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Introduction: Population-level, nationally representative data on the prevalence of minority stressors and traumatic events, mental ill-health effects, and the preventative utility of school climate, among gender and sexuality diverse young people in Australia, is significantly lacking. In this study, we estimated the prevalence and distribution of minority stressors and traumatic events among young people by sexuality identity (gay/lesbian, bisexual, other sexuality, heterosexual), sexuality diversity (sexuality diverse, not sexuality diverse), and gender identity (transgender, cisgender) and assessed associations with mental ill-health and the moderating role of school climate factors., Methods: Using Wave 8 (2018) follow-up data from a population-level, nationally representative longitudinal cohort study, the sample comprised 3037 young people aged 17-19 years in Australia. Prevalence ratios for minority stressors and traumatic events were calculated for gender and sexuality diverse categories using logistic regression models. Linear regression models were used to test associations between traumatic events and minority stressors, and mental ill-health. Multivariate linear regression tested school climate factors as effect modifier between minority stressors and mental ill-health among sexuality diverse young people., Results: Rates of traumatic events and minority stressors were highest among bisexual and gay/lesbian young people and were significantly associated with mental ill-health among all gender and sexuality diverse young people. Highest mental ill-health effects were observed among trans young people. Among sexuality diverse young people, positive and negative feelings toward school climate were associated with decreased and increased mental ill-health, respectively. After accounting for sexuality diversity, positive overall school climate appeared protective of mental ill-health effects of sexuality-based discrimination., Discussion: Minority stressors, traumatic events, and associated mental ill-health are prevalent among gender and sexuality diverse young people in Australia, especially trans, bisexual, and gay/lesbian young people. Promotion of affirmative, safe, and inclusive school climate demonstrates significant promise for the prevention and early intervention of mental ill-health among gender and sexuality diverse young people., (© 2023 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.)

Introduction: Adolescents report using digital technologies for emotion regulation (digital ER), with the aim of feeling better (i.e., improving emotions and reducing loneliness). In this 7-day diary study, we investigated associations of digital ER, emotions, and loneliness, and tested whether prior emotional problems moderated these associations., Method: Participants were 312 Australian adolescents (M age  = 13.91, SD = 1.52; 44% boys). Daily surveys measured digital ER; end-of-day happiness, sadness, worry, anger, and loneliness; and peak sadness, worry, and anger. End-of day emotions were subtracted from peak emotions to calculate emotion recovery for sadness, worry, and anger. Participants were randomly selected from two symptom strata (high/low) defined by depression and social anxiety measures collected before the diary. Data were analyzed using multilevel path modeling. Cross-level interactions tested whether symptom strata moderated associations., Results: Digital ER was associated with more recovery from peak to end-of-day sadness and worry, but also with increased sadness, worry, anger, and loneliness by the next end-of-day. Higher end-of-day loneliness was associated with increased next-day digital ER. Prior emotional symptoms were not a significant moderator of daily digital ER and emotion associations., Conclusion: Adolescents who report more digital ER in a day show more recovery from the peak of negative emotion that day, but this recovery dissipates, with digital ER also associated with increased negative emotion and loneliness by the next day for all adolescents, regardless of prior symptom status. Lonelier adolescents use more digital ER by the next day, suggesting they need support to make social connections-online or offline., (© 2023 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.)

This research investigated the in-situ decay rates of four human wastewater-associated markers (Bacteroides HF183 (HF183), Lachnospiraceae Lachno3 (Lachno3), cross-assembling phage (crAssphage), pepper mild mottle virus (PMMoV) and three enteric viruses (human adenovirus 40/41 (HAdV 40/41), enterovirus (EV) and human norovirus GII (HNoV GII) in two estuarine water environments (Davidson Park (DP) and Hen and Chicken Bay (HCB) in temperate Sydney, NSW, Australia, employing qPCR and RT-qPCR assays. The study also aimed to compare decay rates observed in mesocosms with previously published laboratory microcosms, providing insights into the persistence of markers and viruses in estuarine environments. Results indicated varying decay rates between DP and HCB mesocosms, with HF183 exhibiting relatively faster decay rates compared to other markers and enteric viruses in sunlight and dark mesocosms. In DP mesocosms, HF183 decayed the fastest, contrasting with PMMoV, which exhibited the slowest. Sunlight induced higher decay rates for all markers and viruses in DP mesocosms. In HCB sunlight mesocosms, HF183 nucleic acid decayed most rapidly compared to other markers and enteric viruses. In dark mesocosms, crAssphage showed the fastest decay, while PMMoV decayed at the slowest rate in both sunlight and dark mesocosms. Comparisons with laboratory microcosms revealed faster decay of markers and enteric viruses in laboratory microcosms than the mesocosms, except for crAssphage and HAdV 40/41 in dark, and PMMoV in sunlight mesocosms. The study concludes that decay rates of markers and enteric viruses vary between estuarine mesocosms, emphasizing the impact of sunlight exposure, which was potentially influenced by the elevated turbidity at HCB estuarine waters. The generated decay rates contribute valuable insights for establishing site-specific risk-based thresholds of human wastewater-associated markers., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Wastewater treatment plants (WWTPs) have been recognized as secondary sources of per- and polyfluoroalkyl substances (PFAS) released into the environment. In this study, PFAS concentrations were measured in effluent and biosolids samples collected from 75 WWTPs across Australia during the 2016 Census period, which covers more than half of the Australian population. Twelve PFAS compounds, including six C5-C10 perfluoroalkyl carboxylic acids (PFCAs), four perfluoro sulfonic acids (PFSAs) such as perfluorobutane sulfonate (PFBS), perfuorohexane sulfonic (PFHxS), perfluorooctane sulfonic acid (PFOS), and perfluorodecane sulfonic acid (PFDS), and one fluorotelomer sulfonic acid (6:2 FTS), were detected in the effluent, with concentrations up to 504 ng/L (PFHxS). Among these, perfluorooctanoic acid (PFOA), perfluorohexanoic acid (PFHxA), and perfluoropentanic acid (PFPeA) exhibited the highest median concentrations. In the biosolids, a total of 21 PFAS compounds were detected, encompassing ten C4-C14 PFCAs, four PFSAs, two FTS (6:2 and 8:2 FTS), perfluorooctane sulfonamide (PFOSA), two perfluorooctane sulfonamido acetic acid (NMethyl FOSAA and NEthyl FOSAA), and two perfluorooctane sulfonamido ethanol (FOSE), with dry weight (dw) concentrations approaching 235 ng/g (PFOS). The highest median and mean concentrations were observed for perfluorodecanoic acid (PFDA) and PFOS. An annual discharge of approximately 250 kg of the total 21 PFAS compounds was estimated through the effluent and biosolids of the participating WWTPs. Notably, PFOS and 6:2 FTS constituted the largest proportion of total PFAS in the WWTPs' output. While PFCAs were higher in effluent concentrations compared to influent levels across most WWTPs (92% of WWTPs for ∑ 8 PFCAs), the concentrations of PFSAs either decreased or remained relatively stable (in 80% of WWTPs for ∑ 4 PFSAs) throughout the wastewater treatment process., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Australia, characterized by extensive and heterogeneous terrestrial ecosystems, plays a critical role in the global carbon cycle and in efforts to mitigate climate change. Prior research has quantified vegetation productivity and carbon balance within the Australian context over preceding decades. Nonetheless, the responses of vegetation and carbon dynamics to the evolving phenomena of climate change and escalating concentrations of atmospheric carbon dioxide remain ambiguous within the Australian landscape. Here, we used LPJ-GUESS model to assess the impacts of climate change on Gross Primary Productivity (GPP) and Net Biome Productivity (NBP) of carbon for the state of New South Wales (NSW) in southeastern Australia. LPJ-GUESS simulations were driven by an ensemble of 27 global climate models under different emission scenarios. We investigated the change of GPP for different vegetation types and whether NSW ecosystems will be a net sink or source of carbon under climate change. We found that LPJ-GUESS successfully simulated GPP for the period 2003-2021, demonstrating a comparative performance with GPP derived from upscaled eddy covariance fluxes (R 2  = 0.58, nRMSE = 14.2 %). The simulated NBP showed a larger interannual variation compared with flux data and other inversion products but could capture the timing of rainfall-driven carbon sink and source variations in 2015-2020. GPP would increase by 10.3-19.5 % under a medium emission scenario and 19.7-46.8 % under a high emission scenario. The mean probability of NSW acting as a carbon sink in the future showed a small decrease with a large uncertainty with >8 of the 27 climate models indicating an increased potential for carbon sink. These findings emphasize the significance of emission scenarios in shaping future carbon dynamics but also highlight considerable uncertainties stemming from different climate projections. Our study represents a baseline for understanding natural ecosystem dynamics and their key role in governing land carbon uptake and storage in Australia., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Bioaccessibility and relative bioavailability of As, Cd, Pb and Sb was investigated in 30 legacy gold mining wastes (calcine sands, grey battery sands, tailings) from Victorian goldfields (Australia). Pseudo-total As concentration in 29 samples was 1.45-148-fold higher than the residential soil guidance value (100 mg/kg) while Cd and Pb concentrations in calcine sands were up to 2.4-fold and 30.1-fold higher than the corresponding guidance value (Cd: 20 mg/kg and Pb: 300 mg/kg). Five calcine sands exhibited elevated Sb (31.9-5983 mg/kg), although an Australian soil guidance value is currently unavailable. Arsenic bioaccessibility (n = 30) and relative bioavailability (RBA; n = 8) ranged from 6.10-77.6% and 10.3-52.9% respectively. Samples containing > 50% arsenopyrite/scorodite showed low As bioaccessibility (<20.0%) and RBA (<15.0%). Co-contaminant RBA was assessed in 4 calcine sands; Pb RBA ranged from 73.7-119% with high Pb RBA associated with organic and mineral sorbed Pb and, lower Pb RBA observed in samples containing plumbojarosite. In contrast, Cd RBA ranged from 55.0-67.0%, while Sb RBA was < 5%. This study highlights the importance of using