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Objective: The causal effect of successive population-wide lockdowns in response to increased COVID-19 cases on mental health has yet to be examined using robust methods. A natural experiment design underpinned by objective data can improve our understanding surrounding the definitive impact of social distancing restrictions. Methods: The study employed a natural experiment design underpinned by objective data. Health service cost for visits to general practitioners and psychologists and medication dispensing costs served as objective measures of mental health. Difference-in-difference (DID) estimators, which in this study quantify differences in spending changes between groups over time, were produced based on three comparisons: Victoria 2020 lockdown comparison, Victoria 2021 lockdown comparison, and New South Wales (NSW) 2021 lockdown comparison. Specifically, differences in public health service spending during lockdown periods and the same timeframe in 2019 for Victoria and NSW, and control groups (remaining states and territories), were compared. Results: Positive estimator values indicate that public health service spending for Victoria and NSW increased more during lockdown periods compared to control states and territories. The Victorian lockdowns of 2020 and 2021, but not the NSW lockdown of 2021, resulted in increased public spending for general practitioner mental health consults (2020 DID estimator: $8498.96 [95% CI $4012.84, $12,373.57], 2021 DID estimator: $6630.06 [95% CI $41.27, $13,267.20], all monetary values in AUD$) and short visits to psychologists (2020 DID estimator: $628.82 [95% CI $466.25, $796.00], 2021 DID estimator: $230.11 [95% CI $47.52, $373.98]). The first Victorian lockdown in 2020 and the NSW lockdown in 2021 resulted in greater spending on short visits to clinical psychologists. Spending on long visits to psychologists and clinical psychologists and medication spending did not change. Conclusions: Strict lockdowns can have an adverse impact on population mental health. The impact is particularly evident in those who have a history of previous mental health concerns but does not necessitate extra use of medications, suggesting that psychological care can address the adverse impact of the lockdowns. What is known about the topic? Previous research varied in methodology, using self-reports and healthcare data to understand COVID-19 social distancing public health measures' effects on mental health. What does this paper add? This study introduces robust, objective data via a natural experiment design, examining the impact of successive lockdowns on mental health service usage and medication expenditures in specific Australian regions. What are the implications for practitioners? Findings highlight the need for flexible mental health services that can swiftly respond to increased demands during prolonged restrictions, without necessarily increasing medication use, guiding future policy and resource allocation. [ABSTRACT FROM AUTHOR]

Objective: To provide the first document map of sustainability and decarbonisation actions across the Australian healthcare sector, as reported in publicly available documents online, and to identify gaps in actions. Methods: Healthcare providers were identified across all state and territories. Structured Google searches between August and December 2022 were followed by document searches. Updates were undertaken, most recently in December 2023. Targeted documents included position statements, strategies, and reports. Key points from these documents pertaining to sustainability and/or decarbonisation were extracted and descriptively analysed. Results: A total of 294 documents were included, mostly focused on power generation, transport, building design, and circular procurement/waste pathways. In contrast, relatively few plans for decarbonisation of clinical care were identified (n = 42). National and two state governments (New South Wales, Western Australia) have established healthcare sustainability and decarbonisation units, and two further states have publicly committed to doing so (Queensland, Tasmania). However, these documents generally reported separate, siloed actions. While attempts were made to make this review comprehensive, some documents may have been missed or are only available inside an organisation, and new actions will continue to emerge. Conclusion: Broad sustainability plans have been developed by many healthcare providers; however, to achieve net zero, decarbonising of clinical practices is also needed, and this is where the least action is currently occurring. To decarbonise clinical care, the sector needs to come together in a more coordinated way. What is known about the topic? Little is known about what actions are occurring to make healthcare more sustainable and to reduce the carbon footprint of healthcare in Australia. What does this paper add? This paper provides a snapshot of publicly available documents from healthcare providers and professional organisations as they relate to healthcare sustainability and helps reveal the gaps and siloed nature of current actions. What are the implications for practitioners? This paper can help jurisdictions identify gaps or areas for improvement and may aid in targeted and coordinated interventions, especially as they relate to decarbonised clinical care. [ABSTRACT FROM AUTHOR]

Background: Electronic medical records (EMRs) have been widely implemented in Australian hospitals. Their usability and design to support clinicians to effectively deliver and document care is essential, as is their impact on clinical workflow, safety and quality, communication, and collaboration across health systems. Perceptions of, and data about, usability of EMRs implemented in Australian hospitals are key to successful adoption. Objective: To explore perspectives of medical and nursing clinicians on EMR usability utilising free-text data collected in a survey. Method: Qualitative analysis of one free-text optional question included in a web-based survey. Respondents included medical and nursing/midwifery professionals in Australian hospitals (85 doctors and 27 nurses), who commented on the usability of the main EMR used. Results: Themes identified related to the status of EMR implementation, system design, human factors, safety and risk, system response time, and stability, alerts, and supporting the collaboration between healthcare sectors. Positive factors included ability to view information from any location; ease of medication documentation; and capacity to access diagnostic test results. Usability concerns included lack of intuitiveness; complexity; difficulties communicating with primary and other care sectors; and time taken to perform clinical tasks. Conclusion: If the benefits of EMRs are to be realised, there are good reasons to address the usability challenges identified by clinicians. Easy solutions that could improve the usability experience of hospital-based clinicians include resolving sign-on issues, use of templates, and more intelligent alerts and warnings to avoid errors. Implications: These essential improvements to the usability of the EMR, which are the foundation of the digital health system, will enable hospital clinicians to deliver safer and more effective health care. [ABSTRACT FROM AUTHOR]

Background: StrokeLine is a stroke‐specific helpline used by stroke survivors and their families in Australia to access professional support. There has been little research exploring stroke survivors' experiences of using helplines and their perceived impact on their stroke recovery. Aim: The aim of this study is to explore the reasons prompting stroke survivors to call StrokeLine and their experiences and to describe the perceived impact of calling StrokeLine on their recovery. Methods: An exploratory descriptive qualitative study was undertaken using thematic analysis of data collected through semi‐structured interviews of stroke survivors between December 2020 and May 2022. Participants were recruited using purposive sampling. Interviews were conducted via audio‐recorded Zoom conference calling and transcribed verbatim for thematic analysis. Results: A total of eight callers (four men and women women) participated, with the time since stroke ranging from 3.5 months to 5 years. Four major themes were identified, including 17 sub‐themes. Key themes included (1) factors prompting use of StrokeLine; (2) experience of using StrokeLine; (3) perceived impact of using StrokeLine; and (4) conceptualising StrokeLine service provision. Conclusions: Participants perceived their experience of contacting StrokeLine as having a positive impact on their stroke recovery, leaving them feeling empowered and motivated to self‐manage their condition. Patient or Public Contribution: Stroke survivors with lived experience influenced the conceptualisation of this study through conversations with consumers and the Stroke Foundation. Eight stroke survivors were involved as participants in the research study. [ABSTRACT FROM AUTHOR]

