Volume 207 Issue 5

A likely causal link between breast implants and lymphoma highlights the importance of a prospective registry

Ingrid Hopper · Susannah Ahern · John J McNeil · Anand K Deva · Elisabeth Elder · Colin Moore · Rodney Cooter

In published research, a statistically significant result is often wrongly interpreted as representing a clinically important finding

Ian A Scott

A 68-year-old man presented with a 4-month history of mildly pruritic, well circumscribed, red-brown plaques with overlying scale affecting the axillary and inguinal regions

Deshan F Sebaratnam · Stephen Lee

A comprehensive orientation process is essential in assisting international doctors to adjust to life in a new country

Jennifer A May

28 November 1921 -- 19 November 2016

Michel A Higlett · Lesley M Dillmann · Rick A Higlett · Robert F Higlett

Mayo Clinic internal medicine board review

Simon O'Connor

The significant benefits for patients and hospitals of reduced testing can be achieved without compromising safety

Jonathan Christiansen

Reducing unnecessary objective testing of patients at low risk of an ACS should be encouraged

Louise Cullen · Jaimi H Greenslade · Tracey Hawkins · Chris Hammett · Shanen O'Kane · Kimberley Ryan · Kate Parker · Jessica Schluter · Emily Dalton · Anthony FT Brown · Martin Than · W Frank Peacock · Allan Jaffe · Peter K O'Rourke · William A Parsonage

An evidence-based accelerated diagnostic protocol achieved significant benefits for both patients and hospitals

William A Parsonage · Tanya Milburn · Sarah Ashover · Wade Skoien · Jaimi H Greenslade · Louise McCormack · Louise Cullen

Improving the rates of diabetes testing could achieve better health outcomes for Indigenous Australians

Christine L Paul · Paul Ishiguchi · Catherine A D'Este · Jonathan E Shaw · Rob W Sanson-Fisher · Kristy Forshaw · Alessandra Bisquera · Jennifer Robinson · Claudia Koller · Sandra J Eades

Identification of NCG/WS is important as gluten-free diets carry risks, are socially restricting and are costlier than regular diets

Michael DE Potter · Marjorie M Walker · Nicholas J Talley

Recent advances are likely to further improve the incremental benefit of radiation over and above surgery and systemic therapy and thus increase survival rates

John Boyages

To the Editor: We note with interest the recent review of challenges in the management of maturity onset diabetes of the young associated with glucokinase gene mutations (GCK-MODY).1 In Box 2, Bishay and Greenfield reported a prevalence of gestational diabetes mellitus (GDM) of 5–10%. Indeed, in 2010 we reported an estimated prevalence of 10–11% of GDM in south-western Sydney;2 however, the prevalence is now almost double that figure (18.5% of births at Bankstown-Lidcombe hospital in 2015). Bishay and Greenfield also summarised the findings of Chakera and colleagues3 for a population of predominantly European descent: A lower body mass index (BMI, < 25 kg/m2) and a fasting glucose level greater than or equal to 5.5 mmol/L have sensitivity and specificity of 68% and 96%, respectively. It is estimated that among lean women with mild fasting hyperglycaemia, the number of women needed to test is 2.7 to detect a single case of GCK-MODY.1 In contrast, in our recent study of women with GDM, we found that at least 8.1 women would need to be tested to identify one case of GCK-MODY.4 Given our interest in the management of women with GDM, we sought to determine whether these criteria were applicable in a large multi-ethnic cohort of women with GDM. Analysing de-identified, prospectively collected data from all women with GDM in our ethnically diverse population, diagnosed using the Australasian Diabetes in Pregnancy Society (1998) criteria at our institution between 1993 and 2013, we categorised the women into two groups: those with body mass index ≤ 21 kg/m2 (group A1) and those with body mass index > 21 kg/m2 and < 25 kg/m2 (group A2). We collected complete data, including post-partum oral glucose tolerance test results, for 171 women (54, group A1; 117, group A2). The oral glucose tolerance test and post-partum glycated haemoglobin results identified few women (< 14%) in either group who still had possible GCK-MODY. Testing all 171 of these women in pregnancy would have been a costly exercise with a low yield. In testing data in different ethnic groups, we therefore recommend caution regarding the number suggested by Chakera and colleagues.

