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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]

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]

Background: Doctors, particularly general practitioners, play a significant role in assisting patients to create advance care plans. When medically indicated, these documents are important tools to promote congruence between end-of-life care and patient's personal preferences. Despite this, little is known regarding the availability of these documents in hospitals. The aim of this study was to identify the proportion of people who died in hospital without an advance care plan and how many of these had advance care planning (ACP) documents in their general practice records. Methods: A retrospective cohort study was conducted of patient hospital records with manual linkage to general practice records. The large regional hospital in Victoria, Australia has a catchment population in excess of 300,000 people. The study sample was patients aged 75 years and over who died in the hospital between 1 January 2016 and 31 December 2017. The hospital records of these patients were examined to identify those which did not have a system alert for ACP documents on the file. Alerted ACP documents were limited to those legislated in the state of Victoria: advance care plan, Enduring Power of Attorney (Medical Treatment) or Enduring Power of Guardianship. Where no ACP document system alert was found in the hospital record, the patient's nominated general practice was consented to participate and the corresponding general practice record was examined. Data were analysed using descriptive statistics. Results: Of the 406 patients who died in hospital, 76.1% (309) did not have a system alert for any ACP document. Of the 309 hospital records without a system alert, 144 (46.7%) corresponding general practice records were examined. Of these, 14.6% included at least one ACP document, including four advance care plans, that were not available in hospital. Conclusions: Unless ACP documents are consistently communicated from general practice, patient's preferences may be unknown during end-of-life care. It is important that both doctors and patients are supported to use connected electronic health records to ensure that documents are readily available to healthcare staff when they are required. [ABSTRACT FROM AUTHOR]

Organisational health literacy (OHL) is a relatively new concept and its role in improving population health outcomes is gaining recognition. There are several terms being used in relation to OHL but there is no consensus about the definition of OHL nor agreement on a single approach to its application within health services. This contested space continues to create discussion and debate between health literacy researchers worldwide. Increasingly, health service accreditation standards are moving towards including OHL and so services need to clearly define their roles and responsibilities in this area. Inherent in this is the need to develop and validate quantifiable measures of OHL change. This is not to say it needs a 'one-size-fits-all' approach but rather that terminology needs to be fit for purpose. This paper reviews the literature on OHL, describing and contrasting OHL terminology to assist practitioners seeking OHL information and health services clarifying their roles and responsibilities in this area. [ABSTRACT FROM AUTHOR]

Objective Access to primary healthcare (PHC) services is key to improving health outcomes in rural areas. Unfortunately, little is known about which aspect of access is most important. The objective of this study was to determine the relative importance of different dimensions of access in the decisions of rural Australians to utilise PHC provided by general practitioners (GP). Methods Data were collected from residents of five communities located in 'closely' settled and 'sparsely' settled rural regions. A paired-comparison methodology was used to quantify the relative importance of availability, distance, affordability (cost) and acceptability (preference) in relation to respondents' decisions to utilise a GP service for non-emergency care. Results Consumers reported that preference for a GP and GP availability are far more important than distance to and cost of the service when deciding to visit a GP for non-emergency care. Important differences in rankings emerged by geographic context, gender and age. Conclusions Understanding how different dimensions of access influence the utilisation of PHC services is critical in planning the provision of PHC services. This study reports how consumers 'trade-off' the different dimensions of access when accessing GP care in rural Australia. The results show that ensuring 'good' access requires that policymakers and planners should consider other dimensions of access to services besides geography. [ABSTRACT FROM AUTHOR]

This scoping review explores the breadth of literature on domestic violence (DV) screening by nurses, within the well child setting. The review followed the introduction of universal DV screening into the Victorian maternal and child health (MCH) service, in Australia. A scoping review provides a panoramic overview of a chosen topic that may be later used to influence policy and practice. This review explored the literature in the well child area, with a view to identifying further research priorities. The 'Arksey and O'Malley (2005) framework' was used to ensure methodological rigor. There was little relevant research on DV screening in the well child setting. Emergent themes included barriers and enabling factors associated with DV screening and children at risk. From this research we can conclude that further research is required on the appropriateness of DV screening, risk assessment and referral in MCH practice. [ABSTRACT FROM AUTHOR]

The aim was to determine the extent to which parent and adolescent characteristics and patterns of alcohol use influence parents' plans to supply their adolescent aged 14-16 years with full serves of alcohol (i.e. not necessarily initiation) in the next 6 months. A cross-sectional sample of parents from Victoria, Australia, completed an online survey. Parents' plans to supply alcohol in the next 6 months was significantly associated with their reports of supplying alcohol in the previous 3 months (β = 0.51, P < 0.01), perceptions that their adolescent drinks (β = 0.34, P < 0.01), reports of not practising religion (β = 0.13, P < 0.01), and Alcohol Use Disorders Identification Test scores (β = 0.09, P = 0.04). The total variance explained by the model was 57.4% F (9, 242) = 36.2, P < 0.01. Parents' plans to supply their adolescent with alcohol might be a reflection of the normalisation of alcohol use in Australia. There is a need to support Australian parents to review their own alcohol use, clarify their views on alcohol use by their adolescent and confidently restrict their child's access to alcohol, irrespective of their own drinking patterns. [ABSTRACT FROM AUTHOR]