In Australia, community gardens (CGs) commonly take the form of communally-operated growing spaces situated on public land administered by local governments (LGs). LGs and their policies are gatekeepers for CGs, and their support can determine garden viability; however, evidence regarding the nature of "support" in this context is limited. This research identified CG policies through the websites of all LGs (n = 207) in New South Wales (NSW) and Victoria, Australia and analysed these policies to describe which LGs have a CG policy, the aims of LGs' support, the departments responsible for CGs, and what practical supports LGs provide. Thirty-nine CG policies were analysed. Most commonly, policies existed to provide a standardised framework for how LG would facilitate community groups to establish and manage CGs, and to define the roles and responsibilities of LG and community groups. Departments responsible for CG policy implementation were categorised as Community, Environment and Infrastructure, Planning, and/or Strategic and Corporate. Overall, LGs took a "hands-off" facilitator role, rather than one of an implementation partner. Common supports during application and establishment included LG arranging a licence agreement for leasing the land, assisting with site identification, and helping groups with the application process. During the garden maintenance phase, the most common supports were providing platforms for networking between CGs, providing education and information, assisting groups to apply for grants, and providing in-kind support. Recommendations for LGs, community members, and other levels of government are provided. Key Policy Highlights Currently, the nature of support provided by Australian local governments to community gardens is variable and largely limited to a "facilitator" role. Local government support could be strengthened by producing clear and comprehensive policies, reducing bureaucratic red tape, and institutionalising processes that preserve public land for food production. All levels of government can allocate ongoing funding for edible gardens at community level. [ABSTRACT FROM AUTHOR]

In this paper, we offer a conjunctural analysis of policing and incarceration, examining their expansion in relation to structural economic conditions over the last 50 years and interrogating how the sudden onset of the Covid-19 pandemic enabled extraordinary growth in policing powers in the Australian jurisdictions of New South Wales (NSW) and Victoria (VIC). We examine how popular support for police-led responses to crisis and fines as a common-sense solution to social problems were sought during the period that the Public Health Orders were in effect in the two states. We argue that the discursive project of naturalizing the police-led response to the pandemic—via official communications from the state governments as well as media coverage of the pandemic—attempts to further entrench a vision of law and order governance in which infrastructures of discipline and punishment are necessary and inevitable. We identify this vision as a direct barrier to abolition and a significant limit on the capacity to imagine alternative frameworks for justice. We end by considering a small archive of tweets from users in NSW and VIC published on the social media platform formerly known as Twitter (now called X) in 2020–21. We argue that this archive registers the way the common-sense status of the fine as an efficient, effective, and equitable punishment gives way to punitive fantasies about police and prisons. We read this archive alongside the broad refusal to pay Covid-related fines and the ongoing legal disputes contesting the legitimacy of their issuance, concluding by proposing that the conjunctural moment of the Covid-19 pandemic has given rise to unresolved contradictions between the naturalized logic of law and order crisis management and the potential for this logic to come undone. [ABSTRACT FROM AUTHOR]

The oomycete genus Phytophthora includes plant pathogens that pose significant threats to agricultural systems, natural ecosystems and urban forests. Urban forests are increasingly recognized for their role in mitigating climate change impacts and urban greening initiatives are underway worldwide. However, research suggests that the urban forest is also a reservoir of Phytophthora diversity, acting as bridgeheads for the introduction of these pathogens into production and natural ecosystems. The source of Phytophthora in urban forests is linked to anthropogenic factors, with the live plant trade the primary pathway. This study focused on the incidence and diversity of Phytophthora in amenity tree nursery stock in eastern Australia, primarily New South Wales, with one nursery from Victoria. The findings revealed a high incidence of Phytophthora in nursery stock destined for urban greening projects, having an overall positive rate of 22.1%, with incidence in individual nurseries ranging from 2.5% to 32%. The study detected 13 described Phytophthora species that are considered polyphagous on woody hosts and three lineages that potentially represent novel species. In addition, the detection of P. mediterranea and P. heterospora represent first reports for Australia, with P. mediterranea considered a biosecurity concern. The study highlights the substantial risk associated with the live plant trade as a source of Phytophthora introduction into urban forests and beyond. These findings underscore the urgent need to strictly implement clean nursery management practices to reduce the economic and environmental risks associated with Phytophthora in urban greening programmes. [ABSTRACT FROM AUTHOR]

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

We explore the impact of language education policy on language enrolments and provision in primary and secondary government schools In Australia, specifically in New South Wales (NSW) and Victoria, which have strikingly different policy settings. NSW adopts a 'weak but flexible' policy, mandating a very limited minimum time allocation for language study but allowing multiple entry points at senior secondary level. Victoria adopts a 'strong' mandatory policy, requiring continuous commitment to language study. Using available data, the study first compares enrolment data trends overall before considering the most widely taught languages at primary and secondary level, with additional analysis of a single secondary student cohort. Amongst the findings, we observe a marked reversal of previously falling language enrolments over time in Victoria, with substantially higher numbers overall compared to NSW where numbers have instead fallen, thus seemingly attesting to the impact of effective mandatory policies. While neither policy setting seems impactful enough in attracting and sustaining language study through to senior secondary level, a seeming pattern of convergence at this level masks at least partly the effect of access to alternative learning mechanisms on enrolments, resulting in much more frequent completion of Year 12 language study in Victoria. [ABSTRACT FROM AUTHOR]

The Strengthening Care for Children (SC4C) is a general practitioner (GP)-paediatrician integrated model of care that consists of co-consulting sessions and case discussions in the general practice setting, with email and telephone support provided by paediatricians to GPs during weekdays. This model was implemented in 21 general practices in Australia (11 Victoria and 10 New South Wales). Our study aimed to identify the factors moderating the implementation of SC4C from the perspectives of GPs, general practice personnel, paediatricians and families. We conducted a qualitative study as part of the mixed-methods implementation evaluation of the SC4C trial. We collected data through virtual and in-person focus groups at the general practices and phone, virtual and in-person interviews. Data was analysed using an iterative hybrid inductive-deductive thematic analysis. Twenty-one focus groups and thirty-seven interviews were conducted. Overall, participants found SC4C acceptable and suitable for general practices, with GPs willing to learn and expand their paediatric care role. GPs cited improved confidence and knowledge due to the model. Paediatricians reported an enhanced understanding of the general practice context and the strain under which GPs work. GPs and paediatricians reported that this model allowed them to build trust-based relationships with a common goal of improving care for children. Additionally, they felt some aspects, including the lack of remuneration and the work and effort required to deliver the model, need to be considered for the long-term success of the model. Families expressed their satisfaction with the shared knowledge and quality of care jointly delivered by GPs and paediatricians and highlighted that this model of care provides easy access to specialty services without out-of-pocket costs. Future research should focus on finding strategies to ensure the long-term Implementation of this model of care with a particular focus on the individual stressors in general practices. [ABSTRACT FROM AUTHOR]

