A comparison of content from across contemporary Australian population health surveys.

OBJECTIVE: Associations between place and population health are of interest to researchers and policymakers. The objective of this paper is to explore, summarise and compare content across contemporary Australian geo-referenced population health survey data sets. METHODS: A search for recent (2015 or later) population health surveys from within Australia containing geographic information from participants was conducted. Survey response frames were analysed and categorised based on demographic, risk factor and disease-related characteristics. Analysis using interactive Sankey diagrams shows the extent of content overlap and differences between population health surveys in Australia. RESULTS: Thirteen Australian geo-referenced population health survey data sets were identified. Information captured across surveys was inconsistent as was the spatial granularity of respondent information. Health and demographic features most frequently captured were symptoms, signs and clinical findings from the International Statistical Classification of Diseases and Related Health Problems version 11, employment, housing, income, self-rated health and risk factors, including alcohol consumption, diet, medical treatments, physical activity and weight-related questions. Sankey diagrams were deployed online for use by public health researchers. CONCLUSIONS: Identifying the relationship between place and health in Australia is made more difficult by inconsistencies in information collected across surveys deployed in different regions in Australia. IMPLICATIONS FOR PUBLIC HEALTH: Public health research investigating place and health involves a vast and inconsistent patchwork of information within and across states, which may impact broad-scale research questions. The tools developed here assist public health researchers to identify surveys suitable for their research queries related to place and health.

Australians' perceptions of the potential effects of increased access to alcohol via autonomous delivery services: A multi-method study.

INTRODUCTION: Rapid technological change will affect how people access harmful products. For example, automated delivery services are forecast to provide fast and affordable product access options for those purchasing alcohol. Information about the potential impacts of such innovations on alcohol purchase and consumption behaviors is lacking. The aim of this study was to explore how consumers may respond to future scenarios where alcohol is available via a range of autonomous alcohol delivery options. METHODS: In a two-stage process, qualitative individual interviews (n = 100) and a quantitative online survey (n = 1078) were conducted with Australians aged 18+ years. Quotas were used to achieve national representation on key demographic variables. Participants were exposed to scenarios outlining how autonomous vehicles are likely to be used for alcohol deliveries in the future and asked to discuss their intentions to use such services and their perceptions of any impacts on alcohol consumption at a societal level. RESULTS: Automated alcohol deliveries were generally considered to be highly convenient and therefore likely to be popular. Around one-third (37%) of survey respondents reported an intention to use such automated alcohol delivery services once they are available and almost half (47%) expected overall levels of alcohol consumption to increase across the population. CONCLUSION: Given potential levels of uptake, careful consideration needs to be given to the development and implementation of appropriate policy and regulatory frameworks to minimize the increased risk of alcohol-related harm associated with enhanced alcohol availability resulting from the emerging availability of autonomous delivery services.

The inexorable rise of automated food deliveries and potential anticipatory policy actions.

OBJECTIVE: Food deliveries to consumers using autonomous vehicles are forecast to become commonplace in Australia and globally. The aims of this study were to (i) explore the anticipated nature of AV food delivery services in Australia and (ii) identify available policy options to optimise positive outcomes and minimise any negative consequences for health and well-being. METHODS: In total, 36 interviews were conducted with 40 expert stakeholders across a range of relevant sectors including transport, urban planning, health and telecommunications. Interviewees discussed the ways in which automated food deliveries are likely to be implemented and the potential implications for lifestyles and health. RESULTS: The interviewees expected automated food deliveries to constitute an extension of current trends towards online food ordering and rapid home deliveries, with potential adverse implications for diet quality at the population level. CONCLUSIONS: Effective regulation of automated food and beverage delivery services will be needed to anticipate and address this emerging phenomenon. IMPLICATIONS FOR PUBLIC HEALTH: There is the opportunity to optimise the public health outcomes associated with automated food deliveries while minimising potential negative consequences through proactive anticipatory action. Delays could result in undesirable and irreversible changes to the food environment.

