Context/Aim:
Understanding the charitable food sector's landscape is crucial for public health planning and promoting community well-being. Demand for food relief is growing at an unprecedented rate following the COVID-19 pandemic and subsequent cost of living crisis. Yet, the availability of food relief is poorly understood as many food provision activities are not registered with Local Government (LG) Authorities and are undertaken on an ad hoc basis. This project focuses on mapping the charitable food sector in 13 LG areas in metropolitan Perth.

Methods and research findings:
A dynamic map of the charitable food landscape will be created. This map will display the locations and geospatial metrics of provision and access to charitable food outlets across the 13 local government areas in the East Metropolitan Health Service region, classified by three subcategories: (1) Emergency Food Provision – groceries, (2) Emergency Food Provision – meals, and (3) Meal Preparation and Delivery. Charitable food will be identified using LG registered food business data and by using food relief websites and databases. All identified food relief activities will be geocoded to create spatial metrics of charitable food provision and access.

Translational Outcome:
The findings from this research have direct implications for public health planning and policy development. By mapping the charitable food sector, policymakers and public health officials can better allocate resources, improve service coordination and promotion, and address food insecurity more effectively. Understanding the geographical distribution of food assistance programs can lead to targeted interventions that prioritize underserved areas and vulnerable populations.

Future Action:
The charitable food sector activities should be mapped across Australia and findings into public health plans and community initiatives. Collaborative partnerships between charitable organisations, government agencies, and public health entities are essential for optimizing resource allocation and improving access to nutritious food options. Implementing data-driven decision-making processes, enhancing communication channels among stakeholders, and fostering community engagement can strengthen the charitable food sector's capacity to support public health goals.

Early childhood caries (ECC) and overweight/obesity in childhood have long-term ramifications persisting into adulthood. National Australian surveys in 2017-2018 and 2012-2014 found that one in four children aged 2-4 years had overweight/obesity, and one in three children aged 5-6 years had ECC. Inappropriate bottle feeding practices, such as feeding to sleep and bottle use beyond recommended cessation at 12 months, may increase ECC or overweight risk due to increased exposure of teeth to cariogenic drinks or non-appetitive feeding of caloric drinks. We aimed to determine the association between bottle feeding to sleep at 24 and 36 months, with overweight and ECC at 3-4 years.

Analysis was undertaken of the Healthy Smiles Healthy Kids longitudinal birth cohort, comprising 1035 mother-infant dyads from an ethnically and socioeconomically diverse area in Sydney. The exposure was bottle feeding to sleep at 24 and 36 months. The outcomes were overweight and ECC at 3-4 years, as categorical (prevalence) and continuous (zBMI for weight status; dmfs for caries experience, the number of caries-affected tooth surfaces) variables. Prevalence of ECC and odds of overweight were modelled using multivariable logistic regression. Caries experience and change in zBMI was modelled using multivariable negative binomial distribution and linear regression.

At 3-4 years, 718 and 729 children were assessed for dental health and anthropometry respectively. 30.3% and 21.7% of children were bottle-fed to sleep at 24 and 36 months respectively. Bottle feeding to sleep at 24 months was associated with higher odds of overweight (OR 1.81, 95%CI 1.05-3.12) and moderately associated with higher caries experience (dmfs 1.48, 95%CI 1.00-2.20). Bottle feeding to sleep at 36 months was associated with higher caries experience (dmfs 1.88, 95%CI 1.22-2.91).

These findings contribute to the evidence of chronic disease risk from prolonged bottle feeding. It supports a common risk factor approach to ECC and overweight/obesity prevention by targeting inappropriate bottle feeding practices with behavioural (e.g. feeding to sleep) and nutritional (e.g. cariogenic drink intake) risk factors. We highlight the need to prevent inappropriate bottle feeding practices; support age-appropriate bottle cessation and transition to cup use; and communicate appropriate sleep and settling behaviours throughout early childhood.

Internationally, rising numbers of children are entering out-of- home care during the first year of life due to child protection concerns. Across Australia, infants (children <1 year old) are over-represented in the child protection system. Infants entering care are reported to be at much higher risk of developmental vulnerability, poor health and attachment problems. This includes an increased risk of neonatal withdrawal syndrome, have a birth defect or disability. Developmental vulnerability can impact on children's school readiness, educational achievement, social-behaviour, and mental health conditions. Our study aims to determine the prevalence of developmental vulnerability in a sample of children entering care as infants, and the extent and likelihood of service provision to these children. This study uses interview data and standardised assessments from the Pathways of Care Longitudinal Study (POCLS), linked to administrative data from New South Wales government. The Ages and Stages Questionnaire and the Brief Infant Toddler Social Emotional Assessment were used as baseline measures for children's cognitive and socio-emotional development.
Of the 474 children who entered out-of-home care as infants and participated in POCLS, almost one in four were preterm, one in five were low birth weight, 9% had a diagnosis of neonatal withdrawal syndrome, and one-sixth were identified as having a disability. Close to 70% children were identified as developmentally vulnerable as per the standardised measures. This included children who were born pre-term or of low birth weight (21–29%) and almost 10% of infants who had a diagnosis of neonatal withdrawal syndrome. Unfortunately, only 17.5% of children were receiving services for developmental delay, which is much lower than the 70% who were identified as vulnerable.
Developmental screening infants in this high-risk group provides an important opportunity to address their needs during this important period of development. Not all carers would have sufficient knowledge and skill to identify infant developmental vulnerability, therefore the role of caseworkers is essential in working with carers to discuss developmental milestones. Given the adversity that children identified as requiring child protection intervention are exposed to, it is imperative that sustained effort is made to provide early intervention to address developmental vulnerabilities.

