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Surf lifesaving members are essential first responders who patrol public waterways, performing rescues and resuscitation to individuals in the community when needed. In this way, surf lifesaving members experience arduous physical requirements alongside extensive psychological stress during resuscitation. Surf Life Saving Queensland (SLSQ) represents the predominant, frontline lifesaving service in Queensland, Australia; however, little research has explored key aspects of drowning resuscitations involving this organisation, as well as in the broader lifesaving industry, limiting current understanding on this vital topic. We sought to explore key aspects of drowning resuscitations within SLSQ and create a framework to generate evidence-based practice. In guiding future lines of inquiry addressing this deficiency, a six-step research framework has been proposed to aid in holistically understanding the resuscitation process from a surf lifesaving perspective. Evidence generated from applying this framework will create a much- needed knowledge base for surf lifesaving organisations to use in the development of practical, strategic, and effective decisions to enhance their practices and ultimately better prevent drowning fatalities. [ABSTRACT FROM AUTHOR]

As land becomes increasingly expensive in Australia fewer people can afford it, with consequences for wealth distribution and housing. Real estate, in particular the family home, has formed a foundation for Australians' wealth over many decades, but the possibility of home ownership has been deteriorating in recent years. Alternative proposals for property investment include issuing fractions of land title on blockchain with parallel registration in the land registry. While such proposals are technically feasible, they are silent as to the means of integrating the blockchain ledger with the land administration system. As the land administration system comprises multiple statutory processes, this article uses the Queensland system as a case study, to analyse the relevant statutes in terms of the integration of a fractionalised blockchain titles system. The aim is to identify the law reform necessary to achieve a high level of integration of fractionalised land titles on a blockchain, within an existing land administration system --without detracting from the policy goals of that system., I INTRODUCTION As land becomes increasingly expensive in Australia fewer people can afford it, with consequences for wealth distribution and housing. Real estate, in particular the family home, has formed [...]

The passage of the Human Rights Act 2019 (Qld) ('HRA 2019') was a significant achievement, particularly in a state often known for its parochial conservatism and disinterest in, if not outright rejection of, human rights. The HRA 2019 is substantially based upon the human rights Acts in place in Victoria and the Australian Capital Territory. However, there are some small, but potentially important differences between the HRA 2019 and the corresponding state and territory equivalents. In this article, i focus on one of these differences: the definition of discrimination contained in the HRA 2019. Unlike the Charter of Human Rights and Responsibilities Act 2006 (Vic) the definition of discrimination in the HRA 2019 is not tied to the definition or grounds of discrimination in the state discrimination legislation. This small but important distinction could feasibly allow courts to define discrimination and the broader notion of equality in a more substantive manner, covering a wider variety of actions and conduct, and apply that wider definition to a broader range of attributes (commonly understood as 'grounds'). The purpose of this article is to consider the possibilities and potential challenges confronting Queensland courts in broadening the definition of discrimination in the context of HRA 2019. I argue that, though a substantive interpretation of discrimination and equality is challenging and requires a degree of 'creativity' on the part of judges, it is a challenge worth undertaking., I INTRODUCTION The manner in which the meanings of discrimination and equality have been interpreted by Australian courts has been consistently critiqued. (1) With respect to anti-discrimination statutes, while courts [...]

This paper engages, Sara Ahmed's theorising on 'the uses of use' to frame an analysis of the hidden, embedded effects of standardised testing policy that have become normative practice/s in Queensland, Australia. It (re)examines data from an ethno-case study into the datafication of assessment and learning over one school year, in primary and secondary schooling contexts, to understand the uses of the National Assessment Program – Literacy and Numeracy (NAPLAN) in a new, critical light. We explore schools' contemporary uses of NAPLAN – intended or otherwise – to demonstrate how the policy effects of NAPLAN have become insidiously submerged within the daily practices in schools. Drawing on interviews with 27 teachers and seven school leaders, classroom and staff meeting observations, and artefact data, we reveal the invisible yet profoundly altering presence of NAPLAN and its consequences. Specifically, we analyse the ways in which NAPLAN practices, structures and technologies are both hidden and yet manifestly altering as a) practices that disappear into their uses, becoming unidentifiable and routine; and b) practices that follow well-used pathways that further embed particular uses. We counter rhetoric of NAPLAN normativity and complacency, instead demonstrating that its current uses, while not originally intended, are insidious and profound. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between on-road driving remediation and achieving fitness to drive following acquired brain injury. Design: Randomized controlled trial. Setting: Tertiary hospital outpatient driver assessment and rehabilitation service, Australia. Participants: Thirty-five participants (54.3% male), aged 18–65 years, 41 days-20 years post-acquired brain injury (including stroke, aneurysm, traumatic brain injury) recommended for on-road driving remediation following occupational therapy driver assessment were randomly assigned to intervention (n = 18) and waitlist control (n = 17) groups. Intervention: Intervention group received on-road driving remediation delivered by a qualified driving instructor in a dual-control vehicle. The waitlist control group completed a 6 week period of no driving-related remediation. Main measure: Fitness to drive rated following the conduct of an on-road occupational therapy driver assessment with a qualified driving instructor where outcome assessors were blinded to group allocation. Results: The intervention group were significantly more likely to achieve a fit to drive recommendation than no driving specific intervention (p = 0.003). Conclusion: Following comprehensive assessment, individualized on-road driving remediation programs devised by an occupational therapist with advanced training in driver assessment and rehabilitation and delivered by a qualified driving instructor are significantly associated with achieving fitness to drive after acquired brain injury. [ABSTRACT FROM AUTHOR]

