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The complexity of interdisciplinary research, including the time needed to understand multiple approaches and develop skills, within a university structure organised in disciplines, means that interdisciplinary research can be difficult for a developing researcher. However, early- and mid-career researchers (EMCRs) are key to the future of interdisciplinary research. This paper asks, 'Why and how do EMCRs become interdisciplinarians?' It draws on analysis of interviews supplemented by ethnographic observations from a research project exploring the development of interdisciplinary expertise in universities. This paper outlines six common intersecting career pathways through which EMCRs come to work across disciplines. The diverse and often ad hoc nature of interdisciplinary research careers implies that support systems, resources and training need to be adaptive and flexible.

Calls have been made for a public pedagogy that works at the intersection of education and politics to enact a concern for "publicness." These are calls for pedagogy that values plurality in human togetherness and educational conditions in which all young people can flourish. In this paper my specific focus is exploring how "publicness of education" can be conceived in relation to encouraging inclusive, equitable and decolonial 'ways of being doing and knowing' in HPE. I adopt a genealogical approach to explore 'conditions of possibility' that have contributed to durability of a 'white' Eurocentric norm for HPE. Selected reports, curriculum documents, newspaper and reference articles are drawn on to illuminate discourses, and power relations implicated in this dominant framing. This paper represents an attempt to disrupt common sense understandings and practices of HPE founded settler-colonialism and new forms of neo-liberal colonialism. Approaches premised on activist, culturally responsive pedagogies as well as affective, embodied, relational dimensions of human togetherness are suggested. I propose that questioning 'why' 'how' and 'what' is taught in HPE is critical for reframing 'thinking and feeling' required for pedagogical and curricular practices that can enhance educational justice for Indigenous students.

This paper reports on the findings of a visual text analysis of selected infographics and data visualisations used in news websites during the COVID-19 pandemic in Sydney, Australia. Infographics and data visualisations used in news website articles disseminated and communicated local and national information to the public about the COVID-19 pandemic and related social implications. For the first time live data, animation and interaction were used in reporting health and societal information to a general news readership, contributing to the knowledge base and visual literacy of the public. The information presented was not only clear but also aesthetically appealing. This paper examines the styles of news digital infographics and data visualisation of three longitudinal studies using lessons learned from Grainger "et al." (2016), Dick (2020) and Tufte (2001) and contextualises the context, narrative, aesthetics, communication, data, functionality and examines the collaboration between communication designers, journalists and the development team. The implications for communication design education are explored in the context of skills, tools and teamwork needed for future communication design students.

Purpose. To provide a bibliographical-historical perspective and main interest in the field of myopia. Methods. In this bibliographic study, the Web of Science Database was searched from 1999 to 2018. Recorded parameters included journal name, impact factor, year and language, number of authors, type and origin, methodology, number of subjects, funding, and topics. Results. Epidemiological assessments were the leading type of article (28%), and half of the papers were prospective studies. The number of citations for multicenter studies was significantly higher (P = 0.034). The articles were published in 27 journals, with the majority in Investigative Ophthalmology, Vision Sciences (28%), and Ophthalmology (26%). Etiology, signs and symptoms, and treatment equally encompassed the topics. Papers addressing etiology, specifically genetic and environmental factors (P = 0.029), signs and symptoms (P = 0.001), and prevention, specifically public awareness (47%, P = 0.005), received significantly more citations. Treatment to decrease myopia progression was a much more common topic (68%) than refractive surgery (32%). Optical treatment was the most popular modality (39%). Half of the publications came from 3 countries: the United States (US), Australia, and Singapore. The highest ranked and cited papers came from the US (P = 0.028) and Singapore (P = 0.028). Conclusions. To our knowledge, this is the first report of the top-cited articles on myopia. There is a predominance of epidemiological assessments and multicenter studies originating from the US, Australia, and Singapore, assessing etiology, signs and symptoms, and prevention. These are more frequently cited, emphasizing the great interest in mapping the increase in the incidence of myopia in different countries, public health awareness, and myopia control. [ABSTRACT FROM AUTHOR]

While value-based health care (VBHC) is transforming Australia's health system, with its focus on patient-centred care and outcomes, it cannot transform Australia's health without policy action to address the social determinants of health. Australia is moving towards a wellbeing economy, but governments have not been explicit in the methods by which the health system will contribute to the development of a wellbeing economy at a macro level. It is also unclear how governments will ensure that approaches to valuing wellbeing will complement current health care innovations in defining and evaluating value in relation to health outcomes. To address this gap, we present a value-based public health (VBPH) framework to conceptualise a health-informed model to expand current thinking about defining, delivering and evaluating the value of population health and wellbeing. The framework provides a critical and innovative approach beyond VBHC for improving population health and wellbeing outcomes, in alignment with principles and measures being put forth in early examples of governments using wellbeing economy policies. In VBPH, the focus is on ensuring value in interventions to improve population outcomes. VBPH offers an approach for joined-up policy across government, using Health in All Policies for multi-sector public health interventions in response to population needs, across full cycles of policy development, implementation and evaluation. It promotes social return on investment methods to measure outcomes that matter to diverse stakeholders within and across communities. VBPH also requires cost estimation from a whole of government perspective, across complete cycles and stages of policy., (© 2023 Australian Health Promotion Association.)

Purpose: From 2018, the Schools Up North (SUN) programme worked with three remote Australian schools to enhance their capability and resilience to support the wellbeing and mental health of Aboriginal and Torres Strait Islander students and staff. This paper explores the implementation of SUN during the first two years of COVID-19 (2020-2021). Method: Using grounded theory methods, school staff, other service providers and SUN facilitators were interviewed, with transcripts and programme documents coded and interrelationships between codes identified. An implementation model was developed. Results: The SUN approach was place-based, locally informed and relational, fostering school resilience through staff reflection on and response to emerging contextual challenges. Challenges were the: community lockdowns and school closures; (un)availability of other services; community uncertainty and anxiety; school staff capability and wellbeing; and risk of educational slippage. SUN strategies were: enhancing teachers' capabilities and resources, facilitating public health discussions, and advocating at regional level. Outcomes were: enhanced capability of school staff; greater school-community engagement; student belonging and engagement; a voice for advocacy; and continuity of SUN's momentum. Conclusions: The resilience approach (rather than specific strategies) was critical for building schools' capabilities for promoting students and staff wellbeing and provides an exemplar for remote schools globally.

This case study describes the delivery and achievements of the public health nutrition programme in Queensland, Australia, over more than three decades. Analysis of publicly available documents related to statewide nutrition policy and programmes from 1983 to 2014 identified key inputs and programme impacts and outcomes, including an increase in fruit and vegetable intake by 1.1 serves per person per day and rates of exclusive breastfeeding for the first 6 months quadrupled. Mapping factors and milestones against a framework on determinants of political priority highlighted correlation with effective nutrition promotion policy and practice. Identified enablers included the influence of policy champions and advocates, quality of governance, focus on whole-of-population approaches, and periods of political will and economic prosperity. Key barriers included changes of ideology with government leadership; lack of commitment to long-term implementation and evaluation; and limited recognition of and support for preventive health and nutrition promotion. The case study shows that a coordinated, well-funded, intersectoral approach to improve nutrition and prevent chronic disease and malnutrition in all its forms can be achieved and produce promising impacts at state level, but that sustained effort is required to secure and protect investment. Political support for long-term investment in nutrition is essential to reduce the high cost of all diet-related diseases. Public health leadership to better prepare for risks around political cycles, secure adequate resources for evaluation, and better communicate impacts and outcomes may help protect future investments and achievements., (© The Author(s) 2021. Published by Oxford University Press.)