Introduction: Studies of health utilities among people who use opioids have mostly been based on in‐treatment populations. We aim to report utility‐based quality of life by participants' socio‐demographic, drug and treatment characteristics, and to examine the determinants of health utility among people who use opioids regularly. Methods: Cross‐sectional study of participants who used opioids regularly, recruited across New South Wales, Victoria and Tasmania in 2018–2019. Differences in European Quality of Life (EQ‐5D‐5L) heath utility scores between socio‐demographic and clinical subgroups were assessed using non‐parametric Kruskal–Wallis test by rank. To address the unique distribution of EQ‐5D‐5L health utility scores in the current sample, a two‐part model was applied to assess factors associated with health utility. Results: Among 402 participants enrolled in the study, 385 (96%) completed the EQ‐5D‐5L questionnaire. The mean health utility of the total sample was 0.63 (SD 0.29). Participants who previously received opioid agonist treatment [OAT] (adj marginal effect (ME) −0.11; 95% confidence interval [CI] −0.20 to −0.02) and those currently in OAT (adj ME −0.13; 95% CI −0.22 to −0.06) reported lower health utility than those who had never received OAT. Participants who used both pharmaceutical opioids and benzodiazepines had lower health utility compared to no pharmaceutical opioids and no benzodiazepines use (adj ME −0.17; 95% CI −0.28 to −0.07). Discussion and Conclusions: Findings provide important health utility data for economic evaluations, useful for guiding allocation of resources for treatment strategies among people who use opioids. Lower health utilities among those using benzodiazepines and pharmaceutical opioids suggests interventions targeting these subgroups may be beneficial. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the current study was to develop and assess the psychometric properties of a measure that captures nursing behaviours that have the potential to influence the initiation of antibiotics in residential aged‐care facilities. Design: Cross‐sectional online survey. Method: One hundred and fifty‐seven nurses completed an online survey. The survey consisted of two clinical vignettes and measures of tolerance of uncertainty and anxiety. The vignettes consisted of the most common presentations (urinary tract infections and upper respiratory tract infections) of two hypothetical residents in aged‐care facilities. The vignettes provided participants with incremental information with varying levels of symptoms, input from other people and availability of test results. Both vignettes were subjected to exploratory factor analysis. Results: The results focus on the 16 items in the second vignette which resulted in the extraction of three factors. The derived factors were labelled as follows: (i) Noting and Calling GP, (ii) Consult a Colleague and (iii) Immediate Assessment and Antibiotics. Reliability analysis revealed excellent to satisfactory reliability. All three scales were significantly correlated with measures of clinical tolerance of uncertainty, and the 'noting and calling GP' scale was also negatively correlated with measures of anxiety and general tolerance of uncertainty. The measure showed satisfactory reliability and validity for capturing nursing behaviours that have the potential to influence decisions regarding antibiotics. As such, the current study provides a first step towards addressing the lack of ecologically valid measures that capture the complex and nuanced context of nurses' behaviours in RACF that have the potential to inform future stewardship interventions. [ABSTRACT FROM AUTHOR]

A taxonomic revision of the Pultenaea setulosa species complex (Fabaceae, tribe Mirbelieae) is presented. Prior to this study, P. setulosa Benth. was broadly circumscribed as a single, morphologically variable species. Here, we present evidence supporting the recognition of 18 species, 14 of which are new to science. Pultenaea setulosa is recircumscribed as a morphologically uniform taxon endemic to the Marlborough region in south-east Queensland. We reinstate Pultenaea boormanii H.B.Will., Pultenaea campbellii Maiden & Betche and Pultenaea lapidosa Corrick from synonymy of P. setulosa and describe an additional 14 new species: Pultenaea acanthocalyx R.L.Barrett & Clugston, Pultenaea corrickiae R.L.Barrett, Orme & Clugston, Pultenaea estelleae R.L.Barrett & Clugston, Pultenaea farmeriana R.L.Barrett, Orme & P.H.Weston, Pultenaea hoskingii R.L.Barrett & Clugston, Pultenaea imminuta R.L.Barrett & S.F.McCune, Pultenaea murrayi R.L.Barrett, Pultenaea palssoniae R.L.Barrett & Clugston, Pultenaea praetermissa R.L.Barrett & Albr., Pultenaea purdieae R.L.Barrett & Clugston, Pultenaea renneri R.L.Barrett & Clugston, Pultenaea venusta R.L.Barrett & Orme, Pultenaea westonii R.L.Barrett & Clugston and Pultenaea woolcockiorum R.L.Barrett & Clugston. Sixteen of these species are endemic to New South Wales, one to Queensland and one to Victoria. All taxa are described and illustrated, and habitats and conservation status are discussed. Two additional related species, Pultenaea procumbens A.Cunn. and P. setigera A.Cunn. ex Benth. are recircumscribed. Pultenaea setigera is reinstated here, known from the type collection made in 1822 and is possibly extinct. Lectotypes are selected for the names Pultenaea boormanii, P. campbellii, P. procumbens, P. setigera and P. setulosa. [ABSTRACT FROM AUTHOR]

In Australia, pressure is mounting from multiple stakeholders for a full review of the national social work education standards for field education as evidence grows about compulsory, unpaid placements exacerbating student poverty and the related adverse consequences for students' learning and well-being. This article reports on the findings of an Australian nation-wide qualitative and quantitative survey that explored social work students', educators' and practitioners' perceptions of proposed strategies to address the challenges identified with existing field education requirements. Descriptive statistics were calculated using Excel. Qualitative data were coded for thematic analysis. The main finding of the survey involving 1,191 participants was a call for a reimagined model of field education with flexibility in all aspects of how future placements are conceptualised, structured and delivered. The findings provide important and previously unavailable empirical evidence about field education strategies to inform and support the reimagining of existing Australian Social Work Education and Accreditation Standards. Recommendations for change, which have implications for both the Australian Association of Social Workers and the Australian Government, are discussed in the context of international standards for social work education and the social justice goals of the profession. [ABSTRACT FROM AUTHOR]

An inventory survey of the bird fauna of a small (462 ha) riverine woodland remnant on the Wakool River in the Riverina bioregion in southern inland New South Wales in 2021-2023 recorded 123 species (31 waterbirds and 92 woodland birds) including residents, flood visitors, spring/summer latitudinal migrants and autumn/winter altitudinal migrants. The conservation values of this remnant include habitat value for 22 NSW declining woodland bird species, one waterbird species of conservation concern in NSW, and an additional 9 species (3 woodland birds and 6 waterbirds) of conservation concern in nearby Victoria, as well as landscape connectivity value as part of a major riverine wildlife corridor. Several declining woodland bird species exhibited apparent local preferences for particular vegetation communities, including Gilbert's Whistler Pachycephala inornata (River Red Gum Eucalyptus camaldulensis Forest and Mixed Box-Gum Woodland) and Hooded Robin Melanodryas cucullata (Black Box Eucalyptus largiflorens Woodland). This study highlights the complementary value of small remnants for biodiversity conservation in extensively cleared landscapes and the connectivity role of riverine corridors in these landscapes. [ABSTRACT FROM AUTHOR]

Introduction: The study examined whether increased physical activity (PA) in nonmetropolitan cancer survivors was maintained 12 weeks following the PPARCS intervention. Methods: PA outcomes were assessed using an accelerometer at baseline, end of the intervention, and at 24 weeks. Linear mixed models were used to examine between‐group changes in PA outcomes. Results: The increased moderate‐to‐vigorous PA (MVPA) following intervention was maintained with significantly higher MVPA in the intervention group at 24 weeks (vs. controls) compared to baseline nett change of 52.5 min/week (95% CI 11.0–94.0.4). Conclusions: Distance‐based interventions using wearables and health coaching may produce MVPA maintenance amongst nonmetropolitan cancer survivors. [ABSTRACT FROM AUTHOR]

