Mja cover 020418

Issues

Volume 208 Issue 6

2 April 2018

News

2 April 2018 Free

News briefs

Haphazard cholesterol checks place Australians at risk Researchers from Western Sydney University have found that many Australians may be at risk of developing cardiovascular disease because health checks are not being administered according to the national guidelines. They conducted an analysis of publicly available, linked patient records in the electronic databases of the Medicare Benefit Schedule (MBS) and Pharmaceutical Benefit Scheme (PBS). On the basis of the PBS data, the researchers collated the de-identified records of patients who had received stable prescriptions of cholesterol-lowering medications during the 7-year period, 2008–2014, and could therefore be defined as being at high risk of developing heart disease. They found that 49% of patients receiving medications to lower their cholesterol levels did not undergo the recommended annual high-density lipoprotein-cholesterol (HDL-C) test in a given year; and that 19% of the same population received more HDL-C tests than were necessary. The study, published in BMJ Open, explored several possible explanations for this finding. One pointed to a lack in continuity of care and to the fact that people often consult several different practitioners. The study also identified implications for the federal health budget of current practice. During the study period, the increased yearly expenditure associated with test overutilisation was approximately $4.3 million, while the cost averted because of test underutilisation was approximately $11.3 million per year. http://bmjopen.bmj.com/content/8/3/e019041 Eliminating malaria through gene editing Using the gene editing technique CRISPR/Cas9, researchers from Johns Hopkins University in the US have found that inactivating the gene FREP1 reduces the susceptibility of mosquitoes to infection with Plasmodium, the genus of parasites that cause malaria in humans. In the study published in PLOS Pathogens, the investigators found that FREP1 inactivation significantly suppressed infection of the mosquitoes with both human and rodent Plasmodium parasites. This indicates the potential of using CRISPR/Cas9 editing to alter the genomes of wild mosquito populations in order to prevent the spread of malaria, which kills nearly 500 000 people each year. However, the permanent inactivation of FREP1 throughout all developmental stages and in all tissues also leads to fitness costs for the treated mosquitoes, including reduced blood-feeding ability, lower fertility, lower egg-hatching rate, slowed development, and reduced longevity after feeding on blood. This means that these mosquitoes may not be able to compete with non-mutant mosquitoes in the wild effectively enough to block malaria transmission. The investigators are now exploring ways to inactivate FREP1 in the gut of adult female mosquitoes only, with the hope of retaining resistance to the malaria parasite without reducing the survival fitness of the treated insects. http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006898

Cate Swannell

Introduction

2 April 2018 Free

MJA sports medicine issue

I would firstly like to acknowledge and pay my respect to the past, present and emerging traditional custodians of the land on which we work and live. As a Gold Coast 2018 Commonwealth Games Ambassador, I’m thrilled to be a part of the MJA sports medicine issue, published to coincide with the Games. With over 70 nations and territories of the Commonwealth participating, it’s the biggest global sporting event hosted in Australia in over a decade. It’s a time to celebrate and be inspired by the incredible commitment and dedication that these exceptional athletes will demonstrate to the world. Behind every elite athlete is a team of highly skilled professionals, coaches, doctors and allied health professionals, supporting the preparation of the individual and team efforts of the competing nations. I hope these role models will motivate up-and-coming athletes to achieve their sporting goals as well as encourage ordinary Australians to become more active, participate in sports and consciously make the effort to move each day. This year the team from the Australasian Medical Publishing Company, publisher of the MJA, will again be staying active by running in the annual City2Surf in support of education programs delivered by the Cathy Freeman Foundation for Indigenous children across remote communities in Australia. Education is a critical pathway to increasing access to opportunities and improving the health and wellbeing of our community. In 2017, a record 16 students graduated Year 12 in the Cathy Freeman Foundation’s partner communities. This is a 25% increase from the previous year and shows the long term impact that our work is making within remote Indigenous Australian communities. Education changes lives. If I draw on my own experiences and if I hadn’t have gone to school, I would not have been on a pathway to realising my potential. Particularly as an athlete, but also as an individual.

