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Abstract Introduction Patient‐reported measures that assess satisfaction and experience are increasingly utilised in healthcare sectors, including the alcohol and other drug (AOD) sector. This scoping review identifies how and to what extent people accessing AOD services have been involved in the development of satisfaction and experience measures to date. Methods PubMed, EMBASE, CINAHL, Scopus, ProQuest, Google and Google Scholar were searched. Included papers described the development and/or implementation of a multiple‐item measure of patient‐reported experience or satisfaction specifically for people accessing AOD treatment and/or harm reduction programmes. If there was more than one paper, key papers were chosen that described each measure. The method of development, including service user involvement, was assessed against a framework generated for this review. Two reviewers were involved at each stage. Results Thirty measures—23 satisfaction and 7 experience—were identified. Sixteen measures reported some level of involvement by people accessing AOD services in their development, although, for most measures, at a relatively low level. This involvement increased over the time span of the review becoming more frequent in later years. Only four measures were developed for use in harm reduction‐specific settings, and fewer than half reported undertaking analysis of underlying scale structure and constructs. Conclusion Several gaps could be addressed to enhance the measurement of patient‐centred care in the AOD sector, including: developing experience measures for use in harm reduction settings and across various AOD settings in a service system; improved reporting of psychometric properties of these measures and increasing commitment to the meaningful involvement of AOD service users in measure development. Patient or Public Contribution This scoping review is part of a broader codesign project that involves a partnership between the peak organisation for AOD services and the peer‐based AOD consumer organisation in the Australian Capital Territory, Australia. These organisations are working closely together to engage with AOD service users, service providers and policy makers in this codesign project. As such, the Executive Director of the peer‐based AOD consumer organisation is involved as a co‐author of this scoping review.

The recent outpouring of testimonies about teenage sexual assault has reinvigorated calls for improved education on sexual consent. Better understanding of the approach, content and delivery of these programmes is key to informing best practice. In this paper, we systematically searched for peer-reviewed articles on programmes in education settings for young people aged 15-29 that purport to teach sexual consent, with 18 meeting the inclusion criteria. Nearly all reviewed programmes were implemented in the USA (n = 16) in university settings (n = 15), with short-term duration (1-2-hour sessions), with varied facilitators and interactive teaching strategies. Thematic analysis identified four main approaches to sexual consent education, some of which were interwoven within programmes: risky behaviour, sex-positive, life skills, and socioculturally adapted. In line with existing research into best practice sex and relationship education, we recommend that consent education programmes take a sex-positive and whole-school approach, are interactive and inclusive, and facilitate critical analysis of how experiences of consensual and non-consensual sexual activity are connected to socio-structural forces within socio-cultural contexts. Future research should evaluate a larger number of programmes and ensure consistent measurement of programme outcomes, whilst taking account of complex social systems and their shifting influence on consent.

High-quality teaching is central to the higher education sector. Its pursuit has become heightened with increasing competition across institutions and opportunities to study globally through various modes. This systematic meta-review provides a synthesis of evidence relating to the methods used to assess and enhance the quality of teaching practice within higher education. Key words, synonyms and subject headings were used to search six electronic databases between January 2009 and August 2019. Titles and abstracts of publications were screened and full text articles assessed against the eligibility criteria. Findings were extracted and integrated in a narrative synthesis. Thirteen review articles, revealed that the use of teaching quality: student feedback data, self-assessment tools, peer review of teaching (formative and summative) and the use of teaching portfolios. We report evidence related to the effectiveness of each of these approaches and that a multi-modal approach may be most effective but requires consideration of resourcing.

Plain English summary High proportion of married women do not use an effective contraceptive method and is a public health concern that is associated with unintended pregnancies, unwanted births, and unsafe abortions. This is also associated with increased risks of pregnancy and childbirth-related maternal morbidity. The decision to initiate use and continue the use of contraceptives is influenced by a number of factors. A greater understanding of these factors will inform policymakers, programmers, and other stakeholders to strengthen family planning and other health intervention programs to achieve the SDGs targeted maternal and under-5 child mortality reduction. Thus, the main objective of this study was to understand the social influences in initiating and continuing use of an LARC methods for contraception in a rural setting in Pakistan, using qualitative research. The analysis was done from a total of 27 women, aged 15–49 years, who started the use of long acting reversible contraceptive in the year preceding the study. The findings have an implication for policymakers, programmers, health care providers, and other stakeholders to evaluate and strengthen the provision of different contraceptive methods and improve support provided to women through the family planning programs. The findings of this study strongly recommended the provision of quality counseling on side effects and availability of contraceptive methods, peer support, and support for decision-making regarding long acting reversible contraceptive use.

Sport-for-social-change programs focusing on enhancing young people’s personal and social development emerged in the early to mid-2000s. Children and adolescents who participated in early programs are now adults, providing an opportunity to examine whether these programs have had any influence on their life trajectories. The Football United program has been operating in Sydney, Australia, since 2006 and is used as a case study in this article. This qualitative study draws on 20 interviews conducted in 2018 with a diverse sample of past participants of the program. Key findings were that participants perceived that the relationships they formed at Football United have had a substantial impact on their life trajectories, including influencing education and career decisions. These relationships were found to increase participants’ social capital, creating diverse connections with people and institutions within and external to their geographical communities. This study also found participants embraced a long-term commitment to ‘give back’ to their local geographical, cultural, and ethnic communities, which they attributed to their participation in the program.