Background: The incidence of pancreatic cancer is rising. With improvements in knowledge for screening and early detection, earlier detection of pancreatic cancer will continue to be more common. To support workforce planning, our aim is to perform a model-based analysis that simulates the potential impact on the healthcare workforce, assuming an earlier diagnosis of pancreatic cancer. Methods: We developed a simulation model to estimate the demand (i.e. new cases of pancreatic cancer) and supply (i.e. the healthcare workforce including general surgeons, medical oncologists, radiation oncologists, pain medicine physicians, and palliative care physicians) between 2023 and 2027 in Victoria, Australia. The model compares the current scenario to one in which pancreatic cancer is diagnosed at an earlier stage. The incidence of pancreatic cancer in Victoria, five-year survival rates, and Victoria's population size were obtained from Victorian Cancer Registry, Cancer Council NSW, and Australian Bureau of Statistics respectively. The healthcare workforce data were sourced from the Australian Government Department of Health and Aged Care's Health Workforce Data. The model was constructed at the remoteness level. We analysed the new cases and the number of healthcare workforce by profession together to assess the impact on the healthcare workforce. Results: In the status quo, over the next five years, there will be 198 to 220 stages I-II, 297 to 330 stage III, and 495 to 550 stage IV pancreatic cancer cases diagnosed annually, respectively. Assuming 20–70% of the shift towards pancreatic cancer's earlier diagnosis (shifting from stage IV to stages I-II pancreatic cancer within one year), the stages I-II cases could increase to 351 to 390 or 598 to 665 per year. The shift to early diagnosis led to substantial survival gains, translating into an additional 284 or 795 out of 5246 patients with pancreatic cancer remaining alive up to year 5 post-diagnosis. Workforce supply decreases significantly by the remoteness levels, and remote areas face a shortage of key medical professionals registered in delivering pancreatic cancer care, suggesting travel necessities by patients or clinicians. Conclusion: Improving the early detection and diagnosis of pancreatic cancer is expected to bring significant survival benefits, although there are workforce distribution imbalances in Victoria that may affect the ability to achieve the anticipated survival gain. [ABSTRACT FROM AUTHOR]

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

Background: This paper aimed to describe the legal worries of Australian general practitioners (GPs) and nurses regarding end-of-life care provided in the aged care setting. Methods: An analysis of responses to the final, open-ended question of a cross-sectional online survey of GPs and nurses practising in aged care settings in Queensland, New South Wales and Victoria was undertaken. Results: Of the 162 GPs and 61 nurses who gave valid responses to the survey, 92% (151 GPs and 55 nurses) responded to the open-ended question. Participants identified concerns across all relevant areas of end-of-life law. The most common concerns were substitute decision-makers or family member(s) wanting to overrule an Advance Care Directive, requests for futile or non-beneficial treatment and conflict about end-of-life decision-making. Participants often also identified concerns about their lack of legal knowledge and their fear of law or risk related to both end-of-life care generally and providing medication that may hasten death. Conclusions: Australian GPs and nurses working in aged care have broad-ranging legal concerns about providing end-of-life care. Legal concerns and knowledge gaps identified here highlight priority areas for future training of the aged care workforce. The law supports good end-of-life clinical practice by facilitating health care that aligns with the values and goals of patients, including those residing in residential aged care facilities. GPs and nurses here reported broad-ranging legal concerns relevant to providing end-of-life care within aged care, including substitute decision makers/family members wanting to overrule Advance Care Directives, requests for futile or non-beneficial treatment and conflict about decision-making. Participants' concerns can inform end-of-life legal training for aged care GPs and nurses. [ABSTRACT FROM AUTHOR]

Background: There is a need for clinical quality indicators (CQIs) that can be applied to dementia quality registries to monitor care outcomes for people with Alzheimer's disease and other forms of dementia. Objective: To develop tertiary and primary care-based dementia CQIs for application to clinical registries for individuals with dementia accessing aged care services and determine 1) annual trends in CQI incidence between 2011–2012 and 2015–2016, 2) associated factors, and 3) geographic and facility variation in CQI incidence. Methods: This retrospective repeated cross-sectional study included non-Indigenous individuals aged 65–105 years who lived with dementia between July 2008-June 2016, were assessed for government-funded aged care services, and resided in New South Wales or Victoria (n = 180,675). Poisson or negative binomial regression models estimated trends in annual CQI incidence and associated factors. Funnel plots examined CQI variation. Results: Between 2011–2012 and 2015–2016, CQI incidence increased for falls (11.0% to 13.9%, adjusted incidence rate ratio (aIRR) 1.05 (95% CI 1.01–1.06)) and delirium (4.7% to 6.7%, aIRR 1.09 (95% CI 1.07–1.10)), decreased for unplanned hospitalizations (28.7% to 27.9%, aIRR 0.99 (95% CI 0.98–0.99)) and remained steady for fracture (6.2% to 6.5%, aIRR 1.01 (95% CI 0.99–1.01)) and pressure injuries (0.5% to 0.4%, aIRR 0.99 (95% CI 0.96–1.02)). Being male, older, having more comorbidities and living in a major city were associated with higher CQI incidence. Considerable geographical and facility variation was observed for unplanned hospitalizations and delirium CQIs. Conclusions: The CQI results highlighted considerable morbidity. The CQIs tested should be considered for application in clinical quality registries to monitor dementia care quality. [ABSTRACT FROM AUTHOR]

Background: All Scottish Fold cats are believed to be affected by osteochondrodysplasia, a painful degenerative joint disorder. This retrospective study aimed to estimate the prevalence of osteochondrodysplasia in Scottish Fold and Scottish Straight cats in Australian veterinary clinics using electronic patient records (EPRs), collected between 1992 and 2018. Results: Consultation events (34,926) in EPRs from veterinary clinics located in New South Wales, Queensland, and Victoria, were collected from 1,131 Scottish Fold and 117 Scottish Shorthair cats. A clinical diagnosis of osteochondrodysplasia was made in 12/1,131 Scottish Fold cats. Additionally, 69 cats were identified with suspected osteochondrodysplasia. Of these, 64 were Scottish Fold and 5 were Scottish Shorthair cats. Male and female cats were equally represented. However, a significant difference was observed for the age clinical signs were first recorded in the EPRs. Cats diagnosed clinically with osteochondrodysplasia were significantly younger (p < 0.0001) compared to cats identified as suspected SFOCD cases. Conclusions: Findings from this study suggest a relatively low prevalence of clinically diagnosed Scottish Fold osteochondrodysplasia (SFOCD) in the studied Australian Scottish Fold population, with cats generally diagnosed with SFOCD at less than 30 months of age. Further evidence is required to accurately assess the clinical relevance of SFOCD in the Scottish Fold population. [ABSTRACT FROM AUTHOR]

Although 'child safety' is now a national policy priority in Australia, there is little research exploring the practices in schools that contribute to children and young people's felt sense of safety and wellbeing. Drawing on a mixed-method Australian Research Council (ARC) Discovery project, this article presents findings from interviews with school staff (N = 10), leaders (N = 5) and nine focus groups with students (N = 58), in primary and secondary schools in three Australian states (New South Wales, Victoria and South Australia). We employ relational ethics, recognition theory and the theory of practice architectures to explore practices at school that support student wellbeing and safety. The findings contribute significantly to understanding the 'bundled' nature of current practices and the conditions that enable and constrain these. Close attention to these findings is critical as schools seek to operationalise the National Child Safe Principles and refine ongoing safeguarding procedures. The findings have informed the development of an online survey that is currently testing, on a much larger scale, which elements of ethical practice are most positively associated with students' safety, wellbeing and recognition at school. [ABSTRACT FROM AUTHOR]

