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Background: In Queensland, each hospital and health service (local hospital network) has its own waste reduction and recycling plan to comply with the Queensland Government's Waste Reduction and Recycling Act 2011 (Qld). The aim is to reduce both the hospital's carbon footprint and waste handling costs. Hospital environmental waste services staff do not audit pharmaceutical waste bins as this requires the presence of a registered pharmacist. Aim: Since previous published studies of healthcare waste disposal practices have not included pharmacy waste bin audits, this study aimed to investigate waste disposal behaviours in a hospital pharmacy department. Method: This sequential, two‐phase mixed methods study was conducted in a metropolitan, tertiary public hospital's pharmacy department in Queensland. Phase I involved semi‐structured interviews of hospital pharmacists and pharmacy technicians while Phase II comprised bin audits of the pharmacy department's waste streams. Results: The bin audits revealed 36.1%, 23.8%, and 4.9% of recyclable waste in the clinical waste stream for each of the three bin audits respectively. In the general waste stream, the two bin audits of this stream revealed 14.3% and 44.4%, respectively. The reasons were identified in the interviews: there were no recycling bins in the main dispensing areas and there was confusion surrounding correct disposal of original containers and non‐contaminated packaging waste. Non‐paper waste was found in the confidential (shredded) waste stream in the two bin audits of this stream (10.1% and 16.7%, respectively). Conclusion: Provision of commingled recycling bins and clean office paper waste bins in dispensing areas and education of staff on correct waste segregation processes will improve waste segregation in hospital pharmacy departments with both financial and environmental benefits for the hospital and the general population. [ABSTRACT FROM AUTHOR]

Introduction: This discussion paper investigates workforce shortage of Australian sonographers through identifying educational responses to the shortage. Method: An ethnographic content analysis of insights into the sonographer workforce provided in the Australian Government Department of Employment occupational reports (2007‐2016) and current education models across providers of prequalification sonographer education and data correlation with Australian Sonographer Accreditation Registry, education provider correspondence, and website information were conducted. Results: Industry‐identified shortage factors related to prequalification education including sonographer quantity and suitability, education model and location, student admission, and skill and attribute training. Educational changes related to these factors were identified. Queensland demonstrated the greatest increase in sonographer (166%) and student (1000%) numbers (2007‐2016). Population‐weighted binomial ratios identified South Australia with the highest number of sonographers and students per head of population (2016). In 2016, sonographers graduated from the UG+1 Postgraduate Model (74.6%), Direct Entry Postgraduate Model (18%), and UG+1 Postgraduate Model with mandatory simulated skill training (7.4%). Discussion Sonographer and student supply increased, indicating growth in clinical training capacity (2007‐2016). Increased sonographer demand meant workforce shortage was relatively static. Educational response involved change to education models with characteristics related to shortage factors. Research into these education models may identify strategies to further increase clinical training capacity. [ABSTRACT FROM AUTHOR]

In 2001, a study into issues of concern to assistant-in-nursing, registered and enrolled nurse members of the Queensland Nurses Union was undertaken. Approximately equal numbers of nurses from each of the aged care, acute private and acute public sectors were surveyed. Overall, 1477 nurses responded, representing a response rate of 53%. This article focuses on one aspect of the study—the perceived adequacy of support offered to new nursing graduates as they exit university and begin their transition into the workplace. In particular, responses from nurses are compared with professional level or current role designation, age, time spent in the workplace and health sector. Considerable divergence of opinion among the respondents, particularly across designation, age and years of experience, was found within the three sectors. For example, in the public and private employment sectors, older and more experienced nurses were more likely to perceive the support for new nurses as adequate compared to younger and less experienced nurses. Additionally, in the acute private sector, the more senior the nurse the more likely the perception that there was adequate preparation for new graduates entering the workforce. [ABSTRACT FROM AUTHOR]