Background: The factors informing decisions to fund health services for Aboriginal and Torres Strait Islander children are unclear. This study's objective aimed to describe decision-makers' perspectives on factors informing decisions to fund health services for Aboriginal and Torres Strait Islander children. Methods: We conducted semi-structured interviews with 13 participants experienced in making funding decisions at organisational, state, territory and national levels. Decision-makers were from New South Wales, Northern Territory, Queensland, Victoria and Western Australia. Transcripts were analysed thematically following the principles of grounded theory. Results: We identified five themes, each with subthemes. First, prioritising engagement for authentic partnerships (opportunities to build relationships and mutual understanding, co-design and co-evaluation for implementation). Second, valuing participant experiences to secure receptiveness (cultivating culturally safe environments to facilitate acceptability, empowering for self-determination and sustainability, strengthening connectedness and collaboration for holistic care, restoring confidence and generational trust through long-term commitments). Third, comprehensive approaches to promote health and wellbeing (linking impacts to developmental milestones, maintaining access to health care, broadening conceptualisations of child health). Fourth, threats to optimal service delivery (fractured and outdated technology systems amplify data access difficulties, failure to 'truly listen' fuelling redundant policy, rigid funding models undermining innovation). Fifth, navigating political and ideological hurdles to advance community priorities (negotiating politicians' willingness to support community-driven objectives, pressure to satisfy economic and policy considerations, countering entrenched hesitancy to community-controlled governance). Conclusion: Decision-makers viewed participation, engagement, trust, empowerment and community acceptance as important indicators of service performance. This study highlights factors that influence decisions to fund health services for Aboriginal and Torres Strait Islander children. Making decisions to fund health services requires evidence that decision-makers consider relevant. This study identifies and defines factors of health services for Aboriginal and Torres Strait Islander children that influence funding decisions from the perspectives of decision-makers. Knowing the factors that decision-makers find useful when making decisions to fund health services can inform the types of measures that health services include in reports used to support applications for funding. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the effectiveness of a structured audio-visual educational session for people on asthma symptoms management during a general practitioner visit. Methods: We conducted this single-centre intervention study in a general practice clinic in Queensland, Australia. There were 78 intervention and 78 control participants in this study. We followed 1:1 randomisation to allocate study intervention between two groups of participants with asthma. The intervention group received an audio-visual demonstration of asthma, its symptoms, triggers, and how to use inhalers correctly, along with the standard asthma management by a physician on enrolment. The control group received only the standard asthma management by a physician. We assessed the 'Asthma Control Test' score on enrolment and after 90 days and compared the changes across the groups. Results: Participants were, on average, 28 years old (range: 6–60, 60% women). The intervention group showed a 1.9-unit increment, and the control group showed a −0.5-unit increment in 'Asthma Control Test' score from baseline to endline. The difference of differences between the intervention and control groups was 2.4 units (P = 0.016) after adjusting for potential confounders. In age-stratified analysis, the children (6–17 years) showed a significant difference (mean difference of 2.5 between intervention and control groups) in their asthma control score. Conclusions: Structured educational sessions involving audio-visual media along with standard management for people with asthma during general practice visits would be effective for better asthma control. However, a further multi-centre study with a larger sample is needed to see its efficacy. The effectiveness of an asthma educational adjunct to standard management during a general practice visit is not well studied. A recent study in a Queensland general practice clinic examined the impact of a structured audio-visual educational session on asthma management and showed a significant improvement in Asthma Control Test scores in the intervention group compared to controls. This suggests the potential efficacy of such interventions in enhancing asthma control during general practice visits, although further multi-centre studies are necessary for conclusive evidence. [ABSTRACT FROM AUTHOR]

Background: Patient Assessment of Care in Chronic Conditions (PACIC+), included in some Australian guidelines, has been shown reliable for measuring patient engagement and perception of their care in primary care settings. Various studies have focussed on PACIC+ use in specific conditions. This study aims to expand PACIC+ to measure patient empowerment to self-manage their chronic condition and validate it in the broader Australian primary care population. This study aims to evaluate internal consistency and reliability of PACIC+ and six new supplementary items proposed to assess patient wellbeing and empowerment to self-manage their chronic condition. Methods: A repeated-measures correlation design study assessed the expanded PACIC+ over three time-points. Particpants were patients with at least one chronic disease, referred by consultant physician, or recruited by advertisement posters in hospital clinic areas. Results: PACIC+ (26-item) had acceptable internal consitency (Cronbach's alpha 0.96). Test–retest reliability (Time-1 and 2, P < 0.01) was acceptable: Total score r (48) = 0.43; and New supplementary items: Confidence r (48) = 0.54; Understanding r (48) = 0.62; Support r (48) = 0.43; Overall Health r (48) = 0.42; Overall Health Change r (48) = −0.31, P = 0.03; and Acute Episodes of Care in 1-month r (48) = 0.42, P < 0.01. Four factors from the original PACIC+ accounted for 66.5% of the variance. Conclusions: The expanded PACIC+ is an improved psychometric tool providing for the patient's voice in a shared health journey. It is a valid, reliable tool to monitor and measure self-management of chronic conditions in Australian population clinic and primary healthcare settings. Six new supplementary patient empowerment and health status measures proved reliable and, in combination with the PACIC+ psychometric tool, could offer a method to monitor and measure the self-management of chronic conditions in the Australian clinic setting and for future research. [ABSTRACT FROM AUTHOR]

This article explores the contributions of Maurice Lyons, a Queensland mining entrepreneur, to the mining industry in Queensland and New South Wales from 1876 to 1915. Lyons was involved in various mining ventures, including coal mining and stone quarrying, but faced financial difficulties and had some unsuccessful ventures. He also had interests in fraudulent operations and owned a large opal. Despite facing challenges, Lyons continued to promote mining opportunities until his death in 1917. Overall, his contributions to the mining industry have been largely unrecognized and undocumented. [Extracted from the article]

