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Background and aims: Up to 95% of pregnant women seeking treatment for alcohol and other drug (AOD) use smoke tobacco. Previous reviews indicate few effective smoking cessation treatments for this group. This updated review aimed to identify and measure the efficacy of smoking cessation interventions trialled among pregnant women in AOD treatment settings who smoke tobacco. Methods: A narrative synthesis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. Studies involving psychological, behavioural or pharmacological interventions used to treat tobacco use, including electronic nicotine delivery systems, for pregnant women of any age, who smoked tobacco and were seeking/receiving treatment, or in post‐treatment recovery for AOD concerns, were reviewed. MEDLINE, PsycINFO, CINAHL, EMBASE and ProQuest databases, grey literature and reference lists were searched, and field experts were contacted for unpublished study data. The Effective Public Health Practice Project tool assessed study quality. The review was pre‐registered with PROSPERO no. CRD42018108777. Results: Seven interventions (two randomised controlled trials, two single‐arm pilot studies, two program evaluations and one causal comparative study) treating 875 women were identified. All were United States (US)‐based and targeted women with drug dependence, but not alcohol dependence. Three interventions used contingency management, five provided behavioural counselling, and one offered nicotine replacement therapy. All reported reductions in cigarette consumption; one contingency management‐based study demonstrated higher abstinence rates compared with controls at treatment‐end that were not maintained at follow‐up. Four of six studies were rated as methodologically weak and one unpublished study was not rated. Conclusions: Conclusions about the efficacy of smoking interventions for pregnant women with alcohol and other drug concerns who also smoke tobacco are hindered by the paucity of available data and poor methodological quality of included studies. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about the experiences of continuing care workers (CCW) in the implementation of continuing care programs. The current study sought to understand CCWs and supervisor perceptions of the successes and challenges of implementing a telephone‐based continuing care intervention following residential alcohol and other drug treatment services. It also aimed to provide recommendations for treatment providers wishing to integrate continuing care into their treatment model, including the resources, training and supervision needs of CCWs. Methods: The participants were eight CCWs and two independent supervisors who completed semi‐structured interviews. Interview coding and analysis was guided by Iterative Categorisation procedures and an implementation framework. The Consolidated Framework for Implementation Research was used. Results: Telephone delivery was advantageous, but even more enhanced, when there was a face‐to‐face session first to build rapport. Other key successes included CCWs who were confident and competent, as well as a match between the organisation's values and the philosophy of the continuing care program. Key challenges faced by CCWs related to a perceived lack of support from managers, difficulties accessing quiet office spaces and participant disengagement. Discussion and Conclusions: Interviews revealed several factors that may influence successful delivery of continuing care as part of alcohol and other drug treatment. These included features of the intervention (e.g. telephone delivery, evidence‐based content), characteristics of the individual CCWs (e.g. flexibility in delivery of the intervention while maintaining fidelity), organisational culture (e.g. alignment of organisational values with continuing care) and resources (e.g. office space, flexible work schedules). [ABSTRACT FROM AUTHOR]

To synthesise research describing the long-term unmet needs of carers who are providing care to a stroke survivor at home who is at least 3 months post-discharge. A systematic review with a narrative synthesis of the English-language qualitative and quantitative studies identified from MEDLINE, CINAHL, PsycINFO, EMBASE, AMED, and Scopus was undertaken. Five quantitative studies, seven qualitative studies, and one mixed-method study were included in the review. Five themes of unmet needs were identified from the synthesis: (1) Obtaining adequate information, (2) Taking care of oneself, (3) Service accessibility, (4) Emotional and psychological, and (5) Relationship. Commonly reported needs across the 13 final studies included the need for support from health care and/or service providers, help with self-care, and help with coping and managing emotions. Variables associated with unmet needs included the severity of the stroke that the stroke survivor experienced and the length of hospital stay. Evidence from this review suggests that carers are experiencing a range of long-term unmet needs, particularly in education and training, coping and managing their own emotions, and accessing much-needed services. Recommendations to support carers at home include continuing engagement, assessment, and support from health care providers and services to meet the needs of carers throughout the stroke recovery process. Carers of stroke survivors experience complex long-term unmet needs around managing the recovery process of the stroke survivor when they have been discharged from hospital and returned home. Evidence suggests that continuing engagement and support from health care providers and services may assist carers in meeting their unmet needs. Healthcare professionals should provide help in accessing training and services. Support is required to help carers cope and to manage their emotions. [ABSTRACT FROM AUTHOR]

Introduction and Aims: There has been a rapid increase in smoking crystalline methamphetamine in Australia. We compare the clinical and demographic characteristics of those who smoke versus inject the drug in a cohort of people who use methamphetamine. Design and Methods: Participants (N = 151) were dependent on methamphetamine, aged 18–60 years, enrolled in a pharmacotherapy trial for methamphetamine dependence, and reported either injecting (n = 54) or smoking (n = 97) methamphetamine. Measures included the Timeline Followback, Severity of Dependence Scale, Amphetamine Withdrawal Questionnaire, Craving Experience Questionnaire and the Brief Psychiatric Rating Scale (symptoms of depression, hostility, psychosis and suicidality). Simultaneous regression was used to identify independent demographic correlates of smoking methamphetamine and to compare the clinical characteristics of participants who smoked versus injected. Results: Compared to participants who injected methamphetamine, those who smoked methamphetamine were younger and less likely to be unemployed, have a prison history or live alone. Participants who smoked methamphetamine used methamphetamine on more days in the past 4 weeks than participants who injected methamphetamine (26 vs. 19 days, P = 0.001); they did not differ significantly in their severity of methamphetamine dependence, withdrawal, craving or psychiatric symptoms (P > 0.05). After adjustment for demographic differences, participants who smoked had lower craving [b (SE) = −1.1 (0.5), P = 0.021] and were less likely to report psychotic symptoms [b (SE) = −1.8 (0.7), P = 0.013] or antidepressant use [b (SE) = −1.1 (0.5), P = 0.022]. Discussion and Conclusions: Smoking crystalline methamphetamine is associated with a younger less marginalised demographic profile than injecting methamphetamine, but a similarly severe clinical profile. [ABSTRACT FROM AUTHOR]