multiple lines of evidence during exposure assessment and provides valuable baseline data for co-contaminants associated with legacy gold mining activities., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare that generative artificial intelligence (AI) and AI-assisted technologies were not used in the writing process or any other process during the preparation of this manuscript., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Turtles are a potential sentinel species of aquatic ecosystem health as they inhabit aquatic ecosystems, are long lived, and potentially have high exposure to anthropogenic chemicals via food and water. This study investigated per- and polyfluoroalkyl substances (PFAS) tissue partitioning in female Emydura macquarii macquarii turtle, and the maternal offloading of (PFAS) into eggs and then hatchlings as well as the accumulation of PFAS in male and female Emydura macquarii macquarii serum. Significantly higher levels of perfluorosulfonic acids (PFSAs) and perfluorocarboxylic acids (PFCAs) were measured in the male serum compared to the female turtle serum, whereas perfluoroalkane sulfonamides (FASAs) were significantly higher in the female turtle serum. Perfluorooctane sulfonate (PFOS) was the predominant PFAS in the turtles whereas PFHxA was the predominant PFAS found in the surrounding water. PFHxA was not reported in any turtle tissue or the serum. The short-chain PFSAs and FASAs appeared to be highly associated with blood; long-chain PFSAs and PFCAs were more likely to be associated with tissue. Half of the PFHxS and all the long-chain PFSAs and PFCAs reported in the yolks were transferred into the hatchlings (by mass), suggesting a potential intergenerational effect., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)

Although saltmarshes are critical coastal ecosystems they are threatened by human activities and sea-level rise (SLR). Long-term restoration and management strategies are often hampered by an insufficient understanding of the past, present, and future processes that influence tidal wetland functionality and change. As understanding vegetation distribution in relation to elevation and tidal hydroperiod is often the basis of restoration and management decisions, this study investigated the relationships between micro-topography, tidal hydroperiod, and the distribution of saltmarshes, mangroves, and unvegetated flats in a tropical estuary situated within a Great Barrier Reef Catchment in North Queensland, Australia. A combination of high-resolution unattended-aerial-vehicle (UAV)-derived digital elevation model (DEMs) and land cover coupled with 2D hydrodynamic modelling was used to investigate these aspects. Zonation was more complex than generally recognised in restoration and legislation, with overlapping distribution across elevation. Additionally, although each type of tidal wetland cover had distinct mean hydroperiods, and elevation and hydroperiods were strongly correlated, elevation explained only 15% of the variability in tidal wetland cover distribution. This suggests that other factors (e.g., groundwater dynamics) likely contribute to tidal wetland cover zonation patterns. These findings underline that simplistic rules in the causality of tidal wetlands need to be applied with caution. Their applicability in management and restoration are likely to vary depending on contexts, as observed in our study site, with varying environmental and biological factors playing important roles in the distribution patterns of tidal wetland components. We also identified strong monthly variability in tidal hydroperiods and connectivity experienced by each tidal wetland cover (e.g., 10.26% of succulent saltmarshes were inundated during lower-than-average tides compared to 66% in higher than-average tides), highlighting the importance of integrating temporal dynamics in tidal wetland research and management. Additionally, we explored the potential effects of sea-level rise (SLR) on the tidal hydroperiods and connectivity of our study site. The results show that the inundation experienced by each tidal wetland cover may increase importantly if vegetation does not keep up with SLR (e.g., under a 0.8 m sea level scenarios, mean maximum depth of succulent saltmarsh in higher-than-average tides is 184.1 mm higher than the current mean-maximum inundation depth of mangroves). This underlines the importance of acquiring detailed spatio-temporally resolved data to enable the development of robust long-term and adaptive saltmarsh management strategies. Our results are discussed from a management and restoration perspective. We highlight the uncertainties and complexities in understanding the processes influencing tidal wetland functionality, and hence, their management and restoration prospects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Moral distress is a phenomena that occurs following a compromise to moral beliefs. Moral distress has been reported across health professions, including midwifery. Although there are validated tools to assess for moral distress, none have been identified that suit the Australian healthcare system or midwifery., Aim: The aim of this study was to pilot the Barometer of Moral Distress in Midwifery., Methods: This study was the fourth stage of a mixed method project. Using a cross-sectional approach, a survey tool including demographic questions, the Barometer of Moral Distress in Midwifery, and the Copenhagen Burnout Inventory assessed tool stability, reliability, and validity., Findings: A total of 103 surveys were completed. A test-retest demonstrated tool reliability and stability (a =.97). Factor analysis confirmed internal consistency; Factor 1 - Professional Identity (a=.91), Factor 2 - Inadequate Resources (a=.85), and Factor 3 - Unethical Cultures (a=.88). Concurrent validity was demonstrated through positive correlations between self-reported types of moral distress with mean scores for each Factor. Strong correlations were identified between work-related burnout and mean scores, while only weak correlations were noted between client-related burnout and mean scores. Only Factor 1 demonstrated a correlation between leaving the profession and mean scores., Discussion/conclusion: This was the first moral distress tool that assessed both frequency of exposure and psychological outcomes to score moral distress. Findings indicate that moral distress in midwifery is not associated with caring work but with occupational environments. Further research is required to assess self-sacrifice in moral distress., Competing Interests: Conflicts of interest Conflicts of interest to be declared include Professor Linda Sweet who is Deputy Editor for Women and Birth and Associate Professor Lois McKellar who is on the editorial board. Neither had have any part in the review process of this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Optimising the management of vancomycin by achieving target therapeutic concentrations early during therapy has been associated with reduced mortality and morbidity. Despite the availability of guidelines and training, the management of vancomycin remains suboptimal., Objectives: The primary outcome was the development of interventions and associated implementation strategies to optimise the management of vancomycin therapy. This paper describes how co-design process was used to build a theory informed intervention package, which was implemented across a wide range of in-patient hospital settings in Queensland, Australia., Methods: This multiple methods study was conducted in four phases: 1) a baseline audit to identify the nature of the problem and associated determinants informed by stakeholder interviews 2) mapping these findings to the Theoretical Domains Framework (TDF) to identify behavioural correlates and modifiers 3) prioritising the behavioural modifiers and associated implementation strategies to inform a protype of the intervention in a series of co-design sessions and 4) implementing and evaluating the intervention package. The study was conducted across the four teaching hospitals in a large Queensland Hospital and Health Service across multiple healthcare disciplines namely nurses, doctors, and pharmacists. This intervention package was subsequently implemented across Queensland Health with the support of the local champions under the guidance of the steering group., Results: Clinicians identified that a multifaceted intervention package and training which can be tailored to the health-care professional disciplines, would be best suited to shift clinician behaviour to align with guidelines. The findings from the co-design process aligned with theory-informed intervention package. Each of the intervention strategies varied in their frequency and popularity of use., Conclusions: The use of theory-informed and participatory approach assisted with the intervention development process and aligned the intervention content with the priorities of stakeholders. The TDF provided a structured process for developing intervention content which is both acceptable and useful to stakeholders and may improve the management of vancomycin., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: To investigate what makes Australians decide to screen and follow through for breast, cervical, and bowel cancer population screening programs., Methods: A convenience sample (N = 962) answered open-text questions about their decision to screen and what prompted them to act in an online survey. Open text responses were coded based on shared meaning using content analysis. Frequencies of each code were calculated., Results: For breast and cervical screening, decisions were commonly based on screening being routine (32.58% breast and 35.19% cervical ) or receiving a reminder (20.53% breast 13.07% cervical ), and similarly, common prompts were receiving a reminder (40.68% breast and 29.13% cervical ), screening being routine (22.05% breast and 18.65% cervical ). Participants reported deciding to screen for bowel cancer due to arrival of home screening test kit (40.50%) or the experience of loved one's cancer (13.57%) and were prompted by arrival of home test kit (23.58%), and convenience (15.72%)., Conclusions: Findings can inform the development of interventions targeting non-participants of cancer screening programs., Practice Implications: Messages to encourage breast and cervical cancer screening should frame screening as part of regular healthcare routine. Messages to encourage bowel cancer screening should encourage immediate use of the screening kit upon arrival., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Blunt chest injury is associated with significant adverse health outcomes. A chest injury care bundle (ChIP) was developed for patients with blunt chest injury presenting to the emergency department. ChIP implementation resulted in increased health service use, decreased unplanned Intensive Care Unit admissions and non-invasive ventilation use. In this paper, we report on the financial implications of implementing ChIP and quantify costs/savings., Methods: This was a controlled pre-and post-test study with two intervention and two non-intervention sites. The primary outcome measure was the treatment cost of hospital admission. Costs are reported in Australian dollars (AUD). A generalised linear model (GLM) estimated patient episode treatment costs at ChIP intervention and non-intervention sites. Because healthcare cost data were positive-skewed, a gamma distribution