The complexity of online patient education materials for wound care strategies: A readability analysis.

BACKGROUND: In the United States, over 6 million people are affected by chronic wounds. Patients often rely on the Internet for treatment information; however, these educational materials typically exceed the average eighth-grade health literacy level. This study aimed to assess the readability and language accessibility of online patient education materials on wound care strategies. METHODS: A search was conducted on Google for articles related to wound care strategies. The first 12 unique websites from each search strategy were selected for further analysis. Readability was assessed using 11 tests, with the mean scores calculated for each. RESULTS: A total of 66 articles pertaining to wound care strategies were retrieved from 43 websites. All articles had an average reading grade level of 13.5 ± 2.5 and an average reading age of 18.7 ± 2.5 years. Websites were categorized by the following sources: academic (34.9%), reagent/biologic manufacturers (27.9%), wound care (18.6%), news media organizations (14%), and other (4.7%). Flesch Reading Ease Score, graded from 0 for most difficult to 100 for least difficult, was found to be highest for academic websites (44.2, P = .01) and lowest for news media websites (24.9, P = .01). Academic websites were available in the more languages compared to all other website categories (P < .01). CONCLUSION: Online materials related to wound care strategies often exceed the National Institute of Health recommended eighth-grade reading level. This study emphasizes the need for healthcare providers to create more accessible educational materials to address the gap in health literacy and optimize patient care.

Beyond drowning: Characteristics, trends, the impact of exposure on unintentional non-drowning coastal fatalities between 2012 and 22.

OBJECTIVES: Drowning has been the focus of coastal safety, but a notable proportion of coastal mortality is due to other causes of death. This study describes that burden and quantifies the impact of exposure on Australian unintentional coastal fatalities not due to drowning. METHODS: Analyses of Australian non-drowning coastal fatalities (NDCF) between July 2012 and June 2022 were conducted. Population and exposure-based rates were calculated for Australians 16+ years and compared to all-cause mortality rates. Time series analysis was performed using Joinpoint regression. RESULTS: 616 NDCFs were recorded (0.27/100,000 pop.), with a decreasing average annual percent change of -5.1% (95% CI:-9.5 to -0.4). Cardiac conditions were the primary causal factor, involved in 52% of deaths. Higher fatality rates were seen among men and for incidents occurring in rural and remote areas. Fatality rates were disproportionately high among young adults when compared to all-cause mortality. CONCLUSIONS: Men, young adults, and those living in/visiting regional and remote areas represent high-risk populations. Proximity to emergency services and extended response times represent major determinants of NDCF. IMPLICATIONS FOR PUBLIC HEALTH: Due to the high prevalence of NDCF, coastal safety practitioners should expand their attention beyond drowning to consider the broader range of coastal hazards and fatality types.

Coastal mortality burden on school holidays 2004-2021: an Australian perspective.

INTRODUCTION: School holidays are a known period of increased risk of paediatric drowning. However, the risk of coastal death for all age groups is unknown. METHODS: This case-control study aimed to identify high-risk demographics and behaviours relating to coastal deaths during the school holidays. We address this knowledge gap by comparing unintentional coastal deaths (drowning deaths and other coastal fatalities) in Australia between 1 July 2004-30 June 2021 to a survey sample representative of the Australian population. RESULTS: School holidays increased the risk of coastal death increased overall by 1.39 times (95% CI 1.32 to 146, p=0.00019). This increased risk differed across activities, behaviours and demographics. Few between-group differences were detected, indicating that school holidays pose an increased risk to the wider Australian population on the coast, regardless of demographics and practices. Increased school holiday mortality risk was identified broadly across groups, but notably for young adults (risk ratio, RR 1.41, 95% CI 1.31 to 1.53, p<0.001), when attempting a rescue (RR 1.85, 95% CI 1.42 to 2.39, p=0.0002), scuba diving (RR 1.82, 95% CI 1.48 to 2.23, p<0.0001) and swimming/wading (RR 1.72, 95% CI 1.56 to 1.89, p<0.0001). Children did not have a significantly increased risk of death (RR 1.38, 95% CI 1.03 to 1.87, p=0.054). CONCLUSION: These results highlight that while school holiday risk research regarding drowning has focused on the safety of children, these time periods also pose significant safety concerns to the rest of the population for both drowning deaths and other fatalities. Overall, the research highlights ongoing need for public education for all carers of children, as well as continuing to extend risk education to the broader community. Mitigation strategies, that is, advocacy for extending life-saving service and engaging with accommodation providers during school holidays are proposed.