This paper details the research design of a multidisciplinary, multi-method, collaborative research project investigating health communication from the experiences of the early childhood education (ECE) sector during the COVID-19 pandemic. With the rapidly evolving pandemic, the ECE sector was instantly tasked with expanding their required health practices to prevent the spread of infection. It was evident that the sector needed a system to communicate health advice in a timely, consistent and effective manner. Founded on a partnership model based on 'knowledge brokering' theory, this project demonstrates the value of a multidisciplinary research team collaborating with stakeholder organisations to investigate how COVID-19 health information traversed through complexities of organisational layers and diverse communities of families and staff. Detailing our data collection and analysis protocols, we conclude by outlining how our innovative research design is generating actionable and impactful recommendations for both the ECE and health sectors.

The MJA-Lancet Countdown on health and climate change in Australia was established in 2017, and produced its first national assessment in 2018, its first annual update in 2019, and its second annual update in 2020. It examines indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. Our special report in 2020 focused on the unprecedented and catastrophic 2019-20 Australian bushfire season, highlighting indicators that explore the relationships between health, climate change and bushfires. For 2021, we return to reporting on the full suite of indicators across each of the five domains and have added some new indicators. We find that Australians are increasingly exposed to and vulnerable to excess heat and that this is already limiting our way of life, increasing the risk of heat stress during outdoor sports, and decreasing work productivity across a range of sectors. Other weather extremes are also on the rise, resulting in escalating social, economic and health impacts. Climate change disproportionately threatens Indigenous Australians' wellbeing in multiple and complex ways. In response to these threats, we find positive action at the individual, local, state and territory levels, with growing uptake of rooftop solar and electric vehicles, and the beginnings of appropriate adaptation planning. However, this is severely undermined by national policies and actions that are contrary and increasingly place Australia out on a limb. Australia has responded well to the COVID-19 public health crisis (while still emerging from the bushfire crisis that preceded it) and it now needs to respond to and prepare for the health crises resulting from climate change., (© 2021 AMPCo Pty Ltd.)

Objectives: This paper critiques the haematological monitoring guidelines for clozapine. It describes the history of clozapine, as well as the pathophysiology and epidemiology of clozapine-induced neutropenia (CIN) and agranulocytosis (CIA). The paper appraises the extant literature on mandatory clozapine haematological monitoring. Conclusion: Contemporary Australian protocols for clozapine haematological monitoring are not consistent with the current evidence base. CIN and CIA are rare occurrences, and the associated risk of death is low. Potential modifications to existing guidelines include changing neutrophil thresholds for patients with benign ethnic neutropenia and reducing the frequency or removing haematological monitoring after two years of clozapine treatment. [ABSTRACT FROM AUTHOR]

Objective: To map how public health is funded in Australia. To assess whether changes to funding methods might improve system performance., Methods: Review of publicly accessible documents and discussions with public health key informants., Results: Australia spent $140 per person on public health in 2019-20, (1.8% of total health spending). But there is considerable state and territory variation. This money flows through multiple channels and payment mechanisms. Responsibility for what is funded is largely delegated to authorities close to the problems. This makes it easier to choose the best mechanism for funding an activity. Much information is hidden from view, however. This makes it impossible to assess whether the potential for population benefit is fully realised., Conclusions: Australia avoids some of the difficulties experienced elsewhere because funding is largely devolved to states in block grants; they shape their own investments. The US, by contrast, prefers categorical funds for specific purposes. Three suggestions for making the funding system here more visible, useful and accountable are canvassed, including 'satellite accounts'., Implications for Public Health: Funding needs to be more transparent before it is possible to assess whether public health system performance could be improved through changes to the way public health is funded., Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Abstract: The novel coronavirus disease 2019 (COVID-19) pandemic prompted Australia to implement large-scale domestic lockdowns and halted international travel. However, the impact of these measures on national notifiable diseases is yet to been fully examined. In this paper, we expand on a preliminary analysis conducted in 2020, and conducted a retrospective, observational study using nationally notifiable disease surveillance system (NNDSS) data to examine if the changes identified in the first half of 2020 continued in Australia through wide-scale public health measures. We found that there was an overall reduction in most of Australia's nationally notifiable diseases over the two pandemic years during which wide-scale public health measures remained in operation, particularly for 23 social and imported diseases. We observed an increase in notifications for psittacosis, leptospirosis and legionellosis during these years. The public health measures implemented in 2020 and 2021 (including lockdowns, mask mandates, and increased hand and respiratory hygiene) may have contributed to the observed notification reductions. The outcomes of these measures' implementation provide insights into broader communicable disease control for mass outbreaks and pandemic responses., (© Commonwealth of Australia CC BY-NC-ND.)

Background: The climate crisis is a significant risk to the health and wellbeing of children, young people, and future generations. While there are calls for children and young people's engagement in climate decision making, current power structures limit their participation. This paper aimed to understand children's perspectives about the impact of the climate crisis on their futures, their ability to influence climate decisions, and strategies and mechanisms to facilitate their greater engagement in decisions made about the climate crisis., Methods: Online in-depth interviews were conducted with n = 28 children (aged 12-16 years) across Australia. Photo elicitation techniques were used to prompt discussion about how the climate crisis impacted their futures, their ability to influence climate decisions, and strategies and mechanisms to engage them in climate decision making. A reflexive approach to thematic analysis was used to construct three themes from data. Images were analysed for ascribed meanings., Results: First, participants stated that they and future generations will inherit the climate crisis from older generations, specifically decision makers. Second, they described a need to address a range of age-related barriers that limit children and young people's engagement in climate decision making, including perceptions about their capabilities. Finally, they discussed strategies and mechanisms to embed children and young people's perspectives within climate decision making, including at civic and political levels., Conclusions: Children and young people have the right to be involved in decisions made about the climate crisis which significantly impact their futures, including their health and wellbeing. They argue for structural changes to embed their views in climate decision making, and describe a range of engagement strategies and mechanisms to structure their perspectives and knowledge with decision making processes. Furthermore, genuine involvement of children and young people in climate discussions must avoid youthwashing and tokenistic participation. The public health community can help address barriers to youth participation in climate action and should actively engage and collaborate with children and young people to facilitate their political and democratic influence over the climate crisis. This involves making room and creating an accessible seat at the decision making table to ensure their perspectives are embedded in climate decisions., (© 2024. The Author(s).)

