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Aim Probiotics have been shown to prevent or treat a number of paediatric health problems; however, not much is known about how probiotics are used in the community. This study aimed to describe the prevalence and main predictors of probiotic supplementation among healthy pre-school-aged children. Methods Parents of 4- or 5-year-olds residing in the Australian Capital Territory (ACT) were invited to complete a web-based questionnaire between February and May 2020. There were 469 responses concerning 494 children eligible for analysis. Prevalence was categorised as lifetime exposure and recent exposure. Predictors were determined through multiple logistic regression modelling. Results Almost half (47.4%) of the children had ever been exposed to probiotics and 14.9% had taken probiotics in the previous month. The strongest predictors of lifetime probiotic exposure were parental lifetime probiotic use (OR 13.3; 95% CI 7.4-24.1) and an interaction between functional food consumption and parental lifetime probiotic use (OR 5.6; 95% CI 2.6-12.1). The strongest predictor of recent probiotic exposure was parental recent probiotic use (OR 13.3; 95% CI 5.7-30.8). Conclusions This study illustrates the high prevalence of probiotic exposure among healthy pre-school-aged children in the ACT and emphasises the relationship between parental use of probiotics and exposure in children. These findings will allow comparison and analysis of trends over time. Practitioners should be aware of the evidence for and against probiotics as these findings suggest a high level of acceptability among parents.

Question-order effects are known to occur in surveys, particularly those that measure subjective experiences. The presence of context effects will impact the comparability of results if questions have not been presented in a consistent manner. In this study, we examined the influence of question order on how people responded to two gambling scales in the Australian Capital Territory Gambling Prevalence Survey: The Problem Gambling Severity Index and the Short Gambling Harm Screen. The application of these scales in gambling surveys is continuing to grow, the results being compared across time and between jurisdictions, countries, and populations. Here we outline a survey experiment that randomized the question ordering of these two scales. The results show that question-order effects are present for these scales, demonstrating that results from them may not be comparable across jurisdictions if the scales have not been presented consistently across surveys. These findings highlight the importance of testing for the presence of question-order effects, particularly for those scales that measure subjective experiences, and correcting for such effects where they exist by randomizing scale order.

Introduction The majority of burn injuries in the paediatric age group occur in the home environment and are preventable. Water pipe smoking, commonly known as shisha, is an old practice of tobacco smoking dating from the 16th century with the use of hot coals and water in social gatherings at homes or cafes. The increasing use of shisha worldwide in youth raises public health concerns regarding its detrimental health effects and potential for serious thermal injury. Our aim is to identify and classify epidemiological trends of shisha related burns in the paediatric age group across New South Wales and the Australian Capital Territory. Methods A retrospective review from January 2009 – December 2019 at The Children’s Hospital at Westmead Burns Unit. All burn injuries of age less than 16 years that attended or were referred to the unit were included in this study. Results There were 10 patients who presented with a shisha related burn injury. There was an equal distribution of males to females with all burns occurring in the home or a park. The most common types of injury were a full thickness or mid-dermal burns respectively, three of which required split thickness skin grafting. Conclusions Shisha smoking is part of many cultures that has many potential burn hazards to children and family. Educational awareness targeted to shisha users can bring a better understanding about its potential for burn injury in children.

Aboriginal peoples’ fire management practices captured global attention during the Australian 2019–20 ‘Black Summer’, as a possible method to mitigate bushfire risk; however, these ‘cultural burns’...

BACKGROUND A multifaceted preterm birth (PTB) prevention initiative was launched in the Australian Capital Territory (ACT) in 2019. The aim of this initiative was to safely lower the rate of early births across the ACT and the surrounding areas in New South Wales. Modelled on the Western Australian PTB Prevention Initiative, the program included new clinical guidelines and a new PTB prevention clinic at the main tertiary hospital. AIM To evaluate the initiative and its effects on preterm and early term birth rates at the main tertiary hospital after 16 months of implementation. MATERIALS AND METHODS A before and after intervention study was conducted. Rates of preterm and early term birth before (previous five years) and after 16 months of implementation of the ACT PTB Prevention Initiative were evaluated. RESULTS At the main tertiary hospital in The Canberra Hospital, the rate of PTB was significantly reduced by 10% after 16 months of implementation of the initiative. Rates of PTB were lower than any of the preceding five years and resulted in 45 averted or delayed PTBs. The number of planned early term births with no medical indication was significantly reduced by 34.5% and resulted in 77 averted or delayed early term births. CONCLUSIONS The multifaceted PTB Prevention Initiative safely lowered the rates of early birth in the ACT context. These results highlight the importance of prioritising early birth prevention, education, research and expanding the initiative nationwide.

