Abstract. An obvious sign of potential human impact on animal populations is roadkill. In Tasmania, this impact is perceived as relatively greater than in other Australian states, and is often noted by visitors and locals alike, such that calls for management action are common in the popular press. The goal of this three-year study was to assess the frequency and distribution of species killed on Tasmanian roads. Seasonal surveys were completed along five major routes, for a total of 154 trips. Over 15 000 km of road were surveyed and 5691 individuals in 54 taxa were recorded for an average roadkill density of 0.372 km À1. Over 50% of encountered roadkill could be identified to species, with common brushtail possums (Trichosurus vulpecula) and Tasmanian pademelon (Thylogale billardierii) the most common species identified, both in overall numbers and frequency of trips encountered. The 10 most common taxa accounted for 99% of the items observed. The seasonal occurrence, relationship with vehicle speed, and clustering in local hotspots for particular taxa all suggest that mitigation measures, such as vehicle speed reduction in specific areas, may be effective in reducing the number of animals killed. Mitigation measures, however, will not apply equally to all species and, in particular, success will depend on changing human behaviours.

Providing for patients' psychosocial needs is a potential means of minimising cancer morbidity. Needs assessments can guide responsive patient-centred care. A longitudinal survey of women with early breast cancer consulting a breast nurse in a primarily rural state of Australia was undertaken to measure unmet supportive care needs, identify changes in unmet needs across time and compare results with previous studies. Needs assessments were completed with the Supportive Care Needs Survey (SCNS) at 1 month (n = 74) and 3 months (n = 83) post-diagnosis. Access to services was also examined. High levels of psychological and health system and information needs were identified at 1 month post-diagnosis, but these decreased significantly at 3 months post-diagnosis. Sexuality domain needs increased significantly during the same time. Compared to a previous SCNS study of rural women with breast cancer, unmet supportive care needs in this study were significantly lower than previously reported, although assistance with energy levels (i.e. fatigue) continues to be an unmet need for women with breast cancer. Results suggest there have been positive cultural changes within healthcare systems, specifically in better informing patients and providing support. Although services appear to be more responsive to breast cancer patients, significant unmet needs still exist.

An open referral policy led to a high proportion of patients being self-referred, and nearly a third of these were diagnosed with cognitive impairment or dementia. Open referral policies and nurse-led services may overcome some of the barriers to early diagnosis that are currently experienced. Considering an aging population worldwide and the associated increases in cognitive impairment, which benefits from early identification and intervention, this paper provides an alternative model of nurse-led assessment.

Affirming interactions are a key feature of successful therapeutic encounters when time and context do not allow or warrant the full repertoire of patient-centred communication.

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