Objectives: This study aimed to determine which method to triage intensive care patients using chronic comorbidity in a pandemic was perceived to be the fairest by the general public. Secondary objectives were to determine whether the public perceived it fair to provide preferential intensive care triage to vulnerable or disadvantaged people, and frontline healthcare workers. Methods: A postal survey of 2000 registered voters randomly selected from the Australian Electoral Commission electoral roll was performed. The main outcome measures were respondents' fairness rating of four hypothetical intensive care triage methods that assess comorbidity (chronic medical conditions, long-term survival, function and frailty); and respondents' fairness rating of providing preferential triage to vulnerable or disadvantaged people, and frontline healthcare workers. Results: The proportion of respondents who considered it fair to triage based on chronic medical conditions, long-term survival, function and frailty, was 52.1, 56.1, 65.0 and 62.4%, respectively. The proportion of respondents who considered it unfair to triage based on these four comorbidities was 31.9, 30.9, 23.8 and 23.2%, respectively. More respondents considered it unfair to preferentially triage vulnerable or disadvantaged people, than fair (41.8% versus 21.2%). More respondents considered it fair to preferentially triage frontline healthcare workers, than unfair (44.2% versus 30.0%). Conclusion: Respondents in this survey perceived all four hypothetical methods to triage intensive care patients based on comorbidity in a pandemic disaster to be fair. However, the sizable minority who consider this to be unfair indicates that these triage methods could encounter significant opposition if they were to be enacted in health policy. What is known about the topic? Triage systems can be used to prioritise the order in which patients are treated in a pandemic, but the views of the general public on using chronic comorbidity as intensive care unit (ICU) triage criteria are unknown. What does this paper add? This Australian survey, conducted during the coronavirus disease 2019 pandemic, demonstrated that the majority of respondents perceived ICU triage methods based on comorbidity to be fair, but significant ethical issues exist. What are the implications for practitioners? It may be possible to develop an ICU triage protocol for future pandemics in Australia, but further research is required. [ABSTRACT FROM AUTHOR]

Family violence is becoming increasingly visible in Australia, with many state and federal governments taking on more responsibility to address family violence and its impacts on those affected. Current efforts are focused on practice frameworks, identifying and responding to risk factors, and social justice frameworks including legislating against family violence in a range of jurisdictions and addressing more broadly the structural and cultural forces that perpetuate violence and further oppress those victimised. Family violence is not unique to Australia, with prevalence rates internationally suggesting family violence occurs irrespective of country, race, age, culture, effectiveness of social policies or socioeconomic status. This paper explores relevant foundational concepts of Bowen family systems theory (BFST) as it relates to family violence and explores opportunities to evolve practice in this area. BFST offers a unique contribution towards addressing family violence, particularly in relation to the public health challenge of addressing family polyvictimisation. The paper also explores how BFST conceptualises family violence and the role of the professional in working with the family as a single emotional unit. The unique focus of BFST on observing and defining self within the emotional family unit through observation of the underlying multigenerational emotional patterns of functioning provides unique opportunities to evolve and develop both the capacity of clinicians and responses to families who are navigating the serious and challenging impacts of family violence. [ABSTRACT FROM AUTHOR]

Traditional approaches to system management are not suited to highly uncertain conditions. Hard system approaches with a top‐down management approach are often used to manage well‐defined systems that are not easily able to cope with uncertainty. Soft system approaches of the with bottom‐up or participative style may cause a lack of conformance to industry standards. Few studies have investigated these approaches within the context of COVID‐19 pandemic. Therefore, this paper aims to use the philosophy of Total Systems Intervention to investigate the applicability of an integrated management approach to cope with the uncertainty of COVID‐19. Three different countries from Europe, Oceania and Asia are selected as typical case studies to clarify the strengths and weaknesses of differing management approaches. The case studies demonstrate that using an integrated management approach can potentially assist decision‐makers to deal with crises and conclusively reveal the superiority of the integrated approach, independent of cultural milieu. [ABSTRACT FROM AUTHOR]

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

The many different voices speaking into the current narrative surrounding the health effects of 5G technologies necessitate an exploration of the background of the various published author-spokespersons and their potential motives. This has been attempted recently by de Vocht and Albers. However, that opinion piece used a narrow investigative lens, resulting in an undermining of both the rationality of the concerned general public and the motives of specific researchers. At the same time, biases, conflicts of interest, and flaws found in "independent" reviews were not considered. To address these oversights, an evidence-based appraisal of public opinion and the scientific caliber of authors involved in the 5G health discussion is warranted. Subsequently, this review article presents an analysis of the available Australian data representing public voices, while also conducting a broader investigation of the level of expertise of recent author-spokespersons based on their experience as scientists, particularly in the area of health effects of radiofrequency electromagnetic fields. This review thus attempts to more clearly illustrate for the reader the caliber and motives of the voices speaking into the 5G narrative. The article concludes with a set of questions that need to be answered to enable scientists to advise policy makers more effectively on matters of 5G and public health., Competing Interests: When background affiliations are being investigated, research projects linked with government or industry interests need to be noted. For example, the tobacco industry implemented strategies for suppressing evidence regarding health effects from smoking, which included: funding research that supported the industry position, setting up official “review” bodies who concluded that results were inconsistent, and funding central research centers that would supposedly be a focal point organization of the highest caliber to sponsor and foster quality, objective research … to effectively communicate research findings to a broad scientific community [(22), p. 202]. Similar patterns can be observed in the field of health effects of wireless radiation, as follows: Researchers working at university institutions with laboratories funded by, or in partnership with telecommunication industries seem unable to maintain both their jobs and their independence from these industries. For example, after Dr. Bruce Hocking, former Chief Medical Officer for the Australian telecommunications company Telstra, published on neurological changes in his patients from exposure to their mobile phones (25), he was made redundant. Similarly, after Fred Hollows found that Telstra linesmen exposed to microwaves were three times more likely to develop cataracts (26), Telstra complained to Hollows' university. Hollows received no further funding to conduct follow-up studies (27).The international advisory body, ICNIRP, has members with a history of industry affiliations (28). This creates an inherent industry-bias within ICNIRP members, which has been noted by the Ethical Council at the Karolinska Institute in Stockholm (29) and by the Court of Turin where evidence provided by ICNIRP was deemed biased and not reliable (30).Government advisory agencies are unable to make independent statements about health and exposures, because they are expected to support government plans for comprehensive internet of things (IoT) and smart cities, which are dependent on wireless technologies (31, 32). Moreover, Australia's advisory agency ARPANSA is not permitted to make changes to the RF standard to protect health and the environment if it would prejudice the departments of Defense or National Security (33). The need to support these two agencies most likely creates pressure on ARPANSA not to oppose further wireless technology rollouts or lower exposure limits to improve public safety.Members of government advisory agencies are also members or associates of industry-linked ICNIRP (34); e.g., Karipidis, an ARPANSA researcher, is also a member of ICNIRP.The supposedly independent international advisory body, the WHO International EMF project is strongly influenced by industry in the form of the International Telecommunications Union and ICNIRP [(35), p. 5–6].Government regulatory agencies and advisory bodies may derive their income from industry via RF spectrum sales. For example, in Australia in 2021, $700,000 p.a. of the funding for the government's advisory agency ARPANSA came from revenue from spectrum licenses collected by the self-regulated industry-friendly Australian Communications Media Authority (ACMA). Then, of the money received by ARPANSA that year, a portion went to the WHO EMF project and to ICNIRP (36). ARPANSA state publicly that they take advice from the WHO and from ICNIRP, as if these are independent bodies advising ARPANSA. However, ARPANSA supports the WHO EMF financially and contributes to the WHO EMF project reports (35). Overall, several of the same people appear in all three committees (WHO EMF, ICNIRP and ARPANSA) and money flows from one group to another. Minuted evidence of ARPANSA's strategy to maintain this interdependence between ARPANSA, ICNIRP, research institutions, and the WHO EMF project is given in Supplementary material 3.Such conflicts of interest make it unclear whose interests are being represented when a member of one these groups speaks into the 5G narrative. For example, when a WHO webpage on potential health risks from 5G informs that Provided that the overall exposure remains below international guidelines, no consequences for public health are anticipated (37), it is uncertain who is really speaking: ARPANSA, ICNIRP, ACMA,2 or the telecommunications industry. Similar inter-relationships between government agencies, industry, ICNIRP, and WHO have been documented for other countries (29, 34). It appears that prestigious and supposedly independent health bodies along with the regulatory agencies advising on the 5G rollout have significant elements in that apparatus [that] appear to have been captured by vested interests [(38), p. 565]. So as to discern real from illusory independence therefore, clear categories of “Government/ICNIRP” and “Institution/industry” need to be available for classifying the affiliations of the author-spokespersons within the 5G narrative. When this system is used (see Supplementary material 1), we find that two of the researchers deemed to be “independent” in the opinion article by de Vocht and Albers (5) need to be reclassified, due to Telstra funding of Wood's laboratories (39, 40) (Institution/industry), and Karipidis' employment by ARPANSA and membership of ICNIRP (41) (Government/ICNIRP). 2.4.1 Hidden industry influences via co-authorshipIt is also instructive to look at the coauthors of each of the main author-spokespersons. Supplementary material 4 lists the authors and co-authors and their links with industry. Wood, a coauthor of Karipidis, has published with several authors closely linked to industry. Kenneth Foster has co-authored with Bushberg, Simkó, and Wood, and has several papers funded by the wireless industry. Foster was mentored by the ex-German biophysicist Herman Schwan, who modeled effects using macro biophysics, but did not incorporate the developing biological or quantum perspectives and was thus unable to let go of his “thermal only” position (see Supplementary material 1). Schwan's position along with industry interests are still influencing today's 5G narrative, via the influence of Foster as co-author on many publications.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Weller and McCredden.)