Jeff R Flack · Glynis P Ross · N Wah Cheung

In reply

Ramy H Bishay · Jerry R Greenfield

Modern digital radiological techniques include “stitching” together multiple x-ray images. This provides one overall image of the area of interest, such as the entire spine or lower limbs, for deformity assessment. Dedicated software automatically combines separate exposures and allows for overlap. Image acquisition is rapid, minimising patient motion artefact and reducing distortion.1 However, if images are inappropriately put together (digitally stitched), stitching errors may occur with this computer-driven process. If not manually corrected by the radiology technician, the supplied image may hide pathology or give the false impression of abnormality. Four cases of digital stitching error have recently occurred in our tertiary referral paediatric hospital. Digitally stitched x-rays from the lower limbs were obtained for routine assessment of a child with skeletal dysplasia, and fractures of the left tibia and fibula were apparent (Box, A). This did not correlate with the clinical findings, including the child dancing in the waiting room. The radiology department was contacted and they re-issued corrected images (Box, B). Spinal x-rays in two patients after scoliosis surgery incorrectly showed broken surgical rods. In the context of ongoing symptoms, the option of revision surgery was discussed with the family in the first case. Repeat x-rays, obtained as part of the pre-operative planning, showed the rod was in fact not broken. A stitching error was immediately recognised by the spinal surgeon when a second similar case occurred. In a fourth case, comparison of the anteroposterior and lateral views of a child’s spine showed different numbers of vertebrae in the two views (11 vertebrae on the frontal view and 12 on the lateral). Digital radiology is commonplace and allows rapid image acquisition and ease of digital measurement.2 However, technical errors — digital stitching errors — may occur. Although rarely reported, these may be relatively common, with one study identifying stitching errors in 14 out of 86 reviewed scoliosis studies.1 Despite ongoing technological refinements,3 clinicians should always carefully check digitally stitched images: look for soft tissue mismatch, correlate with source images and clinical presentation, and avoid digital stitching in certain patients, such as people with movement disorders. Box – Digitally stitched long leg images of a paediatric patient, showing the stitching error and apparent fracture (A),* and corrected image with resolution of the stitching error and no fracture (B) * Note the mismatched soft tissue shadow (A).

Clare Faurie · Nicole Williams · Peter J Cundy

To the Editor: Intensive care is a finite and costly resource with nine beds per 100 000 population in Australia and at a cost of $4000 per bed-day. From 1999, the demand for intensive care unit (ICU) beds has increased at an average rate of 2.5% annually.1,2 Faced with increased demand and capacity restraints, fiscal sustainability is dependent on efficient use of limited ICU resources. ICU bed availability varies significantly across countries and creates a threshold for clinicians to admit patients.3 The availability of beds may be influenced by the number of patients well enough for ward discharge but who are exit blocked. ICU access block is a significant safety concern for critically ill patients, and ICU exit block (the inability to discharge a patient who is medically fit for discharge) may contribute significantly to ICU access block.4,5 Using a single-day point prevalence study, we obtained an estimate for ICU exit block in 39 Australian and ten New Zealand adult ICUs in 2014. Across all sites, 13% (median value of exit block across the sample hospitals, 8.1%; interquartile range, 0–23%) of patients in the ICU on the study day were awaiting a ward bed. Patients in Australian ICUs were twice as likely to be exit blocked compared with patients in New Zealand ICUs (14.9% v 7.6%). Hospital and ICU size and location (rural v metropolitan) did not influence levels of exit block, but ICUs with > 80% occupancy had higher levels of exit block (Box). Our results were similar to those of the 2007–14 Australian Council on Healthcare Standards clinical indicator report, which found that about 25% of ICU discharges were delayed for more than 6 hours.5 Using an ICU bed for a patient who no longer needs it represents an inefficient use of resources and risks creating delays in admitting other acutely unwell patients. In the emergency department setting, we have seen the 4-hour rule improve hospital access and outcomes by prioritising transfer of emergency department patients to ward beds. Monitoring ICU access and exit block provides a comparable metric for understanding the effects of prohibiting ICU patient flow and for determining how to safely and efficiently allocate limited resources for critically ill patients. Box – Intensive care unit (ICU) bed occupancy and exit block Bed occupancy No. of ICUs* Median percentage of patients experiencing exit block (IQR) 0–50% 6 0 (0–28.6%) 51–80% 20 0 (0–10.8%) 81–100% 21 13.0% (5.5–25%) IQR = interquartile range. * Two sites did not provide bed occupancy rates so were not included in our analysis.