Public health, Health promotion, Legislation, medical, Health services, Indigenous health, Healthcare disparities, Patient rights This is because access to health services under the AAAQ framework cannot be considered separate and distinct from health service availability, acceptability and quality: all four AAAQ elements are essential, and overlap and interrelate.[8], [9], [10] For example, a health service might be available on paper, but it is not accessible in practice because the Indigenous health consumer has a disability and is unable to access the health service building or cannot access a computer in an appropriate space for a confidential telehealth consultation. Keywords: Public health; Health promotion; Health services; Legislation, medical; Indigenous health; Healthcare disparities; Patient rights EN Public health Health promotion Health services Legislation, medical Indigenous health Healthcare disparities Patient rights 5 8 4 01/17/23 20230116 NES 230116 Queensland's approach to Indigenous health equity planning and implementation should align with existing international frameworks The Australian state of Queensland is embedding Indigenous-led strategies to advance health equity for Aboriginal and Torres Strait Islander people (hereafter respectfully referred to as Indigenous people) on paper and in practice. [Extracted from the article]

Background: Polypharmacy in haemodialysis patients can not only manifest as the continued prescribing of unnecessary medications but also has the potential to increase medication‐related hospital admissions, morbidity, and mortality. A validated deprescribing algorithm has recently been developed, specifically targeted at dialysis patients. This paper audits the experience of implementing this algorithm in Australian dialysis settings. Aim: The aim of this paper was to evaluate the usefulness and applicability of the pharmacist‐led Toronto deprescribing tool in Australian haemodialysis settings. Method: The pharmacist‐led deprescribing algorithm was implemented across two metropolitan sites and one rural site. The audit focused on five medications that could potentially be deprescribed in the target patient group (diuretics, alpha blockers, statins, proton pump inhibitors [PPIs], and quinine). Between 1 and 12 months later, a reaudit was conducted, with patients followed up to confirm if medications remained deprescribed. Results: Two hundred and eleven patients across three sites were reviewed. Application of the algorithm resulted in 168 medications deemed appropriate to deprescribe. Of these 168 medications, 56 (33%) were initially deprescribed, with 50 medications (30%) remaining deprescribed on reaudit. The deprescribing rates varied between the three different services, with initial deprescribing rates ranging from 18% to 61%. After follow‐up, deprescribing changes across target medications were fairly static, with only a small number of patients restarting either their diuretic or PPI. Conclusion: The pharmacist‐led deprescribing algorithm resulted in substantial deprescribing across the three sites. Deprescribing rates varied between the sites due to differences in the team model that the pharmacist worked within and the method of the rollout. Further studies should draw on aspects such as finding enablers to overcome prescriber and patient concerns about deprescribing and the aspects of which team models lead to higher rates of successful deprescribing. [ABSTRACT FROM AUTHOR]

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

Issue Addressed: Queensland children have a higher level of developmental vulnerability compared to the Australian average. This paper reports on Healthy Kids—a capacity building strategy for the early childhood education and care (ECEC) sector targeting communities experiencing socio‐economic and child development vulnerabilities. These communities may face additional barriers when engaging and participating in health promotion models. This paper reports on the development, key components and principles of a capacity building model referred to as Healthy Kids, that strategically responds to these barriers and supports these communities. Methods: The development of the Healthy Kids model emerged through a quality improvement process that included an environmental scan, and review of existing capacity building, health promotion, and workforce development approaches. It also involved consultation and engagement with the ECEC sector. Results: Evidence indicates Healthy Kids to be an innovative health promotion model focussed on building capacity through a workforce development strategy for the ECEC sector in a way that is accessible, low cost, and sustainable. So What?: This paper shares a model for building capacity through the establishment of localised cross‐sector communities of practice across a large geographic region with a centralised coordinating hub. The hub and spoke model has facilitated community ownership to grow and be sustained over time. This model offers opportunities for partnerships, transferability, and contextualisation for those interested in contemporary health promotion, capacity building, and workforce development. The model offers an approach for those willing to step outside traditional boundaries to work across sectors and settings to achieve sustainable knowledge and skills, processes and resources that enables a collective commitment to improving health outcomes. [ABSTRACT FROM AUTHOR]