Abstract Background Couples HIV Testing & Counselling (CHTC) service is an approach that may enable more people to be reached and tested for HIV. However, little is known about how couples may use this service and what they think about CHTC as an approach to finding out their HIV status. This study aimed to understand how individuals who had ever been in an ongoing heterosexual relationship for 6 months or more intended to use CHTC in Ethiopia and their beliefs about its benefits and potential harms. Methods Qualitative in-depth interviews were conducted in Addis Ababa, the capital city of Ethiopia, in 2017. Semi-structured interviews were undertaken with individuals who had ever been in an ongoing heterosexual relationship (n = 21) and key-informants (n = 11) including religious leaders, health care providers, and case managers. The interviews were transcribed verbatim, and an inductive thematic analysis was conducted. The data were coded to look for concepts and patterns across the interviews and relevant themes identified which captured key aspects related to the individual’s views on undertaking HIV testing with a sexual partner. Results Most participants regarded CHTC as an important HIV testing approach for people who are in an ongoing heterosexual relationship and expressed the view that there was “nothing like testing together”. However, many of the individual participants revealed they would prefer first to get tested alone to find out their own HIV status. They feared the consequences if they were HIV-positive, including accusations of infidelity, relationship break-up, and being exposed in the community. Many also reported being pressured to undertake CHTC before marriage by a third party, including religious institutions. Key informant interviews also discussed the requirements for CHTC before marriage. Conclusion The findings of this study suggest that people may be concerned about undertaking couples HIV testing without prior individual HIV testing. The intention of many to first test alone has policy and cost implications and underscores the possible harms of the implementation of CHTC in Ethiopia. Future research should examine whether the views identified in this qualitative study are reflected more broadly among couples in the community.

Abstract Background Complex interacting social, economic and historical factors influence the availability and uptake of alcohol and drugs, including among Indigenous communities. Self-harm and suicide as well as homelessness and incarceration, can both precede and result from drug and alcohol use. Rates of self-harm, suicide and incarceration among Aboriginal and Torres Strait Islander people in Australia are among the highest in the world and drug and alcohol treatment programs need to address these underlying complexities. This study examines whether an ‘holistic’ residential drug and alcohol treatment program for adolescents, with over 30% of clients identifying as Aboriginal and Torres Strait Islander, can improve outcomes post-discharge, including reducing self-harm, suicide attempts, arrests and alcohol and drug use. The program addresses substance use, mental health, employment, accommodation, social/community and family life. Program admission and 3 months’ post-discharge data from 2007 to 2016 were analysed. Results From 2007 to 2016, 619 Aboriginal and Torres Strait Islander young people were admitted to the program; 247 stayed in the program for 30 days or more; 89 were successfully followed up three months post-discharge to determine whether there was a significant improvement from baseline using the McNemar’s Test and the Wilcoxon Signed Ranks Test. On admission, 18 people (20%) of the study population reported attempting suicide in the last 3 months and 23 people (30%) reported self-harm. Most had been engaged in the criminal justice system, with 67 people (75%) having been to court and 62 people (70%) arrested one or more times in the past 3 months, with 35 people (41%) in unstable housing, reporting having lived in three or more places in the previous 6 months. At 3 months post-treatment, all (n = 18) who reported suicide attempts in the 3 months prior to admission reported no attempts in the prior 3 months at follow-up. There was also a significant reduction in self-harm with 23 young people out of the 27 who reported self-harm at baseline not reporting self-harm at follow up (85%) and in the proportion of adolescents who reported using cannabis, amphetamines and alcohol, as well as a reduction in the proportion who reported being arrested. Conclusions The findings provide support for an ‘holistic’ residential treatment program as an approach to improve health and related outcomes for Aboriginal and Torres Strait Islander young people. In addition to a focus on multiple aspects of a young person’s life in treatment, culturally relevant modes of treatment and support should be a future focus to further strengthen programs when Aboriginal and Torres Strait Islander young people are over-represented in the client group.

Background Globally, radon is the leading risk factor for lung cancer in never-smokers (LCINS). In this study, we systematically reviewed and meta-analysed the evidence of the risk of LCINS associated with residential radon exposure. Methods Medline and Embase databases were searched using predefined inclusion and exclusion criteria to identify relevant studies published from 1 January 1990 to 5 March 2020 focused on never-smokers. We identified four pooled collaborative studies (incorporating data from 24 case–control studies), one case–control study and one cohort study for systematic review. Meta-analysis was performed on the results of the four pooled studies due to different measures of effect and outcome reported in the cohort study and insufficient information reported for the case–control study. In a post hoc analysis, the corresponding risk for ever-smokers was also examined. Results Risk estimates of lung cancer from residential radon exposure were pooled in the meta-analysis for 2341 never-smoker cases, 8967 never-smoker controls, 9937 ever-smoker cases and 12 463 ever-smoker controls. Adjusted excess relative risks (aERRs) per 100 Bq·m−3 of radon level were 0.15 (95% CI 0.06–0.25) for never-smokers and 0.09 (95% CI 0.03–0.16) for ever-smokers, and the difference between them was statistically insignificant (p=0.32). The aERR per 100 Bq·m−3was higher for men (0.46; 95% CI 0.15–0.76) than for women (0.09; 95% CI −0.02–0.20) among never-smokers (p=0.027). Conclusion This study provided quantified risk estimates for lung cancer from residential radon exposure among both never-smokers and ever-smokers. Among never-smokers in radon-prone areas, men were at higher risk of lung cancer than women.