Objectives: The Australian Capital Territory (ACT) changed from the Mental Health (Treatment and Care) Act 1994 (ACT) to the Mental Health Act 2015 (ACT) on 1 March 2016. The objective was to find the association between legislative changes and detention rates. Methods: A cross-sectional study of involuntary order rates in the period 3 years before the legislative change was undertaken. Chi-squared analysis was performed to compare proportions. Results: There was a statistically significant decrease in the proportion of Psychiatric Treatment Orders (PTOs) over the two periods, which could be impacted by the change from a period of detention for 7 days to a period of detention of 11 days in Period 2. On the other hand, the total number of Emergency Actions (EAs) increased in Period 2, where ambulance officers could detain patients. Conclusion: The change in mental health legislation in the ACT was associated with a change in detention rates, in particular a decrease in the proportion of PTOs and an increase in EAs. Further study needs to be undertaken, given changes to frontline supports since the study period ended.

Barbecue devices can be classified into several categories, including electrical, gas-fuelled and charcoal-based devices. Recreational outdoor burns are a preventable cause of morbidity and disability. This study aims to describe and analyse contact-related barbecue coal burns in the paediatric age group across New South Wales and the Australian Capital Territory. A retrospective review from January 2010 to January 2019 at The Children’s Hospital at Westmead. All barbecue coal burn injuries in children less than 16 years that attended or were referred to the Burns Unit were included. There were 48 patients whom presented with a contact burn barbecue coal-related injury. The male to female ratio was 5:3 with an average age of 2.5 years. Most injuries occurred in the home setting. The most common site of injury were the hands. The most frequent type of injury was a mid-dermal burn, followed by deep and superficial, respectively. Charcoal barbeque burns in children were uncommon, usually occurred at home and most commonly involved critical burn areas such as the hands, with the potential for long-term functional impairment. This case series highlights the importance of understanding prevention campaigns around barbecues Level of evidence: Level IV, risk/prognostic study.

This paper describes a collaborative approach to professional learning that has provided an opportunity for refreshed practices and growth in capacity in schools supporting students with various learning needs in several schools that are part of the Association of Independent Schools in the Australian Capital Territory. An action research approach to professional learning for school staff was facilitated with the participating schools in 2018/2019, centred on the Nationally Consistent Collection of Data on School Students with Disability.

Background Management options for vesicoureteric reflux are numerous, increasingly diversifying and debated. There is longstanding anecdotal opinion of inexplicable regional variation in vesicoureteric reflux management in Australia. This study investigates temporal trends in ureteric re-implantation for children, and variation between states and territories.Methods Ureteric re-implantation data for children aged 0-14 years were retrieved from the Medicare Benefits Scheme item reports database for the 20-year period from 1998-2017. Claims data were population adjusted for each state then standardized for age using Australian Bureau of Statistics records. National and regional trends were calculated using joinpoint regression. Comparison between eastern (New South Wales, Victoria, Queensland, Tasmania, Australian Capital Territory) and western or central (Western Australia, South Australia) states was performed using the Mann-Whitney U-test.Results There were 4919 procedure rebate claims during the study period. A national decrease in claim rates of 6.3% per 100 000 children was identified (P < 0.001). This was derived from significant decreases observed in eastern states. There was a threefold higher claim rate in Western Australia and South Australia per annum compared to the remainder of the country (4.0 versus 12.6 per 100 000; P < 0.001). For the most recent 5 years of the study period, this difference increased to a sevenfold higher rate (1.6 versus 11.1; P < 0.001).Conclusion There has been a dramatic nationwide decline in the rate of ureteric re-implantation procedure claims. Regional disparity between each side of the country is widening. Further research is required to determine if this degree of variation is warranted or unwarranted. The observed regional variation facilitates opportunity for a nationwide pragmatic clinical trial.