The paper 'Biodiversity values of remnant freshwater floodplain lagoons in agricultural catchments: evidence for fish of the Wet Tropics bioregion, northern Australia', published in Aquatic Conservation: Marine and Freshwater Ecosystems in 2015, has contributed in several ways to the integration of freshwater wetland science within new catchment management policies and practices for Great Barrier Reef (GBR) sustainability.The Tully–Murray biodiversity study developed novel protocols to sample larval, juvenile, and adult fish life‐history stages in floodplain lagoons using a combination of boat‐based backpack electrofishing and fyke netting. In addition, hydrological and hydrodynamic models were applied in a completely new way to quantify the timing, extent, and duration of water connectivity across floodplain streams, cane drains, and wetlands. Combining the two novel approaches enabled an analysis of lagoon fish assemblage patterns in relation to environmental gradients, especially floodplain hydrology, connectivity patterns, and measures related to agricultural land use.In demonstrating the importance of different levels of connectivity for different biodiversity outcomes in freshwater floodplain lagoons of the Tully–Murray catchment, the subject paper established that floodplain connectivity needs to be taken into consideration in wetland management practices.The timing of the subject publication was fortuitous. It coincided with the preparation of the evidence‐based 2017 Scientific Consensus Statement on land‐based water quality impacts on the GBR. As one of the few freshwater wetland ecology publications for the catchments of the GBR at that time, this paper played an important role in demonstrating freshwater wetland values, fish conservation options, and management imperatives to sustain wetland ecological health and services in GBR catchments.By advancing the understanding of factors driving biodiversity patterns, and the importance of connectivity and ecohydrological processes in freshwater floodplain wetlands of the GBR catchment, the Tully–Murray study helped to drive new policy directives for the protection and restoration of catchment, floodplain, and estuary functions, and connectivity, now embedded in the Reef 2050 Long‐Term Sustainability Plan 2018, an overarching strategy for managing the GBR over the next 35 years, and complementary Queensland environmental legislation. [ABSTRACT FROM AUTHOR]

Insects commonly rely on olfactory, gustatory and visual cues when deciding where to lay eggs. The olfactory cues that stimulate oviposition in the Queensland fruit fly, Bactrocera tryoni (Froggatt) (Diptera: Tephritidae), are not well understood. Here, we show that two known oviposition stimulants of the Oriental fruit fly, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae)—γ‐octalactone and benzothiazole—strongly elicit aggregation and oviposition in B. tryoni. Two other known oviposition stimulants of B. dorsalis—ethyl tiglate and 1‐octen‐3‐ol—elicit aggregation but not oviposition. Highlighting species overlap, but also differences, in oviposition stimulants, these findings have practical application for mass‐rearing in which vast numbers of flies are reared for sterile insect technique programs and may also have practical application in the development of pest management and monitoring tools. [ABSTRACT FROM AUTHOR]

Objective: A shared care model was implemented in 2006 in Queensland to facilitate paediatric oncology, haematology and palliative care patients receiving care as close to home as possible. Following initial diagnosis, care planning and treatment at the tertiary children's hospital, appropriate local care was coordinated by Regional Case Managers (RCMs) established at each of 10 Shared Care Units (SCUs). This enabled safe and quality regional care supported by a statewide network providing clinical governance and education. This paper examines learnings from 15 years of this shared care. Setting: Ten hospitals throughout Queensland facilitated a statewide model of shared care for paediatric oncology, haematology and palliative care patients, supported by a tertiary hub in Brisbane. Participants: Regional Case Managers in Shared Care Units and their supporting staff. Design Staff from SCUs were surveyed and focus group interviews conducted. Results: The paper reviews the attributes, knowledge and experience required for RCMs. Standards of care were supported through education workshops, clinical placements, chemotherapy credentialing, guidelines and standards. RCMs facilitated communication and information sharing with the tertiary centre, advocated for their cohort of patients locally and streamlined and supported the family's experience of care. Conclusion: The RCM role provided invaluable clinical leadership for the care of paediatric oncology, haematology and palliative patients across Queensland. As new treatments evolve, the expertise and coordination provided by the RCMs will be even more critical. Achieving high‐quality shared care outcomes is underpinned by the RCMs drive to achieve statewide safety and support for this cohort of children. [ABSTRACT FROM AUTHOR]