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The Upper Hunter Valley is a major coal mining area in New South Wales (NSW), Australia. Due to the ongoing increase in mining activities, PM10 (air-borne particles with an aerodynamic diameter less than 10 micrometres) pollution has become a major air quality concern in local communities. The present study was initiated to quantitatively examine the spatial and temporal variability of PM10 pollution in the region. An earlier paper of this study identified two air quality subregions in the valley. This paper aims to provide a holistic summarisation of the relationships between elevated PM10 pollution in two subregions and the local- and synoptic-scale meteorological conditions for spring and summer, when PM10 pollution is relatively high. A catalogue of twelve synoptic types and a set of six local meteorological patterns were quantitatively derived and linked to each other using the self-organising map (SOM) technique. The complex meteorology–air pollution relationships were visualised and interpreted on the SOM planes for two representative locations. It was found that the influence of local meteorological patterns differed significantly for mean PM10 levels vs. the occurrence of elevated pollution events and between air quality subregions. In contrast, synoptic types showed generally similar relationships with mean vs. elevated PM10 pollution in the valley. Two local meteorological patterns, the hot–dry–northwesterly wind conditions and the hot–dry–calm conditions, were found to be the most PM10 pollution conducive in the valley when combined with a set of synoptic counterparts. These synoptic types are featured with the influence of an eastward migrating continental high-pressure system and westerly troughs, or a ridge extending northwest towards coastal northern NSW or southern Queensland from the Tasman Sea. The method and results can be used in air quality research for other locations of NSW, or similar regions elsewhere. [ABSTRACT FROM AUTHOR]

This paper explores the application of Constructivist Grounded Theory (C-GT) methodology for social work research. First, it argues that C-GT methodology is well aligned with social work as the two value the individual in the context of their environmental influences. Both also prioritise the importance of respecting and valuing the participant or individual, seeing their perspective as unique and significant. Finally, this research methodology's systematic yet flexible guidelines align with social work ethics, which also focus on the importance of professional integrity. The paper then provides an example of a C-GT PhD study in relation to an area of social work practice, that is, stability in statutory kinship care in Queensland, Australia. The paper details the specific recruitment and sampling of participants, data collection and coding analysis examples from the PhD study. The examples evidence the relevance of C-GT methodology and its application for research in the area of social work practice, specifically statutory kinship care. [ABSTRACT FROM AUTHOR]

This article examines the experience and effects of a trauma-responsive program that uses creative methods to address the ongoing psychosocial impacts of transgenerational trauma and youth suicide, which disproportionately affect First Nations people in Australia. Our aim is to understand how the aesthetic (sensory-affective) dimensions of such a program serve to promote experiences of growth after trauma, manifesting in a sense of connection to both self and community. The paper focuses on the second of two immersive, experiential workshops delivered seven months apart in the regional town of Warwick in Queensland, Australia. In the light of self-reports of growth and personal transformation following the initial workshop, the paper examines the key drivers of such growth, focusing in particular on how trauma-related experience is metabolised through cultural containment. It builds on Bion's concept of container/contained, combining analysis of the affordances of immersion. Framed in cultural rather than medical terms, the larger goal of the paper is to establish how cultural programs fill a gap in trauma informed support, facilitating the processing of trauma. [ABSTRACT FROM AUTHOR]

In a recent ambush attack on police in Queensland, Australia, fire was used as a weapon alongside firearms. The application of fire as a weapon can be arranged into several categories referred to as the ABCs. These categories are Ambush, Barricade, Civil Unrest, Complex/Coordinated, and, added for this paper, Bushfire. A range of violent actors can employ fire as a weapon, not limited to terrorists, criminals, and those suffering mental health crises. While the risks associated with its use have been published in a previous Salus Journal article, this insight will explore Fire as a Weapon attacks that have occurred in Australia to highlight the broad range of applications this attack method has and the need for an integrated approach by emergency services, especially police and fire rescue services. Fire as a weapon creates a challenging and dangerous situation for first responders by further complicating scenes likely to already have injured victims and armed threats present. This paper illustrates that these events have occurred in Australia and continue to do so, reinforcing a need for discussions on how best to combat them within a multi-agency setting. Further awareness, doctrine, and training should be provided to prepare our first responders for these events to improve their safety and the service and safety they provide to the community. [ABSTRACT FROM AUTHOR]

Aim: To describe the development of social function in children with cerebral palsy (CP) classified in all levels of the Communication Function Classification System (CFCS). Method: This prospective, longitudinal population‐based cohort study recruited children with CP born in Queensland, Australia. Social functioning was measured using the Pediatric Evaluation of Disability Inventory (PEDI) social function domain at 2 years, 2 years 6 months, 3 years, 4 years, and 5 years, and the PEDI Computer Adaptive Test (PEDI‐CAT) social/cognitive domain at 8 to 12 years. Results: Seventy‐four children provided 356 observations. PEDI‐CAT social/cognitive scaled scores at 8 to 12 years were (mean [SD] n) CFCS level I, 68.6 (2.7) 45; CFCS level II, 64.0 (3.4) 10; CFCS level III, 63.5 (3.7) 4; CFCS level IV, 56.8 (5.0) 9; CFCS level V, 47.2 (5.8) 6. Scores within expected range for age (not less than 2 SD below mean) at 8 to 12 years were achieved by 35 (78%) children in CFCS level I and four (14%) in CFCS levels II to V. Forty‐nine per cent of children scored at least two standard deviations below the population mean on a proxy measure of fluid intelligence. Intellectual impairment was associated with lower PEDI‐CAT social/cognitive scaled scores in univariable analysis (β = −8.3, 95% confidence interval − 10.91 to −5.63; p < 0.001) but had a smaller effect when modelled together with CFCS. Interpretation: Social function attained by 8 to 12 years of age was strongly related to level of communication function (CFCS). The small number of children classified in CFCS levels II to V necessitates caution when viewing these individual CFCS level trajectories. What this paper adds: There is a strong relation between social functioning and Communication Function Classification System (CFCS) levels.At 8 to 12 years, 35 out of 45 children in CFCS level I met social functioning age expectations.Twenty‐five out of 29 in CFCS levels II to V had social functioning below that expected for age.CFCS and age were more strongly associated with development of social functioning than Gross Motor Function Classification System or Manual Ability Classification System and age. What this paper adds: There is a strong relation between social functioning and Communication Function Classification System (CFCS) levels.At 8 to 12 years, 35 out of 45 children in CFCS level I met social functioning age expectations.Twenty‐five out of 29 in CFCS levels II to V had social functioning below that expected for age.CFCS and age were more strongly associated with development of social functioning than Gross Motor Function Classification System or Manual Ability Classification System and age. This original article is commented on by Eslinger on pages 596–597 of this issue. [ABSTRACT FROM AUTHOR]