OBJECTIVE Preanalytical processing of blood samples can affect plasma glucose measurement because ongoing glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined. RESEARCH DESIGN AND METHODS All pregnant women in the Australian Capital Territory (ACT) are recommended for GDM testing with a 75-g OGTT using the World Health Organization diagnostic criteria. From January 2015 to May 2017, OGTT samples were collected into sodium fluoride (NaF) tubes and kept at room temperature until completion of the test (delayed centrifugation). From June 2017 to October 2018, OGTT samples in NaF tubes were centrifuged within 10 min (early centrifugation). RESULTS A total of 7,509 women were tested with the delayed centrifugation protocol and 4,808 with the early centrifugation protocol. The mean glucose concentrations for the fasting, 1-h, and 2-h OGTT samples were, respectively, 0.24 mmol/L (5.4%), 0.34 mmol/L (4.9%), and 0.16 mmol/L (2.3%) higher using the early centrifugation protocol (P < 0.0001 for all), increasing the GDM diagnosis rate from 11.6% (n = 869/7,509) to 20.6% (n = 1,007/4,887). CONCLUSIONS The findings of this study highlight the critical importance of the preanalytical processing protocol of OGTT blood samples used for diagnosing GDM. Delay in centrifuging of blood collected into NaF tubes will result in substantially lower rates of diagnosis than if blood is centrifuged early.

House prices have risen sharply in most Australian capital cities in recent years. Due to Australia’s strong identity as a homeowning nation and the related tendency towards entering the housing ma...

To evaluate the implementation of the first statewide newborn screening (NBS) program for spinal muscular atrophy (SMA) in Australia. Processes that hinder and support clinical development, translation, and sustainability of the first primary genetic screening program in Australia are appraised. The study prospectively describes the course (timelines, health processes, and preliminary clinical outcomes) for SMA screen-positive newborns from 1 August 2018 to 31 July 2019 in New South Wales and Australian Capital Territory, Australia. In the first year of the program, 103,903 newborns were screened. Ten newborns screened positive for SMA. Genetic confirmation of SMA occurred in 9/10 (90%) of infants. Clinical signs of SMA evolved in 4/9 (44%) within 4 weeks of life, heralded by hypotonia and weakness initially recognized in the neck. Median time to implementing a care plan (including commencement of disease-modifying therapies) was 26.5 days (16–37 days) from birth. NBS is essential for early and equitable identification of patients with SMA. Expedient diagnosis and management are vital, as disease latency appears brief in some cases. NBS shows significant clinical utility to support early parental decision making, improve access to specialist neuromuscular expertise, and facilitate initiation of personalized therapeutic strategies.

Human respiratory syncytial virus (RSV) is an important cause of acute respiratory infection (ARI) with the most severe disease in the young and elderly1,2. Non-pharmaceutical interventions (NPIs) and travel restrictions for controlling COVID-19 have impacted the circulation of most respiratory viruses including RSV globally, particularly in Australia, where during 2020 the normal winter epidemics were notably absent3–6. However, in late 2020, unprecedented widespread RSV outbreaks occurred, beginning in spring, and extending into summer across two widely separated states of Australia, Western Australia (WA) and New South Wales (NSW) including the Australian Capital Territory (ACT). Genome sequencing revealed a significant reduction in RSV genetic diversity following COVID-19 emergence except for two genetically distinct RSV-A clades. These clades circulated cryptically, likely localized for several months prior to an epidemic surge in cases upon relaxation of COVID-19 control measures. The NSW/ACT clade subsequently spread to the neighbouring state of Victoria (VIC) and caused extensive outbreaks and hospitalisations in early 2021. These findings highlight the need for continued surveillance and sequencing of RSV and other respiratory viruses during and after the COVID-19 pandemic as mitigation measures introduced may result in unusual seasonality, along with larger or more severe outbreaks in the future.