Discriminating spatialised speech in complex environments in multiple sclerosis.

People with multiple sclerosis (pwMS) frequently present with deficits in binaural processing used for sound localization. This study examined spatial release from speech-on-speech masking in pwMS, which involves binaural processing and additional higher level mechanisms underlying streaming, such as spatial attention. 26 pwMS with mild severity (Expanded Disability Status Scale score <3) and 20 age-matched controls listened via headphones to pre-recorded sentences from a standard list presented simultaneously with eight-talker babble. Virtual acoustic techniques were used to simulate sentences originating from 0°, 20°, or 50° on the interaural horizontal plane around the listener whilst babble was presented continuously at 0° azimuth, and participants verbally repeated the target sentence. In a separate task, two simultaneous sentences both containing a colour and number were presented, and participants were required to report the target colour and number. Both competing sentences could originate from 0°, 20°, or 50° on the azimuthal plane. Participants also completed a series of neuropsychological assessments, an auditory questionnaire, and a three-alternative forced-choice task that involved the detection of interaural time differences (ITDs) in noise bursts. Spatial release from masking was observed in both pwMS and controls, as response accuracy in the two speech discrimination tasks improved in the spatially separated conditions (20° and 50°) compared with the co-localised condition. However, pwMS demonstrated significantly less spatial release (18%) than controls (28%) when discriminating colour/number coordinates. At 50° separation, pwMS discriminated significantly fewer coordinates (77%) than controls (89%). In contrast, pwMS had similar performances to controls when sentences were presented in babble, and for the basic ITD discrimination task. Significant correlations between speech discrimination performance and standardized neuropsychological scores were observed across all spatial conditions. Our findings suggest that spatial hearing is likely to be implicated in pwMS, thereby affecting the perception of competing speech originating from various locations.

Expert stakeholders' views on the potential nature and impacts of autonomous alcohol home delivery.

INTRODUCTION: The emergence of autonomous vehicles (AV) heralds new methods of alcohol delivery that are likely to have substantial implications for home drinking. The aim of this study was to explore the factors that have the potential to hasten or restrict widescale increases in alcohol availability resulting from AVs. METHODS: Thirty-six interviews were conducted with 44 stakeholders across diverse sectors. Interviewees discussed their perceptions of how AVs will evolve and the implications for alcohol access. The interview transcripts were analysed to develop a typology of factors that need to be addressed to minimise harms associated with greater home alcohol consumption due to AVs. RESULTS: The interviewees identified a range of demand-side (e.g., enhanced convenience for consumers) and supply-side (e.g., increased efficiency for providers) factors associated with AV home deliveries that could increase the prevalence and volume of home drinking. A third category of factors related to potential forms of regulation: suggested harm-minimisation options related to appropriate enhancements of licensing restrictions and responsible service requirements and the use of various fiscal levers to introduce price barriers. DISCUSSION AND CONCLUSIONS: The suggested strategies will require collaborative efforts across government and non-government organisations to address the potential issues arising from the advent of AV alcohol deliveries. Technological and policy solutions will be needed to ensure responsible service of alcohol. This study provides policy makers with insights into forms of intervention that may be required to minimise the harms associated with the use of AVs in alcohol home delivery systems.

Speech discrimination impairments as a marker of disease severity in multiple sclerosis.

