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Supervision matters: it serves educational, supportive and management functions. Despite a plethora of evidence on the effectiveness of supervision, scant evidence for the impact of supervision training exists. While three previous literature reviews have begun to examine the effectiveness of supervision training, they fail to explore the extent to which supervision training works, for whom, and why. We adopted a realist approach to answer the question: to what extent do supervision training interventions work (or not), for whom and in what circumstances, and why? We conducted a team-based realist synthesis of the supervision training literature focusing on Pawson's five stages: (1) clarifying the scope; (2) determining the search strategy; (3) study selection; (4) data extraction; and (5) data synthesis. We extracted contexts (C), mechanisms (M) and outcomes (O) and CMO configurations from 29 outputs including short (n = 19) and extended-duration (n = 10) supervision training interventions. Irrespective of duration, interventions including mixed pedagogies involving active and/or experiential learning, social learning and protected time served as mechanisms triggering multiple positive supervisor outcomes. Short-duration interventions also led to positive outcomes through mechanisms such as supervisor characteristics, whereas facilitator characteristics was a key mechanism triggering positive and negative outcomes for extended-duration interventions. Disciplinary and organisational contexts were not especially influential. While our realist synthesis builds on previous non-realist literature reviews, our findings extend previous work considerably. Our realist synthesis presents a broader array of outcomes and mechanisms than have been previously identified, and provides novel insights into the causal pathways in which short and extended-duration supervision training interventions produce their effects. Future realist evaluation should explore further any differences between short and extended-duration interventions. Educators are encouraged to prioritize mixed pedagogies, social learning and protected time to maximize the positive supervisor outcomes from training.

Introduction: Children in families affected by substance use disorders are at high risk of being placed in out‐of‐home care (OOHC). We aimed to describe the characteristics of parents who inject drugs and identify correlates associated with child placement in OOHC. Method s : We used baseline data from a community‐based cohort of parents who inject drugs (SuperMIX) from Melbourne, Australia. Participants were recruited via convenience, respondent‐driven and snowball sampling from April 2008 to November 2020, with follow‐up until March 2021. To explore correlates associated with child placement to OOHC, we used multivariable logistic regression and assessed for potential interactions between gender and a range of relevant covariates. Results: Of the 1067 participants, 611 (57%) reported being parents. Fifty‐six percent of parents reported child protection involvement. Almost half (49%) had children in OOHC. Nearly half of the parents lived in unstable accommodation (44%) and many of them experienced moderate–severe levels of anxiety (48%) and depression (53%). Female or non‐binary gender, identifying as Aboriginal or Torres Strait Islander, experiencing assault and having more children were associated with child removal to OOHC. Of the 563 participants who reported their own childhood care status, 135 (24%) reported they had been removed to OOHC. Discussion and Conclusions: We identified high rates of child placement in OOHC among parents who inject drugs. There is a need for targeted health and social services, that are gender and culturally responsive, in addition to systems‐level interventions addressing social inequities, such as housing, to support parents to care for their children. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic triggered widespread socioeconomic hardship, disproportionately impacting disadvantaged populations. People who use illicit drugs are more likely to experience unemployment, homelessness, criminal justice involvement and poorer health outcomes than the general community, yet little is known about the socioeconomic impacts of the pandemic on their lives. To address this gap in the literature, we conducted in‐depth interviews with 76 participants from two cohort studies of people who use illicit drugs (people who inject drugs and/or use methamphetamine) in Victoria, Australia. Findings support claims that pandemic‐related Social Security supplementary payments and initiatives to reduce homelessness, although not systemically transforming people's lives, produced temporary relief from chronic socioeconomic hardship. Results also indicate how temporary interruptions to drug supply chains inflated illicit drug prices and produced adverse consequences such as financial and emotional stress, which was exacerbated by drug withdrawal symptoms for many participants. Furthermore, increased community demand for emergency food and housing support during the pandemic appeared to reduce participants' access to these services. Our findings about the unintended consequences of pandemic responses on the socioeconomic lives of a group of people who use illicit drugs provide insights into and opportunities for policy reform to redress their entrenched disadvantage. [ABSTRACT FROM AUTHOR]