Failure of governments across the world to address climate change has fuelled social movements focused on climate-related policy and action. Research analysing these movements has focused mainly on the types of strategies employed including blockades and occupations, marches and petitions, divestment, boycotts and litigation as well as how groups are framing climate change as a problem. What has been largely missed are the ways these groups are framing the change they want to see, that is their demands to governments. Not all demands and actions have the same potential to create the changes needed to mitigate climate change. Used in public health and health promotion, the systems science Intervention Level Framework (ILF) is a tool that can help analyse to what extent different demands have the leverage to create change in a system. We use the ILF to analyse 131 demands from 35 different climate-related advocacy groups in Australia. Results show demands are more focused on lower system leverage points, such as stopping particular projects, rather than on more impactful leverage points, such as the governance structures that determine climate-related policy and decision-making mechanisms. Further, the results highlight the lack of attention on public health related topics of transport and food systems. This paper shows how a systems science framework used in health promotion, the ILF, could enable climate advocacy groups to more effectively target demands to achieve more impactful outcomes from governments, corporations and the public., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Public protest continued to represent a prominent form of social activism in democratic societies during the COVID-19 pandemic. In Australia, a lack of specific legislation articulating protest rights has meant that, in the context of pandemic restrictions, such events have been treated as illegal mass gatherings. Numerous large protests in major cities have, indeed, stirred significant public debate regarding rights of assembly during COVID-19 outbreaks. The ethics of infringing on protest rights continues to be controversial, with opinion divided as to whether public health goals or human rights should take precedence. This paper applies public health ethical theory to an in-depth analysis of arguments on both sides of the debate. Using the Nuffield Council on Bioethics framework as a backdrop, proportionality and necessity of restrictions are understood as key concepts that are common to both public health and human rights perspectives. The analysis presented here finds a middle-ground between the prevailing arguments on opposing sides and is further able to rationalize the use of protest itself as an important element of a mature public health ethics response to restrictive policy. Thus, this paper aims to influence public health policy and legislation regarding protest rights during public health emergencies. [ABSTRACT FROM AUTHOR]

The Medicines Repurposing Program was launched on 1 March 2024. It provides a pathway for registering and subsidising off-label medicines of significant public health benefit but which sponsors have no financial incentive to pursue. This article provides a short overview and critical analysis of the program. One concern that emerges is that commercial sponsors still retain de facto veto power over which off-label uses are prioritised and so have the capacity to sway the process. Simple suggestions are proposed to help mitigate this risk. What is known about the topic? The Medicines Purposing Program (MRP) provides a pathway for non-industry actors to have off-label uses of medicines approved and funded if deemed to be of public benefit. What does this paper add? Commercial sponsors can easily sway the prioritisation and selection of candidates under the MRP in their favour, so strategies are recommended to counter this risk. What are the implications for practitioners? The MRP provides an opportunity for the medical community to directly nominate off-label medicines uses for approval and funding improving access to medicines, but only if commercial interests do not intervene. [ABSTRACT FROM AUTHOR]

In Australia, racism remains a challenge to dismantle within public health institutions. This paper examines the pressures I experienced from some public health scholars and practitioners to conform to colonial and positivist approaches in knowledge production that still dominate the field. To challenge this hegemony, my research practices turned into what Mignolo calls "epistemic disobedience," an approach to delink from Western ways of producing knowledge. Based on this experiential learning process, I argue epistemic disobedience should not be overlooked in the discussion of decolonizing research and antiracist pedagogy in the context of doctoral training. [ABSTRACT FROM AUTHOR]

Introduction: Medication-related problems often lead to patient harm. This paper aims to review the Australian literature to determine the overall incidence, severity and preventability of medication-related hospital admissions, as well as providing a national estimate on their extent and cost. Methods: The first part of the paper includes a literature search to identify studies that provided estimates of medication-related problems that caused hospital admissions. Incidence of medication-related hospital admissions, type of medication-related problem contributing to admission (e.g. adverse medicine reaction) and method used to estimate incidence (e.g. chart review) were extracted. Data on severity and preventability of the admissions were extracted where available. The second part of the paper involves use of methodological triangulation to estimate the extent and cost of medication-related hospital admission. Median estimates used to assess medication-related hospital admissions and the 2019–2020 national hospital admissions data were used to calculate the national estimate on the extent of medication-related hospital admission. Costs were also estimated. Results: Seventeen studies provided estimates on the extent of medication-related hospital admissions as assessed using medication chart review. The median incidence of 2.5% (interquartile range [IQR] 0.6%) as a proportion of all hospital admissions suggests 275,000 hospital admissions annually in Australia are medication related. The median incidence of 9% (IQR 3.9%) of emergency admissions suggests that 270,000 admissions annually are medication related. Eight studies provided estimates of the extent of medication-related hospital admissions identified from administrative health data; the median incidence of 1.7% with an under-reporting rate of 82% suggests 280,000 hospital admissions annually are medication related. Triangulation of results suggests that at least 250,000 hospital admissions annually in Australia are medication related, with an estimated cost of 1.4 billion Australian dollars (AUD$). Five studies assessed severity, and nine studies assessed preventability. Preventability estimates suggest two-thirds of medication-related hospital admissions are potentially preventable. Conclusions: We estimated that 250,000 hospital admissions in Australia are medication related, with an annual cost of AUD$1.4 billion to the healthcare system. Two-thirds of medication-related hospital admissions are potentially preventable. [ABSTRACT FROM AUTHOR]

