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Resistance to stagonospora nodorum blotch (SNB) in glumes of hexaploid wheat (Triticum aestivum L.), caused by Phaeosphaeria (Stagonospora anamorph) nodorum was investigated in a recombinant-inbred (RI) population. The Purdue University winter wheat breeding lines P9119301 and P92201D5, unrelated by parentage but both exhibiting partial SNB resistance, were crossed to develop 254 RI lines by single-seed descent (SSD) from a random population of F2 plants, to identify quantitative trait loci (QTLs) controlling SNB resistance in wheat glumes. The RI population, together with parent lines, was pheno- typed for glume resistance to SNB under field conditions in F8:10 at Evansville, Vincennes, and Lafayette, IN, in 2003; in F7:9 at South Perth, Australia, in 2004; and in F8:10 in greenhouse-grown inoculated tests at Lafayette in 2003 and 2004. Two QTLs for resistance to SNB in glumes were identified: QSng.pur-2DL.1 from P9119301 and QSng.pur-2DL.2 from P9220 1 D5. The QTL QSng. pur-2DL.1 explained from 12.3% of the phenotypic variation for resistance in southern Indiana (Evansville and Vincennes) to 38.1% at South Perth; QSng.pur-2DL.2 accounted for 6.9 and 11.2% of the phenotypic variation in Indiana and South Perth, respectively. This study is the first report of SNB glume blotch resistance in which the same QTLs were identified in tests on different continents where Stagonospora nodorum populations are probably genetically diverse. [ABSTRACT FROM AUTHOR]

Background and Objectives: The UK provided guidance for general practitioners (GPs) to deliver essential care services during the COVID-19 pandemic. Our objective was to describe local GP experiences and approaches to delivering care while similar formal guidance in Australia was unavailable., Method: Two hundred and ninety-one GPs who practised during the March 2020 to December 2021 COVID-19 lockdowns in Melbourne and Sydney undertook an electronic survey exploring perceptions of essential care service delivery. The provision of care by Australian practices was compared to UK Royal College of General Practitioners' recommendations., Results: Of 274 completed surveys, Australian GP practices were 60% concordant with UK guideline recommendations. There was a large shift towards telehealth service provision across the board, from diagnosis to follow-up. Most care continued if it was deliverable through telehealth or had urgent or time-sensitive need., Discussion: Local guidance for delivery of essential care services should be developed for future calamities, informed by GPs' experience practising during the COVID 19 pandemic and considering Australian contextual factors.

Background and Objectives: General practitioners (GPs) are ideally placed to deliver early medical abortion (EMA), yet little is known about how GPs deliver this care to women from culturally and linguistically diverse (CALD) backgrounds. We explored GP experiences in providing EMA to women from CALD backgrounds and their recommendations for service improvements., Method: This was a qualitative study involving telephone interviews with 18 Australian GPs who provide EMA to women from CALD backgrounds. Data were thematically analysed using the Capability, Opportunity and Motivation Behaviour model., Results: GPs experienced challenges in communication and cultural competency when delivering EMA to women from CALD backgrounds due to insufficient training, lack of multilingual resources and difficulties accessing interpreters. In addition, the stigma surrounding abortion and concerns around reproductive coercion made engaging these women challenging., Discussion: Upskilling GPs in culturally competent care, improving access to multilingual resources and enabling efficient interpreter use can optimise EMA delivery to women from CALD backgrounds.