The role and significance of schooling in maintaining and renewing social disadvantage is particularly evident in upper secondary education, and especially so in the high-stakes final examination at the end of Year 12. This paper focusses on Senior English in this context, with specific regard to the Australian state of New South Wales. Building on a recent study of the outcomes of the Higher School Certificate (HSC) in 2017, it analyses what the data reveal about the relationship between Senior English and social inequality in this instance. It does so with reference to a brief account of the history of English teaching and senior secondary curriculum policy in New South Wales and also, comparatively, a now well-established comprehensive study of senior secondary schooling in Victoria. It concludes with some implications of this account for further investigations of Senior English and subject English more generally, as well as of the social meaning of senior secondary education in Australia, in particular with regard to the nexus between curriculum and assessment, knowledge, and power. [ABSTRACT FROM AUTHOR]

Lack of service data for cardiac rehabilitation limits understanding of program delivery, benchmarking and quality improvement. This study aimed to describe current practices, management, utilisation and engagement with quality indicators in Australian programs. Cardiac rehabilitation programs (n=396) were identified from national directories and networks. Program coordinators were surveyed on service data capture, management systems and adoption of published national quality indicators. Text responses were coded and classified. Logistic regression determined independent associates of the use of data for quality improvement. A total of 319 (81%) coordinators completed the survey. Annual patient enrolments/programs were >200 (31.0%), 51−200 (46%) and ≤50 (23%). Most (79%) programs used an electronic system, alongside paper (63%) and/or another electronic system (19%), with 21% completely paper. While 84% knew of the national quality indicators, only 52% used them. Supplementary to patient care, data were used for reports to managers (57%) and funders (41%), to improve quality (56%), support funding (43%) and research (31%). Using data for quality improvement was more likely when enrolments where >200 (Odds ratio [OR] 3.83, 95% Confidence Interval [CI] 1.76−8.34) and less likely in Victoria (OR 0.24 95%, CI 0.08−0.77), New South Wales (OR 0.25 95%, CI 0.08−0.76) and Western Australia (OR 0.16 95%, CI 0.05−0.57). The collection of service data for cardiac rehabilitation patient data and its justification is diverse, limiting our capacity to benchmark and drive clinical practice. The findings strengthen the case for a national low-burden approach to data capture for quality care. [ABSTRACT FROM AUTHOR]

To effectively manage a crisis, most decisions made by governments, organizations, communities, and individuals are based on "shared situational awareness" (SSA) derived from multiple information sources. Developing SSA depends on the alignment of mental models, which "represent our shared version of truth and reality on which we can act." Social media has facilitated public sensemaking during a crisis; however, it has also encouraged mental model dissonance, resulting in the digital destruction of mental models and undermining adequate SSA. The study is concerned with the challenges of creating SSA during the COVID‐19 pandemic in Australia. This paper documents a netnography of Australian public health agencies' Facebook communication, exploring the initial impact of COVID‐19 on SSA creation. Chaos theory is used as a theoretical lens to examine information perception, meaning, and assumptions relating to SSA from pre to post‐pandemic periods. Our study highlights how the initial COVID‐19 "butterfly effect" swamped the public health communication channel, leaving little space for other important health issues. This research contributes to information systems, information science, and communications by illustrating how the emergence of a crisis impacts social media communication, the creation of SSA, and what this means for social media adoption for crisis communication purposes. [ABSTRACT FROM AUTHOR]

The value of spiritual care training for all staff working in health and aged care has been demonstrated. This study investigated how spiritual care specialists (SCSs) perceive their role in delivering spiritual care education to other staff. Fourteen SCSs participated in three online focus groups. Two key themes were identified: First, SCSs build upon existing capacity of staff by: (i) recognising existing strengths and capabilities; (ii) using relevant stories; (iii) using language which makes spiritual care accessible; (iv) making training relevant and practical; (v) tapping into staff vocation or calling; and (vi) building awareness of one's own spirituality. Second, SCSs assist staff to draw upon SCS expertise by establishing a trusting relationship and developing staff awareness of the SCS role. The SCS's role in delivering spiritual care education is an important one, and further consideration regarding how to support them in this role is warranted. [ABSTRACT FROM AUTHOR]

Young people with disability and complex support needs are often marginalized and have poor post-school outcomes. These youth often experience disability combined with mental health and behavioral issues, family dysfunction, and involvement with out-of-home care and/or juvenile justice. They often have difficulty accessing support services, such as primary health, mental health, and disability services. These difficulties are likely to increase as they transition to adulthood, potentially resulting in significant social and economic costs. Supported transition planning to adulthood that considers the interaction and relationships a young person has with all of their environments and support services has been shown to increase the likelihood of positive adult outcomes. The current policy mapping study aimed to examine how multisystemic transitions for young people with complex support needs are addressed in current Australian policy. National and state policies were located and qualitatively analyzed. The analysis identified a need for clarity around the terms transition and complex support needs, as well as greater awareness and action in the area of transition planning for young people with complex support needs. [ABSTRACT FROM AUTHOR]

Background: Lesbian, bisexual, and queer (LBQ) women exhibit high rates of alcohol and tobacco use, yet there is limited qualitative research examining why. Previous research has focused on minority stress explanations, linking alcohol and tobacco use to experiences of discrimination. However, other work considers the social contexts and cultural practices associated with alcohol and tobacco consumption. This confirms the need for more in-depth understandings of LBQ women's lived experiences in a contemporary Australian context. Aims: To address gaps in existing research, this project aims to develop a more nuanced contemporaneous theorising of what alcohol and tobacco mean to LBQ women in Australia. Drawing on feminist and critical drugs studies, this research will examine the complexities of alcohol and tobacco in LBQ women's lives, including how patterns of use change over time. We will also critically consider how LBQ women understand risk in relation to these substances, including factors leading to harm reduction and help-seeking. Method: We will employ a longitudinal qualitative approach to explore LBQ women's experiences over time, including three waves of semi-structured interviews and participant photography. We aim to recruit approximately 60 women in Victoria and New South Wales. Interview and visual data will be analysed using a range of narrative and thematic techniques. Conclusion: This study seeks to explore the complexities of individual experiences with alcohol and tobacco use, including pleasure and support-seeking, and to provide a nuanced understanding of the cultural dimensions of use that may change over time. In doing so, we propose a shift from deficit approaches to LBQ women's substance use towards more meaningful strengths-based engagement with the function of substances for LBQ women. Findings will be significant in their contribution to the current understandings of substance use patterns among LBQ women and the implications for harm reduction and health interventions. [ABSTRACT FROM AUTHOR]