Introduction In a majority of low- and middle-income countries (LMICs), levels of child growth failure (CGF) have steadily declined since 2000. However, some countries show a different trend. Despite continued investment from the government of Ethiopia as well as donors, CGF levels are still high in Ethiopia. This study aimed to assess trends in CGF and associated sociodemographic, economic and water, sanitation, and hygiene (WASH) factors from 2000 to 2016 in Ethiopia. Methods Data were taken from four rounds of the Ethiopia Demographic and Health Survey (EDHS). Children aged between 0 to 59 months were included. CGF indicators were categorised based on height-for-age z-score (HAZ) < -2 Standard deviation (SD), weight-for-age z-score (WAZ) < -2 SD and weight-for-height z-score (WHZ) < -2 SD. CGF trends were estimated for predicted probabilities and odds ratios (ORs) between 2000 and 2016. Results A total sample size of 31978 for HAZ, 32045 for WAZ and 32246 for WHZ were included in the current study. Stunting decreased from an adjusted odds ratio (AOR) = 0.77 (95% CI: 0.67 to 0.88) in 2005 to an AOR = 0.45 (95% CI: 0.39 to 0.53) in 2016 compared with the year 2000. Compared with data in 2000, underweight decreased from an AOR of 0.70 (95% CI: 0.61 to 0.80) in 2005 to an AOR of 0.43 (95% CI: 0.36 to 0.50) in 2016. Wasting declined from an AOR of 0.91 (95% CI: 0.75 to 1.10) in 2005 to an AOR of 0.76 (95% CI: 0.61 to 0.94) in 2016, compared with data in 2000. Conclusions Between 2000 to 2016, there was a decline in CGF levels albeit the levels are still relatively high compared with the World Health Organization (WHO) cut-off levels for public health concern. Observed rates of change varied across sociodemographic, economic and WASH factors which suggest that interventions tailored towards addressing the imbalances across those factors are required.

Objective This study aimed to provide clarification on the benefits of water, sanitation and hygiene (WASH) alone separately and combined with nutrition in improving child growth outcomes.Design Systematic review and meta-analysis.Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed, MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science and Science Direct were searched in May 2018 and last updated in April 2019. We included studies that reported WASH interventions alone separately or combined with nutrition. Fixed and random-effects models were used to estimate pooled effect in mean difference (MD). Heterogeneity and publication bias statistics were performed.Results A total of 18 studies were included: 13 cluster randomised controlled trials (RCTs) and 5 non-randomised controlled trials (non-RCTs). Non-RCTs showed effect of WASH interventions alone on height-for-age z-score (HAZ) (MD=0.14; 95% CI 0.08 to 0.21) but RCTs did not. WASH alone of non-RCTs and RCTs that were delivered over 18–60 months indicated an effect on HAZ (MD=0.04; 95% CI 0.01 to 0.08). RCTs showed an effect for children

IntroductionPoor access to water, sanitation, and handwashing (WASH) facilities frequently contribute to child growth failure. The role of access to WASH facilities on child growth outcomes in Ethiopia is largely unknown. The aim of this study was to determine individual and combined effects of access to WASH facilities on child growth outcomes.MethodsData for this analysis was sourced from the recent Ethiopia Demographic and Health Survey (EDHS) 2016. A multivariable logistic regression model was applied to identify the separate and combined association of access to WASH facilities with child growth outcomes. Odds ratio (OR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05.ResultsIncluded in the analyses were data for children 0-59 months of age, which amounted to valid data for 9588 children with a height-for-age z-score (HAZ), 9752 children with a weight-for-age z-score (WAZ) and 9607 children with a weight-for-height z-score (WHZ). Children with access to improved combined sanitation with handwashing facilities had 29% lower odds of linear growth failure (stunting) (adjusted odds ratio (AOR) = 0.71; 95% CI: 0.51-0.99) compared with those with unimproved. Children with access to combined improved WASH facilities were 33% less likely to have linear growth failure (AOR = 0.67; 95% CI: 0.45-0.98). Access to improved handwashing alone reduced the odds of being underweight by 17% (AOR = 0.83; 95% CI: 0.71-0.98) compared with unimproved. Improved water and sanitation separately as well as combined WASH were not associated with decreased odds of underweight and wasting.ConclusionsCombined access to improved water, sanitation and handwashing was associated with reduced child linear growth failure. Further research with robust methods is needed to examine whether combined WASH practices have synergistic effect on child growth outcomes.

Abstract Objective: To explore the knowledge and attitudes underlying contraceptive use and non‐use among Tongan adults and investigate the potential acceptability of contraceptive implants. Methods: A mixed methods study was conducted that used two focus groups and a short self‐completed survey (n=109). Participants were recruited from a Tongan non‐governmental sexual and reproductive health clinic. Results: Contraceptive method discontinuation was high among the study group, with reasons for discontinuation often relating to misconceptions circulating in the community about the side effects of contraceptives. A high proportion (38%) reported using ‘natural’ contraceptive methods. A total of 47% of survey participants reported having heard of implants and 37% indicated they would be willing to try them. Conclusion: Current Tongan contraceptive uptake and continuation is hampered by misconceptions about side effects of methods and their risks, particularly among long‐acting and reversible methods. Contraceptive implants may be acceptable to Tongans given their arm placement, reversibility and long‐lasting effect. Implications: Efforts to improve contraceptive continuation in Tonga should focus on improving counselling on potential side effects for all methods. The introduction of contraceptive implants as an additional long‐acting reversible method should be considered.

