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There is limited evidence on the costs and outcomes of patients with aphasia after stroke. The aim of this study was to estimate costs in patients with aphasia after stroke according to the aphasia therapies provided. A three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment trial conducted in Australia and New Zealand. Usual ward-based care (Usual Care) was compared to additional usual ward-based therapy (Usual Care Plus) and a prescribed and structured aphasia therapy program in addition to Usual Care (the VERSE intervention). Information about healthcare utilization and productivity were collected to estimate costs in Australian dollars for 2017–18. Multivariable regression models with bootstrapping were used to estimate differences in costs and outcomes (clinically meaningful change in aphasia severity measured by the WAB-R-AQ). Overall, 202/246 (82%) participants completed follow-up at 26 weeks. Median costs per person were $23,322 (Q1 5,367, Q3 52,669, n = 63) for Usual Care, $26,923 (Q1 7,303, Q3 76,174, n = 70) for Usual Care Plus and $31,143 (Q1 7,001. Q3 62,390, n = 69) for VERSE. No differences in costs and outcomes were detected between groups. Usual Care Plus was inferior (i.e. more costly and less effective) in 64% of iterations, and in 18% was less costly and less effective compared to Usual Care. VERSE was inferior in 65% of samples and less costly and less effective in 12% compared to Usual Care. There was limited evidence that additional intensively delivered aphasia therapy within the context of usual acute care provided was worthwhile in terms of costs for the outcomes gained. [ABSTRACT FROM AUTHOR]

People with communication disabilities post-stroke have poor quality-of-life. We aimed to explore the association of self-reported communication disabilities with different dimensions of quality-of-life between 90 and 180 days post-stroke. Cross-sectional survey data were obtained between 90 and 180 days post-stroke from registrants in the Australian Stroke Clinical Registry recruited from three hospitals in Queensland. The usual follow-up survey included the EQ5D-3L. Responses to the Hospital Anxiety and Depression Scale, and extra questions (e.g. communication disabilities) were also collected. We used χ2 statistics to determine differences. Overall, 244/647 survivors completed the survey. Respondents with communication disabilities (n = 72) more often reported moderate to extreme problems in all EQ5D-3L dimensions, than those without communication disabilities (n = 172): anxiety or depression (74% vs 40%, p <.001), pain or discomfort (58% vs 39%, p =.006), self-care (46% vs 18%, p <.001), usual activities (77% vs 49%, p <.001), and mobility (68% vs 35%, p <.001). Respondents with communication disabilities reported less fatigue (66% vs 89%, p <.001), poorer cognitive skills (thinking) (16% vs 1%, p <.001) and lower social participation (31% vs 6%, p <.001) than those without communication disabilities. Survivors of stroke with communication disabilities are more negatively impacted across different dimensions of quality-of-life (as reported between 90 and 180 days post-stroke) compared to those without communication disabilities. This highlights the need for timely and on-going comprehensive multidisciplinary person-centered support. [ABSTRACT FROM AUTHOR]

From a fledgling technology with no proven business models, electronic books (e-books) have grown in importance usurping traditional formats as an acquisitions budget line in many academic library contexts. Business models include purchase, subscription, and pay per use. In academic and research libraries, web based e-book delivery is the dominant platform involving desktop, Netbook and iPad user agents. E-books are the hot property of today's academic library, forming the new wave in information services along with web scale discovery and institutional repositories. This paper reports the results of a preliminary analysis of transactional e-log data describing academic and student use of Ebook Library (EBL) titles at Edith Cowan University (ECU) Library, Perth, Western Australia. The data mined and analysed encompassing Semesters One and Two of the 2010 academic year. Analysis includes descriptive statistics and other metrics describing e-book usage patterns and user behaviour. The paper compares usage patterns observed with earlier studies and reports on the phenomenon of the "power user". (Contains 11 tables and 8 figures.)

