Objective: Serious mental illness (SMI) remains a leading cause of disability worldwide. However, there is limited Australian evidence of community-based programs to enhance the psychosocial wellbeing of adults experiencing SMI. Foundations is a long-term community-based psychosocial outreach support program delivered in Tasmania, Australia. A longitudinal non-randomised controlled trial was conducted to examine the effectiveness of the Foundations program on adults\' psychosocial functioning, clinical symptomology, and hospital readmissions, in comparison to standard care only. Method: Participants were adults aged 18-64 years experiencing SMI. Control participants received standard clinical care only. Intervention participants were engaged in the Foundations program in addition to standard care. Data were collected at program commencement, midpoint, closure, and six-months post-closure. Linear mixed modelling was used to examine differences between groups. Results: Intervention participants achieved better psychosocial functioning in comparison to the control group by program closure and at six-month follow-up. No significant differences were observed for clinical mental health symptomology or hospital readmission rates. Length of readmission stay was significantly shorter for intervention participants. Conclusions: The findings highlight the additional value of community-based, recovery-oriented, psychosocial outreach support alongside clinical mental health care to enhance the psychosocial wellbeing of adults experiencing SMI.

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Three models/methods are given to understand the extreme international variation in available and occupied hospital bed numbers. These models/methods all rely on readily available data. In the first, occupied beds (rather than available beds) are used to measure the expressed demand for hospital beds. The expressed occupied bed demand for three countries was in the order Australia > England > USA. Next, the age-standardized mortality rate (ASMR) has dual functions. Less developed countries/regions have low access to healthcare, which results in high ASMR, or a negative slope between ASMR versus available/occupied beds. In the more developed countries, high ASMR can also be used to measure the \'need\' for healthcare (including occupied beds), a positive slope among various social (wealth/lifestyle) groups, which will include Indigenous peoples. In England, a 100-unit increase in ASMR (European Standard population) leads to a 15.3-30.7 (feasible range) unit increase in occupied beds per 1000 deaths. Higher ASMR shows why the Australian states of the Northern Territory and Tasmania have an intrinsic higher bed demand. The USA has a high relative ASMR (for a developed/wealthy country) because healthcare is not universal in the widest sense. Lastly, a method for benchmarking the whole hospital\'s average bed occupancy which enables them to run at optimum efficiency and safety. English hospitals operate at highly disruptive and unsafe levels of bed occupancy, manifesting as high \'turn-away\'. Turn-away implies bed unavailability for the next arriving patient. In the case of occupied beds, the slope of the relationship between occupied beds per 1000 deaths and deaths per 1000 population shows a power law function. Scatter around the trend line arising from year-to-year fluctuations in occupied beds per 1000 deaths, ASMR, deaths per 1000 population, changes in the number of persons hidden in the elective, outpatient and diagnostic waiting lists, and local area variation in births affecting maternity, neonatal, and pediatric bed demand. Additional variation will arise from differences in the level of local funding for social care, especially elderly care. The problems associated with crafting effective bed planning are illustrated using the English NHS as an example.

The surge in wildlife-vehicle collision research has not yet translated into a substantial decrease in animal fatalities. In line with the prevailing view, we suspect that drivers\' behaviour may be the most crucial element. We address a research gap in drivers\' attitudes towards and behaviour in response to wildlife-vehicle collisions from a tourist perspective. We designed a questionnaire to examine tourists\' attitudes and behaviour in relation to wildlife-vehicle collisions while driving in Tasmania. We found that the respondents\' sociodemographic attributes had minimal effect on their practical responses to roadkill. Tourists consider wildlife-vehicle collisions a serious problem for both biodiversity loss and animal welfare reasons, and their willingness to change their behaviour was high. However, many respondents did not stop to check for surviving pouch young. This inaction resulted either from overlooking the importance of pouch checking or a lack of knowledge on what action needed to be taken. There may also be a lack of understanding that roadkill left on the road leads to secondary roadkill incidents. Even though tourist behaviour does not automatically represent residents\' behaviour, these findings will help to improve and tailor educational approaches to rectify the driver awareness/behaviour gap for both tourists and residents.