Background: High-intensity interval training (HIIT) interventions are becoming more common in schools. However, limited input has been sought from end-users, which can help design interventions that are more engaging and context appropriate, therefore increasing their potential for successful implementation. One method of engaging end-users is co-design, which involves an active collaboration to design solutions to pre-specified problems. This paper aimed to: (1) describe the methodology and results of the co-design process in Making a HIIT to develop HIIT workouts for a school-based intervention; and (2) evaluate the feasibility and impact of co-designing HIIT workouts with students and teachers within the health and physical education (HPE) curriculum. Methods: The development of the HIIT workouts occurred during obligatory HPE lessons with year seven and eight students. The co-design process included: (1) identifying barriers and facilitators to exercise to create evaluation criteria for creating the HIIT workouts; (2) exploring HIIT; (3) defining HIIT parameters (intensity and interval length); (4) creating HIIT workouts using the parameters and evaluation criteria; (5) trialling and modifying the HIIT workouts based on class feedback and intensity data. To evaluate the feasibility and impact of the co-design process, a thematic analysis was completed using teacher interviews, student discussions, and student surveys. Results: Five classes comprised of 121 students (12–14 years; 49% female) and five teachers were involved in the co-design process across three schools in Queensland, Australia. A total of 33 HIIT workouts were created aimed at satisfying the HIIT parameters and variations of the following evaluation criteria: (1) fun; (2) social; (3) achievable skill level; (4) feeling accomplished; and (5) beneficial for health. From the thematic analysis, three themes (acceptability; implementation; integration) and 12 codes contributed to the overarching understanding of the feasibility of the lessons within the curriculum and a further three themes (perceived changes to lessons; educative outcomes; personal and social capabilities) and three codes contributed towards understanding their impact. Conclusion: Overall, co-designing HIIT workouts was feasible within the HPE curriculum and may have contributed to positive educative outcomes. Using this methodology could improve the implementation of HIIT interventions within HPE while supporting educative benefits. [ABSTRACT FROM AUTHOR]

The frequency and severity of extremes, including extreme precipitation events, extreme evapotranspiration and extreme water storage deficit events, are changing. Thus, the necessity for developing a framework that estimates non-stationary conditions is urgent. The aim of this paper is to develop a framework using the geeSEBAL platform, Generalised Extreme Value (GEV) models and spatiotemporal analysis techniques that incorporate the physical system in terms of cause and effect. Firstly, the geeSEBAL platform has enabled the estimation of actual evapotranspiration (ETa) with an unprecedented level of spatial-temporal resolution. Following this, the Non-stationary Extreme Value Analysis (NEVA) approach employs the Bayesian method using a Differential Evolution Markov Chain technique to calculate the frequency and magnitude of extreme values across the parameter space. Station and global climate datasets have been used to analyse the spatial and temporal variation of rainfall, reference evapotranspiration (ETo), ETa and water storage (WS) variables in the Lockyer Valley located in Southeast Queensland (SEQ), Australia. Frequency analysis of rainfall, ETa, and water storage deficit for 14 stations were performed using a GEV distribution under stationary and non-stationary assumptions. Comparing the ETa, ETo and ERA5 rainfall with station data showed reasonable agreement as follows: Pearson correlation of 0.59–0.75 for ETa, RMSE of 45.23–58.56 mm for ETa, Pearson correlation of 0.96–0.97 for ETo, RMSE of 73.13–87.73 mm for ETo and Pearson correlation of 0.87–0.92 for rainfall and RMSE of 37.53–57.10 mm for rainfall. The lower and upper uncertainty bounds between stationary and non-stationary conditions for rainfall station data of Gatton varied from 550.98 mm (stationary) to 624.97 mm (non-stationary), and for ERA5 rainfall datasets, 441.30 mm (stationary) to 450.77 mm (non-stationary). The results demonstrate that global climate datasets underestimate the difference between stationary and non-stationary conditions by 9.47 mm compared to results of 73.99 mm derived from station data. Similarly, the results demonstrate less variation between stationary and non-stationary conditions in water storage, followed by a sharp variation in rainfall and moderate variation in evapotranspiration. The findings of this study indicate that neglecting the non-stationary condition in some hydrometeorological variables can lead to underestimating their amounts. This framework can be applied to any geographical area for estimating extreme conditions, providing valuable insights for infrastructure planning and design, risk assessment and disaster management. [ABSTRACT FROM AUTHOR]

A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues" and "lack of cultural awareness," "not feeling supported by their manager," "not having role models or mentors," and "inflexible human resource policies" predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. [ABSTRACT FROM AUTHOR]

This paper proposes a novel data driven framework for detecting topology transitions in a distribution network. The framework analyzes data from phasor measurement units (PMUs) and relies on the fact that changes in network topology results in changes in the structure and admittance of the network. Using voltage and current phasors recorded by PMUs, the proposed method approximates network parameters using an ensemble-based deep learning model and thus, it does not require any knowledge of network parameters and load models. Using the prediction error of the proposed model, a connectivity matrix which shows the status of switches is constructed. In contrast to other methods, this proposed framework does not require a library of voltage and current transients associated with possible network transitions. It can also detect simultaneous switching actions and is robust to noise and load variations. The model yields a lower error detection rate, and its performance is validated using a modified version of the IEEE 33 bus network and a real feeder located in Queensland, Australia, under full and partial observability conditions. The proposed model has also been compared with another data driven method in terms of inference time and error detection rates. [ABSTRACT FROM AUTHOR]

Charities play an increasingly important role in helping people experiencing poverty. However, institutionalized charity shifts the burden of poverty reduction away from the state and exposes recipients to stress and stigma. In this paper, we examine whether the need for institutionalized charity can be offset through enhanced state support. As in other countries, the Australian government responded to the COVID-19 pandemic by substantially increasing the level of income support to citizens through several temporary payments. We draw on this natural experiment and time-series data from the two largest charity organizations in Queensland, Australia to examine how these payments altered the demand for institutionalized charity. We model these data using difference-in-difference regression models to approximate causal effects. By exploiting the timing and varying amounts of the payments, our analyses yield evidence that more generous income support reduces reliance on charity. Halving the demand for charity requires raising pre-pandemic income-support by AUD$42/day, with supplements of approximately AUD$18/day yielding the greatest return on investment. [ABSTRACT FROM AUTHOR]

Data pre-processing for developing a generalised land use and land cover (LULC) deep learning model using earth observation data is important for the classification of a different date and/or sensor. However, it is unclear how to approach deep learning segmentation problems in earth observation data. In this paper, we trialled different methods of data preparation for Convolutional Neural Network (CNN) training and semantic segmentation of LULC features within aerial photography over the Wet Tropics and Atherton Tablelands, Queensland, Australia. This was conducted by trialling and ranking various training patch selection sampling strategies, patch and batch sizes, data augmentations and scaling and inference strategies. Our results showed: a stratified random sampling approach for producing training patches counteracted class imbalances; a smaller number of larger patches (small batch size) improves model accuracy; data augmentations and scaling are imperative in creating a generalised model able to accurately classify LULC features in imagery from a different date and sensor; and producing the output classification by averaging multiple grids of patches and three rotated versions of each patch produced a more accurate and aesthetic result. Combining the findings from the trials, we fully trained five models on the 2018 training image and applied the model to the 2015 test image. The output LULC classifications achieved an average kappa of 0.84, user accuracy of 0.81, and producer accuracy of 0.87. Future research using CNNs and earth observation data should implement the findings of this project to increase LULC model accuracy and transferability. [ABSTRACT FROM AUTHOR]

Background: This paper examines the exclusion of public health from social license narratives within an increasingly financialised food system, through a case study of foreign ownership in the Australian sugar industry. As finance actors such as asset management firms, pension funds, private equity funds, state owned enterprises and sovereign wealth funds engage in speculative farmland investment, commodity futures trading, and the conversion of farmland into a financial asset, power within agro-industrial food supply chains becomes increasingly concentrated. This has been associated with increased food prices and more processed food, contributing to obesogenic diets, hunger, and poorer health outcomes for many. The potential for negative social and environmental impacts has prompted awareness of the need for financial actors to demonstrate sustainability, responsibility and accountability in their farmland investments. Methods: This paper uses thematic analysis of qualitative interviews and key documents to assess four recent acquisitions of sugarcane land in North Queensland. We consider how companies' efforts to establish or maintain a social license to operate (SLO) intersect with their capital accumulation strategies. Results: Our findings demonstrate that the link between the commodification of 'unhealthy' food inputs (such as sugar) and financialisation remains outside the purview of financiers. Instead, agribusiness firms use narratives centred on biofuels investment and energy/food security to justify their legitimacy in the sugar sector. We organise our findings according to two 'narratives:' constructing trust and credibility through ethical compliance; and, biofuels expansion as a legitimate response to climate change. The concept of social license is much stronger in the second narrative, but health is largely missing. Conclusion: The 'distancing' between responsibility and health outcomes highlights the limits to principles of responsible financial investment, and to the legitimacy of finance to claim an SLO -- the ongoing approval and acceptance by society to conduct its activities. [ABSTRACT FROM AUTHOR]