'I actually thought that I was going to die': Lessons on the rip current hazard from survivor experiences.

BACKGROUND: Rip currents are strong, narrow, fast-flowing currents of water that occur on many beaches and in Australia contributing to 26 drowning deaths and several thousand lifeguard/lifesaver rescues each year. Educating the public about the rip current hazard is a primary focus of beach safety practitioners, but there has been a lack of qualitative research exploring the firsthand experiences of being caught in a rip current to assist in this regard. The aim of this study was to analyse interviews of rip current survivors to understand more about how people react when unintentionally caught in a rip current in order to help guide future public education to mitigate rip current drowning. METHODS: Semi-structured interviews were conducted with 56 individuals (primarily Australian-born) about their experience of being caught in a rip current. Interviewees were recruited via an online survey and varied in age and self-reported swimming ability. RESULTS: Thematic analysis revealed three key temporal elements to the rip current experience: Before the Rip in which lack of awareness and knowledge, complacency, over-confidence, and attitude were prevalent themes; During the Rip which identified panic and temporary inhibition of decision-making, physical response, prior experience, and relationships with other beach users as themes; and After the Rip where post-rip effects and rip safety messaging and education were key themes. The importance of experiential immersion was a prevalent thread throughout all phases of the thematic analysis. DISCUSSION: Our research shows that being caught in a rip current can be an intense and traumatic experience and that lessons learned from survivors have significant implications for improving existing and future rip current education efforts. In this regard, we provide several recommendations based on evidence-based insights gained from our interviews including the development of immersive rip current experience using virtual reality. SO WHAT: Despite the prevalence of rip currents causing drowning deaths and rescues, there has been a lack of qualitative research on firsthand experiences to aid in public education. These interviews emphasise the intense and traumatic nature of being caught in a rip current, underscoring the need for improved rip current education to aid in prevention of this, often harrowing, experience.

Open science discovery of potent noncovalent SARS-CoV-2 main protease inhibitors.

We report the results of the COVID Moonshot, a fully open-science, crowdsourced, and structure-enabled drug discovery campaign targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease. We discovered a noncovalent, nonpeptidic inhibitor scaffold with lead-like properties that is differentiated from current main protease inhibitors. Our approach leveraged crowdsourcing, machine learning, exascale molecular simulations, and high-throughput structural biology and chemistry. We generated a detailed map of the structural plasticity of the SARS-CoV-2 main protease, extensive structure-activity relationships for multiple chemotypes, and a wealth of biochemical activity data. All compound designs (>18,000 designs), crystallographic data (>490 ligand-bound x-ray structures), assay data (>10,000 measurements), and synthesized molecules (>2400 compounds) for this campaign were shared rapidly and openly, creating a rich, open, and intellectual property-free knowledge base for future anticoronavirus drug discovery.

Therapeutic Modulation of Cell Morphology and Phenotype of Diseased Human Cells towards a Healthier Cell State Using Lignin.

Despite lignin's global abundance and its use in biomedical studies, our understanding of how lignin regulates disease through modulation of cell morphology and associated phenotype of human cells is unknown. We combined an automated high-throughput image cell segmentation technique for quantitatively measuring a panel of cell shape descriptors, droplet digital Polymerase Chain Reaction for absolute quantification of gene expression and multivariate data analyses to determine whether lignin could therapeutically modulate the cell morphology and phenotype of inflamed, degenerating diseased human cells (osteoarthritic (OA) chondrocytes) towards a healthier cell morphology and phenotype. Lignin dose-dependently modified all aspects of cell morphology and ameliorated the diseased shape of OA chondrocytes by inducing a less fibroblastic healthier cell shape, which correlated with the downregulation of collagen 1A2 (COL1A2, a major fibrosis-inducing gene), upregulation of collagen 2A1 (COL2A1, a healthy extracellular matrix-inducing gene) and downregulation of interleukin-6 (IL-6, a chronic inflammatory cytokine). This is the first study to show that lignin can therapeutically target cell morphology and change a diseased cells' function towards a healthier cell shape and phenotype. This opens up novel opportunities for exploiting lignin in modulation of disease, tissue degeneration, fibrosis, inflammation and regenerative medical implants for therapeutically targeting cell function and outcome.