Terrestrially breeding marine predators have experienced shifts in species distribution, prey availability, breeding phenology, and population dynamics due to climate change worldwide. These central-place foragers are restricted within proximity of their breeding colonies during the breeding season, making them highly susceptible to any changes in both marine and terrestrial environments. While ecologists have developed risk assessments to evaluate climate risk in various contexts, these often overlook critical breeding biology data. To address this knowledge gap, we developed a trait-based risk assessment framework, focusing on the breeding season and applying it to marine predators breeding in parts of Australian territory and Antarctica. Our objectives were to quantify climate change risk, identify specific threats, and establish an adaptable assessment framework. The assessment considered 25 criteria related to three risk components: vulnerability, exposure, and hazard, while accounting for uncertainty. We employed a scoring system that integrated a systematic literature review and expert elicitation for the hazard criteria. Monte Carlo sensitivity analysis was conducted to identify key factors contributing to overall risk. We identified shy albatross (Thalassarche cauta), southern rockhopper penguins (Eudyptes chrysocome), Australian fur seals (Arctocephalus pusillus doriferus), and Australian sea lions (Neophoca cinerea) with high climate urgency. Species breeding in lower latitudes, as well as certain eared seal, albatross, and penguin species, were particularly at risk. Hazard and exposure explained the most variation in relative risk, outweighing vulnerability. Key climate hazards affecting most species include extreme weather events, changes in habitat suitability, and prey availability. We emphasise the need for further research, focusing on at-risk species, and filling knowledge gaps (less-studied hazards, and/or species) to provide a more accurate and robust climate change risk assessment. Our findings offer valuable insights for conservation efforts, given that monitoring and implementing climate adaptation strategies for land-dependent marine predators is more feasible during their breeding season.

BACKGROUND: Greater public transport use has been linked to higher physical activity levels. However, neither the amount of physical activity associated with each daily public transport trip performed, nor the potential total physical activity gain associated with an increase in trips/day, has been determined. Using objective measures, we aimed to quantify the association between public transport use, physical activity and sedentary time.
METHODS: A longitudinal study of Australian adults living in Hobart, Tasmania, who were infrequent bus users (≥ 18 years; used bus ≤ 2 times/week). The number of bus trips performed each day was determined from objective smartcard data provided by the public transportation (bus) provider across a 36-week study timeframe. Accelerometer measured steps/day (primary outcome), moderate-to-vigorous physical activity (min/day), and sedentary time (min/day) were assessed across four separate one-week periods.
RESULTS: Among 73 participants across 1483 day-level observations, on days that public transport was used, participants achieved significantly more steps (β = 2147.48; 95%CI = 1465.94, 2829.03), moderate to vigorous physical activity (β = 22.79; 95% CI = 14.33, 31.26), and sedentary time (β = 37.00; 95% CI = 19.80, 54.21) compared to days where no public transport trips were made. The largest increase in steps per day associated with a one-trip increase was observed when the number of trips performed each day increased from zero to one (β = 1761.63; 95%CI = 821.38, 2701.87). The increase in the number of steps per day was smaller and non-significant when the number of trips performed increased from one to two (β = 596.93; 95%CI=-585.16, 1779.01), and two to three or more (β = 632.39; 95%CI=-1331.45, 2596.24) trips per day. Significant increases in sedentary time were observed when the number of trips performed increased from zero to one (β = 39.38; 95%CI = 14.38, 64.39) and one to two (β = 48.76; 95%CI = 25.39, 72.12); but not when bus trips increased from two to three or more (β=-27.81; 95%CI=-76.00, 20.37).
CONCLUSIONS: Greater public transport use was associated with higher physical activity and sedentary behaviour. Bus use may yield cumulative increases in steps that amount to 15-30% of the daily recommended physical activity target. A policy and public health focus on intersectoral action to promote public transport may yield meaningful increases in physical activity and subsequent health benefits.