Describes a study that defined and provided initial empirical support for differentiating the concepts of computer attitude, subjective computer experience, and objective computer experience. Discusses results of a principal component factor analysis and presents a conceptual analysis of the relation between subjective computer experience and computer attitude. (Contains 50 references.) (Author/LRW)

Issues examined concerns the methods and definitions used to study computer experience, or people's attitudes towards computers and information technology. Topics addressed include the influence of computer experience on computer attitudes, how knowledge and beliefs about computers are formed, and the psychological processes involved in the rejection or acceptance of technology.

This is a retrospective study of the factors which contributed to accidental injuries sustained by those patients who fell in a White provincial hospital in die period 1 January to 30 June 1982. The research study was undertaken by Diploma in Nursing Administration students during their 3-week hospital practice at a White provincial hospital.

The article discusses a study on limitations, in terms of showing causality of different types of study that were published in relation to crystal use in sexual behaviour. It notes that crystal can be a contributory cause of unsafe sex and suggests that promoting the idea that using crystal causes a lot of unsafe sex to occur may be counterproductive. Users perceive crystals to have desirable effects and disseminating information about the alleged effects of crystal in facilitating unsafe sex may lead more people to use it and users might decide that their unsafe sexual behaviour is crystal's fault and it is not their responsibility to avoid it.

The article describes a study which investigated the incidence and risk factors of syphilis in two community-based cohorts of human immunodeficiency virus (HIV)-negative and HIV-positive gay men in Sydney, New South Wales. It notes that the participants underwent annual face-to-face interviews, and syphilis screening was offered. According to this study, 21 men in the HIV-negative cohort seroconverted to syphillis while in the HIV-positive cohort, eight men seroconverted. The study concludes that syphilis incidence is higher in HIV-positive than in HIV-negative gay men.

By measuring the actual number of risk acts engaged in by HIV-positive men participating in the Positive Health (PH) cohort study, this paper sets out to document the distribution of risk acts, to report on the proportion of acts of unprotected anal intercourse with casual (UAIC) partners that occurred between HIV-positive men (i.e. seroconcordant positive) and to examine the factors that differentiated men who 'frequently' compared with 'sometimes' or 'never' engaged in unsafe UAIC (i.e. UAIC with serononconcordant partners: partners who have not tested positive for HIV). The findings show that 42.6% of all UAIC acts occurred between seroconcordant HIV-positive partners, posing no risk of HIV infection to an HIV-negative person. A minority of participants (10%) accounted for the majority (70.7%) of the unsafe acts of UAIC. The HIV-positive men who 'sometimes' engaged in unsafe UAIC had higher treatment optimism scores and were more likely to use Viagra in comparison with those who did not engage in such risk. Those who reported 'frequent' engagement in unsafe UAIC were more likely to engage in a range of esoteric sexual practices, be slightly less well educated and be taking antiretroviral therapy compared with HIV-positive men who 'sometimes' engaged in unsafe UAIC. As such, taking ART but not viral load, predicted frequent unsafe UAIC. When considered alongside earlier studies, these results suggest that HIV-negative men who engage in esoteric sexual practices may be at increased risk of HIV transmission, not necessarily because they engage in esoteric sex practices but because of the sub-cultural milieu in which esoteric sex is occurring. The findings from this study also endorse the measurement of UAIC acts as a useful gauge of risk. [ABSTRACT FROM AUTHOR]

Therapeutic use of marijuana has emerged as an important issue for people living with cancer, HIV/AIDS and multiple sclerosis. This paper examines therapeutic use of marijuana in the Positive Health cohort study, a longitudinal cohort study of men and women living with HIV/AIDS in NSW and Victoria, Australia. Factors that distinguish therapeutic use of marijuana from recreational use were assessed by comparisons on a range of social and health-related variables. The results show that among 408 participants, 59.8% reported some use of marijuana in the past six months. Of those participants (n=244), 55.7% reported recreational use only of marijuana and 44.3% report mixed use of marijuana for therapeutic and recreational purposes. Multivariate logistic regression analysis showed that participants who used marijuana for therapeutic purposes were significantly more likely than recreational-only users to have used other complementary or alternative therapies, experienced HIV/AIDS-related illness or other illnesses in the past 12 months, had higher CD4/T-cell counts, had lower incomes, be younger in age and less likely to have had a casual partner in the six months prior to interview. These results show that a substantial proportion of people living with HIV/AIDS (PLWHA) use marijuana for therapeutic purposes, despite considerable legal barriers, suggesting marijuana represents another option in their health management. Rather than solely using marijuana in response to illness, the experience of illness may influence a person's understanding of their marijuana use, so that they come to understand it as therapeutic. Further research might consider possible interactions between cannabinoids and antiretroviral treatments, potential use of oral THC and the difficulties faced by clinicians and PLWHA in discussing marijuana in the current legal context. [ABSTRACT FROM AUTHOR]

