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Objective To explore the cost-effectiveness of a web-based support tool for parents of children with Juvenile idiopathic arthritis. Methods A multi-centred randomized controlled trial was conducted in paediatric rheumatology centres in England. The WebParC intervention consisted of online information about JIA and its treatment and a toolkit using cognitive-behavioural therapy principles to support parents manage their child's JIA. An economic evaluation was performed alongside the trial involving 220 parents. The primary outcome was the self-report Pediatric Inventory for Parents measure of illness-related parenting stress, with two dimensions: difficulty and frequency. These measures along with costs were assessed post intervention at 4 and 12 months. Costs were calculated for healthcare usage using a UK NHS economic perspective. Data was collected and analysed on the impact of caring costs on families. Uncertainty around cost-effectiveness was explored using bootstrapping and cost-effectiveness acceptability curves. Results The intervention arm showed improved average Pediatric Inventory for Parents scores for the dimensions of frequency and difficulty, of 1.5 and 3.6 respectively at 4 months and 0.35 and 0.39 at 12 months, representing improved PIP scores for the intervention arm. At both 4 and 12 month follow-up, the average total cost per case was higher in the control group when compared with the intervention arm with mean differences of £360 (95% CI £29.6 to £691) at 4 months and £203 (95% CI £16 to £390) at 12 months. The probability of the intervention being cost-effective ranged between 49% and 54%. Conclusion The WebParC intervention led to reductions in primary and secondary healthcare resource use and costs at 4 and 12 months. The intervention demonstrated particular savings for rheumatology services at both follow-ups. Future economies of scale could be realised by health providers with increased opportunities for cost-effectiveness over time. Trial registration ISRCTN, ISRCTN13159730. [ABSTRACT FROM AUTHOR]

Background: Low-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala. Methods: This qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model. Results: Three themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology. Conclusion: Despite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts. [ABSTRACT FROM AUTHOR]

Introduction. The coronavirus disease 2019 (COVID-19) pandemic necessitated the suspension of most educational activities and a shift from face-to-face (FTF) education to virtual education (VE). These changes were associated with new educational experiences for both instructors and students. This study aimed to explore nursing instructors' and students' experiences of VE during the COVID-19 pandemic. Method. This descriptive qualitative study was carried out in 2021. Participants were 21 bachelor's, master's, and Ph.D. nursing students and six nursing instructors purposively selected from the Faculty of Nursing and Midwifery of Tehran University of Medical Sciences, Tehran, Iran. Data were gathered through FTF or online in-depth semistructured interviews and were analyzed through conventional qualitative content analysis as proposed by Graneheim and Lundman (2004). Results. Eight subthemes and three main themes were developed during data analysis. The main themes and subthemes were VE as a double-edged sword (VE as a threat, VE as an opportunity, and necessity to improve VE), weaknesses in clinical education (reduced quality of clinical education and necessity to compensate for students' retarded clinical learning), and reduced reliability of virtual student evaluation (cheating as a problem of virtual evaluation, stresses and tensions of virtual evaluation, and necessity to use new strategies in virtual evaluation). Conclusion. Despite the different shortcomings and challenges of VE during the COVID-19 pandemic, educational experiences gained in this period can be used to improve the quality of nursing VE in future epidemics and pandemics. [ABSTRACT FROM AUTHOR]