Congenital syphilis (CS) infections can result in still births or babies with serious sequelae. CS is entirely preventable if pregnant people are tested for syphilis and treated appropriately. In WA, CS notifications increased from three cases in the 10-year period 2008 to 2017 to 18 cases in the 8-year period 2018 to 2023.
Public health reviews of every CS and ‘near-miss’ case (baby born to an infected mother who did NOT receive treatment more than 30 days before delivery and did not contract CS) commenced in 2019 to identify health system gaps/issues that could be addressed to prevent further cases.
Methods
We reviewed reports from 21 public health reviews covering 17 CS (12 live, 5 stillbirths) and four near-miss cases from 2019 to 2023. Qualitative thematic analysis identified common themes contributing to mother-to-child transmission of syphilis.
Results
CS and near-miss cases occurred in both regional (10 cases) and metropolitan (11 cases) areas and 14 of the infants were Aboriginal.

Characteristics that were over-represented in mothers who had a baby with CS or a near miss included: identifying as Aboriginal, residing in a remote area, experiencing homelessness, alcohol use, drug use and/or other complex social issues.

Lack of access to culturally safe antenatal care and comprehensive primary healthcare was a factor frequently contributing to delayed diagnosis and treatment of syphilis in pregnancy resulting in CS in the infant. Lack of awareness of the ongoing syphilis outbreak and the importance of syphilis testing in pregnancy among health care staff contributed to only a few cases, mostly before 2022.

Future actions
It is important to explore alternative and co-designed models of care involving Aboriginal women, other affected communities and key stakeholders
Conclusions
Prevention of CS requires the delivery of holistic, flexible, culturally safe antenatal care by adequately resourced, knowledgeable healthcare staff.

Context and aim
Unintentional drowning is a leading cause of preventable death in young children in Australia, especially for under-5s. Swimming lessons are a key intervention for drowning prevention; however an estimated 10 million lessons were cancelled in Australia due to COVID-19 restrictions. Re-engagement has been impeded by cost pressures and instructor shortages, which may leave a cohort of children at higher risk of drowning across their lifetime.

Methods and analysis/research findings
To encourage re-engagement in swimming lessons, the NSW government provided parent/carers with $100 lesson vouchers through a program called First Lap. To understand pre-existing barriers to swimming lesson participation, the study examined voucher creation surveys for children participating between December 2021 and June 2022 who had not taken lessons in the preceding 12 months (n=79,553). Binary logistic models were used to analyse associations between sociodemographic factors and reported challenges to participation.

Cost remained a major barrier for families from lower socioeconomic backgrounds (aOR 1.65, 95% CI 1.54-1.75) and with children with disabilities (aOR 1.27, 95% CI 1.13-1.43), while regional families indicated limited swim school availability (aOR 5.21, 95% CI 4.37-6.21). Families speaking languages other than English were more likely to view lessons as unimportant (aOR 1.95, 95% CI 1.52-2.49) or their child too young (aOR 2.55, 95% CI 2.38-2.73).

Translational outcomes
The findings from this study are part of the NSW government’s evaluation of the First Lap program, and will be used to inform ongoing efforts to improve equitable access to swimming lessons for children in NSW. They are relevant to the First Lap program and other initiatives to support swimming lessons and water safety.

Future actions
To address these disparities, a multi-pronged approach is recommended:
• Targeted financial assistance: Increased support through voucher programs or needs-based subsidies for families.
• Culturally inclusive programs: Development and promotion of inclusive swim programs and support services for culturally and linguistically diverse families.
• Regional and remote expansion: Support for establishing or expanding swim schools in underserved areas, potentially through incentives or collaboration with community centres.
• Workforce development: Evaluation and investment in initiatives like subsidized training to ensure a sufficient and qualified swim instructor workforce, particularly in underserved areas.

Context and aim: Sexual dysfunctions are prevalent in the Australian population, affecting over half of men regardless of age and sexual identity. They can have significant impacts on men's physical health, mental well-being, and quality of life if left untreated. The present study aimed to examine the trends of sexual dysfunctions and factors associated with sexual help seeking behaviour among a cohort of Australian men.
Methods: Four waves of longitudinal data from the Australian Longitudinal Study on Male Health (Ten to Men) were used for this analysis. We included adult men aged 18 and above who had engaged in vaginal, oral, or anal sex, resulting in a total sample size of 12,737 (wave 1), 8,933 (wave 2), 6,991 (wave 3), and 5,804 (wave 4) men for our analysis. Logistic regression was employed to identify factors associated with sexual help seeking behaviour.
Results: The results reveal a significant rise in the prevalence of experiencing at least one form of sexual difficulty, climbing from 54.1% (95% CI: 52.7, 62.5) in 2013/14 to 64.7% (95% CI: 62.8, 66.7) in 2022. The increase was most pronounced among men from culturally and linguistically diverse backgrounds which increased from 42.8% (95% CI: 38.1, 47.5) in 2013/14 to 61.5% (95% CI: 55.6, 67.1) in 2022. Only approximately one-fifth of men sought assistance for their sexual health concerns with no significant improvement over the study period. Number of sexual difficulties, age, sexual identity, relationship status, conformity to masculine norms, depression, and number of financial hardships were factors significantly associated with sexual health seeking behaviour.
Translational outcomes: Although the burden of sexual dysfunctions has been increasing among Australian men, only few have sought help suggesting a significant level of unmet sexual health needs. This underscores the necessity for co-designed sexual health services, informed by an intersectional approach, to better engage men and meet their distinct needs and preferences.