Background and Aims: Few studies of the impacts of the coronavirus disease 2019 (COVID‐19) public health measures on drug markets and drug use patterns have used longitudinal data. We aimed to examine whether COVID‐19 measures were associated with increases in methamphetamine price, decreases in methamphetamine use frequency and subsequent changes in secondary outcomes of other drug use frequency in metropolitan Melbourne and regional Victoria. Design: Longitudinal analysis framework was used from a longitudinal cohort of people who use methamphetamine. Setting: Victoria state, Australia. Participants: One hundred eighty‐five VMAX study participants who reported a methamphetamine purchase after the onset of the pandemic were used for the price paid analysis. Methamphetamine or other drug use frequency analysis was performed using 277 participants who used methamphetamine during the pandemic or in the year before the pandemic. Measurements Price paid per gram of methamphetamine derived from the most recent purchase price and most recent purchase quantity. Frequency of methamphetamine and other drug use measured as the average number of days per week used in the last month. Findings Compared with pre‐COVID‐19 period, methamphetamine prices increased by AUD351.63 (P value <0.001) and by AUD456.51 (P value <0.001) in Melbourne and regional Victoria, respectively, during the period in which the most intense public health measures were implemented in Victoria. Although prices decreased after harder restrictions were lifted (by AUD232.84, P value <0.001 and AUD263.68, P value <0.001, in Melbourne and regional Victoria, respectively), they remained higher than pre‐COVID‐19 levels. A complementary 76% decrease was observed in relation to methamphetamine use frequency in regional Victoria (P value = 0.006) that was not offset by any changes in the frequency of use of other drugs such as alcohol, tobacco or other illicit drugs. Conclusion: COVID‐19 public health measures in Victoria state, Australia, appear to have been associated with major price changes in the methamphetamine market and decreased frequency of use of the drug. [ABSTRACT FROM AUTHOR]

Many parents support the "supervised introduction" of alcohol to children. While initiation to regular alcohol consumption in early adolescence has been linked with alcohol-related problems in adult life, the findings from these studies cannot be extrapolated to early childhood. The definition of initiation to alcohol in early childhood is often not reliable and there is a dearth of research regarding the impact of the broader social and cultural context where initiation may occur. Whilst parents need to be supported to make decisions that are informed by "evidence", policymakers need to be mindful of the role of ideology in policy development and the potential differences in risk factors for "initiation" to alcohol and the "misuse" of alcohol.

The majority of parents report that they believe they have an important role in shaping adolescents' values and behaviours in relation to drinking, but they also report that they need more support in this area. Education, welfare, health, youth and other professionals have an important role in providing services to young people and/or their families and have significant opportunities to provide information and support to families in relation to alcohol use. This article provides a framework for practitioners to use when assisting families to develop strategies to reduce young peoples' exposure to risky situations and subsequent alcohol-related harm.

Changes in the higher education sector over the past decade have led to increasing demands on academics and resulted in increasing workloads, longer work hours and increased workplace stress. Declining government commitment to university funding has placed increasing pressure on academics to attract research funding and to publish. In addition, an individual academic's publication record is a core criterion for decisions regarding promotion and tenure at most universities. However, incentives to support and enable that writing to take place have been limited. A range of different interventions have been described in the literature to enhance research output and encourage academics to publish. However, many are expensive in terms of the financial and personal costs involved, when compared with the increased publication outputs. In this article the authors reflect on how their small university department facilitated on-site writing retreats that increased publication output, with minimal disruption and limited costs. They provide a reflective account of two such retreats conducted over a twelve-month period and make recommendations for other departments wishing to adopt a similar approach.