Matthew H Anstey · Kelly Thompson · Ian Seppelt

Associate Professor Bruce Campbell picked neurology over haematology because it seemed a “riskier” thing to do

Cate Swannell

Five young South Australian medical scientists have been named as 2017 SA Tall Poppies of Science. Dr Kate Fennell, from the University of South Australia, works in behavioural medicine and psychological science, researching the health gaps between rural and urban Australians. Dr Fennell’s research strategies include the development of online peer support programs for rural cancer survivors who can’t access face-to-face cancer support groups, and an online self-help program to help improve farmers’ wellbeing and ability to cope with difficult situations beyond their control, such as drought or commodity prices. She works currently at the Sansom Institute for Health Research. Dr Lisa Beatty, from Flinders University, is exploring innovative ways of reducing distress for cancer patients, and has developed online self-help programs which have been shown to reduce distress and improve quality of life of cancer patients. Dr Beatty’s work helps improve the health and wellbeing of people suffering from cancer, overcomes a service gap, and also allows resources for existing face-to-face services to be directed to those patients with the most severe mental health concerns. Her research addresses real world patients’ needs and is shaped by community consultation and engagement at all stages – from successful development through to evaluation and implementation of the programs. Dr Ashleigh Smith, from the University of South Australia, uses cutting edge technology to measure physical activity and fitness, cognitive performance and brain blood flow to discover the underlying mechanisms of how exercise and physical activity modify the brains of older adults at risk of dementia. She hopes to determine the association between physical activity, aerobic fitness, brain health and cognitive performance. This research will help identify the optimal amount and types of physical activity to prevent or reduce dementia symptoms. Dr Frances Corrigan, from the University of Adelaide, focuses on understanding the role of inflammation following concussions. Her work suggests that inflammation can drive the accumulation of an abnormal brain protein and loss of brain tissue. By altering the inflammatory response, it is possible to have beneficial effects, even preventing the development of cognitive deficits. This potentially may lead to the development of the first drug intervention to prevent long term damage resulting from repeated concussion. Dr Zlatko Kopecki, from the University of South Australia, has identified a harmful protein in the skin that contributes to increased skin blistering. He is currently developing a therapy which neutralises the activity of this protein, and leads to improved healing, reduced infection and decreased incidence of cancer in pre-clinical models. It is likely that that the continued development of an active wound healing treatment such as this will improve the lives of many Australians, including the elderly, diabetic and obese. http://www.aips.net.au/tall-poppies/sa-tall-poppies/past-sa-tall-poppy-winners/2017-south-australian-award-winners/ Deakin University has announced that it is establishing its fifth research institute, the Institute for Healthcare Transformation. The new Institute will “deliver cutting edge health systems research, nationally and internationally”, according to an official statement. “This outward facing, collaborative initiative will leverage the University’s research strengths in health, building the scale and scope to support world-class health systems research, eHealth and health innovation. The new Institute will link researchers from diverse disciplines with a common focus on health by establishing multi-disciplinary collaborative approaches both within Deakin and across external organisations. New and existing partnerships with government, NGOs, industry and the community sector will further enhance the impact of our research.” The new institute will draw on the core expertise of two key Faculty of Health strategic research centres, the Centre for Population Health Research and the Centre for Quality and Patient Safety, along with other Faculty of Health research groups. It will also align with the Faculty of Science, Engineering and the Built Environment, and the newly-announced ARC Research Hub for Digital Enhanced Living that will be based at Deakin. Ms Rebecca Bartel has joined Deakin as Executive Lead of the new Institute, after several years as Executive Director of the Australian Centre for Healthcare Research. Initially, she will be responsible for setting up the necessary governance and operational processes, as well as strategic business and communication plans. The Faculty is in the process of appointing a Director for the Institute. http://www.deakin.edu.au/research/research-news/articles/new-health-institute-seeks-better-systems-of-health Curtin University has awarded the title of Emeritus Professor to Professor Michael Alpers from the Faculty of Health Sciences, in recognition of his distinguished service to the University. Professor Alpers is a Professor of International Health. His extensive research career has focused on infectious diseases, particularly tropical diseases. He has published over 300 peer reviewed articles, and he played a major role in unravelling the mystery of prion disease. Prions are proteins whose abnormal forms cause a group of diseases including mad cow disease, Creutzfeldt-Jakob disease (CJD). The title of Emeritus Professor is awarded to a Professor who is within six months of retirement and has demonstrated a distinguished service and commitment to the University. http://news.curtin.edu.au/media-releases/curtin-university-honours-three-outstanding-academics/ Flinders University has announced the appointment of Professor Alison Kitson as inaugural Vice-President and Executive Dean in its new College of Nursing and Health Sciences. Professor Kitson has over 200 publications and brings more than 30 years of experience in academic leadership and innovation to the role. She joins Flinders from the University of Adelaide where she has been Dean and Head of the School of Nursing. Professor Kitson’s prior roles include Executive Director of Nursing (Innovation and Reform) for the Central Adelaide Local Health Network, and Executive Director of Nursing at the Royal College of Nursing in the UK. http://news.flinders.edu.au/blog/2017/08/08/inaugural-leader-joins-college-nursing-health-sciences/