The study aim was to assess whether the sexual behaviour of HIV-negative or untested men who have sex with men (MSM) was related to their perceptions of what it is like to live with HIV/AIDS, their beliefs or their attitudes to highly active antiretroviral treatments. Any unprotected anal intercourse (UAI) with casual partners was used as the sexual-risk indicator. The study enrolled 261 MSM. There were no significant differences between beliefs, attitudes and perceptions about HIV/AIDS, knowledge of post-exposure prophylaxis (PEP) or exposure to the HIV/AIDS epidemic among those who had had UAI with casual partners and those that had not (P>0.12). Those who considered that low levels of viral load and withdrawing before ejaculation reduced the risk of HIV transmission were significantly more likely to have had UAI with a casual partner (P=0.03). Only a minority of MSM engaging in UAI were optimistic about antiretroviral therapy. The study participants were in general pessimistic about life with HIV/AIDS despite their risk-taking sexual behaviour. [ABSTRACT FROM AUTHOR]

The aim of this analysis was to examine gay men's sexual risk practice to determine patterns of risk management. Ten cross-sectional surveys of gay men were conducted six-monthly from February 1996 to August 2000 at Sydney gay community social, sex-on-premises and sexual health sites (average n = 827). Every February during this period, five identical surveys were conducted at the annual Gay and Lesbian Mardi Gras Fair Day (average n = 1178). Among the minority of men who had unprotected anal intercourse which involved ejaculation inside with a serodiscordant regular partner, there was a clear pattern of sexual positioning. Few regular couples were both receptive and insertive. Most HIV-positive men were receptive and most HIV-negative men were insertive. Among the minority of men who had unprotected anal intercourse which involved ejaculation inside with casual partners, there was also a pattern of sexual positioning. Whereas many casual couples were both receptive and insertive (especially those involving HIV-positive respondents), among the remainder HIV-positive men tended to be receptive and HIV-negative men tended to be insertive. These patterns of HIV-positive/receptive and HIV-negative/insertive suggest strategic risk reduction positionings rather than mere sexual preferences among a minority of gay men. If so, they point not to complacency but to an ever more complex domain of HIV prevention. [ABSTRACT FROM AUTHOR]

We examined trends in sexual practice among gay and homosexually active men in Australia. Self-complete questionnaires were distributed with mail-order sex video catalogues in 2000 and returned anonymously through a reply-paid facility. The data were compared with those from men who responded to promotional material sent out with the same catalogues and who participated in national telephone surveys of men who have sex with men conducted in 1992 and 1996. A key independent variable was gay community attached (GCA) versus non-GCA (NGCA) derived from two items about number of gay friends and amount of free time spent with gay men. Responses came from 1,832 men ranging in age from 16 to 80 (median = 39) years. HIV status was 73% negative, 5% positive, 22% untested; 1,181 men were GCA and 651 men were NGCA. Overall, from 1992 to 2000 there was a significant upward trend in the proportion of men reporting any unprotected anal intercourse (UAI) in the previous six months with regular partners: 21.5%, 24.7%, 46.4% of the total sample (p < 0.001). And similarly for UAI with casual partners: 12.4%, 16.2%, 25.5% (p < 0.001). The upward trends in UAI-regular and UAI-casual were similar and significant (p < 0.001) for both GCA and NGCA men. These nationwide Australian data provide evidence of continuing increases in unprotected anal intercourse with regular and with casual partners. Whereas the majority of men do not engage in any unprotected anal intercourse during a defined interval, ever increasing proportions of them do. [ABSTRACT FROM AUTHOR]

The article examines trends in reported drug use and drug of greater concern among adolescents admitted in some residential treatment sites in Australia from 2009 to 2014. Findings showed that methamphetamine use has increased from 10.8% to 48.4% during the period, while use of alcohol, cannabis and tobacco remained high. The findings also suggested that adolescents with learning difficulties or unstable accommodation may be of higher risk of methamphetamine use.

Introduction: Patient-reported measures that assess satisfaction and experience are increasingly utilised in healthcare sectors, including the alcohol and other drug (AOD) sector. This scoping review identifies how and to what extent people accessing AOD services have been involved in the development of satisfaction and experience measures to date., Methods: PubMed, EMBASE, CINAHL, Scopus, ProQuest, Google and Google Scholar were searched. Included papers described the development and/or implementation of a multiple-item measure of patient-reported experience or satisfaction specifically for people accessing AOD treatment and/or harm reduction programmes. If there was more than one paper, key papers were chosen that described each measure. The method of development, including service user involvement, was assessed against a framework generated for this review. Two reviewers were involved at each stage., Results: Thirty measures-23 satisfaction and 7 experience-were identified. Sixteen measures reported some level of involvement by people accessing AOD services in their development, although, for most measures, at a relatively low level. This involvement increased over the time span of the review becoming more frequent in later years. Only four measures were developed for use in harm reduction-specific settings, and fewer than half reported undertaking analysis of underlying scale structure and constructs., Conclusion: Several gaps could be addressed to enhance the measurement of patient-centred care in the AOD sector, including: developing experience measures for use in harm reduction settings and across various AOD settings in a service system; improved reporting of psychometric properties of these measures and increasing commitment to the meaningful involvement of AOD service users in measure development., Patient or Public Contribution: This scoping review is part of a broader codesign project that involves a partnership between the peak organisation for AOD services and the peer-based AOD consumer organisation in the Australian Capital Territory, Australia. These organisations are working closely together to engage with AOD service users, service providers and policy makers in this codesign project. As such, the Executive Director of the peer-based AOD consumer organisation is involved as a co-author of this scoping review., (© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Background: Research into disordered eating (DE), shame and self-compassion (SC) has poorly represented men, general populations and non-Western communities. Aim: To explore associations between these variables in an international community sample of men and women. Methods: An online exploratory sequential mixed methods cross-sectional survey assessed levels of (quantitative Phase 1) and perceptions of (qualitative Phase 2) eating behaviours, external shame and body image shame (BIS) and SC. Results: Phase 1 : Nearly 60% of our 142 survey participants were male (82/142) and about one-third were from India (43/142). About one-third of people (41/142) had a high-level concern regarding dieting, body weight, or eating (based on Eating Attitudes Test scores), and they had significantly higher levels of external shame, BIS and (SC-related) self-judgement and overidentification - compared to the 101/142 participants with low concern. Men had healthier levels of study outcomes than women. Phase 2: Four key themes were identified using inductive thematic analysis of the responses of 55 survey participants: (T1) DE as a Psychological Issue, (T2) DE as a Social Issue, (T3) The Vicious Cycle of Shame and (T4) Seeking Help. Conclusion: In participants in Phase 1 of our study - who were mostly male - DE behaviours were related to more external shame and body image-specific shame, and to less SC. Men had healthier levels of study variables than women. In Phase 2, participants talked about a vicious cycle of pathological eating and shame.