Objectives: To investigate knowledge and awareness of dental complications with oral piercings among adults with oral piercings, a control population with no piercings and body‐piercing professionals in South‐East Queensland, Australia. Methods: Participants recruited from public and private dental clinics and body‐piercing professionals from piercing centres in the same region completed questionnaires to assess knowledge and attitudes. Results: Respondents comprised 54 pierced individuals, 54 controls and 35 body‐piercing professionals. Only 13% of the pierced group were informed about oral piercing‐related complications, and 14% of body‐piercing professionals did not warn their clients about long‐term complications. The latter included chipped teeth (26%) and gingival recession (15%). About 76% play with their piercing, developing teeth grinding (15%), jaw clenching (15%) and sleep disturbances (4%). Interestingly, 41% of those with oral piercings advised others against getting piercings. Conclusions: There is a lack of awareness about dental‐related complications among pierced individuals and body‐piercing professionals. A significant proportion of pierced individuals advise others against getting piercings. Body piercers do not consistently advise clients about risks associated with oral piercings. Thus, it is recommended that programmes be developed to improve awareness of oral and dental complications associated with oral piercings. [ABSTRACT FROM AUTHOR]

In this pilot study, we explored current attitudes and deprescribing practices of clinicians in a large regional health service through a mixed methods approach. Respondents included doctors, pharmacists and nurse practitioners, who outlined three themes including professional and organisational contexts, disconnect between goals and practices and factors influencing deprescribing. [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]

OBJECTIVES: Enterobacterales bloodstream infections (E-BSI) cause a significant burden of disease in children and are associated with antimicrobial resistance. We assessed temporal changes in the population-based incidence of E-BSI in children in Queensland, Australia. METHODS: We conducted a cohort study of incidents of E-BSI occurring in children in Queensland between 2000 and 2019, with a total population of 19.7 million child years. Infections were linked to clinical outcomes in hospital admissions and vital statistics databases. We estimated age- and sex-standardized E-BSI incidence rates over time. Secondary outcomes included the proportion of extended-spectrum b-lactamase phenotypes per year, hospital length of stay, and mortality. RESULTS: We identified 1980 E-BSI in 1795 children. The overall age- and sex-standardized incidence rate was 9.9 cases per 100 000 child years, which increased from 7.3 to 12.9 over the period studied, an increase of 3.9% (95% confidence interval: 3.1-4.7) per year. There were 3.6 cases of E. coli bloodstream infection per 100 000 child years, increasing annually by 4.7% (3.5-5.9). The Salmonella sp. bloodstream infection incidence was 3.0 cases per 100 000 child years, which increased from 2013 by 13.7% (3.8-24.3) per year. The proportion of extendedspectrum β-lactamase E. coli increased over time. Mortality and length of stay were higher among children with comorbidities than those without (4.0% vs 0.3%, and 14 vs 4 days, respectively, P < .001). CONCLUSIONS: The age- and sex-standardized incidence of E-BSI almost doubled in Queensland children over 2 decades, driven by increases in Salmonella sp. and E. coli. Increasing resistance of E. coli should prompt the inclusion of children in antimicrobial clinical trials. [ABSTRACT FROM AUTHOR]

Background and Aims: Cytisine (also known as cytisinicline) is a low‐cost partial agonist of nicotinic acetylcholine receptors used to assist tobacco cessation. We aimed to review the effectiveness of cytisine for tobacco cessation and the effects of dose and co‐use of behavioural or other pharmacological interventions on cessation outcomes. Methods: We searched seven databases, Google Scholar, and reference lists of included publications for randomised controlled trials investigating use of cytisine as a tobacco cessation aid. Studies were eligible if participants were ≥15 years old and used tobacco upon study enrolment. We conducted four random effects meta‐analyses and sensitivity analyses with fixed effects models. We used the Cochrane risk‐of‐bias tool for randomised trials version 2 to assess risk of bias in included studies, with adjustments recommended by the Cochrane Tobacco Addiction Group. Results: Participants using cytisine were significantly more likely to quit tobacco than participants who received placebo/no intervention/usual care (risk ratio [RR] = 2.65, 95% confidence interval [CI] = 1.50–4.67, 6 trials, 5194 participants) or nicotine replacement therapy (RR = 1.36, 95% CI = 1.06–1.73, p = 0.0152, 2 trials, 1511 participants). The difference in cessation rates among participants receiving cytisine versus varenicline was not statistically significant (RR = 0.96, 95% CI 0.63–1.45, P = 0.8464, 3 trials, 2508 participants). Two trials examined longer versus shorter treatment duration, finding higher abstinence rates with longer treatment (RR = 1.29, 95% CI = 1.02–1.63, 2 trials, 1009 participants). The differences in the number of adverse events reported by participants who received cytisine versus placebo (RR = 1.19, 95% CI = 0.99–1.41, P = 0.0624; 6 trials; 4578 participants) or cytisine versus varenicline (RR = 1.37, 95% CI = 0.57–3.33, P = 0.4835; 2 trials; 1345 participants) were not statistically significant. Most adverse events were mild (e.g. abnormal dreams, nausea, headaches). Conclusions: Cytisine is an effective aid for tobacco cessation and appears to be more effective for tobacco cessation than placebo, no intervention, usual care and nicotine replacement therapy. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a common and costly condition of pregnancy. The Healthy Gut Diet for Preventing Gestational Diabetes study is a novel randomised controlled trial that aims to prevent GDM through a diet that modulates the gut microbiota for pregnant women with GDM risk factors. Despite increasing interest in co‐designing interventions with consumers (lived experience experts), co‐design methods and outcomes are often poorly reported. The present study aims to report on the co‐design process used to develop The Healthy Gut Diet intervention. Methods: Co‐design occurred across three online workshops with consumer participants (women with a lived experience of GDM, n = 11), researchers (n = 6) and workshop co‐facilitators (including a consumer co‐facilitator, n = 2). The workshops explored women's preferences for the mode and length of education sessions, as well as the types of information and supportive resources women wanted to receive, and undertook a "behaviour diagnosis" to understand barriers and enablers to the target behaviours (eating for gut health). The final intervention is reported according to the Template for Intervention Description and Replication. Results: A co‐designed dietary intervention (The Healthy Gut Diet), delivered via telehealth, with a suite of educational and supportive resources that integrates published behaviour change techniques, was developed. Generally, the co‐design process was reported as a positive experience based on participant feedback and evidenced by no participant dropouts over the 3‐month study period. Conclusions: Co‐design is recognised as a process that creates a partnership between lived experience experts and researchers who can engage and empower research recipients and improve health behaviours. Highlights: Co‐designing dietary interventions with consumers can reduce research waste, improve applicability and intervention adherence, and enable selection of behaviour change techniques.Although increasing in popularity, co‐design methods, processes and outcomes are minimally described in diet research.Co‐design for The Healthy Gut Diet for Preventing Gestational Diabetes study involved 12 consumers with a lived experience of gestational diabetes and six researchers.Three online co‐design workshops were used to explore and decide on educational formats, content and delivery for the intervention, communication methods and a "behavioural diagnosis".The result was a dietary and behaviour change intervention (The Healthy Gut Diet), which is reported using the Template for Intervention Description and Replication. [ABSTRACT FROM AUTHOR]

