IntroductionGovernments are increasingly identifying priority populations on which to focus health policy and to measure health and wellbeing outcomes. Prioritising populations that are considered to be higher risk or to have particular needs that may not be captured within the parameters of health policy developed for the general population, is essential to health equity and efficient resource allocation. However, the criteria that governments use for prioritising populations is often vague or unspecified. To date, people who use drugs are almost never identified as a priority population in health policy, despite poor health and wellbeing outcomes.MethodsWe developed three-pronged criteria-disadvantage, prevalence/accessibility and amenability to change-for prioritising populations in government health policy. We used these criteria to compare people who access alcohol, tobacco and other drug (ATOD) services with populations which are prioritised within the Australian Capital Territory Government's Wellbeing Framework.ResultsUse of the criteria indicates that health policy prioritisation of people who access ATOD services is warranted. People who access ATOD services experienced worse health and wellbeing outcomes across all measures.Discussion and ConclusionsGiven increasingly explicit prioritisation of populations in health policy, there is an opportunity to advance health equity and embed policy efficiency through formal and transparent consideration of which populations to prioritise. Using set criteria for prioritising populations in health policy is possible, and could help identify populations often overlooked for prioritisation, such as people who access ATOD services.

PurposeIntroducing biomedical approaches to the health impacts of climate change can improve medical student engagement with relevant climate-related issues, improve the development of medical schemas, and minimise displacement into crowded medical curricula. This paper aims to systematically review the medical education curricula related to climate change, with a particular focus on systems-based biomechanisms for the health impacts of climate change. We do this to provide a clear agenda for further development of learning outcomes (LOs) in this area to maximize the clinical applicability of this knowledge.Material and MethodsA systematic review was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Liberati et al. 2009) guidelines for both the published and grey literature. Five databases (PubMed, SCOPUS, ERIC, Open Access Thesis and Dissertation, and Proquest Global Dissertation and Theses) were searched for works published between 2011 and June 2023. Full texts that contained LOs were the main inclusion criteria for the final review. Descriptive and content extraction guided the final narrative synthesis.ResultsAnalysis indicated that biomechanism-related LOs represented about 25% of each published LO set, on average. These outcomes were primarily at the "understand" level of Bloom's taxonomy and were spread across a range of body systems and climate-change aspects. Infectious diseases and extreme heat were strong focuses. Authorship analysis indicated that the majority of these sets of published LOs are from Western contexts and authored by researchers and educators with medical and population health qualifications.ConclusionsBiomechanism-focused teaching about the health impacts of climate change is relatively rare in published curricula. Of the available sets of LOs, the majority are sourced from Western authors and are focused on a fairly circumscribed set of biomedical topics. There is scope to both broaden and deepen curriculum in this area, and we would recommend the field prioritise collaboration with medical educators from the Global South, where the effects of climate change are already the most acutely felt.

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.

N THEIR WORK ON HOW NARRATIVE MAY HELP AUDIENCES THINK DIFFERENTLY ABOUT other species, Wojciech Malecki et al. refer to the ‘narrative turn’ within academia and its proliferation of research that addresses how ‘moral intuitions often yield to narrative persuasion’ (2). In other words, many scholars are currently asking whether narratives can persuade readers to reflect on and perhaps reconsider their own moral beliefs. The research presented in this paper follows a similar trajectory in its discussion of the results and possible implications of a reader response study that investigated how Australian readers respond to works of Australian eco-crime fiction that portray non-humans and global ecological issues such as climate change in a local Australian context. Resonant with ‘narrative persuasion’— the idea amongst social scientists that ‘a narrative is a catalyst for perspective change’ (Hamby et al. 114)— we consider the capacity of such texts to possibly engage readers with the plight of non-humans in Australia under the impacts of climate change. This study employed reader response methodology to determine some of the key themes that Australian readers are drawn to when reading Australian eco-crime fiction, with particular emphasis placed on understanding their responses to representations of the non-human and associated environmental issues in these texts. While this study originally focused on literary as well as genre ecofiction, this paper focuses in a more targeted way on the reader responses to Australian