Documentation of malformed trilobites has presented invaluable insight into the palaeobiology of a wholly extinct euarthropod group. Although the northern hemisphere record is relatively well documented, examples of abnormal trilobites from Australia are limited. Furthermore, most recorded specimens are from Cambrian-aged rocks. To extend this limited record, we document five new examples of malformed Australian trilobites from the Middle and Late Silurian (Wenlock and Ludlow) deposits of the Yarralumla Formation of the Australian Capital Territory and Yarwood Siltstone Member, Black Bog Shale in New South Wales. We record the first examples of abnormal pygidial and thoracic nodes and present new evidence for bifurcating pygidial ribs. These abnormal features are considered teratological morphologies. The aberrant nodes likely arose through developmental malfunctions, while the bifurcating ribs represent either similar defects, or an injury that developed into a teratological feature. Explanations for the limited record of malformed Australian trilobites and for the decrease in injured trilobites after the end-Ordovician are presented. Further documentation of malformed Australian trilobites from the middle-to-late Paleozoic will undoubtedly paint a more complete picture of how Gondwanan taxa recovered from injuries or unfortunate developmental complications.

Objective:To compare the cost and affordability of two fortnightly diets (representing the national guidelines and current consumption) across areas containing Australia’s major supermarkets.Design:The Healthy Diets Australian Standardised Affordability and Pricing protocol was used.Setting:Price data were collected online and via phone calls in fifty-one urban and inner regional locations across Australia.Participants:Not applicable.Results:Healthy diets were consistently less expensive than current (unhealthy) diets. Nonetheless, healthy diets would cost 25–26 % of the disposable income for low-income households and 30–31 % of the poverty line. Differences in gross incomes (the most available income metric which overrepresents disposable income) drove national variations in diet affordability (from 14 % of the median gross household incomes in the Australian Capital Territory and Northern Territory to 25 % of the median gross household income in Tasmania).Conclusions:In Australian cities and regional areas with major supermarkets, access to affordable diets remains problematic for families receiving low incomes. These findings are likely to be exacerbated in outer regional and remote areas (not included in this study). To make healthy diets economically appealing, policies that reduce the (absolute and relative) costs of healthy diets and increase the incomes of Australians living in poverty are required.

This study attempts to analyze the ability of precious metals (gold, silver, platinum, and palladium) to act as a safe haven and hedging instruments on some of the capital market in the world. This study uses monthly data from January 2007 to December 2016. Stationarity Test, ARCH Effect Test and GARCH (1,1) Analysis are used to analyse the data. The results of this study indicate that gold is only capable of being a safe haven instruments in the capital markets of Tokyo, as well as gold are not able to be a hedging instrument for all capital markets studied. Silver is only capable of being a safe haven instruments separately Tokyo capital markets, as well as silver are not able to be a hedging instrument for all capital markets studied. Platinum is not capable of being a safe haven instruments for all capital markets studied, but platinum is able to be a hedging instrument for the Korean stock market and Tokyo. Palladium is not capable of being a safe haven instruments for all capital markets studied, but palladium is able to be a hedging instrument separately Australian capital markets, New York, Hong Kong, Korea, and Tokyo.

A simple method is presented to evaluate bed numbers between countries using a logarithmic relationship between beds per 1000 deaths and deaths per 1000 population, both of which are readily available. The method relies on the importance of the nearness to death effect. This method was tested using data from Australian States. Beds per 1000 deaths varied considerably between States. This variation reduced after adjusting for the ratio of deaths per 1000 population which is a measure of population age structure. After this adjustment, most Australian States roughly approximate to the international average for developed countries while Tasmania was shown to have a chronic bed shortage, as has been recognized for many years. The Northern Territory and the Australian Capital Territory, both of which have the youngest populations, have more beds relative to the other States. The nearness to death effect must be incorporated into capacity planning models in order to give robust estimates of future bed demand and to evaluate differences between countries and health care systems.

Families are increasingly choosing to raise children in the growing number of private, high-rise apartment complexes developed in Australian capital cities. However, most of these developments have...