Simple Summary: Infectious diseases that spread from animals to humans pose a risk to both human and animal health. In recent years, the bacteria Chlamydia psittaci has been identified as an important cause of equine reproductive loss in Australia and has also resulted in human disease following contact with infected horses or horse tissue. This is different from the traditional pathway of transmission from birds to humans. Despite the importance of this bacteria to both horse and human health, infections in horses are incompletely understood, and risks to human and horse health remain. These risks may be exacerbated by the incomplete awareness of Chlamydia psittaci among Australian horse owners and others working in the equine industry. This study sought to identify the total number of cases of equine reproductive loss due to Chlamydia psittaci in Australia between 2018 and 2022 and thus contribute data to our growing understanding of Chlamydia psittaci infection in horses. A total of 31 cases were identified. These were geographically restricted to Victoria and New South Wales and were more commonly detected in the winter and spring. The results show that cases of equine reproductive loss due to Chlamydia psittaci remain consistent and ongoing and highlight the need for further studies. Chlamydia psittaci is an important zoonotic pathogen. Although primarily a pathogen of birds, from which infection can spillover into humans and other mammalian hosts, the importance of C. psittaci as a cause of equine reproductive loss and the risk of infection to humans in contact with infected horses are increasingly being recognised in Australia and elsewhere. Despite the risks to both human and equine health, C. psittaci infection in horses is incompletely understood. This study aimed to update and summarise cases of equine psittacosis in Australia in the period 2018–2022, thus addressing a knowledge gap relating to recent cases in this country. These cases were identified from the examination of records held by state and federal veterinary authorities and from a review of published cases. A total of 31 cases were identified. Spatial and temporal trends were identified, with cases being more prevalent in winter and spring and geographically restricted to Victoria and New South Wales. The results show that cases of equine reproductive loss due to C. psittaci are consistent and ongoing and demonstrate the importance of routinely considering C. psittaci in diagnostic investigations. The need for ongoing study to better understand this important zoonotic pathogen is evident. [ABSTRACT FROM AUTHOR]

The significance of the role of students' interpretation and creation of multiple forms of representation in science learning has long been established and advocated, but there is a paucity of research into the extent to which this emphasis in science education is reflected in high stakes final year high school science examinations. This study investigated the inclusion of visualizations in the questions within such examinations that require students to construct a response, and also the extent to which such questions required students to create or modify diagrams or graphs within their responses. Examinations in physics, biology and chemistry from the Cambridge International Examination, New Zealand, Singapore and the States of New South Wales and Victoria in Australia over a six-year period (2014-2019) were analysed. The results indicate that less than one third of constructed response item (CRI) questions include visualisations, with most occurring in physics, then biology and then chemistry. An infinitesimally small percentage of questions across all subjects and in all but one of the jurisdictions required the creation or augmentation of visualisations. The misalignment between the integral role of visualizations in science pedagogy and the paucity of visualizations in CRIs in final year high school examinations as well as implications for examination re-design and associated further research are discussed. [ABSTRACT FROM AUTHOR]

Anthesis and fruiting of cultivated Bolwarra Eupomatia laurina in Melbourne and Metung are described, and photographs presented. The flowering season was later and androecia of flowers were retained on gynoecia longer than those of Bolwarra in natural populations in Queensland and New South Wales. The normal flowering cycle with a flowerless day or two after anthesis, also varied occasionally in Victoria, resulting in flowering on two consecutive days. Artificial pollination experiments showed that pollen on non-abscised androecia was viable and demonstrated geitonogamous self-compatibility. Honey Bees Apis mellifera and Reed Bees Exoneura sp. collected pollen from these androecia, but were not observed visiting flowers in the female phase, and are not considered pollinators of this primitive plant. In the absence of weevil pollinators (Elleschodes spp.), fruit-set was rare and varied between years and locations. Areas for further research on the mechanism/s for self-pollination are suggested. [ABSTRACT FROM AUTHOR]

Simple Summary: Difficulties in sensory processing are often found in neurodevelopmental disorders and can significantly impact how a child responds to and functions within their environment. Studies examining sensory processing in children with neurofibromatosis type 1 (NF1) are sparse. This cross-sectional study aims to address this gap by examining parent-reported sensory processing in a sample of 152 children with NF1. Approximately 61% of children with NF1 displayed differences in how they respond to sensory stimuli when compared to a typically developing control group. These difficulties were seen equally across ages and sex and were found to be associated with a higher degree of autistic behaviors, ADHD symptoms, lower adaptive skills, poorer social skills, and increased anxiety and affective symptoms. The results highlight the importance of accommodating multisensory processing difficulties at home and school when deciding how to support a child with NF1 across environments. Despite the evidence of elevated autistic behaviors and co-occurring neurodevelopmental difficulties in many children with neurofibromatosis type 1 (NF1), we have a limited understanding of the sensory processing challenges that may occur with the condition. This study examined the sensory profile of children and adolescents with NF1 and investigated the relationships between the sensory profiles and patient characteristics and neuropsychological functioning. The parent/caregivers of 152 children with NF1 and 96 typically developing children completed the Sensory Profile 2 (SP2), along with standardized questionnaires assessing autistic behaviors, ADHD symptoms, internalizing symptoms, adaptive functioning, and social skills. Intellectual functioning was also assessed. The SP2 data indicated elevated sensory processing problems in children with NF1 compared to typically developing children. Over 40% of children with NF1 displayed differences in sensory registration (missing sensory input) and were unusually sensitive to and unusually avoidant of sensory stimuli. Sixty percent of children with NF1 displayed difficulties in one or more sensory modalities. Elevated autistic behaviors and ADHD symptoms were associated with more severe sensory processing difficulties. This first detailed assessment of sensory processing, alongside other clinical features, in a relatively large cohort of children and adolescents with NF1 demonstrates the relationships between sensory processing differences and adaptive skills and behavior, as well as psychological well-being. Our characterization of the sensory profile within a genetic syndrome may help facilitate more targeted interventions to support overall functioning. [ABSTRACT FROM AUTHOR]

Background: Sixty percent of people have non-functional arms 6 months after stroke. More effective treatments are needed. Cochrane Reviews show low-quality evidence that task-specific training improves upper limb function. Our feasibility trial showed 56 h of task-specific training over 6 weeks resulted in an increase of a median 6 points on the Action Research Arm test (ARAT), demonstrating the need for more definitive evidence from a larger randomised controlled trial. Task-AT Home is a two-arm, assessor-blinded, multicentre randomised, controlled study, conducted in the home setting. Aim: The objective is to determine whether task-specific training is a more effective treatment than usual care, for improving upper limb function, amount of upper limb use, and health related quality of life at 6 weeks and 6 months after intervention commencement. Our primary hypothesis is that upper limb function will achieve a = 5 point improvement on the ARAT in the task-specific training group compared to the usual care group, after 6 weeks of intervention. Methods: Participants living at home, with remaining upper limb deficit, are recruited at 3 months after stroke from sites in NSW and Victoria, Australia. Following baseline assessment, participants are randomised to 6 weeks of either task-specific or usual care intervention, stratified for upper limb function based on the ARAT score. The task-specific group receive 14 h of therapist-led taskspecific training plus 42 h of guided self-practice. The primary outcome measure is the ARAT at 6 weeks. Secondary measures include the Motor Activity Log (MAL) at 6 weeks and the ARAT, MAL and EQ5D-5 L at 6 months. Assessments occur at baseline, after 6 weeks of intervention, and at 6 months after intervention commencement. Analysis will be intention to treat using a generalised linear mixed model to report estimated mean differences in scores between the two groups at each timepoint with 95% confidence interval and value of p. Discussion: If the task-specific home-based training programme is more effective than usual care in improving arm function, implementation of the programme into clinical practice would potentially lead to improvements in upper limb function and quality of life for people with stroke. [ABSTRACT FROM AUTHOR]