Speech Pathology programs usually send students to workplaces to learn clinical skills necessary for practice. During COVID-19, programs needed to respond quickly to ensure that students continued to gain the necessary experiences and skills required to progress through their program and graduate as clinicians, while simultaneously complying with COVID-19 requirements. Case studies from seven different universities in Australia, Ghana and Hong Kong described the diverse ways in which placements were adapted to be COVIDsafe, taking into account local needs. Some practices which had been included in placement education prior to the pandemic, such as telepractice and simulation-based learning, were extended and developed during this time. Educators, students, clinicians and clients responded to the rapidly changing needs of the time with flexibility and innovation, utilising a variety of technologies and tools to support case-based and virtual learning opportunities. Feedback from these diverse stakeholders about the experiences was positive, despite inevitable limitations and less-than-ideal circumstances. The positive findings provided insights for consideration in the future: could strategies implemented in response to the pandemic continue to be incorporated into placement experiences, enhancing current prompted exceptional responses; flexibility and innovation were accelerated in response to the pandemic and may transform future placement-based learning opportunities. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to validate and to determine the individual characteristics and demographic factors associated with parents' knowledge of hospital‐based pediatric falls and to identify parent populations more likely to report low levels of falls‐related knowledge. Design: Validation of a questionnaire and a cross‐sectional survey design. Methods: Parents (n = 200) of hospitalized children admitted to a tertiary specialist pediatric hospital in Australia completed an online questionnaire. Parents were asked to rate their hospital‐based falls knowledge using a Likert scale (1–5). The questionnaire was administered to parents across six hospital wards, 1 day a week, from May to August 2019. Validation of the questionnaire involved factor analyses and reliability tests. Finally, descriptive analysis measured parents' knowledge, and a multivariate logistic regression analysis reported factors associated with parents' falls knowledge. All data were analyzed in Statistical Package for the Social Sciences (V27). Ethical approval was received for all stages. Results: The final version of the parent knowledge of falls (PKOF) questionnaire consisted of 23 questions across five domains (Cronbach α =.929–.70). Parents' knowledge of hospital‐based falls ranged from 2.5 to 4.5, while knowledge that children may fall during parental presence rated the lowest score. Knowledge of inpatient falls was higher if their child had a high risk of falls (odds ratio [OR]: 2.1, p =.04) and they were Australian‐born parents (OR: 1.9, p =.05). Practice Implications: The PKOF questionnaire is an evidence‐based instrument developed for a pediatric hospital setting. Findings highlight knowledge gaps and parent groups with the highest risk of having inadequate hospital‐based falls knowledge. The questionnaire enables pediatric nurses and educators to measure parents' knowledge of hospital‐based falls accurately and consistently, and so to identify gaps and, subsequently, develop, implement, and evaluate falls education using an evidence‐based approach. [ABSTRACT FROM AUTHOR]

Aims: This study explored the acceptability of a workplace health promotion intervention embedded into a transition to practice (TTP) programme to assist new graduate nurses in establishing healthy dietary and physical activity (PA) behaviours from career commencement. Design: A sequential mixed methods design. Methods: The Start Healthy and Stay Healthy (SH&SH) intervention, informed by the Behaviour Change Wheel, was conducted in an Australian Local Health District. It included face‐to‐face education sessions, the use of a fitness tracker and twice‐weekly short answer messages. Participants completed three online surveys: at orientation, 6 weeks and 6 months. A sub‐sample participated in semi‐structured interviews to explore their experience of the intervention. Interview data were analysed thematically. Results: The intervention was delivered from February to December 2019. A total of 99 nurses completed the baseline survey, 62 at 6 weeks and 69 at 6 months. After 6 months, health knowledge increased as participants correctly identified recommended amounts of fruits, vegetables and PA. Fruit consumption increased at 6 months with little change to vegetable intake. Takeaway consumption decreased, but consumption of some discretionary foods increased. Across the three time points, there was a low engagement in PA during leisure time. The interviews identified three themes: (1) Support of Colleagues and Peers, (2) The Work Environment and (3) Engagement with SH&SH. Conclusion: Providing a targeted intervention for new graduate nurses embedded into a TTP programme improved their health knowledge, some dietary behaviours, and participation in PA by some participants. Impact: Ensuring a healthy nursing workforce is critical to retaining staff. Implementing a workplace health promotion intervention that targets new graduate nurses can help them adopt and maintain healthy lifestyle behaviours to support them in their future careers. [ABSTRACT FROM AUTHOR]

The small hive beetle, Aethina tumida Murray (Coleoptera: Nitidulidae), is a significant pest of managed honeybees in the USA and eastern Australia. The beetle damages hives by feeding on hive products and leaving behind fermented wastes. The beetle is consistently associated with the yeast Kodamaea ohmeri (Etchells & Bell) Yamada et al. (Saccharomycetales: Metschnikowiaceae), and this yeast is the presumed agent of the fermentation. Previous work has noted that the small hive beetle is attracted to volatiles from hive products and those of the yeast K. ohmeri. In this study, we investigated how the volatile compounds from the fermenting hive products change depending upon the source of the hive material and also how these volatiles change through time. We used gas chromatography–mass spectrometry and choice‐test behavioural assays to investigate these changes using products sampled from apiaries across the established range of the beetle in eastern Australia. The starting hive products significantly affected the volatile composition of fermenting hive products, and this composition varied throughout time. We found 61.7% dissimilarity between attractive and non‐attractive fermenting hive products, and identified individual compounds that characterise each of these groups. Eleven of these individual compounds were then assessed for attractiveness, as well as testing a synthetic blend in the laboratory. In the laboratory bioassay, 82.1 ± 0.02% of beetles were trapped in blend traps. These results have strong implications for the development of an out‐of‐hive attractant trap to assist in the management of this invasive pest. [ABSTRACT FROM AUTHOR]

