Government of New South Wales

The long-term stability of coral reef islands and associated reef top sedimentary landforms requires the delivery of sediment from the forereef, but the rates and pathways of sediment delivery to these systems remain unclear. Spurs and grooves (SAGs) are ubiquitous geomorphic features fringing coral reefs, characterised by shore-normal coral ridges (spurs) separated by channels (grooves) with either bare substrate or a relatively low sediment infill. SAGs dissipate wave energy, facilitate offshore sediment transport and enhance nutrient exchange. Here we present the first evidence that SAG can also act as channels for onshore transport of rubble during high-energy events, contributing to maintaining reef islands and rubble-based ecosystems.

ABSTRACTEffective conservation of threatened species relies on precise detection methods to inform conservation management strategies. Here, we developed a new environmental DNA (eDNA) assay to detect the endangered Booroolong frog (Litoria booroolongensis) in river water samples throughout their range in Australia. The suitability of the assay to detect Booroolong frog eDNA was first validated ex situ from a population of captive‐bred frogs at Taronga Zoo, New South Wales. We then established the detectability of Booroolong frog DNA from river water samples collected in situ. The new assay successfully detected Booroolong frog eDNA in water samples collected from the breeding enclosure, from water samples exposed to adult frogs and frog egg masses. Testing in the field confirmed the effectiveness of the assay at detecting Booroolong frog eDNA in environmental water samples collected in situ from sites with known presence of the species determined from prior nocturnal surveys. Our results demonstrate the efficacy of eDNA for detecting Booroolong frogs from river water samples across its geographic range. Ongoing monitoring utilizing eDNA has the potential to support conservation efforts by enabling more efficient and widespread surveys for this endangered species.

ABSTRACTIntroductionDue to the ongoing impact of colonisation, Aboriginal and Torres Strait Islander people live with a greater burden of cardiovascular disease (CVD) than non‐Indigenous Australians. Shared decision‐making (SDM) is recognised as an essential component of person‐centred care. However, there has been a lack of tools to support clinician communication and SDM to address CVD prevention in this important ‘at‐risk’ population.MethodsWe developed the Heart Health Yarning Tool, an online SDM resource co‐designed with Aboriginal and Torres Strait Islander people, to be implemented alongside the new Australian guidelines for primary CVD risk assessment and management. This was a three‐phase project, consisting of a stakeholder consultation and co‐design (Phase 1), concept mapping of qualitative data to an existing SDM model (Phase 2), and content development and testing (Phase 3).ResultsPhase 1 consisted of a stakeholder consultation and co‐design process, including consumer yarning workshops (n = 21), individual yarning sessions with Aboriginal and Torres Strait Islander Health Workers/Practitioners (n = 8), consumers (n = 17), and interviews with general practitioners (n = 5). Phase 2 involved a mapping process, where qualitative interview data was integrated into the conceptual framework of an existing culturally adapted SDM model, ‘Finding Your Way,’ to tailor the model to the CVD context. Phase 3 involved developing and testing content for the new tool, based on findings from Phases 1 and 2, using evidence‐based SDM formats such as question prompt lists, action planning tools and decision aids to support communication and understanding of CVD risk. This phase included user testing with consumers and health professionals (n = 10), as well as presentation of the tool to key advisory groups.ConclusionsThe Heart Health Yarning Tool supports health professionals in making shared decisions about heart health with Aboriginal and Torres Strait Islander people. It can be used as a conversation guide in primary care consultations or as a training tool for health professionals. Future research will assess whether the use of the Heart Health Yarning Tool improves health professionals' cultural and SDM competencies as well as cardiovascular outcomes in Aboriginal and Torres Strait Islander people.Patient or Public ContributionThiitu Tharrmay Aboriginal and Torres Strait Islander Reference Group is convened by Yardhura Walani at the Australian National University. Thiitu Tharrmay members are Aboriginal and Torres Strait Islander peoples who are consumers or providers of healthcare, with knowledge and/or experience with research and health policy. Thiitu Tharrmay advised on the appropriate conduct of this study, and provided comments on the research methods, including recruitment and data collection methods. Aboriginal and Torres Strait Islander researchers were involved in all stages of the project, including study design, data collection, analysis, interpretation, and writing and revising the manuscript (J.P., D.F. and M.D.). Aboriginal and Torres Strait Islander consumers were involved in the co‐design and user testing of the Heart Yarning Tool.

Myrtle rust is a plant disease caused by the invasive fungal pathogen Austropuccinia psidii (G. Winter) Beenken, which has a global host list of 480 species. It was detected in Australia in 2010 and has caused the rapid decline of native Myrtaceae species, including rainforest trees Rhodamnia rubescens (Benth.) Miq. (scrub turpentine) and Rhodomyrtus psidioides (G.Don) Benth. (native guava). Ex situ collections of these species have been established, with the goal of preserving remaining genetic variation. Analysis of reduced representation sequencing (DArTseq; n = 444 for R. rubescens and n = 301 for R. psidioides) showed genetic diversity is distributed along a latitudinal gradient across the range of each species. A panel of samples of each species (n = 27 for R. rubescens and n = 37 for R. psidioides) was resequenced at genome scale, revealing large historical effective population sizes, and little variation among individuals in inferred levels of deleterious load. In Rhodamnia rubescens, experimental assays (n = 297) identified individuals that are putatively resistant to myrtle rust. This highlights two important points: there are tangible pathways to recovery for species that are highly susceptible to rust via a genetically informed breeding programme, and there is a critical need to act quickly before more standing diversity is lost.

