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People who are homeless and at-risk have been significantly impacted by the COVID-19 pandemic. Homelessness services are on the frontline of the pandemic response. Operating these services effectively in pandemic conditions is challenging. This article examines the perceptions of homelessness services workers about the impacts of, and responses to, the COVID-19 pandemic in homelessness services in Australia. A mixed-methods survey was distributed to homelessness services across Australia in June–July 2020. Fifty-nine services from all eight states and territories responded. Homelessness services workers discussed the impacts of COVID-19 and responses to the pandemic under the following six themes: (i) changes in the numbers of people seen, referred, and accommodated; (ii) immediate responses to the pandemic; (iii) the impact on staff hours, stress, and workload; (iv) use of service emergency and contingency plans; (v) effectiveness of service and government responses; and (vi) the future impacts on services. Respondents reported that although the impacts of the COVID-19 pandemic were significant, services responded by actively changing delivery to meet needs and demands. Understanding the impacts of and responses to the pandemic is vital to informing the activities undertaken by homelessness services as they continue to operate in pandemic conditions and prepare for pandemic recovery. Homelessness services are on the frontline of the COVID-19 pandemic response. The impacts of the pandemic on Australian homelessness services have been significant, and workers need support to maintain and expand upon their innovative responses. Understanding the impacts of and responses to the pandemic will inform activities undertaken by homelessness services workers, who continue to operate in pandemic conditions and prepare for pandemic recovery. [ABSTRACT FROM AUTHOR]

To explore patient perspectives of the integrated intervention (intervention arm) of a recent randomised clinical trial that found clinically relevant and sustained benefits of a physiotherapist delivered integrated stress inoculation training (SIT) and exercise for people with acute whiplash-associated disorders (WAD) and at risk of poor recovery. Twelve patients from the 53 who participated in the SIT and exercise arm of a randomised controlled trial (StressModex RCT) participated in semi-structured interviews. Data were analysed using inductive thematic analysis. Five main themes were identified: "balance between the physical and psychological components," "dealing with stress," "coping with the injury," "pain relief and return to function," and "elements enhancing therapeutic alliance." The majority of patients found the SIT techniques to be helpful in managing stress and pain, coping with their injury, and returning to function. The patients also found the exercises useful and acknowledged the importance of both the physical and the psychological aspects of whiplash injury. Patients with acute WAD at risk of poor recovery welcomed the inclusion of psychological strategies as part of physiotherapy treatment. The patients nominated both the psychological (SIT) component and exercise as assisting them with their stress, pain, and recovery. Physiotherapists could consider including strategies targeting early stress responses in their management of patients with acute WAD. [ABSTRACT FROM AUTHOR]

Evidence suggests equine-assisted activities may provide psychological benefits to young people "at-risk." Results are presented from an equine program among 14- to 16-year-old children (N = 7), mostly boys (N = 6), attending a non-traditional flexi-school in Australia. Thematic analyses were undertaken on observations by facilitators, researchers, and a school teacher, and interviews with a school teacher. Key themes suggest that program participants benefited from positive engagement, social connectedness, and increased confidence, relationships, and attachment. Mechanisms were identified as a desire and an ability to connect with the horse and a positive environment. The social context of the equine program contrasts with other contexts in these young people's lives, which allowed them to engage through more positive relational, affectionate behavior. For the boys, positive rather than damaging masculine behavior was displayed. Furthermore, the compatible student-environment interactions provide a backdrop which makes other positive changes possible. [ABSTRACT FROM AUTHOR]

Therapeutic drug monitoring (TDM) of cancer drugs has been shown to improve treatment effectiveness and safety. The aim of this paper was to comprehensively review economic evaluations of TDM interventions for cancer drugs. Searches were conducted in 4 electronic databases, Medline, EMBASE, and Centre for Reviews and Dissemination databases (Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database), from their inception to June 2019. Studies were included if they were economic evaluations of TDM interventions for an active cancer treatment. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS checklist). Of the 11 publications identified, imatinib with TDM and 5‐fluorouracil with TDM were the most commonly assessed interventions (4 publications each). Overall study quality was good, with publications meeting 61 to 91% (median 80%) of CHEERS checklist criteria. A variety of studies were used to estimate the clinical effectiveness inputs for the cost effectiveness models. All publications considered TDM to be cost‐effective based on an incremental cost‐effectiveness ratio below the willingness to pay threshold (64%) or being cost‐saving (36%). TDM interventions were considered cost‐effective across the economic evaluations. Further clinical research assessing the impact of TDM on overall survival or other long‐term health outcomes may enhance the evidence base for TDM in oncology. Future economic evaluations of TDM should explicitly consider uncertainty in the underlying clinical evidence and incorporate changes in the use of newer targeted drugs that form the current standard of care. [ABSTRACT FROM AUTHOR]

Objectives Neck pain remains highly prevalent and costly worldwide. Although reassurance has been recommended as a first line of treatment, specific advice on the best ways to provide reassurance has not been provided due to lack of evidence. Pain symptoms and experiences differ between patients with whiplash-associated disorder (WAD) and those with nontraumatic neck pain (NTNP). The aims of this study were to 1) identify and compare the concerns, fears, and worries of patients with WAD and NTNP; and 2) determine if patients believe their concerns are addressed by primary care providers. Methods These questions were investigated through an online survey, with a convenience sample of 30 participants with NTNP and 20 with WAD. Results A thematic analysis of survey responses resulted in the following seven themes related to common concerns, and two regarding how well concerns were addressed. Common concerns expressed by both groups shared four themes: 1) further structural damage, 2) psychological distress, 3) concerns about the future, and 4) hardships that eventuate. Theme 5), pain/disability is long term, was specific to WAD. Themes 6), pain is current or reoccurring, and 7), interference with daily life, were specific to NTNP. Regarding how well patient concerns were addressed, two overarching themes were common to both conditions: 1) concerns were addressed, with both groups sharing the subthemes "successful treatment," "reassurance," and "trust"; and 2) concerns were not addressed, where all subthemes were shared with the exception of two unique to NTNP. Conclusions This detailed comparison provides information about neck pain patients' concerns and fears, while providing health practitioners support for selecting strategies to promote reassurance appropriately for individual patient needs. Our findings from patients' perspectives enhance the understanding for providing reassurance for neck pain as proposed by our analysis. [ABSTRACT FROM AUTHOR]

Purpose: The aims of the present study were to identify information that individuals with whiplash associated disorders (WAD) need to know in the early stages of recovery and to establish whether there is a difference between what physiotherapists and whiplash-injured patients perceive as important information. Method: Forty-one participants were recruited (20 whiplash-injured patients, 21 physiotherapists). Participants were asked to provide five statements to one open-ended question about what they believe is the most important information individuals with WAD need to know in the early stages of recovery. Participants provided 182 statements which were reviewed independently and organised into themes by two of the authors. Results: Six key themes emerged from the statements. These included general information about whiplash injury, treatment and recovery, reassurance, provision of poor information and patients' interaction with general practitioners, maintaining daily activities, and compensation claims and litigation. Both patients and physiotherapists agreed on the type of general whiplash information that should be provided however, major differences were found with regard to information pertaining to compensation claims and litigation and maintaining daily activities. Conclusions: The findings of this study provide some insight into the type of information that WAD individuals require in the early stages of recovery. [ABSTRACT FROM AUTHOR]