Background: Evidence associating plant-based diets with the proposed 'obsessively healthy eating' eating disorder, orthorexia nervosa, has mostly focused on females. Diet motivations have seldom been assessed., Aim: To compare orthorexic tendencies between vegans/vegetarians and omnivores of both sexes, and reasons behind food choice with an English-validated Food Choice Questionnaire., Methods: A cross-sectional survey of 444 males and females were recruited via social media, email, and Amazon MTurk; to investigate eating patterns, orthorexic tendencies using the ORTO-15 questionnaire, and eating motivations using the Food Choice Questionnaire., Results: Over half of the participants were male (53.4%), younger adults (mean ± SD 37.2 ± 11.2 years), and mostly from the United States (89%). Vegan and vegetarian eating habits were reported by 15.8% of people. Vegans/vegetarians had significantly higher orthorexic tendencies than omnivores, and chose food significantly more often for Weight Control, Ethical Concern, Natural Content, and Mood reasons. People with greater orthorexic tendencies (ORTO-15 score<35) chose food significantly more often for Weight Control and Ethical Concern reasons than those with less orthorexic tendencies (ORTO-15 score 35+)., Conclusion: This study's results are in line with the majority of the evidence that shows an association between vegan/vegetarian diets and orthorexic tendencies, but strengthens the evidence base by including more male participants. Additionally, this is the first study to use an English-validated motivation-based questionnaire that explored diet motivators in vegans/vegetarians compared to omnivories, and in those with orthorexic tendencies vs. those without orthorexic tendencies.

Introduction: This study examines the association between treatment in a therapeutic community for adolescents with drug and alcohol problems on hospitalisation outcomes up to 15 years later for all clients, and separately for those with and without a history of criminal conviction., Method: A quasi-experimental design was used to examine the linked administrative health and criminal justice records for all adolescents admitted to the Program for Adolescent Life Management (PALM) from January 2001 to December 2016 (n = 3059) in Sydney, Australia. ICD-10AM codes were used to designate hospitalisation outcomes as either physical injury, mental health problems, substance use disorders, or organic illness. The treatment and comparison groups were matched on factors associated with program retention, resulting in a final sample of 1266 clients. We examined the rate of hospitalisation up to 15 years posttreatment for all clients and stratified by prior conviction status using Cox regression analyses., Results: The treatment group had significantly lower rates of hospitalisation for a physical injury (HR = 0.77 [95% CI = 0.61-0.98]), mental health problem (HR = 0.62 [95% CI = 0.47-0.81]), substance use disorder (HR = 0.59 [95% CI = 0.47-0.75]), and organic illness (HR = 0.71 [95% CI = 0.55-0.92]). There was a significant interaction between treatment and prior criminal conviction status on rate of hospitalisation for physical injury, suggesting that the effect of treatment on physical injury was significantly greater for clients with a prior criminal conviction., Conclusions: Adolescents who engage in a therapeutic community treatment program may have a long-lasting reduction in the risk of subsequent hospitalisation. This also appears to apply to those with a history of criminal conviction., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: Socioeconomic inequalities in child growth failure (CGF) remain one of the main challenges in Ethiopia. This study examined socioeconomic inequalities in CGF and determinants that contributed to these inequalities in Ethiopia., Methods: The Ethiopia Demographic and Health Surveys 2000 and 2016 data were used in this study. A pooled unweighted sample of the two surveys yielded 21514 mother-child pairs (10873 in 2000 and 10641 in 2016). We assessed socioeconomic inequalities in CGF indicators using the concentration curve and concentration index (CI). We then decomposed the CI to identify percentage contribution of each determinant to inequalities., Results: Socioeconomic inequalities in CGF have increased in Ethiopia between 2000 and 2016. The CI increased from -0.072 and -0.139 for stunting, -0.088 and -0.131 for underweight and -0.015 and -0.050 for wasting between 2000 and 2016, respectively. Factors that mainly contributed to inequalities in stunting included geographical region (49.43%), number of antenatal care visits (31.40%) and child age in months (22.20%) in 2000. While in 2016, inequality in stunting was contributed mainly by wealth quintile (46.16%) and geographical region (-13.70%). The main contributors to inequality in underweight were geographical regions (82.21%) and wealth quintile (27.21%) in 2000, while in 2016, wealth quintile (29.18%), handwashing (18.59%) and access to improved water facilities (-17.55%) were the main contributors. Inequality in wasting was mainly contributed to by maternal body mass index (-66.07%), wealth quintile (-45.68%), geographical region (36.88%) and paternal education (33.55%) in 2000, while in 2016, wealth quintile (52.87%) and urban areas of residence (-17.81%) were the main driving factors., Conclusions: This study identified substantial socioeconomic inequalities in CGF, and factors that relatively contributed to the disparities. A plausible approach to tackling rising disparities may involve developing interventions on the identified predictors and prioritising actions for the most socioeconomically disadvantaged groups., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Young people with problematic alcohol and other drug (AOD) use are often referred to residential treatment. Subsequent mortality rates among this high-risk group is not known. This study estimates mortality rates and determines causes of death amongst young people referred to residential treatment in Sydney, Australia., Design: Retrospective data linkage study. Data of young people (13-18 years) referred to a residential treatment service 2001-2015 (n = 3256) linked with Australian death registration data, and followed up to 16 years (2001-2016)., Methods: Mortality rates (CMRs) and standardised mortality ratios (SMRs, age-, gender-, calendar-year-adjusted) calculated using population mortality rates. Causes of death were analysed using ICD-10 codes for AOD-induced, AOD as contributory and non-AOD related causes., Results: During follow-up of the cohort (28,838 person-years), 63 people died (71.4 % males; 48 % Indigenous; median age at death = 21.9 years; median follow-up = 5.1years), with 76 % dying before aged 25 years. Overall mortality (SMR = 4.91, 95 % CI: 3.8-6.2; CMR = 2.18/1000 person-years, 95 % CI: 1.7-2.8) was significantly higher than age-gender-matched general population, particularly in females (SMR = 9.55; males: SMR = 4.11; RR: 2.3, 95 % CI: 1.3-4.1). SMRs were not significantly different between treatment groups (SMRs>5.5) and non-attend group (SMR = 3.7) (p = 0.359). Two-thirds of deaths involved AOD, with AOD-induced deaths comprising 42 % and AOD as contributory for 22 % deaths. Overdose, mainly opioids (including opiates), suicide, and transport accidents were major causes of deaths., Conclusion: Very high mortality rates, particularly among females, and the high incidence of overdose and suicide emphasise early screening for those at high-risk, targeted and culturally appropriate interventions, and maximised continuing after-care accessible to young people., (Copyright © 2021. Published by Elsevier B.V.)