Transitional housing programs aim to improve living skills and housing stability for tenuously housed patients with mental illness. 113 consecutive Transitional Housing Team (THT) patients were matched to 139 controls on diagnosis, time of presentation, gender and prior psychiatric hospitalisation and compared using a difference-in-difference analysis for illness acuity and service use outcomes measured 1 year before and after THT entry/exit. There was a statistically significant difference-in-difference favouring THT participants for bed days (mean difference in difference −20.76 days, SE 9.59, p = 0.031) and living conditions (HoNOS Q11 mean difference in difference −0.93, SE 0.23, p < 0.001). THT cost less per participant (I$14,024) than the bed-days averted (I$17,348). The findings of reductions in bed days and improved living conditions suggest that transitional housing programs can have a significant positive impact for tenuously housed patients with high inpatient service usage, as well as saving costs for mental health services. [ABSTRACT FROM AUTHOR]

Objective: There is increasing international evidence that crisis houses can reduce the time spent in acute psychiatric inpatient units for patients with severe and persistent mental illness, at a lower cost and in an environment preferable to patients. We evaluated the Alternatives to Hospitalisation (AtH) program, a crisis house operating in outer suburban Brisbane. Methods: One hundred and ninety-three AtH patients were compared to 371 matched controls admitted to a peer hospital district acute psychiatric unit. Hospitalisations, demographics and illness acuity were compared one year before and after an acute index episode of residential care involving hospital and/or AtH. Hospital bed-days during the index episode were compared between AtH participants and controls. The cost of bed-days averted was compared to the cost of providing the AtH program. Results: AtH participants spent 5.35 fewer days in hospital during the index episode than controls, after adjustment for illness acuity, living conditions, marital status and emergency department (ED) presentations. Per patient cost of averted psychiatric inpatient bed-days, $5948.22, was higher than the per patient cost of providing AtH, $3071.44. AtH participants had higher levels of illness acuity, ED presentations and acute psychiatric admissions than controls in the year after the index episode. Conclusions: For acutely unwell, stably housed patients, able to be managed outside of a secure facility, a crisis house program can reduce acute psychiatric bed-days, providing a cost saving for mental health services. [ABSTRACT FROM AUTHOR]

The article reports on the formation of an Internet web site that will serve as an open studio for Australian broadcasters, educational institutions and individual contributors. The space is also intended to be a testing place for educational, civic and public media applications. According to the organizers this testing ground is a place where software designers and Internet-based media designers would be able to discover the need for collaborative relationships that would assist with aspects of community development.

Purpose: While there has been extensive published research into adult inpatient falls, less is known about pediatric falls in Australia. Falls pose a safety risk to pediatric patients potentially causing harm, increased length of stay, and death. Parents play a central role in reducing falls‐related incidents given that, as parents, they provide care and/or oversee care delivered to their child at the bedside. Developing a better understanding of what parents and carers know about falls and associated risks, particularly those hospital‐naïve, is central to developing family centered strategies and targeted education to meet the needs of parents. Our study aimed to explore Australian parents' knowledge and awareness of pediatric inpatient falls. Design: Qualitative methods utilizing descriptive thematic analysis. Methods: Parents of children and/or young people hospitalized during the last 6 months were eligible to participate. Potential participants attending the outpatient clinics of two tertiary pediatric outpatient clinics hospitals in Sydney, Australia were invited to participate in the study. Willing participants consented to complete a face to face in‐depth interview. Open‐ended questions sought to explore participants' knowledge, knowledge acquisition, and awareness of inpatient falls. Interviews were digitally recorded and transcribed verbatim. Data familiarization and open coding were completed by researchers independently. Researchers explored and discussed emerging categories until patterns emerged and a consensus of dominant themes were agreed upon. Results: Interviews were conducted with mothers (n = 17), fathers (n = 4), or both parents together (n = 2) of a child or a young person who had been recently hospitalized. Four dominant themes emerged from the data namely: Supervision: falls won't happen, unexpected, parent priorities, and ways of learning about inpatient falls and risks. Despite parents' awareness of falls risk, parents were unaware that falls occur within a hospital setting and did not prioritize "falls prevention" during admission. Practice implications: Findings have implications for nursing practice, particularly in the delivery, content, and timing of falls prevention education. [ABSTRACT FROM AUTHOR]

Reports on medical publications in Australia that call for ethical participatory processes in public health research. Concerns about the Retractable Needle and Syringe Technology Initiative; Implication of the communitarian approach.