and log-link function were applied., Results: A total of 1705 patients were included in the cost analysis. The interaction (Phase x Treatment) was positive but insignificant (p = 0.45). The incremental cost per patient episode at ChIP intervention sites was estimated at $964 (95 % CI, -966 - 2895). The very wide confidence intervals reflect substantial differences in cost changes between individual sites Conclusions: The point estimate of the cost of the ChIP care bundle indicated an appreciable increase compared to standard care, but there is considerable variability between sites, rendering the finding statistically non-significant. The impact on short- and longer-term costs requires further quantification., Competing Interests: Declaration of competing interest The authors have nothing to disclose., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (dl-PCBs) are a suite of harmful chemicals (hereafter collectively referred to as 'dioxins'), and their emission into aquatic habitats leads to persistent contamination of sediments, aquatic food-webs, and seafoods. Quantifying contaminant levels in seafood species is important for the ongoing management of exposure risk by fishers, particularly after any remediation actions. We present dioxin concentrations in four seafood species (Yellowfin Bream Acanthopagrus australis, Sea Mullet Mugil cephalus, Eastern School Prawn Metapenaeus macleayi, and Eastern King Prawn Penaeus plebejus) in a recreationally fished estuary, in relation to a contaminated site that has undergone a remediation process, partially removing contaminated sediments (Homebush Bay, Port Jackson, New South Wales, Australia). Dioxin concentrations in these species were measured before (2005/6) and after (2015/16) remediation at a range of locations in and around the remediated site. Dioxin concentrations and congener profiles differed substantially among taxa, and concentrations were frequently higher than Australian screening criteria. The two prawn species showed evidence of a decline in dioxin concentrations after remediation, but the fish species only showed a declining dioxin concentration with distance from the contaminated site (not between periods). There were some minor changes in the congener profile for some species following remediation. While there was evidence for greatly reduced dioxin concentrations in prawn species following remediation, the complex patterns for fish were likely affected by environmental changes, species-specific and temporal changes in lipid content, and animal movement patterns. Future monitoring may aid interpretation of the patterns and modelling of exposure risk associated with seafood consumption into the future., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)

Pesticide active ingredients (PAIs) are one of the main contributors affecting water quality in the Great Barrier Reef Catchment Area (GBRCA). While an extensive list of pesticides is monitored in the GBRCA, only a limited number have water quality guideline values (WQGs), meaning it is not possible to know whether these PAIs are present at concentrations that may pose a hazard to the aquatic environment. In the current study, we derived 66 ecotoxicity threshold values (ETVs) for PAIs, the equivalent of WQGs, with a focus on PAIs applied to sugar cane. The hazard posed by PAIs monitored as part of the Great Barrier Reef Catchment Loads Monitoring Program (GBRCLMP) was assessed by comparing the derived ETVs with monitoring data from 2016/2017 to 2021/2022. The derived ETVs included herbicides, insecticides and fungicides, with the values that should protect 99 or 95 % of aquatic species (PC99 or PC95) spanning nine orders of magnitude. The concentrations of 10 PAIs exceeded their respective ETVs, giving a hazard quotient (HQ) >1. Of particular concern were insecticides chlorpyrifos, diazinon and methomyl, which have maximum HQ values >10. However, joint probability plots indicated that the PAIs generally pose a low risk to the aquatic environment, with most samples below the limit of reporting. As PAIs are predominantly found in mixtures in the GBRCA, the hazard posed by PAI mixtures was assessed by summing all individual HQ values in a sample for all PAIs with an ETV or WQG. On average, the insecticide active ingredient imidacloprid and herbicide active ingredients metolachlor, metsulfuron methyl, diuron and imazepic were the drivers of combined mixture hazard. Methomyl was an important contributor at some sites, suggesting that this pesticide should be considered for inclusion in any future PAI mixture hazard and/or risk assessment of the GBRCA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Synthetic opioids, particularly the nitazene analogues class, have become a public health concern due to their high potency. Wastewater-based epidemiology can detect community use of these compounds. The objective of this work was to detect nitazene analogues in wastewater from samples collected from eight sites in the United States. Influent wastewater samples were collected from eight sites in seven states (Arizona, Oregon, New Mexico, Illinois, New Jersey, Washington and Georgia) in the United States. Samples were collected from each site on three days between 27 December 2022 and 4 January 2023, acidified on collection, stored frozen and shipped to Arizona State University (Tempe, AZ) for sample processing. Samples were then shipped to The University of Queensland (Brisbane, Australia) for sample analysis. Protonitazene was found in samples collected from two sites in Washington and Illinois. The concentration was estimated up to 0.5 ng/L, with estimated excreted mass loads up to 0.3 mg/day/1000 people. This work has shown that it is possible to detect nitazene analogues in wastewater using a combination of sample pre-concentration and sensitive instrumentation, thereby further expanding the utility of wastewater-based epidemiology., Competing Interests: Declaration of competing interest RUH and EMD are cofounders of AquaVitas, LLC, Phoenix, Arizona, United States, an Arizona State University startup company providing commercial services in wastewater-based epidemiology. RUH also is the founder of OneWaterOneHealth, a nonprofit project of the Arizona State University Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: We aimed to evaluate Aboriginal and Torres Strait Islander involvement in research focusing on cancer experiences using an Aboriginal and Torres Strait Islander quality appraisal tool (the QAT)., Methods: We conducted a systematic review of the peer-reviewed literature on Aboriginal and Torres Strait Islander peoples' experiences associated with cancer, recently published elsewhere. We then appraised articles for the inclusion of Aboriginal and Torres Strait Islander-led research, community consultation, and involvement., Results: 91 articles were appraised. A lack of Aboriginal and Torres Strait Islander-led research and consultation was reported in the majority of articles, only 10 (11%) demonstrated success across seven (50%) or more questions of the QAT., Conclusions: This review underscores the need for anti-racist research and publication practices that actively engage Aboriginal and Torres Strait Islander peoples and researchers. This approach is vital to enhance cancer outcomes within these communities., Implications for Public Health: To advance and prioritise appropriate involvement of Aboriginal and Torres Strait Islander peoples in cancer research, the onus must be on 'systems owners,' including academic journals and institutions, to require and report genuine engagement as standard practice. Researchers will produce higher-calibre research with a strengths-based focus, advancing the cause of equitable research., Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Satellite retrieval of total suspended solids (TSS) and chlorophyll-a (chl-a) was performed for the Gold Coast Broadwater, a micro-tidal estuarine lagoon draining a highly developed urban catchment area with complex and competing land uses. Due to the different water quality properties of the rivers and creeks draining into the Broadwater, sampling sites were grouped in clusters, with cluster-specific empirical/semi-empirical prediction models developed and validated with a leave-one-out cross validation approach for robustness. For unsampled locations, a weighted-average approach, based on their proximity to sampled sites, was developed. Confidence intervals were also generated, with a bootstrapping approach and visualised through maps. Models yielded varying accuracies (R 2  = 0.40-0.75). Results show that, for the most significant poor water quality event in the dataset, caused by summer rainfall events, elevated TSS concentrations originated in the northern rivers, slowly spreading southward. Conversely, high chl-a concentrations were first recorded in the southernmost regions of the Broadwater., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Government inquiries present a policy window for advocates to influence policy. Evidence on how to write influential submissions, however, is sparse. We aimed to identify features of successful written submissions to the Parliament of Australia's Inquiry into Food Pricing and Food Security in Remote Indigenous Communities (Inquiry)., Method: A scoping review was conducted to identify influential features of written submissions to government inquiries. A content analysis of a sub-sample of government Inquiry submissions and their recommendations was then coded for influential features. The frequency of submission recommendations incorporated into the final Inquiry report was recorded, as was their link to influential features., Results: Thirty features were identified. Results from 21 submissions indicate that when writing a submission to a government inquiry, advocates should: (1) ensure their submission is clear and concise; (2) convey the authority of both the writer and supporting evidence; and (3) where possible, align submission recommendations with the government agenda., Conclusions: We encourage future research to test the framework of influential features on other inquiry topics and in other countries to increase the reliability of results., Implications for Public Health: This study consolidates and presents a list of features that advocates can consider incorporating when writing a submission to a government inquiry., Competing Interests: Conflicts of interest Adam Delaine works for the Australian Government Department of Health and Aged Care. However this paper is in no way affiliated with the Department’s views or policies. All other authors disclose no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Microplastics (MPs) accumulating in freshwater sediment have raised concerns about potential risks to benthic dwelling organisms, yet few studies have examined the long-term impacts caused by MP exposure. This study investigated alterations to lipid profiles in an Australian freshwater invertebrate, Chironomus tepperi, induced by polyethylene MP fragments (1-45 μm) at environmentally relevant concentrations (125, 250, 500 and 1000 MPs/kg sediment), using a two-generational experimental design. In the parental generation, the relative abundance of triacylglycerols, total fatty acids and unsaturated fatty acids exhibited apparent hormetic patterns, with low-concentration stimulation and high-concentration inhibition observed. The overall trend in these lipid classes is consistent with previously observed