Introduction: In a majority of low- and middle-income countries (LMICs), levels of child growth failure (CGF) have steadily declined since 2000. However, some countries show a different trend. Despite continued investment from the government of Ethiopia as well as donors, CGF levels are still high in Ethiopia. This study aimed to assess trends in CGF and associated sociodemographic, economic and water, sanitation, and hygiene (WASH) factors from 2000 to 2016 in Ethiopia., Methods: Data were taken from four rounds of the Ethiopia Demographic and Health Survey (EDHS). Children aged between 0 to 59 months were included. CGF indicators were categorised based on height-for-age z-score (HAZ) < -2 Standard deviation (SD), weight-for-age z-score (WAZ) < -2 SD and weight-for-height z-score (WHZ) < -2 SD. CGF trends were estimated for predicted probabilities and odds ratios (ORs) between 2000 and 2016., Results: A total sample size of 31978 for HAZ, 32045 for WAZ and 32246 for WHZ were included in the current study. Stunting decreased from an adjusted odds ratio (AOR) = 0.77 (95% CI: 0.67 to 0.88) in 2005 to an AOR = 0.45 (95% CI: 0.39 to 0.53) in 2016 compared with the year 2000. Compared with data in 2000, underweight decreased from an AOR of 0.70 (95% CI: 0.61 to 0.80) in 2005 to an AOR of 0.43 (95% CI: 0.36 to 0.50) in 2016. Wasting declined from an AOR of 0.91 (95% CI: 0.75 to 1.10) in 2005 to an AOR of 0.76 (95% CI: 0.61 to 0.94) in 2016, compared with data in 2000., Conclusions: Between 2000 to 2016, there was a decline in CGF levels albeit the levels are still relatively high compared with the World Health Organization (WHO) cut-off levels for public health concern. Observed rates of change varied across sociodemographic, economic and WASH factors which suggest that interventions tailored towards addressing the imbalances across those factors are required., Competing Interests: The authors have declared that no competing interests exist.

Sub-Saharan African (SSA) migrants face nutrition and lifestyle changes upon arrival in a host country. The shift in diet and lifestyle reflects post-migration acculturation and could predispose migrants to nutrition- and lifestyle- related chronic diseases. A mixed-methods systematic review of published studies and the grey literature on post-migration nutrition and lifestyle transition among SSA migrants will be undertaken. Studies published in English and conducted from 2000 to 2020 using quantitative and/or qualitative methods will be included. Ten bibliographic databases will be searched: Scopus, Ovid MEDLINE, EMBASE, Global Health, CINAHL, PubMed, ProQuest, PsycINFO, Informit and Web of Science. Data extraction will be informed by the Cochrane PROGRESS-Plus framework and the Joanna Briggs Institute manual. The quality of the included studies will be appraised for risk of bias using validated tools. An integrated approach to quantitative and qualitative data synthesis through data transformation will be undertaken, and a narrative synthesis of the findings will be provided. This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and provides insight into the scope and parameters of the systematic review to be conducted. The aim of the review is to evaluate the association between post-migration nutrition and lifestyle transition and the risk of developing chronic diseases among SSA migrants in Australia. This review will provide insight into possible areas for interventions to improve the health of migrants. Systematic Review Registration: The protocol was registered with the PROSPERO international prospective register of systematic reviews CRD42020206560.