Objective: Quad bikes are a leading cause of death and incident-related injury on farms, yet little is understood about rules used by farmers to ensure their safe operation. This study explored rules about quad bikes set by those who live or work on farms. Through the case of quad bikes, this study sought to understand how rules are determined and implemented at the farm level. Setting: A mix of farm types and locations in rural Australia including Queensland, South Australia, and New South Wales. Participants: Eight farmers were interviewed and recruited from information sheets at farmers' markets, through a local health organisation, and a media release. Design: Thematic analysis was used to transform data from eight semi-structured interviews with farmers in rural Australia. Results: Data were distilled into two themes – "Rule content" described the explicit rules farmers had set on their properties, while the theme "Underlying rule principles" explored the values and norms which underpinned the creation and implementation of these rules. Conclusions: Through the case of quad bike rules, this study illustrated how rules are determined and implemented at the farm level. Perceptions of risk were tied to farmers being experts in their own environment and therefore able to mitigate risk. In contrast to injury data, reckless use of quad bikes was perceived to cause incidents, and this was the basis of rules for adults and children. [ABSTRACT FROM AUTHOR]

Background: Telehealth can extend the reach of specialist palliative care providers to ensure that patients can access specialist services closer to home. Aim: To examine the cost and consequences of the Specialist Palliative Rural Telehealth (SPaRTa) service compared to the traditional non-specialist general practice-based services for people requiring palliative care. Design: The costs and outcomes for SPaRTa were compared using cost-consequence analysis principles, with a focus on net benefit and return on investment. Costs were estimated from the perspective of the health service provider for the 2020/2021 financial year, and cost-offsets associated with change in location of death and change in hospital transfers. Setting/participants: Patients of the SPaRTa in Queensland Australia. Results: During study period 5472 consultations were conducted from four major metropolitan hub sites to regional, rural, and remote areas at a total cost of $4 426 644. When remuneration for consultations, change to location of death and reduction in ambulance transfers were taken into account, the net-benefit to the state health system was $1 244 060, giving a return on investment of $1.28 for every dollar spent. SPaRTa complimented existing local care services, and enabled access to specialist care into the home. Conclusions: SPaRTa resulted in potential cost savings for the health service by enabling more convenient access to palliative care services outside of hospital settings. Decisions regarding funding for telepalliative care should consider not only the costs, but also the potential benefits to both the service providers, and the patients and families receiving this care. [ABSTRACT FROM AUTHOR]

Objectives: With high disease and disability burden in rural and remote regions, student-assisted clinics can be an effective workforce development tool to meet community health needs and workforce shortages. This research sought to identify the conditions under which student-assisted clinics can be successfully utilised as a workforce development strategy, with specific application to remote Queensland, Australia. Methods: A rapid review of the international literature in English was conducted. This was the most appropriate type of review because the results of the review were time-sensitive, with the student-assisted clinic model being trialled in Queensland soon. A mixed methods design was applied, with the search strategy piloted with one database. Results: Eleven studies met the inclusion criteria. Seven reported data on participant experiences, including consumers, students, services/clinics, and educators/supervisors/health professionals. Each of the studies operationalised student-assisted clinics through practice models (university-driven learning need), service delivery models (service driven need addressed through a student workforce), community need models (student delivered services primarily addressing a community health need), and blended models (practice need and community need). Some studies reported concerns about fragmentation of services, referral pathways and issues with follow-up, while others reported concerns about sustainable funding. All models reported successful outcomes when focused on service or consumer health outcomes, or student learning outcomes. Conclusions: Student-assisted clinics make an important contribution to the development of the rural and remote health workforce. Student-assisted clinics can complement and extend existing services, supporting workforce development in an overstretched health system impacted by an ongoing pandemic. [ABSTRACT FROM AUTHOR]

Purpose: Recovery-focused mental health treatment continues to grow, yet staff are often uncertain how best to define and implement it. As a quality assurance activity, we examined the effect of a novel orientation program embedded with a recovery framework structure, philosophy, and content, together with true lived experience codesign, on knowledge of recovery principles and acceptability. Method: Staff of a new sub-acute adolescent mental health inpatient center completed a 6-week orientation in early 2020. Recovery processes of connectedness, hope and optimism, identity, meaning, and empowerment were mapped to session topics and the structure, design, and philosophy of the program. Results: Mean knowledge scores improved from pre- to post-assessment and most (≥70%) participants reported topics as relevant, impactful, and would recommend. Approximately all (95%) comments were positive. Conclusion: Findings suggest that person-centered orientations that embed a recovery framework are promising for mental health staff orientation. [Journal of Psychosocial Nursing and Mental Health Services, 62(10), 7–14.] [ABSTRACT FROM AUTHOR]