Introduction: The aim is to perform an economic evaluation alongside a randomized controlled trial comparing guided self‐help cognitive behavioral therapy‐enhanced (CBT‐E) for binge‐eating disorder (BED) to a waiting list control condition. Methods: BED patients (N = 212) were randomly assigned to guided self‐help CBT‐E or the 3‐month waiting list. Measurements took place at baseline and the end‐of‐treatment. The cost‐effectiveness analysis was performed using the number of binge‐eating episodes during the last 28 days as an outcome indicator according to the eating disorder examination. A cost‐utility analysis was performed using the EuroQol‐5D. Results: The difference in societal costs over the 3 months of the intervention between both conditions was €679 (confidence interval [CI] 50–1330). The incremental costs associated with one incremental binge eating episode prevented in the guided self‐help condition was approximately €18 (CI 1–41). From a societal perspective there was a 96% likelihood that guided self‐help CBT‐E led to a greater number of binge‐eating episodes prevented, but at higher costs. Each additional quality‐adjusted life year (QALY) gained was associated with incremental costs of €34,000 (CI 2494–154,530). With a 95% likelihood guided self‐help CBT‐E led to greater QALY gain at higher costs compared to waiting for treatment. Based on the National Institute for Health and Clinical Excellence willingness‐to‐pay threshold of €35,000 per QALY, guided self‐help CBT‐E can be considered cost‐effective with a likelihood of 95% from a societal perspective. Discussion: Guided self‐help CBT‐E is likely a cost‐effective treatment for BED in the short‐term (3‐month course of treatment). Comparison to treatment‐as‐usual is recommended for future research, as it enables an economic evaluation with a longer time horizon. Public Significance: Offering treatment remotely has several benefits for patients suffering from binge‐eating disorders. Guided self‐help CBT‐E is an efficacious and likely cost‐effective treatment, reducing binge eating and improving quality‐of‐life, albeit at higher societal costs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To estimate the cost savings associated with a pedometer-based, web-mediated physical activity intervention in a cohort of US veterans with chronic obstructive pulmonary disease (COPD). STUDY DESIGN: Economic analysis. METHODS: We constructed a decision tree from the health care system perspective incorporating adjusted relative risk of a pedometer-based, web-mediated intervention for COPD- related acute exacerbations, acute exacerbation--related costs (ie, emergency department visits and hospitalizations), and intervention-related costs. Total COPD-related costs were estimated per patient across 12 months. Probabilistic sensitivity analysis with Monte Carlo simulation was used to estimate uncertainty in the model findings. RESULTS: In the deterministic (base case) model, the model estimated costs to be $4236 per participant who used the pedometer-based, web-mediated intervention compared with $7913 per participant in the control group (estimated $3677 saved in 1 year compared with the control group). The model findings were robust to probabilistic sensitivity analysis, with a difference in mean costs of $4582 (95% probability interval, $4084-$5080; P < .001). Cost savings in the model were driven by the adjusted relative risk of the web-based intervention, probability of a COPD-related acute exacerbation, rate of hospitalization, probability of hospitalization, and cost of hospitalization. CONCLUSIONS: A pedometer-based, web-mediated physical activity intervention yielded substantial cost savings. Increased implementation of the intervention could markedly reduce the economic burden of COPD for payers and patients. [ABSTRACT FROM AUTHOR]

Background: For care planning and support, under-detection and late diagnosis of Alzheimer's disease (AD) is a great challenge. Models of Patient-Engagement for Alzheimer's Disease (MOPEAD) is an EU-funded project aiming at testing different strategies to improve this situation.Objective: To make a cost-consequence analysis of MOPEAD.Methods: Four screening strategies were tested in five countries (Germany, the Netherlands, Slovenia, Spain, and Sweden): 1) a web-approach; 2) Open-House initiative; 3) in primary care; and 4) by diabetes specialists. Persons-at-risk of AD in all strategies were offered referral to a hospital-based specialist. The primary health-economic outcome was the cost per true-positive case (TP) of AD from the screened population.Results: Of 2,847 screened persons, 1,121 screened positive (39%), 402 were evaluated at memory clinics (14%), and 236 got an AD diagnosis (8%). The cost per TP of those screened was €3,115 with the web-approach, €2,722 with the Open-House, €1,530 in primary care, and €1,190 by diabetes specialists. Sensitivity analyses that more likely reflect the real-world situation confirmed the results. The number-needed-to-screen was 30 with the web-approach, 8 with the Open-House and primary care, and 6 with the diabetes specialists.There were country differences in terms of screening rates, referrals to memory clinics, staff-types involved, and costs per TP.Conclusion: In primary care and by the diabetes specialist, the costs per TP/screened population were lowest, but the capacity of such settings to identify cases with AD-risk must be discussed. Hence new diagnostic strategies such as web-solutions and Open-House initiatives may be valuable after modifications. [ABSTRACT FROM AUTHOR]