Background: Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia. Methods: A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12–14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term. Discussion: If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control. Trial registration: The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023). [ABSTRACT FROM AUTHOR]

Objective: Bariatric surgery is an effective treatment for type 2 diabetes and morbid obesity. This paper analyses the clinical and patient-reported outcomes of patients treated through the Bariatric Surgery Initiative, a health system collaboration providing bariatric surgery as a state-wide public service in Queensland, Australia. Research design and methods: A longitudinal prospective cohort study was undertaken. Eligible patients had type 2 diabetes and morbid obesity (BMI ≥ 35 kg/m2). Following referral by specialist outpatient clinics, 212 patients underwent Roux-en-Y gastric bypass or sleeve gastrectomy. Outcomes were tracked for a follow-up of 12-months and included body weight, BMI, HbA1c, comorbidities, health-related quality of life, eating behaviour, and patient satisfaction. Results: Following surgery, patients' average body weight decreased by 23.6%. Average HbA1c improved by 24.4% and 48.8% of patients were able to discontinue diabetes-related treatment. The incidence of hypertension, non-alcoholic steatohepatitis, and renal impairment decreased by 37.1%, 66.4%, and 62.3%, respectively. Patients' emotional eating scores, uncontrolled eating and cognitive restraint improved by 32.5%, 20.7%, and 6.9%, respectively. Quality of life increased by 18.8% and patients' overall satisfaction with the treatment remained above 97.5% throughout the recovery period. Conclusions: This study confirmed previous work demonstrating the efficacy of publicly funded bariatric surgery in treating obesity, type 2 diabetes and related comorbidities, and improving patients' quality of life and eating behaviour. Despite the short follow-up period, the results bode well for future weight maintenance in this cohort. [ABSTRACT FROM AUTHOR]

Recent decades have seen an exponential rise in the application of machine learning in geoscience. Fundamental differences distinguish geoscience data from most other data types. Geoscience datasets are typically multi-dimensional, and contain 1-D (drillholes), 2-D (maps or cross-sections), and 3-D volumetric and point data (models/voxels). Geoscience data quality is a product of its resolution and the precision of the methods used to acquire it. The dimensionality, resolution, and precision of each layer within a geoscience dataset translates to limitations in spatiality, scale and uncertainty of resulting interpretations. Historically, geoscience datasets were overlaid cartographically, to incorporate subjective, experience-driven knowledge, and variances in scale, and resolution. The nuances and limitations that underpin the reliability of automated interpretation are well understood by geoscientists, but are rarely appropriately transferred to data science. However, for true integration of geoscience data, such issues cannot be overlooked without consequence. To apply data analytics to complex geoscience data (e.g., hydrothermal mineral systems) effectively, methodologies must be used that characterise the system quantitatively, using collocated analyses, at a common scale. This paper provides research and exploration insights from an innovative district-wide, scale-integrated, geoscience data project, which analysed 1,590 samples from 23 mineral deposits and prospects across the Cloncurry District, Queensland, Australia. Ten different analytical techniques, including density, magnetic susceptibility, remanent magnetisation, anisotropy of magnetic susceptibility, radiometrics, conductivity, scanning electron microscopy (SEM)-based automated mineralogy, geochemistry, and short-wave infrared (SWIR) hyperspectral data with 561 columns of scale-integrated data (+2151 columns of SWIR). All data were collected on 2 cm x 2.5 cm sample cylinders; a scale at which the confidence in coupling of data from techniques can be high. These data are integrated by design, to eliminate the need to downscale coarser measurements via assumptions, inferences, inversions, and interpolations. This scale-consistent approach is critical to the quantitative characterisation of mineral systems and has numerous applications to mineral exploration, such as linking alteration paragenesis with structural controls and petrophysical zonation. [ABSTRACT FROM AUTHOR]

Background: Hospitalisation rates for older people are increasing, with end-of-life care becoming a more medicalised experience. Innovative approaches are warranted to support early identification of the end-of-life phase, communicate prognosis, provide care consistent with people's preferences, and improve the use of healthcare resources. The Intervention for Appropriate Care and Treatment (InterACT) trial aimed to increase appropriate care and treatment decisions for older people at the end of life, through implementation of a prospective feedback loop. This paper reports on the care review outcomes.Methods: A stepped-wedge randomised controlled trial was conducted in three large acute hospitals in Queensland, Australia between May 2020 and June 2021. The trial identified older people nearing the end of life using two validated tools for detecting deterioration and short-term death. Admitting clinical teams were provided with details of patients identified as at-risk with the goal of increasing awareness that end of life was approaching to facilitate appropriate patient centred care and avoid non-beneficial treatment. We examined the time between when the patient was identified as 'at-risk' and three outcomes: clinician-led care review discussions, review of care directive measures and palliative care referrals. These were considered useful indicators of appropriate care at the end of life.Results: In two hospitals there was a reduction in the review of care directive measures during the intervention compared with usual care at 21 days (reduced probability of - 0.08; 95% CI: - 0.12 to - 0.04 and - 0.14; 95% CI: - 0.21 to - 0.06). In one hospital there was a large reduction in clinician-led care review discussions at 21 days during the intervention (reduced probability of - 0.20; 95% CI: - 0.28 to - 0.13). There was little change in palliative care referrals in any hospital, with average probability differences at 21 days of - 0.01, 0.02 and 0.04.Discussion: The results are disappointing as an intervention designed to improve care of hospitalised older people appeared to have the opposite effect on care review outcomes. The reasons for this may be a combination of the intervention design and health system challenges due to the pandemic that highlight the complexity of providing more appropriate care at the end of life.Trial Registration: Australia New Zealand Clinical Trial Registry, ACTRN12619000675123 (registered 6 May 2019). [ABSTRACT FROM AUTHOR]

Background: Maternity services have limited formalised guidance on planning new services such as midwifery group practice for vulnerable women, for example women with a history of substance abuse (alcohol, tobacco and other drugs), mental health challenges, complex social issues or other vulnerability. Continuity of care through midwifery group practice is mostly restricted to women with low-risk pregnancies and is not universally available to vulnerable women, despite evidence supporting benefits of this model of care for all women. The perception that midwifery group practice for vulnerable women is a high-risk model of care lacking in evidence may have in the past, thwarted implementation planning studies that seek to improve care for these women. We therefore aimed to identify the barriers and enablers that might impact the implementation of a midwifery group practice for vulnerable women.Methods: A qualitative context analysis using the Consolidated Framework for Implementation Research was conducted at a single-site tertiary health facility in Queensland, Australia. An interdisciplinary group of stakeholders from a purposeful sample of 31 people participated in semi-structured interviews. Data were analysed using manual and then Leximancer computer assisted methods. Themes were compared and mapped to the Framework.Results: Themes identified were the woman's experience, midwifery workforce capabilities, identifying "gold standard care", the interdisciplinary team and costs. Potential enablers of implementation included perceptions that the model facilitates a relationship of trust with vulnerable women, that clinical benefit outweighs cost and universal stakeholder acceptance. Potential barriers were: potential isolation of the interdisciplinary team, costs and the potential for vicarious trauma for midwives.Conclusion: There was recognition that the proposed model of care is supported by research and a view that clinical benefits will outweigh costs, however supervision and support is required for midwives to manage and limit vicarious trauma. An interdisciplinary team structure is also an essential component of the service design. Attention to these key themes, barriers and enablers will assist with identification of strategies to aid successful implementation. Australian maternity services can use our results to compare how the perceptions of local stakeholders might be similar or different to the results presented in this paper. [ABSTRACT FROM AUTHOR]