ObjectiveTo examine the accuracy of the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), the population‐based clinical quality registry for people with kidney failure, in identifying Aboriginal and/or Torres Strait Islander people.DesignPopulation‐based cohort study of reporting accuracy.SettingNew South Wales, 2006–2020.ParticipantsIncident kidney failure patients.Main outcome measuresSensitivity and specificity of identification of Aboriginal and/or Torres Strait Islander people in ANZDATA compared with identification with Enhanced Reporting of Aboriginality (ERA) methods using linked health datasets.ResultsOf 11 708 patients, 693 (5.9%) were identified as Aboriginal and/or Torres Strait Islander people using ERA methods, with 484 recognised in ANZDATA. Overall ANZDATA sensitivity was 67.0% (95% CI, 63.3–70.5%), with high specificity (99.8%; 95% CI, 99.7–99.9%). Sensitivity was lowest for males (63.8%; 95% CI, 58.7–68.6), people aged under 18 years (45.0%; 95% CI, 23.1–68.5%) or over 65 years (61.7%; 95% CI, 53.8–69.2%), and those with greater socio‐economic advantage (56.6%; 95% CI, 46.6–66.2%), living in major cities (53.8%; 95% CI, 48.0–59.5%) and with no comorbidities (47.7%; 95% CI, 37.0–58.6%). Aboriginal and/or Torres Strait Islander people identified in ANZDATA had lower rates of waitlisting for kidney transplantation (17.8% v 25.3%; P = 0.016) and receiving a kidney transplant (12.2% v 23.1%; P < 0.001) and a higher rate of death (56.0% v 44.5%; P = 0.004) compared with those not recognised in ANZDATA.ConclusionAboriginal and/or Torres Strait Islander people were under‐reported in ANZDATA. There were multiple biases in characteristics and outcomes for people identified in ANZDATA compared with those identified by ERA using linked data. This highlights the importance of data integration as a quality improvement mechanism and identifying barriers to disclosure.

As urbanization expands globally, human–wildlife interactions will inevitably increase. Here, we analysed 10 years of wildlife rehabilitation records of squamate (snake and lizard) reptiles (n = 37 075) from the Greater Sydney region, New South Wales, Australia, to explore their value to address management and conservation issues. Rescues were highly non-random regarding taxonomic focus, spatial occurrences and temporal trends due to the combined influence of (i) reptile phenology and behaviour and (ii) human perceptions of reptiles. Seasonal peaks in rescues reflect reptile and, to a lesser extent, human activity. Spatial patterns of rescues were informative about distributions and presence of easily identified taxa but were primarily driven by human presence. Larger squamate species were rescued more frequently, potentially reflecting a perception of greater danger or rescue priority. While uncommon species were often misidentified, accurate reports of these taxa may guide targeted surveys. The value of these data for conservation and management could be enhanced by emphasizing reptile identification training of volunteers and use of applications for informed species identification. Wildlife rehabilitation data offer a cost-effective means of quantifying thousands of human–reptile interactions, identifying foci (in both time and space) of human–wildlife conflict such as snakebite risk and roadkill-related reptile mortality.

Shared Decision Making (SDM) in healthcare is a patient-centred approach that acknowledges the importance of involving patients in healthcare decisions. SDM is gaining prominence, it often overlooks the perspectives of Indigenous populations. This abstract explores the crucial need for establishing a global foundation incorporating Indigenous health perspectives into SDM.Indigenous communities worldwide confront distinct healthcare challenges due to historical disparities, cultural disparities, and socioeconomic factors. Integrating Indigenous voices, values, and traditional knowledge into healthcare decision-making is vital for achieving equitable health outcomes. However, current healthcare systems often need to address these issues more.This initiative proposes creating a global network that collaborates with Indigenous communities, international leaders, and healthcare experts to advance Indigenous health perspectives within the SDM framework. The network’s objectives include:Promoting Cultural Competence: Understanding Indigenous cultures and traditions among healthcare providers and policymakers to integrate cultural competence into SDM.Empowering Indigenous Communities: Through capacity-building initiatives and education, Indigenous communities can actively engage in healthcare decision-making, ensuring alignment with values and preferences.Bridging Knowledge Gaps: Facilitating research and knowledge-sharing to bridge the divide between Western medical knowledge and Indigenous traditional healing practices, enabling a holistic healthcare approach.Advocating for Policy Change: Serving as a platform for advocating policy changes prioritising Indigenous health perspectives and addressing healthcare disparities.Promoting Ethical and Inclusive Practices: Centralising ethical considerations, including informed consent and respect for Indigenous data sovereignty, to uphold the rights and dignity of Indigenous populations.Establishing a global foundation for Indigenous health perspectives within SDM is crucial for fostering more inclusive and equitable healthcare systems. This represents a pivotal step toward ensuring that healthcare decisions genuinely reflect all patients‘ diverse needs and viewpoints, including Indigenous populations. It aims to enhance health outcomes and cultivate a fairer, more inclusive healthcare environment for Indigenous communities worldwide.