Background Substance use disorders (SUDs) contribute significantly to global rates of morbidity and mortality. Internet- and mobile-based interventions (IMIs) have been suggested as an adjunct to face-to-face health services. However, the evidence for the cost-effectiveness of IMIs for SUDs is scant. Methods A comprehensive literature search in PubMed, PsycINFO, the Cochrane Central Register of Controlled Trials, NHS Economic Evaluations Database, NHS Health Technology Assessment Database, Office of Health Economics Evaluations Database and EconLit was conducted. We included economic evaluations alongside randomized controlled trials of IMIs for SUDs compared with a control group. Results Of 1687 abstracts identified, 11 studies met the inclusion criteria. Targeted conditions were alcohol use disorder (four studies) and tobacco smoking (five studies) whereas two studies included any SUD. Cost-effectiveness results demonstrated that IMIs had a firm probability of being more cost-effective than TAU (e.g. less costs per additional abstinent person). Compared with (online) psycho-education, evidence towards an additional benefit of IMIs was less clear. Regarding cost-utility (e.g. costs per quality-adjusted life year gained), except for one study, results suggested that TAU and online psycho-education would probably be more preferable than IMIs. Quality of study reporting was at least adequate. Conclusions The likelihood of IMIs being more cost-effective than TAU looks promising but more economic evaluations are needed in order to determine the economic merit of IMIs. With an increasing pressure on health care budgets, strategies to disseminate effective interventions at affordable costs are required. This review suggests that IMIs might carry that promise and have potential as a cost-effective strategy to scale-up existing evidence-based treatments for SUDs. Systematic review registration The systematic review has been registered in the PROSPERO database (no. CRD42018099486). [ABSTRACT FROM AUTHOR]

Objective: To examine whether Society for Assisted Reproductive Technology (SART) member in vitro fertilization (IVF) centers adhere to the Society's new advertising policy, updated in January 2018, and evaluate other services advertised by region, insurance mandate and university affiliation status. Historically, a large percentage of IVF clinics have not adhered to SART guidelines for IVF clinic website advertising and have had variability in how financial incentives and other noncore fertility services are advertised.Design: Cross-sectional study.Setting: Not applicable.Patient(s): None.Intervention(s): None.Main Outcome Measure(s): Adherence of SART participating websites to objective criteria from the 2018 SART advertising guidelines.Result(s): All 361 SART participating clinic websites were evaluated. Approximately one third of clinics reported success rate statistics directly on their websites, but only 52.6% of those clinics reported current statistics. Similarly, only 67.5% of SART member clinics included the required disclaimer statement regarding their outcome statistics. Only 10.5% of websites were wholly compliant with SART guidelines regarding presentation of supplemental data. There were no significant differences between academic and nonacademic centers, programs in mandated versus nonmandated states, or East versus West Coast clinics in any of these areas.Conclusion(s): Many of the SART member websites failed to adhere to core guidelines surrounding reporting IVF clinic success rates. Consideration for additional education and streamlining as well as simplifying success rate advertising guidelines is recommended. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the cost-utility of a guided Internet-based intervention for people living with HIV and depressive symptoms, compared to attention only (control condition). It was previously found that the intervention was effective in decreasing depressive symptoms, compared to the control group.Methods: This economic evaluation was conducted alongside a randomized controlled trial. The control group received attention only and was put on a waiting list. Quality adjusted life years were calculated over six months. The study was conducted from a societal perspective and included intervention costs, healthcare costs, and non-healthcare costs. Participants completed a pretest, a post-test after two to three months, and a second post-test after six months. Cost-utility acceptability curves were constructed and two sensitivity analyses were conducted.Results: No differences between the intervention and the control group were found in quality adjusted life years and total societal costs. The results indicate that the intervention is likely to be cost-effective, compared to attention only. The findings of the sensitivity analyses point in the same direction.Conclusion: More research with larger samples is necessary to confirm the findings. The outcomes of this study may inform policy makers to decide which interventions will be included in policies. The guided Internet intervention may improve psychological care for people living with HIV and depressive symptoms, against low costs.Trial Registration: Nederlands Trialregister NTR5407, September 11, 2015. [ABSTRACT FROM AUTHOR]