The landmark 2021 Resolution on Oral Health by the 74th World Health Assembly has elevated the importance of oral health into the global health policy agenda. This has led to the development and adoption of the World Health Organization (WHO) Global Strategy on Oral Health in 2022. It acknowledged the need to integrate oral health as part of universal health coverage (UHC), which is supported by national clinical leadership for oral health. Although Australia is a signatory WHO member state, it is yet to appoint a Commonwealth Chief Dental Officer to provide national clinical leadership. This commentary provides a background on the current issues on population oral health in Australia, an insight into the Australian oral healthcare system, and explores some of the challenges and learnings related to previous Commonwealth dental programs. This paper highlights why expertise in dental public health is required to steer national oral health policy that is focused on prevention and early intervention. A population oral health approach for UHC should be informed by evidence, prioritise and address oral health inequities, and be co-ordinated by national clinical leadership for oral health. What is known about the topic? Many countries, including Australia, currently do not provide universal access to affordable oral healthcare. There are significant oral health inequities that exist in Australia, particularly for priority populations who are at higher risk for oral diseases. What does this paper add? National clinical leadership on oral health is needed to implement evidence-based oral health policy. This commentary provides justification for the Australian Government to appoint a Commonwealth Chief Dental Officer. What are the implications for practitioners? Strengthening advocacy efforts by the public health practitioners and other stakeholders is important to promote oral health as a critical health issue for urgent action. [ABSTRACT FROM AUTHOR]

Objectives: To determine the total annual screening and further-investigation costs of investigating false-positive and true-positive mammograms in the Australian population breast-screening program. Methods: This economic analysis used aggregate-level retrospective cohort data of women screened at a breast-screening clinic. Counts and frequencies of each diagnostic workup-sequence recorded were scaled up to national figures and costed by estimating per-patient costs of procedures using screening clinic cost data. Main outcomes and measures estimated were percentage share of total annual screening and further-investigation costs for the Australian population breast-screening program of investigating false-positive and true-positive mammograms. Secondary outcomes determined were average costs of investigating each false-positive and true-positive mammogram. Sensitivity analyses involved recalculating results excluding subgroups of patients below and above the screening age range of 50–74 years. Results: Of 8235 patients, the median age was 60.35 years with interquartile range of 54.17–67.17 years. A total of 15.4% (ranging from 13.4 to 15.4% under different scenarios) of total annual screening and further-investigation costs were from investigating false-positive mammograms. This exceeded the share of costs from investigating true-positives (13%). Conclusions: We have developed a transparent and non-onerous approach for estimating the costs of false-positive and true-positive mammograms associated with the national breast-screening program. While determining an optimal balance between false-positives and true-positive rates must rely primarily on health outcomes, costs are an important consideration. We recommend that future research adopts and refines similar approaches to facilitate better monitoring of these costs, benchmark against estimates from other screening programs, and support optimal policy development. What is known about the topic? Screening mammogram results suggesting cancer later found to be wrong by follow-up testing (false-positive mammograms) consume healthcare resources unnecessarily and increases anxiety among screened women. What does this paper add? This paper estimates the share of total annual costs of Australia's national breast screening program caused by follow up testing of false-positive mammograms at approximately 15%. What are the implications for practitioners? The share of annual breast cancer screening costs from follow-up testing of false-positive mammograms can be monitored over time using the transparent and non-onerous method developed in this paper. [ABSTRACT FROM AUTHOR]

Australia and the United Kingdom (UK) have each witnessed a 'punitive turn' in relation to youth justice responses. A lack of contextualisation, such as the impact of trauma and adverse childhood experiences on young people, is often overlooked by media outlets, governments and policymakers, in favour of individual pathologisation of young people. In direct contrast to these punitive responses, the public health approach (PHA) has emerged particularly in the UK; and it identifies experiences of trauma as one of the leading causes of violence within communities. Drawing on the perspectives of those working with children and young people, we critically explore whether the implementation of a PHA could be an effective approach to addressing the underlying causes of young people's involvement in violence. The paper focuses specifically on a case study of the youth justice system in Victoria, Australia and draws on domestic and global perspectives of key stakeholders, to consider whether the introduction of a PHA in Victoria, Australia, would position young people's diverse needs at the centre of policy change in youth justice and better outcomes for young people and communities. [ABSTRACT FROM AUTHOR]

This paper applies the theory of change model (Kotter in Harv Bus Rev 2:59-67, 1995; Moore et al. in Viet Nam J Public Health 1(1):66-75, 2013) to describe the pathway that lead to Australia's first pill testing/drug checking services in Canberra, in the Australian Capital Territory. The paper takes each step of the model and illustrates the key activities that largely occurred over an approximately 24 month period resulting in the service being operational on 29 April 2018. The paper demonstrates that leadership, advocacy and activism are key components, alongside evidence, to bringing about public policy change. It provides a unique insight to the extensive efforts undertaken to achieving the first legally sanctioned pill testing at festivals in Australia and provides a positive case study for those seeking to introduce contested harm reduction services in the drug and alcohol field., (© 2023. The Author(s).)

Knowledge synthesis methods help summarize evidence and utilize content expertise to draw out key messages to aid knowledge mobilization and translation. Systems thinking and coproduction can support this by facilitating a multiperspective view and ensuring that knowledge is mobilized and translated in a useful and meaningful way for policy-makers and practitioners. In this paper, we describe the development of a knowledge synthesis approach that utilizes coproduction with policy-makers to combine the findings of a programme of research with policy knowledge to support decision-makers working in chronic disease prevention. The process developed by The Australian Prevention Partnership Centre combined the expertise of research, policy and science communications experts. We reflect on how we used coproduction processes to embed policy-makers as partners in the evidence synthesis process via research-policy dialogues, and embedded science communication into the development and presentation of the findings. This differs from a more common approach of researchers generating evidence for policy with limited input from policy-makers themselves. By collaborating with policy-makers and using coproduction, we can better inform policy-relevant research and generate policy-relevant knowledge. We describe the development of our knowledge synthesis approach using two case studies: the first drawing on a body of work in public health law, and the second on a body of work focused on the first 2000 days of life. We consider how these case studies demonstrate the value of working with policy partners as part of a knowledge synthesis process, and discuss how this process could be adapted and used in future., (© 2023. The Author(s).)