Cathy Freeman

Perspectives

Reflection

Medical education

Book/media/app reviews

Editorials

Research

Research letter

Guideline review

Letters

Surgery 2 April 2018 Free

Untapped potential in Australian Hospitals for organ donation after circulatory death

To the Editor:We thank Rakhra and colleagues,1 whose report highlighted a group of potential donors yet to be fully exploited for organ transplantation. While this untapped potential appears to largely affect kidney and lung donor pools, we must not exclude the effect that relaxing donor suitability criteria may have on the heart. While not largely emphasised, the data collected for the heart are compelling, particularly for an organ so susceptible to ischaemic injury. Similar to the kidney and lungs, the data show that when including ideal and expanded criteria, potential donors more than doubled the number of donor hearts available for heart transplantation.1 This is an important finding, particularly if the authors have conservatively underestimated the actual potential for organ donation. In Australia, donation after circulatory death (DCD) kidney and lung donors comprise 25–30% of the total donor pool for these organs.2,3 Since 2014, the number of national and international hospitals now investigating DCD heart donation has increased, and we anticipate that DCD heart transplantation will follow the same trend as DCD lung and kidney transplant over time. The Critical Care Research Group at the Prince Charles Hospital has developed a clinically relevant 24-hour ovine model of brain stem death,4 and these donor hearts are being used to transplant into recipient animals. Transplant clinicians and researchers from the Prince Charles Hospital, the Alfred Hospital and St Vincent’s Hospital will collaboratively employ an ex vivo hypothermic perfusion system, capable of safely storing animal hearts up to 24 hours,5 together with novel cardioprotective therapeutics to increase the allowable ischaemic times for donor hearts without impairing graft function. This technology will hopefully extend to DCD donors in the future, which are currently only preserved using a warm blood perfusion system. By relaxing donor heart suitability criteria, and using novel machine perfusion technology to increase the storage time of the donor heart,5 thus eliminating time and travel distance constraints in Australia, the donor heart pool could be greatly increased. While the numbers may ultimately be modest, the positive effect on those recipients would be substantial.

Louise E See Hoe · David McGiffin · John F Fraser

Digestive system diseases 2 April 2018 Free

Eradicating hepatitis C from the New South Wales prison system

To the Editor:In October 2016, we achieved the eradication and control of hepatitis C virus (HCV) in a New South Wales correctional centre, which we believe to be a first of its kind in NSW. HCV prevalence in NSW prisons is 30–40 times higher than in the community, where prevalence is about 1%.1,2 Elevated risk of HCV infection is associated with the high proportion of prisoners who have injected drugs, the rate of injecting in prison, and restricted or limited access to bleach and needle and syringe programs.3 The Justice Health and Forensic Mental Health Network (the Network) is responsible for health care in the NSW forensic mental health and criminal justice systems. The availability of direct-acting antivirals on the Pharmaceutical Benefits Scheme in March 20164 created an opportunity for the Network to cure all patients with HCV infection in one prison. The Compulsory Drug Treatment Program (CDTP) is run at the Compulsory Drug Treatment Correctional Centre — a stand-alone prison with a stable sentenced inmate population, where patients with repeat drug-related charges participate in comprehensive drug treatment and rehabilitation. Patients at this correctional centre have longer sentences than those in other centres, which allowed for the full course of treatment. The Network, Corrective Services NSW and Hepatitis NSW formed a partnership to ensure that patients were able to access health centres, have their medication scripted and administered, could undertake monitoring and were supported through the Network’s established nurse-led model of care.5 All 58 patients in the CDTP were offered screening, and 54 patients with risk factors were screened; of these, 18 patients had chronic HCV infection. After further work-up, including liver elastography to measure fibrosis, all patients were concurrently commenced on treatment. Of the remaining four patients who were not screened, all had recent negative HCV pathology results. Three months after the treatment, 15 patients achieved sustained virological response equating to cure of their chronic HCV infection, and three patients were released before final assessment.6 Concurrent treatment commencement with the direct-acting antivirals was recognised as an innovative measure in reducing re-infection, in conjunction with the more common practices of harm minimisation education and use of the hospital-grade disinfectant for general cleaning purposes offered by Corrective Services NSW to all incarcerated people. Throughout the course of the project, two new patients were admitted, screened, and returned negative HCV pathology results. A proactive screening approach with patient consent was adopted to ensure that new cases were able to be identified and treated to maintain elimination. Maintaining a prison HCV-free may mean that patients have to take some responsibility with regard to sharing needles with new inmates. A peer education approach is being developed to increase patients’ ownership of a prison’s HCV-free status. The CDTP treatment model, combined with ongoing screening of new admissions, is an innovative approach for eliminating HCV, and is considered suitable for adoption in similar-sized prisons across Australia. The Network is currently rolling out this approach within NSW.