Objectives: Overprescribing of antibiotics by general practitioners (GPs) is seen as a major driver of antibiotic resistance. Training in communication skills and C-reactive protein (CRP) testing both appear effective in reducing such prescribing. This study assesses the cost-effectiveness (compared with usual care) of: (i) training GPs in the use of CRP testing; (ii) training GPs in communication skills; and (iii) training GPs in both CRP testing and communication skills.Methods: Economic analyses [cost-utility analysis (CUA) accounting for the cost of antibiotic resistance and cost-effectiveness analysis (CEA)] were both conducted from a healthcare perspective with a time horizon of 28 days alongside a multinational, cluster, randomized, factorial controlled trial in patients with respiratory tract infections in five European countries. The primary outcome measures were QALYs and percentage reduction in antibiotic prescribing. Hierarchical modelling was used to estimate an incremental cost per QALY gained and an incremental cost per percentage reduction in antibiotic prescribing.Results: Overall, the results of both the CUA and CEA showed that training in communication skills is the most cost-effective option. However, excluding the cost of antibiotic resistance in the CUA resulted in usual care being the most cost-effective option. Country-specific results from the CUA showed that training in communication skills was cost-effective in Belgium, UK and Netherlands whilst training in CRP was cost-effective in Poland.Conclusions: Internet-based training in communication skills is a cost-effective intervention to reduce antibiotic prescribing for respiratory tract infections in primary care if the cost of antibiotic resistance is accounted for. [ABSTRACT FROM AUTHOR]

In the 2000s, China and Russia emerged as outspoken actors with global ambitions. To communicate their status aspirations, both countries introduced a range of nation-branding institutions and initiatives. Global Internet governance – the design and administration of Internet technology and related policymaking – is among the domains where China and Russia have asserted their national brands. The Chinese and Russian governments co-advance the brand narrative of ‘Internet sovereignty’ in opposition to perceived technological and governance hegemony of the United States. Given the power that private online intermediaries wield in the political economy of the Internet, national digital media champions, China’s Baidu and Russia’s Yandex, have been integral to their countries’ Internet branding efforts. The article examines how China and Russia have forged a public–private relationship with respective digital media champions in the context of building and branding an Internet sovereignty agenda. [ABSTRACT FROM AUTHOR]

This article examines the extent to which economic, cultural, social, and personal types of engagement with the Internet result in a variety of economic, cultural, social, and personal outcomes. Data from a representative survey of the Dutch population are analyzed to test whether engagement with a certain type of activity is related to "collateral" benefits in different domains of activities, independent from the socioeconomic or sociocultural characteristics of the person. The results show that what people do online and the skills they have affect outcomes in other domains and that this is independent of the characteristics of the person. This means that policy and interventions could potentially overcome digital inequalities in outcomes through skills training and providing opportunities to engage online in a broad variety of ways. A semiologic rather than an economistic approach is more likely to be effective in thinking about and tackling digital inequalities. [ABSTRACT FROM AUTHOR]

Purpose: To describe the impact of the National Cancer Institute's promotion of its youth smoking cessation program, Smokefree Teen (SFT).Design: We provide a description of campaign strategies and outcomes as a means to engage a teen audience in cessation resources using a cost-effective approach.Setting: The campaign occurred nationally, using traditional (TV and radio), online, and social media outreach.Participants: Ads targeted adolescent smokers (aged 14-17). The baseline population was 42 586 and increased to 464 357 during the campaign.Measures: Metrics used to assess outcomes include (1) visits to SFT website from traditional and online ads, (2) cost to get an online ad clicked (cost-per-click), and (3) SmokefreeTXT program enrollments during the 8-week campaign period.Analysis: We conducted a quantitative performance review of all tactics.Results: The SFT campaign achieved an online ad click-through rate of 0.33%, exceeding industry averages of 0.15%. Overall, web traffic to teen.smokefree.gov increased by 980%, and the online cost-per-click for ads, including social media actions, was approximately $1 as compared with $107 for traditional ads. Additionally, the campaign increased the SmokefreeTXT program teen sign-ups by 1334%.Conclusion: The campaign increased engagement with evidence-informed cessation resources for teen smokers. Results show the potential of using multiple, online channels to help increase engagement with core resources. [ABSTRACT FROM AUTHOR]

