Search

Background: The cloud-penetrating and fog-penetrating capability of Synthetic Aperture Radar (SAR) give it the potential for application in forest fire progress monitoring; however, the low extraction accuracy and significant salt-and-pepper noise in SAR remote sensing mapping of the burned area are problems. Aims: This paper provides a method for accurately extracting the burned area based on fully exploiting the changes in multiple different dimensional feature parameters of dual-polarised SAR images before and after a fire. Methods: This paper describes forest fire progress monitoring using dual-polarisation SAR images combined with multi-scale segmentation and unsupervised classification. We first constructed polarisation feature and texture feature datasets using multi-scene Sentinel-1 images. A multi-scale segmentation algorithm was then used to generate objects to suppress the salt-and-pepper noise, followed by an unsupervised classification method to extract the burned area. Key results: The accuracy of burned area extraction in this paper is 91.67%, an improvement of 33.70% compared to the pixel-based classification results. Conclusions: Compared with the pixel-based method, our method effectively suppresses the salt-and-pepper noise and improves the SAR burned area extraction accuracy. Implications: The fire monitoring method using SAR images provides a reference for extracting the burned area under continuous cloud or smoke cover. This paper describes a method to monitor forest fire progress using dual-polarisation Synthetic Aperture Radar (SAR) images combined with multi-scale segmentation and unsupervised classification. We aimed to take full advantage of the many different dimensions of feature parameter changes caused by forest fires, relying on time-series dual-polarised SAR imagery to achieve burned area extraction and forest fire progress monitoring. [ABSTRACT FROM AUTHOR]

Background: Asynchronous observations refer to observations that are obtained at multiple moments. The observation moments of fire fronts may differ throughout an entire wildfire area. Asynchronous observations include historical data, which hinders the effectiveness of data assimilation due to the lack of timely updates on changing fire fronts. Aims: This paper proposed a distributed strategy combined with the Ensemble Transform Kalman filter (ETKF-distributed) for asynchronous observations. It can assimilate fire fronts immediately at any location by using new matching schemes between prediction and observation. Methods: The ETKF-distributed undergoes testing using a wildland fire generated based on real terrain, vegetation, and historical weather data from the local area. In addition, the ETKF and ETKF-centralised proposed in our previous work were employed as comparisons. Observing System Simulation Experiments were conducted to generate asynchronous observation fire fronts. Key results: The benefit of immediate assimilation enables the new method to maintain high accuracy predictions. Conclusions: The allocation of observation resources can be focused in regions with high rates of speed when employing ETKF-distributed. Implications: The ETKF-distributed has high efficiency and adaptability, making it highly promising for implementation in wildfire prediction. Observation composed of data from multiple moments is asynchronous observation, which will bring errors when performing data assimilation. This paper proposes a distributed strategy combined with the Ensemble Transform Kalman filter for asynchronous observation. It could conduct the analysis step immediately by a new matching scheme between prediction and observation. [ABSTRACT FROM AUTHOR]

Background: Every year, people in Canada are evacuated due to wildland fires to avoid death, injury, and illness from fire and smoke events. Aims: In this paper, we provide an overview of evacuations recorded in the Canadian Wildland Fire Evacuation Database between 1980 and 2021. Methods: Our analysis covers evacuations in Canada from 1980 to 2021. We provide summary statistics including number of evacuations and evacuees, evacuation duration, seasonality, evacuation causes, community types, structure losses, and fatalities. We also investigate temporal and spatial patterns. Key results: Between 1980 and 2021, there were 1393 wildland fire evacuation events with 576,747 people evacuated. During this period, there was an overall increase in frequency of evacuations, number of evacuees, and duration of events. Structure loss occurred during 194 evacuation events, with 4105 homes burned. We estimate wildland fire evacuations cost at least CAD3.7 billion (excluding structural losses), jumping to CAD4.6 billion if we include productivity losses. Indigenous peoples are disproportionately impacted in wildfire evacuations compared to the general Canadian population. Conclusions: Wildland fire evacuations continue to occur across Canada and are increasing. Implications: The findings from this study give us a better understanding of the characteristics of wildland fire evacuations, which can help guide emergency management. This paper summarises data on wildland fire evacuations in Canada between 1980 and 2021. There were 1393 wildland fire evacuation events with 576,747 people evacuated, costing approximately CAD4.6 billion CDN including productivity losses. [ABSTRACT FROM AUTHOR]

INTRODUCTION: There are important changes in the health care needs of women presenting to general practice in New Zealand, which prompted an evaluation of postgraduate training needs of general practitioners (GPs) who care for women in the community. AIM: To evaluate the perceived relevance of the curriculum of Otago University postgraduate programmes in women's health to GPs' work profile to identify any need for curricular change. This study was also performed to investigate the need for refresher courses or a Master's degree in obstetrics, gynaecology and women's health. METHODS: In total, 426 GPs and GP trainees who had completed the postgraduate Certificate and Diploma programmes in women's health were invited to complete an online survey. The survey consisted of multiple-choice questions with five-point Likert scale ratings to rate the relevance of papers to general practice, and options for free-text comments. RESULTS: There were 86 responses (20.2% response rate) and we analysed 73 (17.1%). Curriculum modules related to gynaecological care were rated as more relevant than obstetric and newborn care. GPs suggested more training in contraception and management of infertility, abnormal uterine bleeding and pelvic pain including procedural skills such as insertion of long-acting reversible contraceptives, implants and intrauterine devices. An interest in a refresher course was indicated by 76.6% of GPs. DISCUSSION: GPs recognised the need for enhanced training in women's gynaecological care. Revision of the postgraduate women's health curriculum and development of new refresher courses will enable GPs, trainees and prospective GPs to improve their care for women in the community. [ABSTRACT FROM AUTHOR]

Background: Fire danger rating systems are used daily across Australia to support fire management operations and communications to the general public regarding potential fire danger. Aims: In this paper, we introduce the Australian Fire Danger Rating System (AFDRS), providing a short historical account of fire danger rating in Australia as well as the requirements for an improved forecast system. Methods: The AFDRS combines nationally consistent, spatially explicit fuel information with forecast weather and advanced fire behaviour models and knowledge to produce locally relevant ratings of fire behaviour potential. Key results: A well-defined framework is essential for categorising and defining fire danger based on operational response, the potential for impact and observable characteristics of fire incidents. The AFDRS is modular, supporting continuous and incremental improvements and allowing upgrades to components in response to new science. Conclusions: The AFDRS provides a new method to estimate fire danger based on the best available fire behaviour models, leading to potentially significant improvements in the way fire danger is calculated, forecast and interpreted. Implications: The Australian Fire Danger Rating System was implemented in 2022, the most significant change to fire danger forecasting in Australia in more than 50 years. We introduce the Australian Fire Danger Rating System (AFDRS), providing a history of fire danger rating in Australia and requirement for advancements. We describe development, design principles and the supporting framework of the AFDRS as an introduction to subsequent papers in this series. This article belongs to the Collection Australian Fire Danger Rating System. [ABSTRACT FROM AUTHOR]