There is a high prevalence of gambling harms co-occurring with substance use harms. Where harms are co-occurring, they may be experienced as more severe. However, there is little evidence that services are systematically screening for such co-occurring harms in treatment-seeking populations. Furthermore, treatment modalities remain relatively under-developed, with treatment usually addressing only one source of harm. This scoping review looks at the current literature on screening and therapeutic interventions for co-occurring gambling and substance use harms to understand how co-occurring harms may be managed in a treatment setting. It draws together available data on the intersections of substance use harms and gambling related harms, in a treatment context. This research identifies a range of potentially useful validated tools for clinicians in substance use treatment settings to screen for gambling harms. For workers in gambling treatment settings who are seeking validated tools to screen for co-occurring substance use harms, the literature provides less guidance. The validated toolbox of therapeutic interventions for those experiencing co-occurring substance use and gambling harms is relatively sparse. Psychosocial interventions appear to offer the best outcomes on gambling measures for those experiencing co-occurring substance use harms. Further research is needed to establish the benefits of different combinations of treatment and treatment types in achieving reductions across both substance use and gambling harms, when these harms are experienced concurrently.

Abstract Medical professionals need to be equipped with competencies to provide sustainable healthcare and promote planetary health. The aims of this study were to map the presence of planetary health themes in one Australian medical program, develop and pilot a planetary health blended-learning module drawing on constructivism learning theory, and evaluate the effectiveness of the activities. A mixed methods approach was used comprising quantitative mapping of learning outcomes, measurement of pre- and post-intervention planetary health knowledge, and a feedback survey. Mapping revealed little integration of environmental issues across the medical program. Student’s knowledge score increased by 2.37 points on average (95% confidence interval 1.66–3.09) (response rate 46%); 84.2% of respondents rated the activities as excellent/good. Since planetary health education is not currently required in Australian medical curricula, there is still little information for local medical educators on how to develop it, therefore studies such as this can provide some preliminary guidance. Supplemental data for this article is available online at https://doi.org/10.1080/13504622.2021.2025343 .

OBJECTIVES:To describe the numbers of degree completions, variety of available courses and demographics of students who study public health in Australia.METHODS:We utilised national completions data from universities between 2001 and 2018 and analysed data for students who had completed degrees labelled as public health at the bachelor's and master's by coursework level.RESULTS:There have been 21,000 master's by coursework public health graduates since 2001, and 15,770 public health bachelor's degrees. Nearly two-thirds of all students study in a 'broad' degree, such as a Bachelor of Health Science or Master of Public Health. There has been an increase in the proportion of overseas students and a decreasing proportion of Indigenous students over this time.CONCLUSIONS:Given the growth of graduates with public health degrees, there should be an increased focus on relevant job opportunities, as supply may be outpacing demand. Implications for public health: We note three potential issues with public health education and practice in Australia. Firstly, there may be an oversupply of graduates relative to opportunities. Secondly, there may be inconsistencies in the delivery of public health courses. Thirdly, curricula may need to be revised, owing to differences in student composition.

Background: It is not well understood what occupations public health graduates have after graduation, nor is it well known whether their education provides them with the relevant knowledge and skills to feel well matched to their occupations. Furthermore, it is commonly presumed that public health graduates work in government, and investments in education would bolster this workforce. Methods: We aimed to describe the common occupations of Australian public health graduates, describe the heterogeneity of graduate destinations, describe the level of mismatch that graduates report, and compare these results with other fields of study. We used eight years of Australian graduate survey data (2008–2015) from the Graduate Destinations Survey, examining outcomes data from 8900 public health graduates from four levels of education. We compared occupation and industry heterogeneity, and level of occupational mismatch between public health graduates, and graduates from other fields of education. Results: Public health graduates report having a broad set of occupations in a broad set of industries after graduation, and this breadth is dissimilar to most health degrees. Furthermore, public health graduates tend to have average or lower-than-average rates of mismatch. Conclusions: Despite going into a broad set of occupations and industries, graduates from public health tend to report being well prepared given their education. Given that both occupation and industry outcomes are heterogeneous for graduates, an investment in public health education does not guarantee an increase in the governmental public health workforce.