Economic theory predicts that pricing electricity to better‐reflect the costs imposed by peak demand will benefit consumers by deferring network capacity augmentation. To date, the Australian Capital Territory is one of the first Australian jurisdictions to see significant uptake rates of more cost‐reflective network electricity tariffs by small consumers. This paper identifies lessons learned from the implementation of these tariffs, suggesting consumers have responded to price signals, thereby improving network utilisation. It also finds that the uptake of cost‐reflective tariffs is considerably greater under an opt‐out tariff assignment policy, and consultation plays an important role in gaining community support.

The wrongful conviction of David Harold Eastman in the Australian Capital Territory represents one of Australia’s most recent and high-profile public failures of the criminal justice system and highlights the limits of the Australian legal system. Further, the Eastman case draws into question the use of inquiries into miscarriages of justice, particularly when an inquiry’s recommendations can be disregarded by governments (as it was in this instance). This article provides an overview of the Eastman case and critically evaluates how it sheds light on the use of inquiries as an avenue to investigate and correct wrongful convictions more broadly in Australia.

We examine the dynamic and asymmetric responses of house prices to changes in mortgage interest rates in Australia from January 1995 to November 2017. We propose a threshold intervention model to d...

This study examines inequalities of school funding as exclusively generated by the parent community in urban public schools, and potentially illuminates a secondary impact of between-school segregation. For schools that are largely understood as free, the substantial injections of private financing into public schools indicate a concerning tension for fairness and equity. Using a census dataset of all public schools in one Australian capital city (n = 150), we compare reported parent ‘contributions, fees and charges’ and how they are patterned by measures of school disadvantage and advantage. We found a statistically significant relationship between private financing and measures of school-based advantage or disadvantage, over a four-year period. Advantaged schools generate up to six times greater income in comparison to disadvantaged schools over a four-year period, and we argue that the substantial gaps function as another form of ‘compounded disadvantage’ for residualised public schools and a tiered effect of segregation.

On 1st July 2015, Out of Home Care (OOHC) services in the Australian Capital Territory (ACT) joined together to form the ACT Together consortium and aimed to improve outcomes for children and young people who are unable to live with their birth families. Within the consortium, the Therapeutic Services Team (TST) steers the evolution of trauma-informed therapeutic practice, a key focus of which is the establishment of therapeutic care. Current research indicates that a holistic therapeutic approach has the greatest impact in supporting a young person to overcome adverse childhood experiences. This leads to the necessity of a therapeutic care system providing input across the whole domain of OOHC, including trauma-informed therapeutic carers. A common issue met by the TST is the lack of clarity regarding the difference between therapeutic intervention and therapy. This paper defines the concepts of therapy and therapeutic care, discusses how this forms a continuum which flows throughout the whole OOHC system and reflects on what support carers require to make the shift to becoming therapeutic carers, including outlining their role in underpinning better outcomes for the children and young people who pass through their doors.

OBJECTIVES: There are a growing number of people aged over 55 years living in retirement communities in Australia. These communities typically consist of accommodation, services and community facilities which cater to older people and the desire to maintain independence. The Nutrition and Healthy Ageing Trajectories in Retirement Living (NutriHAT-RL) study aims to investigate the nutrition and lifestyle-based behaviours which contribute to healthy ageing and the maintenance of social and physical functioning among older people living in retirement communities. METHODS: This study will recruit a total of 2,770 people aged 55 years or over living in retirement communities in the Australian Capital Territory and southern New South Wales regions of Australia for a four-year prospective longitudinal study commencing in March 2021. A range of measures, including nutritional intake, health and lifestyle behaviours, cognitive and psychological function, and physical health, will be completed on three occasions over a total of four years. Participants will complete a face-to-face comprehensive, validated food frequency questionnaire at each time point. Risk of malnutrition and nutritional behaviour (emotional appetite and intuitive eating) will also be evaluated. Multiple mental, social, and physical health domains will be assessed at each time point. This will include cognitive and mental health (depression, anxiety, and loneliness) screening, social and occupational functioning questionnaires, self-reported and observed physical function assessments, and sleep quality. Bitter taste endophenotype, salivary C-reactive protein, telomere length, and blood biomarkers associated with healthy ageing will also be evaluated. RESULTS: Ethics approval has been obtained through the University of Canberra Human Ethics Research Committee (UCHREC-2306). To reduce risk of COVID-19 transmissions, a risk mitigation plan has been developed. CONCLUSIONS: The NutriHAT-RL study will be the first Australian longitudinal study with a focus on nutrition and healthy ageing in people living in retirement communities. Findings from this study will contribute to understanding of nutrition and healthy ageing in this growing population and will inform policy and practice related to nutrition and ageing in place. FUNDING SOURCES: N/A.

