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The industry diversity thesis of economic resilience to economic shocks is embedded in community development policy across Australia. The idea being that in the event of an economic shock some industries will prove more recession‐proof than others. The greater the industry diversity, the greater the likelihood of off‐setting industry effects, resulting in greater economic resilience. The COVID‐19 pandemic and the associated restrictions created a unique natural experiment to explore whether the industry diversity thesis holds true under the conditions of a global health pandemic. In this policy paper, we use JobKeeper applications as a proxy for decreased economic resilience. We explore if Australian local government areas (LGAs) with higher industry diversity had less necessity for JobKeeper. We also briefly consider if concentrations of certain industries acted as a better economic buffer to the COVID‐19 economic shock. We observe that as diversity increases, economic resilience strengthens except for Victoria (where the association is inverted). This observation has important implications for current and future policy formation and implementation across all layers of government. [ABSTRACT FROM AUTHOR]

This paper presents a method to analyze and improve the set of equations constituting a rainfall‐runoff model structure based on a combination of a data assimilation algorithm and polynomial updates to the state equations. The method, which we have called "Data Assimilation Informed model Structure Improvement" (DAISI) is generic, modular, and demonstrated with an application to the GR2M model and 201 catchments in South‐East Australia. Our results show that the updated model generated with DAISI generally performed better for all metrics considered included Kling‐Gupta Efficiency, NSE on log transform flow and flow duration curve bias. In addition, the elasticity of modeled runoff to rainfall is higher in the updated model, which suggests that the structural changes could have a significant impact on climate change simulations. Finally, the DAISI diagnostic identified a reduced number of update configurations in the GR2M structure with distinct regional patterns in three sub‐regions of the modeling domain (Western Victoria, central region, and Northern New South Wales). These configurations correspond to specific polynomials of the state variables that could be used to improve equations in a revised model. Several potential improvements of DAISI are proposed including the use of additional observed variables such as actual evapotranspiration to better constrain internal model fluxes. Plain Language Summary: This paper presents a data‐driven method to improve rainfall‐runoff models used to generate future water resources scenario in climate change studies. The method, which we have called "Data Assimilation Informed model Structure Improvement" (DAISI) is generic, modular, and demonstrated with an application to monthly streamflow simulations over a large data set of catchments in South‐East Australia. Our results show that DAISI improves model performance for a wide range of metrics and increases the sensitivity of the model to climate inputs, which is critical in climate change scenarios. Finally, the improvements identified by DAISI take a simple mathematical form with distinct regional patterns in three sub‐regions of the study domain (Western Victoria, central region, and Northern New South Wales). Several improvements of DAISI are discussed including the inclusion of additional observed variables such as evapotranspiration to better constrain model simulations. Key Points: Data Assimilation Informed model Structure Improvement method diagnoses hydrological model structures by combining data assimilation with a polynomial update of state equationsThe method was applied to the GR2M rainfall‐runoff model with significantly improved streamflow simulations in 201 Australian catchmentsThe method identified updates to state equations with marked regional characteristics that could guide future improvement of GR2M [ABSTRACT FROM AUTHOR]

In Disaster Management (DM), reusing knowledge of best practices from past experiences is envisaged as the best approach for dealing with future disasters. But analysing and modelling processes involved in those experiences is a well-known challenge. But the efficient storage of those processes to allow reuse by others in future DM endeavours is even more challenging and less discussed. Without an efficient process in place, DM knowledge reuse becomes even more remote as the effort incurred gets construed as a hindrance to more pressing activities during the execution of disaster activities. Efficiency has to also be pursued without compromising the effectiveness of the knowledge analysis and reuse. It is important to ensure that knowledge remains meaningful and relevant after it is transformed. This paper presents and validates a DM knowledge analysis framework (DMKAF 2.0) that caters for efficient transformation of DM knowledge intended for reuse. The paper demonstrates that undertaking knowledge transformation and storage in the context of its use is crucial in DM for both, effectiveness and efficiency of the transformation process. Design Science Research methodology guides the research undertaken, by informing enhancements and how the framework is evaluated. A real case study of flood DM from the State Emergency Service of Victoria State Australia is successfully used to validate these enhancements. [ABSTRACT FROM AUTHOR]

Indigenous young people around the world suffer poorer mental health outcomes than their non-Indigenous peers. Currently, how culture matters for health, what cultural practices are used in community to support health and well-being, and how culture is passed on in Aboriginal contemporary life in southeast Australia--the region most affected by settler-colonisation--is not well understood. This paper presents findings from yarns with a representative sample of 44 Indigenous participants working in the field of health and well-being that explored how culture interleaves with health and well-being. It uses grounded theory as the overarching methodology with community participation in all aspects of the project. Participants were nominated through snowball sampling and screened by a governing board of Elders. They included men and women of varied ages with half residing in urban areas and half in rural Victoria, Australia. They had declared affiliations to 31 traditional tribal groups. The yarns were held over Zoom videoconferencing between an Indigenous research assistant who was part of the community, and each participant. Each yarn was recorded, transcribed, coded and analysed by a multi-perspectival team. Culture was viewed as central to individual and communal life and passed on through relationships with people and Country itself. Community members used a wide variety of cultural practices to aid and maintain health and wellbeing in profound ways. Myriad extant obstacles to health and well-being were also described, from experiences of disconnection through to barriers for accessing services. These findings have the potential to shape future holistic care and policy. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has demonstrated how a stochastic disruptive event can dramatically alter community soundscapes. Whilst religious bells have symbolism in many worldwide faiths, the sound emanating from church bells can be considered public domain and therefore, is not exclusive to the church. Pandemic-related interruption of these sounds impacts not only the church involved, but both the surrounding soundscape and any members of the community who ascribe value to these sounds. This paper examines the soundscape of Christian churches in the states of New South Wales and Victoria, to give an Australian perspective one year after the declaration of the COVID-19 pandemic in March 2020. It provides an update of the situation in Australia, building on our previous work from August of that year. In doing so, it explores the activity of church tower bell ringing, and how this "non-essential" activity has been affected, both during and subsequent to the heavy community restrictions applied in Australia. The paper also explores what lengths bellringers have undertaken to be permitted to conduct such activities, such as the use of adaptive measures due to "social distancing", and considers what implications this enforced silence has in similar soundscapes elsewhere in the world. [ABSTRACT FROM AUTHOR]

Background: Calls for the adoption of a systems approach to chronic disease prevention date back at least ten years because of the potential to empower communities to identify and address the complex causes of overnutrition, undernutrition and climate change. Australia, like many countries, has high levels of obesity and extreme climate events. The Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND) trial aims to prevent unhealthy weight gain in children in 10 intervention and two pilot communities in north-east Victoria, Australia using community-based participatory approaches informed by systems science. Intervention activities co-designed in 2019 were disrupted by COVID-19 and bushfires. This paper explores the impacts of these 'shocks' on the local prevention workforce to implement actions within communities. Methods: A case study design involving one-hour online focus groups and an on-line survey (November 2021-February 2022). Purposive sampling was used to achieve diverse representation from RESPOND stakeholders including local council, health services, primary care partnerships and department of health. The focus group interview schedule and survey questions were based on Durlak and DuPre's implementation factors. Results: Twenty-nine participants from seven different communities participated in at least one of nine focus groups to discuss the impacts of COVID-19 and bushfires on localised implementation. Twenty-eight participants (97% of focus group sample) also completed the on-line survey. Implementation of RESPOND stalled or stopped in most communities due to bushfires and/or COVID-19. These shocks resulted in organisational priorities changing, loss of momentum for implementation, redeployment of human resources, culminating in fatigue and exhaustion. Participants reported adaptation of RESPOND, but implementation was slowed due to limited resources. Conclusion: Further research is needed to advance risk management strategies and protect resources within health promotion. System shocks such as bushfires and COVID-19 are inevitable, and despite multiple adaptation opportunities, this intervention approach was not 'shock proof'. [ABSTRACT FROM AUTHOR]

This paper proposes a spatiotemporal clustering algorithm and its implementation in the R package spotoroo. This work is motivated by the catastrophic bushfires in Australia throughout the summer of 2019-2020 and made possible by the availability of satellite hotspot data. The algorithm is inspired by two existing spatiotemporal clustering algorithms but makes enhancements to cluster points spatially in conjunction with their movement across consecutive time periods. It also allows for the adjustment of key parameters, if required, for different locations and satellite data sources. Bushfire data from Victoria, Australia, is used to illustrate the algorithm and its use within the package. [ABSTRACT FROM AUTHOR]