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

Aims and Objectives: The aim of this study is to enhance the understanding of the core elements and influencing factors on the community‐based epilepsy nurse's role and responsibilities. Background: Internationally, epilepsy nurse specialists play a key role in providing person‐centred care and management of epilepsy but there is a gap in understanding of their role in the community. Design: A national three‐stage, mixed‐method study was conducted. Methods: One‐on‐one, in‐depth semi‐structured qualitative interviews were conducted online with 12 community‐based epilepsy nurses (Stage 1); retrospective analysis of data collected from the National Epilepsy Line, a nurse‐led community helpline (Stage 2); and focus group conducted with four epilepsy nurses, to delve further into emerging findings (Stage 3). A thematic analysis was conducted in Stages 1 and 3, and a descriptive statistical analysis of Stage 2 data. Consolidated Criteria for Reporting Qualitative studies checklist was followed for reporting. Results: Three key themes emerged: (1) The epilepsy nurse career trajectory highlighted a lack of standardised qualifications, competencies, and career opportunities. (2) The key components of the epilepsy nurse role explored role diversity, responsibilities, and models of practice in the management of living with epilepsy, and experiences navigating complex fragmented systems and practices. (3) Shifting work practices detailed the adapting work practices, impacted by changing service demands, including COVID‐19 pandemic experiences, role boundaries, funding, and resource availability. Conclusion: Community epilepsy nurses play a pivotal role in providing holistic, person‐centred epilepsy management They contribute to identifying and addressing service gaps through innovating and implementing change in service design and delivery. Relevance to Clinical Practice: Epilepsy nurses' person‐centred approach to epilepsy management is influenced by the limited investment in epilepsy‐specific integrated care initiatives, and their perceived value is impacted by the lack of national standardisation of their role and scope of practice. No Patient or Public Contribution: Only epilepsy nurses' perspectives were sought. [ABSTRACT FROM AUTHOR]

P2/N95 respirators or filtering facepiece respirators may not have the same pass rate on quantitative fit testing. The aim of this study was to investigate the pass rate of four commonly used filtering facepiece respirators in Australian healthcare providers. The secondary objectives included assessing the ease of donning, doffing and comfort of wearing these four filtering facepiece respirators for more than 30 minutes. A multivariable analysis was also conducted to assess if certain variables (e.g. age, sex, body mass index, ethnicity, facial width and length) were associated with passing or failing fit testing. We conducted a prospective observational study of 150 hospital staff who presented for fit testing in a metropolitan hospital in Victoria, Australia. The order of the four filtering facepiece respirators being tested was randomised. A Cochran's Q test was used to test the global null hypothesis that all four filtering facepiece respirators being tested have the same pass rate. A difference in pass rate was found between the four filtering facepiece respirators that were tested (P < 0.001). The 3M™ Aura 1870+ (3M Australia Pty Ltd, North Ryde, NSW) had the highest pass rate (83%) followed by the 3M™ 1860 (3M Australia Pty Ltd, North Ryde, NSW) (61%), BSN ProShield™ N95 (BSN Medical, Mulgrave, Victoria) (55%) and the BYD DE2322 N95 (BYD Care, Los Angeles, CA, USA) (44%). There was also a difference in the ease of donning, doffing and comfort. Therefore, healthcare facilities that perform fit testing should take these factors into consideration when designing an effective respiratory protection programme. [ABSTRACT FROM AUTHOR]

A new Australian genus in the orb-weaving spider family Araneidae Clerck, 1757 is described, Kangaraneus gen. nov., with K. arenaceus (Keyserling, 1886) comb. nov. (New South Wales, Queensland, South Australia, Victoria and Western Australia) as the type species and also including two other species: Kangaraneus amblycyphus (Simon, 1908) comb. nov. (Australian Capital Territory, New South Wales, Queensland, South Australia, Victoria and Western Australia) and K. farhani sp. nov. (Australian Capital Territory, New South Wales, South Australia, Victoria and Tasmania). The new genus is included in the informally termed Australasian 'backobourkiine' clade due to the presence of its putative synapomorphies, specifically a single patellar macroseta on the male pedipalp and its median apophysis forming an arch over the radix. It includes medium-sized orb-weaving spiders (total length 3-12 mm) with distinct humeral humps on the almost triangular abdomen. Therefore, within the backobourkiines, it is somatically most similar to Novakiella Court & Forster, 1993 but differs considerably in male genitalic characters, including a C-shaped median apophysis with an acute tip. Genitalia are most similar to those in Quokkaraneus Castanheira & Framenau, 2023 from which the new genus differs by the lack of the white colouration and the shape of the abdomen. [ABSTRACT FROM AUTHOR]

Purpose: Many countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults, paediatric HAH has been developed more recently. Specificities of paediatric care make it difficult to directly extend an adult HAH model to the paediatric population. The objective of this study is to compare the organisation of paediatric HAH in four countries: France, Australia (states of Victoria and New South Wales), the Netherlands and Belgium. Ultimately, lessons can be drawn for further development in the countries analysed and/or for implementation in other countries. Design/methodology/approach: Legal documents and other grey literature were analysed to describe the legal context for the provision of paediatric HAH in the selected countries. In addition, semi-structured in-depth interviews were conducted with key informants from paediatric HAH organisations in these countries, addressing the following topics: historical background, legal framework, functioning of HAH models, workforce, number of services, profile of children, type of care activities, funding, coordination with other providers and quality of care. Results were reviewed by a content expert from the respective country. Findings: Organisational differences were highlighted in terms of coordinating actor (hospital or home nursing care services), decision-making process, range of clinical conditions treated, territorial organisation, qualifications and expertise of the team members, medical expertise, financing, responsibilities, etc. Originality/value: There is no single preferred model for the provision of HAH care for children. There is a large variety in almost all aspects of organisation. There are, however, also some common characteristics across the different models. Notably, paediatric expertise of nurses within the HAH team was considered indispensable in all programmes. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to map the geographic distribution of tertiary hospitals in Australia’s most populous cities. Good access to hospital facilities improves the health and welfare of a community. The use of geographic information system (GIS) technology can assist in understanding spacial accessibility to services. Methods. Using Quantum GIS, a geodatabase was constructed to incorporate hospital locations and demographic distribution data throughout Australia’s 20 most populous cities. Data on the population’s age groups were integrated into the geodatabase to investigate the distribution of age groups and their utilisation of access to emergency departments in tertiary public health care. Overall this study reported the geospatial distribution of 89 tertiary hospitals and the demographics of the population in areas around these hospitals. Results. The majority of hospitals were located in the three most populated cities of New South Wales (NSW), Sydney, Wollongong and Newcastle, which contain a total of 32 hospitals, with 23 (72%) of the hospitals in Sydney. There were 7.8, 24.0, 53.4 and 81.0% of the population in NSW within 1.5, 3, 6 and 50 km of the hospitals, respectively. The second-highest number of hospitals was in Victoria (n = 22), with 18 (82%) hospitals located in Melbourne. This was followed by Queensland (n = 14), with eight (57%) hospitals located in Brisbane. Conclusions. The results indicate that 82.2% of the Australian population lives within a 50 km radius of a tertiary hospital, with NSW having higher age distribution percentages than the other states. The results of this study could be used to locate and improve areas of need with a high burden of disease and low accessibility to healthcare services. [ABSTRACT FROM AUTHOR]