Introduction. Key New Zealand ethical documents that describe appropriate ethical behaviour for doctors do not consider rurality and how this might impact on the practice of medicine. Aim. The aim of this study was to understand the literature on key ethical issues experienced by general practitioners in a rural context that might inform the development of a New Zealand agenda of rural medical ethics Methods. A rapid review was undertaken of three databases using a variety of key words relating to rurality, ethics, professionalism and medicine. Inclusion criteria were research articles focussing on the experience of doctors working in a rural healthcare setting, commentaries and narratives. The findings from the paper were synthesised and broad ethical categories created. Results. Twelve studies were identified that met the inclusion and exclusion criteria. Synthesis of the data revealed five ethical issues that predominately arose from living and working within communities. These ethical issues related to juggling personal and professional lives, managing friendships with patients, managing loss of privacy and anonymity, assuring confidentiality and practicing outside of comfort zones. Discussion. The majority of ethical issues arose from managing overlapping relationships. However, these overlapping relationships and roles are considered normal in rural settings. A tension is created between adhering to urban normative ethical guidelines and the reality of living in a rural environment. Professional ethical guidelines, such as those developed by the New Zealand Medical Council, do not account for this rural lived reality. Rural practitioners in New Zealand should be engaged with to progress a specific rural ethics agenda. [ABSTRACT FROM AUTHOR]

This document is a corrigendum to an article published in the International Journal of Wildland Fire. The correction addresses an error in the citation of a publication related to the grass model used in the Australian Fire Danger Rating System. The incorrect citation is McArthur (1973), and the correct citation should be Cheney et al. (1998). The correction also mentions that the incorrect reference is now redundant as it is not cited anywhere else in the paper. [Extracted from the article]

Background: The extent of past Indigenous cultural burning in the eastern US remains contested. Historical documents (e.g. early histories, journals, and reports) contain descriptions of burning. Scholars have summarised descriptions, but few have compiled them into databases. Aims: This paper presents efforts to compile descriptions of past Indigenous burning in the eastern US and early results from mapped descriptions. Methods: Utilising previously cited descriptions and those discovered from digitised historical texts, the current dataset mapped >250 descriptions of burning in the northeastern US. Most were historical summaries from 19th century authors, and fewer were firsthand observations. Descriptions are currently shared as a GIS data layer, a tabular file, and an interactive web map. Key results: Descriptions correspond with fire-adapted vegetation, and clusters of descriptions suggest burning over large extents (e.g. southern New England, western New York). Estimated dates of burning or initial Euro-American settlement show an east–west succession in Indigenous fire exclusion and replacement with early Euro-American burning. Conclusions: Historical descriptions suggest regional-extent influence of Indigenous burning upon past forested ecosystems, but the veracity of descriptions should be carefully evaluated. Implications: This study provides a dataset for further examination of Indigenous burning and comparison with other methodologies for historical cultural fire reconstruction. This study creates a dataset of historical descriptions of Indigenous wildland burning from digitised historical texts in the eastern US. The current version of the dataset contains >250 descriptions in the northeastern US, mainly from 19th century historians. Descriptions correspond with geographic patterns in past fire-adapted vegetation. [ABSTRACT FROM AUTHOR]

Introduction. Through a unique, inter-sectoral and interprofessional initiative, practitioners from education, health and social service sectors were invited to participate in communities of practice, facilitated online. The focus was on building workforce capacity to address the mental health needs of children and youth. Aim. This paper explores interprofessional workforce development by translating knowledge from a mental health promotion initiative developed overseas into the Aotearoa New Zealand context. Methods. Over a 6-month period, practitioners engaged in an iterative, capacity-building process, where they had access to the initiative materials and resources, shared practice stories, networked, and discussed barriers and facilitators for implementation. Qualitative thematic analysis was used to interpret data. Results. Members of the communities of practice engaged in storytelling and made sense of the initiative in relation to their previous knowledge and experiences: practice and thinking were validated. Mental health promotion was positioned as the responsibility of all sectors and the need for effective interprofessional collaboration was deemed essential. Furthermore, translation of the initiative into the bicultural context of Aotearoa New Zealand demanded and deserved sustained attention. Discussion. This study contributes interprofessional and inter-sectoral evidence for building workforce capacity to address the mental health needs of children and youth. Further research is warranted to investigate the outcomes for the children and youth served. Interprofessional communities of practice were shown to provide a sustainable mechanism by which knowledge can be received, transformed and translated into practice. [ABSTRACT FROM AUTHOR]

Introduction. Within primary health care policy, there is an increasing focus on enhancing involvement with secondary health care, social care services and communities. Yet, translating these expectations into tangible changes frequently encounters significant obstacles. As part of an investigation into the progress made in achieving primary health care reform in Aotearoa New Zealand, realist research was undertaken with those charged with responsibility for national and local policies. The specific analysis in this paper probes primary health care leaders' assessments of progress towards more collaboration with other health and non-health agencies, and communities. Aim. This study aimed to investigate how ideas for more integration and joinedup care have found their way into the practice of primary health care in Aotearoa New Zealand. Methods. Applying a realist logic of inquiry, data from semi-structured interviews with primary health care leaders were analysed to identify key contextual characteristics and mechanisms. Explanations were developed of what influenced leaders to invest energy in joined-up and integrated care activities. Results. Our findings highlight three explanatory mechanisms and their associated contexts: a willingness to share power, build trusting relationships and manage task complexity. These underpin leaders' accounts of the success (or otherwise) of collaborative arrangements. Discussion. Such insights have import in the context of the current health reforms for stakeholders charged with developing local approaches to the planning and delivery of health services. [ABSTRACT FROM AUTHOR]