Background: The online BeUpstanding™ program is an eight-week workplace-delivered intervention for desk-based workers to raise awareness of the benefits of sitting less and moving more and build a supportive culture for change. A workplace representative (the "champion") delivers the program, which includes a workshop where teams collectively choose their sit less/move more strategies. A toolkit provides the champion with a step-by-step guide and associated resources to support program uptake, delivery, and evaluation. Here we report on the main findings from the Australian national implementation trial of BeUpstanding. Methods: Recruitment (12/06/2019 to 30/09/2021) was supported by five policy and practice partners, with desk-based work teams from across Australia targeted. Effectiveness was measured via a single arm, repeated-measures trial. Data were collected via online surveys, toolkit analytics, and telephone calls with champions. The RE-AIM framework guided evaluation, with adoption/reach (number and characteristics); effectiveness (primary: self-reported workplace sitting time); implementation (completion of core components; costs); and, maintenance intentions reported here. Linear mixed models, correcting for cluster, were used for effectiveness, with reach, adoption, implementation, and maintenance outcomes described. Results: Of the 1640 website users who signed-up to BeUpstanding during the recruitment period, 233 were eligible, 198 (85%) provided preliminary consent, and 118 (50.6%) champions consented and started the trial, with 94% (n = 111 champions) completing. Trial participation was from across Australia and across industries, and reached 2,761 staff, with 2,248 participating in the staff survey(s): 65% female; 64% university educated; 17% from a non-English speaking background. The program effectively changed workplace sitting (-38.5 [95%CI -46.0 to -28.7] minutes/8-hour workday) and all outcomes targeted by BeUpstanding (behaviours and culture), with small-to-moderate statistically-significant effects observed. All participating teams (n = 94) completed at least 5/7 core steps; 72.4% completed all seven. Most champions spent $0 (72%) or >$0-$5 (10%) per team member; most (67/70 96%) intended to continue or repeat the program. Conclusions: BeUpstanding can be adopted and successfully implemented by a range of workplaces, reach a diversity of staff, and be effective at creating a supportive culture for teams of desk-based workers to sit less and move more. Learnings will inform optimisation of the program for longer-term sustainability. Trial registration: ACTRN12617000682347. [ABSTRACT FROM AUTHOR]

Family‐focussed practice is an important component of mental health care. In Australia, service users' views about their experience of service are collected using instruments such as the Your Experience of Service (YES) survey. This study examined 10,579 Queensland (Australia) service users' experiences of mental health services during 2019–2021, with a particular focus on their perspectives of how family and carers are involved in their care. The study examined if family‐focussed practice is welcomed by service users and if it is important in terms of predicting recovery‐related outcomes (e.g., hopefulness, managing day‐to‐day life, well‐being, and experience of care) and which demographics (e.g., age, gender, and Indigenous status) and service characteristics (e.g., time in service, duration, year of service, and setting type) are associated with these outcomes and with family member involvement. A substantial majority of service users reported a positive experience of care (very good or excellent), feeling they had opportunities for family involvement and that their opinions about family involvement were respected (usually or always). Chi‐square tests and nonlinear regression models showed that family involvement predicts care outcomes. Specifically, where individuals felt that their perspectives were recognised, their outcomes were consistently rated as more positive. The results also revealed that setting, age group, time in service, and admission status were significantly correlated with all user experience outcome variables and family‐oriented variables. Future research has the potential to further strengthen this understanding of service users' preferred opportunities and opinions about family involvement and how to improve family engagement and better meet the needs of service users and their families. [ABSTRACT FROM AUTHOR]

Homelessness is a significant issue in Australia, particularly for Aboriginal and Torres Strait Islander people, who are disproportionally affected compared to non-Indigenous Australians. In this article, we present new findings into the barriers and enablers of housing stability for Aboriginal and Torres Strait Islander people in the Brisbane and Logan areas of Queensland. The aim of the study was to document workers perceptions of barriers and enablers faced by Aboriginal and Torres Strait Islander people in Queensland when seeking to access housing. We drew on extensive interview data with front-line staff from an Aboriginal Community-Controlled Health Organisation (ACCHO) and in doing so identified five key themes: Bureaucratic Barriers and Inaccessibility of Services; Experiences of Discrimination; Impact of Family Dynamics on Housing Stability; Geographic Location; Comprehensive Support Needs. We demonstrated that consistent with the scholarly literature the interplay of systemic, structural, and cultural factors continues to impact housing stability. These findings suggest more work is required if governments are to address housing stability for Aboriginal and Torres Strait Islander individuals and families.IMPLICATIONSPresenting original data from social workers at an Aboriginal Community-Controlled Health Organisation (ACCHO) contributes to available understandings.In addressing housing challenges, cultural connection and competency are of vital importance.Voices from social workers can provide guidance for policymakers aiming to address homelessness for Aboriginal and Torres Strait Islander people.Presenting original data from social workers at an Aboriginal Community-Controlled Health Organisation (ACCHO) contributes to available understandings.In addressing housing challenges, cultural connection and competency are of vital importance.Voices from social workers can provide guidance for policymakers aiming to address homelessness for Aboriginal and Torres Strait Islander people. [ABSTRACT FROM AUTHOR]