James Blogg · James Wood · Colette McGrath · Camilla Lobo

Environmental health 2 April 2018 Free

Tackling antimicrobial resistance globally

To the Editor:Your publication of a review on global approaches to antimicrobial resistance is timely.1 We especially note that antibiotic-resistant pathogens are not limited by borders, have greater impact on disadvantaged communities, and will require coordinated, high level government commitment to minimise their threat.1 In Australia, Indigenous communities bear a disproportionate burden of infectious diseases. This burden arises on a background of overcrowding, poorly built and maintained water and sanitation infrastructure, and colonisation of companion animals by human pathogens. The delivery of biomedically oriented health services leads to frequent use of broad spectrum antibiotics, promoting the development of multiresistant pathogens.2 The prominent multiresistant pathogen methicillin-resistant Staphylococcus aureus first emerged in hospitals, but, in Australia, it was soon identified in remote Indigenous communities.2 Health services have been unable to control its development and spread. As a consequence, community-acquired methicillin-resistant S. aureus is now the dominant strain of this bacterium in Central Australia, where Indigenous people are one-quarter of the population, but bear three-quarters of the S. aureus disease burden in Alice Springs Hospital.3 Primary health care is founded on full community participation and an intersectoral approach, incorporating education, housing and other sectors to complement health services.4 Housing for Indigenous communities remains inadequate, and government responses deficient, particularly in remote regions.5 As a result, even high quality health services have limited impact on Indigenous people’s health and wellbeing. Safe, secure, functioning housing that is appropriate for its occupants is a building block to manage other areas of Indigenous disadvantage.5 The deficit in appropriate housing contributes to bacterial colonisation, infection and development of antimicrobial resistance among Indigenous Australians.2 “Illness is a weapon” was intended as a metaphor for the resistance of Indigenous people to their ongoing colonisation.6 However, the threat of antibiotic resistance evolving through the neglected conditions in which some communities find themselves could make this metaphor more real than was likely intended. The spread of antibiotic-resistant pathogens in Indigenous communities and elsewhere is a global threat, which highlights the need to transform services for Indigenous people using approaches driven by communities and focused on their strengths.

Rosalie Schultz

Careers

2 April 2018 Free

Serendipity and the joy of surgery

Professor Tony Holmes, AO, has trained some of the world’s best craniofacial surgeons at the Royal Children’s Hospital and helped through his Jigsaw Foundation

