noted to offer higher protection against the DV among populations who received two vaccine doses compared with the unvaccinated population. This finding would help efforts to maximise vaccine coverage (i.e., at least 60% to 70% of the population), with two doses among vulnerable populations, in order to have herd immunity to break the chain of transmission and gain greater overall population protection more rapidly.

Examining the determinants of eHealth usage among elderly people with disability: The moderating role of behavioural aspects.

BACKGROUND: Existing studies have demonstrated that behavioural barriers impede eHealth usage among senior citizens. However, thus far, no analysis of how such barriers affect elderly people with disabilities (PwD) has been conducted. Thus, the study investigates the predictors of eHealth usage among elderly PwD. METHODS: Using data from a 2018 nationwide disability survey comprising 14,798 respondents in Australia, multivariate logistic regression models are used to predict the relationship between eHealth usage and the various characteristics of respondents, including access to information and communication technologies (ICTs), socioeconomic status, and level of education. RESULTS: Although most participants (approximately 88%) have access to ICTs, few (only around 9%) have used eHealth services. The results show a number of factors are associated with an increased likelihood of using eHealth services, including higher educational attainment (odds ratio [OR] = 3.12, 95% confidence interval [CI]: 2.38, 4.24), employment (OR = 1.43, 95% CI: 1.06, 1.94), higher household income (OR = 1.39, 95% CI: 1.00, 1.96), and ICT access (OR = 15.92, 95% CI: 10.51, 27.01). The probability of eHealth use is lower for the oldest-old (OR = 0.35, 95% CI: 0.22, 0.45). In addition, the estimates from interaction effects suggest the effect of ICT penetration on use of eHealth falls by a negligible amount because of resistive attitudinal barriers (OR = 0.01, 95% CI: 0.01, 0.06). CONCLUSION: Given the challenges of ageing populations and pandemics, such as COVID-19, eHealth services are a vital part of an effective, inclusive, and robust health care system. This study demonstrates the presence of a significant digital divide among elderly PwD and suggests that public and private efforts should be made to increase the availability of ICT infrastructure. Training could also increase inclusion in this regard.

Does ICT maturity catalyse economic development? Evidence from a panel data estimation approach in OECD countries.

To date, definitions of information and communication technology (ICT) development used in quantitative studies on the relationship between economic development and ICT are incomplete and often based on single indicators. Thus, this study investigates the link between ICT maturity and economic development in the Organisation of Economic Cooperation and Development (OECD) countries. A novel composite index of ICT maturity that includes previously neglected dimensions of ICT maturity, such as affordability and quality of internet connectivity, is utilised. The baseline estimations using the feasible generalised least squares indicate that ICT maturity is associated with an increase in economic development by 1%-3.8% in OECD countries. These findings have been cross-validated by applying the generalised method of moments estimation. Results imply that the holistic development of ICT, including infrastructure, skills, and affordability, can augment economic development.

Determinants of ICT usage for healthcare among people with disabilities: The moderating role of technological and behavioural constraints.

Existing studies have demonstrated that people with disabilities (PwD) face a range of technological and behavioural barriers to successful adoption of information and communication technology (ICT)-enabled health services. However, there has been little examination and no scholarly consensus on the relative impact of each factor. This study investigates the determinants of ICT usage for health care among PwD. Using national-level disability survey data in Australia, several multivariate hierarchical regression models are deployed to predict the relationship between ICT-enabled health service adoption and the explanatory variables. In addition, several measures of the overall goodness-of-fit are estimated for each model. The results indicate that age, gender, income, level of education, language proficiency and geographical remoteness are significant predictors of ICT-enabled health care usage among PwD. It is also found that technological constraints have a stronger moderating effect than behavioural factors. This provides valuable insight for policymakers and private organisations on which approaches and interventions are most likely to narrow the digital disability divide.

The Mediating Effect of Information and Communication Technology Usages on the Nexus Between Assistive Technology and Quality of Life Among People with Communication Disability.

This study aims to investigate the mediating effect of information and communication technology (ICT) on the nexus between quality of life (QoL) and assistive technology among people with communication disabilities. Using a national-level disability survey data in Australia, this study employs a series of causal mediation models based on counterfactual framework for mediation analysis. The results indicate that about 61% to 73% of the impact of assistive technology on QoL among people with communication disabilities is mediated through ICT use. Furthermore, it is evident that the degree of communication impairment partially moderates the impact of ICT-enabled assistive technology on QoL. The findings of the study have several practical implications. First, this study indicates that better integration of assistive technology with ICT will enhance the quality of people with communication disabilities. The second broad recommendation is that improved accessibility with affordable high-speed broadband Internet can deliver services that people with disabilities need.