Introduction. New Zealand health training institutions have an important role in supporting health workforce training programmes in the Pacific Region. Aim. To explore the experience of Pacific Island country-based doctors from the Cook Islands, Niue, and Samoa, studying in New Zealand’s University of Otago distance-taught Rural Postgraduate programme. Methods. Document analysis (16 documents) was undertaken. Eight semi-structured interviews were conducted with Pacific Island country-based students. Thematic analysis of the interviews was undertaken using the framework method. The two data sources were analysed separately, followed by a process to converge and corroborate findings. Results. For Pacific Island countries with no previous option for formal general practice training, access to a recognised academic programme represented a milestone. Immediate clinical relevance and applicability of a generalist medical curriculum with rural remote emphasis, delivered mainly at a distance, was identified as a major strength. Although technologies posed some issues, these were generally easily solved. The main challenges identified related to the provision of academic and other support. Traditional university support services and resources were campus focused and not always easily accessed by this group of students who cross educational pedagogies, health systems and national borders to study in a New Zealand programme. Study for individuals worked best when it was part of a recognised and supported Pacific in-country training pathway. Discussion. The University of Otago’s Rural Postgraduate programme is accessible, relevant and achievable for Pacific Island country-based doctors. The programme offers a partial solution for training in general practice for the Pacific region. Student experience could be improved by tailoring and strengthening support services and ensuring their effective delivery. [ABSTRACT FROM AUTHOR]

Background: In 1986, CSIRO conducted a large program of experimental fires in grassland at Annaburroo Station, Northern Territory, Australia, with the objective of quantifying the effect of fuel condition (load and height) on fire behaviour. Aims: This paper provides the data collected during this program, representing a unique set of observations and measurements of large, free-burning experimental fires conducted in a multi-factor experimental design. Methods: Data are collated by experimental burn plot, providing detailed measurements of weather (wind speed, air temperature, relative humidity), fuel state (load, height, moisture content, curing) and fire behaviour (rate of spread, flame depth, flame height, head fire width), as well as processed information (e.g. steady-state rate of spread). Data availability: The data are made available for free download on the CSIRO Data Access Portal () and include detailed metadata descriptions of the data and their structure, also provided in this article. Conclusions: We have made the data available for fire behaviour researchers around the world to use in their research under the Creative Commons Attributions licence. It is hoped they will analyse these data and extract new and innovative insights to help improve our understanding of wildland fires burning in grass fuels. The 1986 Annaburroo grassland fire experiments conducted in the Northern Territory, Australia, created a unique dataset of fire behaviour across a range of fuel and burning conditions. This dataset, comprising detailed observations of fuels, weather and fire behaviour in 121 plots, is now publicly available via the CSIRO Data Access Portal. [ABSTRACT FROM AUTHOR]

Background: Spot fires play a significant role in the rapid spread of wildland and wildland–urban interface fires. Aims: This paper presents an experimental and modelling study on the flaming and smouldering burning of wood firebrands under forced convection. Methods: The firebrand burning experiments were conducted with different wind speeds and firebrand sizes. Key results: The burning rate of firebrands under forced convection is quantified by wood pyrolysis rate, char oxidation rate and a convective term. The firebrand projected area is correlated with firebrand diameter, char density, wind speed, and flaming or smouldering burning. A surface temperature model is derived in terms of condensed-phase energy conservation. We finally establish a simplified firebrand transport model based on the burning rate, projected area and surface temperature of firebrands. Conclusion: The mass loss due to wood pyrolysis is much greater than that due to char oxidation in self-sustaining burning. The burning rate is proportional to U 1/2, where U is wind speed. The projected area for flaming firebrands decreases more rapidly than that for smouldering ones. The firebrand surface temperature is mainly determined by radiation. Implications: Knowledge about firebrand burning characteristics is essential for predicting the flight distance and trajectory in firebrand transport. Knowledge about firebrand burning characteristics is essential for predicting the flight distance and trajectory for transport. This work studies the flaming and smouldering burning of firebrands under forced convection. Models are established for burning rate, projected area and surface temperature of firebrands, and applied to predict firebrand transport. [ABSTRACT FROM AUTHOR]

Background: The Australian Fire Danger Rating System program (AFDRS) has built a new fire danger rating system for Australia. A live trial of the system's Research Prototype (AFDRSRP), based on fire behaviour thresholds, was run and evaluated between October 2017 and March 2018. Aims: Live trial results are critically analysed, and knowledge gaps and recommendations for future work discussed. Methods: Australian bushfire experts assessed wildfires and prescribed burns across a range of vegetation types and weather conditions. Forecast fire danger ratings calculated using: (1) AFDRSRP; and (2) Forest Fire Danger Index (FFDI) and Grassland Fire Danger Index (GFDI) were compared against ratings derived by expert opinion for each evaluation fire (n = 336). Key results: Overall performance of AFDRSRP was superior to the FFDI/GFDI system (56 vs 43% correct), with a tendency to over-predict rather than under-predict fire potential. AFDRSRP also demonstrated its value to assess fire danger in fuel types not conforming to current grassland or forest models; e.g. for fuels that were grouped to use mallee-heath, spinifex and shrubland fire spread models. Conclusions: The AFDRSRP live trial was successful, outperforming the existing operational fire danger system. Implications: Identified improvements would further enhance AFDRSRP performance, ensuring readiness for operational implementation. A Research Prototype of the Australian Fire Danger Rating System (AFDRSRP) was designed and tested in a live trial. Fire danger ratings derived from the AFDRSRP and FFDI/GFDI systems were compared to expert-derived ratings for 336 fires. In this paper the results of the live trial are presented and discussed. This article belongs to the Collection Australian Fire Danger Rating System. [ABSTRACT FROM AUTHOR]

Background: Wildfires are thought to become more prevalent during periods of extended dry weather. This issue is examined using two dryness metrics commonly applied in Australian fire management agencies. Aims: This paper investigated links between wildfire incidence and the Keetch–Byram Drought Index (KBDI) and McArthur's Drought Factor (DF) across the state of Victoria, Australia. Methods: Weather records and data from 41 418 wildfires that occurred across the State over a 17-year period were compiled to examine the distributions of KBDI and DF on days with fires smaller and larger than 5 ha in area and all days, using kernel density plots. Key results: Days with fires, particularly days with fires that escaped initial attack, have higher DFs and KBDIs compared with all days. These differences vary between regions and are greatest in areas with moist climates. Conclusions and implications: An appreciation of dryness conditions using tools such as KBDI and DF is useful for understanding fire potential, particularly in areas that experience higher and more regular rainfall. McArthur's Drought Factor and the Keetch–Byram Drought Index are higher than normal on days with fires in Victoria, Australia. These metrics provide a more reliable indication of fire potential in high-rainfall areas than in lower-rainfall areas. This article belongs to the Collection Fire and Climate. [ABSTRACT FROM AUTHOR]

Aims: We investigate the associations between major Australian climate drivers and extreme weekly fire danger throughout the year. Methods: We use a composite-based approach, relating the probability of top-decile observed potential fire intensity to the positive and negative modes of the El Niño Southern Oscillation, Indian Ocean Dipole, Madden–Julian Oscillation, Southern Annular Mode, split-flow blocking and Subtropical Ridge Tasman Highs, both concurrently and at a variety of lag times. Key results: The chance of extreme fire danger increases over broad regions of the continent in response to El Niño and positive Indian Ocean Dipole events, the negative mode of the Southern Annular Mode, split-flow Blocking Index and Subtropical Ridge Tasman High, and Madden–Julian Oscillation phases 5, 6, 2 and 8 in Austral summer, autumn, winter and spring respectively. These relationships exist not only concurrently, but also when a climate event occurs up to 6 months ahead of the season of interest. Conclusions: These findings highlight the importance of considering the influence of diverse climate drivers, at a range of temporal lag periods, in understanding and predicting extreme fire danger. Implications: The results of this study may aid in the development of effective fire management strategies and decision-making processes to mitigate the impacts of fire events in Australia. This paper explores the relationships between the major forces influencing Australian weather and climate, and the chance of severe fire seasons. The findings could be valuable in decision making and preparation for upcoming fire seasons to avoid more seasons with devastating outcomes such as the 2019–2020 Black Summer. This article belongs to the Collection Fire and Climate. [ABSTRACT FROM AUTHOR]

Introduction. Body image dissatisfaction and its associated challenges have been related to poorer health outcomes among adolescents worldwide, including disordered eating behaviour, depression, and anxiety. However, current prevalence estimates of these issues in Aotearoa New Zealand or, relatedly, the estimates of positive attitudes and behaviours, such as intuitive eating and body appreciation are dated. Aim. The primary aim of this paper was to provide updated estimates for a variety of constructs related to eating behaviours and body image, sourced from a diverse range of early adolescent participants. Methods. For this report, a brief online survey was advertised to adolescents throughout Aotearoa New Zealand (n = 893) via school and community noticeboards. Results. Approximately one-in-three male participants and one-intwo female participants reported body image dissatisfaction. One in four participants reported clinically significant symptoms of depression and anxiety. Discussion. Given such issues, there is clearly still much progress to be made in advancing positive health among early adolescents. Identifying potentially protective constructs such as intuitive eating and body appreciation may offer guidance into the best targets for prevention and early intervention. [ABSTRACT FROM AUTHOR]

Background and context. The Canterbury health system adopted a whole-system approach towards integrated patient care. There was a need to optimise the use of allied health resources, across private and public settings. Assessment of the problem. There was no common means for consensus and communication among allied health professions about consistent patient care, and barriers such as a lack of trust existed. This paper describes the implementation and monitoring of Allied Healthways, a website for allied health professionals, set up in 2017 using the HealthPathways approach. Results. Over 100 pathways have been published on Allied Healthways, with >13 000 clinicians using the site in Canterbury. Targeted education sessions for allied health professionals, combined with newsletters, raised awareness of new pathways or changes in the system. A survey highlighted the usefulness of Allied Healthways, and the majority of respondents agreed that the site should be available nationwide. Strategies for improvement. Development of pathways was found to be a useful mechanism for improving integration in the system. The workgroups and direct meetings engaged allied health professionals and helped achieve local consensus on pathways. They also enabled improvements to be designed and then communicated as a pathway. Lessons learnt. Although the patient journey should be consistent, irrespective of their point of contact with the health system, guidance and processes need to be relevant to their target audience. It was essential to write pathways specifically for allied health professionals. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Evidence for the effectiveness of drug treatment for depression in primary care settings remains limited, with little information on newer antidepressant classes. AIM: To update an earlier Cochrane review on the effectiveness of antidepressants in primary care to include newer antidepressant classes, and to examine the efficacy of individual agents. METHODS: Selection criteria included antidepressant studies with a randomly assigned placebo group where half or more subjects were recruited from primary care. The Cochrane Collaboration Depression, Anxiety and Neurosis (CCDAN) group searched multiple databases to identify eligible studies. Data extraction was performed independently by two reviewers. Data were analysed using Revman version 5.3.5. RESULTS: In total, 17 papers and 22 comparisons were included for analysis. Significant benefits in terms of response were found for tricyclic antidepressants (TCA) with a relative risk (RR) = 1.23 (95% CI, 1.01-1.48), and serotonin selective reuptake inhibitors (SSRI) with a RR = 1.33 (95% CI, 1.20-1.48). Mianserin was effective for continuous outcomes. Numbers needed to treat (NNT) for TCA = 8.5; SSRI = 6.5; and venlafaxine = 6. Most studies were industry-funded and of a brief duration (≤ 8 weeks). There was evidence of publication bias. There were no studies comparing newer antidepressants against placebo. CONCLUSION: Antidepressants such as TCA, SSRI, SNRI (serotonin-norepinephrine reuptake inhibitor) and NaSSA (noradrenergic and specific serotonergic antidepressant) classes appear to be effective in primary care when compared with placebo. However, in view of the potential for publication bias and that only four studies were not funded by industry, caution is needed when considering their use in primary care. [ABSTRACT FROM AUTHOR]

Introduction. Education on health care for patients with diverse sexual orientation, sex characteristics and gender identities is lacking in Aotearoa's medical schools. Aim. This study surveyed fifth-year medical students at the University of Otago Wellington (UOW) about confidence in providing health care to lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) patients to identify learning needs. Methods. This anonymous crosssectional survey was designed with input from an advisory group (community members, education, research and subject matter experts). It was administered on paper during class, using Likert scales (level of agreement) and open-ended questions. All fifth-year medical students at the UOW campus were invited to participate in May 2021. Data were analysed in Microsoft Excel (Microsoft Corporation) and free-text comments were analysed using template analysis. Results. In total, 74.7% (71/95) of students completed a survey. Participants lacked knowledge and confidence in their consultation skills with LGBTQIA+ patients and did not feel they had enough teaching in this area. Most (=78.8%) were comfortable with common terms, but half or fewer could explain intersex, gender affirmation and Takatāpui. Free-text comments revealed learning needs relating to consultation skills, ways to approach this topic with sensitivity, and a desire to learn more about the cultural context. Discussion. Medical students view LGBTQIA+ health care as an important topic and want opportunities to improve knowledge and confidence in this area. Students lack confidence in consulting with LGBTQIA+ patients, suggesting that more education focused on practical experience and interactions with real patients would be of benefit. [ABSTRACT FROM AUTHOR]

Introduction: Since 1991 the University of Otago, Dunedin, New Zealand has offered postgraduate qualifications specifically designed to educate general practitioners (GPs) about their unique work environment. Aim: To determine motivations and impacts of postgraduate education for practising GPs. Methods: Survey of the 100 graduates of the University of Otago, Dunedin postgraduate general practice programme. Ninety five living graduates were approached and 70 (73.7%) responded. Quantitative data about disposition of respondents before enrolling and after completion of the programme were analysed using chi-square and paired t-tests. Free text responses about motivations, impacts and outcomes of the program were thematically analysed. Results: 64 GPs graduated with a postgraduate diploma and 36 with a masters degree in general practice. Although the mean number of graduates was 3.5 and 2.0 (respectively), annual enrolments averaged 25.1. Most graduates (60.9%) were aged in their 40s when they started studying and most (94.3%) had a spouse and/or children at home. Intellectual stimulation and challenge motivated study. Outcomes included perceived improvement of medical care delivery; development of critical thinking about medical epistemology, education, and research; and personal growth. Graduates increased engagement in academic and advisory roles, published papers, and some completed doctoral studies. Respondents valued scholarship and enjoyed the learning environment, but felt their qualification had low perceived value within the profession. Cost and a perception of time commitment were important barriers to study. Di scussion: This voluntary postgraduate medical education complements traditional medical training but has low external value despite personal, practising and professional benefits. Graduates valued engagement above completion of a qualification. [ABSTRACT FROM AUTHOR]

Introduction: This paper argues that particular experiences in the workplace are more important than others and can lead to transformational learning. This may enable practitioners to cross 'vocational thresholds' to new ways of being. Aim: A notion of 'vocational thresholds' is developed, aiming to help build an understanding of the most powerful learning experiences of general practitioners (GPs). Vocational thresholds takes its cue from the idea of 'threshold concepts' - concepts that transform perspectives and integrate previously disconnected or hidden knowledge, sometimes in ways that are 'troublesome' to previously held beliefs. Methods: The paper is based on a thematic analysis of 57 GPs' brief written accounts of a particularly powerful learning experience during their development. Accounts were provided in a conference session about an ongoing study of workplace-based structured learning arrangements in the fields of general practice medicine, engineering, and building. Findings: Most GPs' accounts focused on development of dispositional attributes that moved them to a new understanding of themselves in relation to their work and patients. Just under two-thirds picked out informal and formal collegial relationships within purposeful learning arrangements as pivotal. A third picked out direct experiences with patients as shifting their perspective. Conclusion: The emergent idea of vocational thresholds is offered as a way to frame the most important learning experiences identified by GPs. It supports a focus in early and ongoing development beyond accumulating clinical expertise and skills (knowing and doing), to dispositional capability (being) - vital for practitioners negotiating inherent and daily uncertainty. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The delivery of health care by primary care general practices rapidly changed in response to the coronavirus disease 2019 (COVID-19) pandemic in early 2020. AIM: This study explores the experience of a large group of New Zealand general practice health-care professionals with changes to prescribing medication during the COVID-19 pandemic. METHODS: We qualitatively analysed a subtheme on prescribing medication from the General Practice Pandemic Experience New Zealand (GPPENZ) study, where general practice team members nationwide were invited to participate in five surveys over 16 weeks from 8 May 2020. RESULTS: Overall, 78 (48%) of 164 participants enrolled in the study completed all surveys. Five themes were identified: changes to prescribing medicines; benefits of electronic prescription; technical challenges; clinical and medication supply challenges; and opportunities for the future. There was a rapid adoption of electronic prescribing as an adjunct to use of telehealth, minimising in-person consultations and paper prescription handling. Many found electronic prescribing an efficient and streamlined processes, whereas others had technical barriers and transmission to pharmacies was unreliable with sometimes incompatible systems. There was initially increased demand for repeat medications, and at the same time, concern that vulnerable patients did not have usual access to medication. The benefits of innovation at a time of crisis were recognised and respondents were optimistic that e-prescribing technical challenges could be resolved. DISCUSSION: Improving e-prescribing technology between prescribers and dispensers, initiatives to maintain access to medication, particularly for vulnerable populations, and permanent regulatory changes will help patients continue to access their medications through future pandemic disruption. [ABSTRACT FROM AUTHOR]

The article presents the discussion on forcing change without preparedness and causing the discomfort of having in making the sorts of changes. Topics include promoting and maintaining the health of the individual people comprising the entire population; and publishing a paper about a project for establishing a community mental health service for youth with gender identity issues.

Background and context. This paper outlines the process of moving a continuing education programme for primary healthcare professionals from a fully in-person model to fully online so it could continue during coronavirus disease 2019 (COVID-19) lockdowns. The programme uses a peer-led Small Group model with the leader facilitating interactive discussion based on background content researched by a team from Pegasus Health. Assessment of problem. When the COVID-19 restrictions were implemented in March 2020, the usual in-person Small Group meetings could not continue. Rather than allowing the programme to lapse, a new format was needed. Strategies for improvement. In response, the Pegasus Health team transitioned the programme to an eSmall Group model using Zoom. Training packages were developed and disseminated online and the interactive, real-time nature of the programme retained. eSmall Groups began in May and were evaluated late in 2020. Results. The online format was strongly supported, though some attendees missed the collegiality of meeting in-person. From 2021, attendees could opt for either online, in-person, or a summer/winter split between in-person and online. The ability to return to fully online was retained, allowing a seamless transition during the periods of further restrictions that followed in 2021-22. Lessons learnt. The Small Group model has evolved to a multi-format programme that suits individual preferences, but can respond to pandemic or emergency situations if needed. It continues to have a high level of engagement among primary healthcare professionals. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including uncertainties in New Zealand's health system, challenges in primary care training, and barriers to diabetes management and skin condition treatment.

INTRODUCTION: Dietetic service delivery in primary health care is an emerging area of dietetic practice in New Zealand. AIM: This paper aims to describe the dietetic services being delivered in this setting and dietitians' perceptions of the factors that have an effect on their ability to deliver an optimal service. METHODS: Individual, qualitative, semi-structured, face-to-face interviews were conducted with 12 primary healthcare dietitians from a range of age, ethnicity and professional backgrounds. Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis. RESULTS: Participants were delivering a range of services including: providing nutrition care directly to patients, helping to upskill other primary health care professionals in nutrition, and delivering health promotion initiatives to their local community. Three key factors were identified that participants perceived as having an effect on their ability to deliver effective dietetic services in primary health care: being part of a multidisciplinary general practice team, having flexible service delivery contracts appropriate for the setting and that supported integration, and having an adequate level of dietetic experience. DISCUSSION: Dietitians working in primary health care recognise the importance of being well integrated into a multidisciplinary general practice team. This enables them to deliver more collaborative and coordinated nutrition care alongside their colleagues, to benefit patient care. Establishing flexible dietetic service delivery contracts, which support integration and take into account funding and workforce capacity requirements, may help ensure that the unique skill set of a dietitian is utilised to best effect. [ABSTRACT FROM AUTHOR]

The article introduces various topics covered in the issue including difficulty in maintaining balanced diet by patients, ethnic differences in the use of different contraceptives, and the importance of social networks by testing the knowledge in general practice about patients' social networks.

INTRODUCTION: The HealthPathways programme is an online health information system used mainly in primary health care to promote a consistent and integrated approach to patient care. AIM: The aim of this study is to perform a scoping review of the methodologies used in published impact and outcomes evaluations of HealthPathways programmes. METHODS: The review included qualitative, quantitative or mixed-methods evaluations of the impact or outcome of HealthPathways. MEDLINE, Embase, CINAHL and Web of Science databases were searched. Seven programme aims were identified in the impact and outcome evaluation: (1) increased awareness and use of HealthPathways; (2) general practitioners are supported to adopt best practice, patient-centred care; (3) increased appropriate use of resources and services; (4) improved quality of referrals; (5) enhanced consistent care and management of health conditions; (6) improved patient journeys through the local health system; and (7) reduction in health-care cost and increased value for money. RESULTS: Twenty-one studies were included in the final review; 15 were research papers and six were reports. 'Increased awareness and use of HealthPathways' was the most frequent programme aim evaluated (n = 12). Quantitative and qualitative research methodologies, as well as prospective and retrospective data collections, have been adopted to evaluate the impact and outcome of HealthPathways. DISCUSSION: Assessing the impacts and outcomes of HealthPathways may be challenging due to limitations in primary data and the interconnectedness of change across the measured aims. Each aim may therefore require specific methodologies sensitive enough to capture the impact that HealthPathways are making over time. [ABSTRACT FROM AUTHOR]

Introduction. Clear terminology is critical to allow accurate communication between practitioners, policy makers and the public. Aim. We investigated how the term 'green prescription' has been used in the peer-reviewed literature. Methods. We conducted a scoping review of the peer-reviewed literature that used the term 'green prescription(s)' and determined how this term was used. We then investigated how the term has been used over time, in different geographic locations and in different academic disciplines. Results. We included 268 articles that used the term 'green prescription(s)'. We found that the phrase 'green prescription(s)' has been used since 1997 to mean a written prescription for a lifestyle change, most commonly physical activity, provided by a health practitioner. However, more recently (since 2014) the term has also been used to mean exposure to nature. Despite the emergence of this new meaning, 'green prescription' remains, in the health and medical science literature across all continents, most commonly used to describe a prescription for physical activity. Conclusion. The use of the term 'green prescriptions' is inconsistent and has led to misuse of the research evidence regarding written prescriptions for exercise/diet being used to justify nature exposure to improve human health. We recommend that the term 'green prescriptions' continues to be used only as per its original definition, to refer to written prescriptions for physical activity and/or diet. For prescriptions to spend time in nature, we suggest use of the more appropriate term 'nature prescriptions'. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including medical education, chronic obstructive pulmonary disease, and Paget-Schroetter syndrome, or effort thrombosis.

BACKGROUND AND CONTEXT: Rural health services without an onsite laboratory lack timely access to haematology results. Set in New Zealand's far north, this paper provides a rural nursing perspective on how a health service remote from a laboratory introduced a haematology analyser suitable for point-of-care use and established the associated quality assurance programme. ASSESSMENT OF PROBLEM: Five broad areas were identified that could impact on successful implementation of the haematology analyser: quality control, staff training, physical resources, costs, and human resource requirements. RESULTS: Quality control testing, staff training and operating the haematology analyser was more time intensive than anticipated. Finding adequate physical space for placement and operation of the analyser was challenging and costs per patient tests were higher than predicted due to low volumes of testing. STRATEGIES FOR IMPROVEMENT: Through a collaborative team approach, a modified quality assurance programme was agreed on with the supplier and regional point-of-care testing co-ordinator, resulting in a reduced cost per test. The supplier provided dedicated hours of staff training. Allocated time was assigned to run point-of-care testing quality assurance. LESSONS: Having access to laboratory tests can reduce inequalities for rural patients, but natural enthusiasm to introduce new point-of-care technologies and devices needs to be tempered by a thorough consideration of the realities on the ground. Quality assurance programmes need to fit the locality while being overseen and supported by laboratory staff knowledgeable in point-of-care testing requirements. Associated costs need to be sustainable in both human and physical resources. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Pegasus Health Charitable Ltd, a Christchurch Primary Health Organisation, is contracted by the Canterbury District Health Board to provide continuing professional development for primary care practitioners in the region. Rurally located health practitioners have largely been unable to participate because of the travel time and distances involved. AIM: The initiative reported in this paper aimed to fill this gap by developing an accessible and high-quality multidisciplinary model of professional development for general practitioners, nurse practitioners, practice nurses and community pharmacists in rural areas of North Canterbury, New Zealand. METHODS: A survey was conducted to learn from the experiences of 14 health professionals in an existing multidisciplinary group, which had developed as a local initiative in one rural community. RESULTS: The survey had an 86% response rate. All respondents believed the multidisciplinary format worked well, had improved collaborative working and increased the consistency of patient care. Access to professional development had improved and the meetings provided a useful forum for the mostly part-time staff to interact as a group. The main caution noted was the potential to become inward looking without being exposed to fresh ideas from other practices. DISCUSSION: The multidisciplinary model was considered workable and valuable by the survey respondents. Based on our findings, the multidisciplinary model has been formalised by the Pegasus team responsible, and three new groups are now operating successfully in rural areas of North Canterbury. [ABSTRACT FROM AUTHOR]