Background Chlamydia pneumoniae (Cp) and Mycoplasma pneumoniae (Myco) bacteria are atypical pathogens that can cause pneumonia and exacerbate underlying conditions such as asthma and chronic obstructive pulmonary disease. In the Australian Capital Territory, there is limited information on how seasonal patterns for positive infections and testing may vary, a gap that has implications for control strategies. Methods We examined seasonal patterns of immunoassay results of patients from Canberra Hospital, Australia, who were tested for Cp and/or Myco. Pathology data, collected from August 1997 to March 2007 from 7,275 patients, were analysed with time series additive decomposition and time series regression. Results The proportion of positive Cp infections was highest in March and April (autumn) and lowest in June and August (winter). The proportion of positive Myco infections was highest in December and January (summer) and lowest in August (winter), even though testing for the pathogen peaked in winter with a low in summer. Models with a long-term trend and a variable for month were a better fit for the data than the null models for both infections. Conclusion We found differences in seasonal patterns of testing and in the proportion of positive infections. These findings suggest that preventative measures for common infections need to account for seasonal testing practices so as to build an accurate picture of temporal changes in these infections.

The aims of this study are to evaluate and describe mental health workforce and capacity, and to describe the relationship between workforce capacity and patterns of care in local areas. We conducted a comparative demonstration study of the applicability of an internationally validated standardised service classification instrument—the Description and Evaluation of Services and Directories—DESDE-LTC) using the emerging mental health ecosystems research (MHESR) approach. Using DESDE-LTC as the framework, and drawing from international occupation classifications, the workforce was classified according to characteristics including the type of care provided and professional background. Our reference area was the Australian Capital Territory, which we compared with two other urban districts in Australia (Sydney and South East Sydney) and three benchmark international health districts (Helsinki-Uusima (Finland), Verona (Italy) and Gipuzkoa (Spain)). We also compared our data with national level data where available. The Australian and Finnish regions had a larger and more highly skilled workforce than the southern European regions. The pattern of workforce availability and profile varied, even within the same country, at the local level. We found significant differences between regional rates of identified rates of psychiatrists and psychologists, and national averages. Using a standardised classification instrument at the local level, and our occupational groupings, we were able to assess the available workforce and provide information relevant to planners about the actual capacity of the system. Data obtained at local level is critical to providing planners with reliable data to inform their decision making.

The aim of this study was to estimate the childhood prevalence of achondroplasia, trends over time in birth prevalence, and age at diagnosis in Australia. Children born between 1990 and 2019 with a clinical and radiological and/or molecular diagnosis of achondroplasia were identified from a tertiary hospital servicing New South Wales (NSW) and the Australian Capital Territory (ACT) and compared with population data from the Australian Bureau of Statistics. Childhood prevalence of achondroplasia, based on children ≤19 years of age and resident in NSW/ACT on June 30, 2019 (n = 109), was 5.2 per 100,000. A total of 127 individuals with achondroplasia were born in 1990-2019 in NSW/ACT. Birth prevalence rates increased across birth decades, from 3.3 per 100,000 live births in 1990-1999 to 5.3 per 100,000 in 2010-2019 (p < 0.0001). Median age at diagnosis decreased to 17 days in 2010-2019 compared with 30 days in 1990-1999 (p = 0.035), although the overall decreasing trend across consecutive decades did not reach statistical significance. This is the first study to show a rising birth prevalence rate for achondroplasia in Australia with a concurrent decreasing age at diagnosis, both of which were statistically significant after 2 decades.