Objective. Data linkage is a very powerful research tool in epidemiology, however, establishing this can be a lengthy and intensive process. This paper reports on the complex landscape of conducting data linkage projects in Australia. Methods. We reviewed the processes, required documentation, and applications required to conduct multi-jurisdictional data linkage across Australia, in 2023. Results. Obtaining the necessary approvals to conduct linkage will likely take nearly 2 years (estimated 730 days, including 605 days from initial submission to obtaining all ethical approvals and an estimated further 125 days for the issuance of unexpected additionally required approvals). Ethical review for linkage projects ranged from 51 to 128 days from submission to ethical approval, and applications consisted of 9-25 documents. Conclusions. Major obstacles to conducting multi-jurisdictional data linkage included the complexity of the process, and substantial time and financial costs. The process was characterised by inefficiencies at several levels, reduplication, and a lack of any key accountabilities for timely performance of processes. Data linkage is an invaluable resource for epidemiological research. Further streamlining, establishing accountability, and greater collaboration between jurisdictions is needed to ensure data linkage is both accessible and feasible to researchers. [ABSTRACT FROM AUTHOR]

There is opportunity for universities to actively engage with Aboriginal communities to participate, conduct and ideally lead responsible research that attends to community priorities and issues. The Health from the Grassroots (Grassroots) project sought to address an ongoing mismatch between university-defined and community-defined priorities in rural northern New South Wales (NSW), Australia. Grassroots, led by Aboriginal staff of the University Centre for Rural Health (UCRH), aimed at engaging Aboriginal communities in conversations to inform research priorities. The Grassroots project was a true representation of collaborative research led by and for Aboriginal people. The team designed a local survey conducted yarning sessions with community members and used this information to visualize report findings. Community members were highly engaged in the consultation process and the "rich picture" continues to be used to further conversations about evolving health and research priorities. The Aboriginal research team identified strengths and challenges faced by communities and health services in the region and centred community in decision-making for project design and direction. Challenges encountered include limited resources and time for team members to devote to the project outside of their substantive paid positions. This paper describes the project vision, implementation, and research team lessons in the first years. Meaningful consultation to inform research action arose from the team's deep-rooted relationships and identities as members of the community in which we live and work. Research priorities identified through the Grassroots project have been integrated into the ongoing work of the UCRH. [ABSTRACT FROM AUTHOR]

Aims: In tackling rising diabetes‐related emergencies, the need to understand and address emergency service usage by people with type 1 diabetes is vital. This review aimed to quantify current trends in presentations for type 1 diabetes‐related emergencies and identify public health strategies that reduce the frequency of diabetes‐related emergencies and improve glycaemic management. Methods: Medline (OVID), Cochrane and CINAHL were searched for studies published between 2000 and 2023, focusing on people with type 1 diabetes, severe hypoglycaemia and/or diabetic ketoacidosis, and ambulance and/or emergency department usage. There were 1313 papers identified, with 37 publications meeting review criteria. Results: The incidence of type 1 diabetes‐related emergencies varied from 2.4 to 14.6% over one year for hypoglycaemic episodes, and between 0.07 and 11.8 events per 100 person‐years for hyperglycaemic episodes. Notably, our findings revealed that ongoing diabetes education and the integration of diabetes technology, such as continuous glucose monitoring and insulin pump therapy, significantly reduced the incidence of these emergencies. However, socio‐economic disparities posed barriers to accessing these technologies, subsequently shifting the cost to emergency healthcare and highlighting the need for governments to consider subsidising these technologies as part of preventative measures. Conclusions: Improving access to continuous glucose monitoring and insulin pump therapy, in combination with ongoing diabetes education focusing on symptom recognition and early management, will reduce the incidence of diabetes‐related emergencies. Concurrent research assessing emergency healthcare usage patterns during the implementation of such measures is essential to ensure these are cost‐effective. [ABSTRACT FROM AUTHOR]

Background: Communities of practice (CoPs) are frequently used in health settings to enhance knowledge and support action around public health issues. Yet, most are ineffective and often at risk of not delivering on this promise. To prevent loss of time and resources by organisations, facilitators, and members, this paper argues for a reliable assessment of the needs of people who intend to join and to set realistic expectations to assure effective communities of practice. This research proposes a valid and reliable needs assessment and analysis tool for starting communities of practice, by presenting the results of using such a tool. Methods: Inception needs assessments were developed, tested and administered to 246 respondents entering five communities of practice that focused on one of three public health issues: health literacy, mental health literacy and trauma-informed care. One community of practice had a global audience, four were based in Australia. Data from the needs assessments were analysed qualitatively and supplemented with descriptive statistics. Results were used to develop an analysis tool to support future communities of practice. Results: The short-term expectations of respondents included seeking to increase their knowledge and getting to know other members of the community of practice. Long-term expectations shifted towards undertaking action, collaborating and improving health outcomes. While respondents learning expectations included a wide range of topics, they articulated very specific knowledge they expected to share with others. There were high expectations of receiving practical support from the facilitator and a strong preference for meetings with synchronous interaction. Most respondents who planned to join focused initially on the direct and individual benefits and participation they expected from others, whereas they indicated limited intention to actively contribute to the learning needs of other community members. Respondents appeared to need to take time to build self-confidence and trust, and frequently applied a wait-and-see attitude. Conclusions: The findings of this study suggest that an inception needs assessment allows members to express their needs and expectations, which directly informs the direction and structure of a community of practice, gives voice to members, and supports facilitators in managing expectations. [ABSTRACT FROM AUTHOR]

Australian bat lyssavirus (ABLV) is a member of the Lyssavirus genus of the Rhabdoviridae family and is found in Australian bat species. It is of public health concern because of the rabies‐like syndrome it causes in humans, resulting in government health and wildlife agencies using varied communication approaches to inform targeted audiences about zoonotic risks associated with handling bats. Despite these warnings, the number of reports of human‐bat interactions remains high. This paper details a survey conducted to analyse the approaches utilised by a range of stakeholders to educate and communicate warnings to their target audiences. The survey focused on identifying the target audiences, communication methods used, along with the message frequency, content, and perceived effectiveness. Analysis of the top three messages delivered by stakeholders revealed that over half were information‐focused messages and over a third, instruction‐focused. Stakeholders identified the need to balance messaging about bat handling risks with information regarding the vulnerable status of bats and their environmental significance. Whilst the most common and (perceived) effective method of communication was one‐on‐one discussions, it was also identified to be ineffective for targeting mass audiences leading stakeholders to recognise the need to adapt to more efficient means of communication. The outcomes of this study may be useful to improve risk communication strategies regarding ABLV in Australia. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe nurses' and midwives' experiences following the first phase of the implementation of an electronic medical record (EMR) system at a large public health service in metropolitan Melbourne, Australia. Methods: Four focus groups were held 8–10 months after implementation of the EMR. Transcripts were analysed using thematic analysis. Results: Of 39 participants, 25 were nurses (64%), 12 were midwives (31%) and two did not provide this information. The mean (±s.d.) duration of clinical experience was 15.6 ± 12.2 years (range 2–40 years). Three main themes were identified: (1) effects on workflow: although some participants reported that EMR facilitated easier access to real-time patient data, others indicated that workflow was disrupted by the EMR being slow and difficult to navigate, system outages and lack of interoperability between the EMR and other systems; (2) effects on patient care and communication: some participants reported that the EMR improved their communication with patients and reduced medication errors, whereas others reported a negative effect on patient care and communication; and (3) negative effects of the EMR on nurses' and midwives' personal well-being, including frustration, stress and exhaustion. These experiences were often reported in the context of cognitive workload due to having to use multiple systems simultaneously or extra work associated with EMR outages. Conclusion: Nurses' and midwives' experiences of the EMR were complex and mixed. Nurses and midwives require significant training and ongoing technical support in the first 12 months after implementation of an EMR system. Including nurses and midwives in the design and refinement of the EMR will ensure that the EMR aligns with their workflow. What is known about the topic?: Studies reporting nurses' and midwives' experiences of using EMR are scarce and mostly based in countries where whole-of-service implementations are carried out, funded by governments. What does this paper add?: Nurses and midwives perceive benefits of using an EMR relatively soon after implementation in terms of their workflow and patient care. However, in the first year after EMR implementation, nurses and midwives experience some negative effects on workflow, patient care and their own well-being. The effects on clinical workflow are further compounded by EMR downtime (scheduled and unscheduled) and hybrid systems that require users to access other technology systems alongside the EMR. What are the implications for practitioners?: In countries like Australia, whole-of-service, simultaneous implementation of EMR systems using best-available server technology may not be possible due to funding constraints. In these circumstances, nurses and midwives may initially experience increased workload and frustration. Ongoing training and technical support should be provided to nurses and midwives for several months following implementation. Including nurses and midwives in the design of the EMR will result in better alignment with their specific workflow, thus maximising benefits of EMR implementation. [ABSTRACT FROM AUTHOR]