changes to polar metabolite profiles, indicating that ingestion of MPs could inhibit nutrient assimilation from food leading to disruption of energy availability. In the first filial generation continuously exposed to MPs, however, abundance of cholesterol and total fatty acids increased with increasing exposure concentrations, suggesting different effects on energy metabolism between the parental generation and offspring. No differences in the lipidome were observed in first filial larvae that were not exposed, implying that MPs pose negligible carry-over effects. Overall, the combined results of this study together with a preceding metabolomics study provide evidence of a physical effect of MPs with subsequent impacts to bioenergetics. Nevertheless, future research is required to explore the potential long-term impacts caused by MPs, and to unravel the impacts of the surfactant control as a potential contributor to the observed hormetic response, particularly for studies exploring sub-lethal effects of MP exposure using sensitive omics techniques., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Wildlife are implicated in the dissemination of antimicrobial resistance, but their roles as hosts for Escherichia coli that pose a threat to human and animal health is limited. Gulls (family Laridae) in particular, are known to carry diverse lineages of multiple-antibiotic resistant E. coli, including extra-intestinal pathogenic E. coli (ExPEC). Whole genome sequencing of 431 E. coli isolates from 69 healthy Australian silver gulls (Chroicocephalus novaehollandiae) sampled during the 2019 breeding season, and without antibiotic selection, was undertaken to assess carriage in an urban wildlife population. Phylogenetic analysis and genotyping resolved 123 sequence types (STs) representing most phylogroups, and identified diverse ExPEC, including an expansive phylogroup B2 cluster comprising 103 isolates (24 %; 31 STs). Analysis of the mobilome identified: i) widespread carriage of the Yersinia High Pathogenicity Island (HPI), a key ExPEC virulence determinant; ii) broad distribution of two novel phage elements, each carrying sitABCD and iii) carriage of the transmissible locus of stress tolerance (tLST), an element linked to sanitation resistance. Of the 169 HPI carrying isolates, 49 (48 %) represented diverse B2 isolates hosting FII-64 ColV-like plasmids that lacked iutABC and sitABC operons typical of ColV plasmids, but carried the serine protease autotransporter gene, sha. Diverse E. coli also carried archetypal ColV plasmids (52 isolates; 12 %). Clusters of closely related E. coli (<50 SNVs) from ST58, ST457 and ST746, sourced from healthy gulls, humans, and companion animals, were frequently identified. In summary, anthropogenically impacted gulls host an expansive E. coli population, including: i) putative ExPEC that carry ColV virulence gene cargo (101 isolates; 23.4 %) and HPI (169 isolates; 39 %); ii) atypical enteropathogenic E. coli (EPEC) (17 isolates; 3.9 %), and iii) E. coli that carry the tLST (20 isolates; 4.6 %). Gulls play an important role in the evolution and transmission of E. coli that impact human health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Catastrophic fish death events are increasing in frequency and severity globally. A series of major recent fish deaths in the semi-arid lower Darling-Baaka river system (LDBR) of Australia are emblematic of these issues with tens of millions of native fish perishing. In 2018-2019 there was a major death event for Australia's largest freshwater fish, Murray cod (Maccullochella peelii). To aid the recovery and guide restoration activities of local Murray cod populations, it is essential to gather information on the mating strategies and effective population size following the fish death event. After the fish deaths, we collected larvae during the 2020 and 2021 breeding seasons and used single nucleotide polymorphisms (SNPs) to provide insight mating strategies and to estimate effective population size. Larvae were detected in both years along the entire length of the LDBR. Sixteen percent of the inferred breeding individuals were found to contribute to multiple pairings, confirming a complex and polygamous mating system. A high frequency of polygamy was evident both within and between years with 100 % polygamy identified among parents that produced offspring in both 2020 and 2021 and 95 % polygamy identified among parents involved in multiple spawning events within years. Post-larval Murray cod samples collected between 2016 and 2021 were co-analysed to further inform kinship patterns. Again, monogamy was rare with no confirmed cases of the same male-female pair contributing to multiple breeding events within or between seasons. Effective population size based on Murray cod collected after the fish death event was estimated at 721.6 (CI 471-1486), though this has likely declined following a subsequent catastrophic fish death event in the LDBR in March 2023. Our data provide insight into the variability of Murray cod mating strategies, and we anticipate that this knowledge will assist in planning conservation actions to ultimately help recover a species in crisis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)

Objectives: To determine how the perception of physical function 6-months following critical illness compares to objectively measured function, and to identify key concerns for patients during recovery from critical illness., Research Methodology and Design: A nested convergent parallel mixed methods study assessed physical function during a home visit 6-months following critical illness, with semi-structured interviews conducted at the same time., Setting: Participants were recruited from two hospitals at one healthcare network in Melbourne, Australia from September 2017 to October 2018 with follow-up data completed in April 2019., Main Outcome Measures: Physical function was assessed through four objective outcomes: the functional independence measure, six-minute walk test, functional reach test, and grip strength. Semi structured interviews focused on participants function, memories of the intensive care and hospital stay, assistance required on discharge, ongoing limitations, and the recovery process., Findings: Although many participants (12/20, 60%) stated they had recovered from their critical illness, 14 (70%) had function below expected population norms. Decreased function on returning home was commonly reported, although eleven participants were described as independent and safe for discharge from hospital-based staff. The importance of family and social networks to facilitate discharge was highlighted, however participants often described wanting more support and issues accessing services. The effect of critical illness on the financial well-being of the family network was confirmed, with difficulties accessing financial support identified., Conclusion: Survivors of critical illness perceived a better functional state than measured, but many report new limitations 6-months after critical illness. Family and friends play a crucial role in facilitating transition home and providing financial support., Implications for Clinical Practice: Implementation of specific discharge liaison personnel to provide education, support and assist the transition from hospital-based care to home, particularly in those without stable social supports, may improve the recovery process for survivors of critical illness., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This study quantified the extent of anthelmintic resistance (AR) in ascarid and strongylid nematodes against commonly used anthelmintics in Australian Thoroughbred horses. Faecal egg count reduction tests (FECRTs, n = 86) and egg reappearance period (ERP) tests were conducted on 22 farms across Australia. Faecal egg counts (FECs) were determined using the modified McMaster technique, and percent faecal egg count reduction (%FECR) was calculated using the Bayesian hierarchical model and hybrid Frequentist/Bayesian analysis method. The results were interpreted using old (published in 1992) and new (2023) research guidelines of the World Association for the Advancement of Veterinary Parasitology (WAAVP). The species composition of strongylid nematodes was detected utilising a DNA-metabarcoding method using pre- and post-treatment samples. Resistance was observed in strongylid nematodes to commonly used single-active and combination anthelmintics, including ivermectin (IVM %FECR range: 82%-92%; 95% lower credible interval (LCI) range: 80%-90%), abamectin (ABM: 73%-92%; 65%-88%), moxidectin (MOX: 89%-91%; 84%-89%), oxfendazole (OFZ: 0%-56%; 0%-31%) and its combination with pyrantel (OFZ + PYR: 0%-82%; 0%-78%). Resistance in Parascaris spp. was observed to IVM (10%-43%; 0%-36%), ABM (0%; 0%) and MOX (0%; 0%). When the new thresholds recommended by the WAAVP were used, AR was detected in six additional FECRTs for strongylids and three more tests for Parascaris spp., introducing resistance to OFZ and OFZ + PYR in the latter. Shortened ERPs (4-6 weeks) of strongylids were observed in 31 FECRTs in which AR was not detected at 2 weeks post-treatment for all the anthelmintics tested. Among cyathostomins, Cylicocyclus nassatus, Cylicostephanus longibursatus and Coronocyclus coronatus were the most prevalent species at 2 weeks post-treatment, whereas the main species appearing at five weeks following treatments with macrocyclic lactones were Cylicocyclus nassatus, Cylicostephanus longibursatus and Cylicocyclus ashworthi. After treatment with OFZ + PYR, the latter three, plus Coronocyclus coronatus and Cyathostomum catinatum, were detected at 5 weeks post-treatment. Overall, the study highlights the prevalence of AR in both ascarids and strongylid nematodes against commonly used anthelmintic products to control worms in Australian horses. The results indicate that ML combination products provided acceptable efficacy at 2 weeks. However, ERP calculations suggest that products work less effectively than previously measured. It is suggested to regularly monitor the efficacy of the anthelmintics and consider changing the worm control practices to better manage worms and AR in Australian horses., Competing Interests: Declaration of competing interest The authors of this manuscript are members of the Australian Equine Parasitology Advisory Panel (AEPAP), including Abdul Jabbar, Ghazanfar Abbas, Jenni Bauquier, Charles El-Hage, Abdul Ghafar and Ian Beveridge (The University of Melbourne), Anne Beasley (University of Queensland), Kristopher Hughes (Charles Sturt University), Caroline Jacobson and Emma McConnell (Murdoch University), Edwina Wilkes (Racing Victoria), Peter Carrigan and Lucy Cudmore (Scone Equine Hospital) and John Hurley (Swettenham Stud). Boehringer Ingelheim supported the panel. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Living shorelines aim to enhance the resilience of coastlines to hazards while simultaneously delivering co-benefits such as carbon sequestration. Despite the potential ecological and socio-economic benefits of living shorelines over conventional engineered coastal protection structures, application is limited globally. Australia has a long and diverse coastline that provides prime opportunities for living shorelines using beaches and dunes, vegetation, and biogenic reefs, which may be either natural ('soft' approach) or with an engineered structural component ('hybrid' approach). Published scientific studies, however, have indicated limited use of living shorelines for coastal protection in Australia. In response, we combined a national survey and interviews of coastal practitioners and a grey and peer-reviewed literature search to (1) identify barriers to living shoreline implementation; and (2) create a database of living shoreline projects in Australia based on sources other than scientific literature. Projects included were those that had either a primary or secondary goal of protection of coastal assets from erosion and/or flooding. We identified 138 living shoreline projects in Australia through the means sampled starting in 1970; with the number of projects increasing through time particularly since 2000. Over half of the total projects (59 %) were considered to be successful according to their initial stated objective (i.e., reducing hazard risk) and 18 % of projects could not be assessed for their success based on the information available. Seventy percent of projects received formal or informal monitoring. Even in the absence of peer-reviewed support for living shoreline construction in Australia, we discovered local and regional increases in their use. This suggests that coastal practitioners are learning on-the-ground, however more generally it was stated that few examples of living shorelines are being made available, suggesting a barrier in information sharing among agencies at a broader scale. A database of living shoreline projects can increase knowledge among practitioners globally to develop best practice that informs technical guidelines for different approaches and helps focus attention on areas for further research., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background To investigate what factors contribute to a working age adult with a simple fracture seeking care in an Australian metropolitan Emergency Department (ED) Methods In this Qualitative Descriptive study, we interviewed ED patients with simple fractures including 5th metacarpal, 5th metatarsal, toe, radial head and clavicle fractures. Results We interviewed 30 patients aged 18-65. Two thirds of participants were aware they might have a minor injury. Many were well informed health consumers and convenience was the most important decision-making factor. Participants focussed on organising imaging, diagnosis and immobilisation. This sequence of care was often perceived as more complex and inefficient in primary care. ED was trusted and preferred to urgent primary care with an unknown doctor. Some patients defaulted to attending ED without considering alternatives due to poor health system knowledge or from escalating anxiety. Conclusions ED is safe, free and equipped to manage simple and complex injuries. Patients would attend primary care if comprehensive fracture management was easily accessible from a trusted clinician. To effectively divert simple fracture presentations from ED, primary care requires collocated imaging, imaging interpretation, orthopaedic expertise, and fracture management resources. Services need to operate 7 days a week and must have accessible 'urgent' appointments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This paper shows how drinking in one's own home affords different affective experiences to drinking in public settings such as bars, pubs and restaurants. A thematic analysis of interviews with 40 Australians aged 30-65 identified three main variations in alcohol-associated feelings, sensations and urges. Alcohol was used at home to decelerate, but in contrast, people were enlivened when drinking in public venues. Drinking in public generated a sense of vigilance and greater requirement to self-monitor than usually felt necessary at home. For some, drinking at home seemed more habitual; governed by urges rather than intentionality, than drinking outside it did. Policy and interventions that target drinking in the home should be prioritised, such as those focussed on off-premise pricing and availability., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Deciding how to regulate nicotine vaping products (NVPs) is a challenge for many countries. Balanced regulation should consider the potential harms to young people from uptake of NVPs alongside the possible benefits of NVPs as a smoking cessation aid. One option is to make NVPs only available via medical prescription to adults who smoke. From October 2021, Australia adopted a unique model that allows prescription access to NVPs that meet a product standard without requiring the NVPs to be approved as therapeutic goods. This research explored the impact of this regulatory model on the smoking cessation practices of health professionals, and their views on the model., Methods: Semi-structured interviews were conducted with 39 Australian health professionals recruited from professional networks and social media. Health professionals were eligible if they provided smoking cessation advice as part of their role, and included medical practitioners (n = 9), pharmacists (n = 9), and other health professionals that provided smoking cessation counselling (n = 21). Interviews were mostly completed by phone and online teleconferencing software. Questions focused on smoking cessation practices, advice and information provided to patients about NVPs, views about the effectiveness of the model for supporting use of NVPs for smoking cessation and preventing youth uptake, and barriers and facilitators to prescribing and dispensing NVPs. Coding and analysis used a combination of inductive and deductive approaches., Results: Findings indicated a lack of consensus amongst the participants about NVPs as a cessation or harm reduction tool. Participants broadly agreed that the model has not been effective in improving quality control of NVPs, or in reducing youth access. Many participants eligible to prescribe or dispense NVPs felt that the current regulatory model placed an undue time and responsibility burden on clinicians., Conclusion: Our research identified several limitations associated with the current Australian prescription-only regulatory model. These were perceived by healthcare professionals to limit the potential for the regulations to reduce youth use and to increase access to safer NVP products for people who smoke to use for smoking cessation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: Rural nurses play a vital role in the provision of resuscitation care, as first responders and often the sole healthcare professionals delivering timely interventions with greater role autonomy and extended scope of practice. Whilst there is a developing body of literature describing the 'generalist' roles of rural nurses when providing care in acute care settings, little is known about the roles rural nurses assume during a resuscitation., Aim: The aim of this study was to explore the role/s that rural nurses enact when delivering resuscitative care to their rural community., Design/methods: An ethnographic methodology was used across two rural hospital sites in Australia, involving non-participant observation and interviews., Results: Reflexive thematic analysis led to three themes that described the resuscitative roles of rural nurses: Senior and junior nurse, formal and informal leadership roles, multiple roles., Conclusion: This study has placed a spotlight on rural nurse's capacity to be adaptive in a dynamic and highly variable resuscitative environment. Building leadership capacity should be a rural nursing workforce strategy, aimed at supporting the unique roles that rural nurses undertake when working with various external teams during resuscitations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Black-box deep learning (DL) models trained for the early detection of Alzheimer's Disease (AD) often lack systematic model interpretation. This work computes the activated brain regions during DL and compares those with classical Machine Learning (ML) explanations. The architectures used for DL were 3D DenseNets, EfficientNets, and Squeeze-and-Excitation (SE) networks. The classical models include Random Forests (RFs), Support Vector Machines (SVMs), eXtreme Gradient Boosting (XGBoost), Light Gradient Boosting (LightGBM), Decision Trees (DTs), and Logistic Regression (LR). For explanations, SHapley Additive exPlanations (SHAP) values, Local Interpretable Model-agnostic Explanations (LIME), Gradient-weighted Class Activation Mapping (GradCAM), GradCAM++ and permutation-based feature importance were implemented. During interpretation, correlated features were consolidated into aspects. All models were trained on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. The validation includes internal and external validation on the Australian Imaging and Lifestyle flagship study of Ageing (AIBL) and the Open Access Series of Imaging Studies (OASIS). DL and ML models reached similar classification performances. Regarding the brain regions, both types focus on different regions. The ML models focus on the inferior and middle temporal gyri, and the hippocampus, and amygdala regions previously associated with AD. The DL models focus on a wider range of regions including the optical chiasm, the entorhinal cortices, the left and right vessels, and the 4th ventricle which were partially associated with AD. One explanation for the differences is the input features (textures vs. volumes). Both types show reasonable similarity to a ground truth Voxel-Based Morphometry (VBM) analysis. Slightly higher similarities were measured for ML models., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The uptake and distribution of copper, zinc, arsenic, and lead was examined in two rare Australian saltmarsh species, Tecticornia pergranulata and Wilsonia backhousei. The bioconcentration factors and translocation factors were generally much lower than one, except for the Zn translocation factors for T. pergranulata. When compared to other Australian saltmarsh taxa, these species generally accumulated the lowest levels observed among taxa, especially in terms of their BCFs. Essential metals tended to be regulated, while non-essential metals increased in concentration with dose during transport among compartments, a pattern not previously observed in Australian saltmarsh taxa. The uptake of metals into roots was mainly explained by total sediment metal loads as well as more acidic pH, increased soil organic matter, and decreased salinity. The low uptake and limited translocation observed in these rare taxa may offer a competitive advantage for their establishment and survival in the last urbanised populations, where legacy metal contamination acts as a selective pressure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: To reduce transmission risk during the COVID-19 pandemic, 'telehealth' (health care delivered via telephone/video-conferencing) was implemented into Australian maternity services. Whilst some reports on telehealth implementation ensued, there was scant evidence on women and midwives' perspectives regarding telehealth use., Methods: A qualitative study was conducted in Australia during 2020-2021 using two data sources from the Birth in the Time of COVID-19 (BITTOC) study: i) interviews and ii) surveys (open-text responses). Content analysis was utilised to analyse the data and explore telehealth from the perspective of midwives and women accessing maternity care services. In-depth interviews were conducted with 20 women and 16 midwives. Survey responses were provided from 687 midwives and 2525 women who