Background: Drowning kills thousands of young children in Bangladesh every year. To address this, the Government of Bangladesh launched the Integrated Community-Based Centre for Child Care, Protection and Swim-Safe Facilities (ICBC) Project (2022–2025), combining centre-based childcare for children aged 1–5 years with survival swimming training for those aged 6–10 years across 45 upazilas in 16 districts.
Objectives: To assess implementation fidelity, service quality, governance performance, and readiness for national scale-up of the ICBC model.
Methods: A mixed-methods process evaluation was conducted across all 16 districts through structured observations in 402 Child Care Centres (CCCs) and 81 Swim-Safe Centres, complemented by 13 key informant interviews, 28 in-depth interviews, and 9 focus group discussions, triangulated with routine programme monitoring data.
Results: Nearly all CCCs (96%) were operational, serving 9,594 children with roughly equal gender distribution, though average attendance was 68%. While 88% of caregivers completed foundational training, only 14% of centres had working first aid kits and 13% met basic space requirements. At Swim-Safe Centres, 18,178 children enrolled and 56% completed full training. Fencing compliance was strong at 85%, but nearly half of centres lacked adequate flotation devices. Governance committees were established but inconsistent in practice.
Conclusions: The ICBC model demonstrates that combining early childhood care with drowning prevention is both feasible and community-accepted. Closing infrastructure gaps, strengthening workforce capacity, upgrading monitoring systems, and building consistent local governance are essential for sustainable scale-up. Embedding this model within national early childhood development and injury prevention policies offers a practical pathway to reducing preventable child deaths in Bangladesh.

Introduction
LGBTQA+ individuals often experience discrimination and exclusion, which impacts their health. This may be especially true for those living in regional areas, where social and environmental systems can limit access to inclusive physical activity (PA) and active recreation opportunities. Therefore, this study explored experiences and factors influencing PA and active recreation engagement among LGBTQA+ adults living in regional Victoria.
Methods
Using a citizen science methodology, this study involved LGBTQA+ adults from the City of Greater Bendigo, Victoria, in partnership with local government and a national not-for-profit LGBTQA+ organisation. Participants used mobile phones to capture and caption environmental aspects influencing PA and active recreation. This was followed by Ripple Effect Mapping (REM) discussions to identify priorities, solutions, and messages for the local council. A visual map was created at the end of the session. Data were analysed using a deductive–inductive thematic analysis guided by the socio-ecological model.
Results
Nine participants contributed 44 photographs with captions. Most barriers (e.g., gendered sports) and facilitators (e.g., well-maintained parks) were identified at the environmental and organisational/policy levels. REM findings identified organisational/policy barriers, including gendered sports and spaces, limited institutional support, and socio-political influences. Social and organisational/policy barriers, particularly safety concerns from witnessing discrimination, were also identified. These findings informed priorities to address gendered culture and highlighted solutions, including gender-neutral, non-competitive PA opportunities and inclusive training for coaches and staff supported by local government.
Conclusion
This is one of the few studies to actively involve LGBTQA+ members in understanding PA experiences. By prioritising lived experience, findings highlighted multilevel systemic barriers, including limited support, discrimination, and exclusionary spaces. Participants also emphasised the need for stronger local government support and cultural change. This will require systems change at the policy level and beyond, including implementing gender-neutral spaces and inclusive training for sports club staff and coaches.

The World Health Organization’s Age-friendly Cities Framework advocates for inclusive built environments to support a rapidly ageing global population. The framework identifies social connectedness as a key characteristic of age-inclusive living environments. This research explores the relationship between older people’s experiences of social connectedness and the design of age-inclusive neighbourhoods in Tasmania, Australia. Tasmania has the highest rate of ageing among all Australian states and territories, making it a relevant case study. Empirical data were collected from participants aged 65 years and over (n=17) using the novel visual-based research method of self-directed photography. The study was conducted in the City of Clarence, Hobart, Tasmania between March and July 2025. Data were analysed using thematic analysis, with affordance theory employed as the theoretical framework. Four key themes emerged that influence both the motivation for social interaction and the quality of such social experiences among older people, namely, (i) Accessibility (physical, social, and cognitive), (ii) Safety (objective and perceived), (iii) Novelty of experiences, and (iv) Belongingness in place. The findings highlight how older people experience and use their local neighbourhoods, the motivations and opportunities for social interaction in daily life, and how the design of built environment elements may facilitate or hinder social connectedness in later life. By foregrounding older people’s lived and visualised experiences of neighbourhood affordances, this study provides empirically grounded insights to inform age‑inclusive urban design and neighbourhood planning aimed at fostering social connectedness in later life.