The poor health status of Australia's Indigenous people is well-documented, as are the links between health and education. Aboriginal communities recognise the utmost importance of improving educational, physical, social and economic well-being in an environment where disproportionate numbers of Aboriginal students fail to complete secondary schooling. The aim of this paper is to highlight the issues of access, participation, retention and outcomes for Indigenous students wishing to study or currently studying health courses at a tertiary level. This project used a qualitative descriptive approach, conducting in-depth interviews with a number of key stakeholders and students in rural Victoria. Sixteen participants were interviewed, 14 of whom were from the Indigenous community. Participants identified key issues that were linked to the university and broader community environment. Factors in the university environment included lack of Indigenous staff within the mainstream university system, limited support and culturally inappropriate teaching that lead to negative learning experiences and poor motivation to continue with education. In the broader community, the isolating experience of leaving close-knit rural communities and the influence of past experiences on students' aspirations for tertiary education was highlighted. The importance of community support and liaison with the university and marketing of health courses to the Indigenous communities in the region were key issues that participants identified as needing further attention.

The prevalence and factors associated with advance care planning (ACP) documents for Australian public hospital inpatients were determined through cross‐sectional study of 123 Victorian hospitals between July 2016 and December 2018. Of the 611 786 included patients, 2.9% had an ACP document. Odds increased significantly in those comorbid, unpartnered, regional and >5 admissions, which supports future ACP conversations and document creation. [ABSTRACT FROM AUTHOR]

To examine the prevalence, frequency and characteristics of drug driving and being caught for a drug driving offense and their key correlates among people who used methamphetamine in rural and metropolitan areas of Victoria, Australia. Cross-sectional analysis of a sample of 744 people who used methamphetamine. Outcomes included self-reported drug driving (driving within three hours of consuming drugs, yes/no) and having been caught for a drug driving offense (yes/no). Sociodemographic (including rurality) and drug use variables were included in multivariable analyses. Of the 511 participants who reported driving in the six months prior to the survey, 407 (80%) reported drug driving (driving within three hours of taking an illicit drug). Most drug drivers (92.6%) reported taking methamphetamine (in combination with other drugs (59.5%) or in isolation (33.2%)) before driving. Most reported drug driving daily (31%) or weekly (25%), with passengers often (31%) or sometimes (28%). Most reported believing their driving was not at all impaired (49%), or only slightly impaired (32%) when preceded by drug taking. Multivariable analysis revealed that drug driving was not associated with rurality, nor with other socio-demographic characteristics. However, participants residing outside metropolitan areas were more likely to report having been caught previously for a drug driving offense (Adjusted odds ratio [aOR] = 1.93, 95% CI = 1.18–3.16). The majority of people within this cohort of people who used methamphetamine reported drug driving. An enhanced focus on public health campaigns and strategies to prevent drug driving is needed. [ABSTRACT FROM AUTHOR]

Little is known about the level and correlates of social support amongst people who use methamphetamine. We aimed to describe, and determine characteristics associated with, social support amongst a community‐recruited cohort of Australians who primarily smoked methamphetamine. A cross‐sectional study was conducted with data from the Victorian Methamphetamine Cohort Study (VMAX). Adults (aged ≥18 years) who used methamphetamine were recruited from June 2016 to March 2020 across metropolitan and non‐metropolitan areas using convenience, snowball, and respondent‐driven sampling. Social support was measured using the seven‐item Enhancing Recovery In Coronary Heart Disease (ENRICHD) Social Support Inventory (ESSI). Characteristics independently associated with ESSI quartiles were assessed via multivariable partial proportional odds regression. Overall, 718 participants were included for complete‐case analysis. Their mean (standard deviation [SD]) age was 34.7 (9.7) years and 62% were male. The mean (SD) and median (lower quartile‐upper quartile) ESSI scores were 22.6 (7.6) and 24 (16–29), respectively, on a scale of 8 to 34 where higher scores denote better self‐perceived social support. Characteristics independently associated with lower ESSI included past‐year homelessness (adjusted odds ratio [aOR] = 0.49, 95% confidence interval [CI] = 0.36–0.66), moderate/severe depression (aOR = 0.60, 95% CI = 0.42–0.86), increasing age relative to <30 years (aOR[30–39] = 0.61, 95% CI = 0.41–0.91; aOR[≥40] = 0.56, 95% CI = 0.35–0.91) and greater than fortnightly methamphetamine use (aOR = 0.69, 95% CI = 0.52–0.91). Characteristics independently associated with higher ESSI were employment (aOR = 1.51, 95% CI = 1.06–2.14) and female gender (aOR = 1.39, 95% CI = 1.00–1.92). Social support services for people who use methamphetamine could be targeted and tailored to subgroups defined by correlates of social support, such as those who experience homelessness, depression or unemployment. [ABSTRACT FROM AUTHOR]