This study derived a set of Australian low-risk gambling limits and explored the relative and absolute risk associated with exceeding these limits. Secondary analysis of population-representative Tasmanian and Australian Capital Territory (ACT) cross-sectional (11,597 respondents) and longitudinal studies (2027 respondents) was conducted. Balancing sensitivity and specificity, the limits were: gambling frequency of 20–30 times per year; gambling expenditure of AUD $380–$615 per year (USD $240–$388 per year); gambling expenditure comprising 0.83–1.68% of gross personal income; and two types of gambling activities per year. All limits, except number of activities, predicted subsequent harm, with limits related to gambling expenditure consistently the best-performing. Exceeding the limits generally conferred a higher degree of relative and absolute risk, with gamblers exceeding the limits being 3–20 times more likely to experience harm than those who do not, and having a 5–17% risk of experiencing harm. Only 7–12% of gamblers exceeding the limits actually experienced harm. Gambling consumption lower than the limits also conferred a considerable amount of harm. Using a relative risk method, this study derived similar limits from disparate Australian states and territories. These limits can serve as working guidelines for the consideration of researchers, clinicians, and policy makers, but need to be subject to further rigorous empirical investigation.

This chapter emphasises the demographic effects that migration makes to both sending and receiving areas in terms of population change, age-sex compositions and subsequent demographic processes, such as fertility, ageing and further internal or international migration. Underlying the framework is a multiregional demographic model, which connects populations together through origin–destination migration flows. To illustrate the framework, an analysis of the role of internal migration in regional population change is presented for the Australian state of New South Wales and the Australian Capital Territory from 1981 to 2011.

Using daily hedonic housing price index for five Australian capital cities, we document a negative relationship between prior COVID-19 cases and daily housing returns. Specifically, the daily housing return drops by 0.35 basis points or 1.26 percentage points annually for every doubling of newly confirmed COVID-19 cases in a state. We also examine the effect of government lockdown orders on housing returns and find insignificant results. These findings are robust under alternative pandemic proxies such as total active COVID-19 cases and other model specifications. Overall, our paper contributes to the literature on the geographic spread of pandemics and real estate prices.

Mercury (Hg) contamination is an environmental concern as a by-product of legacy mining in Australia. Here we investigate the spatial and temporal distribution of Hg in the Molonglo River system in New South Wales, Australia, and assess the physical and chemical factors influencing that distribution. Mercury concentrations in sediment cores were measured in conjunction with 210Pb and 137Cs dating to establish historical contamination. This was done at the source mine site of Captains Flat, New South Wales, and the system’s sink in Lake Burley Griffin, Australian Capital Territory. Additionally, surficial sediment Hg concentrations along the Molonglo River were analyzed to determine the spatial distribution of Hg. Analytical results showed the primary physical and chemical factors influencing Hg dispersion to be distance, total organic matter, and the presence of iron oxides and oxyhydroxides. The highest Hg concentrations were near the mine site at Captains Flat and decreased significantly with distance. Sediment core analyses in both Captains Flat and the lake showed reductions in Hg concentrations toward surficial sediment layers. It is suggested government-funded rehabilitation programs are playing a part in reducing the release of metal contamination.

Objective To evaluate the Australian Capital Territory (ACT) Preterm Birth (PTB) Prevention Initiative and its effects on preterm and early term birth rates at the main tertiary hospital after 16 months of implementation. Design: A non-randomised before and after study, where the intervention was a multifaceted PTB prevention initiative. Setting: The main tertiary referral hospital in the ACT. Population: Women who birthed at the main tertiary hospital in the ACT in the pre and post intervention period. Methods: The PTB prevention initiative was implemented in 2019. Rates of early birth were assessed using run charts of bimonthly preterm and early term rates from 2014-2020. Main Outcomes measured: The main outcomes measured were rates of preterm and early term births before and after implementation of the PTB prevention initiative. Results: At the main tertiary hospital in the ACT, the rate of PTB was significantly reduced by 10% after 16 months of implementation of the initiative, corresponding to 45 averted or delayed PTBs. The number of iatrogenic early term births with no medical indication (NMI) was significantly reduced by 34.5% and resulted in 77 averted or delayed early term births. Conclusions: The multifaceted PTB prevention initiative safely lowered the rates of early birth in the ACT context. These results highlight the importance of prioritising early birth prevention, education, research and expanding the PTB Prevention Initiative nationwide.