Fibropapillomatosis (FP) is a tumor‐forming disease which affects all species of marine turtle, but predominantly the green turtle (Chelonia mydas). Expression of this disease is thought to be precipitated by poor environmental conditions and often linked to anthropogenically induced environmental changes. Although FP is a globally distributed disease, targeted studies on the spatial distribution of the disease in Australia are limited. Here, we present the first comprehensive report of FP prevalence in Queensland, Australia. A retrospective analysis of 25,645 capture records for 15 sites along the Queensland coast were used to determine FP prevalence and trends in foraging green turtles. Within this data set, 791 turtles (3.1%) with FP tumors were recorded. Our analysis showed that prevalence varies between sites and years, with juvenile turtles being the most frequently affected by the disease. We found that survey method has a significant influence on the apparent FP prevalence detected at each site. That is, surveys which were explicitly FP‐targeted detected higher numbers of individual turtles with FP, and therefore generated higher prevalence rates than comprehensive population surveys. We also report the first attempt at developing water quality indices (WQIs) to compare with FP prevalence data in foraging green turtles. The WQIs were built from metrics published in a range of peer‐reviewed papers, reports, and based on expert opinion. Despite utilizing an extensive data set, a relationship between FP prevalence and WQI rankings at each site could not be quantified. The analysis was confounded by a range of limitations, including data gaps, varying temporal scales and data capture methods in the FP prevalence, and water quality data sets. This study has significant implications for management as it highlights the benefits of designing and collecting centralized data that can be integrated and used across multiple projects or programs. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why. Methods: The study was conducted between 2013 and 2015 in three medical oncology clinics located in public hospitals in Australia: in metropolitan New South Wales, metropolitan Queensland, and in Tasmania. Those patients who provide written informed consent were asked to complete a brief paper and pencil survey in the clinic containing questions on sociodemographic, disease and treatment characteristics. Approximately 1 month later, participants were mailed a second paper and pencil survey which contained questions about whether they had sought a second opinion and their motivation for doing so. Non-responders were followed up by letter at 3 and 6 weeks. Results: Of 823 patients screened for eligibility, 698 eligible patients, 612 provided consent. Of those who consented, 355 completed both the initial survey and the second survey and were included in the analyses. Of the 57 patients who sought a second opinion, the most frequent reasons given for doing so were the need for reassurance (49.1%) and the need to consider the range of treatment options (41.8%). Of the 297 (83.6%) participants who did not seek a second opinion, the main reason was confidence in the first doctor (88.7%). Only 3.1% patients did not know that they could ask for a second opinion. Occasionally the doctor will initiate the referral for a second opinion. Conclusions: Our study suggests that a minority of cancer patients seek a second opinion at some phase during their care. Most did so for reassurance or to ensure that they had covered all of the treatment options and not because of discomfort or distrust of their treating doctor. Few patients reported a lack of awareness of second opinions. This suggests that second opinions form part of a patient-centred approach to information provision about care options. Whether the second opinion improves the quality of care or indeed outcomes has been difficult to demonstrate. [ABSTRACT FROM AUTHOR]

Background Compared to national averages, the Gold Coast, Australia, has a proportionately higher number of children entering their first year of primary school with 'at risk' or 'vulnerable' language skills. This paper investigates the distribution of paediatric speech-language pathology (SLP) services on the Gold Coast, relative to children's language and cognitive skills, and socioeconomic status (SES). Methods SLP service locations were identified through national association data and a manual search and mapped against SES and Australian Early Development Census data, for language and cognitive skills. Results Data for 7595 children was included, with 943 (12.4%) at risk and 780 (12.6%) vulnerable for language and cognitive skills. A total of 75 SLPs were identified (85.3% private, 14.6% public), which is 1 SLP to every 23 children who might have current or impending speech, language and communication needs. Fewer services were available in areas where vulnerable children were located and most were private providers, leading to further potential barriers to service access. Conclusions The number of SLP services located on the Gold Coast is inadequate to meet the needs of children with language and cognitive skill vulnerabilities. Consideration of how services might be distributed is explored and warrants further consideration. [ABSTRACT FROM AUTHOR]

A broad consensus exists that Australian economic activity is too heavily concentrated in capital cities, and regional employment creation should be encouraged. Given the magnitude of international migration to Australia, it is important to determine the impact of migration on regional development by investigating business ownership and job creation by international migrants in regional areas. This paper examines the probability that regional migrant business owners are employers – and thereby employment generators – using a multivariate logit model. We find that migrant business owners with staff are more likely to be male, married and live in regional NSW, metropolitan Victoria and regional and metropolitan Queensland. [ABSTRACT FROM AUTHOR]

Tick paralysis resulting from bites from Ixodes holocyclus and I. cornuatus is one of the leading causes of emergency veterinary admissions for companion animals in Australia, often resulting in death if left untreated. Availability of timely information on periods of increased risk can help modulate behaviors that reduce exposures to ticks and improve awareness of owners for the need of lifesaving preventative ectoparasite treatment. Improved awareness of clinicians and pet owners about temporal changes in tick paralysis risk can be assisted by ecological forecasting frameworks that integrate environmental information into statistical time series models. Using an 11-year time series of tick paralysis cases from veterinary clinics in one of Australia's hotspots for the paralysis tick Ixodes holocyclus, we asked whether an ensemble model could accurately forecast clinical caseloads over near-term horizons. We fit a series of statistical time series (ARIMA, GARCH) and generative models (Prophet, Generalised Additive Model) using environmental variables as predictors, and then combined forecasts into a weighted ensemble to minimise prediction interval error. Our results indicate that variables related to temperature anomalies, levels of vegetation moisture and the Southern Oscillation Index can be useful for predicting tick paralysis admissions. Our model forecasted tick paralysis cases with exceptional accuracy while preserving epidemiological interpretability, outperforming a field-leading benchmark Exponential Smoothing model by reducing both point and prediction interval errors. Using online particle filtering to assimilate new observations and adjust forecast distributions when new data became available, our model adapted to changing temporal conditions and provided further reduced forecast errors. We expect our model pipeline to act as a platform for developing early warning systems that can notify clinicians and pet owners about heightened risks of environmentally driven veterinary conditions. Author summary: Tick-borne illnesses constitute a diverse group of debilitating conditions for pet dogs and cats around the world. In Australia, thousands of domestic dogs are admitted to emergency veterinary clinics due to tick paralysis each year. These admissions are highly seasonal and may be associated with changing environmental conditions, suggesting models that learn from environmental patterns to forecast the oncoming tick season could inform pet owners and clinicians about changing risks. In this paper we use a series of statistical forecasting models to analyse and predict tick paralysis admissions to veterinary clinics in a tick paralysis hotspot in Queensland, Australia. Our approach is novel in that we combine individual models into a superior ensemble that is trained to reduce forecast uncertainty, giving more accurate estimates of what the coming tick season will look like. Our model consistently outperforms a field-leading benchmark while uncovering important patterns about environmental drivers of paralysis tick exposure, including changes to levels of moist vegetation and maximum temperature. We also demonstrate how our model can be used to automatically produce forecasts of tick paralysis admissions as new data become available. This can have important implications for designing improved early warning systems for tick-borne illness. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is one of the leading causes of death in Australia. Longitudinal record linkage studies have the potency to influence clinical decision making to improve cardiac health. This paper describes the baseline characteristics of the Queensland Cardiac Record Linkage Cohort study (QCard). Methods: International Classification of Disease, 10th Revision Australian Modification (ICD-10-AM) diagnosis codes were used to identify CVD and comorbidities. Cost and adverse health outcomes (e.g., comorbidities, hospital-acquired complications) were compared between first-time and recurrent admissions. Descriptive statistics and standard tests were used to analyse the baseline data. Results: There were 132,343 patients with hospitalisations in 2010, of which 47% were recurrent admissions, and 53% were males. There were systematic differences between characteristics of recurrent and first-time hospitalisations. Patients with recurrent episodes were nine years older (70 vs. 61; p < 0.001) and experienced a twice higher risk of multiple comorbidities (3.17 vs. 1.59; p < 0.001). CVD index hospitalisations were concentrated in large metropolitan hospitals. Conclusions: Our study demonstrates that linked administrative health data provide an effective tool to investigate factors determining the progress of heart disease. Our main finding suggests that recurrent admissions were associated with higher hospital costs and a higher risk of having adverse outcomes. [ABSTRACT FROM AUTHOR]