This calendar will be updated each month. If you have an event you would like to add, please include relevant details in an email to cswannell@mja.com.au. The full version of the calendar is available online at www.mja.com.au September 4 Mental Health in Education Summit, Sydney, NSW 5-7 11th National Aboriginal and Torres Strait Islander Environmental Health Conference, Cairns, QLD 6 Paediatric Nephrology Update, Darwin, NT 6 VicFEAT: Paediatrics Further Education and Training 2017, Melbourne, VIC 6-7 6th Annual International Emergency Care Conference, Melbourne, VIC 6-8 2017 Australian Palliative Care Conference: Connection with community, Adelaide, SA 6-8 10th ANZSIN Meeting, Darwin, NT 8 The Alfred Emergency and Trauma Centre Resuscitation Update, Melbourne, VIC 7-9 New Zealand Sexual Health Society 39th Annual Conference, Christchurch, NZ 8-10 Joint Neuroanaesthesia and Trauma SIG Meeting, Byron Bay, NSW 8-10 International Cornea and Contact Lens 2017 Congress: See The Light, Sydney, NSW 9-10 ANZCA/ASA SA NT Burnell Jose Visiting Professionals ASM: Anaesthesia and You: Understanding Human Factors and Optimising Performance, Rowland Flat, SA 12-14 AACB 55th Annual Scientific Conference: Time sensitive testing, Melbourne, VIC 13-15 28th Annual Conference of the Australasian Society of Clinical Immunology and Allergy, Auckland, NZ 14 RUOK? Day 14 2017 Innovations in Cancer Treatment and Care Conference, Sydney, NSW 14-15 3rd Australian Nursing and Midwifery Conference, Newcastle, NSW 14-16 Australian Doctors’ Health Conference, Sydney, NSW 14-16 Internal Medicine Society of Australia and New Zealand Annual Conference 2017, Hobart, TAS 14-17 Neuro-Ophthalmology Society of Australia 33rd Clinical and Scientific Meeting and NeuroVision Training Weekend, Sydney, NSW 15-17 RANZP Faculty of Psychotherapy Conference 2017, Ayers Rock, NT 15-17 ASBDD Biennial Conference: Better Treatments, Better Outcomes, Melbourne, VIC 15-17 ANZAAG Symposium: Perioperative drug hypersensitivity – working together to keep patients safe, Auckland, NZ 16 Epworth Healthcare Perioperative Medicine Symposium, Melbourne, VIC 17-20 2017 Rehabilitation Medicine Society of Australia and New Zealand 2nd ASM, Canberra, ACT 20 11th Florey International Postgraduate Research Conference, Adelaide, SA 20-22 6th APAC Forum: Lead the Change You Want to See, Gold Coast, QLD 20-23 AIDA Conference 2017: Family, Unity, Success, 20 Years Strong, Pokolbin, NSW 21-22 Big Data and Analytics Innovation Summit: Maximise the Potential of Your Big Data Initiatives, Sydney, NSW 22-23 Practical Management for Clinicians with Leadership Responsibilities, Queenstown, NZ 23 Trauma Radiology Course, Brisbane, QLD 25-27 RANZP New Zealand National Conference 2017: Uniting the pathways, Tauranga, NZ 25-27 9th International Global Virus Network Meeting, Melbourne, VIC 27-29 Joint 2017 ACHSM/ACHS Asia-Pacific Congress: The winds of change, adjust your sails, Sydney, NSW 29-30 