were pregnant or gave birth in 2021, generating 212 and 812 comments respectively., Findings: Telehealth delivery was variable nationally and undertaken primarily by telephone/videoconferencing. Perceived benefits included: reduced COVID-19 transmission risk, increased flexibility, convenience and cost efficiency. However, women described inadequate assessment, and negative impacts on communication and rapport development. Midwives had similar concerns and also reported technological challenges., Conclusion: During the COVID-19 pandemic, telehealth offered flexibility, convenience and cost efficiency whilst reducing COVID-19 transmission, yet benefits came at a cost. Telehealth may particularly suit women in rural and remote areas, however, it also has the potential to further reduce equitable, and appropriate care delivery for those at greatest risk of poor outcomes. Telehealth may play an adjunct role in post-pandemic maternity services, but is not a suitable replacement to traditional face-to-face maternity care., Competing Interests: Conflict of interest The authors declare no personal or financial relationships that influence the development of this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Postpartum mental illnesses and hypertensive disorders of pregnancy (HDP) are both common, and both associated with adverse maternal and child health outcomes. However, the relationship between them is unclear. This study aimed to investigate prevalence and symptom severity of depression, anxiety, and post-traumatic stress disorder (PTSD) 2-years postpartum in women with normal blood pressure (NBP) during pregnancy versus preeclampsia or gestational hypertension (GH)., Methods: Two-years follow-up of the prospective Postpartum, Physiology, Psychology and Paediatric (P4) Cohort Study was conducted in metropolitan Australia. Prevalence and symptom severity of depression (Edinburgh Postnatal Depression Scale, EPDS > 12), anxiety (7-item Generalized Anxiety Disorder scale, GAD-7 ≥ 10) and PTSD (Posttraumatic stress Diagnostic Scale, PDS/PDS-5) were measured and calculated for women with NBP, preeclampsia and GH., Results: Among 365 participants (NBP: n = 271, preeclampsia: n = 75, GH: n = 19), 2-years postpartum depression prevalence was 3.9% (95% CI 2.3-6.4%): 4.4% after NBP, and 2.7% after preeclampsia (p = 0.53). Anxiety prevalence was higher after GH than NBP (15.8% versus 3.3%, p = 0.02). Prevalence of any mental illness (depression/anxiety/PTSD) was 5.9% (95% CI 3.8-8.8%); 5.6% after NBP, 4.1% after PE, and 15.8% after GH (p = 0.15). Although PTSD prevalence was low (1.4%), and similar between groups (p = 0.97), around 3 times more women after PE (8.1%), compared to NBP (2.5%), recalled childbirth as traumatic (p = 0.003)., Conclusions: Preeclampsia, although associated with persistent perceptions of traumatic childbirth, did not alter the risk of mental illnesses at 2-years postpartum. GH (albeit in a small subgroup) was associated with increased anxiety scores. Larger, multicentre studies are required to clarify relationships between HDP and postpartum mental illness., Trial Registration: Retrospectively registered on 18/11/2013 with the Australian and New Zealand Clinical Trials Registry., Registration Number: ACTRN 12613 00,126 0718., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Anti-inflammatory bioassay-guided compound isolation from the exocarp of the Australian rainforest tree Endiandra insignis (family Lauraceae) has led to the discovery and structural elucidation of unusual α, β-unsaturated twenty-four carbon fatty acids and their positional isomers, insignoic acids A - E (1a - 5c). The stereochemistry and position of the double bond within the aliphatic chain were independently determined via NMR spectroscopy and Ozone-Induced Dissociation (OzID) Mass Spectrometry, respectively. Compounds (1a - 5c) displayed good to moderate anti-inflammatory activity in the range of 8-84 μM. The low therapeutic index observed when assessing the cell viability in the RAW macrophage cell lines, prompted us to investigate the anticancer potential of these unusual fatty acids. The anti-cancer activity was assessed in A-431 carinoma cell lines and MM649 melanoma cell lines. Insignoic acid C (3a-f) exhibited the highest level of potency with an IC 50 value of 5-7 μM against both the cell lines. The insignoic acids are the first of their kind known for incorporating an alpha-beta unsaturated system flanked next to a keto group with an additional level of oxygenation at C-6 in a 24‑carbon fatty acid backbone., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Problem: Despite 10 years of prescribing scheduled medicines by Endorsed Midwives, little is known about prescribing practices., Background: Endorsed Midwives can prescribe scheduled medicines and have access to Medicare rebates to support service provision. Endorsed Midwives have the potential to improve access to medications for women, however, are met with barriers, including inconsistencies in state and national legislation., Aim: To search for what is published regarding Endorsed Midwife prescribing of scheduled medicines in Australia, report on the literature, synthesise the findings and discuss the results., Methods: A scoping review utilising the Joanna Brigg's Institute methodology. A search of CINAHL, PubMed, Science Direct and Medline databases was conducted. Seven peer-reviewed articles were identified; three discussion papers, one literature review and three research papers, published between 2016 and 2023 in English. Qualitative content analysis was used to identify topic areas., Findings: Four topic areas were identified: 1) Endorsed Midwives increase women's access to prescribed medications; 2) the Pharmaceutical Benefits Scheme is restrictive and diminishes midwifery prescribing; 3) medication prescribing depends on internal and external structures; 4) professional relationships support prescribing., Discussion: The authority to prescribe augments Endorsed Midwives' practice, improves timely access to medications and enhances role satisfaction. The effective use of midwifery prescribing is hampered by barriers such as the Pharmaceutical Benefits Scheme, inappropriate medication formularies, and poorly designed health service policy., Conclusion: To fully utilise Endorsed Midwife prescribing in all settings of maternity care, further work is required to develop education, remove barriers, and demonstrate the safety and effectiveness of midwifery prescribing., Competing Interests: Conflicts of Interest There are no Conflicts of Interest to declare., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

This is the fourth in a series of papers that provides an historical record in this journal of contributions made by the most influential figures in the field of stuttering. Ann Packman is an Australian researcher who will retire shortly. This paper reflects on her long and productive career, and her contributions to the field. With a background in literature, linguistics, philosophy, psychology, and the brain and language, she became well equipped to contribute to understanding stuttering causality. That work, and an accompanying collection of basic and applied clinical research, was constantly grounded with the thoughts and feelings of those who stutter in the community., Competing Interests: Declaration of Competing Interest The author certifies the absence of any conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject of this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The presence of doubly uniparental inheritance (DUI) in bivalves represents a unique mode of mitochondrial transmission, whereby paternal (male-transmitted M-type) and maternal (female-transmitted F-type) haplotypes are transmitted to offspring separately. Male embryos retain both haplotypes, but the M-type is selectively removed from females. Due to the presence of heteroplasmy in males, mtDNA can recombine resulting in a 'masculinized' haplotype referred to as M f -type. While mtDNA recombination is usually rare, it has been recorded in multiple mussel species across the Northern Hemisphere. Given that mitochondria are the powerhouse of the cell, different mtDNA haplotypes may have different selective advantages under diverse environmental conditions. This may be particularly important for sperm fitness and fertilization success. In this study we aimed to i) determine the presence, prevalence of the M f -type in Australian blue mussels (Mytilus sp.) and ii) investigate the effect of M f -mtDNA on sperm performance (a fitness correlate). We found a high prevalence of recombined mtDNA (≈35 %) located within the control region of the mitochondrial genome, which occurred only in specimens that contained Southern Hemisphere mtDNA. The presence of two female mitotypes were identified in the studied mussels, one likely originating from the Northern Hemisphere, and the other either representing the endemic M. planulatus species or introduced genotypes from the Southern Hemisphere. Despite having recombination events present in a third of the studied population, analysis of sperm performance indicated no difference in fertilization success related to mitotype., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Fecal pollution contributes to global degradation of water quality and requires identification of the source(s) for predicting human health risk, tracking disease, and developing management strategies. While fecal indicator bacteria are commonly used to detect fecal pollution, they cannot identify sources. Novel approaches, such as microbial source tracking (MST), can be applied to evaluate the origin of fecal pollution. This study examined fecal pollution in the coral reef lagoons of Norfolk Island, Australia where reef health decline has been related to nutrient input. The primary objective of this study was to evaluate the host sensitivity and specificity of two human wastewater-associated marker genes (Bacteroides HF183 (HF183) and cross-assembly phage (crAssphage)) and four animal feces associated marker genes targeting avian, ruminant, dog, and pig (Helicobacter-associated GFD (GFD), Bacteroides BacR (BacR), Bacteroides DogBact (DogBact), and Bacteroides Pig-2-Bac (Pig-2-Bac)) in wastewater and animal fecal samples collected from Norfolk Island. The prevalence and concentrations of these marker genes along with enterococci genetic marker (ENT 23S rRNA) of general fecal pollution and human adenovirus (HAdV), which is considered predominantly a pathogen but also a human-wastewater associated marker gene, were determined in surface, ground, and marine water resources. A secondary objective of this study was to assess the sources and pathways of fecal pollution to a sensitive marine environment under rainfall events. HF183, crAssphage, HAdV, and BacR demonstrated absolute host sensitivity values of 1.00, while GFD and Pig-2-Bac had host sensitivity values of 0.60, and 0.20, respectively. Host specificity values were > 0.94 for all marker genes. Human and animal (avian, ruminant, dog) fecal sources were present in the coral reef lagoons and surface water whereas groundwater was polluted by human wastewater markers. This study provides understanding of fecal pollution in water resources on Norfolk Island, Australia after precipitation events. The results may aid in effective water quality management, mitigating potential adverse effects on both human and environmental health., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Joanne