Palaeoclimate data relating to hydroclimate variability over the past millennia have a vital contribution to make to the water sector globally. The water industry faces considerable challenges accessing climate data sets that extend beyond that of historical gauging stations. Without this, variability around the extremes of floods and droughts is unknown and stress-testing infrastructure design and water demands is challenging. User-friendly access to relevant palaeoclimate data is now essential, and importantly, an efficient process to determine which proxies are most relevant to a planning scenario, and geographic area of interest. This paper presents PalaeoWISE (Palaeoclimate Data for Water Industry and Security Planning) a fully integrated, and quality-assured database of proxy data extracted from data repositories and publications collated in Linked Paleo Data (LiPD) format. We demonstrate the application of the database in Queensland, one of Australia's most hydrologically extreme states. The database and resultant hydroclimate correlations provides both the scientific community, and water resource managers, with a valuable resource to better manage for future climate changes. Measurement(s) climate Technology Type(s) digital curation Factor Type(s) proxy type • geographic location • temporal interval • environmental material Sample Characteristic - Environment climate system Sample Characteristic - Location Earth (planet) Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.16607162 [ABSTRACT FROM AUTHOR]

Background: Maternity care is a significant contributor to overall healthcare expenditure, and private care is seen as a mechanism to reduce the cost to public funders. However, public funders may still contribute to part of the cost of private care. The paper aims to quantify (1) the cost to different funders of maternal and early childhood healthcare over the first 1000 days for both women giving birth in private and public hospitals; (2) any variation in cost to different funders by birth type; and (3) the cost of excess caesarean sections in public and private hospitals in Australia. Methods: This study utilised a whole of population linked administrative dataset, and classified costs by the funding source. The mean cost to different funders for private hospital births, and public hospital births in the Australian state, Queensland are presented by time period and by birth type. The World Health Organization's (WHO's) C-model was used to identify the optimal caesarean section rate based upon demographic and clinical factors, and counterfactual analysis was utilised to identify the cost to different funders if caesarean section had been utilised at this rate across Australia. Results: We found that for women who gave birth in a public hospital as a public patient, the mean cost was $22 474. For women who gave birth in a private hospital the mean cost was $24 731, and the largest contributor was private health insurers ($11 550), followed by Medicare ($7261) and individuals ($3312). Private hospital births cost government funders $10 050 on average; whereas public hospital public patient births cost government funders $21 723 on average and public hospital private patient births cost government funders $20 899 on average. If caesarean section deliveries were reduced, public hospital funders could save $974 million and private health insurers could save $216 million. Conclusion: Private hospital births cost government funders less than public hospital births, but government funders still pay for around 40% of the cost of private hospital births. Caesarean sections, which are more frequently performed in private hospitals, are costly to all funders and reducing them could impart significant cost savings to all funders. [ABSTRACT FROM AUTHOR]

Data collection for fresh-water regions of The Ecosystem Health Monitoring Program (EHMP), in southeast Queensland, Australia, involves the sampling of over 130 sites among 19 catchments twice per year and has been ongoing for over ten years. The sampling design was derived following an exhaustive process of indicator and site selection to develop a composite indicator that represented aquatic ecosystem health. After 13 years of implementation, there was an interest in identifying redundancies in sampling to reduce sampling costs without making a substantial impact on the integrity of the program and its capacity to report on ecosystem health. This paper focuses on identifying a subset of sites and times that could be removed from sampling with a minimal impact on the subsequent ecosystem health scores. Herein, Mixed models are employed to assess a variance structure from which optimality criteria are utilized to identify the scheme. Integer programs are then used to ensure specific practical constraints are observed. [ABSTRACT FROM AUTHOR]

The Princess Alexandra Hospital (PAH) Gamma Knife® Centre of Queensland (GKCoQ) began operations in October of 2015 as a sub‐specialty located within a larger radiation oncology service at PAH. It is uniquely positioned as the only Leksell Gamma Knife® (LGK) treatment unit available in the public hospital system in Australia, and the first and only service in Queensland. The GKCoQ treated the 1000th patient on 23 January 2019. LGK is a non‐invasive alternative to neurosurgery which uses radioactive cobalt sources to treat a variety of intracranial conditions ranging from tumours and metastases to functional disorders. It is a platform for stereotactic radiosurgery, a highly precise form of radiotherapy utilising very high doses to the target while maximally sparing surrounding normal brain. LGK enables patient planning and treatment to be done in one day as an outpatient procedure. This paper will outline our LGK service and provide insight into the expanded role that radiation therapists have within the multidisciplinary team required to deliver radiosurgery in a timely manner. The training programme and radiation licensing pathway that have been established for radiation therapists will also be described. [ABSTRACT FROM AUTHOR]

Road crash fatality is a universal problem of the transportation system. A massive death toll caused annually due to road crash incidents, and among them, vulnerable road users (VRU) are endangered with high crash severity. This paper focuses on employing machine learning-based classification approaches for modelling injury severity of vulnerable road users—pedestrian, bicyclist, and motorcyclist. Specifically, this study aims to analyse critical features associated with different VRU groups—for pedestrian, bicyclist, motorcyclist and all VRU groups together. The critical factor of crash severity outcomes for these VRU groups is estimated in identifying the similarities and differences across different important features associated with different VRU groups. The crash data for the study is sourced from the state of Queensland in Australia for the years 2013 through 2019. The supervised machine learning algorithms considered for the empirical analysis includes the K-Nearest Neighbour (KNN), Support Vector Machine (SVM) and Random Forest (RF). In these models, 17 distinct road crash parameters are considered as input features to train models, which originate from road user characteristics, weather and environment, vehicle and driver condition, period, road characteristics and regions, traffic, and speed jurisdiction. These classification models are separately trained and tested for individual and unified VRU to assess crash severity levels. Afterwards, model performances are compared with each other to justify the best classifier where Random Forest classification models for all VRU modes are found to be comparatively robust in test accuracy: (motorcyclist: 72.30%, bicyclist: 64.45%, pedestrian: 67.23%, unified VRU: 68.57%). Based on the Random Forest model, the road crash features are ranked and compared according to their impact on crash severity classification. Furthermore, a model-based partial dependency of each road crash parameters on the severity levels is plotted and compared for each individual and unified VRU. This clarifies the tendency of road crash parameters to vary with different VRU crash severity. Based on the outcome of the comparative analysis, motorcyclists are found to be more likely exposed to higher crash severity, followed by pedestrians and bicyclists. [ABSTRACT FROM AUTHOR]