The views expressed here are based on my professional experience as a consultant obstetrician, and previous role as clinical head of service for a small (<1800 births/year) obstetric unit in Perth metro. The obstetric unit in which I work has no 24/7 on‐site staffed theatre capacity, no high dependency unit, and at night is staffed by a resident medical officer and junior obstetric registrar, with a consultant on‐call within 30 min travel time. Based on my review of the literature on obstetric services nationally and various state guidelines (see Sources section), other Australian metro‐located obstetric services appear to have similar challenges, but in this paper I focus on the health service models and patient safety systems that I am most familiar with (Perth metro) and ask why obstetric services in this, and by inference, other areas of the country which have similar high population density, would continue to have these staffing/service profiles. [ABSTRACT FROM AUTHOR]

Australia was a world leader in managing the earlier waves of the COVID‐19 pandemic. Subsequently, three major turning points changed the trajectory of the pandemic: mass vaccinations, emergence of more transmissible variants and re‐opening of Australia's borders. However, there were also concomitant missteps and premature shifts in pandemic response policy that led to mixed messaging, slow initial vaccination uptake and minimal mitigation measures in response to the Omicron variant. The latter marked Australia's entry into a new phase of (or approach to) the pandemic: widespread transmission. This led to an exponential increase in cases and significant impacts on the health system, particularly, EDs. This paper reflects on this phase of the pandemic to urge for system‐level changes that instal better safeguards for ED capacity, safety and staff well‐being for future pandemics. This is essential to strengthening our health system's resilience and to better protecting our communities against such emergencies. [ABSTRACT FROM AUTHOR]

The phenomenon and implications of stigma have been recognized across many contexts and in relation to many discrete issues or conditions. The notion of spatial stigma has been developed within stigma literature, although the importance and relevance of spatial stigma for rural places and rural people have been largely neglected. This is the case even within fields of inquiry like public and rural health, which are expansively tasked with addressing the socio-structural drivers of health inequalities. In this paper, we argue that developing a better understanding of rural place stigma is critical for addressing contemporary patterns of spatial injustice and health inequalities affecting rural communities globally. Drawing on international literature and examples from the reported experiences of rurally living Australians and news and other media, we present an analysis highlighting the power in rural place stigma. In doing so, we build a case for the relevance and importance of interrogating rural place stigma, especially in the fields of public and rural health, for changing the conditions within—and the broader positioning of—the rural in the public and political landscapes. [ABSTRACT FROM AUTHOR]

This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking; it uncritically accepts evidence of harms from e‐cigarettes while adopting a highly sceptical attitude towards evidence of their benefits; it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal; and it understates the evidence of the benefits of e‐cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e‐cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body. [ABSTRACT FROM AUTHOR]

Objectives: As mental health services move towards implementing 'Trauma-informed care', there is a need to consider the challenges posed within services and systems. This paper raises some of the challenges associated with integrating TIC into the current public mental health system.. Conclusion: The lack of clarity about expectations of trauma-informed approaches causes difficulties for its integration into services, but the wider political context of mental health services is also of relevance. Transparent and ongoing debate is required about approaches to mental health care, to ensure the system meets the needs of those who require it, while questioning what other purposes it may be serving at social and political levels. [ABSTRACT FROM AUTHOR]

Background: Achieving system-level, sustainable 'scale-up' of interventions is the epitome of successful translation of evidence-based approaches in population health. In physical activity promotion, few evidence-based interventions reach implementation at scale or become embedded within systems for sustainable health impact. This is despite the vast published literature describing efficacy studies of small-scale physical activity interventions. Research into physical activity scale-up (through case-study analysis; evaluations of scale-up processes in implementation trials; and mapping the processes, strategies, and principles for scale-up) has identified barriers and facilitators to intervention expansion. Many interventions are implemented at scale by governments but have not been evaluated or have unpublished evaluation information. Further, few public health interventions have evaluations that reveal the costs and benefits of scaled-up implementation. This lack of economic information introduces an additional element of risk for decision makers when deciding which physical activity interventions should be supported with scarce funding resources. Decision-makers face many other challenges when scaling interventions which do not relate to formal research trials of scale-up; Methods: To explore these issues, a multidisciplinary two-day workshop involving experts in physical activity scale-up was convened by the University of Newcastle, Australia, and the University of Ottawa, Canada (February 2019); Results: In this paper we discuss some of the scale-up tensions (challenges and conflicts) and paradoxes (things that are contrary to expectations) that emerged from this workshop in the context of the current literature and our own experiences in this field. We frame scale-up tensions according to epistemology, methodology, time, and partnerships; and paradoxes as 'reach without scale', 'planned serendipity' and 'simple complexity'. We reflect on the implications of these scale-up tensions and paradoxes, providing considerations for future scale-up research and practice moving forward; Conclusions: In this paper, we delve deeper into stakeholders' assumptions, processes and expectations of scaling up, and challenge in what ways as stakeholders, we all contribute to desired or undesired outcomes. Through a lens of 'tensions' and 'paradoxes', we make an original contribution to the scale-up literature that might influence current perspectives of scaling-up, provide future approaches for physical activity promotion, and contribute to understanding of dynamic of research-practice partnerships.

Based on the latest coronavirus corpus of the English corpus collection list (English-corpora), this paper aims to do the data mining of the China-related reports reported by the media of the United States, Canada, Britain, and Australia in public health emergencies. It tries to analyze how the English world media construct China's national image on the basis of the theory of evidentiality. It is found that the national media in the English world media report on China's national image show a dynamic process of "concern-worry-stigmatization-dumping." The western media made the construction of China's national image by subjective reports, objective but negative media discourse, and "double standards.", Competing Interests: The author declares that there are no conflicts of interest regarding the present study., (Copyright © 2022 Dian Zhang.)