Evaluating the impact of skill development for drowning prevention: a relationship-building approach to community engagement.

OBJECTIVE: Evaluate the impact of a broadened theoretical and empirical model of community engagement aimed at coastal drowning prevention via relationship building between lifeguards and beachgoers through the delivery of skill development sessions on the beach. SETTING: A lifeguard-patrolled beach in Lorne, Victoria, Australia, during the 2023 peak summer holiday season. METHODS: In total, 12 skill development sessions were delivered by teams of lifeguards and risk researchers to beachgoers. Sessions were codesigned by the research team and shared with lifeguards beforehand to review and include lifeguards' interpretations of localised risk during delivery. In total, 85 survey interviews were conducted with self-selecting beachgoers post participation. RESULTS: In total, 79 participants (93%) enjoyed participating in the session(s) and 77 participants (91%) reported learning something new. Learning how to identify rip current (n=59) and escape a rip current (n=40) were the two most commonly learnt skills. Participants' intended changes in future beachgoing behaviours (n=46) include asking lifeguards at patrolled beaches how to identify site-specific (rip current) risk (n=11) and attempting to identify a rip current before entering the water (n=10). The spillover effects of participation include sharing what participants had learnt with family and friends. CONCLUSIONS: Creating a dialogic model of collaboration via participatory community engagements between lifeguards and researchers with the beachgoing public can successfully prompt learning drowning prevention skills. These skills are required when navigating dynamic coastal hazards at unpatrolled beaches. Supporting lifeguards and life-savers to provide skill development expands the ways that life-saving services can engage the public, including measurement of lifeguards' contributions to coastal drowning prevention.

Better late than never: Optimising the proteomic analysis of field-collected octopus.

Proteomics, the temporal study of proteins expressed by an organism, is a powerful technique that can reveal how organisms respond to biological perturbations, such as disease and environmental stress. Yet, the use of proteomics for addressing ecological questions has been limited, partly due to inadequate protocols for the sampling and preparation of animal tissues from the field. Although RNAlater is an ideal alternative to freezing for tissue preservation in transcriptomics studies, its suitability for the field could be more broadly examined. Moreover, existing protocols require samples to be preserved immediately to maintain protein integrity, yet the effects of delays in preservation on proteomic analyses have not been thoroughly tested. Hence, we optimised a proteomic workflow for wild-caught samples. First, we conducted a preliminary in-lab test using SDS-PAGE analysis on aquaria-reared Octopus berrima confirming that RNAlater can effectively preserve proteins up to 6 h after incubation, supporting its use in the field. Subsequently, we collected arm tips from wild-caught Octopus berrima and preserved them in homemade RNAlater immediately, 3 h, and 6 h after euthanasia. Processed tissue samples were analysed by liquid chromatography tandem mass spectrometry to ascertain protein differences between time delay in tissue preservation, as well as the influence of sex, tissue type, and tissue homogenisation methods. Over 3500 proteins were identified from all tissues, with bioinformatic analysis revealing protein abundances were largely consistent regardless of sample treatment. However, nearly 10% additional proteins were detected from tissues homogenised with metal beads compared to liquid nitrogen methods, indicating the beads were more efficient at extracting proteins. Our optimised workflow demonstrates that sampling non-model organisms from remote field sites is achievable and can facilitate extensive proteomic coverage without compromising protein integrity.

Public holiday and long weekend mortality risk in Australia: A behaviour and usage risk analysis for coastal drowning and other fatalities.