Background: Globally, radon is the leading risk factor for lung cancer in never-smokers (LCINS). In this study, we systematically reviewed and meta-analysed the evidence of the risk of LCINS associated with residential radon exposure., Methods: Medline and Embase databases were searched using predefined inclusion and exclusion criteria to identify relevant studies published from 1 January 1990 to 5 March 2020 focused on never-smokers. We identified four pooled collaborative studies (incorporating data from 24 case-control studies), one case-control study and one cohort study for systematic review. Meta-analysis was performed on the results of the four pooled studies due to different measures of effect and outcome reported in the cohort study and insufficient information reported for the case-control study. In a post hoc analysis, the corresponding risk for ever-smokers was also examined., Results: Risk estimates of lung cancer from residential radon exposure were pooled in the meta-analysis for 2341 never-smoker cases, 8967 never-smoker controls, 9937 ever-smoker cases and 12 463 ever-smoker controls. Adjusted excess relative risks (aERRs) per 100 Bq·m -3 of radon level were 0.15 (95% CI 0.06-0.25) for never-smokers and 0.09 (95% CI 0.03-0.16) for ever-smokers, and the difference between them was statistically insignificant (p=0.32). The aERR per 100 Bq·m -3 was higher for men (0.46; 95% CI 0.15-0.76) than for women (0.09; 95% CI -0.02-0.20) among never-smokers (p=0.027)., Conclusion: This study provided quantified risk estimates for lung cancer from residential radon exposure among both never-smokers and ever-smokers. Among never-smokers in radon-prone areas, men were at higher risk of lung cancer than women., Competing Interests: Conflict of interest: E.S. Cheng has no conflicts of interest to declare. Conflict of interest: S. Egger has nothing to disclose. Conflict of interest: S. Hughes has nothing to disclose. Conflict of interest: M. Weber reports other support from Cancer Australia and Australian Department of Health, outside the submitted work. Conflict of interest: J. Steinberg has nothing to disclose. Conflict of interest: B. Rahman has nothing to disclose. Conflict of interest: H. Worth has nothing to disclose. Conflict of interest: A. Ruano-Ravina has nothing to disclose. Conflict of interest: P. Rawstorne has nothing to disclose. Conflict of interest: X.Q. Yu has nothing to disclose., (Copyright ©ERS 2021.)

Objectives: To examine the representation and framing in Australian print media of methamphetamine and methamphetamine users from 2014 to 2016 when media attention was heightened around the National Ice Taskforce, including the implications of the coverage and framing in limiting public health responses to the problem., Methods: A quantitative media content analysis examined media portrayals of methamphetamine, including crystalline methamphetamine (also referred to by other names including 'crystal' or 'ice'), in 1,364 Australian print media articles published 2014-2016., Results: The largest number of articles about methamphetamine were published in 2015 with a higher proportion of these articles framed as a crisis than in other years. A crisis framing predominated media reporting across all years, with crime and legal consequences a key focus. Users were positioned predominantly as criminals, deviants or addicts., Conclusions: The coverage of methamphetamine in the Australian print media mostly serves to construct methamphetamine use as an urgent social problem, often framed from a legal perspective and associated with violent, dangerous, deviant and aggressive users. Implications for public health: Such reporting and stigmatisation of methamphetamine use can undermine public health policy responses and strategies, including early intervention and treatment and focused efforts directed at those most at risk of harm., (© 2020 The Authors.)

Background: Contracting non-government services to provide alcohol and other drug (AOD) treatment requires the specification of performance measures to ensure accountability for public funds. There is currently no standardised approach by funders to the measurement of performance of AOD treatment in Australia. Funding to non-government organisations (NGOs) is complex, with NGOs managing funding agreements from a range of sources that contain a large number of differing performance measures. This study aimed to assess performance measures used in contracts for NGO AOD treatment providers and how they align with best practice., Methods: Performance measures contained in funding agreements for treatment providers were collected from a diverse sample of both funders (n=8) and treatment providers (n=20) resulting in more than 1,100 measures. The list of measures was synthesized to a finite, non-duplicative list (n=537). Measures were assessed by three raters against 11 criteria (for example, measurable and timely) documented as best practice elements of performance measures (Council of Australian Governments, 2011a). Measures were also coded into different measurement types (such as outcome and process)., Results: None of the 537 unique performance measures used in funding agreements for treatment providers fully met the criteria for best practice in performance measurement. Whilst the literature and government policy is being directed towards outcomes-based funding and reporting, only 7.6% of measures were classified as outcome measures. The majority of measures were classified at output (41.3%) and process (23.6%) measures., Conclusion: Current measures in contracts applied by funders to treatment services do not adhere to best practice. The development and implementation of new performance measures is required to inform AOD policy and accountability of public funds. Further, identifying more robust performance measures has the potential to lead to reduced reporting burden on service providers and better monitoring of service quality and outcomes., Competing Interests: Declarations of Interests None., (Copyright © 2020 Elsevier B.V. All rights reserved.)