Annual Scientific and Education Meeting of the Paediatric Society of Queensland, Brisbane, QLD October 3-4 2017 NDARC Annual Research Symposium, Sydney, NSW 4-6 Global Alcohol Policy 2017 Conference: Mobilising for Change: Alcohol Policy and The Evidence for Action, Melbourne, VIC 4-6 Australasian Gastro-intestinal Trials Group 19th Annual Scientific Meeting, Cairns, QLD 4-6 2017 Obesity Surgery Society of Australia and New Zealand Conference, Adelaide, SA 6-8 AORA ASM 2017, Adelaide, SA 6-8 ASUM 47th Annual Scientific Meeting, Melbourne, VIC 7-10 ASA National Scientific Congress 2017, Perth, WA 8-12 AOA 77th ASM and AGM, Adelaide, SA 9-13 Activity Based Funding Conference 2017 and 33rd Patient Classification Systems International Conference 2017, Sydney, NSW 11-13 42nd Australian and New Zealand ASM in Intensive Care and the 23rd Annual Paediatric and Neonatal Intensive Care Conference: ICU: Thinking Outside The Flags, Gold Coast, QLD 12-14 The Australian and New Zealand Head and Neck Cancer Society ASM, Brisbane, QLD 12-15 2017 Combined Orthopaedic Knee Societies Meeting, Noosa, QLD 13-14 Neonatal Organ Donation Workshop, Sydney, NSW 13-16 RCPA 47th Annual Scientific and Business Meeting, Canberra, ACT 12-14 APELSO 2017: ECMO and Beyond (The Future of Mechanical Support), Gold Coast, QLD 14-15 RANZCP Victorian Branch Conference, Marysville, VIC 16-18 3rd International Conference on Antimicrobial Agents and Chemotherapy, Melbourne, VIC 18-19 7th National Borderline Personality Disorder Conference 2017: From stigma, to strength, Perth, WA 18-21 9th World Congress of Melanoma and 14th International Congress of the Society for Melanoma Research, Brisbane, QLD 18-21 RACMA 2017 Conference: Past Reflections, Future Directions, Melbourne, VIC 19-22 RANZP Faculty of Child and Adolescent Psychiatry 2017: Growing Minds: The Early Origins of Mental Health and Disorder, Adelaide, SA 19-22 2017 RANZCR ASM: Explore The Extraordinary, Perth, WA 20 Crisis Management in Obstetric Anaesthesia and Neonatal Resuscitation, Sunshine, VIC 21-22 Update on Cardiac Arrhythmias and Devices, Sydney, NSW 22 Epworth HealthCare Seventh Cardiac Sciences Clinical Institute Symposium, Melbourne, VIC 23 10th Asian Conference on Pharmacoepidemiology, Brisbane, QLD 23-24 10th COGNO Annual Scientific Meeting, Melbourne, VIC 24-27 Australian Association of Practice Managers National Conference: The Magic of Management, Perth, WA 26-28 GP17 RACGP Annual Conference, Sydney, NSW 26-28 SPANZA 2017 Conference, Perth, WA 27-28 6th Annual Neuropsychiatry and Behavioural Neurology Conference, Sydney NSW 27-28 RACP Northern Territory ASM, Alice Springs, NT 28 Oct-1 Nov 49th RANZCO Annual Scientific Congress, Perth, WA 29-31 ISPE’s 10th Asian Conference on Pharmacoepidemiology, Brisbane, QLD 29 Oct-1 Nov RANZCOG Annual Scientific Meeting, Auckland, NZ November 1-3 10th Health Services and Policy Research Conference: Shifting Priorities: Balancing Acute and Primary Care