Background: Law purports to regulate end-of-life care but its role in decision-making by doctors is not clear. This paper, which is part of a three-year study into the role of law in medical practice at the end of life, investigates whether law affects doctors' decision-making. In particular, it considers whether the fact that the law differs across Australia's three largest states - New South Wales (NSW), Victoria and Queensland - leads to doctors making different decisions about withholding and withdrawing life-sustaining treatment from adults who lack capacity. Methods: A cross-sectional postal survey of the seven specialties most likely to be involved in end-of-life care in the acute setting was conducted between 18 July 2012 and 31 January 2013. The sample comprised all medical specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in those three Australian states. The survey measured medical specialists' level of legal compliance, and reasons for their decisions, concerning the withholding or withdrawal of lifesustaining treatment. Multivariable logistic regression was used to examine predictors of legal compliance. Linear regression was used to examine associations between the decision about life-sustaining treatment and the relevance of factors involved in making these decisions, as well as state differences in these associations. Results: Response rate was 32% (867/2702). A majority of respondents in each state said that they would provide treatment in a hypothetical scenario, despite an advance directive refusing it: 72% in NSW and Queensland; 63% in Victoria. After applying differences in state law, 72% of Queensland doctors answered in accordance with local law, compared with 37% in Victoria and 28% in NSW (p < 0.001). Doctors reported broadly the same decision-making approach despite differences in local law. Conclusions: Law appears to play a limited role in medical decision-making at the end of life with doctors prioritising patient-related clinical and ethical considerations. Different legal frameworks in the three states examined did not lead to different decisions about providing treatment. More education is needed about law and its role in this area, particularly where law is inconsistent with traditional practice. [ABSTRACT FROM AUTHOR]

It is evident that developing more accurate forecasting methods is the pillar of building robust multi-energy systems (MES). In this context, long-term forecasting is also indispensable to have a robust expansion planning program for modern power systems. While very short-term and short-term forecasting are usually represented with point estimation, this approach is highly unreliable in medium-term and long-term forecasting due to inherent uncertainty in predictors like weather variables in long terms. Accordingly, long-term forecasting is usually represented by probabilistic forecasting values which are based on probabilistic functions. In this paper, a self-organizing mixture network (SOMN) is developed to estimate the probability density function (PDF) of peak load in long-term horizons considering the most important drivers of seasonal similarity, population, gross domestic product (GDP), and electricity price. The proposed methodology is applied to forecast the PDF of annual and seasonal peak load in Queensland Australia. [ABSTRACT FROM AUTHOR]

In this paper, the influence of organisational factors and the role of individual factors on affective commitment is examined, particularly whether volunteers' motive fulfilment mediates the influence of perceived organisational support on volunteers' affective commitment. A cross-sectional survey was used to collect data from 213 volunteers from five non-profit organisations in Queensland, Australia. Perceived organisational support is found to have a significant relationship with volunteers' affective commitment. Furthermore, motive fulfilment has a significant effect on the impact of perceived organisational support (POS) on the outcome. The results of the study provide new knowledge about the importance of motive fulfilment as a tool for improving volunteers' positive experiences of an organisation and explain how motive fulfilment promotes increased affective commitment [ABSTRACT FROM AUTHOR]

With long colonial histories, Aboriginal and Torres Strait Islander Peoples in Australia experience lower life expectancy and a higher burden of illness. To this day, Indigenous Peoples experience interpersonal, systemic, and institutional racism in the mainstream public health system of Australia, leading to the underuse of mainstream health services and resulting in many Indigenous Australians living in a state of persistent crisis. Extreme and unacceptable levels of institutional racism have been identified in the hospitals and health services of Queensland, Australia, using the Marrie Institutional Racism Matrix (MIRM), an evidence-based assessment tool for identifying, measuring, and monitoring racism in institutional settings. This paper aims to identify ways to address institutional racism against Indigenous Peoples in the health care sector. Specifically, using publicly available documents, a case study analysis of the Institute for Urban Indigenous Health (IUIH), a network of Aboriginal Community Controlled Health Services, is conducted using the MIRM as a guide. The conclusion is that the IUIH actively works to address institutional racism by (a) including Indigenous people in key decision-making processes and structures; (b) undertaking numerous community engagement strategies; (c) building partnerships within and outside the health sector to address the social determinants of health; and (d) working in ways that align with Indigenous ways of being and doing. It is argued that mainstream health services need to be aware of institutional racism and learn from the approaches of Indigenous-led organizations to create institutions that are inclusive of Indigenous members of society. [ABSTRACT FROM AUTHOR]

Summary: Protecting native biodiversity is a difficult prospect in extremely modified landscapes, especially where high‐impact exotic species are widespread. Using new data and a review of the literature, this paper comments on the use of livestock grazing to manage the invasive and highly combustible pasture grass species, Buffel Grass (Cenchrus ciliaris) and thereby help conserve fire‐sensitive Brigalow (Acacia harpophylla) vegetation in reserves in Queensland, Australia. We cite evidence that shows that grazing is a potentially useful management tool in such cases and its use can be compatible with the protection of both fire‐sensitive vegetation and other native plant species within the understorey. However, there are limitations in implementing grazing within conservation reserves including the lack of a clear understanding of the influence of grazing on biodiversity and resource condition. Importantly, we highlight secondary invasion by the exotic grass Indian Couch (Bothriochloa pertusa) as a key emerging threat that may undermine the biodiversity benefits gained by grazing in reserves. Grazing can be a useful tool for conservation management in particular scenarios, but the associated risks demand accompanying monitoring and reporting of positive and negative impacts to ensure the fundamental aim of biodiversity protection is being achieved. [ABSTRACT FROM AUTHOR]

The claims that all coconuts (Coco Nucifera L.) were introduced into Australia by Europeans were researched by studying the journals of the maritime expeditions, the records of the Queensland Acclimatisation Society, historical data and published papers. The 1869 minutes of the Queensland Acclimatisation Society stated that no introduced coconuts were fruiting, and the Queensland Governor stated that there were self-sown coconut palms on the coast. A large spherical niu vai phenotype was introduced from the 1870s to 1900. Field research was conducted in the vicinity of an historical coconut plantation at Wonga Beach. Nuts and palms were examined to understand if all coconuts in that region were descended from the introduced phenotype. Most self-sown coconuts are intermediate types with native Australian origins, not the introduced phenotype. [ABSTRACT FROM AUTHOR]

Introduction: This paper reports on the findings of the Nursing and Midwifery Exchange Program, initiated to promote rural and remote nursing and midwifery, and to facilitate clinical skills development and clinical collaboration between health services in Queensland, Australia. The project was undertaken over an 18-month period in one state of Australia, offering structured, temporary exchange of personnel between metropolitan and rural health services. Background: Globally, there is an increasing awareness of nursing shortages, and with it, the need to ensure that nurses and midwives are prepared for specialist roles and practice. This is particularly important in rural and remote areas, where there are pre-existing barriers to access to services, and difficulties in attracting suitably qualified, permanent staff. Methods: A mixed methods approach to the evaluation was undertaken with two cohorts. One cohort was the nurses and midwives who participated in the exchange (n = 24) and the other cohort were managers of the participating health services (n = 10). The nurses and midwives who participated in the exchange were asked to complete a questionnaire that included questions related to embeddedness and job satisfaction. The managers participated in a Delphi series of interviews. Results: Those who participated in exchange reporting a higher score on the reported degree of understanding of rural client, which was accompanied with a moderate-to-large effect size estimate (d = 0.61). Nurses/midwives in the exchange group reported higher scores on their perceptions of aspects of their home community that would be lost if they had to leave, which was accompanied with a large effect size (d = 0.83). Overall, NMEP was reported by the participants to be a positive way to improve professional development opportunities for nurses and midwives. The findings also show the program supported practical collaboration and raised the profile of nursing and midwifery in rural areas. Conclusion: Exchange programs support clinical and professional development, raising the awareness of different contexts of practice and related skills requirements, and thereby supporting a greater understanding of different nursing roles. In the light of increasingly complex care required by patients with chronic conditions being managed in community-based services, programs such as NMEP provide the opportunity to build collaborative networks between referring and referral centres as well as contribute to the ongoing skills development. [ABSTRACT FROM AUTHOR]