Identifying mechanisms that drive population divergence under varying geographic and ecological scenarios can inform our understanding of evolution and speciation. In particular, analysis of genetic data from island populations with known colonisation timelines allows us to identify potential source populations of diverging island subspecies and current relationships among populations. Silvereyes (Zosterops lateralis) are a small passerine that have served as a valuable study system to investigate evolutionary patterns on both large and small geographic scales. We examined genetic relatedness and diversity of two silvereye subspecies, the mainland Z. l. cornwalli and island Z. l. chlorocephalus, and used 18 077 single nucleotide polymorphisms (SNPs), to compare locations across southeast Queensland, Australia. Although silvereyes are prolific island colonisers our findings revealed population divergence over relatively small spatial scales was strongly influenced by geographic isolation mediated by water barriers. Strong genetic connectivity was displayed between mainland sites, but minimal inter-island connectivity was shown despite comparable sampling distances. Genetic diversity analysis showed little difference in heterozygosity between island and mainland populations, but lower inbreeding scores among the island populations. Our study confirmed the range of the Z. l. chlorocephalus subspecies throughout the southern Great Barrier Reef. Our results show that water barriers and not geographic distance per se are important in driving incipient divergence in island populations. This helps to explain the relatively high number of phenotypically differentiated, but often geographically proximate, island silvereye subspecies compared to a lower number of phenotypically less well-defined Australian continental subspecies. [ABSTRACT FROM AUTHOR]

Introduction: Non-invasive hormone assessment is growing in interest as producers and livestock researchers seek new methods to assess animal welfare. Non-invasive wool assessment offers long-term, historic reflections of hormone concentration at the scale of weeks and months - and are not limited by sampling stress - thus making wool an appropriate tissue for long-term hormone analysis. This pilot study quantified cortisol and testosterone concentrations of ram fleece and determined if there is a significant difference between segments of the sample staple, and whether there is a correlation between hormones. Cortisol is a glucocorticoid produced within the adrenal glands and secreted in anticipation of or in response to a stressor. Testosterone is an androgen mainly synthesised within the testes of males and responsible for several critical functions including regulation of muscle growth, libido and spermatogenesis. Methods: In our study, 70 topknot wool samples were collected from rams on a commercial stud property in Dirranbandi, Queensland, Australia. Of these animals, 12 samples were selected at random to undergo cortisol and testosterone quantification. In the laboratory, a single, intact staple was isolated from the total sample, divided into 10 mm segments and prepared for their respective (cortisol or testosterone) immunoassays. Results: No significant difference (p > 0.05) was found between wool segments for either cortisol or testosterone, however, statistical differences (p < 0.05) were found between individuals for both hormones. A strong positive correlation (R2 = 0.9173, p < 0.05) was found between wool cortisol and testosterone concentrations. Discussion: In summary, this study reveals the major future possibilities for noninvasive wool hormone assessment in merino rams. [ABSTRACT FROM AUTHOR]

There is a significant body of research that attests to the deleterious impact of an accumulation of adverse childhood experience across the lifespan, which provides a strong rationale for the development of a means for evaluating this accumulation in a high‐risk population. We developed a theory‐driven measure, the Cumulative Experiences Index, and conducted a pilot study to test its utility. The Cumulative Experiences Index derives a cumulative harm score that can be used to inform intervention and prevention strategies, programmes and initiatives across all tiers of public health prevention intervention. The Cumulative Experiences Index was piloted with 50 participants aged 8–17 years old who were actively engaged with an Intensive Family Support service. The study explores whether cases rated as low, medium or high severity on the Cumulative Experiences Index corresponded with severity ratings on the three measures of concurrent validity: the Strengths and Difficulties Questionnaire, Kessler‐10 and Children's Revised Impact of Events Scale. The Index provides a valid and accurate means of reflecting the interconnectedness and complexity of exposure to different forms of harm that accumulates over time. Practitioners and researchers will benefit from using the Cumulative Experiences Index—a new valid and reliable measure of cumulative harm. Key Practitioner Messages: The Cumulative Experiences Index assists practitioners understand the frequency, duration and severity of the harm to a child or young person.The Index provides a valid and accurate means of reflecting the interconnectedness and complexity of exposure to different forms of harm that accumulates over time.Practitioners and researchers are likely to benefit from using the Cumulative Harm Index—a new valid and reliable measure of cumulative harm. [ABSTRACT FROM AUTHOR]

BACKGROUND: While some evidence has potentially linked climate change to carcinogenic factors, the long-term effect of climate change on liver cancer risk largely remains unclear. OBJECTIVES: Our objective is to evaluate the long-term relationship between temperature increase and liver cancer incidence in Australia. METHODS: We mapped the spatial distribution of liver cancer incidence from 2001 to 2019 in Australia. A Bayesian spatial conditional autoregressive (CAR) model was used to estimate the relationships between the increase in temperature at different lags and liver cancer incidence in Australia, after controlling for chronic hepatitis B prevalence, chronic hepatitis C prevalence, and the Index of Relative Socio-economic Disadvantage. Spatial random effects obtained from the Bayesian CAR model were also mapped. RESULTS: The research showed that the distribution of liver cancer in Australia is spatially clustered, most areas in Northern Territory and Northern Queensland have higher incidence and relative risk. The increase in temperature at the lag of 30 years was found to correlate with the increase in liver cancer incidence in Australia, with a posterior mean of 30.57 [95% Bayesian credible interval (CrI): 0.17, 58.88] for the univariate model and 29.50 (95% CrI: 1.27, 58.95) after controlling for confounders, respectively. The results were not highly credible for other lags. DISCUSSION: Our Bayesian spatial analysis suggested a potential relationship between temperature increase and liver cancer. To our knowledge, this research marks the first attempt to assess the long-term effect of global warming on liver cancer. If the relationship is confirmed by other studies, these findings may inform the development of prevention and mitigation strategies based on climate change projections. [ABSTRACT FROM AUTHOR]