Services, Gold Coast, QLD 1-3 Epilepsy Society of Australia 31st Annual Scientific Meeting, Perth, WA 2-4 Perioperative Medicine SIG Congress 2017: Cancer Surgery and Perioperative Medicine: Prehab to Rehab, Sydney, NSW 3 Swinburne Body Image and Related Disorders (BIRD) Conference, Hawthorn Campus, Melbourne, VIC 3-4 APS/ISPAD 10th Annual Diabetes Workshop, Gold Coast, QLD 5-6 Hepatitis C in Drug and Alcohol Settings Education Program, Canberra, ACT 7-8 20th Anniversary Showcase: National Centre for Immunisation Research and Surveillance, Sydney, NSW 8-11 NZ Anaesthesia ASM 2017: Fear and Excitement, Rotorua, NZ 9-10 RANZP Faculty of Psychiatry of Old Age Conference 2017, Queenstown, NZ 9-10 Hot topics in cerebral palsy research forum, Brisbane, QLD 10-12 General Practice Conference and Exhibition, Melbourne, VIC 12-15 22nd Australian and New Zealand Prevocational Medical Education Forum: Singing From the Same Songsheet, Brisbane, QLD 13-14 Global Experts Meeting on Gastroenterology, Melbourne, VIC 13-15 Clinical Oncology Society of Australia 2017 ASM: Immunotherapy: Molecules and Mountains, Sydney, NSW 13-19 Antibiotic Awareness Week 14-15 6th Annual NHMRC Symposium on Research Translation, Co-Hosted With The Lowitja Institute, Brisbane, QLD 14-16 2017 Annual Scientific Meeting of the Paediatric Society of New Zealand, Christchurch, NZ 15-17 Hospital in the Home Society of Australasia ASM: Changes, Challenges and Opportunity, Melbourne, VIC 15-17 2017 Australian & New Zealand Spinal Cord Society Annual Scientific Meeting, Brisbane, QLD 16-17 National NDIS Mental Health Conference, Sydney, NSW 16-18 ASID NZ 2017 Annual Meeting, Dunedin, NZ 17-18 Annual Australian Clinical Genomics Symposium 2017, Melbourne, VIC 17-19 National Histology Conference, Hobart, TAS 19-23 Australasian College for Emergency Medicine 34th ASM: Impossible is Just a Perspective, Sydney, NSW 20-21 11th International Conference on Immunopharmacology and Immunotoxicology: Novel Development and Applications in Immunology and Immunopharmacology, Melbourne, VIC 20-22 28th International Conference on Psychiatry and Mental Health 2017: Modernising and Accomplishing Mental Wellness Through Psychology and Psychiatric Empathy, Melbourne, VIC 20-24 Psychiatry Update 2017, Christchurch, NZ 23-26 Asian Pacific Society of Respirology Congress 2017, Sydney, NSW 24-25 Practical Management for Clinicians with Leadership Responsibilities, Sydney, NSW 25 Monash Medicine and the Media Workshop, Melbourne, VIC 26-29 APCCN 2017 – Asia Pacific Conference on Clinical Nutrition, Adelaide, SA 27-29 6th National Closing the Gap Indigenous Health Conference, and 2017 National Indigenous Mental Health Conference, Cairns, QLD 30 Nov-2 Dec Mercy Perinatal Global Obstetrics Update 2017, Melbourne, VIC December 1-2 International Summit on Infectious Diseases and Antibiotics, Brisbane, QLD 1-3 ResHealth2017: 3rd International Respiratory and Sleep Medicine Conference, Adelaide, SA 