In the absence of quantitative relationships, a cross-gradient function can be used to correlate unknown physical properties in a joint inversion of geophysical data sets. It introduces a structural correlation between properties. A commonly used, inexact approach adds a weighted cross-gradient term as a penalty to the cost function being minimized during inversion. This weighting factor needs to be tuned to balance the regularization and cross-gradient terms. In this paper we propose nonlinear weighting for the cross-gradient function which addresses the very different magnitudes of the cross-gradient and regularization terms. This approach also couples the weighting factors for the regularization and correlation terms reducing the number of tuning parameters. The approach is investigated for a synthetic case. Results are also shown for the 3-D joint inversion of high-resolution magnetic and gravity anomaly data from Southern Queensland in Australia with over 30 million cells. [ABSTRACT FROM AUTHOR]

Background: We investigate factors affecting Australian general practitioners' decisions to adopt novel oral anticoagulants (NOACs) for the prevention of stroke/systemic embolism among patients with atrial fibrillation. Australia has a national homogeneous review and coverage system, which enables us to distinguish physician level factors while maintaining system level factors and patient coverage information constant.Methods: We conduct a cohort analyses by using longitudinal physician survey data from the Medicine in Australia: Balancing Employment and Life panel survey of Australian physicians (MABEL). MABEL data contain rich physician-level information such as age, gender, education, risk preferences, personality, physicians' communications with other medical professionals, and other practice characteristics. Importantly, the survey data were linked, with physician's consent, to actual utilization data from the Australian Pharmaceutical Benefits Scheme and the Medicare Benefits Schedule between January 1, 2012 and December 31, 2015. We measure speed (days until first time prescribing) of adopting NOACs. We estimate a Cox proportional hazard model to estimate factors affecting the adoption speed.Results: Several factors predict earlier adoption of NOACs: being male, more likely to take clinical risk, higher prescribing volume, being a principal or partner in the practice instead of an employee, spending less time in a typical consultation, and practicing in more affluent areas or areas with a higher proportion of older patients. GPs in Queensland are more likely to adopt NOACs and more likely to be extensive early adopters compared to other GPs. Other characteristics including physician personality, family circumstances, their involvement with public hospitals and teaching activities, and the distance between physician practice location to other clinics in the area are not statistically associated with earlier adoption.Conclusions: Our paper is one of the first to study the relationship between GPs' risk preferences, personality and their decisions to adopt new prescription drugs. Because NOACs are commonly prescribed and considered more cost-effective than their older counterpart, understanding factors affecting physicians' decisions to adopt NOACs has direct policy implications. Our results also highlight that even with universal coverage for prescription drugs, access to new drugs is different among patients, partially because who their doctors are and where they practice. [ABSTRACT FROM AUTHOR]

Work-integrated learning (WIL) for students studying medical laboratory science (MLS) provides hands-on experience that prepares graduates for entry into the pathology workforce. This study explored the student perceptions of studying MLS, before and after WIL placement in a pathology service, and the associated employment opportunities in a pathology laboratory. The WIL pathology technician model enabled students to gain experience across regional and metropolitan locations within the state of Queensland, Australia. With nearly two thirds of graduates employed in the profession and a quarter continuing further education in this field, this program was regarded as a success and helps meet the needs of a growing population with an expectancy of high quality health care. Discussed in this paper is the unique role of the pathology industry working with a regional university to develop successful graduates for a career in pathology, with a focus on the impact of WIL. [ABSTRACT FROM AUTHOR]

Exposure monitoring and health surveillance of coal mine workers has been improved in Australia since coal workers' pneumoconiosis was reidentified in 2015 in Queensland. Regional variations in the prevalence of mine dust lung disease have been observed, prompting a more detailed look into the size, shape, and mineralogical classes of the dust that workers are being exposed to. This study collected respirable samples of ambient air from three operating coal mines in Queensland and New South Wales for characterization analysis using the Mineral Liberation Analyser (MLA), a type of scanning electron microscope (SEM) that uses a combination of the backscattered electron (BSE) image and characteristic X-rays for mineral identification. This research identified 25 different minerals present in the coal samples with varying particle size distributions for the overall samples and the individual mineralogies. While Mine 8 was very consistent in mineralogy with a high carbon content, Mine 6 and 7 were found to differ more significantly by location within the mine. [ABSTRACT FROM AUTHOR]

Introduction: Minor amputation is commonly needed to treat diabetes-related foot disease (DFD). Remoteness of residence is known to limit access to healthcare and has previously been associated with poor outcomes. The primary aim of this study was to examine the associations between ethnicity and remoteness of residency with the risk of major amputation and death following initial treatment of DFD by minor amputation. A secondary aim was to identify risk factors for major amputation and death following minor amputation to treat DFD. Research design and methods: This was a retrospective analysis of data from patients who required a minor amputation to treat DFD between 2000 and 2019 at a regional tertiary hospital in Queensland, Australia. Baseline characteristics were collected together with remoteness of residence and ethnicity. Remoteness was classified according to the 2019 Modified Monash Model (MMM) system. Ethnicity was based on self-identification as an Aboriginal and Torres Strait Islander or non-Indigenous person. The outcomes of major amputation, repeat minor amputation and death were examined using Cox-proportional hazard analyses. Results: A total of 534 participants were included, with 306 (57.3%) residing in metropolitan or regional centres, 228 (42.7%) in rural and remote communities and 144 (27.0%) were Aboriginal or Torres Strait Islander people. During a median (inter quartile range) follow-up of 4.0 (2.1–7.6) years, 103 participants (19.3%) had major amputation, 230 (43.1%) had repeat minor amputation and 250 (46.8%) died. The risks (hazard ratio [95% CI]) of major amputation and death were not significantly higher in participants residing in rural and remote areas (0.97, 0.67–1.47; and 0.98, 0.76–1.26) or in Aboriginal or Torres Strait Islander people (HR 1.44, 95% CI 0.96, 2.16 and HR 0.89, 95% CI 0.67, 1.18). Ischemic heart disease (IHD), peripheral artery disease (PAD), osteomyelitis and foot ulceration (p<0.001 in all instances) were independent risk factors for major amputation. Conclusion: Major amputation and death are common following minor amputation to treat DFD and people with IHD, PAD and osteomyelitis have an increased risk of major amputation. Aboriginal and Torres Strait Islander People and residents of remote areas were not at excess risk of major amputation. [ABSTRACT FROM AUTHOR]