Background: In 2022, publicly funded influenza vaccine was made available to all residents of Queensland, Australia. This study compared influenza epidemiology in 2022 with previous years (2017–2021) and estimated influenza vaccine effectiveness (VE) during 2022. Methods: The study involved a descriptive analysis of influenza notifications and a case–control study to estimate VE. Cases were notifications of laboratory‐confirmed influenza, and controls were individuals who were test negative for COVID‐19. Cases and controls were matched on age, postcode and specimen collection date. VE against hospitalisation was investigated by matching hospitalised cases to controls. Conditional logistic regression models were adjusted for sex. Results: In 2022, Queensland experienced an early influenza season onset (April–May) and high case numbers (n = 45,311), compared to the previous 5 years (annual average: 29,364) and 2020–2021 (2020:6047; 2021:301) during the COVID‐19 pandemic. Adjusted VE (VEadj) against laboratory‐confirmed influenza was 39% (95% confidence interval [CI]: 37–41), highest for children aged 30 months to < 5 years (61%, 95% CI: 49–70) and lowest for adults aged ≥ 65 years (24%, 95% CI: 17–30). VEadj against influenza‐associated hospitalisation was 54% (95% CI: 48–59). Among children < 9 years of age, VEadj against laboratory‐confirmed influenza (55%, 95% CI: 49–61) and hospitalisation (67%, 95% CI: 39–82) was higher in those who received a complete dose schedule. Conclusion: In Queensland, the 2022 influenza season started earlier than the previous 5 years. VE against influenza notifications varied across age groups. VE estimates against influenza‐associated hospitalisation were higher than those against laboratory‐confirmed influenza. [ABSTRACT FROM AUTHOR]

Sport plays an important role in the conception of Australian national identity. Much of the scholarly work on this topic has concentrated on professional, high-profile sports and athletes. In this article, we draw attention to a highly symbolic aspect of popular sporting culture—school sports houses—and the prominent historical figures and motifs that they project through their team names, mascots and colours. School sports houses are potent examples of banal nationalism, whereby elements of Australianness are reinforced through the tradition of school athletics and swimming carnivals. Here, we highlight the overlap between the school-based agenda of encouraging group identity and the broader notion of the nation as an imagined community. Using a comprehensive dataset of Queensland high school sport houses in 1969 and 2023, we observe several trends, such as the persistence of houses named after colonial explorers and the disparity between houses with women's and men's namesakes. We consider the role of school sports houses as "identity primers", or scripts, that encourage schoolchildren to identify with specific historic figures, landforms, animal totems, character traits and other qualities as indicators of the region and nation in which they live. [ABSTRACT FROM AUTHOR]

Background: The health and well-being of children in the first 2000 days has a lasting effect on educational achievement and long-term chronic disease in later life. However, the lack of integration between high-quality data, analytic capacity and timely health improvement initiatives means practitioners, service leaders and policymakers cannot use data effectively to plan and evaluate early intervention services and monitor high-level health outcomes. Objective: Our exploratory study aimed to develop an in-depth understanding of the system and clinical requirements of a state-wide paediatric learning health system (LHS) that uses routinely collected data to not only identify where the inequities and variation in care are, but also to also inform service development and delivery where it is needed most. Method: Our approach included reviewing exemplars of how administrative data are used in Australia; consulting with clinical, policy and data stakeholders to determine their needs for a child health LHS; mapping the existing data points collected across the first 2000 days of a child's life and geospatially locating patterns of key indicators for child health needs. Results: Our study identified the indicators that are available and accessible to inform service delivery and demonstrated the potential of using routinely collected administrative data to identify the gap between health needs and service availability. Conclusion: We recommend improving data collection, accessibility and integration to establish a state-wide LHS, whereby there is a streamlined process for data cleaning, analysis and visualisation to help identify populations in need in a timely manner. [ABSTRACT FROM AUTHOR]

Background: Polyps are the predominant precursors of colorectal cancer. In the past three decades, the incidence and mortality rates of colorectal cancer have been increasing in adults younger than 50 years. Aims: The aim of this clinical audit was to evaluate the prevalence, characteristics and clinical associations of polyps in adults aged 18–49 years presenting to an established private gastroenterology clinic in the Toowoomba Darling Downs region. Methods: The audit included data from 353 patient records held by the Toowoomba Gastroenterology Clinic. Data extracted from patient medical records through the Medical Director program software contained structured endoscopy/colonoscopy and histology reports of excised lesions of patients presenting to the clinic. The extract involved identifying all patients aged 18–49 years in the database from January 2019 to March 2022. Patients were screened based on audit inclusion and exclusion criteria. Patients were risk stratified for recommended surveillance intervals as per Australian Clinical Guidelines. Results: Of the sample population, 33.4% were identified with polyps and 22.4% were identified with neoplastic polyps (NPs). A total of 6.7% of 18‐ to 29‐year‐old patients were identified with intermediate risk for colorectal cancer (CRC) screening, and 19.8% and 19.3% of 30‐ to 39‐year‐old and 40‐ to 49‐year‐old patients identified with intermediate or high risk for CRC screening respectively. Increased age, greater size of polyps and surveillance of previous polyps were associated with increased NP prevalence. Conclusions: Data from this audit supported the temporal trend of increasing prevalence of polyps in adults younger than 50 years. Patient cohorts aged 30–39 and 40–49 years may benefit from earlier first colonoscopies. Findings could be the impetus for future research in young adults presenting for colonoscopy. [ABSTRACT FROM AUTHOR]

Background: The short Synacthen test (SST) is widely used to investigate adrenal insufficiency, but it can be time‐consuming, costly and labour‐intensive to perform and is not without risk of adverse events. Aim: To review SST requesting patterns and practices across public hospitals in Queensland. Methods: The electronic medical records of patients who underwent a SST with Pathology Queensland between January 2020 and December 2020 were reviewed to collect data regarding the indication for the test, the requesting speciality, SST results and any adverse events. Results: Six hundred and fifty‐two SSTs were identified, of which 363 individual patients were included in the analysis. The majority of the tests (n = 198, 54.5%) were performed in the inpatient setting. Endocrinology most commonly ordered SSTs (n = 188, 51.8%). The suspected aetiology of adrenal insufficiency was unclear in a large proportion of requests (n = 167, 46.0%). Static testing of morning cortisol prior to SST was performed in only 249 (68.6%) patients. Of 140 inpatients data, 17.9% (n = 25) showed a robust static cortisol of ≥400 nmol/L and were treated as having normal adrenal function, suggesting SST was unnecessary in these patients. Twenty‐two (6.1%) patients had a documented adverse event occurring during or after the SST. Conclusions: There was wide variability in requesting patterns and practices for SSTs across Queensland. More than one in six SSTs could have been avoided if a static morning cortisol had been performed prior. Clinician education and the adoption of a structured referral form may improve testing practices. [ABSTRACT FROM AUTHOR]

Racialized stereotyping and derogatory (self-)labelling of Pasifika young peoples in Australia as intellectually ungifted, unsophisticated and lazy impact greatly upon their sense of self-worth and belonging. This is supported by the overrepresentation of Pasifika in youth justice systems and high suicide rates among this demographic, despite Pasifika peoples forming less than a few percent of Australia's population. This research focuses mainly on South-east Queensland and builds upon an earlier study which demonstrated that Pasifika young peoples in the region foster a sense of belonging through the formation of dynamic, multicultural identities and spaces of belonging (Durham et al. 2022). Drawing from talanoa with 30 Pasifika youth participants (16–24 years) and a series of group activities and writing circles led by the authors, we examine the layered and complex conceptualisations and usage of two common social labels, 'FOB' ('Fresh of the Boat') and 'plastic'. We argue that while these social labels predominantly reinforce derogatory stereotypes and racial discourses, some Pasifika peoples have been able to find empowerment through 'owning' or reclaiming these labels and by capitalising on their cultural differences. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether family poverty over the early childhood, adolescent, and adult periods of the life course independently predicts experiences of intimate partner violence (IPV) in adulthood. This was a birth cohort study in Brisbane, Australia, with pregnant women recruited at their first booking-in visit and their children, followed up to 30 and 40 years of age. Family income was obtained from the mother when the child was 6 months, 5 and 14 years of age. Offspring reported their own family income at 21, 30, and 40 years of age. The offspring completed the Composite Abuse Scale at 30 and 40 years. Adjusted logistic regression models are used to predict experiences of IPV at 30 (n = 2157) and 40 (n = 1438) years. The findings at 30 and 40 years of age are consistent. Only poverty experienced concurrently with the assessment of IPV is strongly associated. At the 40-year follow-up, family poverty predicts higher ratios of all four forms of IPV; severe combined abuse (odds ratio [OR] = 2.24, 95% confidence interval [CI] = 1.24, 4.05), physical abuse (OR = 3.37, 95% CI = 1.95, 5.82), emotional abuse (OR = 2.09, 95% CI = 2.58, 8.57) and harassment (OR = 4.70, 95% CI = 2.58, 8.57). Concurrent family poverty is strongly and consistently associated with patterns of IPV. These associations are for cross-sectionally collected data with the prospectively collected data not replicating these findings. Although it is not possible to identify a specific causal pathway, the findings suggest that the immediate consequences of poverty are strongly associated with IPV. Programmes that address poverty reduction provide the best prospect for reducing societal levels of IPV. [ABSTRACT FROM AUTHOR]

Individuals seeking alcohol and other drug (AOD) treatment consistently experience higher rates of suicidal behaviours and death by suicide when compared to the general population. By linking residential AOD treatment data to administrative healthcare and death datasets, we aimed to examine suicide-related behaviours and identify risk and protective factors for these events following discharge from residential treatment. Participants included 1056 individuals aged 18–69 (M = 32.06, SD = 9.55, male = 696,65.9 %) admitted to three residential treatment facilities in Queensland, Australia from January 1, 2014 to December 31, 2016. Treatment data was linked to administrative hospital, emergency department (ED), mental health service, and Registry of Deaths data 2-years post-discharge. ICD-10 codes were used to identify and analyse suicide-related events. Within 2-years post-discharge, 175 (16.6 %) individuals had a suicide-related event (n = 298 episodes). The highest proportion of episodes (11.1 %) occurred within 1-month of discharge. Higher risk of a recurrent suicide-related event was associated with receiving a Disability Support Pension (aHR = 1.69 (95%CI:1.10,2.59), two or more previous episodes of residential AOD treatment (aHR = 1.49 (95%CI:1.30,2.15). Completing residential treatment was associated with a lower risk of suicide-related events (aHR = 0.54 (95%CI:0.35,0.83). The amalgamation of suicidal ideation, attempts, and death into a single outcome oversimplifies their complex nature and interplay. The exclusive focus on one service provider limits generalisability, and data constraints and missingness preclude many analyses. Understanding suicidal behaviours and critical risk periods following discharge from residential treatment is crucial for improving continuing care, developing effective suicide prevention, and implementing targeted interventions among this high-risk population. • Suicide-related events were common among individuals seeking substance use treatment. • Suicide-related events were not isolated and often indicated further suicide-related events. • Factors indicating disadvantage were associated with a greater likelihood of suicidal behaviour. • Health service presentations currently represent missed opportunities for suicide prevention. • Continuing care and targeted suicide interventions are needed following substance use treatment. [ABSTRACT FROM AUTHOR]