Cate Swannell

2 April 2018 Free

Around the universities and medical institutes

Burnet Institute Deputy Director Professor Margaret Hellard has been appointed to chair the Viral Hepatitis Forum at this year’s World Innovation Summit for Health (WISH) in Qatar. Viral hepatitis has just been announced as one of nine research topics that will form the focus of the WISH 2018 conference, an initiative of Qatar Foundation (QF), from 13-14 November. The group’s findings will be presented in a report that will be published in time for WISH 2018 and will feature during a panel session, chaired by Professor Hellard. The aim of the report is to produce policy recommendations that can have a positive impact on the management of viral hepatitis and support global efforts being made to prevent transmission – particularly in vulnerable populations. Professor Hellard boasts more than 2 decades of clinical and research expertise, including using new technologies, such as social media, for health promotion and prevention interventions. https://www.burnet.edu.au/news/924_eliminating_viral_hepatitis_a_major_focus_at_wish_2018 Baker Heart and Diabetes Institute has announced the sale of its clinical research subsidiary, Nucleus Network – which operates Australia’s leading phase one clinical trial facility -- to Australian private equity firm, Crescent Capital Partners. The sale will enable the Baker Institute to invest more funds in medical research to tackle the greatest health challenges facing Australians today. Start-up funding and the foresight of the then Labor Government in Victoria helped establish Nucleus Network in 2003 through the provision of establishment grants. Nucleus Network has since conducted more than 500 early phase and first-in-human clinical trials for global pharmaceutical and biotechnology companies. Crescent Capital Partners is one of the most active and experienced investors in the Australian health care sector, including through its investments in National Dental Centre, skin cancer clinic owner Sun Doctors, MyHealth Medical Centres, pathology provider Australian Clinical Labs and previous interests in National Hearing Care and ASX listed device company, LifeHealthcare. The Baker Institute will continue to take an active interest in Nucleus Network, with an option to maintain up to 20% of the business. Nucleus Network employs more than 100 full-time and part-time employees, with the company conducting trials for a wide range of global biotechnology and pharmaceutical clients. Nucleus Network is based in the Alfred Medical Research and Education Precinct in Melbourne’s inner south-east, adjacent to the Baker Institute. The company, which operates an 80-bed clinical trials facility, has extensive experience evaluating new therapeutic treatments including vaccines and devices in both healthy volunteer and patient populations for a variety of early-stage clinical trials. https://www.baker.edu.au/news/media-releases/MR-nucleus-network-sale A multidisciplinary team of scientists from research institutes across Australia, Israel, the UK and the USA has been shortlisted to the final stages of Cancer Research UK’s Grand Challenge – an ambitious series of £20m global grants tackling some of the toughest questions in cancer research. The project aims to demystify the phenomenon of “cell dormancy” – where cancer cells not killed by initial treatment can “go to sleep” for months or years, only to wake later and start to form a new cancer. The reawakening of dormant cells often happens without warning, making the returning cancers hard to predict and treat, often with devastating effect. The researchers seek to accelerate understanding of cancer cell dormancy and to answer questions once thought impossible to solve: Why do cancer cells become dormant? And what causes them to wake up and form a new cancer? Their Grand Challenge project aims to create a map of the biological environment around dormant cancer cells in space and time, and to uncover the processes that control them – with the ultimate aim of stopping an individual’s cancer from returning. Led by Professor Peter Croucher (Garvan Institute of Medical Research, Sydney), the international team involves researchers at Garvan, QIMR Berghofer Medical Research Institute and the University of Adelaide in Australia, as well as Israel’s Weizmann Institute of Science, the Babraham Institute (UK), University of Oxford (UK), Yale University (USA) and Washington University (USA). http://www.qimrberghofer.edu.au/2018/02/australian-led-team-shortlisted-cancer-research-uks-grand-challenge-award/ A team of researchers, led by Professor Rod Hicks from the Peter MacCallum Cancer Centre, has been awarded a $1.5 million grant from the US-based Neuroendocrine Tumour Research Foundation (NETRF) to study new treatment approaches for this rare and difficult to treat cancer. The international NETRF grant will allow a team of Peter Mac-led researchers to investigate new ways to tackle