Long-term or residential services are designed to support older people who experience challenges to their physical and mental health. These services play an important role in the health and well-being of older adults who are more susceptible to problems such as malnutrition. Estimates of the significance of malnutrition require up-to-date prevalence data to inform government strategies and regulation, but these data are not currently available in Australia. The aim of this study was to collect malnutrition prevalence data on a large sample of people living in residential aged care facilities in Australia. A secondary aim was to examine the relationship between malnutrition and anthropometry (body mass index (BMI) and weight loss). This prevalence study utilised baseline data collected as part of a longitudinal study of malnutrition in 10 Residential Aged Care facilities across three states in Australia (New South Wales, South Australia, and Queensland). The malnutrition status of eligible residents was assessed by dietitians and trained student dietitians using the Subjective Global Assessment (SGA) with residents categorised into SGA-A = well nourished, SGA-B = mildly/moderately malnourished, and SGA-C = severely malnourished. Other data were extracted from the electronic record. Of the 833 listed residents, 711 residents were eligible and had sufficient data to be included in the analysis. Residents were predominantly female (63%) with a mean (SD) age of 84 (8.36) years and a mean (SD) BMI of 26.74 (6.59) kg/m2. A total of 40% of residents were categorised as malnourished with 34% (n = 241) categorised as SGA-B, and 6% (n = 42) SGA-C. Compared to the SGA, BMI and weight loss categorisation of malnutrition demonstrated low sensitivity and high specificity. These findings provide recent, valid data on malnutrition prevalence and highlight the limitations of current Australian practices that rely on anthropometric measures that under-detect malnutrition. There is an urgent need to implement a feasible aged care resident screening program to address the highly prevalent condition of malnutrition in Australia. [ABSTRACT FROM AUTHOR]

Background: Organisational health literacy is a promising area of research that enables a focus on how systems and services can be designed in ways that are responsive to populations with varying states and levels of health literacy, knowledge, and practices, including African refugees. The challenge is how organisations and professionals do this in practice, and research in this area is in its early stages. This qualitative study examined barriers to implementing health literacy responsive care practices in primary health care settings in Australia. It also offered suggestions to potentially address the barriers to improving organisational health literacy. Methods: Refugees (n = 19), primary health care professionals (n = 14), and other key stakeholders (n = 19) were recruited through convenience and snowball strategies from three states in Australia: New South Wales, Victoria, and Queensland. All but one participant was interviewed face-to-face via Zoom. Semi-structured interview guides were used to guide the conversations. Transcriptions from audio recordings were analysed using directed content analysis. Results: Thirteen themes were extracted from the data. Themes were organised into the following categories: structural and systemic, organisational context, individual professional level, individual patient level, and socio-community level. Major structural and system-level factors affecting organisational health literacy included rigid systems and structures and limited time. Key organisation-level factors included inflexible organisational processes and policies, institutionalised othering, discrimination and racism, and lack of interpreters. Individual professional factors were poor communication with patients and cultural knowledge gaps. Linguistic issues and service mistrust were key individual patient-level factors. Socio-community factors included limited community engagement. Participants identified potential solutions to help services navigate out of the barriers and improve their response to health literacy. Conclusion: The findings suggest that mainstream services and organisations could improve timely and appropriate health care access and utilisation for refugees through strategies such as designing services and health literacy programs with refugee communities, promoting health literacy champions in the workforce, integrating health literacy and culturally responsive care plans and strategies into organisational priorities. [ABSTRACT FROM AUTHOR]

Introduction: Despite a decline in unintended teenage pregnancy in Australia, rates remain higher amongst justice-involved adolescent girls, who are more likely to be from disadvantaged socio-economic backgrounds, have histories of abuse, substance use and/or mental health issues. Furthermore, exposure to the criminal justice system may alter access to education and employment and opportunities, potentially resulting in distinct risk-factor profiles. We examine factors associated with unintended pregnancy, non-contraceptive use and Long-Acting Reversible Contraception (LARC) in a sample of sexually active, justice-involved adolescent girls from Western Australia and Queensland. Methods: Data from the Mental Health, Sexual Health and Reproductive Health of Young People in Contact with the Criminal Justice System (MeH-JOSH) Study was analysed on 118 sexually active adolescent girls. Participants were aged between 14 and 17 years, purposefully sampled based on justice-system involvement and completed an anonymous telephone survey. We constructed two multivariate models taking reproductive outcomes as the dependent variables. Results: Over one quarter (26%, 30/118) reported a past unintended pregnancy, 54 did not use any contraception at their last sexual encounter, and 17 reported LARC use. Following adjustments in the multivariate analysis, lifetime ecstasy use was associated with both unintended pregnancy (aOR 3.795, p = 0.022) and non-contraception use (aOR 4.562, p = 0.004). A history of physical abuse was also associated with both any contraception (aOR 3.024, p = 0.041) and LARC use (aOR 4.892, p = 0.050). Identifying as Aboriginal & Torres Strait Islander, education/employment status and geographic location appeared to have no association. Conclusion: Our findings suggest that justice-involved adolescent girls have distinct risk factors associated with unplanned pregnancy and contraception use compared to the general population, but more research is required to understand the mechanisms and contexts underlying these risk factors. How exposure to physical violence may encourage contraception and LARC use, in particular, warrants further attention as does the association with ecstasy use. [ABSTRACT FROM AUTHOR]

Coxiella burnetii, the causative agent of Q fever, is a zoonotic bacteria of global public health significance. The organism has a complex, diverse, and relatively poorly understood animal reservoir but there is increasing evidence that macropods play some part in the epidemiology of Q fever in Australia. The aim of this cross-sectional survey was to estimate the animal- and tissue-level prevalence of coxiellosis amongst eastern grey (Macropus giganteus) and red (Osphranter rufus) kangaroos co-grazing with domestic cattle in a Q fever endemic area in Queensland. Serum, faeces and tissue samples from a range of organs were collected from 50 kangaroos. A total of 537 tissue samples were tested by real-time PCR, of which 99 specimens from 42 kangaroos (84% of animals, 95% confidence interval [CI], 71% to 93%) were positive for the C. burnetii IS1111 gene when tested in duplicate. Twenty of these specimens from 16 kangaroos (32%, 95% CI 20% to 47%) were also positive for the com1 or htpAB genes. Serum antibodies were present in 24 (57%, 95% CI 41% to 72%) of the PCR positive animals. There was no statistically significant difference in PCR positivity between organs and no single sample type consistently identified C. burnetii positive kangaroos. The results from this study identify a high apparent prevalence of C. burnetii amongst macropods in the study area, albeit seemingly with an inconsistent distribution within tissues and in relatively small quantities, often verging on the limits of detection. We recommend Q fever surveillance in macropods should involve a combination of serosurveys and molecular testing to increase chances of detection in a population, noting that a range of tissues would likely need to be sampled to confirm the diagnosis in a suspect positive animal. [ABSTRACT FROM AUTHOR]

We assess the impact of three bias correction approaches on present day means and extremes, and climate change signal, for six climate variables (precipitation, minimum and maximum temperature, radiation, vapour pressure and mean sea level pressure) from dynamically downscaled climate simulations over Queensland, Australia. Results show that all bias‐correction methods are effective at removing systematic model biases, however the results are variable and season‐dependent. Importantly, our results are based on fully independent cross‐validation, an advantage over similar studies. Linear scaling preserves the climate change signals for temperature, while quantile mapping and the distribution‐based transfer function modify the climate change signal and patterns of change. The Perkins score for all the values above the 95th percentile and below the 5th percentile was used to evaluate how well the climate model matches the observational data. Bias correction improved Perkins score for extremes for some variables and seasons. We rank the bias‐correction methods based on the Kling–Gupta efficiency (KGE) score calculated during the validation period. We find that linear scaling and empirical quantile mapping are the best approaches for Queensland for mean climatology. On average, bias correction led to an improvement in the KGE score of 23% annually. However, in terms of extreme values, quantile mapping and statistical distribution‐based transfer function approaches perform best, and linear scaling tends to perform worst. Our results show that, except linear scaling, all approaches impact the climate change signal. [ABSTRACT FROM AUTHOR]