Objective: The aim of this study is to estimate the prevalence of unintended pregnancy and associated socio-demographic and health-related factors among a national cohort of young Australian women., Methods: Secondary analysis of three waves (2013-2015) of the Australian Longitudinal Study on Women's Health new young cohort. Women born between 1989 and 1995 were recruited through internet and traditional media, and peer referral. Respondents completed a baseline web-based survey in 2013 (n=17,010) on their health and healthcare use and were followed up annually. This analysis uses data from women reporting ever having vaginal sex in waves 2 (n=9,726/11,344) and 3 (n=6,848/8,961). We assessed correlates of lifetime and recent unintended pregnancy using multivariable regression models., Results: At wave 2, among women aged 19-24, lifetime prevalence of unintended pregnancy was 12.6%, rising to 81.0% among ever pregnant women. Pregnancy outcomes among women with a history of unintended pregnancy differed by geographical residence. Disparities in odds of unintended pregnancy were seen by relationship and educational status, contraceptive use, sexual coercion and risky alcohol use., Conclusions: Unintended pregnancy among young Australians is disproportionally experienced by women with structural disadvantages and exposure to sexual coercion., Public Health Implications: Service improvements to achieve equitable distribution of contraception and abortion services must be integrated with initiatives responding to sexual coercion., Competing Interests: Conflict of interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kristina Edvardsson reports financial support was provided by SPHERE, the National Health and Medical Research Council Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care. Wendy V Norman reports a relationship with Society of Family Planning that includes: board membership. Co-author Wendy V Norman receives family planning research grants from Canadian and UK governments and not for profit associations, none of which are related to this project., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: Women living in rural and regional Australia often experience difficulties in accessing long-acting reversible contraception (LARC) and medical abortion services. Nurse-led models of care can improve access to these services but have not been evaluated in Australian general practice. The primary aim of the ORIENT trial (ImprOving Rural and regIonal accEss to long acting reversible contraceptioN and medical abortion through nurse-led models of care, Tasksharing and telehealth) is to assess the effectiveness of a nurse-led model of care in general practice at increasing uptake of LARC and improving access to medical abortion in rural and regional areas., Methods and Analysis: ORIENT is a stepped-wedge pragmatic cluster-randomised controlled trial. We will enrol 32 general practices (clusters) in rural or regional Australia, that have at least two general practitioners, one practice nurse and one practice manager. The nurse-led model of care (the intervention) will be codesigned with key women's health stakeholders. Clusters will be randomised to implement the model sequentially, with the comparator being usual care. Clusters will receive implementation support through clinical upskilling, educational outreach and engagement in an online community of practice. The primary outcome is the change in the rate of LARC prescribing comparing control and intervention phases; secondary outcomes include change in the rate of medical abortion prescribing and provision of related telehealth services. A within-trial economic analysis will determine the relative costs and benefits of the model on the prescribing rates of LARC and medical abortion compared with usual care. A realist evaluation will provide contextual information regarding model implementation informing considerations for scale-up. Supporting nurses to work to their full scope of practice has the potential to increase LARC and medical abortion access in rural and regional Australia., Ethics and Dissemination: Ethics approval was obtained from the Monash University Human Research Ethics Committee (Project ID: 29476). Findings will be disseminated via multiple avenues including a knowledge exchange workshop, policy briefs, conference presentations and peer-reviewed publications., Trial Registration Number: This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000086763)., Competing Interests: Competing interests: DM has received research and conference attendance funding, speaker fees and been an advisory board member for Bayer, Organon and MSD. DB has provided education for doctors sponsored by Bayer and Organon and has been an advisory board member for Bayer, Organon and MSD. DB has never received personal remuneration for these services. During this study WVN was a member of the Board of Directors of the Society of Family Planning. She receives family planning research grants from Canadian and UK governments and not for profit associations, none of which are related to this project., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Key Message: Novel sources of genetic resistance to tan spot in Australia have been discovered using one-step GWAS and genomic prediction models that accounts for additive and non-additive genetic variation. Tan spot is a foliar disease in wheat caused by the fungal pathogen Pyrenophora tritici-repentis (Ptr) and has been reported to generate up to 50% yield losses under favourable disease conditions. Although farming management practices are available to reduce disease, the most economically sustainable approach is establishing genetic resistance through plant breeding. To further understand the genetic basis for disease resistance, we conducted a phenotypic and genetic analysis study using an international diversity panel of 192 wheat lines from the Maize and Wheat Improvement Centre (CIMMYT), the International Centre for Agriculture in the Dry Areas (ICARDA) and Australian (AUS) wheat research programmes. The panel was evaluated using Australian Ptr isolates in 12 experiments conducted in three Australian locations over two years, with assessment for tan spot symptoms at various plant development stages. Phenotypic modelling indicated high heritability for nearly all tan spot traits with ICARDA lines displaying the greatest average resistance. We then conducted a one-step whole-genome analysis of each trait using a high-density SNP array, revealing a large number of highly significant QTL exhibiting a distinct lack of repeatability across the traits. To better summarise the genetic resistance of the lines, a one-step genomic prediction of each tan spot trait was conducted by combining the additive and non-additive predicted genetic effects of the lines. This revealed multiple CIMMYT lines with broad genetic resistance across the developmental stages of the plant which can be utilised in Australian wheat breeding programmes to improve tan spot disease resistance., (© 2023. Crown.)