Violence and abuse against people with intellectual disabilities are internationally recognised as a pervasive social problem. Recent years have seen the development and implementation of preventative strategies, yet only few of them have been rigorously evaluated. The present paper aims to identify preventative abuse strategies for people with intellectual disabilities and explore the evidence about their quality and effectiveness. A scoping review method was implemented, and a comprehensive search of 14 online databases identified six peer-reviewed articles, published between January 2007 and June 2019, that reported on evaluation of violence prevention strategies designed for adults with intellectual disabilities. Each program and its evaluation were critically and systematically reviewed. Overall, the analysis reveals the strategies' core elements, and highlights strengths and gaps in delivery and evaluation. More rigorous evaluation is required to establish the effectiveness of violence prevention strategies and to advance evidence-based practice in this field. IMPLICATIONS The social work profession has a critical role in the development, implementation, and evaluation of violence prevention strategies for adults with intellectual disabilities. Design of violence prevention strategies needs to be multifaceted, and embedded within the social and cultural environments of people with intellectual disabilities. Violence prevention strategies need to evolve from focusing solely on risk reduction to a broader approach encompassing the safety of adults with intellectual disabilities as part of their human rights. [ABSTRACT FROM AUTHOR]

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Purpose: The Australian prisoner population has experienced a dramatic increase in the number of older inmates over the past decade, consistent with the greying of the prisoner population that is being observed worldwide. Reviews suggest the need for further evidence and practice outside of the USA. This paper aims to review and discuss the cost and social implications of the rising health-care needs of this population in Australia. Design/methodology/approach: A review of international research and policies is presented, as well as the results of basic economic modelling relating to the expected rise in health-care costs of the ageing prisoner population in Australia. Findings: Taking into consideration the continued rise in incarceration rates, the calculations show that the health costs of prisoners could increase by anywhere between 17% and 90% depending on whether the increase of older prisoners continues as it has in the past decade. These trends are likely to continue over the next decade and will result in higher health costs of prisons under a number of different imprisonment scenarios. Policy responses in Australia have been slow so far, with most initiatives being undertaken in the USA with promising results. Practical implications: The authors suggest that in the absence of a coordinated policy response, covering a range of interventions, costs will continue to increase, particularly as this population continues to age more rapidly than the general population due to an accumulation of risk factors. Well-conceived interventions would be a worthwhile investment from both financial and social perspectives. Originality/value: To the best of the authors' knowledge, this is the first commentary to acknowledge this rising public health issue and to both review and model its implications for the future. [ABSTRACT FROM AUTHOR]

This paper asks what the regulatory assessment of the novel processed meat analogue products reveals about the nature of food regulation in Australia. We analyse Food Standards Australia and New Zealand's ('FSANZ') assessment of the recent application by Californian technology company Impossible Foods Inc to sell its proprietary burger products which contain a genetically modified protein that is said to make their burger 'bleed'. We show that FSANZ's assessment process has little capacity to engage with broader and longer term, social, ecological and public health implications of novel foods and changing food markets. FSANZ's regulatory pre-approval process focuses almost exclusively on the safety of individual ingredients rather than the impact of novel foods on the food supply as whole and leaves broader issues to the market and consumer choice with limited support from laws addressing misleading labelling and marketing of foods. Extending the capacity of Australia's regulatory regime for food to deal with more than the safety of individual ingredients will become more urgent as other novel foods, such as cell-based meats, enter the marketplace. [ABSTRACT FROM AUTHOR]

Surveillance of people's health takes on an important meaning in the practice of public health because it allows monitoring of diseases and prompt response to change in proportions and rates at which diseases occur in populations. Improving health of populations requires establishment of an effective public health system. Population level data and analysis is critically important in government policy and program development and monitoring. Lack of or inadequate information about the health of populations leads to ineffective policies that may often attenuate health problems instead of solving them. Australia's current oral health surveillance is mostly through ad hoc sentinel surveys, which lack recency in time. This position paper is to present the need for real-time oral health surveillance in Australia, which can be used to inform health decision-making in a timely manner.

Background: One important way to transform food systems for human and planetary health would be to reduce the production and consumption of animals for food. The over-production and over-consumption of meat and dairy products is resource-intensive, energy-dense and creates public health and food equity risks, including the creation of superbugs and antimicrobial resistance, contamination and pollution of land and waterways, and injustice to animals and humans who work in the sector. Yet the continuing and expanding use of animals is entrenched in food systems. One policy response frequently suggested by parties from all sectors (industry, government and civil society) is voluntary or mandatory labelling reforms to educate consumers about the healthiness and sustainability of food products, and thus reduce demand. This paper evaluates the pitfalls and potentials of labelling as an incremental regulatory governance stepping-stone to transformative food system change., Methods: We use empirical data from a study of the regulatory politics of animal welfare and environmental claims on Australian products together with an ecological regulation conceptual approach to critically evaluate the potential of labelling as a regulatory mechanism., Results: We show that labelling is generally ineffective as a pathway to transformative food system change for three reasons: it does not do enough to redistribute power away from dominant actors to those harmed by the food system; it is vulnerable to greenwashing and reductionism; and it leads to market segmentation rather than collective political action., Conclusion: We suggest the need for regulatory governance that is ecological by design. Labelling can only be effective when connected to a broader suite of measures to reduce overall production and consumption of meat. We conclude with some recommendations as to how public health advocates and policy entrepreneurs might strategically use and contest labelling and certification schemes to build support for transformative food system change and to avoid the regressive consequences of labelling., (© 2021 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

INTRODUCTION Mounting evidence suggests that electronic cigarettes (e-cigarettes) are extensively promoted and marketed using social media, including through user-generated content and social media influencers. This study explores how e-cigarettes are being promoted on Instagram, using a case-study approach, and the extent to which Meta's Restricted Goods and Services Policy (Meta's policy) is being applied and enforced. METHODS We identified the accounts followed by an Australian Instagram influencer who primarily posts e-cigarette-related content. The main foci of these 855 accounts were coded and 369 vaping-focused accounts were identified. These vaping-focused accounts were then further coded by two trained coders. RESULTS All (n=369; 100.0%) of the vape content posted by these accounts was positive in sentiment. One-third of the vape accounts (n=127; 34.4%) had a shared focus, indicating that vape content may permeate into other online communities through shared interests. A total of 64 accounts (17.3%) potentially violated Meta's policy by attempting to purchase, sell, raffle or gift e-cigarette products. CONCLUSIONS The findings of this study suggest that pro-vaping information is available and accessible on Instagram. Much of the content identified in this study promoted the purchase or gifting of e-cigarette products and potentially violates Meta's policy. Greater regulation and/or stronger enforcement of e-cigarette content on social media platforms such as Instagram is necessary to prevent the ongoing promotion of these harmful products. [ABSTRACT FROM AUTHOR]

Popular commercial meal kit subscription services (MKSSs) may support families to overcome barriers to cooking and eating at home, and facilitate improved vegetable consumption. The global meal kit market has expanded rapidly creating a gap in our understanding of the health-promoting potential of MKSSs. This paper describes the contemporary MKSS market in Australia and provides a vegetable-specific content analysis of a sample of recipes. A 1-week subscription was purchased for all Australian-based MKSSs (n  = 9) and websites were systematically reviewed to document key characteristics and recipe features. Vegetable content of all available recipes within a 1-week period were analysed. Our findings highlight the rapid expansion and evolution of MKSS market offerings over the past decade and their potential to support family vegetable consumption. Across all analysed recipes (n  = 179), MKSSs provided a median of 2.5 vegetable serves per person (range 0.7–7.5 serves) and a median of 3 different types of vegetables from 2 vegetable subgroups (i.e. dark green, red and orange, starchy, legumes and all other vegetables). This suggests that MKSSs may support family vegetable consumption if families select recipes with a greater number and variety of vegetables. However, an opportunity remains for MKSSs to improve both vegetable quantity and variety to positively influence population health. Further research is required to describe how families use meal kits promoting a greater understanding of their potential to improve family nutrition. [ABSTRACT FROM AUTHOR]