What is the definition of work? How do we measure work in a brick-and-mortar industry as opposed to a global network? In this article I will discuss these ideas along with a description of human versus software generated messages on the Internet. I will also touch on static historical labor, and conclude with a shirt discussion on artificial intelligence and work. [ABSTRACT FROM AUTHOR]

City networks have been a critical topic in the fields of urban geography and regional economics. Numerous studies have explored city networks, focusing mainly on infrastructure and industrial networks. Unlike traditional urban network of which the major measuring indexes are population sizes and entity industries, online commodity service networks could reflect well the influencing of emerging economies, especially the Internet economy, on city networks. This study analyzes and reveals structural features of China's city networks through online commodity services, providing the internet economic approach on city networks. Results indicate that the core cities of online commodity service networks are mainly concentrated in eastern coastal areas. In addition, spatial polarization and layer structure of network connections are obvious, descending from the centers in eastern China to peripheral cities in central and western China. Online commodity services of different cities show apparent differences and uncertainties in terms of specialization rates of international connection, which presents a tendency toward diversification. Online commodity service networks are not only associated with goods production, supply, and consumption in physical space but also reflect virtual information, capital, and technology flows, thus providing a new empirical approach for understanding city networks in information and internet economic age. [ABSTRACT FROM AUTHOR]

The rapid growth of the internet in China has been propelled by the Chinese government’s push to develop the country’s information infrastructure and its tight control over the internet. The most recent stage of internet development in China, however, has been driven by a three-way dynamic between the State, internet companies, and international finance capital. This relationship has yielded three internet giants—Baidu, Alibaba, and Tencent—that stand at the apex of the internet economy in China. They also rival their US counterparts like Google, Facebook, and Amazon, on several key measures. We examine annual reports and other financial documents to better understand these three companies’ character as ‘capitalist enterprises’ and the tight nexus that links them to international investment banks, venture capital funds, and other foreign investors. While these processes are now fundamentally shaping ‘the Chinese internet’, they have not yet been adequately explored in the scholarly literature, we argue. [ABSTRACT FROM AUTHOR]

Background: Australia has a reputation as an anomaly with regard to cryptomarket drug trading, with seemingly disproportionately high levels of activity given its relatively small size, high prices and anecdotal accounts of it being a destination where many foreign-based vendors will not sell. This paper aims to investigate these claims from a risk and prices perspective.Methods: By analysing data for over 60,000 drug products available for purchase from eight cryptomarkets in January 2016 this work builds a descriptive picture of the Australian online market in comparison to the rest of the world, before moving onto analyse the prices of drugs available to Australian consumers, both online and though conventional drug supply routes.Results: Results show that the Australian online illicit drugs market is of considerable size, internally isolated and with methamphetamine sales being particularly large by comparison to other countries. Australian cryptomarket vendors sell drugs at significantly higher prices than those listed by their foreign counterparts. Online prices are however broadly comparable to street prices, with the exception of methamphetamine where prices appear to be much lower online.Conclusions: These findings indicate that the perceived stringency of Australian border protection inadvertently increases the competitiveness and local market share of domestic cryptomarket vendors via a consumer side 'risk tariff', challenging the traditionally vendor-oriented drugs risk and prices framework. [ABSTRACT FROM AUTHOR]

Globalization, liberalization of markets, internationalization and Internet has led to new open visions and business opportunities. Now, large and small businesses may have business relationships all over the world and obtain many important advantages such as: rapid transfer of information, rapid connectivity, diversity, interculturality, finding new knowledge, experiences, and values, and lower costs for communication and collaboration, anytime, anywhere. In a world where many activities are now online, why not the commercial activity to not be online? The Internet, as the newest direct marketing technique, has led to increased sales made online. The customers and the organizations, make purchase and sale online, known as e-commerce. In this article we analyse the role played by the Internet in commerce activities, implementing mathematical modeling and simulation to show their implication in commercial activities and to show there is a direct and positive relation between the Internet and the commercial activities. [ABSTRACT FROM AUTHOR]

The Open Science (OS) movement promises nothing less than a revolution in the availability of scientific knowledge around the globe. By removing barriers to online data and encouraging publication in Open Access formats and Open Data archives, OS seeks to expand the role, reach and value of research. The promises of OS imply a set of expectations about what different publics hope to gain from research, how accountability and participation can be enhanced, and what makes science public in the first place. This paper presents empirical material from fieldwork undertaken in (bio)chemistry laboratories in Kenya and South Africa to examine the extent to which these ideals can be realized in a sub-Saharan context. To analyse the challenges African researchers face in making use of freely available data, we draw from Amartya Sen’s Capabilities Approach. His theorisations of ‘conversion factors’ helps to understand how seemingly minor economic and social contingencies can hamper the production and (re-)use of online data. In contrast to initiatives that seek to make more data available, we suggest the need to facilitate a more egalitarian engagement with online data resources. [ABSTRACT FROM PUBLISHER]

Introduction: Video games are not only changing due to technical innovation, but also because of new game design and monetization approaches. Moreover, elite gamer groups with financial in-game-investments co-finance all users of free-to-play-games. Besides questions on youth protection, the growing popularity of free-to-play games has fostered discussions on supposed associations to Internet Gaming Disorder (IGD).Method: Children and adolescents using free-to-play browser games were examined in a German school-based representative study (N=3967; age range 12 to 18). Based on a clinical self-report AICA-S (Wölfling et al., 2011), students were categorized into non-problematic, risky, and addicted users. Psycho-social problems (SDQ; Goodman, 1997), perceived stress (PSS; Cohen, Kamarck & Mermelstein, 1983), coping strategies (BriefCOPE; Carver, 1997), and Average Revenue per (Paying) User (ARPU) were investigated as dependent variables. Furthermore, an industry classification (Freeloaders, Minnows, Dolphins, and Whales) for free-to-play gamers was used for additional relations regarding IGD, SDQ, PSS, BriefCOPE, and ARPU.Results: Among free-to-play gamers the prevalence of IGD amounted to 5.2%. Subjects classified with IGD displayed higher psycho-social symptoms than non-problematic users, reported higher degrees of perceived stress, and applied dysfunctional coping strategies more frequently. Additionally, we found a higher ARPU among subjects with IGD.Conclusion: ARPU is significantly associated with IGD. Whales share significant characteristics with addicted video gamers; Dolphins might be classified as risky consumers; Minnows and Freeloaders are rather non-pathological gamers. Vulnerability for stress, dysfunctional coping, and free-to-play gaming represent an unhealthy combination. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated the effectiveness of Internet-based interventions for depression in comparison with usual care. However, evidence on the cost-effectiveness of these interventions when delivered in outpatient clinics is lacking. The aim of this study was to estimate the cost-effectiveness of an Internet-based problem-solving guided self-help intervention in comparison with enhanced usual care for outpatients on a waiting list for face-to-face treatment for major depression. After the waiting list period, participants from both groups received the same treatment at outpatient clinics.Methods: An economic evaluation was performed alongside a randomized controlled trial with 12 months follow-up. Outcomes were improvement in depressive symptom severity (measured by CES-D), response to treatment and Quality-Adjusted Life-Years (QALYs). Statistical uncertainty around cost differences and incremental cost-effectiveness ratios were estimated using bootstrapping.Results: Mean societal costs for the intervention group were €1579 higher than in usual care, but this was not statistically significant (95% CI - 1395 to 4382). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective in comparison with usual care was 0.57 at a ceiling ratio of €15,000/additional point of improvement in CES-D, and 0.25 and 0.30 for an additional response to treatment and an extra QALY respectively, at a ceiling ratio of €30,000. Sensitivity analysis showed that from a mental healthcare provider perspective the probability of the intervention being cost-effective was 0.68 for a ceiling ratio of 0 €/additional unit of effect for the CES-D score, response to treatment and QALYs. As the ceiling ratio increased this probability decreased, because the mean costs in the intervention group were lower than the mean costs in the usual care group.Limitations: The patients in the intervention group showed low adherence to the Internet-based treatment. It is possible that greater adherence would have led to larger clinical effects.Conclusions: Offering an Internet-based intervention to depressed outpatients on waiting list for face-to-face treatment was not considered cost-effective in comparison with enhanced usual care from a societal perspective. There was a high probability of the intervention being cost-effective in comparison with enhanced usual care from the perspective of the mental healthcare provider. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports on topics including the featured scholarship of Association of Internet Researchers, the uncover issue on how Internet influenced people to different intersecting ways and the status of Internet Research as discipline.

The growth of users connected to the Internet with a high bandwidth connection hasfavored the increase of multimedia services. As many of these services are provided by means of SIP, adding support for payment to SIP might benefit vendors. Payments in SIP have been proposed for accessing services, for microbilling and even as a solution to SPAM in VoIP systems. Current proposals have some limitations such as either not being suitable for low payments or micropayments, or not supporting the use of different payment protocols or the payment is always made for the whole session or they do not take into account that streams of different quality could have different prices. In response to these limitations, we propose a new SIP extension for supporting any kind of payments (both micropayments and macropayments) on SIP. In addition to being payment-independent, our proposal solves interoperability problems. Our proposal is based in an standard extension of SDP and SIP in order to maximize the compatibility. This facilitates the deployment of payment in SIP-based services. Moreover, our SIP extension supports an offer/answer model that allows the choice of the quality of the streams as well as the payment options to use. Furthermore, it is flexible and not only supports payment but also more complex business models such as loyalty models, credentials and subscriptions. In this paper, we provide a generic way to incorporate new payment methods and business models in the vendor's software. Using some application scenarios, we make a comparison between our proposal and previous work to show some of the advantages of using our proposal. [ABSTRACT FROM AUTHOR]

The article discusses the author's contention that law reviews should transition to an Internet-based electronic format, and it mentions the potential elimination of all hard copy versions of legal journals. Several historic developments involving publishing and printing are examined, along with cost control, environmentalism, and the economical aspects of digital-only publications. Publishing speed, flexibility, and efficiency are assessed, along with the Lexis and Westlaw research services.

Background: Substance misuse and excessive alcohol consumption are major public health issues. Internet-based interventions for substance use disorders (SUDs) are a relatively new method for addressing barriers to access and supplementing existing care. This study examines cost-effectiveness in a multisite, randomized trial of an internet-based version of the community reinforcement approach (CRA) with contingency management (CM) known as the Therapeutic Education System (TES). Methods: Economic evaluation of the 12-week trial with follow-up at 24 and 36 weeks. 507 individuals who were seeking therapy for alcohol or other substance use disorders at 10 outpatient community-based treatment programs were recruited and randomized to either treatment as usual (TAU) or TES+TAU. Sub-analyses were completed on participants with a poorer prognosis (i.e., those not abstinent at study entry). Results: From the provider's perspective, TES+TAU as it was implemented in this study costs $278 (SE=87) more than TAU alone after 12 weeks. The quality-adjusted life years gained by TES+TAU and TAU were similar; however, TES+TAU has at least a 95% chance of being considered cost-effective for providers and payers with willingness-to-pay thresholds as low as $20,000 per abstinent year. Findings for the subgroup not abstinent at study entry are slightly more favorable. Conclusions: With regard to the clinical outcome of abstinence, our cost-effectiveness findings of TES+TAU compare favorably to those found elsewhere in the CM literature. The analyses performed here serve as an initial economic framework for future studies integrating technology into SUD therapy. [ABSTRACT FROM AUTHOR]

The article acknowledges the evolution of the Internet and how it affects the economy in areas such as business and industrial transformation. It emphasizes the importance of digital revolution in the field of medicine, transportation, and education. Venture capitalist Marc Andreessen is acknowledged for his views on Internet evolution and humanity. A concern is raised regarding its negative effect on workforce.

One of the key attempts towards a collective African vision is the New Economic Partnership for African Development (NEPAD). Barnard and Vonk (2003) report that "53 countries have been urged to implement ICTs in three crucial development arenas: education, health and trade". While NEPAD and other initiatives have contributed to the provision of ICT infrastructure with positive results as seen in the growth of Internet uses, the disparities in development across Africa are enormous. The challenge to Higher Education Institutions in Africa has been summarised by Colle (2005): "central to creating digital resources and academic infrastructure is the question of universities' relevance to the world around them, and especially to the challenge of being an active player - 'an anchor of a broad-based poverty alleviation strategy' in an increasingly knowledge-based economy". It can be inferred from Colle that the activities of HEIs in Africa ought to be geared towards contributing to the realisation of the Millennium development goals. In 2003, the World Summit on the Information Society (WSIS) adopted a declaration of principles aimed at enabling everyone to create access, utilise, and share information and knowledge. In this declaration, member states affirmed their commitment to aggressive investment in ICT for social and economic development (Ngwenyama, Andoh-Baidoo, Bollou, & Morawecynski, 2006). [ABSTRACT FROM AUTHOR]