OBJECTIVE: This article aims to determine the impact of public holidays and long weekends on the risk of drowning and non-drowning deaths on the Australian coast. METHODS: A retrospective case-control study using relative risk ratios and Z-scores to compare all unintentional fatalities on the Australian coast between 2004 and 2021 to a longitudinal representative survey sample of the Australian public and their coastal usage. RESULTS: Overall, the coastal mortality risk increased by 2.03 times for public holidays (95%CI = 1.77-2.33, p<0.0001) and 2.14 times by long weekends (95%CI = 1.85-2.48, p<0.0001). Children <16 years had the highest increased risk of death on public holidays (RR = 3.53, 95%CI = 1.98-6.31, p = 0.0005) and long weekends (RR = 2.90, 95%CI = 1.43-5.89, p = 0.011), while residents who were born overseas had a higher risk of death compared to those born in Australia. For public holidays, the greatest increase in risk was for swimming/wading and bystander rescues, while for long weekends, it was for scuba diving and snorkelling. CONCLUSIONS: Public holidays and long weekends increase the risk of both drowning and non-drowning deaths on the Australian coast, which differed by demographics and activities. IMPLICATIONS FOR PUBLIC HEALTH: These results highlight periods of risk when targeted coastal safety messaging to high-risk demographics (particularly children and overseas-born residents), and provision of surf lifesaving resources can be increased.

The epidemiology, risk factors and impact of exposure on unintentional surfer and bodyboarder deaths.

Surfing and bodyboarding (SAB) are popular activities, but not without risk. Limited SAB mortality and exposure risk explorations exist, so this cross-sectional study explores epidemiology and risk factors for SAB deaths (1 July, 2004-30 June,2020) in Australia: including decedent and incident profiles, causes of death, differences between fatalities during SAB and other coastal activities; and the impact of exposure on SAB mortality risk. Fatality data were sourced from the National Coronial Information System, incident and media reports. Tide-state data, population data and participation data were sourced from relevant authorities. Analyses included chi-square testing and simple logistic regression with odds ratios. There were 155 SAB deaths (80.6% surfing; 96.1% male; 36.8% aged 55+years; 0.04/100,000 residents; 0.63/100,000 surfers). Drowning was the most common cause of death (58.1%; n = 90), but higher in bodyboarding, with bodyboarders 4.62 times more likely to drown than surfers (95%CI: 1.66-12.82; p = 0.003). Almost half (44.5%; n = 69; χ22 = 9.802; p = 0.007) were with friends/family, and the largest proportion occurred during a rising tide (41.3%; n = 64; χ23 = 180.627; p<0.001) followed by a low tide (36.8%;n = 57). Australians surf 45.7 times each year, for 1.88 hours each visit equalling 86.1 'exposed' hours. With exposure-time considered, exposure-adjusted surfer mortality rate (0.06/1 million hours) is lower than other in-water activities (0.11/1 million hours). Younger surfers (14-34 years) surfed more yet had the lowest mortality rate (114.5 hours/year; 0.02/1 million hours). Older surfers (55+ years) had a lower SAB mortality rate (0.052) than the all-cause crude mortality rate of their average population counterparts (1.36). Cardiac conditions were identified in 32.9% (n = 69) of SAB deaths. SAB are relatively safe, with lower exposure mortality rates than other activities. Prevention should target older surfers, inland residents, and identification of surfers with risk factors for cardiac events.

A preliminary study investigating the neglected domain of mental health in Australian lifesavers and lifeguards.

BACKGROUND: Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The preliminary study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and attitudes towards mental health problems in Surf Life Saving (SLS) members. METHODS: An anonymous, online survey was developed (adolescent and adult versions) and created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson's correlations investigated relationships between PTEs, PTSS, self-efficacy, social support, attitudes towards mental health problems, age, years as a SLS member, and years patrolling. Spearman's Rank was used for violations of normality. RESULTS: A total of 57 surf lifesavers/lifeguards aged 13-59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative attitudes towards mental health problems towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed. CONCLUSION: This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and well-being associated with this first responder role. More research to protect the vulnerability of this population is warranted.

Cell morphology as a biological fingerprint of chondrocyte phenotype in control and inflammatory conditions.