Marine monitoring efforts are increasingly supported by opportunistic shipboard surveys. However, opportunistic survey methods often require adaptation to suit the vessel and the operations being conducted onboard. Whilst best-practice techniques for surveying marine wildlife on vessels of opportunity are yet to be established, testing and development of alternative methods can provide means for capturing ecological information in otherwise under-surveyed areas. Explicitly, survey methods can be improved while baseline ecological data for new regions are gathered simultaneously. Herein, we tested different survey approaches on a vessel of opportunity in a remote offshore area where little is known about the community composition of top-order marine vertebrate predators: western and south-western Tasmania, Australia. We found that continuous surveys provide greater species counts than structured \"snapshot\" surveys over the course of a voyage, but that structured surveys can be more practical when managing factors such as observer fatigue. Moreover, we provide a baseline dataset on the marine vertebrate community encountered in western and south-western Tasmania. This information will be critically important for industry and conservation management objectives, and is key to our understanding of the offshore ecosystem around Tasmania.

OBJECTIVE: To estimate the direct costs during the prenatal, delivery and postpartum periods in mothers with diabetes in pregnancy, compared to those without.
METHODS: This study used a population-based dataset from 2004 to 2017, including 57,090 people with diabetes and 114,179 people without diabetes in Tasmania, Australia. Based on diagnostic codes, delivery episodes with gestational diabetes mellitus (GDM) were identified and matched with delivery episodes without diabetes in pregnancy. A group of delivery episodes with pre-existing diabetes was identified for comparison. Hospitalisation, emergency department and pathology costs of these groups were calculated and adjusted to 2020-2021 Australian dollars.
RESULTS: There were 2774 delivery episodes with GDM, 2774 delivery episodes without diabetes and 237 delivery episodes with pre-existing diabetes identified. Across the 24-month period, the pre-existing diabetes group required the highest costs, totalling $23,536/person. This was followed by the GDM ($13,210/person), and the no diabetes group ($11,167/person). The incremental costs of GDM over the no diabetes group were $890 (95% CI 635; 1160) in the year preceding delivery; $812 (616; 1031) within the delivery period and $341 (110; 582) in the year following delivery (p < 0.05). Within the year preceding delivery, the incremental costs in the prenatal period were $803 (579; 1058) (p < 0.05). Within the year following delivery, the incremental costs in the postpartum period were $137 (55; 238) (p < 0.05).
CONCLUSIONS: Our results emphasised the importance of proper management of diabetes in pregnancy in the prenatal and postpartum periods and highlighted the significance of screening and preventative strategies for diabetes in pregnancy.

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Tasmanian eucalypt forests are among the most carbon-dense in the world, but projected climate change could destabilize this critical carbon sink. While the impact of abiotic factors on forest ecosystem carbon dynamics have received considerable attention, biotic factors such as the input of animal scat are less understood. Tasmanian devils (Sarcophilus harrisii)-an osteophageous scavenger that can ingest and solubilize nutrients locked in bone material-may subsidize plant and microbial productivity by concentrating bioavailable nutrients (e.g., nitrogen and phosphorus) in scat latrines. However, dramatic declines in devil population densities, driven by the spread of a transmissible cancer, may have underappreciated consequences for soil organic carbon (SOC) storage and forest productivity by altering nutrient cycling. Here, we fuse experimental data and modeling to quantify and predict future changes to forest productivity and SOC under various climate and scat-quality futures. We find that devil scat significantly increases concentrations of nitrogen, ammonium, phosphorus, and phosphate in the soil and shifts soil microbial communities toward those dominated by r-selected (e.g., fast-growing) phyla. Further, under expected increases in temperature and changes in precipitation, devil scat inputs are projected to increase above- and below-ground net primary productivity and microbial biomass carbon through 2100. In contrast, when devil scat is replaced by lower-quality scat (e.g., from non-osteophageous scavengers and herbivores), forest carbon pools are likely to increase more slowly, or in some cases, decline. Together, our results suggest often overlooked biotic factors will interact with climate change to drive current and future carbon pool dynamics in Tasmanian forests.