Simple Summary: Lack of comprehensive and accurate data on the frequency of stray and owner-relinquished cats entering municipal pounds, animal welfare shelters, and rescue groups across the states and territories in Australia is an impediment to targeting management of domestic cats to where it is most needed. Our study aimed to evaluate availability of data as well as collect and analyze comprehensive data to establish a baseline to measure future improvements in domestic cat management. Data were collected for 2018–2019 by email and phone where not publicly available. Unavailable municipal pound data were imputed based on known data and the human population. We estimated a total of 179,615 stray and surrendered cat admissions to pounds, shelters, and rescue groups in Australia in 2018–2019 (7.2/1000 human residents) and that 5% of admissions were reclaimed, 65% rehomed, and 28% euthanized. Municipal councils operating their own pounds rehomed 26% and euthanized 46% of cat intake compared to 65% rehomed and 25% euthanized for welfare organizations. Data collation and analyses at a national level would be facilitated by open public access to standardized intake and outcome data for municipal pounds, shelters, and rescue groups. This would highlight where improvements are most needed and serve as a baseline to track the impact of new policies, protocols, and legislation. More effective management of domestic cats will ultimately benefit the community, cats, and wildlife. Access to comprehensive municipal pound, animal welfare shelters, and rescue group data for admissions and outcomes for stray and owner-relinquished cats in Australia is currently lacking. This hinders effective assessment of existing management strategies for domestic cats by animal management agencies. Our study aimed to estimate the numbers of cat admissions and intakes to Australian municipal council pounds, animal welfare organizations (excluding smaller animal welfare organizations thought to have annual cat intakes of less than 500), and animal rescue groups and their respective outcomes for 2018–2019 (pre-COVID). Unavailable municipal council data were imputed based on known data and council human populations. Only Victoria and New South Wales had publicly available municipal data, and only RSPCA had publicly available data in all states. We estimated a total of 179,615 (7.2/1000 human residents) admissions to pounds, shelters, and rescue groups in 2018–2019, with an estimated 5% reclaimed, 65% rehomed, and 28% euthanized. Reclaim rates were low across all the agencies. Councils operating their own pound had nearly double the euthanasia rate (estimated at 46%) compared to animal welfare organizations (25%). Rescue groups rehomed an estimated 35% of the total number of cats rehomed by all agencies. The upper quartiles of councils with intakes of >50 cats in Victoria and New South Wales had estimated euthanasia rates from 73% to 98%, and 67% to 100%, respectively. We recommend that comprehensive municipal pound, shelter, and rescue statistics be routinely calculated using standardized methods and made available publicly in a timely fashion. This would inform management strategies to optimize live outcomes and therefore reduce the negative mental health impacts on staff tasked with euthanizing healthy and treatable cats and kittens. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationship between structural characteristics of Australian residential aged care facilities (RACFs) and breaches of the aged care quality standards. Methods: Facility‐level analysis of audits, sanctions and non‐compliance notices of all accredited Australian RACFs between 2015/16 and 2018/19. Structural factors of interest included RACF size, remoteness, ownership type and jurisdiction. Two government data sources were joined. Each outcome was analysed to calculate time trends, unadjusted rates and relative risks. Results: Non‐compliance notices were imposed on 369 RACFs (13%) and 83 sanctions on 75 RACFs (3%). Compared with New South Wales (NSW), non‐compliance notices were less likely in Victoria, Queensland and the Northern Territory (NT), more likely in South Australia (SA), and comparable in Western Australia (WA), Tasmania and the Australian Capital Territory (ACT). RACFs with more than 100 beds and RACFs located in remote and outer regional areas (vs. major cities) also increased the likelihood of non‐compliance notices. Compared with NSW, sanctions were less likely in Victoria, Queensland, NT and WA and comparable in SA, Tasmania and ACT. Additionally, the likelihood of sanctions was higher for RACFs with more than 40 beds. For both non‐compliance notices and sanctions, no significant relationship was found with RACF ownership type. Conclusions: We partially confirmed other Australian findings about the relationship between RACF structural characteristics and regulatory sanctions and reported new findings about non‐compliance notices. Routine and standardised public reporting of RACF performance is needed to build trust that Australia's latest aged care reforms have led to sustained quality improvements. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and health costs of a new primary care service delivery model (the Optimising Primary Care Management of Knee Osteoarthritis [PARTNER] model) to improve health outcomes for patients with knee osteoarthritis (OA) compared to usual care. Methods: This study was a 2‐arm, cluster, superiority, randomized controlled trial with randomization at the general practice level, undertaken in Victoria and New South Wales, Australia. We aimed to recruit 44 practices and 572 patients age ≥45 years with knee pain for >3 months. Professional development opportunities on best practice OA care were provided to intervention group general practitioners (GPs). All recruited patients had an initial GP visit to confirm knee OA diagnosis. Control patients continued usual GP care, and intervention patients were referred to a centralized care support team (CST) for 12‐months. Via telehealth, the CST provided OA education and an agreed OA action plan focused on muscle strengthening, physical activity, and weight management. Primary outcomes were patient self‐reported change in knee pain (Numerical Rating Scale [range 0–10; higher score = worse]) and physical function (Knee Injury and Osteoarthritis Outcome Score activities of daily living subscale [range 0–100; higher score = better] at 12 months. Health care cost outcomes included costs of medical visits and prescription medications over the 12‐month period. Results: Recruitment targets were not reached. A total of 38 practices and 217 patients were recruited. The intervention improved pain by 0.8 of 10 points (95% confidence interval [95% CI] 0.2, 1.4) and function by 6.5 of 100 points (95% CI 2.3, 10.7), more than usual care at 12 months. Total costs of medical visits and prescriptions were $3,940 (Australian) for the intervention group versus $4,161 for usual care. This difference was not statistically significant. Conclusion: The PARTNER model improved knee pain and function more than usual GP care. The magnitude of improvement is unlikely to be clinically meaningful for pain but is uncertain for function. [ABSTRACT FROM AUTHOR]

The law presumes that children who are sexually abused will experience long-term physical and/or psychological harm. The research suggests that child sexual abuse can cause cognitive distortions and may reduce the victim's ability to empathise with others. Despite this, when it comes to sentencing child sexual offenders who were also victims of childhood sexual abuse, some judges impute knowledge of the victims' harm onto the offenders. This article examines 13 sentencing remarks made in New South Wales, Tasmania and Victoria between 2005 and 2018 containing these imputations and discusses whether these statements are appropriate when considering the empirical evidence. The sentencing remarks show that the victims' lived experiences align with the literature. This article argues that it is inappropriate for sentencing judges to impute knowledge of the victims' harm onto offenders, and similar statements should be avoided in future. [ABSTRACT FROM AUTHOR]