Aim: To describe post‐neonatally acquired (PNN) cerebral palsy (CP) in terms of temporal trends in prevalence, clinical and sociodemographic profiles, known causes and associations between causes, and sociodemographic variables. Method: Numerator data, a count of children with PNN‐CP confirmed at 5 years of age (n = 523), was drawn from two Australian state CP registers (birth years 1973–2012). Poisson regression was used to investigate temporal trends in the prevalence of PNN‐CP by 5‐year intervals, calculated per 10 000 live births. Using data from all state and territory Australian CP registers (n = 469), distributions of clinical characteristics, PNN‐CP causes, and sociodemographic factors were tabulated (birth years 1995–2012). χ2 and logistic regression analyses were used to assess associations between sociodemographic profile, Australian reference data, and known causes. Results: A significant temporal decline in PNN‐CP in Victoria (p = 0.047) and Western Australia (p = 0.033) was observed. The most common proximal causes of PNN‐CP were cerebrovascular accidents (34%, n = 158), infection (25%, n = 117), and non‐accidental injuries (12%, n = 58). Children born to teenage mothers, Aboriginal and/or Torres Strait Islander mothers, or children born in remote areas were over‐represented in this cohort compared with reference data (all p ≤ 0.001). Infectious causes were strongly associated with teenage motherhood (odds ratio 3.0 [95% confidence interval 1.1–8.2], p = 0.028) and remote living (odds ratio 4.5 [95% confidence interval 2.0–10.2], p < 0.001). Interpretation: Although prevalence of PNN‐CP has declined, the over‐representation of priority populations, and the relative severity of a condition that is largely preventable, suggest the need for more specific primary preventive measures and support. What this paper adds: Prevalence of post‐neonatally acquired (PNN) cerebral palsy (CP) in Australia significantly declined between 1973 and 2012.Cerebrovascular accidents are the most common proximal cause of PNN‐CP.Children born in remote areas are at greater risk of PNN‐CP. [ABSTRACT FROM AUTHOR]

Wind energy is a rapidly expanding renewable technology with massive global investments; however, operating turbines are associated with bat strikes globally, and evidence suggests that without intervention, wind farm collisions could drive some common species to extinction. One widely regarded method for reducing strike mortality is operational mitigation, or curtailment, where turbine operation is restricted at low wind speeds. Despite an increasing number of studies in the Northern Hemisphere demonstrating curtailment effectiveness, no empirical studies have yet been conducted in Australia. This paper reports the findings of a curtailment study implemented at the Cape Nelson North wind farm in southwest Victoria, Australia. Conservation detection dog teams conducted mortality surveys between January and April in 2018 (before; pre‐curtailment) and 2019 (after; during curtailment). Results were consistent with similar studies in the USA and Europe, as curtailment significantly reduced pooled species mortality by 54%. Bat calls did not decline during the study period, and thus were not an explanation for the reduction in fatalities. This study demonstrates that curtailment is a valid method for reducing bat turbine collision in south‐eastern Australia. Consideration should be given to curtailment as a means to reduce bat turbine impacts in Australia, particularly at sites with known endangered and threatened populations, as we act to reduce anthropogenic climate change and its time‐sensitive negative consequences. [ABSTRACT FROM AUTHOR]

Background: Community engagement or community involvement in Aboriginal health research is a process that involves partnering, collaborating and involving Aboriginal and Torres Strait Islander people or potential research participants to empower them to have a say in how research with Aboriginal communities is conducted. In the context of Aboriginal health, this is particularly important so that researchers can respond to the priorities of the community under study and conduct research in a way that is respectful of Aboriginal cultural values and beliefs. One approach to incorporating the principals of community engagement and to ensure cultural oversight and guidance to projects is to engage a community reference group. The aim of this study was to describe the process of establishing an Aboriginal community reference group and terms of reference. The community reference group was established to guide the research activities of a newly formed research collaboration aiming to to develop osteoarthritis care that meets the needs of Aboriginal and Torres Strait Islander people in Australia. Methods: Adopting a Participatory Action Research approach, this two-phase study was conducted in Victoria, Australia. In phase one, semi-structured research yarns (a cultural form of conversation used as a data gathering tool) were conducted collaboratively by Aboriginal and non-Aboriginal co-investigators to explore Aboriginal health stakeholder perspectives on establishing a community reference group and terms of reference. In phase two, recommendations in phase one were identified to invite members to participate in the community reference group and to ratify the terms of reference through a focus group. Data were analyzed using a framework analysis approach. Results: Thirteen people (eight female, four male) participated in phase one. Participants represented diverse professional backgrounds including physiotherapy, nursing, general practice, health services management, hospital liaison, cultural safety education, health research and the arts. Three themes were identified in phase one; Recruitment and Representation (trust and relationships, in-house call-outs, broad-spectrum expertise and Aboriginal majority); Purpose (community engagement, research steering, knowledge dissemination and advocacy) and; Function and Logistics (frequency and format of meetings, size of group, roles and responsibilities, authority, communication and dissemination). In phase two, six Aboriginal people were invited to become members of the community reference group who recommended changes which were incorporated into the seven domains of the terms of reference. Conclusion: The findings of this study are captured in a 10-step framework which describes practical strategies for establishing a community reference group and terms of reference in Aboriginal health research. Plain English Summary: Community engagement or community involvement in Aboriginal health research is a process that involves partnering with Aboriginal and Torres Strait Islander people or potential research participants to empower them to have a say in how research with Aboriginal communities is carried out. In the context of Aboriginal health, this is particularly important so that researchers can respond to the priorities of the community and conduct research in a way that respectful of Aboriginal cultural values and beliefs. One approach to community engagement in research is to form a community reference group to provide input to the research project. Although using a community reference group is considered to be an effective way to involve community members in research, often there are practical challenges in setting up and sustaining such a group. In this paper, we set out to describe an approach used to set up a community reference group for a new Aboriginal health research project exploring joint pain in Aboriginal and Torres Strait Islander people. This involved interviewing 13 health professionals and researchers (12 who identified as Aboriginal and one who identified as Aboriginal and Torres Strait Islander) about how to best go about setting up a community reference group. We used recommendations from these participants to inform who we approached to be members of the group and how the group would function. In describing the process we used to establish a community reference group, we were able to design a 10-step practical guide which may help other research groups who are looking to conduct new, ethical Aboriginal health research projects. [ABSTRACT FROM AUTHOR]

Background: The RUBY randomised controlled trial was found to be effective in promoting breastfeeding continuation, in the setting of a high income country, through a program of proactive telephone-based peer support in the first 6 months postpartum. This paper explores women's experiences of receiving the peer support intervention in the RUBY trial. Methods: Ten in-depth, face-to-face interviews were conducted between December 2015 and November 2016 in Metropolitan Melbourne, and regional Victoria, Australia. Participants were women who received the peer support intervention in the RUBY trial and were between 11 and 15 months postpartum at the time of interview. Interviews were underpinned by social support theories and were analysed using inductive thematic analysis. Results: A global theme of 'non-judgemental support and guidance' was identified, which included five organising themes. Four of the organising themes centred on the support from the peer, in which women felt the support was a 'positive experience with empathy and understanding', 'non-judgemental', 'practical advice', and a 'social connection that was more than just breastfeeding'. In contrast to the support from peers was the theme 'not all support from family and friends is supportive'. Conclusion: Participants, including those who considered that they had adequate and available family and friend support for breastfeeding, valued and appreciated the non-judgemental, empathetic and understanding support from peers. This support, facilitated by the anonymity of the telephone-based program, allowed open and honest conversations, normalising women's experiences and helping them feel less alone in their challenges with breastfeeding and transition to motherhood. These findings can inform the design, and upscaling, of innovative and sustainable peer support models, ensuring delivery of effective and engaging support with a broad population reach. [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]

Objective: In Australia, the National Disability Strategy provides a framework to guide actions and investment to achieve equity in social inclusion and economic participation for people with disability. We investigated the social outcomes of school leavers with cerebral palsy (CP) in Victoria, Australia and explored the determinants of desirable outcomes. Methods: We used the Victorian CP Register to invite all adults with CP aged 18–25 years (n = 649). On-line and/or paper-based surveys explored participation in education, employment, community activities, living situation, relationships and life satisfaction. Functional and health status data were collected. Social outcomes were summarized descriptively and compared between individuals with CP and non-disabled peers aged 18–25 years from the Household Income and Labor Dynamics in Australia dataset. Within the CP cohort we explored whether physical and mental health and level of functioning were associated with social outcomes. In addition, a descriptive comparison was undertaken between the social outcomes of the current CP cohort with that of a previously reported 2007 cohort. Results: Ninety participants (57% male; mean age 22.4 years (SD: 2.2) in 2020; 61.1% self-reported) provided data for analyses; response rate 16.9%. CP characteristics were similar between respondents and non-respondents. In comparison to similar aged peers, 79.8% had completed secondary school (compared to 83.2%); 32.6% (compared to 75.8%) were in paid work; 87.5% (compared to 48.2%) were living in their parental home; and 3.4% (compared to 31.6%) were married or partnered. Individuals with CP and higher levels of functional capacity and better physical health were more likely to undertake post-secondary education. Higher levels of functional capacity and physical health, as well as lower mental health status were associated with being employed. Conclusions: While foundational education completion rates were similar to non-disabled peers, significant gaps in social outcomes remain, including residence in the parental home and single status. While addressing these issues is challenging, substantial efforts are needed to reduce these disparities—work that needs to be done in collaboration with people with CP and their families. [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]

Simple Summary: Free-roaming cats in urban areas are a source of nuisance complaints. In Australia, legislation relating to requirements that cat owners microchip and contain their cats on their property has been largely ineffective in reducing the number of free-roaming cats, because most are strays with no owner. Cats causing nuisance complaints are typically trapped and impounded, but only 7% of cats entering local government facilities are reclaimed by owners, with the remaining either rehomed or euthanized. Many healthy cats are euthanized, negatively impacting the staff involved. In 2013, the city of Banyule in Victoria funded and implemented a free program for cat sterilization, microchipping, and registration. The program was largely targeted at low-socioeconomic suburbs with the highest cat-related complaints and microtargeted at "hot-spots". Free transport of cats was offered to community members if needed. Stray cats fed by community members enrolled in the program became owned. Over 8 years, 33.0 cats/1000 residents were sterilized in the three target suburbs (average 4.1 cats/1000 per year). Key findings were city-wide decreases in impoundments by 66%, euthanasia by 82%, and cat-related calls by 36% over 8 years, with savings to council of AU $440,660 for an outlay of AU $77,490. In most states of Australia, local governments (councils) are responsible for the enforcement of legislation relating to domestic cats. Traditional methods used for cat management based on trap–adopt or euthanize programs have been ineffective, with cat-related calls and cat impoundments continuing to increase, resulting in many healthy cats being euthanized. This has detrimental effects on the mental health of animal management officers, staff in shelters and council facilities, and cat caregivers. The city of Banyule, Victoria, implemented a free cat sterilization, microchipping, and registration (licensing) program in 2013/14. Initially, it was targeted at three low-socioeconomic suburbs with the highest cat-related calls and intake, and was microtargeted at call locations. An average of 4.1 cats/1000 residents per year were sterilized over eight years. The program included stray cats being fed by caregivers, provided they took ownership. The program was later expanded city-wide. Over eight years, city-wide cat intake decreased by 66%, euthanasia by 82%, and cats reclaimed by owners increased from 6% of intake (2012/13) to 16% (2020/21). Cat-related calls decreased in the target area by 51%, and city-wide by 36%. The council realized cost savings of AU $440,660 associated with reduced costs for cat-related calls to council (AU $137,170) and charges from the contracted welfare agency (AU $303,490), for an outlay of AU $77,490 for sterilization costs. Instead of the traditional management of urban cats, proactive management based on targeted sterilization should be utilized by government and animal welfare agencies in Australia and internationally. These types of programs are effective at reducing cat intake and euthanasia and are cost-effective. [ABSTRACT FROM AUTHOR]

Prior to its introduction in Australia, many people opposed euthanasia—or voluntary assisted dying as it is known—because of its potentially detrimental impact on grief and bereavement outcomes for family members and carers. We examine the novel experiences of grief and bereavement of VAD for family members and carers who were going through, had gone through, or were contemplating VAD, juxtaposing the international literature on grief and bereavement. As such, 42 semistructured interviews with family members and carers were undertaken in the state of Victoria, which was the first jurisdiction to legislate in favour of VAD. Interviews explored many themes around end‐of‐life decision‐making in order to ascertain the ways in which VAD helped or hindered grief and bereavement processes. A thematic analysis of the interview data was undertaken using QSR NVivo software. Four key themes were identified: values and meaning‐making, expression of a continuing bond, anticipatory grief, and the burden of care associated with supporting loved ones going through VAD. These themes were juxtaposed with the key literature on grief and bereavement to demonstrate how VAD presents novel challenges for carers. We argue that while VAD deaths share similar characteristics to other deaths; in some respects, grief and bereavement outcomes for family members and carers are unique. For family members and carers helping a loved one go through VAD, they were able to derive a sense of meaning from fulfilling their wishes and striving for them to have a "good death"; they were able to maintain a bond with them through advocacy of VAD and unique rituals; and they were able to plan and prepare effectively by knowing the exact time of death. Family members and carers also noted that VAD presents some significant challenges for grief and bereavement, especially in terms of the impact of VAD on familial relationships and burdens associated with moral predicaments. Nonetheless, VAD was generally viewed positively by family members and carers, who expressed gratitude for mitigating their loved one's suffering. [ABSTRACT FROM AUTHOR]

Simple Summary: Jumps racing is a form of Thoroughbred horse racing that involves hurdles and steeples and typically longer distances and heavier weights compared with flat racing, which does not incorporate obstacles. The continuation of jumps racing remains contentious due to the higher risk of fatalities, falls and injuries for horses, compared with flat racing. In Australia, jumps racing is carried out only in the state of Victoria after a legislated ban on jumps racing in South Australia in 2022. Jumps races account for only 1.8% of Thoroughbred horse races in Victoria. This study compared the incidence of fatalities, falls and injuries in horses participating in hurdle and steeplechase races with those participating in flat races at the same race meets, for all jumps races in the 2022 and 2023 Thoroughbred horse jumps racing seasons in Victoria, Australia. Overall, horse fatalities, falls and injuries occurred at higher rates in jumps races compared with flat races during the study period. Jumps racing is a form of Thoroughbred horse racing that involves hurdles and steeples and typically longer distances, and heavier weights compared with flat racing, which does not incorporate obstacles. In Australia, jumps racing is carried out only in Victoria, one of eight states and territories. The continuation of jumps racing is contentious due to the higher risk of fatalities, falls and injuries for horses, compared with flat racing. While measures have been introduced by the industry to improve the safety of riders and horses, the rates of fatalities, falls and injuries in horses participating in jumps races have not been collectively reported in Australia since the 2012 to 2014 race seasons. Although information on individual horse fatalities, falls and injuries is published by Racing Victoria in Stewards' Reports, the data are not aggregated, and so cannot readily be used to assess trends or evaluate the efficacy of safety measures introduced by the industry. The aim of this study was to determine the fatality, fall and injury rates for horses participating in hurdle and steeplechase races in Victoria in the 2022 and 2023 Thoroughbred horse jumps racing seasons compared with horses participating in flat races at the same race meets. Data on horse fatalities, falls and injuries were extracted from the published Racing Victoria race results and Stewards' Reports for the jumps races (n = 150) and corresponding flat races (n = 157) held at the 38 jumps race meets in Victoria in 2022 and 2023. Overall, horse fatalities, falls and injuries occurred at higher rates in jumps races compared with flat races during the study period. The rate of horse fatalities in jumps races was 3.3 per 1000 starts, with no fatalities in flat races. The rate of horse falls in hurdle races was 24 per 1000 starts and 41.6 per 1000 starts in steeplechase races, comparable with rates previously reported in the 2012 to 2014 seasons. There were no falls in flat races. Horse injuries occurred at a rate of 68.9 per 1000 starts in jumps races compared with 18.8 per 1000 starts in flat races. In hurdle and steeplechase races, veterinary clearance being required following horse injury was 5.4 times (OR 5.4, 95% CI 2.8–10.2) and 7.2 times (OR 7.2, 95% CI 3.3–15.6) more likely, respectively, compared with flat races. The risk of trauma was 4 times more likely in hurdle and steeplechase races (OR 4.8, 95% CI 1.7–13.3 and OR 4.1, 95% CI 1.2–13.4, respectively) and the risk of lameness was increased by 2.5 times in hurdles (OR 2.5, 95% CI 1.2–5.2) and 5.1 times in steeplechase races (OR 5.1, 95% CI 2.3–11.5), compared with flat races. These findings support concerns about the welfare of horses involved in jumps racing and of the need for further safety measures to reduce these risks. [ABSTRACT FROM AUTHOR]

Introduction: Effective primary healthcare services have been identified by the World Health Organization as the most equitable approach to enhancing universal healthcare. Robust models of mentoring for registered nurses (RNs) transitioning to primary healthcare roles have yet to be described in the Australian context. A robust mentoring model can support RNs to fulfill their potential, bridging the gap between theory and practice. In 2015, the peak body for nurses in primary health care (PHC) began developing a transition to practice program, including embedded mentoring to support newly graduated and more experienced registered and enrolled nurses. This quality improvement study reports the experiences and perspectives of nurses participating as mentors in two separate offerings of the program delivered between 2019 and 2021. Method: A two-phase concurrent mixed methods evaluation utilized data from pre- and post online surveys and post program meetings. Quantitative items underwent descriptive analyses. Thematic analysis of free-text responses and comments was conducted independently by two researchers. Mentors voluntarily provided self-report data and were informed that data is routinely collected to support continuous quality improvement processes for all programs. An Information Sheet informed mentors of data usage, confidentiality, and options to withdraw without penalty from the program at any time. Results: Seventy-nine mentors were recruited to support two groups of nurses (N = 111). Mentor self-rated overall satisfaction with program participation was 86.67% (very or extremely satisfied). Mentors described being "witness to mentee growth," "having facilitated access to learning" and receiving "unexpected benefits" including personal and professional growth and enhanced enthusiasm for their role in PHC. Conclusion: The embedded mentoring reported in this article combined a focus on skills acquisition and professional identity with the provision of a range of resources and support activities. Sustainable mentoring programs will be an important mechanism for supporting the expanding roles required of nurses working in primary health. [ABSTRACT FROM AUTHOR]

Introduction: Voluntary assisted dying (VAD) is increasingly being legalised internationally. In Australia, all six states have now passed such laws, with Victoria being the first in 2019. However, early research in Victoria on the patient experience of seeking VAD shows that finding a connection to the VAD system is challenging. This study analyses the causes of this 'point of access' barrier. Methods: We conducted semi‐structured qualitative interviews with family caregivers and a person seeking VAD, with participants recruited via social media and patient interest groups. Data were thematically analysed. We also undertook documentary analysis (content and thematic) of publicly available reports from the oversight body, the Voluntary Assisted Dying Review Board. Results: We interviewed 32 family caregivers and one patient across 28 interviews and analysed six Board reports. Finding a point of access to the VAD system was reported as challenging in both interviews and reports. Four specific barriers to connecting with the system were identified: (1) not knowing VAD exists as a legal option; (2) not recognising a person is potentially eligible for VAD; (3) not knowing next steps or not being able to achieve them in practice; and (4) challenges with patients being required to raise the topic of VAD because doctors are legally prohibited from doing so. Conclusion: Legal, policy and practice changes are needed to facilitate patients being able to find a connection to the VAD system. The legal prohibition on doctors raising the topic of VAD should be repealed, and doctors and institutions who do not wish to be involved in VAD should be required to connect patients with appropriate contacts within the system. Community awareness initiatives are needed to enhance awareness of VAD, especially given it is relatively new in Victoria. Patient or Public Contribution: Families and a patient were the focus of this research and interviews with them about the experience of seeking VAD were the primary source of data analysed. This article includes their solutions to address the identified point of access barriers. Patient interest groups also supported the recruitment of participants. [ABSTRACT FROM AUTHOR]

The fossil record for Cretaceous birds in Australia has been limited to rare skeletal material, feathers, and two tracks, a paucity shared with other Gondwanan landmasses. Hence the recent discovery of 27 avian footprints and other traces in the Early Cretaceous (Barremian-Aptian, 128–120 Ma) Wonthaggi Formation of Victoria, Australia amends their previous rarity there, while also confirming the earliest known presence of birds in Australia and the rest of Gondwana. The avian identity of these tracks is verified by their tridactyl forms, thin digits relative to track lengths, wide divarication angles, and sharp claws; three tracks also have hallux imprints. Track forms and sizes indicate a variety of birds as tracemakers, with some among the largest reported from the Early Cretaceous. Although continuous trackways are absent, close spacing and similar alignments of tracks on some bedding planes suggest gregariousness. The occurrence of this avian trace-fossil assemblage in circumpolar fluvial-floodplain facies further implies seasonal behavior, with trackmakers likely leaving their traces on floodplain surfaces during post-thaw summers. [ABSTRACT FROM AUTHOR]

Objective: Government policy guidance in Victoria, Australia, encourages schools to provide affordable, healthy foods in canteens. This study analysed the healthiness and price of items available in canteens in Victorian primary schools and associations with school characteristics. Design: Dietitians classified menu items (main, snack and beverage) using the red, amber and green traffic light system defined in the Victorian government's School Canteens and Other School Food Services Policy. This system also included a black category for confectionary and high sugar content soft drinks which should not be supplied. Descriptive statistics and regressions were used to analyse differences in the healthiness and price of main meals, snacks and beverages offered, according to school remoteness, sector (government and Catholic/independent) size, and socio-economic position. Setting: State of Victoria, Australia Participants: A convenience sample of canteen menus drawn from three previous obesity prevention studies in forty-eight primary schools between 2016 and 2019. Results: On average, school canteen menus were 21 % 'green' (most healthy – everyday), 53 % 'amber' (select carefully), 25 % 'red' (occasional) and 2 % 'black' (banned) items, demonstrating low adherence with government guidelines. 'Black' items were more common in schools in regional population centres. 'Red' main meal items were cheaper than 'green'% (mean difference –$0·48 (95 % CI –0·85, –0·10)) and 'amber' –$0·91 (–1·27, –0·57)) main meal items. In about 50 % of schools, the mean price of 'red' main meal, beverages and snack items were cheaper than 'green' items, or no 'green' alternative items were offered. Conclusion: In this sample of Victorian canteen menus, there was no evidence of associations of healthiness and pricing by school characteristics except for regional centres having the highest proportion of 'black' (banned) items compared with all other remoteness categories examined. There was low adherence with state canteen menu guidelines. Many schools offered a high proportion of 'red' food options and 'black' (banned) options, particularly in regional centres. Unhealthier options were cheaper than healthy options. More needs to be done to bring Victorian primary school canteen menus in line with guidelines. [ABSTRACT FROM AUTHOR]

Background: Pregnant women are at an increased risk of hospitalisation, admission to the intensive care unit, mechanical ventilation, and death from SARS-CoV-2 infection. The aim of this study is to determine the predictive factors associated with COVID-19 vaccine uptake during pregnancy over time in a population with a high background uptake of maternal influenza and pertussis vaccination. Methods: This is a population-based, cohort study of all pregnant women who gave birth in Victoria, Australia between 1 July 2021 and 30 June 2022. Data from the Victorian Perinatal Data Collection were analysed using univariable and multivariable logistic regression. Results: This study reports on 77,719 women who gave birth over a 12 month period, of whom 49,281 (63.4%) received a COVID-19 vaccine, 54,887 (70.6%) received an influenza vaccination and 63,594 (81.8%) received a pertussis vaccine by the time of delivery. Pregnant women aged >30 years (aOR 1.31 CI 1.27, 1.36), who had >=8 antenatal visits (aOR 1.08 CI 1.04, 1.12), and those who received influenza vaccine (aOR 1.23 CI 1.19, 1.28) were more likely to have received a COVID-19 vaccine. Those who smoked (aOR 0.7 CI 0.66, 0.74), were First Nations (aOR 0.83 CI 0.74, 0.93) and those who gave birth in public hospitals (aOR 0.65 CI 0.63, 0.68) were less likely to receive COVID-19 vaccine in the first 12 months of the rollout. Conclusion: Maternal age, smoking, parity and Indigenous status were factors associated with delayed and sustained lower coverage, even in a population with background maternal influenza and pertussis coverage of 70.6% and 81.8%, respectively. [ABSTRACT FROM AUTHOR]

Background: World-wide, health service providers are moving towards innovative models of clinical home-based care services as a key strategy to improve equity of access and quality of care. To optimise existing and new clinical home-based care programs, evidence informed approaches are needed that consider the complexity of the health care system across different contexts. Methods: We present a protocol for working with health services and their partners to perform rapid identification, prioritisation, and co-design of content-appropriate strategies to optimise the delivery of healthcare at home for older people in rural and regional areas. The protocol combines Systems Thinking and Implementation Science using a Consensus Mapping and Co-design (CMC) process delivered over five workshops. Discussion: The protocol will be implemented with rural and regional healthcare providers to identify digital and non-digital solutions that have the potential to inform models of service delivery, improve patient experience, and optimise health outcomes. The combination of system and implementation science is a unique approach for optimising healthcare at home for older populations, especially in the rural context where need is high. This is the first protocol to integrate the use of systems and implementation science into one process and articulating these methods will help with replicating this in future practice. Results of the design phase will translate into practice through standard health service planning methods to enhance implementation and sustainability. The delivery of the protocol will include building capacity of health service workers to embed the design, implementation, and evaluation approach into normal practice. This protocol forms part of the DELIVER (Delivering Enhanced heaLthcare at home through optImising Virtual tools for oldEr people in Rural and regional Australia) Project. Funded by Australia's Medical Research Future Fund, DELIVER involves a collaboration with public health services of Western Victoria, Australia. [ABSTRACT FROM AUTHOR]

Background: Residential aged-care facilities in Australia emerged as the high-risk setting the COVID-19 outbreaks due to community transmission. The vulnerable aged-care residents of these facilities suffered due to low hospital transfers and high mortality and morbidity rates. This study aimed to monitor and report the burden of COVID-19 in residential aged-care facilities across Australia and the impact of hospital transfer policies on resident hospitalisation during the first year of the pandemic. Methods: We conducted a retrospective cohort study by collecting data from weekly aged-care outbreak reports published by open sources and official government sources between 1st March and 20th November 2020. A comprehensive line list of outbreaks was created using open-source data. The line list included the name of the facility, location, COVID-19 cases among residents, & staff, resident hospitalisations, mode of transmission, number of resident deaths, and state policies involving resident hospitalisation. We also searched the websites of these facilities to collect data on their COVID-19 policies for the residents, staff, and visitors. Statistical analyses were performed on the data obtained. Results: 126 aged-care COVID-19 outbreaks were identified in Australia during the study period. The incidence rate of COVID-19 infections among aged-care residents in Australia was (1118.5 per 100,000 resident population) which is 10 times higher than the general population (107.6 per 100,000 population). The hospitalisation rate for aged-care residents in Australia was 0.93 per 100,000 population. The hospitalisation rate of aged-care residents in Victoria was 3.14 per 100,000 population despite having the highest COVID-19 cases. Excluding South Australia, all states followed ad-hoc case-by-case hospital transfer policies for aged-care residents. Conclusion: This study documented a higher risk of COVID-19 infection for aged-care residents and workers but found low hospitalisation rates among residents across Australia. The hospitalisation rates in Victoria were higher than the national average but low when considering the COVID-19 infection rates in the state. The hospitalisation rates could have been impacted due to the state hospital transfer policies at that time. Immediate transfer of infected residents to hospitals may improve their survival and reduce the risk of infection to the other residents, as healthcare settings have more advanced infection control measures and are well-equipped with trained staff and resources. [ABSTRACT FROM AUTHOR]

Background: Breast cancer survival in Australia varies according to socio‐economic status (SES) and between rural and urban places of residence. Part of this disparity may be due to differences in prognostic factors at the time of diagnosis. Methods: Women with invasive breast cancer diagnosed from 2008 until 2012 (n = 14,165) were identified from the Victorian Cancer Registry and followed up for 5 years, with death from breast cancer or other causes recorded. A prognostic score, based on stage at diagnosis, cancer grade, whether the cancer was detected via screening, reported comorbidities and age at diagnosis, was constructed for use in a mediation analysis. Results: Five‐year breast cancer mortality for women with breast cancer who were in the lowest quintile of SES (10.3%) was almost double that of those in the highest quintile (5.7%). There was a small survival advantage (1.7% on average, within each socio‐economic quintile) of living in inner‐regional areas compared with major cities. About half of the socio‐economic disparity was mediated by prognostic factors, particularly stage at diagnosis and the presence of comorbidities. The inner‐regional survival advantage was not due to differences in prognostic factors. Conclusions: Part of the socio‐economic disparity in breast cancer survival could be addressed by earlier detection in, and improved general health for, more disadvantaged women. Further research is required to identify additional causes of socio‐economic disparities as well as the observed inner‐regional survival advantage. [ABSTRACT FROM AUTHOR]

The incidence of pyro-cumulonimbus (pyroCb) caused by extreme wildfires has increased markedly in Australia over the last several decades. This increase can be associated with a dangerous escalation of wildfire risk and severe stratospheric pollution events. Atmospheric and fuel conditions are important influences on pyroCb occurrence, but the exact causal relationships are still not well understood. We used the Continuous Haines Index (C-Haines) to represent atmospheric instability and the Fuel Moisture Index (FMI) to represent fuel moisture to provide better insight into the effects of atmospheric and fuel conditions on pyroCb occurrence over southeast Australia. C-Haines and FMI were related to the probability of pyroCb occurrence by employing a logistic regression on data gathered between 1980 and 2020. Emphasis is placed on investigating the independent effects and combined effects of FMI and C-Haines, as well as assessing their potential to predict whether a pyroCb develops over a fire. The main findings of this study are: (1) high C-Haines and low FMI values are representative of favorable conditions for pyroCb occurrence, but C-Haines can offset the effect of FMI—the addition of C-Haines to the logistic model muted the significance of FMI; (2) among the components of C-Haines, air temperature lapse rate (CA) is a better predictor of pyroCb occurrence than the dryness component (CB); (3) there are important regional differences in the effect of C-Haines and FMI on pyroCb occurrence, as they have better predictive potential in New South Wales than in Victoria. [ABSTRACT FROM AUTHOR]

Background: Research suggests that rates of mental illness are similar in rural and urban Australia, although there are significant workforce shortages in rural regions along with higher rates of chronic disease and obesity and lower levels of socioeconomic status. However, there are variations across rural Australia and limited local data on mental health prevalence, risk, service use and protective factors. This study describes the prevalence of self-reported mental health problems of psychological distress and depression, in a rural region in Australia and aims to identify the factors associated with these problems. Methods: The Crossroads II study was a large-scale cross-sectional study undertaken in the Goulburn Valley region of Victoria, Australia in 2016–18. Data were collected from randomly selected households across four rural and regional towns and then screening clinics from individuals from these households. The main outcome measures were self-reported mental health problems of psychological distress assessed by the Kessler 10 and depression assessed by Patient Health Questionnaire-9. Unadjusted odd ratios and 95% confidence intervals of factors associated with the two mental health problems were calculated using simple logistic regression with multiple logistic regression using hierarchical modelling to adjust for the potential confounders. Results: Of the 741 adult participants (55.6% females), 67.4% were aged ≥ 55 years. Based on the questionnaires, 16.2% and 13.6% had threshold-level psychological distress and depression, respectively. Of those with threshold-level K-10 scores, 19.0% and 10.5% had seen a psychologist or a psychiatrist respectively while 24.2% and 9.5% of those experiencing depression had seen a psychologist or a psychiatrist, respectively in the past year. Factors such as being unmarried, current smoker, obesity, were significantly associated with a higher prevalence of mental health problems whereas physical activity, and community participation reduced the risk of mental health problems. Compared to rural towns, the regional town had higher risk of depression which was non-significant after adjusting for community participation and health conditions. Conclusions: The high prevalence of psychological distress and depression in this rural population was consistent with other rural studies. Personal and lifestyle factors were more relevant to mental health problems than degree of rurality in Victoria. Targeted lifestyle interventions could assist in reducing mental illness risk and preventing further distress. [ABSTRACT FROM AUTHOR]

Our recent study compared monitoring data collected using surrogate metrics during 2014–2018 inclusive with baseline data from 2007 to evaluate the trajectory of the population status of the threatened heath skink Liopholis multiscutata in Victoria. The heath skink is a secretive burrowing species that is a habitat specialist and exists in north‐western Victoria as a few small and highly disjunct populations on large dunes in semi‐arid heathland or mallee. We re‐assessed the trajectories of the Victorian populations with additional monitoring data collected in 2021 and found continuing decline across all four Victorian heath skink populations. Urgent management intervention is required to arrest this decline, likely due to predation, reduced availability of habitat and life history and demographic traits that make this species susceptible to decline. [ABSTRACT FROM AUTHOR]

Our transformation of global environments into human-dominated landscapes has important consequences for wildlife. Globally, wildlife is interacting with humans or impacted by human activities, which often results in negative outcomes such as population declines, disruption of social bonds, biodiversity loss, imperilment of threatened species, and harm to individual animals. Human and non-human threats to wildlife can be challenging to quantify and tend to be poorly understood especially over large spatial scales and in urban environments. The extent to which such damage is mitigated by reactive approaches (e.g., wildlife rescue) is also not well understood. We used data from the main state-based Wildlife Emergency Response Services (WERS) in Victoria, Australia to address these issues. The data, which describe tens of thousands of cases of threats to wildlife annually over a ten-year period, allowed a detailed characterisation of the type and extent of threats in the state. We identified the main common and threatened species impacted by various threats and showed that the vast majority of them were anthropogenic (e.g., vehicle collisions, cat attacks, and entanglements). The extent to which different taxonomic groups and species were impacted by various threats differed and threats were dependent on locations. The Greater Melbourne area was identified as a hotspot for threats to wildlife. The WERS was able to source service providers for thousands of animals annually, facilitating their assessment, release into the wild and rehabilitation. However, every year, thousands of animals died or were euthanased and thousands more were left unattended. WERS case reports are increasing and there is a growing service–demand gap. Whilst studies reporting on the demand and response of WERS are rare, situations in other parts of Australia and the world might be similar. This highlights the urgent need to understand and mitigate human and non-human threats to wildlife, particularly in urban environments, where the rate of biodiversity loss is high. We discuss opportunities and barriers to doing so. [ABSTRACT FROM AUTHOR]

Background: In Australia, maternity care services provide care for pregnant and postpartum women and their newborns. The COVID-19 pandemic forced these services to quickly adapt and develop policies and procedures for dealing with transmission in health care facilities, as well as work under public health measures to counter its spread within the community. Despite well-documented responses and adaptations by healthcare systems, no studies have examined the experiences of maternity service leaders through the pandemic. This study aimed to explore the experiences of maternity service leaders, to understand their perspectives on what happened in health services and what was required of a leader during the COVID-19 pandemic in one Australian state. Methods: A longitudinal qualitative study collected data from 11 maternity care leaders during the pandemic in the state of Victoria. Leaders participated in a series of interviews over the 16-month study period, with a total of 57 interviews conducted. An inductive approach to developing codes allowed for semantic coding of the data, then a thematic analysis was conducted to explore patterned meaning across the dataset. Results: One overarching theme, 'challenges of being a maternity service leader during the pandemic', encompassed participant's experiences. Four sub-themes described the experiences of these leaders: (1) needing to be a rapid decision-maker, (2) needing to adapt and alter services, (3) needing to filter and translate information, and (4) the need to support people. At the beginning of the pandemic, the challenges were most acute with slow guideline development, rapid communications from the government and an urgent need to keep patients and staff safe. Over time, with knowledge and experience, leaders were able to quickly adjust and respond to policy change. Conclusion: Maternity service leaders played an important role in preparing and adapting services in accordance with government directives and guidelines while also developing strategies tailored to their own health service requirements. These experiences will be invaluable in designing high quality and responsive systems for maternity care in future crises. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to explore, analyse, and describe the patterns of public dental service utilisation among the refugee populations in Victoria, Australia, and determine their predictors at the individual and contextual levels. Methods: Data on the refugees who attended Victorian public dental services between July 2016 to June 2020 was gathered from the Dental Health Program dataset. Latent profile analysis was used to identify discrete groups among the refugee clientele with similar mean utilisation patterns across six indicator variables describing the attributes of dental services received and the site of care provision, over the study period. Multilevel multinomial logistic regression analysis was performed to examine the individual and contextual level correlates of the identified utilisation patterns. Results: Six distinct profiles of public dental service utilisation were identified among the study population (n = 25,542). The largest group comprised refugees predominantly using restorative services under general course of care (38.10%), followed by extraction services under emergency course of care (23.50%). Only a small proportion were estimated as having a higher mean utilisation of preventive services under general course of care (9.10%). Multilevel analysis revealed that the following variables had a significant association with refugee utilisation pattern: at the individual-level – demographic and ethnic attributes including age, gender, region of birth, preferred language for communication, use of language interpreter services, and type of eligibility card; at the contextual-level – characteristics of refugees' neighbourhood of residence including urbanicity, socioeconomic disadvantage, delivery of Refugee Health Program at the community health centres, and spatial accessibility to public dental services via driving and public transit modes of travel. Conclusions: The study represents a significant step towards the development of an evidence-based knowledge around public dental service utilisation among Victorian refugees. Overall, the study findings reiterate the critical need for targeted strategies to promote the importance of routine dental visits, oral disease prevention, and timely intervention among refugee groups. [ABSTRACT FROM AUTHOR]

The emission of black carbon (BC) particles, which cause atmospheric warming by affecting radiation budget in the atmosphere, is the result of an incomplete combustion process of organic materials. The recent wildfire event during the summer 2019–2020 in south-eastern Australia was unprecedented in scale. The wildfires lasted for nearly 3 months over large areas of the two most populated states of New South Wales and Victoria. This study on the emission and dispersion of BC emitted from the biomass burnings of the wildfires using the Weather Research Forecast–Chemistry (WRF–Chem) model aims to determine the extent of BC spatial dispersion and ground concentration distribution and the effect of BC on air quality and radiative transfer at the top of the atmosphere, the atmosphere and on the ground. The predicted aerosol concentration and AOD are compared with the observed data using the New South Wales Department of Planning and Environment (DPE) aethalometer and air quality network and remote sensing data. The BC concentration as predicted from the WRF–Chem model, is in general, less than the observed data as measured using the aethalometer monitoring network, but the spatial pattern corresponds well, and the correlation is relatively high. The total BC emission into the atmosphere during the event and the effect on radiation budget were also estimated. This study shows that the summer 2019–2020 wildfires affect not only the air quality and health impact on the east coast of Australia but also short-term weather in the region via aerosol interactions with radiation and clouds. [ABSTRACT FROM AUTHOR]

There is a need to ensure that healthcare organisations enable their workforces to use digital methods in service delivery. This study aimed to evaluate the current level of digital understanding and ability in nursing, midwifery, and allied health workforces and identify some of the training requirements to improve digital literacy in these health professionals. Representatives from eight healthcare organizations in Victoria, Australia participated in focus groups. Three digital frameworks informed the focus group topic guide that sought to examine the barriers and enablers to adopting digital healthcare along with training requirements to improve digital literacy. Twenty-three participants self-rated digital knowledge and skills using Likert scales and attended the focus groups. Mid-range scores were given for digital ability in nursing, midwifery, and allied health professionals. Focus group participants expressed concern over the gap between their organizations' adoption of digital methods relative to their digital ability, and there were concerns about cyber security. Participants also saw a need for the inclusion of consumers in digital design. Given the widening gap between digital innovation and health workforce digital capability, there is a need to accelerate digital literacy by rapidly deploying education and training and policies and procedures for digital service delivery. [ABSTRACT FROM AUTHOR]

Pyrethrum (Tanacetum cinerariifolium) cultivation in Australia, which accounts for the majority of global production of natural insecticidal pyrethrins, is affected by a persistent yield decline which in part is caused by a complex of pathogens. Globisporangium and Pythium species were isolated from crown and roots of pyrethrum plants showing stunting and brown discoloration of crown tissue, and from soil adjacent to diseased plants from yield-decline-affected sites in Tasmania and Victoria, Australia. Ten known Globisporangium species (Globisporangium attrantheridium, G. erinaceum, G. intermedium, G. irregulare, G. macrosporum, G. recalcitrans, G. rostratifingens, G. sylvaticum, G. terrestris and G. ultimum var. ultimum), two new Globisporangium species (Globisporangium capense sp. nov. and Globisporangium commune sp. nov.) and three Pythium species (Pythium diclinum/lutarium, P. tracheiphilum and P. vanterpoolii) were identified through morphological studies and multigene phylogenetic analyses using ITS and Cox1 sequences. Globisporangium ultimum var. ultimum, G. sylvaticum, G. commune sp. nov. and G. irregulare were most abundant. Globisporangium attrantheridium, G. macrosporum and G. terrestris were reported for the first time in Australia. Seven Globisporangium species were pathogenic on both pyrethrum seeds (in vitro assays) and seedlings (glasshouse bioassays), while two Globisporangium species and three Pythium species only caused significant symptoms on pyrethrum seeds. Globisporangium irregulare and G. ultimum var. ultimum were the most aggressive species, causing pyrethrum seed rot, seedling damping-off and significant plant biomass reduction. This is the first report of Globisporangium and Pythium species causing disease in pyrethrum globally and suggests that oomycete species in the family Pythiaceae may have an important role in the yield decline of pyrethrum in Australia. [ABSTRACT FROM AUTHOR]

Consumption of a healthy diet is required to manage blood glucose level in people with diabetes or pre-diabetes. The aim of this study was to test the internal validity of healthy eating habits assessed using a self-reported scale, the Rapid Eating Assessment for Participants (REAP) scale, in participants with pre-diabetes. The scale had 15 items with 4 categories: "Never", "Rarely", "Some days" and "Usually/most days". Those items were administered to 119 participants from 2006 to 2008 in Victoria, Australia. Rasch analysis was applied using RUMM2030 software. Overall fit was adequate in the unaltered model (χ2 = 29.29, p = 0.500, person separation index (PSI) = 0.500), however, seven items had disordered thresholds which were remedied by collapsing "Rarely" with "Some days" (χ2 = 37.36, p = 0.166, psi = 0.550). Item 1 ("Eat 3 main meals") remained disordered after collapsing. Two persons were removed due to their fit residuals being outside ±2.5, however, these deletions did not improve the fit, so it was decided to retain these persons in the scale. Overall, there was no significant differential item functioning (DIF) or local dependency. However, there was evidence of multidimensionality and a ceiling effect toward healthy eating in the person item threshold. The results from Rasch analysis showed that the current scale needs some improvement, such as addressing disordered thresholds, for measuring eating habits for people with pre-diabetes. A modified version with middle categories collapsed would provide a psychometrically more robust measure. Further study is needed to validate the scale as a screening tool for measuring healthy eating among people with pre-diabetes. [ABSTRACT FROM AUTHOR]

Ticks and tick-borne pathogens pose a significant threat to the health and welfare of humans and animals. Our knowledge about pathogens carried by ticks of Australian wildlife is limited. This study aimed to characterise ticks and tick-borne microorganisms from a range of wildlife species across six sites in Victoria, Australia. Following morphological and molecular characterisation (targeting 16S rRNA and cytochrome c oxidase I), tick DNA extracts (n = 140) were subjected to microfluidic real-time PCR-based screening for the detection of microorganisms and Rickettsia-specific real-time qPCRs. Five species of ixodid ticks were identified, including Aponomma auruginans, Ixodes (I.) antechini, I. kohlsi, I. tasmani and I. trichosuri. Phylogenetic analyses of 16S rRNA sequences of I. tasmani revealed two subclades, indicating a potential cryptic species. The microfluidic real-time PCR detected seven different microorganisms as a single (in 13/45 ticks) or multiple infections (27/45). The most common microorganisms detected were Apicomplexa (84.4%, 38/45) followed by Rickettsia sp. (55.6%, 25/45), Theileria sp. (22.2% 10/45), Bartonella sp. (17.8%, 8/45), Coxiella-like sp. (6.7%, 3/45), Hepatozoon sp. (2.2%, 1/45), and Ehrlichia sp. (2.2%, 1/45). Phylogenetic analyses of four Rickettsia loci showed that the Rickettsia isolates detected herein potentially belonged to a novel species of Rickettsia. This study demonstrated that ticks of Australian wildlife carry a diverse array of microorganisms. Given the direct and indirect human–wildlife–livestock interactions, there is a need to adopt a One Health approach for continuous surveillance of tick-associated pathogens/microorganisms to minimise the associated threats to animal and human health. [ABSTRACT FROM AUTHOR]

Background: In vitro fertilisation (IVF) is a common mode of conception. Understanding the long-term implications for these children is important. The aim of this study was to determine the causal effect of IVF conception on primary school-age childhood developmental and educational outcomes, compared with outcomes following spontaneous conception. Methods and findings: Causal inference methods were used to analyse observational data in a way that emulates a target randomised clinical trial. The study cohort comprised statewide linked maternal and childhood administrative data. Participants included singleton infants conceived spontaneously or via IVF, born in Victoria, Australia between 2005 and 2014 and who had school-age developmental and educational outcomes assessed. The exposure examined was conception via IVF, with spontaneous conception the control condition. Two outcome measures were assessed. The first, childhood developmental vulnerability at school entry (age 4 to 6), was assessed using the Australian Early Developmental Census (AEDC) (n = 173,200) and defined as scoring <10th percentile in ≥2/5 developmental domains (physical health and wellbeing, social competence, emotional maturity, language and cognitive skills, communication skills, and general knowledge). The second, educational outcome at age 7 to 9, was assessed using National Assessment Program–Literacy and Numeracy (NAPLAN) data (n = 342,311) and defined by overall z-score across 5 domains (grammar and punctuation, reading, writing, spelling, and numeracy). Inverse probability weighting with regression adjustment was used to estimate population average causal effects. The study included 412,713 children across the 2 outcome cohorts. Linked records were available for 4,697 IVF-conceived cases and 168,503 controls for AEDC, and 8,976 cases and 333,335 controls for NAPLAN. There was no causal effect of IVF-conception on the risk of developmental vulnerability at school-entry compared with spontaneously conceived children (AEDC metrics), with an adjusted risk difference of −0.3% (95% CI −3.7% to 3.1%) and an adjusted risk ratio of 0.97 (95% CI 0.77 to 1.25). At age 7 to 9 years, there was no causal effect of IVF-conception on the NAPLAN overall z-score, with an adjusted mean difference of 0.030 (95% CI −0.018 to 0.077) between IVF- and spontaneously conceived children. The models were adjusted for sex at birth, age at assessment, language background other than English, socioeconomic status, maternal age, parity, and education. Study limitations included the use of observational data, the potential for unmeasured confounding, the presence of missing data, and the necessary restriction of the cohort to children attending school. Conclusions: In this analysis, under the given causal assumptions, the school-age developmental and educational outcomes for children conceived by IVF are equivalent to those of spontaneously conceived children. These findings provide important reassurance for current and prospective parents and for clinicians. In a population-wide cohort study, Dr Anthea C Lindquist and colleagues, examine school-age outcomes among IVF-conceived children in Australia. Author summary: Why was this study done?: More than 8 million children have been conceived globally with the assistance of in vitro fertilisation (IVF). Some studies suggest these children have an increased risk of congenital abnormalities, autism spectrum disorder, developmental delay, and intellectual disability. Educational and school-age developmental outcomes following IVF conception have not yet been adequately characterised. What did the researchers do and find?: Using statewide, linked population data from Victoria, Australia, we investigated the school-age developmental and educational outcomes for children born following IVF-assisted conception. The study examined 2 separate assessments of school-age development and educational outcomes among 585,659 children, including 11,059 children who were conceived via IVF. This study was designed and performed within a causal framework, in order to produce the best possible estimate of exposure effect using observational data. We found no difference in school-age childhood developmental and educational outcomes between IVF- and spontaneously conceived children. What do these findings mean?: These findings provide reassurance for current and prospective parents, as well as clinicians who are involved in IVF. This information may be useful in providing informed consent and education to those considering IVF and those with children conceived via IVF. [ABSTRACT FROM AUTHOR]

High-resolution palaeoclimate proxies are fundamental to our understanding of the diverse climatic history of the Australian mainland, particularly given the deficiency in instrumental datasets spanning more than a century. Annually resolved, tree-ring-based proxies play a unique role in addressing limitations in our knowledge of interannual to multi-decadal temperature and hydroclimatic variability prior to the instrumental period. Here we present cross-dated ring-width (RW) and minimum blue-intensity (BI) chronologies spanning 70 years (1929–1998) for Podocarpus lawrencei Hook.f., the Australian mainland's only alpine conifer, based on nine full-disc cross-sections from Mount Loch in the Victorian Alps. Correlations with climate variables from observation stations and gridded data across the 1929–1998 period reveal a significant positive relationship between RW and mean monthly maximum temperatures in winter throughout central Victoria (r=0.62 , p<0.001) and a significant negative correlation to winter precipitation (r=-0.51 , p<0.001). We also found significant negative correlations between RW and monthly snow depth at Spencer Creek in New South Wales (r=-0.60 , p<0.001). Of the assessed BI parameters, delta blue intensity (Δ BI; the difference between early- and late-wood BI) displayed the greatest sensitivity to climate, with robust spatial correlations with mean October to December maximum and minimum monthly temperatures (r=-0.43 , p<0.001 ; r=-0.51 , p<0.001) and July precipitation (r=0.44 , p<0.001), across large areas of northern Victoria. These promising findings highlight the utility of this species for future work. With the very limited availability of suitable long-lived and cross-datable species on the Australian mainland, these results have significant implications for advancing high-resolution palaeoclimate science in southeastern Australia and for improving our understanding of past climate in the region. [ABSTRACT FROM AUTHOR]

Protecting "wilderness" and removing human involvement in "nature" was a core pillar of the modern conservation movement through the 20th century. Conservation approaches and legislation informed by this narrative fail to recognise that Aboriginal people have long valued, used, and shaped most landscapes on Earth. Aboriginal people curated open and fire-safe Country for millennia with fire in what are now forested and fire-prone regions. Settler land holders recognised the importance of this and mimicked these practices. The Land Conservation Act of 1970 in Victoria, Australia, prohibited burning by settler land holders in an effort to protect natural landscapes. We present a 120-year record of vegetation and fire regime change from Gunaikurnai Country, southeast Australia. Our data demonstrate that catastrophic bushfires first impacted the local area immediately following the prohibition of settler burning in 1970, which allowed a rapid increase in flammable eucalypts that resulted in the onset of catastrophic bushfires. Our data corroborate local narratives on the root causes of the current bushfire crisis. Perpetuation of the wilderness myth in conservation may worsen this crisis, and it is time to listen to and learn from Indigenous and local people, and to empower these communities to drive research and management agendas. [ABSTRACT FROM AUTHOR]

The Australian dingo is a recent anthropogenic addition to the Australian fauna, which spread rapidly across the continent and has since widely interbred with modern dogs. Genetic studies of dingoes have given rise to speculation about their entry to the continent and subsequent biogeographic effects, but few studies of their contemporary population structure have been conducted. Here we investigated the dingo ancestry and population structure of free-living dogs in western Victoria and contrasted it with a wider southern Australian sample. We wished to determine whether their geographic isolation was mirrored in genetic isolation. To address this question, we analysed 34 microsatellite markers using Bayesian clustering and discriminant analysis of principal components, and summarised genetic diversity at the population and individual level. The broader southern Australia sample (n = 1138) comprised mostly hybrid animals, with 30% considered pure dingoes. All western Victorian individuals (n = 59) appeared to be hybrids with high dingo ancestry. The population showed no evidence of admixture with other populations and low genetic diversity on all measures tested. Based upon our characterisation of this unusual mainland population, we advise against assuming homogeneity of dingoes across the continent. [ABSTRACT FROM AUTHOR]

Aim: The distribution and abundance of forest biodiversity can be shaped by multiple drivers, including disturbances like wildfires. We quantified the influence of wildfire severity and bird life history attributes on temporal patterns of bird site occupancy. Location: Wet eucalypt forests of Victoria, Australia. Methods: We employed a Before, After, Control, Impact experimental design, gathering occupancy data on birds 5 years before, and for 10 years after, a wildfire in 2009. We quantified post‐fire decline and then recovery on sites subject to high‐severity fire, comparing these temporal patterns with those for birds at sites that were unburnt or burnt at moderate severity. We also tested the influence of life history attributes on bird responses to wildfire. Data were analysed using joint species distribution modelling, accounting for imperfect detection. Results: We found a two‐way interaction between fire severity and time period for overall bird site occupancy. The largest change between time periods was on sites burnt at high severity where bird occupancy declined immediately after fire followed by a strong recovery. Occupancy patterns remained largely unchanged on unburnt sites. For many individual species, interactions between fire severity and time period were similar to overall species occupancy. On sites subject to high‐severity fire, most species recovered to pre‐fire levels within 6 years. We found no evidence of a three‐way interaction between fire severity, time period, and life history attributes, with all trait groups of birds examined largely recovered to pre‐fire site occupancy levels 10 years post‐fire. Main conclusions: The Victorian 2009 wildfires were severe, but their impacts on common bird species were relatively short‐lived, with immediate post‐fire declines mostly reversed within ~10 years. Rapid post‐fire stand regeneration appears a likely driver of these responses and may account for the relatively limited influence of life history attributes on bird species recovery. However, diet influenced bird species occupancy after fire, with nectivores recovering slower than insectivores on sites subject to high severity fire. Our findings may be relevant to other forests types globally where there can be rapid post‐fire vegetation growth and stand regeneration. [ABSTRACT FROM AUTHOR]

Carnivores have key ecological roles in structuring and regulating ecosystems through their impacts on prey populations. When apex‐ and meso‐predators co‐occur in ecosystems, there is the potential for complex interspecific interactions and trophic dynamics that can affect the composition and functioning of ecological communities. Investigating the diet of sympatric carnivores can allow us to better understand their ecological roles (e.g. potential suppression of herbivores) or impacts (e.g. predation of threatened species). Australia's alpine region provides an ideal system in which to explore spatial and temporal variation in predator and prey interactions, using the dingo (Canis dingo) and invasive red fox (Vulpes vulpes) diet. We examined the diet of dingoes and foxes across three different mountains and seasons in Victoria's alpine region, using macroscopic scat analysis. There was little diet overlap between the two carnivores, with foxes having a broader diet than dingoes. Dingoes primarily consumed larger mammal species, including invasive sambar deer (Cervus unicolor, 44%), and the native common wombat (Vombatus ursinus, 34%), whereas foxes typically consumed smaller mammals, including the native bush rat (Rattus fuscipes, 55%), and the invasive European rabbit (Oryctolagus cuniculus, 15%). Dingoes consumed more than thirty times the volume of large invasive mammals (predominantly sambar deer) than did foxes. Foxes consumed close to 15 times as many critical weight range individuals per scat than dingoes. Only one threatened critical weight range mammal species was identified within scats, the broad‐toothed rat (Mastacomys fuscus), found within five fox scats. Our results suggest that the introduction of novel prey may alter predator–predator interactions by causing a reduction in the dietary overlap. Therefore, in the context of integrated wildlife management and biodiversity conservation, any control of novel, invasive prey populations needs to consider possible flow on effects to apex‐ and meso‐predator diets and potential secondary impacts on native prey. [ABSTRACT FROM AUTHOR]

Rapid development of underground space necessitates the efficient management of underground areas. Data modelling plays an underpinning role in integrating and managing underground physical and legal data. The physical data refers to semantic and spatial data of underground assets such as utilities, tunnels, and basements, while the legal data comprises the ownership information and the extent of underground legal spaces and the semantic and spatial relationships between legal spaces. Current Underground Land Administration (ULA) practices mainly focus on representing only either legal spaces or the physical reality of subsurface objects using fragmented and isolated 2D drawings, leading to ineffective ULA. A complete and accurate 3D representation of underground legal spaces integrated with the 3D model of their physical counterparts can support different use cases of ULA beyond underground land registration, such as planning, design and construction of underground assets (e.g. tunnels and train stations), utility management and excavation. CityGML is a prominent semantic data model to represent 3D urban objects at a city scale, making it a good choice for underground because underground assets such as tunnels and utilities are often modelled at city scales. However, CityGML, in its current version, does not support legal information. This research aims to develop an Application Domain Extension (ADE) for CityGML to support 3D ULA based on the requirements defined in the Victorian state of Australia. These requirements include primary underground parcels and secondary underground interests. This work extends CityGML 3.0, which is the new version of this model. In CityGML 3.0, UML conceptual models as platform-independent models are suggested to express ADEs. Thus, the ADE proposed in this study will be based on UML. The findings of this study show that extending CityGML to support legal information can be a viable solution to meet the requirements of a 3D integrated model for ULA. The CityGML ADE proposed in this study can potentially provide a new solution for 3D digital management of underground ownership rights in Victoria, and it can be used to implement an integrated 3D digital data environment for ULA. [ABSTRACT FROM AUTHOR]

Background: There has been a decline in the stroke incidence across high income countries but such knowledge exists at Country or State rather than areal unit level such local government area (LGA). In this disease mapping study, we evaluate if there are local hot spots or temporal trends in TIA rate. Such knowledge will be of help in planning healthcare service delivery across regions. Methods: Linked hospital discharge data (Victorian Admitted Episodes Dataset or VAED) was used to collect TIA (defined by ICD-10-AM codes G450-G459) cases from 2001 to 2011. The State of Victoria is the second most populous state in Australia, with a population of 6.7 million and can be divided into 79 administrative units or LGA. The data is anonymized and contains residence of the patient in terms of LGA but not exact location. The date of the TIA event when the patient is admitted to hospital is provided in the dataset. The number of TIAs per year was aggregated for each LGA. Standardized TIA ratios were calculated by dividing actual over expected cases for each LGA per year. We used Integrated Nested Laplace Approximation (INLA) to perform spatial and spatiotemporal regression, adjusting for hypertension, sex and population, age (≥60), and socio-economic status (SES) decile within the LGA. The final model was chosen based on the lowest the Deviance Information Criterion (DIC) and Watanabe-Akaike information criteria (WAIC). Results: Choropleth maps showed a higher standardized TIA ratios in North-West rural region. Compared to the baselinemodel (DIC 13,159, WAIC 13,261), adding in a spatial random effect significantly improved the model (DIC 6,463, WAIC 6,667). However, adding a temporal component did not lead to a significant improvement (DIC 6,483, WAIC 6,707). Conclusion: Our finding suggests a statically significant spatial component to TIA rate over regional areas but no temporal changes or yearly trends. We propose that such exploratory method should be followed by evaluation of reasons for regional variations and which in turn can identify opportunities in primary prevention of stroke, and stroke care. [ABSTRACT FROM AUTHOR]

Women's rates of remand, or pre-trial detention, have grown dramatically in Australia and the rates at which Aboriginal and Torres Strait Islander women are incarcerated without conviction are particularly high. However, there is little research examining bail and remand practices and their relationship to social inequalities. This article presents findings from research on the drivers behind women's increasing rates of custodial remand in Victoria--a jurisdiction that has significantly restricted access to bail through legislative reforms. Drawing on data derived from interviews with criminal defence and duty lawyers, we outline how bail and remand practices systematically disadvantage women experiencing housing insecurity and domestic and family violence (DFV), increasing their risk of becoming trapped in longer-term cycles of incarceration. Our analysis reinforces the need to move away from 'tough on crime' approaches to bail. It also highlights unintended consequences of DFV reforms, including further marginalising and punishing criminalised women who are victimsurvivors. [ABSTRACT FROM AUTHOR]

Regional flood frequency analysis (RFFA) is widely used to estimate design floods in ungauged catchments. Both linear and non-linear methods are adopted in RFFA. The development of the non-linear RFFA method Adaptive Neuro-fuzzy Inference System (ANFIS) using data from 181 gauged catchments in south-eastern Australia is presented in this study. Three different types of ANFIS models, Fuzzy C-mean (FCM), Subtractive Clustering (SC), and Grid Partitioning (GP) were adopted, and the results were compared with the Quantile Regression Technique (QRT). It was found that FCM performs better (with relative error (RE) values in the range of 38–60%) than the SC (RE of 44–69%) and GP (RE of 42–78%) models. The FCM performs better for smaller to medium ARIs (2 to 20 years) (ARI of five years having the best performance), and in New South Wales, over Victoria. In many aspects, the QRT and FCM models perform very similarly. These developed RFFA models can be used in south-eastern Australia to derive more accurate flood quantiles. The developed method can easily be adapted to other parts of Australia and other countries. The results of this study will assist in updating the Australian Rainfall Runoff (national guide)-recommended RFFA technique. [ABSTRACT FROM AUTHOR]