Introduction: Little is known how inflammatory processes quantitatively affect chondrocyte morphology and how single cell morphometric data could be used as a biological fingerprint of phenotype. Methods: We investigated whether trainable high-throughput quantitative single cell morphology profiling combined with population-based gene expression analysis can be used to identify biological fingerprints that are discriminatory of control vs. inflammatory phenotypes. The shape of a large number of chondrocytes isolated from bovine healthy and human osteoarthritic (OA) cartilages was quantified under control and inflammatory (IL-1ß) conditions using a trainable image analysis technique measuring a panel of cell shape descriptors (area, length, width, circularity, aspect ratio, roundness, solidity). The expression profiles of phenotypically relevant markers were quantified by ddPCR. Statistical analysis, multivariate data exploration, and projection-based modelling were used for identifying specific morphological fingerprints indicative of phenotype. Results: Cell morphology was sensitive to both cell density and IL-1ß. In both cell types, all shape descriptors correlated with expression of extracellular matrix (ECM)- and inflammatory-regulating genes. A hierarchical clustered image map revealed that individual samples sometimes responded differently in control or IL-1ß conditions than the overall population. Despite these variances, discriminative projection-based modeling revealed distinct morphological fingerprints that discriminated between control and inflammatory chondrocyte phenotypes: the most essential morphological characteristics attributable to non-treated control cells was a higher cell aspect ratio in healthy bovine chondrocytes and roundness in OA human chondrocytes. In contrast, a higher circularity and width in healthy bovine chondrocytes and length and area in OA human chondrocytes indicated an inflammatory (IL-1ß) phenotype. When comparing the two species/health conditions, bovine healthy and human OA chondrocytes exhibited comparable IL-1ß-induced morphologies in roundness, a widely recognized marker of chondrocyte phenotype, and aspect ratio. Discussion: Overall, cell morphology can be used as a biological fingerprint for describing chondrocyte phenotype. Quantitative single cell morphometry in conjunction with advanced methods for multivariate data analysis allows identifying morphological fingerprints that can discriminate between control and inflammatory chondrocyte phenotypes. This approach could be used to assess how culture conditions, inflammatory mediators, and therapeutic modulators regulate cell phenotype and function.

Affective Responses to Increasing- and Decreasing-Intensity Resistance Training Protocols.

This study compared the effects of an increasing-intensity (UP) and a decreasing-intensity (DOWN) resistance training protocol on affective responses across six training sessions. Novice participants (Mage 43.5 ± 13.7 years) were randomly assigned to UP (n = 18) or DOWN (n = 17) resistance training groups. Linear mixed-effects models showed that the evolution of affective valence within each training session was significantly moderated by the group (b = -0.45, p ≤ .001), with participants in the UP group reporting a decline in pleasure during each session (b = -0.82) and the DOWN group reporting an improvement (b = 0.97; ps < .001). Remembered pleasure was significantly higher in the DOWN group compared to the UP group (b = 0.57, p = .004). These findings indicate that a pattern of decreasing intensity throughout a resistance exercise session can elicit more positive affective responses and retrospective affective evaluations of resistance training.

Mortality trends and the impact of exposure on Australian coastal drowning deaths, 2004-2021.

OBJECTIVE: The aim of this study is to characterise Australian coastal drowning trends and evaluate impact of exposure on drowning risk. METHODS: Descriptive epidemiological analysis of unintentional fatal drowning occurring July 2004-June 2021 at Australian coastal sites (beaches, rock platforms, bays, harbours, offshore locations etc.). Total population, exposed-person and exposed-person-time rates per 100,000 population were calculated by age, sex, socio-economic status, remoteness category and pre-submersion activity. Annual trends were assessed using joinpoint regression. Exposure-based rates used estimates from Surf Life Saving Australia's National Coastal Safety Survey. RESULTS: The cumulative unintentional coastal fatal drowning rate was 0.43 per 100,000 Australian residents (95%CI: 0.41-0.45) and did not change throughout the study period (p=0.289). The exposed-person rate was 0.67 per 100,000 coastal visitors (95%CI: 0.62-0.72), and there were 0.55 coastal drowning deaths per 10 million coastal visitor hours (95%CI: 0.51-0.59). Men, older people and residents of lower socio-economic and remote areas had higher drowning rates; rock fishing and scuba diving had the highest activity exposure-based rates. CONCLUSIONS: Education- and policy-based coastal safety interventions should focus on identified risk factors to reduce annual coastal drowning rates. IMPLICATIONS FOR PUBLIC HEALTH: Exposure-based risk measurements are important for developing and prioritising interventions; assessments based on counts or total population measures alone may misinform prevention efforts.

Expression of CISH, an Inhibitor of NK Cell Function, Increases in Association with Ovarian Cancer Development and Progression.