3-6 Australasian Neuroscience Society annual meeting, Sydney, NSW 6 AHHA Data and Innovation Collaboration Network Meeting, Dubbo, NSW 6-8 Sydney Cardiovascular Symposium 2017, Sydney, NSW 7-8 CPET and Prehabilitation Symposium: Incorporating POETTS (UK) accredited CPET course, Melbourne, VIC 7-12 Melbourne Neuro and Orthopaedic MRI Course, Melbourne, VIC 8-10 Entheogenesis Australis Outdoor Psychedelic Symposium, Eildon, VIC 2018 February 4-8 World Congress on Phlebology, Melbourne, VIC 7-9 National Indigenous Men’s Health Conference, National Indigenous Women’s Wellbeing Conference, Sydney, NSW 9-10 4th International 4 Corners of Cardiology Meeting, Melbourne, VIC 17 4th Australian Paediatric Society Allergy Masterclass, Melbourne, VIC 23-24 PICET Obstetric Intensive Care Symposium, Adelaide, SA 25-28 World Psychiatric Association 2018 Thematic Conference: Innovation in Psychiatry: Effective interventions for health and society, Melbourne, VIC 26 Feb-2 Mar Leadership and Innovation in Health 2017, Melbourne, VIC March 2-4 Pathology Update 2018, Sydney, NSW 8-11 APSCVIR 2018, Auckland, NZ 25-28 12th International Symposium on Medical Information and Communication Technology, Sydney, NSW 28-30 7th National Indigenous Domestic Violence Conference, Gold Coast, QLD April 7-8 2018 Neuromodulation Society of Australia and New Zealand 13th ASM, Sydney, NSW 11-13 2nd International Selection in the Health Professions Conference, Melbourne, VIC 18-20 New Zealand Population Health Congress 2018, Auckland, NZ 22-27 Hunter Paediatric Society Conference, Palm Cove, QLD May 7-11 Royal Australasian College of Surgeons Annual Scientific Congress 2018: Reflecting on what really matters, Sydney, NSW 13-17 RANZP Congress 2018: Becoming well together: Partnerships in health, Auckland, NZ 18-22 Australasian College of Dermatologists ASM, Gold Coast, QLD 20-23 5th Asian and Oceanic Regional Congress on Radiation Protection, Melbourne, VIC June 7-9 Rural Doctors Association of Queensland 29th Annual Conference, TBC August 15-18 World Congress on Cancers of the Skin, Sydney, NSW September 13-14 NOSA Annual Meeting 2018, Melbourne, VIC 15-16 Neurovision, Melbourne, VIC October 6-9 ASA National Scientific Congress 2018, Adelaide, SA 10-12 IHF World Hospital Congress 2018, Brisbane, QLD 25-28 2018 RANZCR ASM, Canberra, ACT November 8-10 New Zealand Anaesthesia Annual Scientific Meeting 2018, Auckland, NZ 8-10 RANZCP Faculty of Psychiatry of Old Age and the Asian Society Against Dementia Conference 2018, Melbourne, VIC 13-15 Clinical Oncology Society of Australia 2018 ASM, Perth, WA 18-22 Australasian College for Emergency Medicine, 35th ASM, Perth, WA 26-28 1st International Motor Impairment Conference, Sydney, NSW 2019 November 17-19 10th World Congress of Itch, Sydney, NSW 2021 November 10-13 XIII International Congress of Dermatology, Melbourne, VIC December TBA FIGO World Congress of Gynaecology and Obstetrics, Sydney, NSW

Cate Swannell