neuroendocrine tumours (NETs) using cutting-edge peptide receptor radionuclide therapy (PRRT) combined with different types of drugs in the hope of improving survival of people with NET. The new study will build on previous work into the use of drugs to sensitive cancers to PRRT, established by Prof Rod Hicks, Peter Mac’s Director of the Centre for Cancer Imaging, Head of the Molecular Imaging and Targeted Therapeutic Laboratory and Co-Chair of the Neuroendocrine Service, and Dr Shahneen Sandhu, clinician researcher and Medical Oncologist at Peter Mac. The project will bring together experts from across Australia and New Zealand, including Dr Price Jackson whose medical physics program will provide tools that allow the accurate measurement of radiation dose to tumours, and Dr Richard Tothill and Associate Professor Kaylene Simpson who will perform sophisticated genomic studies to identify genetic signatures associated with response to PRRT. These studies will be supported by the expertise of the University of Melbourne’s Professor Sean Grimmond, a world authority on NET genomics, and genomics and clinical experts from the University of Auckland, Professor Cris Print and Dr Ben Lawrence. In parallel, pre-clinical testing of new drug combinations with PRRT will be undertaken by Dr Carleen Cullinane, and a clinical trial of a novel combination therapy will be led by Dr Grace Kong from Cancer Imaging and Associate Professor Michael Michael from Medical Oncology at Peter Mac. Dr Sandhu will provide her expertise for the final design and implementation of the clinical study. https://www.petermac.org/news/research-rare-cancers-receives-funding-boost A total of 17 finalists have been shortlisted for the 24th Victorian Premier’s Awards for Health and Medical Research. For Public Health Researcher, the finalists are: Dr Peter Azzopardi (The University of Melbourne/Murdoch Children’s Research Institute and Wardliparingga Aboriginal Research Unit), The health of Australian Aboriginal and Torres Strait Islander adolescents; Dr Paddy Dempsey (Monash University/Baker Heart and Diabetes Institute), Sitting on a ticking time bomb: preventing and managing type 2 diabetes in a sitting-centric world; Dr Daniel Engelman (The University of Melbourne/Murdoch Children’s Research Institute), Novel strategies for the prevention of rheumatic heart disease; Dr Jason Kwong (The University of Melbourne/The Peter Doherty Institute for Infection and Immunity), Whole-genome sequencing to enhance the public health control of infectious diseases in Australia; Ms Kerryn Moore (The University of Melbourne/ Burnet Institute/Shoklo Malaria Research Unit), The impact of malaria in pregnancy on birth outcomes in Asia. For Basic Science Researcher, the finalists are: Dr Nicholas Gherardin (The University of Melbourne at the Peter Doherty Institute for Infection and Immunity), Understanding immune cells that respond to vitamins: How they work, and how we can use them to fight cancer; Dr Hui-Fern Koay (The University of Melbourne/Peter Doherty Institute for Infection and Immunity), How our mucosal associated invariant T (MAIT) cells develop; Dr Tan Nguyen (The University of Melbourne/Walter and Eliza Hall Institute for Medical Research), Love thy neighbour: how uninfected cells help combat viral infection; Dr Ashleigh Poh (The University of Melbourne/Oliva Newton John Cancer Research Institute), Understanding the role of Haematopoietic Cell Kinase (Hck) in gastric and colon cancer; Mr Dean Sydney Tyler (The University of Melbourne/Peter MacCallum Cancer Centre), Preclinical evaluation of targeted epigenetic therapies. For Clinical Researcher the finalists are: Dr Ada Cheung (The University of Melbourne, Department of Medicine, Austin Health), Muscle effects of hormone therapy in men with prostate cancer; Dr Ingrid Hopper (Monash University, Department of Epidemiology and Preventive Medicine), Reducing medication in patients with heart failure; Ms Aya Mousa (Monash University, Monash Centre for Health Research and Implementations), Vitamin D and cardiometabolic risk factors and diseases; Dr Benjamin Teh (The University of Melbourne/Peter MacCallum Cancer Centre), Improving the care of infections in patients with blood cancer multiple myeloma treated with new generation therapies; Dr Paul Yeh (The University of Melbourne/Peter MacCallum Cancer Centre), Non-invasive testing for blood cancers using liquid biopsy. For Health Services Researcher, the finalists are: Dr Gabrielle Haeusler (Sir Peter MacCallum Department of Oncology, The University of Melbourne), Improving the quality of research and the delivery of care for one of the most common complications of cancer treatment in children; Dr Jason Trubiano (The University of Melbourne/Department of Medicine, Austin Health), The impact of antibiotic allergy on the safe and appropriate use of antibiotics in Australian hospitals. https://www2.health.vic.gov.au/about/clinical-trials-and-research/premiers-award