Vanderzalm reports financial support was provided by Australian Government Department of Infrastructure, Transport, Regional Development, Communications and the Arts. Warish Ahmed is an Associate Editor for Science of the Total Environment If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Pollen allergies pose a considerable global public health concern. Allergy risk can vary significantly within plant families, yet some key pollen allergens can only be identified to family level by current optical methods. Pollen information with greater taxonomic resolution is therefore required to best support allergy prevention and self-management. We used environmental DNA (eDNA) metabarcoding to deepen taxonomic insights into the seasonal composition of airborne pollen in cool temperate Australia, a region with high rates of allergic respiratory disease. In Hobart, Tasmania, we collected routine weekly air samples from December 2018 until October 2020 and sequenced the internal transcribed spacer 2 (ITS2) and chloroplastic tRNA-Leucine tRNA-Phenylalanine intergenic spacer (trnL-trnF) regions in order to address the following questions: a) What is the genus-level diversity of known and potential aeroallergens in Hobart, in particular, in the families Poaceae, Cupressaceae and Myrtaceae? b) How do the atmospheric concentrations of these taxa change over time, and c) Does trnL-trnF enhance resolution of biodiversity when used in addition to ITS2? Our results suggest that individuals in the region are exposed to temperate grasses including Poa and Bromus in the peak grass pollen season, however low levels of exposure to the subtropical grass Cynodon may occur in autumn and winter. Within Cupressaceae, both metabarcodes showed that exposure is predominantly to pollen from the introduced genera Cupressus and Juniperus. Only ITS2 detected the native genus, Callitris. Both metabarcodes detected Eucalyptus as the major Myrtaceae genus, with trnL-trnF exhibiting primer bias for this family. These findings help refine our understanding of allergy triggers in Tasmania and highlight the utility of multiple metabarcodes in aerobiome studies., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Fay H Johnston reports financial support was provided by Tasmania Department of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Timor ponies (TP) were first shipped to Australia in the early 1800s and were highly valued as transport and pack animals, which resulted in TPs contributing to the development of Australian horse breeds. Today, while the exact number of TPs in Australia is currently unknown, there has been recent interest in establishing a domestic breeding program for Australian TPs. The aim of this study was to evaluate the relatedness of a sample of TPs, as well as provide estimates of genomic inbreeding levels to better inform the feasibility of using these animals as founders for a domestic breeding program. Hair samples from each horse were genotyped using the Illumina 80K Infinium Equine genotyping array and data were analysed using PLINK v1.90b7, KING 2.3.2 and R v4.3.1. The results illustrate that there are distantly related and minimally inbred horses within the sampled TPs. Lengths of the ROH segments also indicated that recent inbreeding events are likely to only have occurred in a third of the horses. Overall, these results are promising for the success of a domestic TP breeding program; however, considering the low number of domestic TPs known to reside in Australia, there would certainly still be substantial benefits to incorporating additional TPs either directly from Timor or from areas in Australia that are believed to contain wild descendants of TPs., Competing Interests: Declaration of competing interest None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: The objective of this study was to quantify the impact of heatwaves on likelihood of ambulance callouts for Australia., Methods: A systematic review and meta-analysis was conducted to retrieve and synthesise evidence published from 1 January 2011 to 31 May 2023 about the association between heatwaves and the likelihood of ambulance callouts in Australia. Different heatwave definitions were used ranging from excess heat factor to heatwave defined as a continuous period with temperatures above certain defined thresholds (which varied based on study locations)., Results: We included nine papers which met the inclusion criteria for the review. Eight were eligible for the meta-analyses. The multilevel meta-analyses revealed that the likelihood of ambulance callouts for all causes and for cardiovascular diseases increased by 10% (95% confidence interval: 8%, 13%) and 5% (95% confidence interval: 1%, 3%), respectively, during heatwave days., Conclusions: Exposure to heatwaves is associated with an increased likelihood of ambulance callouts, and there is a dose-response association between heatwave severity and the likelihood of ambulance callouts., Implications for Public Health: The number of heatwave days are going to increase, and this will mean an increase in the likelihood of ambulance callouts, thereby, spotlighting the real burden that heatwaves place on our already stressed healthcare system. The findings of this study underscore the critical need for proactive measures, including the establishment of research initiatives and holistic heat health awareness campaigns, spanning from the individual and community levels to the healthcare system, in order to create a more resilient Australia in the face of heatwave-related challenges., Competing Interests: Conflicts of interest Authors declare no conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: Government policies that support the health and wellbeing of young people (aged 10 to 25) can have important individual and societal impacts. The aim of this study was to explore policy actor perspectives on the development and implementation of Australian government policies focussed on the health and wellbeing of young people., Methods: We utilised a qualitative research design consisting of semi-structured interviews with policy actors with experience working with Australian youth health policies. Our interview guide and analyses were informed by the Consolidated Framework for Implementation Research (CFIR). We interviewed 19 participants from various national, state, and territory bodies., Results: Several specific barriers and facilitators to policy development and implementation were identified using the Consolidated Framework for Implementation Research. Key policy development barriers were limited available resources (e.g. staffing and funding) and low relative priority within health and political systems. Key policy implementation barriers were limited available resources, limited policy compatibility with health services, cosmopolitanism issues related to interagency collaboration, and a lack of policy evaluation. Meaningful engagement of young people could also be improved., Conclusions: Although Australian youth health policies are perceived as evidence-based and comprehensively developed, the ability to promote implementation remains stalled., Implications for Public Health: The development of policy implementation plans, monitoring and evaluation mechanisms, funding and resources, and a strong commitment to removing barriers to working across multiple departments and systems is required to improve outcomes for young people., Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: Research evidence and clinical practice guidelines exist on preventing central line-associated bloodstream infections. However, there is limited knowledge about the barriers and facilitators to evidence-based central venous access device care., Aim: The aim of this study was to investigate the facilitators and barriers to evidence-based central venous access device care in the adult intensive care setting., Method: This exploratory qualitative study involved focus groups and interviews with registered nurses and physicians involved in central venous access device insertion and management in a tertiary Australian intensive care unit. Purposive sampling was used to recruit staff (n = 26) with varying years of clinical experience and clinical positions. Six focus groups and three individual interviews were conducted. Interviews were audio recorded, transcribed verbatim and analysed using content analysis., Results: Three overarching categories emerged: work structures to support optimal performance; processes to optimise quality of care, and factors influencing staff members' behaviour. Perceived facilitators to optimal central venous access device care included explicit language use in procedure documents, work-system integrated strategies, research evidence dissemination, audit, and feedback. However, there was a lack of consistency in practices such as audit, feedback, and patient participation., Conclusion: To bring about effective improvement in central venous access device care, future interventions should be tailored to address identified barriers, including integrating audit and feedback into clinicians' work processes. Additionally, future research is needed to explore the role of patients and their families in central venous access device care., Implications for Clinical Practice: When developing practice policies or procedure manuals, it is important to use explicit language to ensure clear communication of evidence-based recommendations to clinicians. Strategies integrated into work processes can enhance adherence to evidence-based practice. Large departments with limited educators should explore innovative methods like online education to ensure optimal central venous access device care., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Drug prescription registries has become an alternative data source to hospital admission databases for measuring comorbidities. However, the predictive validity of prescription-based comorbidity measures varies based on the population under investigation and outcome of interest. We aimed to determine which prescription-based index of comorbidity has most utility in Australian men with prostate cancer., Methods: We studied 25,414 South Australian men diagnosed with prostate cancer between 2003 and 2019 from state-wide administrative linked datasets. The Rx-Risk index, Chronic Disease Score (CDS), Drug Comorbidity Index (DCI) and Pharmaceutical Prescribing Profile (P3) with one year lookback period from prostate cancer diagnosis were evaluated. The predictive ability of each index to determine all-cause deaths within two and five years of prostate cancer diagnosis was compared using the c-statistic from flexible parametric survival models, adjusting for age, socioeconomic status and year of prostate cancer diagnosis., Results: The Rx-Risk index performed better in predicting two-year (c-statistic = 0.818) and five-year (c-statistic = 0.784) all-cause mortality than P3, CDS and DCI. Including comorbidity measures as continuous scores resulted in a better performance than including them as categories. Grouping scores into four categories (≤0, >0 - ≤1, >1 - ≤2, and >2) resulted in better performance and calibration than using fewer categories., Conclusion: Rx-Risk was validated in Australia and reflects Australian prescribing patterns. It showed better predictive performance for mortality in our study, with a modest improvement over P3, CDS and DCI. For research with prostate cancer populations, we recommend