Epithelial ovarian cancer (OVCA), a fatal malignancy of women, disseminates locally. Although NK cells mount immune responses against OVCA, tumors inhibit NK cells, and the mechanism is not well understood. Cytokines stimulate NK cells; however, chronic stimulation exhausts them and induces expression of cytokine-inducible SH2-containing protein (CISH). Tumors produce anti-inflammatory cytokine interleukin (IL)-10 which may induce NK cell exhaustion. The goal of this study was to examine if CISH expression in NK cells increases during OVCA development and to determine the mechanism(s) of OVCA-induced CISH expression in NK cells. Normal ovaries (n = 7) were used for CISH, IL-10 and GRP78 expression. In tumor ovaries, CISH was examined in early and late stages (n = 14 each, all subtypes) while IL-10 and GRP78 expression were examined in early and late stage HGSC (n = 5 each). Compared to normal, the population of CISH-expressing NK cells increased and the intensity of IL-10 and GRP78 expression was significantly higher in OVCA (p < 0.05). CISH expression was positively correlated with IL-10 expression (r = 0.52, r = 0.65, p < 0.05 at early and late stages, respectively) while IL-10 expression was positively correlated with GRP78 expression (r = 0.43, r = 0.52, p < 0.05, respectively). These results suggest that OVCA development and progression are associated with increased CISH expression by NK cells which is correlated with tumor-induced persistent cellular stress.

Listening to Fast-Tempo Music Improves Physical Performance in Recreational Swimmers.

Purpose: To determine whether swimming while listening to fast (140 bpm) or moderate tempo (120 bpm) music enhances physical performance compared to a non-music condition. Methods: Sixteen healthy university students (21.5 ± 2.3 years) with a minimum of one year of experience swimming front crawl were recruited. All completed four testing sessions. In the first session, a graded exercise treadmill test was performed to establish baseline fitness. The next three visits were at the swimming pool and participants were asked to swim as far as possible in 12-minutes (i.e., Swimming Cooper Test) under each of three randomly assigned conditions: 120 bpm (M120), 140 bpm (M140) and a non-music condition (NM). Results: No significant differences were found between conditions for either heart rate (p > .05) or rating of perceived exertion (p > .05). However, differences were found on distance covered (p = .014) between M120 (305.7 ± 19.7 m) and M140 (321.2 ± 19.4 m; p = .035), and on stroke frequency (p = .009) between M120 (48.4 ± 1.8) and M140 (51.6 ± 1.9; p = .028). Conclusion: These results suggest that distance covered and the frequency of strokes per minute were greater when participants were exposed to fast tempo music (M140) compared to moderate tempo music (M120) and a non-music condition (NM) in a 12-minute swimming test.

Awareness without learning: A preliminary study exploring the effects of beachgoer's experiences on risk taking behaviours.

Most drowning deaths on Australian beaches occur in locations not patrolled by lifeguards. At patrolled locations, where lifeguards supervise flagged areas in which beachgoers are encouraged to swim between, the incidence of drowning is reduced. To date, risk prevention practices on coasts focus on patrolled beaches, deploying warning signs at unpatrolled locations with the aim of raising public awareness of risk. What remains unexplored is the potential for learning and behaviour change that can transfer from patrolled to unpatrolled beaches through beachgoer's experiences and interactions with lifeguards. The aim of this preliminary study is to explore the risk perceptions of beachgoers at a patrolled beach to establish if and how their experiences of beach risk and interactions with lifeguards affect their behaviours. Data was collected in Gerroa, Australia by engaging 49 beachgoers using a mixed survey-interview methodology. Results show that beachgoers are aware that they should 'swim between the flags', but many did not know the basis for the positioning of safety flags. A key finding is that beachgoer's express a clear desire for a skills-based model of community engagement that enables learning with lifeguards. This demonstrates a reflective public that desires skill-development, which may transfer from patrolled to unpatrolled beaches to affect broader risk reduction on the Australian coast. Learning how to avoid site-specific rip hazards with lifeguards at the beach presents a promising, and previously unexplored model for beach drowning risk prevention that has the potential to affect behaviour at unpatrolled beaches, providing an empirically-supported alternative to prevailing deficit-based awareness raising methods.