BACKGROUND: Multiple Sclerosis (MS) pathology is likely to disrupt central auditory pathways, thereby affecting an individual's ability to discriminate speech from noise. Despite the importance of speech discrimination in daily communication, it's characterization in the context of MS remains limited. This cross-sectional study evaluated speech discrimination in MS under "real world" conditions where sentences were presented in ecologically valid multi-talker speech or broadband noise at several signal-to-noise ratios (SNRs). METHODS: Pre-recorded Bamford-Kowal-Bench sentences were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All auditory stimuli were presented via headphones to control (n = 38) and MS listeners with mild (n = 20), moderate (n = 16) and advanced (n = 10) disability. Disability was quantified by the Kurtzke Expanded Disability Status Scale (EDSS) and scored by a neurologist. All participants passed a routine audiometric examination. RESULTS: Despite normal hearing, MS psychometric discrimination curves which model the relationship between signal-to-noise ratio (SNR) and sentence discrimination accuracy in speech-weighted noise and babble did not change in slope (sentences/dB) but shifted to higher SNRs (dB) compared to controls. The magnitude of the shift in the curve systematically increased with greater disability. Furthermore, mixed-effects models identified EDSS score as the most significant predictor of speech discrimination in noise (odds ratio = 0.81; p < 0.001). Neither age, sex, disease phenotype or disease duration were significantly associated with speech discrimination performance in noise. Only MS listeners with advanced disability self-reported audio-attentional difficulty in a questionnaire designed to reflect auditory processing behaviours in daily life. CONCLUSION: Speech discrimination performance worsened systematically with greater disability, independent of age, sex, education, disease duration or disease phenotype. These results identify novel auditory processing deficits in MS and highlight that speech discrimination tasks may provide a viable non-invasive and sensitive means for disease monitoring in MS.

Speech discrimination performance in multiple sclerosis dataset.

The most complex interactions between human beings occur through speech, and often in the presence of background noise. Understanding speech in noisy environments requires the integrity of highly integrated and widespread auditory networks likely to be impacted by multiple sclerosis (MS) related neurogenic injury. Despite the impact auditory communication has on a person's ability to navigate the world, build relationships, and maintain employability; studies of speech-in-noise (SiN) perception in people with MS (pwMS) have been minimal to date. Thus, this paper presents a dataset related to the acquisition of pure-tone thresholds, SiN performance and questionnaire responses in age-matched controls and pwMS. Bilateral pure-tone hearing thresholds were obtained at frequencies of 250 hertz (Hz), 500 Hz, 750 Hz, 1000 Hz, 1500 Hz, 2000 Hz, 4000 Hz, 6000 Hz and 8000 Hz, and hearing thresholds were defined as the lowest level at which the tone was perceived 50% of the time. Thresholds at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz were used to calculate the four-tone average for each participant, and only those with a bilateral four tone average of ≤ 25 dB HL were included in the analysis. To investigate SiN performance in pwMS, pre-recorded Bamford-Kowal-Bench (BKB) sentences were presented binaurally through headphones at five signal-to-noise ratios (SNR) in two noise conditions: speech-weighted noise and multi-talker babble. Participants were required to verbally repeat each sentence they had just heard; or indicate their inability to do so. A 33-item questionnaire, based on validated inventories for specific adult clinical populations with abnormal auditory processing, was used to evaluate auditory processing in daily life for pwMS. For analysis, pwMS were grouped according to their Expanded Disability Status Scale (EDSS) score as rated by a neurologist. PwMS with EDSS scores ≤ 1.5 were classified as 'mild' (n = 20); between 2 and 4.5 as 'moderate' (n = 16) and between 5 and 7 as 'advanced' (n = 10) and were compared to neurologically healthy controls (n = 38). The outcomes of the SiN task conducted in pwMS can be found in Iva et al., (2021). The present data has important implications for the timing and delivery of preparatory education to patients, family, and caregivers about communication abilities in pwMS. This dataset will also be valuable for the reuse/reanalysis required for future investigations into the clinical utility of SiN tasks to monitor disease progression.

Speech Discrimination Tasks: A Sensitive Sensory and Cognitive Measure in Early and Mild Multiple Sclerosis.

There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (<5 years) and late (>10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score < 3]. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All speech and noise were presented via headphones to controls (n = 38), early MS (n = 23), and late MS (n = 12) who were required to verbally repeat the target speech. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble - but not speech-weighted noise. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of -1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed.