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Nineteen new species of Karaops are described: K. durrantorumsp. nov. (♂), K. morganoconnellisp. nov. (♀♂), K. joehaenerisp. nov. (♀), K. dalmanyisp. nov. (♀♂), K. garyodwyerisp. nov. (♂), K. dejongisp. nov. (♀♂), K. malumbusp. nov. (♀♂), K. conilurussp. nov. (♂), K. yumbubaarnjisp. nov. (♀♂), K. markharveyisp. nov. (♀♂), K. nitmiluksp. nov. (♀), K. kennerleyorumsp. nov. (♂), K. jawaywaysp. nov. (♀), K. mparntwesp. nov. (♀), K. larapintasp. nov. (♀), K. kwartatumasp. nov. (♂), K. madhawundusp. nov. (♀), and K. mareebasp. nov. (♀). The male of K. umiida Crews, 2013 was found to be misidentified and is now K. conilurussp. nov.Karaops yindjibarndisyn. nov. is a new synonym of K. nyiyaparli. Selenops australiensis L. Koch, 1875 is considered a nomen dubium because the holotype is an immature male, and the species previously referred to as K. australiensis (L. Koch, 1875) is here described as K. strayamatesp. nov. (♀♂). The males of K. marrayagong Crews & Harvey, 2011 and K. banyjima Crews, 2013 are described for the first time. To manage the growing diversity of the genus, most of the species have been placed in species groups, which are diagnosed. They are the Central Desert group, the strayamate group, the raveni group, the dawara group, the francesae group, the Kimberley group, and the Pilbara-Gascoyne group. New keys are provided to accommodate the new species, and new distribution maps and new records are provided for all species. Diagnoses and descriptions are emended where required. Images of live spiders, many not previously seen alive, and natural history information are also provided.

Risk profiles are changing for patients who undergo percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). In Australia, little is known of the nature of these changes in contemporary practice and of the impact on patient outcomes. We identified all CABG (n = 40,805) and PCI (n = 142,399) procedures in patients aged ≥18 years in New South Wales, Australia, during 2008 to 2019. Between 2008 and 2019, the age- and gender-standardized revascularization rate increased by 20% (from 267/100,000 to 320/100,000 population) for all revascularizations. The increase in revascularization was particularly driven by a 35% increase (from 194/100,000 to 261/100,000) in PCI, whereas the rate of CABG decreased by 20% (from 73/100,000 to 59/100,000). Mean age and the prevalence of co-morbidities (especially diabetes and atrial fibrillation) increased for patients with PCI in more recent years but remained consistently lower than for patients with CABG. CABGs performed in patients presenting with a non-ST-segment-elevation acute coronary syndrome halved from 34.3% to 18.7% during the study period, whereas PCIs in this group decreased from 36.5% to 29.6%. Risk-adjusted in-hospital mortality decreased by 7.5 deaths/1,000 procedures per month for CABG but remained unchanged for PCI. Risk-adjusted readmission rates were consistently higher for CABG than for PCI and did not change significantly over time. In conclusion, we observed a dramatic shift over time from CABG to PCI as the revascularization procedure of choice, with the patient base for PCI extending to older and sicker patients. There was a large decrease in mortality after CABG, whereas mortality after PCI remained unchanged.

We assessed access to vaping products and types of products used and the factors associated with vaping and smoking among young people in the state of New South Wales (NSW), Australia.A cross-sectional survey was conducted with a sample of 721 young people aged 14 to 17 years from NSW recruited through online panels. Poisson regression with robust variance was used to estimate relative risks of ever-vaping and ever-smoking.Almost one-third of the sample (32%, n=233) reported being an ever-vaper, of which more than half (54%) had never smoked prior to starting vaping. Ever-vaping was independently associated with age and being Aboriginal or Torres Strait Islander, and ever-smoking was independently associated with being male. Ever-smokers were seven times more likely to be ever-vapers than those who had never smoked, and ever-vapers were 18 times more likely to be ever-smokers than those who had never vaped. Among ever-vapers who reported which type of device they were using, 86% reported the use of disposable products. "Flavourings and taste" was rated as the most important characteristic of vapes. More than half of ever-vapers reported getting the last vape they used from their friends (55%, n=130). More than half of ever-vapers had used a vape that they knew contained nicotine (53%, n=123).Vaping was the strongest risk factor for smoking, and vice versa, suggesting there is not a straightforward, unidirectional relationship between vaping and smoking in young people. Young people appear to be readily accessing nicotine vaping products, which are often disposable and flavoured, through both social and commercial channels.Stronger enforcement of federal and state policies designed to protect young people from vaping products is urgently needed.

Walkability scores have been developed to measure how well the characteristics of the physical environment support walking. However, because pedestrian safety is not taken into account, areas that have higher Walk Scores could be associated with more walking and also more pedestrian-related injury. We aimed to explore the association between Walk Score and pedestrian-related injury in Sydney.Pedestrian-related injuries from 2010 to 2018 in Sydney were identified in the New South Wales Combined Admitted Patient Epidemiology Data. Walk Score was used to measure area-level walkability in Sydney statistical division. Regression models were used to examine the association between Walk Score, pedestrian-related injury, length of hospital stay (LOS) and injury severity.Among people aged ≤64 years, there was no significant association between walkability score and pedestrian-related injury. Among people aged ≥ 65 years, walkability score was significantly positively associated with pedestrian-related injury, which peaked at Somewhat Walkable. For most disadvantaged areas, the risk of pedestrian-related injury was highest for areas that were classified as Somewhat Walkable. For moderately disadvantaged areas, the risk of pedestrian-related injury was highest at Very Walkable to Walker's Paradise areas. For the least disadvantaged areas, there was no significant association between walkability score and pedestrian-related injury. For LOS among people aged ≥ 65 years or in the most disadvantaged areas, it peaked at Somewhat Walkable areas. For injury severity, the risk of serious pedestrian-related injury was highest at Very Walkable to Walker's Paradise areas among people aged 16-64 years.For the majority of the population, built environment characteristics that are considered to make walking attractive also make it safer, offsetting any exposure-related increase injury risk. However, this is not the case for people aged ≥ 19 years, and those living in socioeconomically disadvantaged areas. Incorporating measures of pedestrian safety in walkability scores may create an impetus to ensure that the built environment is designed to support the safety of pedestrians from these groups.

To describe patterns of SARS-CoV-2 transmission in non-healthcare workplace settings during the first six months of COVID-19 spread, in New South Wales (NSW), Australia.Locally acquired COVID-19 cases between February 2020 and August 2020 were reviewed to determine the: total number of workplace-associated cases and clusters; workplace type; and modes of transmission.There were 72 COVID-19 workplace clusters with 231 cases and an additional 11 workplace-acquired cases who were not part of a cluster. Workplaces most associated with clusters included construction, manufacture and trade (31%, 22 clusters), office and clerical (25%, 18 clusters) and retail (14%, 10 clusters). Most transmission events were best explained by direct transmission, with two workplace clusters demonstrating evidence of partial indirect spread.Findings demonstrate workplace settings, particularly construction, office and retail settings have heightened risk of transmission.The risk of infectious disease transmission is well understood for healthcare workers, despite other workplace types representing higher volumes of workers with less risk controls. This study should assist policy makers and the public to understand COVID-19 transmission in workplaces and the heightened risks associated with certain workplace settings.

In the late nineteenth century, the prognosis of late-life melancholia was believed to be poor. The medical casebooks of 40 patients aged 60+years, admitted to two Hospitals for the Insane in New South Wales with melancholia between 1871 and 1905, were examined. Psychosis (87.5%), depressed mood (80%), suicidal behaviour (55%), physical ill health (55%), restlessness (50%) and fears of harm to self (50%) were identified. Main outcomes were discharge (40%) and death (37.5%). Victoria’s Kew Hospital patient register for 1872–88 revealed 669 melancholia admissions with 30 aged 60+. Outcomes worsened significantly with age (chi square = 16.19, df = 4, p < 0.005), mainly due to higher mortality. Nineteenth-century late-life melancholia was a severe disorder despite many cases recovering.

ObjectivesTo explore the impact of mandatory lifejacket wear legislation on unintentional rock fishing-related drowning fatalities at declared high-risk rock platforms in New South Wales (NSW; Australia).MethodsRock fishing-related drownings for the five years pre-legislation enactment (23 November 2011 to 22 November 2016) and five years post-legislation enactment (23 November 2016 to 22 November 2021) were compared. Google Earth was used to assess if drowning deaths occurred at declared areas under legislation. Binary logistic regression was used to analyse change in the number of deaths in declared areas pre-legislation/post-legislation.ResultsOver the 10 years, 80 rock fishing drowning deaths occurred in New South Wales; 23 in declared areas pre-legislation and 13 post-legislation (−43.5%). The odds of a rock fishing drowning death occurring in a declared area pre-legislation was 2.3 times higher (95% CI 0.942 to 5.752; p=0.067).ConclusionReductions in rock fishing deaths at declared areas were observed since the legislation’s introduction, but were not significant. Greater enforcement and extension to other high-risk platforms may reduce deaths further.

INTRODUCTION: Involuntary drug and alcohol treatment occurs in many countries and its role is often controversial. This can be a particular concern in relation to First Nations or other culturally distinct populations. This study explores beliefs and attitudes of drug and alcohol clinicians when considering referral of Aboriginal Australians to involuntary drug and alcohol treatment in New South Wales (NSW), Australia. METHODS: The Involuntary Drug and Alcohol Treatment program (IDAT) is legislated by the NSW Drug and Alcohol Treatment Act 2007. There are two IDAT units-in urban (Sydney, four beds) and regional NSW (Orange, eight beds). NSW Health drug and alcohol clinicians who had referred clients to IDAT between 2016 and 2018 were invited to participate in a semi-structured 1:1 interview. Eleven clinicians (n = 2, male) from six local health districts (urban through to remote) agreed to participate. A descriptive qualitative analysis of responses was conducted. RESULTS: Two key themes summarised the beliefs and attitudes that clinicians reported influencing them when considering referral of Aboriginal Australians to involuntary drug and alcohol treatment in NSW: (i) dilemma between saving someone's life and being culturally safe; and (ii) need for holistic wrap-around care. DISCUSSION AND CONCLUSIONS: Almost all clinicians were worried that being in IDAT would further erode their Aboriginal client's autonomy and be retraumatising. Strategies are needed to support the involvement of Aboriginal-specific services in IDAT processes and ensure local support options for clients on discharge. Future research should examine the effectiveness, acceptability and feasibility of involuntary drug and alcohol treatment programs.

The incidence of enterovirus D68 (EV-D68) in New South Wales, Australia, is unknown. As part of a state-wide surveillance program, enterovirus positive diagnostic specimens were assessed from patients presenting to hospitals with respiratory and meningitis syndromes from August 2018 to November 2019. Diagnostic enterovirus positive samples were collected from 339 patients and re-extracted followed by targeted PCR across the whole EV-D68 genome (7.4 kb). Obtained amplicons (n=208) were sequenced using Illumina sequencing technology and the phylogenetic relationships analysed relative to EV-D68 Fermon strain. We identified EV-D68 in 31 patients, both children (n=27) and adults (n=4). Phylogenetically, the majority (n=30) were from subclade B3, the same as that causing outbreaks of EV-D68 across the USA and Europe during 2018. These data strengthen the importance of having an active enterovirus surveillance network.

To evaluate the impact of a multi-component, Aboriginal-led strategy to reduce alcohol-related criminal incidents for Aboriginal people in four rural/remote communities in New South Wales (NSW), Australia.A retrospective multiple baseline design (MBD), using interrupted time series analysis of routinely collected crime data.A statistically significant reduction in alcohol-related criminal incidents was observed in one community for both victims of crime (parameter estimate -0.195; p≤0.01) and persons of interest (parameter estimate -0.282; p≤0.001). None of the analyses show level shifts, meaning there were no measurable changes immediately post the introduction of the Breaking the Cycle (BTC) programs.It is not possible to conclude that the program was effective independently of any other community factors, because the statistically significant result was not observed across multiple communities. The statistically significant result in one community has clear practical benefits in that community: a sustained impact over two years would reduce Aboriginal victims of alcohol-related crime from an estimated 56 incidents per annum to 36, and reduce Aboriginal persons of interest in alcohol-related crime from an estimated 68 alcohol-related person of interest (POI) per annum to 40.The statistically and practically meaningful result in Community 1 highlights the potential of multi-component, Aboriginal-led strategies to reduce alcohol-related criminal incidents. Earlier engagement with researchers, to identify best-evidence strategies to reduce alcohol harms and to facilitate the use of prospective evaluation designs, would help translate the positive outcome in one community across multiple communities.

Abstract. Background: Bystanders can play a key role in preventing railway suicides by taking direct action or by raising an alarm. Aims: The study investigated in this context: (1) the prevalence of preventative actions by bystanders; (2) the relationship, if any, between first-hand preventions by bystanders and the degree of ambiguity around the imminence of danger; and (3) the nature of first-hand preventions by bystanders. Method: Data were obtained from a security reporting database at Sydney Trains for 2011–2019 for accident and suicide-related incidents ( N = 1,278). Results: In 635 cases of suicide prevention, bystanders were identified as first responders in 11% of cases and as raising the alarm in 11% of cases. Bystanders as first responders intervened proportionally more where the ambiguity of danger is low (jumping) compared with high (sitting, standing, wandering). Of the 69 cases of bystander preventions, 77% involved physical interaction (e.g., holding back) and 49% involved more than one bystander. Limitations: The data source could be biased because of incompleteness or nonstandard reporting. Conclusion: Rail policy-makers should consider education and support for bystanders and staff: for example, by making known the prevalence of helping, the importance of intervening, and what types of intervention are most helpful.

There is little research to understand reasons for suboptimal influenza vaccination uptake among Aboriginal people of different ages in Australia. This study aimed to better understand the communication needs and preferences of Aboriginal families (Phase 2) in New South Wales, Australia, and their health service providers (Phase 1), to inform future interventions to improve influenza immunisation coverage in Aboriginal communities. This paper reports from Phase 1 of the study.Aboriginal and non-Aboriginal researchers designed and conducted the study, with cultural governance provided by Aboriginal health care professionals and other community members working within health departments or community healthcare settings across Australia. In Phase 1 we conducted interviews and focus groups with 18 Aboriginal immunisation providers and mainstream immunisation co-ordinators from three geographic areas in New South Wales. We used group-based thematic analysis with a cultural lens and sought participants' feedback prior to finalising results.We identified four themes, framed as opportunities for improvement: better supporting Aboriginal Medical Services as providers of influenza vaccinations; improving the accessibility and appropriateness of mainstream services for Aboriginal families; improving health providers' knowledge of Aboriginal people' influenza risk and their willingness to recommend vaccination; and engaging communities to design influenza vaccination resources.To achieve optimal influenza vaccination coverage, all health services must take responsibility for providing culturally responsive clinical care to Aboriginal families. We suggest that, where possible, mainstream services incorporate elements of the family-centred and broader model of health used by Aboriginal Medical Services. This includes creating a welcoming environment, appropriately identifying and getting to know Aboriginal patients, taking a preventative approach, and opportunistically offering and strongly encouraging influenza vaccination to the individual and their family.

Problem: Fieldwork is a vital component of public health emergency response, yet little has been published on undertaking fieldwork safely. Safety is of particular importance with emerging pandemic viruses, which can pose additional risks to public health fieldwork staff. Context: During a pandemic, surge health staff may be drawn from diverse professional backgrounds; they may have limited experience in fieldwork or be unfamiliar with the risks posed by a novel virus. Novel pathogens pose dangers to fieldwork staff, particularly when there are global or local shortages of personal protective equipment. Action: During the coronavirus disease 2019 (COVID-19) pandemic, New South Wales (NSW) Health’s Public Health Emergency Operations Centre (PHEOC) deployed staff for fieldwork in a range of settings. The PHEOC developed a protocol to systematize planning, risk assessment and management for COVID-19 fieldwork. The protocol was accompanied by training, discussion exercises and debriefs to support PHEOC fieldwork staff. Lessons learned: Effective fieldwork is an essential component of outbreak investigation and management, including stakeholder management. Here, we share and discuss key elements of the NSW Health protocol to support fieldwork during outbreak responses for emerging communicable diseases across various resource contexts. Limited understanding of novel viruses, particularly in the early phases of a pandemic, must be considered in decisions to deploy fieldwork staff and implement precautionary risk mitigation approaches. Planning is essential to protect staff and ensure ethical allocation of resources. Through appropriate selection of teams and training, surge staff can be supported to effectively conduct fieldwork.

Increasing the number of infants exclusively breastfeeding on discharge from the hospital after birth is a key goal of breastfeeding policy in New South Wales (NSW), Australia. Despite consistent efforts, exclusive breastfeeding on discharge rates have declined over the past decade. Using pooled data from the New South Wales Perinatal Data Collection from 2011 to 2020, we examined the association between antenatal care (ANC) and exclusive breastfeeding at discharge from birth admission outcomes for mother–baby dyads in Southern New South Wales Local Health District (SNSWLHD). Our study confirmed that exclusive breastfeeding rates in SNSWLHD have declined over the past decade, providing local evidence to support action. Late entry to ANC and a failure to attend the recommended number of ANC visits were important predictors of a lower rate of exclusive breastfeeding on discharge. Improving accessibility to ANC visits for rural and regional mothers has potential to positively impact breastfeeding rates in SNSWLHD. We suggest that wider implementation of caseload midwifery models may have a positive impact on breastfeeding outcomes in the region for all mother–baby dyads, but particularly for Aboriginal mothers and infants, younger mothers and mothers experiencing disadvantage.

As in many other nations, the Australian Government implemented monetary and fiscal policies in response to the COVID-19 pandemic to aid economic recovery. Among these policies were specific measures to assist first home buyers (FHBs) in entering the housing market. However, these unprecedented economic policies might have other direct and indirect implications on FHBs, which have yet to be thoroughly explored in the literature. To fill this gap, through a survey, we collected information via public and online mortgage broker platforms from 61 FHBs who successfully entered the housing market or were actively searching during the pandemic. The results found COVID-19 economic responses counterproductive for FHBs, pushing them to a more disadvantaged position due to an overheated property market. In addition, since the onset of the pandemic, property prices have risen significantly, exacerbating housing inequality as FHBs increasingly rely on intergenerational family support, take on more financial risk, and relocate to regional areas due to fear of missing out. The study highlights the need for macroeconomists and housing policymakers to consider these unintended consequences in formulating policies that minimise the adverse effects of economic stimulus measures.

The Striped Legless Lizard Delma impar Fischer 1882 occurs in grasslands of south-eastern Australia where it is sometimes sympatric with several congeners. Previous molecular analyses have revealed mitochondrial divergence between the northern and southern lineages of D. impar, but the status of a recently detected population assigned to the species in the Hunter Valley of New South Wales (NSW), 250 km north of other populations, remains unknown. Via morphological and molecular analyses across the known distribution of D. impar, we distinguish the population from the Hunter Valley, Liverpool Plains region as a unique taxon and describe this species as D. vescolineata sp. nov. The new species is divergent from D. impar in both nuclear and mitochondrial analysis, and differing facial scalation and colour patterning from the limited number of specimens available. The degree of mitochondrial and nuclear divergence between the previously identified northern and southern clades of D. impar is consistent with a single species. This is the first description of a Delma from south-eastern Australia since 1974, but the second new vertebrate taxon identified from the Hunter Valley region within a decade. Our research highlights our incomplete understanding of the biodiversity of the Hunter Valley region, despite its relative proximity to populous areas. The range of D. vescolineata sp. nov. is restricted and heavily overlaps with major habitat modification including mining and grazing, with no parks or reserves in this distribution protecting the species’ grassland habitat. Gathering more data to understand conservation status of this species should be a priority.

Video laryngoscopy (VL) is increasingly used as an alternative to direct laryngoscopy (DL) to improve airway visualisation and endotracheal intubation (ETI) success. Intensive Care Paramedics in New South Wales Ambulance, Australia started using VL in 2020, and recorded success in a new advanced airway registry. We used this registry to compare VL to DL.The present study was a retrospective analysis of out-of-hospital data for ETI by specialist paramedics using an airway registry. We calculated overall and first-pass success for VL versus DL, and compared success using a ΧThe DL overall success was 61 out of 78 (78.2%) and VL was 233 out of 246 (94.7%); difference of 16.5% (P 0.001). First-pass for DL was successful for 49 out of 78 (62.8%) and for VL in 195 out of 246 (79.3%); difference of 16.5% (P = 0.003). There were five (1.6%) patients where both VL and DL were used and in all instances, DL was used first.This analysis of a new airway registry used by specialist paramedics in New South Wales shows a substantial increase in overall and first-pass intubation success with the use of VL when compared to DL.

The authors report a first sighting of a euryhaline fish in the climate change hotspot along Australia's south-eastern coast. The barred javelin, Pomadasys kaakan (Cuvier, 1830) was found in the Nambucca River in New South Wales, Australia, during 2021 and 2022. Specimens were adult, suggesting they may not be transitory vagrants. The new southernmost location recorded here represents a c. 200 km out-of-range sighting compared to previous records, and is c. 380 km south of the southernmost Australian stronghold of the species in Moreton Bay, Queensland.

Prompt help-seeking behaviour by music festival attendees can reduce risks associated with drug use; however, little is known about perceived barriers to help-seeking when experiencing or witnessing illness at music festivals. We explored potential barriers and their association with festivalgoer characteristics.We conducted an on-site cross-sectional survey of attendees at New South Wales music festivals in 2019/2020. Perceived barriers to help-seeking in the hypothetical event of the respondent or a friend becoming unwell at the festival were assessed, and regression analyses were conducted to identify characteristics associated with these barriers.Across six festivals, 1229 people were surveyed and four-fifths (83.2%) reported ≥1 barrier: 32.7% fear of getting in trouble with the police, 20.6% not knowing where to find help, 17.2% not knowing how unwell someone might be and 15.3% concern about friends or relatives finding out. In multivariable analyses, people of diverse sexuality and people using drugs that day had greater odds of reporting fear of trouble with the police. People reporting drug use that day had lower odds of reporting not knowing where to find help. Men, gender-diverse people and people using drugs that day had greater odds of reporting concern about friends or relatives finding out.Our data substantiate concerns regarding policing strategies and their impact on festivals. Initiatives to support conversations about drugs with friends and families may be best targeted to younger people and those from gender-diverse backgrounds.

Objective To describe patterns of emergency department (ED) presentations and predictors of 30-day mortality in patients referred from a residential aged care facility (RACF). Methods A retrospective analysis of linked state-wide emergency, inpatient and death data from 136 public ED hospitals in New South Wales, Australia. Data were collected from the NSW Emergency Department Data Collection database, the NSW Admitted Patient Data Collection database and the NSW Registry of Births, Deaths and Marriages. All patients aged ≥65 years presenting to the ED from a RACF between January 2017 and July 2018 were included. ED diagnosis categories, re-admission rates within 30 days and 30-day all-cause mortality were measured. Results In total, 43 248 presentations were identified. The most common ED diagnosis categories were: injury (26.48%), respiratory conditions (14.12%) and cardiovascular conditions (10.74%). Prolonged ED length of stay was associated with higher adjusted hazard ratios for 30-day all-cause mortality after adjustments for age Charlson Comorbidity Index, triage category and diagnosis category (HR 1.10 95% CI 1.05–1.14 P

Objective It has been established that the implementation of patient-reported outcome measures (PROMs) in routine care provides significant benefits to patients, providers and health services. However, there are patient-level barriers that must be identified and addressed for the successful implementation of PROMs. This study aimed to understand the capabilities and preferences of our cancer patient population prior to implementation of electronically collected PROMs (ePROMs). Specifically, we conducted a clinic audit to determine the proportion of patients in clinics with access to out-of-clinic internet; those preferring to complete PROMs on paper or via an electronic device; those capable of completing PROMs in English; and those anticipating requiring assistance to complete PROMs. Methods Patients receiving cancer treatment or follow-up care at two Local Health Districts (LHDs) in New South Wales, Australia, completed a questionnaire (audit form) with items about internet and mobile access, communication preferences and assistance needed to complete PROMs. Participant demographic and treatment information were extracted from their electronic medical records. Results Across both LHDs, 637 of 1668 participants (38%) completed the audit forms. Mean participant age was 65 years (range = 23–98), 53% were female, and 92% were outpatients. Patients in the two LHDs differed in their levels of internet and email access, and ability to complete PROMs independently in English, suggesting that some LHD-specific tailoring of implementation strategies is necessary to optimise ePROMs uptake. Conclusion This study highlights the importance of understanding the specific local contexts and patient populations, including potential technology and language barriers, which can influence patient ability to complete ePROMs.

Climatic cycles have frequently been hypothesised to influence the phylogeography of temperate marine organisms through such factors as hydrological changes and landbridge formation at glacial maxima. However, it is rarely considered whether observed phylogeographic patterns are predominantly influenced by the most recent cycle or those that preceded it. Whether high genetic divergences within intertidal taxa provide an opportunity to investigate such questions is studied here. Three southeastern Australian gastropod taxa that exhibit such divergence were studied, namely, Ascorhis tasmanica, Phallomedusa solida and the regions’ two species of the genus Nerita. Maximum likelihood phylogenetic analyses revealed bootstrap-supported clades within Nerita atramentosa, N. melanotragus and P. solida each of which may have been influenced by climatically induced isolation in previous glacial cycles. These clades are all now very widely distributed within the ranges of their respective species. The loss of variants resulting in the divergence of the haplotypes in the clades may be stochastic but was more likely due to selection, at least for P. solida. Ascorhis tasmanica was revealed to have a comparatively large number of sporadically distributed divergent groups; however, their evolution may have been more influenced by factors other than climate cycles.

Koala retrovirus subtype A is the youngest endogenized retrovirus, providing a unique system to elucidate retroviral-host co-evolution. We characterised KoRV geography using faecal DNA from 192 samples across 20 populations throughout the koala’s range. We reveal an abrupt change in KoRV genetics and incidence at the Victoria/NSW state border. In northern koalas, pol gene copies were ubiquitously present at greater than 5 per-cell, consistent with endogenous KoRV. In southern koalas, pol copies were detected in only 25.8% of koalas and always at copy numbers less than one, while the env gene was detected in all animals and in a majority at copy numbers of greater than one per-cell. These results suggest that southern koalas carry partial endogenous KoRV-like sequences. Deep sequencing of the env hypervariable region revealed three putatively endogenous KoRV-A sequences in northern koalas and a single, distinct sequence present in all southern koalas. Among northern populations, env sequence diversity decreased with distance from the equator, suggesting infectious KoRV-A invaded the koala genome in northern Australia and then spread south. The previously described exogenous KoRV subtypes (B-K), two novel subtypes (L and M), and intermediate or hybrid subtypes were detected in all northern koala populations but strikingly absent from all southern animals tested. Apart from KoRV-D, these exogenous subtypes were generally locally prevalent but geographically restricted, producing KoRV genetic differentiation among northern populations. This suggests that sporadic evolution and local transmission of the exogenous subtypes has occurred within northern Australia, but this has not extended into animals within southern Australia.Author SummaryRetrovirus infection is generally synonymous with disease; however, retroviruses can also become endogenous (incorporated into the germline) and thereby directly contribute to the genetic makeup of a species. This has occurred in all vertebrates, yet little is known about the endogenization process. As the youngest virus known to be endogenized, koala retrovirus (KoRV) offers a unique opportunity to study these early stages of co-evolution. This study reveals a comprehensive picture of KoRV biogeography that informs our understanding of how host population history, host suppression and transmission dynamics can influence retroviral evolution. KoRV is also associated with chlamydiosis and neoplasia in the vulnerable koala. Our improved understanding of how KoRV variants are distributed should guide conservation management to help limit disease.

During a mouse plague in early 2021, a farmer from New South Wales, Australia, sought treatment for aseptic meningitis and was subsequently diagnosed with locally acquired lymphocytic choriomeningitis virus infection. Whole-genome sequencing identified a divergent and geographically distinct lymphocytic choriomeningitis virus strain compared with other published sequences.

The aim of the study is to examine common approaches to pre-school vision screening, including the current New South Wales model which is known as Statewide Eyesight Preschooler Screening (StEPS) to determine whether the criteria set by the World Health Organization are fulfilled by StEPS, and therefore, whether there is sufficient justification to deploy a similar model nationally. A literature review was conducted to answer four key questions related to vision screening. The authors sought to review (i) the justification for vision screening of a pre-school population; (ii) the principles and best approaches to vision screening such as how, where and who should conduct vision screening; (iii) the conditions that are targeted in vision screening; and (iv) the acceptable pass/fail vision screening criteria. The StEPS vision screening model is an accurate, reliable and economical way of screening for reduced vision at a time when neural plasticity allows improvement in vision following intervention. It fulfils World Health Organization criteria for a successful screening programme. StEPS has very high participation rates compared to other screening methods in Australia due to its unique model whereby screeners utilise early childhood settings to recruit and screen 4-year-old children. Due consideration should be given to deploying the StEPS vision screening model nationally.

To describe on-scene times for out-of-hospital cardiac arrests (OHCA) transferred to hospital, the number of these that were extracorporeal cardiopulmonary resuscitation (ECPR) eligible and potential association between end-tidal carbon dioxide (ETCOProspective cohort study of all OHCA, of suspected medical cause, where resuscitation was commenced and who were transported to participating hospitals from October 2020 to May 2021.One hundred and forty-nine OHCA were included. Forty-four (30%) patients survived to hospital discharge. Eighteen (8%) met ECPR inclusion criteria. Median on-scene time was 33 min (interquartile range [IQR] 24-44). Initial hospital ETCOAverage on-scene time did not differ on survivorship. A small number of transferred patients with OHCA were ECPR eligible. ETCO

Several vaccine candidates for control of the Coronavirus disease 19 (COVID19) are in phase three trials, with some being approved in different countries. A limited initial supply of vaccine doses is likely in most countries, and will require a judicious vaccination strategy to be developed until supply is unlimited. Vaccines may be effective as post-exposure prophylaxis (PEP) in contacts, but no data are yet available for COVID19 vaccines. If vaccines do have efficacy as PEP, this provides more options for strategies with limited supply. We simulated an epidemic response with limited supply (targeted or ring vaccination) and mass vaccination for the State of New South Wales (NSW) in Australia. For targeted vaccination, the effectiveness of vaccinating young adults was compared to older adults. For mass vaccination, we tested outcomes for varying vaccine efficacy and distribution capacities, and for ring vaccination, we tested different contacts tracing rates. With a limited vaccine stockpile of 1 million doses in NSW, if there is efficacy as PEP, the most efficient way to control COVID19 will be ring vaccination, however at least 90% of contacts per case needs to be traced and vaccinated. Age based strategies make minimal impact on the epidemic due to low coverage rates, but vaccinating older people prevents more deaths. Herd immunity and interruption of community transmission can only be achieved with mass vaccination using a high efficacy vaccine. With a 90% efficacy, herd immunity can be achieved by vaccinating 73% of the population. If the vaccine stockpile is unlimited, distributing at least 60,000 doses per day is required to achieve herd immunity. Slower rates of vaccination will result in the population living with COVID19 longer, and higher cases and deaths.

Hemorrhage is a leading cause of preventable death in trauma. Prehospital medical teams can streamline access to massive transfusion and definitive hemorrhage control by alerting in-hospital trauma teams of suspected life-threatening bleeding in unstable patients. This study reports the initial experience of an Australian "Code Crimson" (CC) pathway facilitating early multidisciplinary care for these patients.This data-linkage study combined prehospital databases with a trauma registry of patients with an Injury Severity Score greater than 12 between 2017 and 2019. Four groups were created; prehospital CC activation with and without in-hospital links and patients with inpatient treatment consistent with CC, without one being activated. Diagnostic accuracy was estimated using capture-recapture methodology to replace the missing cell (no prehospital CC and Injury Severity Score12).Of 72 prehospital CC patients, 50 were linked with hospital data. Of 154 potentially missed patients, 42 had a prehospital link. Most CC patients were young men who sustained blunt trauma and required more prehospital interventions than non-CC patients. Code Crimson patients had more multisystem trauma, especially complex thoracic injuries (80%), while missed CC patients more frequently had single organ injuries (59%). Code Crimson patients required fewer hemorrhage control procedures (60% vs. 86%). Lower mortality was observed in CC patients despite greater hospital and intensive care unit length of stay. Despite a low sensitivity (0.49; 95% confidence interval [CI], 0.38-0.61) and good specificity (0.92; 95% CI, 0.86-0.96), the positive likelihood ratio was acceptable (6.42; 95% CI, 3.30-12.48).The initiation of a statewide CC process was highly specific for the need for hemorrhage control intervention in hospital, but further work is required to improve the sensitivity of prehospital activation. Patients who had a CC activation sustained more multisystem trauma but had lower mortality than those who did not. These results guide measures to improve this pathway.Therapeutic/Care Management; Level IV.

Background Digital proximity tracing apps were rolled out early in the COVID-19 pandemic in many countries to complement conventional contact tracing. Empirical evidence about their benefits for pandemic response remains scarce. We evaluated the effectiveness and usefulness of COVIDSafe, Australia's national smartphone-based proximity tracing app for COVID-19. Methods In this prospective study, done in New South Wales (NSW), Australia, we included all individuals in the state who were older than 12 years with confirmed, locally acquired SARS-CoV-2 infection between May 4 and Nov 4, 2020. We used data from the NSW Notifiable Conditions Information Management System, the national COVIDSafe database, and information from case interviews, including information on app usage, the number of app-suggested contacts, and the number of app-suggested contacts determined by public health staff to be actual close contacts. We calculated the positive predictive value and sensitivity of COVIDSafe, its additional contact yield, and the number of averted public exposure events. Semi-structured interviews with public health staff were done to assess the app's perceived usefulness. Findings There were 619 confirmed COVID-19 cases with more than 25 300 close contacts identified by conventional contact tracing during the study period. COVIDSafe was used by 137 (22%) cases and detected 205 contacts, 79 (39%) of whom met the close contact definition. Its positive predictive value was therefore 39%. 35 (15%) of the 236 close contacts who could have been expected to have been using the app during the study period were identified by the app, making its estimated sensitivity 15%. 79 (0·3%) of the estimated 25 300 contacts in NSW were app-suggested and met the close contact definition. The app detected 17 (

The Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y.) program is an immersive hospital-based education program designed to reduce trauma in adolescents. The efficacy of the program in reducing risk-taking attitudes and preventing traumatic injuries has been proven through various methodologies. However, there is currently no study that has investigated the efficacy of the program using a validated, multi-domain questionnaire. This study outlines the design of the P.A.R.T.Y. Program Questionnaire (PPQ) and validates it through examining its construct and criterion validity as well as its internal consistency. Its capacity to risk-stratify participants was compared against the RT-18, a robust, 18-item risk-profiling instrument. The PPQ and the RT-18 were completed by New South Wales school students (N = 458) aged 15 to 18. The PPQ was designed in consultation with relevant field experts to optimise engagement and sensitivity. Examination of the construct validity of the PPQ was performed through exploratory factor analysis which demonstrated the presence of two underlying factors which aligned with the constructed two-scenario questionnaire format. The PPQ was shown to be internally consistent with a Cronbach's alpha of 0.77. Individual scenarios were shown to be internally consistent as well (α = 0.69, α = 0.66). The PPQ also identified high risk and low risk participants effectively as demonstrated by comparison against the risk stratification performed with the RT-18 (p-value0.001). This suggests the PPQ demonstrates criterion validity. Hence, the PPQ is an effective and valid tool for assessing risk-taking attitudes in adolescent populations.

Background Following the introduction of the emergency department (ED) primary contact physiotherapy role, emergency physiotherapy models of care have evolved and are increasingly being adopted in the Australian EDs. This has occurred due to growing ED patient demand and a need for greater workforce flexibility. Since introduction, there has been limited evaluation of the scope of work physiotherapists are providing in Australian EDs. Objectives To identify the activities of ED physiotherapists provided through different models of care in NSW. Methods Prospective observation study in 19 participating EDs conducted over 6 months between September 2014 and April 2015. Results The study identified different models of care across participating hospitals where physiotherapists worked independently or in conjunction with a team through a referral service. The individual’s scope of work was determined by organisational policy, culture, individual competence, knowledge and skills, and varied significantly between sites. Conclusions These findings could guide both ED work flow and the development of multidisciplinary workforce structures to improve the utilisation of the physiotherapy service in EDs. This will allow for better service levels in hospitals, better access for patients and better use of resources.

People living with HIV (PLHIV) are a priority population to receive hepatitis C virus (HCV) screening and treatment. We aimed to characterize the HCV care cascade among PLHIV between 2010 and 2018 and to compare HCV testing and treatment uptake pre- and post-availability of direct-acting antivirals (DAAs) in New South Wales (NSW), Australia. Records of all HCV notifications (1993-2017) were linked to HIV notifications, deaths, hospitalizations, incarcerations, opioid agonist therapy, HCV RNA testing and treatment databases. Numbers and proportions were calculated for all stages of the care cascade and factors associated with HCV testing, and DAA treatment uptake were evaluated using logistic regression. From 383 individuals with HCV notification (2009-2017), 349 (91%) were ever HCV RNA tested, 285 (74%) had an indicator of chronic HCV infection, and from those eligible for treatment, 210 (74%) received HCV treatment. HCV testing was recorded for 85% pre-DAA era and reached a cumulative proportion of 90% post-DAA while treatment uptake had a 10-fold increase from 7% pre- to 73% post-DAA era. Younger age (adjusted odds ratio [aOR] 0.98; 95% CI 0.96-0.99), female gender (aOR 1.87; 95% CI 1.10-3.19), and rural region residence at notification (aOR 1.56; 95% CI 1.03-2.36) were associated with not receiving HCV testing. No identified factor was associated with not receiving treatment post-DAA era. Removing barriers to HCV testing, expanding treatment to a variety of settings and continuous education and harm reduction are essential to achieve HCV elimination among PLHIV in Australia.

Many rural communities in New South Wales (NSW), Australia, have poor-quality water supplies. The lack of a palatable alternative increases the risk of the high consumption of sugar-sweetened beverages, a significant contributor to adverse health outcomes. This disproportionately effects Aboriginal people living in these towns, who are also profoundly affected by the social determinants of health. Therefore, examining health inequalities linked to water access is important. This study investigated the availability of drinking water fountains in rural and remote communities in NSW. Telephone interviewer-assisted surveys were conducted with 32 representatives from local government councils or Local Aboriginal Land Councils in NSW from communities with a population of

To investigate if positive changes in the clinical performance of radiologists are associated with reading mammographic test sets.This study investigated the clinical audit history for a cohort of 39 participants in the BreastScreen Reader Assessment Strategy who have read for BreastScreen New South Wales in the period between 2010 and 2018, inclusively. Based on the year in which each radiologist completed his or her first test set, data of multiple clinical audit metrics from two calendar years before test-set reading were compared against similar data from three different periods after test-set completion. The same process was repeated after dividing radiologists into two subgroups based on their median screen-reading volume (3,688), to test if experience is a determinant of post-test set performance.On average, radiologists showed significant improvements (p0.05) in the recall rate for subsequent screening rounds, in positive predictive value 1 (PPV1), and in specificity. When dividing radiologists based on their average annual reading volume, radiologists with higher reading numbers demonstrated similar significant improvements in the recall rate and in PPV1. In addition, they showed significant improvements in the detection rates of invasive breast cancer and ductal carcinoma in situ (DCIS). In contrast, the radiologists with lower reading volume indicated significant changes in the recall rate and in PPV1, both accruing in one of the three compared periods.Mammographic test-set participants improve over time in identifying normal breast screens and detecting breast cancer in association with reading higher volumes of breast screening cases.

BACKGROUND In 2018, an innovative, State government funded cannabis medicines drug information service was established for health professionals in New South Wales (NSW). The NSW Cannabis Medicines Advisory Service (CMAS) provides expert clinical guidance and support to medical practitioners considering prescribing a cannabis medicine to their patient(s). AIMS This research examines quality assurance and patient outcomes related to enquirers' experience with NSW CMAS. METHODS Data collection involved an online, anonymous survey with two components. Following a health professional enquiry, quality assurance data was collected about the enquirers' experience with NSW CMAS. The second survey focused on patient outcomes and provides real-world observational data about cannabis medicines safety and effectiveness across a wide range of indications. RESULTS Data collection occurred between January 2020 and June 2021. Preliminary analyses were based on 68 quality assurance and 50 patient outcomes survey responses. General practitioners represented the highest proportion of survey responses (n = 33, 49%). The most common enquiry involved 'patient-specific advice' (n = 50, 74%). Patient-specific information provided by the service was mainly used for prescribing decision support (n = 45, 90%). CONCLUSIONS Preliminary findings highlight the impact of an innovative cannabis medicines drug information service in supporting health professional clinical practice in an area of rapid knowledge translation. Quality assurance data indicates that the service is perceived well by the majority of enquirers. Patient outcomes data across a wide range of indications suggest some effectiveness and a reasonable safety profile for prescribed cannabis medicines for most patients. This article is protected by copyright. All rights reserved.

Our study measures the impact of diagnosing cancers early before they metastasise on reducing the burden of cancer death. A cohort of 716 501 people aged 15 to 89 years diagnosed with a solid cancer in New South Wales, Australia, during 1985 to 2014 were followed-up to December 2015. Crude probabilities of cancer death by stage at diagnosis were calculated for all solid cancers combined and five individual cancers using flexible parametric relative survival models. These probabilities were used to estimate the number of avoided cancer deaths within 10 years of diagnosis in three 10-year diagnostic periods if all cases with known distant stage were instead diagnosed at an earlier stage. Cancers are known to be diagnosed at distant stage composed ~16% of all solid cancers diagnosed during 2005 to 2014. Assuming all these cases were instead diagnosed at regional stage, an annual average of 2064 cancer deaths would have been potentially avoided within 10 years of diagnosis. This equated to ~21% of modelled observed deaths. Alternatively, if half of all known distant cases diagnosed during 2005 to 2014 were diagnosed as regional and half as localised, the average number of deaths avoided per year would increase to 2677 (~28%). Estimates varied by diagnostic period, sex and cancer type, reflecting both the different stage distributions for the cancer types, and the respective survival differences between cancer stages. While prevention is the most effective pillar of cancer control, these findings quantify the potential benefits of diagnosing all cancer types when they are less advanced to reduce the burden of cancer mortality.

BACKGROUND: Timely definitive paediatric trauma care influences patient and parental physical and emotional outcomes. New South Wales (NSW) covers a large geographical area with all three NSW paediatric trauma centres (PTC) located in two approximated major cities, meaning it is inevitable that some injured children receive initial treatment locally and then require transfer. Little is known about the factors that then impact timely arrival of injured children to definitive care. METHODS: This included children admitted between July 2015 and September 2016, 2) between transferred and directly transported cohorts. There were significant differences in mechanism of injury between the two groups (χ2(9) = 45.9, p < 0.001). The median (IQR) time to book a transfer from arrival at the referring facility, was 146.5 (86-238) minutes. Time from injury to arrival at the PTC more than doubled for children transferred, with significant and unwarranted variability between transporting agencies resulting in unwarranted delays to surgical intervention. For example, time spent at the referring facility by Aeromedical Retrieval Service was less than half that of the Newborn & paediatric Emergency Transport Service [53 (IQR:47-61) vs 115 (84-155) minutes (p

The Plough and Harrow Inn at 75-79 Argyle Street is the second oldest hotel in Camden and is still on the original site. The Camden Inn (1841) was the first hotel in Camden. Located on the Great South Road, the Plough and Harrow was part of the fabric of Macarthur's private village of Camden within the Cowpastures. By the early 20th century, travellers who arrived at the inn were moving down the Hume Highway, renamed from the Great South Road in 1928, with increased motorised traffic.

The Camden township is located 65 kilometres southwest of the Sydney CBD and, in recent years, has been absorbed by Sydney's urban growth. The main streets are a mix of Victorian, Edwardian and interwar architecture comprising commercial, government and domestic buildings. The town site was originally the entry point into what became Governor King's Cowpasture Reserve at the Nepean River crossing, part of the lands of the Dharawal people, which then called Benkennie. Jill Wheeler argues that while local histories are embedded in a long storytelling tradition, new understandings inform our interpretation in a contemporary context. This article seeks to examine some of what Wheeler calls 'the other' by looking beyond the conventional history of Camden as found in newspapers, journals, monuments, celebrations, commemorations and other places. It explores how Camden's history-making has been constructed and represented over time.

The humble fibro cottage in Camden in the 1950s and 1960s is integral to the town's 20th-century history. The fibro house was representative of the baby-boomer era when drive-ins, Holdens, Chiko rolls, black & white TV, rock & roll and vinyl LPs were the norm. Fibro is evocative of long hot summer holidays by the beach with adolescent love, boogie boards, zinc cream and paddle pops.

In central Camden is an empty bank building of understated significance at the intersection of John and Argyle Streets. This building was once the premises of Westpace, formerly the Bank of New South Wales, and was the second banking chamber on that site. Constructed in the 1930s by a prominent firm of Sydney architects, the building is of much architectural merit, but few know its history.

This thesis examines how the problematisation of sexual offending and contemporary constructions of ‘sex offenders’ have impacted on the emergence of technologies to govern known perpetrators living in the NSW community. Mechanisms include a sex offender register; extended supervision and continuing detention orders; restrictions on residency, movement and association; and intrusive surveillance. By means of a genealogical analysis, and a multi-method research design, it examines the incidents, actors, claims and rationalities that have influenced the emergence of an extensive and exceptional post-sentence governance regime aimed at community protection. It draws on the perceptions of 21 stakeholders (including psychiatrists, psychologists, lawyers, and volunteers who work with sex offenders) about the introduction, operation and impacts of the contemporary NSW post-sentence governance framework. It analyses participants’ views about monitoring and supervision of offenders, as well as the provision of treatment, support, and assistance to them. This thesis demonstrates that in NSW exclusionary, incapacitating crime control measures have been pursued with the aim of preventing sexual (re)offending, and that more inclusive, capacity-building mechanisms have been marginalised. This has occurred despite a lack of evidence that measures which rely on strictly enforced external controls reduce recidivism and mounting evidence that such approaches act as barriers to reintegration and desistance. This thesis finds the emergence of contemporary approaches has been influenced by a lack of understanding of the empirical realities of sexual offending; extremely negative (mis)perceptions about perpetrators; and the particular way that risk has been conceptualised in relation to sexual (re)offending. While tools to assess and manage the risks posed by sex offenders are imbued with an actuarial, impersonal and seemingly objective logic; risk assessment and management has also been underpinned by highly emotional and moralising discourse and perennial panic. These factors have rendered sex offenders exceptionally high-risk, both deserving and in need of exceptional governance measures. This thesis suggests that shifts in the NSW governance framework to reduce sexual (re)offending and enhance community safety are possible. However, this will require enhanced understanding and education about the realities of sexual offending and the factors that support desistance, and a reconfiguration of the extant risk-paradigm.

Nineteen new species of Karaops are described: K. durrantorum sp. nov. (♂), K. morganoconnelli sp. nov. (♀♂), K. joehaeneri sp. nov. (♀), K. dalmanyi sp. nov. (♀♂), K. garyodwyeri sp. nov. (♂), K. dejongi sp. nov. (♀♂), K. malumbu sp. nov. (♀♂), K. conilurus sp. nov. (♂), K. yumbubaarnji sp. nov. (♀♂), K. markharveyi sp. nov. (♀♂), K. nitmiluk sp. nov. (♀), K. kennerleyorum sp. nov. (♂), K. jawayway sp. nov. (♀), K. mparntwe sp. nov. (♀), K. larapinta sp. nov. (♀), K. kwartatuma sp. nov. (♂), K. madhawundu sp. nov. (♀), and K. mareeba sp. nov. (♀). The male of K. umiida Crews, 2013 was found to be misidentified and is now K. conilurus sp. nov. Karaops yindjibarndi syn. nov. is a new synonym of K. nyiyaparli. Selenops australiensis L. Koch, 1875 is considered a nomen dubium because the holotype is an immature male, and the species previously referred to as K. australiensis (L. Koch, 1875) is here described as K. strayamate sp. nov. (♀♂). The males of K. marrayagong Crews & Harvey, 2011 and K. banyjima Crews, 2013 are described for the first time. To manage the growing diversity of the genus, most of the species have been placed in species groups, which are diagnosed. They are the Central Desert group, the strayamate group, the raveni group, the dawara group, the francesae group, the Kimberley group, and the Pilbara-Gascoyne group. New keys are provided to accommodate the new species, and new distribution maps and new records are provided for all species. Diagnoses and descriptions are emended where required. Images of live spiders, many not previously seen alive, and natural history information are also provided.

The Burragorang Valley is one of those lost places that people fondly remember from the past. A place of imagination and dreaming where former residents fondly re-tell stories from their youth. These places create potent memories and nostalgia for many people and continue to be places of interest. They are localities of myths and legends and imminent danger, yet at the same time, places of incredible beauty.

The story of European settlement in the Cowpastures is intimately connected to the story of the convicts and their masters. This story has not been told, and there is little understanding of the role of the convicts in the Cowpastures district before 1840. Who were they? What did they do? Did they stay in the district?

Camden War Cemetery is located on the corner of Burragorang and Cawdor Roads, three kilometres south of the Camden Post Office. The cemetery is on a slight rise above the Nepean River floodplain, with a northerly aspect at an elevation of 75 metres. The cemetery contains the graves of 17 Royal Australian Air Force servicemen, four army personnel and two Royal Air Force servicemen.

Public art at Campbelltown has been used to lift and invigorate run-down parts of the city centre. The City Council has commissioned murals to brighten otherwise dull streets and laneways. The city has effectively adopted the definition of public art from the Australian Centre for Contemporary Art. This position states that public art is 'an artwork in any medium, planned and executed outside a gallery context and intended specifically for exhibition within public space.’

In the 1890s, Camden Municipal Council started beautifying the town area by planting various trees, including peppercorns. These cultural plantings defined the local urban landscape for decades, yet only a handful remain today.