Background: Grocery retailers across the world commonly implement nutrition-related initiatives or actions. However, many of these fail to address major drivers of purchasing behaviour or consider equity impacts. This study takes a global perspective to examine major global retailers’ voluntary actions, the potential impact of these actions and identify where government intervention is needed to support healthier and more equitable diets.
Methods: An umbrella review of recommended actions to improve the health and equity of grocery retail food environments informed data collection. Based on this, a matrix of potential nutrition and equity-related retailer actions was constructed, with nutrition related actions categorised by marketing mix components (product, price, place, promotion). Using Euromonitor Passport, the top five grocery retail brands (by 2025 market share) in seven global regions were identified. Each brand’s website and company annual reports were searched for voluntary nutrition and equity-related actions taken in the past five years. Identified actions were mapped against the matrix. Where actions did not align with existing matrix categories, new categories were created. The potential public health impact of retailer actions was subsequently assessed using a novel multi-factor framework.
Results: Retailers varied greatly in the number and range of voluntary actions taken. Few retailers implemented actions addressing high-impact areas, including the relative price of healthy and unhealthy foods and product placement at key sites in-store, such as end-of-aisles. Equity actions generally related to workforce participation and rarely focused on customers.
Conclusion: Few major global grocery retailers are taking significant voluntary action to create healthy and equitable retail food environments. Areas of action with significant public health potential are rarely addressed. With limited voluntary action in this area, mandated government action is likely to be warranted.

Background: Remote stores have direct impact on the availability, quality, pricing and promotion of food and beverages, thus influencing food purchase and consumption and  health outcomes of remote Aboriginal and Torres Strait Islander communities. Structured benchmarking tools (e.g., Healthy Stores 2020 (HS2020) Policy Action Series) offer systematic approaches to assessing and improving store food environments.

Aim: Implement the HS2020 Policy Actions in Community Enterprise Queensland (CEQ) stores, explore implementation determinants and measure changes in store healthiness.

Methodology: A research partnership was formed with CEQ, a not-for-profit operating in remote community stores across Queensland. Over 18-months HS2020 strategies that redesigned store environments were implemented across 21 CEQ remote stores. Data were collected through 1) appraisal of CEQ Nutrition Polices against the HS2020 Policy Actions using a Policy Action Progress Audit tool, 2) Store Scout Assessment and Action Planning with participating stores at baseline and 6 monthly follow ups to assess store healthiness, and 3) interviews with 36 CEQ team members to determine implementation factors.

Findings: Store healthiness scores increased by 11% (p<0.05) over 18 months. Compliance with HS2020 Policy Actions improved across CEQ stores, supported by the introduction of a revised CEQ Nutrition and Health policy. These improvements were further enabled by leadership commitment, a dedicated CEQ nutrition workforce, and a flexible, gradual implementation approach responsive to the remote retail context. CEQ team members reported high levels of satisfaction and acceptability were reported, identifying whole-of-organisation commitment and an evidence-based, fit-for-setting model as key facilitators.

Conclusion: This project demonstrated the effectiveness of the HS2020 Policy Action Series in improving remote store environments over 18 months. Implementation factors may inform future strategies in embedding evidence-based policy actions in remote retail settings for community health.

Background: Wastewater surveillance can complement clinical testing by monitoring pathogen and health signals from whole communities. Its value for outbreak and pandemic preparedness depends on whether these signals are interpreted, linked to public health systems and used for action. This review aimed to map and synthesise evidence on wastewater surveillance systems in Australasia and the Pacific, and assess their contribution to public health response and preparedness.
Methods: We conducted a PROSPERO-registered, PRISMA-informed systematic evidence mapping review (CRD420251151052). Searches were conducted in PubMed, Scopus, Web of Science, Embase/Ovid, EBSCO databases, Google Scholar and targeted grey literature sources. Eligible records reported regional wastewater, sewage or related environmental surveillance evidence with public health relevance. After duplicate removal, 3,239 records were screened. Data were analysed using descriptive counts, percentages and cross-tabulations.
Results: Fifty-two articles published from 1995 to 2026 were included. Evidence was concentrated in Australia (31/52, 59.6%) and in studies using centralised wastewater treatment plants or sewer networks (36/52, 69.2%), with limited direct evidence from Pacific Island Countries and Territories (3/52, 5.8%). Enteric pathogens/faecal indicators (25/52, 48.1%) and SARS-CoV-2/COVID-19 (15/52, 28.8%) dominated, although post-2024 studies included broader respiratory, zoonotic, multi-pathogen and biomarker applications. Molecular methods were common (41/52, 78.8%), indicating strong detection capacity. However, evidence for outbreak detection and response was more limited: 42 studies (80.8%) linked wastewater findings with clinical, epidemiological or public health data, but 32 studies (61.5%) did not assess agreement with these data. Only eight studies (15.4%) showed or reported an early-warning role, and 15 studies (28.8%) directly reported or informed response action.
Conclusion: Wastewater surveillance in the region is well developed for detection and increasingly relevant to preparedness, but its use in decision-making remains limited. Future systems should prioritise fit-for-context models for Pacific, rural, remote and decentralised settings, with stronger data comparison, governance, reporting standards and response pathways.