Modern urban science views differences in attractiveness of residential suburbs as the main driver of resettlement within a city. In particular, certain suburbs may attract residents due to lower commute costs, and this is believed to lead to compactification of a city, with highly populated central business district and sprawled suburbia. In this paper we assess residential resettlement patterns in Australian capital cities by analyzing the 2011 and 2016 Australian Census data. Rather than explicitly defining a residential attractiveness of each suburb in subjective terms, we introduce and calibrate a model which quantifies the intra-city migration flows in terms of the attractiveness potentials (and their differences), inferring these from the data. We discover that, despite the existence of well-known static agglomeration patterns favouring central districts over the suburbia, the dynamic flows that shape the intra-city migration over the last decade reveal the preference directed away from the central districts with a high density of jobs and population, towards the less populated suburbs on the periphery. Furthermore, we discover that the relocation distance of such resettlement flows plays a vital role, and explains a significant part of the variation in migration flows: the resettlement flow markedly decreases with the relocation distance. Finally, we propose a conjecture that these directional resettlement flows are explained by the cities’ structure, with monocentric cities exhibiting outward flows with much higher reluctance to long-distance relocation. This conjecture is verified across the major Australian capitals: both monocentric (Sydney, Melbourne, Brisbane, Adelaide, Perth, Hobart) and polycentric (Darwin and Canberra).

During surveys of the waterbirds of the Lake Bathurst wetland system on the Southern Tablelands of New South Wales, near Canberra (Australian Capital Territory) in most months from 1980 onwards, Hoary-headed Grebes Poliocephalus poliocephalus were found breeding on only six occasions. Nests were built along islands that formed only when Lake Bathurst and the neighbouring Southern Morass reached specific water depths. At higher and lower water levels, Grebes were present but did not breed. The maximum number of nests in a season was 985, much greater than any reported in the literature, but young were produced in only three seasons. Nest failures resulted from falling water levels, heavy rain (and associated rise in water level) or a wind-induced temporary rise in water level. Partial reflooding of the lake triggered late nesting, in April, but the nests were abandoned as the water level fell. High mobility, congregating at refilling wetlands and attempts to nest late in the season by this species may be responses to the ‘boom and bust’ scenario of inland wetlands.

Background Patients with chronic disease in rural and remote regions endure limited access to specialised medicine. Telehealth has addressed this issue with demonstrable benefits such as a reduction in costs to patients. Aim This study aimed to explore the patient satisfaction of Telehealth in Australia. Methods Patients from all around Australia, including Queensland, Victoria, Tasmania, South Australia, Australian Capital Territory and even Western Australia were referred to a Sydney based neurologist. After their initial face to face consultation, review consultations were performed by Telehealth. All had chronic diseases (trigeminal neuralgia, facial pain or Parkinson's disease) and received a standardised questionnaire comprising of demographics, satisfaction of technical aspects and quality of the consultation. The questionnaires were administered by the Practice Manager to remove observer bias. Results Twenty-nine (29) patient questionnaires were completed by thirteen (13) patients who had follow-up Telehealth consultations. 100% of patients reported satisfaction with the overall telehealth experience and would use it again. All were satisfied with the specialist and the privacy. The majority were satisfied with the voice quality (86%), visual quality (79%), ease of connectivity (93%) and length of the consultation (97%). In total, they saved nearly $17 000 in travel costs and on average, each patient avoided 937 km and saved $550. Conclusion Telehealth has proven to have multiple advantages, including improved access to health care, decreased costs, reduced inconvenience and improved management of chronic and complex conditions. The positive results advocate the use of Telehealth for follow-up of rural and remote patients with chronic disease. This article is protected by copyright. All rights reserved.