Cate Swannell

2 April 2018 Free

Calendar of conferences in Australia and New Zealand

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 https://www.mja.com.au/careers April 4-6 2018 ANZICS New Zealand Regional ASM, Auckland, NZ 7-8 2018 Neuromodulation Society of Australia and New Zealand 13th ASM, Sydney, NSW 8-11 Australian Pain Society 38th and New Zealand Pain Society Conjoint ASM, Sydney, NSW 9 Paediatric Anaesthesia Crisis Management (PACMaC) Course, Wellington, NZ 11-12 6th Rural and Remote Health Scientific Symposium: Outback Infront, Canberra, ACT 11-12 Australian Telehealth Conference 2018, Sydney, NSW 11-12 Molecular Microbiology Meeting 2018, Sydney, NSW 11-13 2nd International Selection in the Health Professions Conference, Melbourne, VIC 11-18 Pain Revolution 2018: Rural Outreach and Cycling Tour, various venues 13-15 12th Annual Update in Paediatric Emergencies, Noosa, QLD 15-19 International Symposium on Pneumococci and Pneumococcal Diseases, Melbourne, VIC 17 RACGP Vic: Walking on Thin ICE: Methamphetamine in General Practice, Warrnambool, VIC 18 GEM SEM 2018, Brisbane, QLD 18-20 New Zealand Population Health Congress 2018, Auckland, NZ 20-24 12th Congress of the World Federation of Nuclear Medicine and Biology, Melbourne, VIC 22-27 Hunter Paediatric Society Conference, Palm Cove, QLD 27-29 Spine Society of Australia 29th Annual Scientific Meeting, Adelaide, SA 28-29 Transplantation Society of Australia and New Zealand PGC, Melbourne, VIC 29 Apr-1 May Transplantation Society of Australia and New Zealand ASM, Melbourne, VIC MAY 1-4 New Zealand Society for the Study of Diabetes, Hamilton, NZ 2-4 Toxicology and Poisons Network Australasia Scientific Meeting, Sydney, NSW 4-6 Melbourne Private Practice “Comprehensive” 2018, Melbourne, VIC 5 Melbourne Ophthalmic Alumni Meeting, Fitzroy, VIC 5 Toxic Issues in Acute Care - Wikitox Course, Sydney, NSW 5-6 Australasian Musculoskeletal Imaging Group 2018 ASM: Upper limb and spine imaging, Gold Coast, QLD 5-8 ANZCA/ASA/NZSA Obstetric Anaesthesia SIG Meeting, Sydney, NSW 6 ANZCA Faculty of Pain Medicine Refresher Course Day and Faculty Dinner, Sydney, NSW 7-11 Royal Australasian College of Surgeons Annual Scientific Congress 2018: Reflecting on what really matters, Sydney, NSW 7-11 ANZCA ASM, Sydney, NSW 9 ANZCA Airway Management SIG Meeting, Sydney, NSW 10-12 Australasian Society for Infectious Diseases ASM, Surfers Paradise, QLD 11 Bendigo Regional Critical Care Conference 2018, Bendigo, VIC 11-12 RANZCO New Zealand Branch ASM, Auckland, NZ 12 RACGP SA: Introduction To Point-of-care Ultrasound for GPs, TBA 13-17 RANZP Congress 2018: Becoming well together: Partnerships in health, Auckland, NZ 14-16 RACP Congress 2018: Disruption for Health Futures, Sydney, NSW 15 RACGP Vic: Walking on Thin ICE: Methamphetamine in General Practice, East Melbourne, VIC 18-20 General Practice Conference and Exhibition, Sydney, NSW 18-22 Australasian College of Dermatologists ASM, Gold Coast, QLD 20-23 5th Asian and Oceanic Regional Congress on Radiation Protection, Melbourne, VIC 26 AGES Laparoscopic Pelvic Anatomy Demonstration Workshop, Brisbane, QLD 26-27 Australian and New Zealand Society of Retinal Specialists Meeting, Melbourne, VIC 27 Australasian Gynaecological Endoscopy and Surgery Society Pelvic Anatomy Dissection Cadaveric