Background: Problematic alcohol consumption is associated with a high disease burden for affected individuals and has a detrimental impact on companies and society due to direct and indirect health costs. This protocol describes a study design to evaluate the (cost)-effectiveness of a guided and unguided Internet-based self-help intervention for employees called "GET.ON Clever weniger trinken" (be smart - drink less) compared to a waiting list control group.Methods: In a three-arm randomized controlled trial, 528 German adults who are currently members of the workforce will be recruited by occupational health departments of major health insurance companies. Employees aged 18 and older displaying problematic drinking patterns (>21/14 drinks per week and an AUDIT score > 8/6 for men/women) will be randomly assigned to one of three following study conditions: 1. unguided web-based self-help for problematic drinking, 2. adherence-focused guided self-help, and 3. waiting list control. Self-report data will be collected at baseline (T1), 6 weeks (T2), and 6 months (T3) after randomization. The primary outcome will be the reduction of alcohol standard units during the 7 days prior to T2, using the Timeline Followback method. Cost-effectiveness analyses to determine direct and indirect costs will be conducted from the perspectives of employers and the society. Data will be analyzed on an intention-to-treat basis and per protocol.Discussion: There is a need to identify effective low-threshold solutions to improve ill-health and reduce the negative economic consequences due to problematic alcohol drinking in workforces. If the proposed web-based intervention proves both to be efficacious and cost-effective, it may be a useful tool to increase utilization rates of interventions for problematic drinking in occupational settings.Trial Registration: German Register of Clinical Studies (DRKS): DRKS00006105 , date of registration: 2014-07-07. [ABSTRACT FROM AUTHOR]

Due to the hybrid nature of material and digital spaces, more decisions are being made online that have a direct effect on offline actions. This is increasingly true for the locations where people are choosing to consume goods and services such as restaurants or retail outlets. The growth of the GeoWeb-personal data uploaded to certain Internet sites such as social media platforms-has established large databases showing the locations where people go during their daily lives for the purposes of consumption. One such repository is the social network, Foursquare, which people use to display their physical location to their friends, digitally. In looking more closely at datasets from Foursquare overlaid with information on racial characteristics in census tracts, a pattern emerges: predominantly African-American tracts are increasingly left out of this type of online participation. This paper will compare Foursquare data from several U.S. cities to discuss the implications of being left off of social media platforms tied to economic activity. It is likely that these virtually invisible areas will have a direct impact on the economic vitality of their physical counterparts [ABSTRACT FROM AUTHOR]

In a country as large as Canada, connectivity-whether by road, rail, radio, or the Internet-plays an important role in economic growth, political and social development, and civic engagement. The importance of communications infrastructure especially is evident in the northern two-thirds of Canada, where radio, television, and the Internet have been instruments of democratic expression and civic participation. As pressures for resource extraction mount, northern communities must respond to economic, social, and political challenges from a position of geographical and, more significantly, "knowledge" isolation. Northern community residents need effective, community-led channels of communication. Addressing these needs will require both social and technological innovation-which can, fortunately, proceed from an existing base of experience and community expertise. In this article, we analyze two moments in northern public policy discourse in which new communications media played a pivotal role in advancing democratic dialogue in northern Canada: the 1975-7 Mackenzie Valley pipeline inquiry, and the 2012-3 hearings into the Mary River iron ore project in Nunavut. Our goal is to advance understanding of the purposeful use of communications infrastructure to support the development of local understanding, citizen engagement, and opportunities for effective community participation in development decisions. We find that technological capacity is foundational, but effective only under specific social and organizational conditions, which include the existence of appropriate institutions at the local level for citizen mobilization and response, dominance of Indigenous language use by northern citizens, appropriate levels of funding, and receptive public institutions to and through which northern citizens can speak. [ABSTRACT FROM AUTHOR]