Key Message: GWAS detected 11 yellow spot resistance QTL in the Vavilov wheat collection. Promising adult-plant resistance loci could provide a sustainable genetic solution to yellow spot in modern wheat varieties. Yellow spot, caused by the fungal pathogen Pyrenophora tritici-repentis (Ptr), is the most economically damaging foliar disease of wheat in Australia. Genetic resistance is considered to be the most sustainable means for disease management, yet the genomic regions underpinning resistance to Ptr, particularly adult-plant resistance (APR), remain vastly unknown. In this study, we report results of a genome-wide association study using 295 accessions from the Vavilov wheat collection which were extensively tested for response to Ptr infections in glasshouse and field trials at both seedling an adult growth stages. Combining phenotypic datasets from multiple experiments in Australia and Russia with 25,286 genome-wide, high-quality DArTseq markers, we detected a total of 11 QTL, of which 5 were associated with seedling resistance, 3 with all-stage resistance, and 3 with APR. Interestingly, the novel APR QTL were effective even in the presence of host sensitivity gene Tsn1. These genomic regions could offer broad-spectrum yellow spot protection, not just to ToxA but also other pathogenicity or virulence factors. Vavilov wheat accessions carrying APR QTL combinations displayed enhanced levels of resistance highlighting the potential for QTL stacking through breeding. We propose that the APR genetic factors discovered in our study could be used to improve resistance levels in modern wheat varieties and contribute to the sustainable control of yellow spot.

The Australian continent was free from wheat stripe rust caused by Puccinia striiformis f. sp. tritici until exotic incursions occurred in 1979 and 2002. The 2002 incursion enabled the identification of a new stripe rust resistance gene (Yr34) in the advanced breeding line WAWHT2046. In this study, we developed and validated markers closely linked with Yr34, which is located in the distal region in the long arm of chromosome 5A. Four kompetitive allele-specific polymerase chain reaction (KASP) and three sequence-tagged site (STS) markers derived from the International Wheat Genome Sequencing Consortium RefSeq v1.0 scaffold-77836 cosegregated with Yr34. Markers sun711, sun712, sun725, sunKASP_109, and sunKASP_112 were shown to be suitable for marker-assisted selection in a validation panel of 71 Australian spring wheat genotypes, with the exception of cultivar Orion that carried the Yr34-linked alleles for sunKASP_109 and sunKASP_112. Markers previously reported to be linked with adult plant stripe rust resistance gene Yr48 also cosegregated with Yr34. Wheat genotypes carrying Yr34 and Yr48 produced identical haplotypes for the Yr34-linked markers identified in this study and those previously reported to be linked with Yr48. Phenotypic testing of genotypes carrying Yr34 and Yr48 showed that both genes conferred similar seedling responses to pre-2002 and post-2002 P. striiformis f. sp. tritici pathotypes. Further testing of 600 F 2 plants from a cross between WAWHT2046 and RIL143 (Yr48) with P. striiformis f. sp. tritici pathotype 134 E16A+Yr17+Yr27+ failed to reveal any susceptible segregants. Our results strongly suggest that Yr34 and Yr48 are the same gene, and that Yr48 should be considered a synonym of Yr34.

Objectives: To examine access and equity to induced abortion services in Australia, including factors associated with presenting beyond nine weeks gestation., Methods: Cross-sectional survey of 2,326 women aged 16+ years attending for an abortion at 14 Dr Marie clinics. Associations with later presentation assessed using multivariate logistic regression., Results: Over a third of eligible women opted for a medical abortion. More than one in 10 (11.2%) stayed overnight. The median Medicare rebated upfront cost of a medical abortion was $560, compared to $470 for a surgical abortion at ≤9 weeks. Beyond 12 weeks, costs rose considerably. More than two-thirds (68.1%) received financial assistance from one or more sources. Women who travelled ≥4 hours (AdjOR: 3.0, 95%CI 1.2-7.3), had no prior knowledge of the medical option (AdjOR: 2.1, 95%CI 1.4-3.1), had difficulty paying (AdjOR: 1.5, 95%CI 1.2-1.9) and identified as Aboriginal and/or Torres Strait Islander (AdjOR: 2.1, 95%CI 1.2-3.4) were more likely to present ≥9 weeks., Conclusions: Abortion costs are substantial, increase at later gestations, and are a financial strain for many women. Poor knowledge, geographical and financial barriers restrict method choice. Implications for public health: Policy reform should focus on reducing costs and enhancing early access., (© 2017 The Authors.)