Objective: Anxiety and depression are the most common mental health disorders experienced by Australians. These disorders are commonly found in people who use methamphetamine; however, much of this research has involved participants recruited from treatment settings who inject methamphetamine. We therefore explored (1) the prevalence of moderate to severe anxiety and depression in a community-recruited cohort who smoked methamphetamine and (2) examined potential factors associated with moderate to severe anxiety or depression in this cohort. Method: Data were derived from baseline surveys of 725 participants of the prospective 'VMAX' study, recruited from metropolitan and non-metropolitan areas of Victoria, Australia, via snowball and respondent-driven sampling. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9 instruments. Independent associations between moderate to severe scores on these measures and demographic, socio-economic, substance use and other health and social characteristics were examined using multivariable logistic regression. Results: More than half (60%) of the participants were classified as experiencing moderate to severe anxiety and/or depression. In the multivariable models, having poor/very poor self-rated health, methamphetamine dependence and being unemployed were associated with higher odds of experiencing both moderate to severe depression and moderate to severe anxiety. Living in a large rural town, identifying as Aboriginal and Torres Strait Islander and smoking methamphetamine were associated with lower odds of experiencing moderate to severe depression. Being female was associated with higher odds of experiencing moderate to severe anxiety. Conclusion: The high rates of anxiety and/or depression found in the VMAX cohort were associated with demographic, socio-economic, substance use and other health and social factors. The prevalence of moderate to severe anxiety is a novel finding that warrants further study. Further work is needed to determine how anxiety and depression change over time among people who smoke methamphetamine, to help identify key intervention points. [ABSTRACT FROM AUTHOR]

Objective: To identify and address particular challenges in the teaching of epidemiological concepts to undergraduate students in non-clinical health disciplines. Methods and Results: Relevant pedagogical literature was reviewed to identify a range of evidence-based teaching approaches. The authors also drew on their experience in curriculum development and teaching in this field to provide guidelines for teaching epidemiolegy in a way that is engaging to students and likely to promote deep, rather than surface, learning. Discussion of a range of practical strategies is included along with applied examples of teaching epidemiological content. Conclusions and Implications: Increasingly, there is a greater emphasis on improved learning outcomes in higher education. Graduates from non-clinical health courses are required to have a core understanding of epidemiology and teachers of epidemiology need to be able to access resources that are relevant and useful for these students. A theoretically grounded framework for effective teaching of epidemiological principles to non-clinical undergraduates is provided, together with a range of useful teaching resources (both paper and web-based). Implementation of the strategies discussed will help ensure graduates are able to appropriately apply epidemiological skills in their professional practice.

JOHN Henry Newman's most powerful poems--'Lead Kindly Light,' and The Dream of Gerontius--seek to make the light of faith a reality in his audience. His use of poetry for that [...]

An editorial is presented on the challenges in rural health workforce recruitment and the need for innovative approaches to address the disparities between metropolitan and rural healthcare. It emphasizes the necessity for a new approach that understands local community needs, identifies available resources, and matches them with health service requirements.