Telehealth, the delivery of health care services at a distance using information and communications technology, has been slow to be adopted and difficult to sustain. Researchers developing theories concerning the introduction of complex change into health care usually take a multifactorial approach; we intentionally sought a single point of intervention that would have maximum impact on implementation. We conducted a qualitative interview study of 36 Australian telehealth services, sampled for maximum variation, and used grounded theory methods to develop a model from which we chose the most important factor affecting the success of telehealth. We propose that clinician acceptance explains much of the variation in the uptake, expansion, and sustainability of Australian telehealth services, and that clinician acceptance could, in most circumstances, overcome low demand, technology problems, workforce pressure, and lack of resourcing. We conclude that our model offers practical advice to those seeking to implement change with limited resources.
Acceptance is the Key
Unfortunately, self-acceptance was also the "happiness habit" that participants in the survey practiced the least. The new study is titled "Self-Acceptance Could Be the Key to a Happier Life, Yet It's the Happy Habit Many People Practice the Least."
It's important to identify specific lifestyle choices, habits, and character traits that you should happily accept while also being objective about things you might want to work on improving. Finding the sweet spot between self-acceptance vs. self-improvement requires being honest and compassionate about who you are, while simultaneously acknowledging that nobody's perfect and we can always improve ourselves. This can be a tightrope walk.
I'm optimistic that consistently practicing the three positive actions to increase self-acceptance, along with the 10 keys to happier living, and loving-kindness meditation can make everybody more self-accepting and happier.
The widespread use of sustainable energy technologies is a key element in the transformation of the energy system from fossil-based to zero-carbon. In line with this, technology acceptance is of great importance as resistance from the public can slow down or hinder the construction of energy technology projects. The current study assesses the social acceptance of three energy technologies relevant for the German energy transition: stationary battery storage, biofuel production plants and hydrogen fuel station.
The results indicate that general acceptance for all technologies is slightly higher than local acceptance. In addition, we discuss which public concerns exist with regard to the respective technologies and how they are more strongly associated with local than general acceptance. Further, we show that trust in stakeholders and attitudes towards financial support is relatively high across the technologies discussed.
To date, biomass is one of the most important and flexible renewable energy source in Germany. Regionally available biomass is used in solid, liquid and gaseous form to generate electricity and heat and to produce biofuels, making biomass a very versatile energy carrier. This way, the use of bioenergy can contribute to ensuring energy supply security and compensate for fluctuations caused by other renewable energy sources [40]. Furthermore, biofuels can play a valuable role in reducing carbon dioxide emissions and are often considered as carbon emission neutral [41, 42], as the carbon dioxide that is released when biofuels are burned is equal to the carbon dioxide that is absorbed by the biomass during its growth [43]. With biofuels having gained increasing importance in the field of renewable energies, analyzing its public importance is a key issue. For biofuel projects, local opposition is an issue that can cause project delays and interrupt operations [44, 45]. Residents living nearby a biofuel production plant oftentimes report having to put up with odor and noise emissions induced by the plant [46, 47], which can influence acceptance.
Previous studies on the acceptance of energy technologies have shown that factors such as perceived risks and benefits, trust, perceived fairness and personal norms influence attitudes and behaviors towards technologies [57,58,59,60,61]. In the following, we will shortly introduce the factors examined in the current study.
Research has shown that perceived risks and benefits play an important role when it comes to public acceptance of technologies [57, 67,68,69]. Most studies examine risks and benefits on a rather general level, such as by asking respondents how useful, positive or safe they judge the technologies [70]. Risks and benefits assessed in this way have been shown to be (in)directly associated with general and local energy technology acceptance [70, 71]. Some studies however recommend placing the focus on specific costs and benefits perceived by local residents when studying the local acceptance of energy technologies [47] as local acceptance can be much more dependent on project-specific variables [66]. For instance, in the case of biogas, unpleasant smells are a cost associated with local acceptance [47], whereas for wind energy, the visual impacts of the technology have been shown to be associated with local acceptance [72]. In line with this reasoning, we assess which specific public concerns are perceived with regard to the three technologies and examine whether they are more strongly associated with local compared to general acceptance.
Last, we will examine attitudes towards financial support/funding. Technologies that receive funding or financial support from the government are more likely to be rolled out on a broader scale in the future. Therefore, assessing attitudes for financial support can serve as another indicator towards support for new technologies. As attitudes towards financial support/funding are examined on a general level (i.e., not for an energy project in a certain location), we expect attitudes towards financial support/funding to be associated with general acceptance but not local acceptance.
Overall, the three technologies were evaluated as fairly positive, meaning that general acceptance of all three technologies is high (see Fig. 5). With regard to stationary battery storage, 37% of the participants indicated to perceive the technology as very positive. Biofuel production plants were evaluated as very positive by 16% of the participants, whereas hydrogen refueling stations were rated as very positive by 25% of the participants. Furthermore, for all three technologies, about half of the participants evaluated the technologies as rather positive (48% for stationary battery storage systems, 58% for biofuel production plants, 50% for hydrogen refueling stations). Only few participants indicated to perceive the technologies negatively. For both biofuel production plants and hydrogen refueling stations, about a fifth of the participants were undecided with regard to the technologies (17% for biofuel production plants, 20% for hydrogen refueling stations). With regard to stationary battery storage, only 10% of respondents indicated to be undecided about the technology.
The current study supports and extends findings with regard to common public concerns about the three technologies studied: stationary battery storage, biofuel production plants and hydrogen refueling stations. The most frequently mentioned concerns with regard to stationary battery storage include fire and explosion hazards, followed by electrosmog and the technology having a negative impact on the landscape and cityscape. These results go in line with previous results from a qualitative study conducted in the UK [37], which mentioned fire and explosion hazards as well as electromagnetic radiation as perceived risks. The study also reports that stationary battery storage systems may be more acceptable if situated out of the way or if the technology fit in with the environment, a finding that is consistent with participants in our study indicating to be concerned about the negative impact of the technology on the landscape or cityscape. About a fifth of the participants in our study mentioned noise pollution as a concern, a finding that was not reported in previous studies. An additional concern that was mentioned by some participants in the open text field included environmental impacts, more specifically with regard to the raw materials and production and disposal of the technology, which is a concern that was also found in the study by Thomas, Demski and Pidgeon [37]. With regard to biofuel production plants, the most commonly mentioned concern in our study was smell pollution, followed by noise pollution and the technology having a negative impact on the landscape and cityscape. These concerns go in line with previous studies conducted in Switzerland and Austria. In a study on the local acceptance of existing biogas plants in Switzerland [47], the authors found that smell perception influences acceptance indirectly via perceived benefits and risks as well as trust. Furthermore, results of a study based on expert interviews indicate that low acceptance of biogas plants in Austria is related to complaints about high levels of smell, noise and traffic by residents, which can result in planned projects having to be scaled down or shut down [77]. A concern not commonly reported in previous studies was biofuel production plants having a negative impact on the landscape. Potentially, the visual impact of energy infrastructure increasingly concerns citizens as more and more new energy infrastructure is introduced as the energy transition progresses. For hydrogen fuel stations, the most frequently reported concerns were explosion hazards and fire hazards, followed by noise pollution and the technology having a negative impact on the landscape and cityscape. Especially the risk of explosion is a commonly reported safety concern in studies on hydrogen acceptance [52, 78], with hydrogen often being associated with explosions and fire. As a lack of trust in safety is associated with opposition to hydrogen infrastructures, such concerns need to be taken very seriously during the planning process of the technology. 2ff7e9595c
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