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Introduction and Aims Changes in risk and protective factors of adolescent alcohol use may be contributing to the recent decline in Australian adolescents alcohol use. The study aimed to determine the: (i) prevalence of alcohol use, risk and protective factors in 2011 and 2014; and (ii) association between alcohol use and risk and protective factors in 2011 and 2014. Design and Methods A repeat cross‐sectional study was conducted. Grade 9–10 (aged 15–17 years) students from 32 Australian secondary schools were sampled in 2011 and 2014. A self‐report survey collected data regarding alcohol use (ever, recent, ‘binge drinking’), risk factors (e.g. alcohol use/permissive attitude to alcohol by friends/siblings/parents) and protective factors (e.g. self‐efficacy; school/home/community support; peer caring relationships). Descriptive statistics were used to determine differences in alcohol use, risk and protective factors between 2011 and 2014. Adjusted multivariable logistic regression analyses examined associations between alcohol use, risk and protective factors separately in 2011 and 2014 (six models). Results Fewer adolescents reported alcohol use in 2014 compared with 2011 (ever: 56.6% vs. 67.9%, recent: 17.3% vs. 21.2%, ‘binge drinking’: 20.0% vs. 23.5%; 2011: n = 4366; 2014: n = 5199). Significant differences between 2014 and 2011 were found for some risk (five lower; one higher) and protective factors (four lower). Risk factors that were significantly lower in 2014 compared to 2011 were amongst variables with the strongest associations with alcohol use. Discussion and Conclusions The strength of associations with alcohol use, and decrease in the prevalence of certain risk factors in 2014 compared to 2011, suggests such factors may be contributing to the decline in adolescent alcohol use.

Context: Understanding the types and extent of need is critical to informing needs-based care for people with chronic heart failure (CHF). Objectives: To explore the psychometric quality of a newly developed rapid screening measure to assess the supportive and palliative care needs of people with CHF. Methods: A convenience sample of multidisciplinary health professionals working in heart failure care was invited to comment, via an online survey and consultation, on suitability and required modifications to a validated cancer care needs assessment measure to inform the support and palliative care needs of patients with CHF and their caregivers. Psychometric testing was then undertaken with 52 patients with CHF recruited from a multidisciplinary heart failure service to explore inter-rater reliability and concurrent validity of the newly adapted Needs Assessment Tool: Progressive Disease-Heart Failure (NAT: PD-HF). Results: Health professionals (n = 21) rated the tool as easy to administer, comprehensive, and relevant for the CHF population. Prevalence- and bias-adjusted kappa values indicated good agreement between pairs of raters for each item in the NAT: PD-HF (range 0.54-0.90). Participants indicating a higher severity of concern in the NAT: PD-HF physical, daily living, and spiritual items reported significantly higher Heart Failure Needs Assessment Questionnaire physical and existential scores. Conclusion: This study provides preliminary evidence for the NAT: PD-HF as a potential strategy for identifying and informing the management of physical and psychosocial issues experienced by people with CHF. Further work is needed to examine additional psychometrics, benefits relating to unnecessary symptom burden, futile treatments, and admissions to hospital. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Objective: To assess the impact of the systematic use of the Palliative Care Needs Assessment Guidelines and Needs Assessment Tool: Progressive Disease-Cancer (NAT: PD-C) on clinical assessment, response and service utilisation. Study setting: Three major oncology treatment centres in NSW, Australia. Study design: Between March 2007 and December 2009, 219 people with advanced cancer were recruited to complete bi-monthly telephone interviews. The intervention, introduced after at least two baseline interviews, involved training health professionals to complete the NAT: PD-C with patients approximately monthly. Data collection: Rates of service use and referrals were compared pre- and post-introduction of the NAT: PD-C. Rates of completion of the tool; its impact on consultation length; and the types of needs and follow-up care to address these were also assessed. Principal findings: The NAT: PD-C had a high rate of completion; identified needs consistent with those self-reported by patients in interviews; and did not alter consultation length. No changes in the number of health professionals seen by patients were found pre- and post-intervention. Conclusion: The NAT: PD-C is an efficient and acceptable strategy for supporting needs-based cancer care that can potentially be incorporated into standard routine care without increasing the burden on care providers. Copyright © 2011 John Wiley & Sons, Ltd.