Abstract
Background: Psychiatric nurses are exposed to high levels of occupational stress, increasing their risk of burnout and compassion fatigue. Psychological resilience has emerged as a critical factor in promoting wellbeing and sustaining professional quality of life among nurses. However, limited evidence exists within the Saudi Arabian context.
Aim: This study aimed to examine the relationship between psychological resilience and professional quality of life among psychiatric nurses in Saudi Arabia.
Methods: A cross-sectional design was conducted among 167 psychiatric nurses working in a major mental health hospital in Riyadh. Data were collected using the Connor–Davidson Resilience Scale (CD-RISC) and the Professional Quality of Life Scale (ProQOL-5). Statistical analyses included Pearson correlation and linear regression to explore associations between resilience, compassion satisfaction, burnout, and compassion fatigue.
Results: Nurses demonstrated moderate levels of resilience (mean = 70.72) and professional quality of life. Resilience showed a significant positive correlation with compassion satisfaction (r = 0.594) and a negative correlation with burnout (r = −0.362). Burnout was positively associated with compassion fatigue (r = 0.580). Regression analysis confirmed that resilience significantly predicted higher compassion satisfaction (β = 0.536, p < 0.001).
Conclusion: Psychological resilience plays a crucial role in enhancing nurses’ professional quality of life and mitigating burnout. Strengthening resilience through targeted interventions can improve nurse wellbeing and support sustainable, high-quality patient care. These findings align with global priorities to build resilient healthcare systems and workforce capacity.

The challenge: Queensland is the skin cancer capital of the world, yet school sun safety efforts have traditionally focused on individual behaviour change rather than the systems shaping daily choices. The Sun Safety Partnership Initiative (SSPI) responds by shifting responsibility upstream, redesigning policies, environments, and routines so sun protection is normalised, supported, and sustained across the education system, rather than relying on individual schools or champions.
The evidence: High ultraviolet exposure during childhood and adolescence significantly increases lifetime skin cancer risk. Schools are critical prevention settings, yet system-level gaps mean the sun-safe choice is often the harder choice. School-by-school approaches are difficult to scale and sustain and can exacerbate gaps particularly identified in secondary schools and rural and remote settings.
Real-world action: SSPI is a five-year Queensland Health funded initiative that brings together health, education, and sector partners through formal governance structures and working groups. This partnership model supports shared ownership and coordinated decision-making to enable system-level change that no single organisation could achieve alone.
SSPI prioritises scalable system levers, including policy, procurement, shade infrastructure, curriculum, youth leadership, equity, and communications, to embed sun safety into existing education systems and ensure equitable access to protective environments, regardless of location or school resources. An implementation science approach and the WHO Health Promoting Schools Framework underpins its success in achieving real-world changes.
Learning objectives and outcomes: Using SSPI as a case study, attendees will develop an understanding of the impact and importance of a multi-partner approach to creating systems-based action for health promotion, particularly in school settings.
Contribution to policy, practice, and system-level changes: While systems thinking is well described in theory, few practical examples exist in school sun safety. Through cross-sector partnerships, SSPI will identify, test, and embed high impact system-level actions, offering a transferable model for other school-based prevention priorities.

Urban tree canopy (TC) provides multiple physical and mental health benefits. However, these benefits are often unequally distributed, raising concerns about environmental injustice. Socio-economic status (SES) is a frequently studied determinant of health, and unequal distribution of TC may further reinforce existing health-related disadvantage among socio-economically disadvantaged populations by limiting their access to TC and related benefits. Although previous Australian research has examined the relationship between TC and SES, few studies have investigated fine-scale spatial correlation. Our research addressed this gap by examining TC-SES spatial autocorrelation at the Statistical Area 1 level (SA1) in Sydney, mapping neighbourhoods where socio-economic disadvantage and limited TC coincide.

We integrated the Index of Relative Socio-Economic Disadvantage with high-resolution TC data at the SA1 level. Bivariate Moran’s I analysis was employed to examine spatial autocorrelation between TC and SES. We identified significant TC-SES spatial correlation (Moran’s I = 0.354, p < 0.001). In addition, High-High clusters, where high SES co-occurred with high TC, were concentrated along the northern and eastern coastal corridor. In contrast, Low-Low clusters, where low SES co-occurred with limited TC, extended across western and south-western Sydney. Our results revealed a spatially heterogeneous pattern of environmental injustice across Sydney.

Sydney has set a target to increase TC to 40% by 2036; however, universal TC targets may increase total canopy cover while leaving spatial inequalities unchanged. Our findings highlight that unequal TC distribution is not only an environmental planning issue, but also a public health concern related to social and environmental determinants of health. Planning and policy should prioritise targeted TC investment in socio-economically disadvantaged neighbourhoods, particularly Low-Low cluster areas, to improve equitable access to the health and wellbeing benefits of urban trees and support sustainable urban planning.

Keywords: Environmental injustice; Tree canopy; Socio-economic disparities; Determinants of health; Sydney.