Patient portals enable people to access their health information electronically, but concerns about confidentiality and privacy breaches, particularly for young people, may be impeding portal adoption in New Zealand. This paper considers the legal and ethical framework relating to health information privacy and informed consent in New Zealand, and proposes an approach to implementing patient portals for young people. Shared portal access (where both a young person and their parent or guardian have access to the young person's portal) may be appropriate for young children whose parents or guardians are responsible for their health care. However, as children mature and their capacity to make health care decisions increases, general practitioners will need to consider shifting to independent portal access by competent young people. The circumstances of each young person, including their best interests and rights, cultural needs and their views on information disclosure should be taken into account. [ABSTRACT FROM AUTHOR]

Introduction: In New Zealand, 41% of general practitioners (GPs) intend to retire by 2025. Increasing workforce shortages and other stressors are putting doctors at risk of burnout, which in turn can put patients at risk of harm. Offering a range of resources can signal an organisation's commitment to physician wellness while improving patient safety and organisational stability. Aim: To replace the current reactive approach to impaired doctors with a proactive system of monitoring performance with the goal of identifying problems early. METHODS: This paper reports on an initiative of Pegasus Health Charitable to provide pastoral care to GPs in Canterbury experiencing increased stress, burnout or problems leading to impaired performance. RESULTS: The pastoral care programme has been running successfully for 9 years and has helped 32 GPs. Because of the low numbers, the programme needs to be individualised and confidential. CONC LUSION : Recent developments have seen Pegasus Health adopt a systematic approach to monitoring and supporting health practitioners. This includes the monitoring of available data on GPs at risk. Data collection is being used to manage the "psychological health" of doctors, including complaints, prescribing, referral data and attendance at education sessions. [ABSTRACT FROM AUTHOR]

Globally, declining soil quality due to soil degradation is of great concern, and directly affects crop production, soil health and sustainability of natural resources. In conventional farming practices, the loss of fertile topsoil via runoff and erosion from arable land is a big concern. In addition, changes in land use and management practices result in loss of soil organic carbon (SOC) stock by -10-59%. The change from conventional till (CT) with residue burning/removal to no-till (NT) farming with residue retention/conservation agriculture (CA) practices have been recognised as important soil management practices for sustaining soil health and reversing land degradation. Worldwide, NT/CA practices are now being adopted on about 180 million ha (i.e. ~14% of arable land). CA practices promote soil health by increasing organic carbon, and soil aggregation, thus improving infiltration and minimising erosion losses. In addition, CA has the potential to increase SOC sequestration, reduce greenhouse gas (GHG) emissions and help to mitigate global climate change. Among sustainable food production systems, CA is often advocated with a view to increase food production while conserving natural resources and SOC. This special issue 'No-till farming: prospects, challenges--productivity, soil health, and ecosystem services' addresses and critically reviews these important issues and aims to foster awareness of NT farming. The collection of 15 papers lucidly covers various facets of NT farming. A summary and salient findings of these papers are provided in this Editorial. NT farming is a promising practice, which not only improves soil physical, chemical and biological health but also enhances carbon sequestration, crop productivity and mitigates GHG emissions through appropriate crop residue and nutrient management strategies. The adage says 'one size won't fit all' or 'a single recipe will not solve all problem/challenges', so we need to adopt site-specific NT systems for higher benefits and productivity and sustaining soil health. Keywords: carbon sequestration, climate smart agriculture, conservation agriculture, food security, greenhouse gases, GHG, no-till farming, simulation model, soil health, soil properties., In 2050 the world population is estimated to reach ~10 billion, an increase of 25% despite the Covid-19 mortalities, therefore, there is a continuous need for increasing food production. Soils [...]

An introduction is presented which discusses reports on selection of physicians for general practice vocational training, clinical decision making, and mental health.

Introduction. The 2001 Primary Health Care Strategy provided significant new government funding for primary care (general practice and related services) via capitation funding formulas. However, there remain important unanswered questions about how capitation funding formulas should be redesigned to ensure equitable and sustainable service provision to all population groups. Aim. To compare levels of chronic illness, utilisation, and unmet need in patients categorised as ‘high-need’ with those categorised as non-‘high-need’ using the definitions that are used in the current funding context, in order to inform primary care funding formula design. Methods. Respondents of the New Zealand Health Survey (2018–19) were categorised into ‘high-need’ and non-‘high-need’, as defined in current funding formulas. We analysed: (i) presence, and number, of chronic diseases; (ii) self-reported primary care utilisation (previous 12 months); and (iii) self-reported unmet need for primary care (previous 12 months). Analyses used integrated survey weights to account for survey design. Results. In total, 29% of respondents were ‘high-need’, of whom 50.2% reported one or more chronic conditions (vs 47.8% of non-‘highneed’ respondents). ‘High-need’ respondents were more likely than non-‘high-need’ respondents to: report three or more chronic conditions (14.4% vs 13.7%); visit a general practitioner more often (seven or more visits per year: 9.9% vs 6.6%); and report barriers to care. Discussion. There is an urgent need for further quantification of the funding requirements of general practices serving high proportions of ‘high-need’ patients in order to ensure their viability, sustainability and the provision of quality of care. [ABSTRACT FROM AUTHOR]

BACKGROUND AND CONTEXT: New Zealand is becoming more ethnically diverse, with more limited English proficiency (LEP) people. Consequently there are more primary care consultations where patients have insufficient English to communicate adequately. Because effective communication is essential for good care, interpreters are needed in such cases. ASSESSMENT OF PROBLEM: The literature on the use of interpreters in health care includes the benefits of using both trained interpreters (accuracy, confidentiality, ethical behaviour) and untrained interpreters (continuity, trust, patient resistance to interpreter). There is little research on the actual pattern of use of interpreters. RESULTS: Our research documented a low use of trained interpreters, despite knowledge of the risks of untrained interpreters and a significant use of untrained interpreters where clinicians felt that the communication was acceptable. A review of currently available guidelines and toolkits showed that most insist on always using a trained interpreter, without addressing the cost or availability. None were suitable for direct use in New Zealand general practice. STRATEGIES FOR IMPROVEMENT: We produced a toolkit consisting of flowcharts, scenarios and information boxes to guide New Zealand practices through the structure, processes and outcomes of their practice to improve communication with LEP patients. This paper describes this toolkit and the links to the evidence, and argues that every consultation with LEP patients requires clinical judgement as to the type of interpreting needed. LESSONS: Primary care practitioners need understanding about when trained interpreters are required. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Clinical reminders have been shown to help general practice achieve an increase in some preventive care items, especially if they identify a patient's eligibility for the target item, prompt clinicians at the right time, provide a fast link to management tools and facilitate clinical recording. WRPHO has introduced the Patient Dashboard clinical reminder and monitored its impact on health targets. AIM: This paper reports the impact of a computerised colour-coded clinical reminder on achieving agreed health targets in Whanganui regional practices. METHODS: Patient Dashboard was developed from previous versions in Auckland and Northland and provided to Whanganui regional practices with Primary Health Organisation (PHO) support. The Dashboard was linked with existing and new clinical management tools which automatically updated clinical records. Data from practices was pooled by Whanganui Regional Primary Health Organisation and target achievement rates reported over 15 months. RESULTS: Over the initial 15 months of Patient Dashboard use, recording of smoking status increased from 74% to 82% and of alcohol use from 15% to 47%. Screening for diabetes increased from 62% to 74%, cardiovascular risk assessment from 20% to 43%, cervical screening from 71% to 79%, and breast screening from 60% to 80%. DISCUSSION: Patient Dashboard was associated with increased performance indicators both for those targets which were part of a PHO programme and for targets without additional support. [ABSTRACT FROM AUTHOR]

This is a reflective piece from the author around death and dying. It shares her personal story from her own and close family perspectives. It then summaries these experiences into a few key themes and what she hopes are some lessons for doctors involved in the care of a dying person and their whānau. It has been adapted after being originally submitted as a reflective essay assignment for a University of Otago GENA725 Communication in Rural Hospital Medicine paper. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Very little is known how patients react to learning about their own doctors' illnesses. Doctors can be uncertain if and when such disclosures can be helpful, and in what way, to patients. This paper attempts to bridge this gap by providing an in-depth analysis of one group of patients' experiences with this type of disclosure. AIM: To understand from patients' perspectives, the effects on them of doctors disclosing their own illnesses, to provide guidance concerning the uses of this disclosure for general practitioners. METHODS: This qualitative study was an exploration of 13 patients' reactions to receiving such information, using semi-structured interviews and thematic analysis. RESULTS: The major themes were the emotional dimensions of illness and patienthood, the doctor–patient relationship and patients' concerns about disclosures. Disclosures can have profound effects on patients with both negative and positive consequences. CONCLUSION: We present suggestions about how to use such disclosures in primary care to minimise potential harms and emphasise potential benefits, based on these patients' perspectives and the current literature. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The effectiveness of cancer screening programmes is highly dependent on screening uptake. Many interventions have been tested to increase screening uptake. AIM: The goal of this study was to evaluate the effectiveness of cancer screening pamphlets as a standalone intervention. The outcome of interest was uptake of cancer screening tests. METHODS: A systematic review was performed on the effectiveness of pamphlets compared to usual care without pamphlets. We searched five databases for research papers in English from 2000 up to May 2019. Randomised controlled trials were included. This research group independently selected studies, extracted data, assessed risk of bias and then compared the information as a group. RESULTS: A total of nine trials involving 4912 participants met our inclusion criteria, of which five were about colorectal cancer screening, three were about prostate cancer screening and one was about lung cancer screening. Five of the nine trials showed that pamphlets alone increased uptake significantly, while the remaining four trials did not show significant effects. DISCUSSION: There is some evidence that pamphlets increase uptake for cancer screenings, especially for colorectal cancer. Due to the small number of studies in this area, generalisability could be limited. [ABSTRACT FROM AUTHOR]

BACKGROUND AND CONTEXT: In 2008, public specialist and general practice services in Canterbury were unable to manage demand for skin cancer treatment. Local clinicians decided the solution was to develop a see-and-treat skin excision clinic staffed by plastic surgeons and general practitioners (G Ps), and the introduction of subsidised excisions in general practice. This paper describes the collaboration between clinicians, managers and funders and the results and quality management measures of these initiatives. ASSESSMENT OF PROBLEM: There is an increasing incidence of skin cancer. GPs in Canterbury were unable to meet increasing demand for skin cancer treatment because some lacked confidence and competence in skin cancer management. There was no public funding for primary care management of skin cancer, driving patients to fully funded secondary care services. Secondary care services were at capacity, with no coordinated programme across primary and secondary care. RESULTS: The programme has resulted in a greater number of skin cancers being treated by the public health system, a reduction in waiting times for treatment, and fewer minor skin lesions being referred to secondary care. Quality measures have been achieved and are improving steadily. Development of the programme has improved working relationships between primary and secondary care clinicians. STRATEGIES FOR IMPROVEMENT: The strategy was to facilitate the working relationship between primary and secondary care and increase the capacity for skin lesion excisions in both sectors. LESSONS: Skin cancer management can be improved by a coordinated approach between primary and secondary care. [ABSTRACT FROM AUTHOR]

The Australian Community Climate and Earth System Simulator (ACCESS) has contributed to the World Climate Research Programme’s Coupled Model Intercomparison Project Phase 6 (CMIP6) using two fully coupled model versions (ACCESS-CM2 and ACCESS-ESM1.5) and two ocean–sea-ice model versions (1° and 0.25° resolution versions of ACCESS-OM2). The fully coupled models differ primarily in the configuration and version of their atmosphere components (including the aerosol scheme), with smaller differences in their sea-ice and land model versions. Additionally, ACCESS-ESM1.5 includes biogeochemistry in the land and ocean components and can be run with an interactive carbon cycle. CMIP6 comprises core experiments and associated thematic Model Intercomparison Projects (MIPs). This paper provides an overview of the CMIP6 submission, including the methods used for the preparation of input forcing datasets and the post-processing of model output, along with a comprehensive list of experiments performed, detailing their initialisation, duration, ensemble number and computational cost. A small selection of model output is presented, focusing on idealised experiments and their variants at global scale. Differences in the climate simulation of the two coupled models are highlighted. ACCESS-CM2 produces a larger equilibrium climate sensitivity (4.7°C) than ACCESS-ESM1.5 (3.9°C), likely a result of updated atmospheric parameterisation in recent versions of the atmospheric component of ACCESS-CM2. The idealised experiments run with ACCESS-ESM1.5 show that land and ocean carbon fluxes respond to both changing atmospheric CO2 and to changing temperature. ACCESS data submitted to CMIP6 are available from the Earth System Grid Federation (https://doi.org/10.22033/ESGF/CMIP6.2281 and https://doi.org/10.22033/ESGF/CMIP6.2288). The information provided in this paper should facilitate easier use of these significant datasets by the broader climate community.