the use of drug-based comorbidity indices that have been validated in a similar population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Infection prevention and control (IPC) is essential for quality healthcare, with healthcare associated infections (HAI) a known risk to patients requiring medical imaging (MI). To date, few papers have adopted a national approach to understanding or benchmarking the knowledge of, attitudes toward, and practice (KAP) of IPC in the context of MI and no validated surveys or scales are identified in the literature. The Computed Tomography (CT) suite is a unique MI environment where radiographers deliver prescription medicines to patients via intravenous (IV) means through an injector system. This paper describes the development of a survey that informs the use of IPC processes in the CT suite., Methods: Standard Precautions via current national guidelines formed the benchmark of the survey, with a KAP survey used as the framework to explore IPC. The questions and associated responses are developed based on the National Health and Medical Research Council (NHMRC) guidelines, industry/professional protocols and adapted to the equipment and practices commonly used in the CT suite of MI departments by radiographers and nurses., Results: Key survey development steps are described to include the justification of the benchmarking source, the survey framework and design. Detailed information is given to show the evolution of truth statements and sources, KAP question variations, and rationales for the methodology of question responses. National guidelines are mapped to survey questions and responses and pilot testing reflections are included., Conclusion: This paper reports on the construction of a standardised KAP survey for IPC specific to the CT suite in the Australian healthcare setting. The survey is ready for dissemination amongst MI departments. Documented use will aid validation and reliability as a survey tool to measure and map IPC specifically in relation to IV contrast administration., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Antimicrobial resistance (AMR) is a major public health concern, and environmental bacteria have been recognized as important reservoirs of antimicrobial resistance genes (ARGs). Citrobacter, a common environmental bacterium and opportunistic pathogen in humans and other animals, has been largely understudied in terms of its diversity and AMR potential. Whole-genome (short-read) sequencing on a total of 77 Citrobacter isolates obtained from Australian silver gull (Chroicocephalus novaehollandiae) (n = 17) and influent wastewater samples (n = 60) was performed, revealing a diverse Citrobacter population, with seven different species and 33 sequence types, 17 of which were novel. From silver gull using non-selective media we isolated a broader range of species with little to no mobilised ARG carriage. Wastewater isolates (selected using Carbapenem- Resistant Enterobacterales (CRE) selective media) carried a heavy burden of ARGs (up to 21 ARGs, conferring resistance to nine classes of antibiotics), with several novel multidrug-resistant (MDR) lineages identified, including C. braakii ST1110, which carried ARGs conferring resistance to eight to nine classes of antibiotics, and C. freundii ST1105, which carried two carbapenemase genes, bla IMP-4 in class 1 integron structure, and bla KPC-2 . Additionally, we identified an MDR C. portucalensis isolate carrying bla NDM-1 , bla SHV-12 , and mcr-9. We identified IncC, IncM2, and IncP6 plasmids as the likely vectors for many of the critically important mobilised ARGs. Phylogenetic analyses were performed to assess any epidemiological linkages between isolation sources, demonstrating low relatedness across sources beyond the ST level. However, these analyses did reveal some closer relationships between strains from disparate wastewater sources despite their collection some 13,000 km apart. These findings support the need for future surveillance of Citrobacter populations in wastewater and wildlife populations to monitor for potential opportunistic human pathogens., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

This study investigated the decay rates of wastewater-associated markers and enteric viruses in laboratory microcosms mimicking estuarine water environments in temperate Sydney, NSW, Australia using qPCR and RT-qPCR assays. The results demonstrated the reduction in concentrations of Bacteroides HF183, Lachnospiraceae Lachno3, cross-assembly phage (crAssphage), pepper mild mottle virus (PMMoV), human adenovirus (HAdV 40/41), and enterovirus (EV) over a span of 42 days under spring/summer temperatures, presence/absence of microbiota, and different light conditions. The study found that HF183, Lachno3, crAssphage, PMMoV, HAdV 40/41, and EV exhibited varying decay rates depending on the experimental conditions. The average T 90 values ranged from a few days to several months, indicating the rapid decay or prolonged persistence of these markers and enteric viruses in the estuarine environment. Furthermore, the study examined the effects of indigenous microbiota and spring/summer temperatures on wastewater-associated markers and enteric viruses decay rates. It was found that the presence of microbiota and temperature significantly influenced the decay rates of HF183 and PMMoV. Additionally, the study compared the effects of artificial sunlight and spring/summer temperatures on marker decay rates. Bacterial markers decayed faster than viral markers, although among viral markers crAssphage decay rates were relatively faster when compared to PMMoV. The exposure to artificial sunlight significantly accelerated the decay rates of bacterial markers, viral markers, and enteric viruses. Temperature also had an impact on the decay rates of Lachno3, crAssphage, and HAdV 40/41. In conclusion, this study provides valuable insights into the decay rates of wastewater-associated markers and enteric viruses under different experimental conditions that mimicked temperate environmental conditions. The findings contribute to our understanding of the fate and persistence of these markers in the environment which is crucial for assessing and managing risks from contamination by untreated human wastewater., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Per- and polyfluoroalkyl substances (PFAS) concentrations were investigated in hepatic tissue of four dolphin species stranded along the south-east coast of Australia between 2006 and 2021; Burrunan dolphin (Tursiops australis), common bottlenose dolphin (Tursiops truncatus), Indo-Pacific bottlenose dolphin (Tursiops aduncus), and short-beaked common dolphin (Delphinus delphis). Two Burrunan dolphin populations represented in the dataset have the highest reported global population concentrations of ∑ 25 PFAS (Port Phillip Bay median 9750 ng/g ww, n = 3, and Gippsland Lakes median 3560 ng/g ww, n = 8), which were 50-100 times higher than the other species reported here; common bottlenose dolphin (50 ng/g ww, n = 9), Indo-Pacific bottlenose dolphin (80 ng/g ww, n = 1), and short-beaked common dolphin (61 ng/g ww, n = 12). Also included in the results is the highest reported individual ∑ 25 PFAS (19,500 ng/g ww) and PFOS (18,700 ng/g ww) concentrations, at almost 30 % higher than any other Cetacea reported globally. Perfluorooctane sulfonate (PFOS) was above method reporting limits for all samples (range; 5.3-18,700 ng/g ww), and constituted the highest contribution to overall ∑PFAS burdens with between 47 % and 99 % of the profile across the dataset. The concentrations of PFOS exceed published tentative critical concentrations (677-775 ng/g) in 42 % of all dolphins and 90 % of the critically endangered Burrunan dolphin. This research reports for the first time novel and emerging PFASs such as 6:2 Cl-PFESA, PFMPA, PFEECH and FBSA in marine mammals of the southern hemisphere, with high detection rates across the dataset. It is the first study to show the occurrence of PFAS in the tissues of multiple species of Cetacea from the Australasian region, demonstrating high global concentrations for inshore dolphins. Finally, it provides key baseline knowledge to the potential exposure and bioaccumulation of PFAS compounds within the coastal environment of south-east Australia., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

In 2017 Cooktown resident Donna Steele was murdered and the case remained unsolved for more than a year. The forensic evidence from the investigation included two lengths of synthetic twine and a new protocol for the comparison of twine was developed to enhance the potential value of any evidence. The method was developed using 23 samples of similar twine collected across Australia. Traditional methods of physical and microscopic comparisons and polymer analysis by infrared spectroscopy were retained. Micro-spectrophotometry was used as an objective assessment of colour and was able to identify five groupings within the background samples. Measurements of hydrogen and carbon stable isotopic composition provided further delineation of the background samples. Combining traditional methods with micro-spectrophotometry and stable isotope measurements, the two case samples were found to be distinct from the background population and were indistinguishable when compared to each other., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2023. Published by Elsevier B.V. All rights reserved.)

Background: Postnatal depression (PND) is a leading cause of illness and death among women following childbirth. Physical inactivity, sedentary behaviour, poor sleep, and sub-optimal diet quality are behavioural risk factors for PND. A feasible, sustainable, and scalable intervention to improve healthy behaviours and reduce PND symptoms among women at postpartum is needed. This study aims to examine the effectiveness of a multi-behavioural home-based program Food, Move, Sleep (FOMOS) for Postnatal Mental Health designed to improve PND symptoms in women at postpartum., Methods: This randomised clinical trial will recruit 220 Australian women (2-12 months postpartum) experiencing heightened PND symptoms (Edinburgh Postnatal Depression Scale score ≥ 10). Participants will be randomised to FOMOS or wait-list control receiving standard clinical care. FOMOS is a 6-month mobile health (mHealth) intervention targeting diet quality, physical activity, sedentary behaviour, sleep, and mental health. The intervention, informed by the Social Cognitive Theory and incorporating behaviour change techniques defined in the CALO-RE taxonomy and Cognitive Behavioural Treatment of Insomnia, provides exercise equipment, and educational/motivational material and social support via mHealth and social media. Data collection pre-intervention and at 3, 6 and 12 months will assess the primary outcome of PND symptoms and secondary outcomes (diet quality, physical activity, sitting time, sleep quality) using self-report and device measures. Process evaluation will explore acceptability, appropriateness, cost-effectiveness, feasibility, and sustainability via analytic tools, record keeping, interviews, and surveys., Discussion: If effective, FOMOS could be a feasible and potentially scalable management strategy to support improvement of health behaviours and mental health for women with PND symptoms., Trial Registration: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12622001079730p., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)