COVID-19 has altered public health higher education and its impact on pedagogy will be felt long into the future. In response to social distancing measures, teaching academics implemented a number of changes to curricula. It is important to better understand and begin to evaluate these changes, as well as set a course for future changes to public health curricula both during and after the pandemic to best enable transformative learning. Teaching academics have an understanding of academic hierarchies and student perceptions and are well placed to provide insights into current and future changes to pedagogy in response to the pandemic. A survey was developed to examine changes that academics had made to their teaching in response to COVID-19. Responses were received from 63 public health teaching academics from five universities in Australia, the United States, and Canada. Public health teaching academics rapidly implemented a number of changes to their teaching, including alterations that enabled online teaching. The great majority of changes to teaching were related to tools or techniques, such as synchronous tutorials delivered in a video meeting room. There remains further work for the public health pedagogy community in reevaluating teaching aims and teaching philosophies in light of the COVID-19 pandemic. This could include examination of the weighting of different topics, including communicable diseases, in curricula. A series of questions to assist academics reformulating their curricula is provided. Public health teaching evolved rapidly to meet the challenges of COVID-19; however, ongoing adaptation is necessary to further enhance pedagogy.

Aim: To explore the health workforce responses to COVID-19. Design: Analysis of job advertisements. Methods: We collected advertisements for healthcare jobs which were caused by and in response to COVID-19 between 4 March-17 April 2020 for the United States, Canada, United Kingdom, Australia and New Zealand. We collected information on the date of the advertisement, position advertised and location. We categorized job positions into three categories: frontline, coordination and decision support. Results: We found 952 job advertisements, 72% of which were from the United States. There was a lag period between reported COVID-19-confirmed cases and job advertisements by several weeks. Nurses were the most advertised position in every country. Frontline workers were substantially more demanded than coordination or decision-support roles. Job advertisements are a novel data source which leverages a readily available information about how workforces respond to a pandemic. The initial phases of the response emphasise the importance of frontline workers, especially nurses.

Public health officials communicate the relevant risks of bushfire smoke exposure and associated health protection measures to affected populations. Increasing global bushfire incidence in the context of climate change motivated this scoping review. English-language publications related to adverse health outcomes following bushfire smoke exposure and publications relating to communication during natural disasters were included. Bushfire smoke events potentially increase healthcare contact, especially presentations triggered by respiratory illness. At-risk populations include those with underlying cardiorespiratory disease, elderly, paediatric, pregnant persons, and First Nations people. We found that social media, television, and radio are among the most common information sources utilised in bushfire smoke events. Message style, content, and method of delivery can directly influence message uptake and behaviour modification. Age, rurality, and geographical location influence information source preferences. Culturally and linguistically diverse groups and those with hearing, vision, and mobility-related disabilities may benefit from targeted health recommendations. This review emphasises the health effects of bushfire smoke exposure and related communication recommendations during and after bushfire smoke events. Additional investigation may further clarify the health effects of bushfire smoke exposure and efficacy of related health messaging, particularly in at-risk populations. Quantitative comparison of communication methods may yield more specific recommendations for future bushfire smoke events.

Background: The future health workforce needs to be equipped with the knowledge, skills, and motivation to deliver sustainable healthcare and promote planetary health. The aim of this study was to design, implement and evaluate a new suite of planetary health learning activities piloted by medical students for a range of medical professionals. Methods: The study consisted of three components: curriculum mapping, development of learning activities and evaluation. Curriculum mapping involved searching program learning outcomes using relevant search terms. Two learning activities were co-developed with medical students comprising of an e-learning component and an inquiry-based small group workshop presented to 99 2nd year students. Evaluation consisted of pre- and post-learning knowledge quizzes and a student feedback survey. Results: A total of 30 learning outcomes were identified with the majority located in the first two years of the four-year program. The overall evaluation response rate was 49.5%, and 19% completed the feedback survey. The mean pre- and post-lesson scores, respectively, were 7.09 (SD=1.84) and 9.53 (SD=1.69) out of a possible score of 12, increasing by 2.37 points on average (95% confidence interval [CI] 1.66-3.09). Overall, the new activities were rated as excellent/good by 84.2% of respondents. The e-learning module rated more highly as a meaningful learning experience than the workshop (89% v. 63.2%). The most common criticism was the length of time it took to complete the e-learning. Conclusion: Students already had a good understanding of planetary health facts and the e-learning lesson served to confirm, review and update their knowledge. Students embraced the opportunity to engage in interactive learning through the problem-solving group work activity. There is very little vertical alignment of environmental and climate issues across all four years of the medical program in our institution and a variety of learning approaches should be considered when revising the curriculum.