Workshop, Brisbane, QLD 29 May-1 Jun Australian and New Zealand Association of Neurologists 2018 ASM, Darwin, NT 30 May-1 Jun Choosing Wisely Australia: National Medicines Symposium, Canberra, ACT 30 May-1 Jun GPDU18: Learning, peer support, advocacy, Gold Coast, QLD 31 May-2 Jun Combined meeting: Australian Orthopaedic Association Continuing Orthopaedic Education Conference and the 2018 Asia-Pacific Knee, Arthroscopy and Sports Medicine Society Congress, Sydney, NSW JUNE 7-9 Rural Doctors Association of Queensland 29th Annual Conference, TBC 8-10 AOA Queensland 2018 Annual Scientific Meeting, Noosa, QLD 9-10 RANZCO Tasmanian Branch ASM, Hobart, TAS 14-16 2nd International Conference and Expo on Cataract and Advanced Eye Care, Melbourne, VIC 15-16 ANZCA Rural SIG Meeting, Ayers Rock Resort, NT 16-17 Rehabilitation Medicine Society of Australia and New Zealand Snapshots 2018, Melbourne, VIC 18 World Continence Week 22-23 ASOHNS Head and Neck Cadaver Dissection Course, Brisbane, QLD 22-24 2018 Australasian Orthopaedic Trauma Society meeting, Noosa, QLD 23-24 Australasian Gynaecological Endoscopy and Surgery Society Trainee Workshop, Sydney, NSW 27-29 Australian & New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2018, Sydney, NSW JULY TBA AMSA National Convention 2018, Perth, WA 1-4 Australian & New Zealand Association for Health Professional Educators Conference, Hobart, TAS 4-7 Australian Society of Gynaecologic Oncologists ASM 2018, Taupo, NZ 9-11 20th Asia Pacific Diabetes Conference: Therapeutic Approaches for Diabetes Management and Endocrine Complications, Sydney, NSW 12-13 Hematologists Global Summit 2018, Sydney, NSW 12-14 RANZCO Paediatrics SIG ASM, Noosa Heads, QLD 16-18 21st World Nursing Education Conference, Melbourne, VIC 20 AOA South Australia/Northern Territory Branch Annual Scientific Meeting, Darwin, NT 22 ASOHNS 2018 Robert Guerin Memorial Annual Trainees Meeting, TBA 23-24 AGES Trainee Workshop, Sydney, NSW 27-28 WA TSANZ Annual Scientific Meeting, Floreat, WA 28 Sydney Eye Hospital Alumni Association 12th Biennial Meeting, Sydney, NSW 28 Annual ANZCA/ASA Combined CME Meeting, Melbourne, VIC 28-29 General Practice Conference and Exhibition, Perth, WA 29 Jul-1 Aug Health Informatics Society of Australia HIC 2018, Sydney, NSW AUGUST 2-4 Australasian Gynaecological Endoscopy and Surgery Society Pelvic Floor Symposium, Brisbane, QLD 2-4 Australian Society for Psychosocial Obstetrics and Gynaecology 44th ASM: Women’s Health, Lives and Rights, Sydney, NSW 2-5 RANZCO Queensland Branch ASM, Main Beach, QLD 3-4 AGES XIX Pelvic Floor Symposium 2018, Brisbane, QLD 14-16 Otitis Media Australia 2018: Closing the gap with hearing, Darwin, NT 15-17 TSANZ NZ Branch Annual Scientific Meeting, Queenstown, NZ 15-18 World Congress on Cancers of the Skin, Sydney, NSW 26-29 Don’t Forget the Bubbles 2018: Science + story, Melbourne, VIC 27 ANZICS 9th Annual Winter Research Forum, Sydney, NSW 29 Aug-2 Sep Society for Paediatric Anaesthesia in New Zealand and Australia 2018 Annual Conference, Darwin, NT 30 Aug-1 Sep 2018 Annual Conference of the Neurodevelopmental and Behavioural Paediatric Society of Australasia, Melbourne, VIC 30 Aug-1 Sep Frontiers 2018 - The Art, Science and Future of Otorhinolaryngology, Cairns, QLD SEPTEMBER 3-5 11th World Congress on Endocrinology and Metabolic Disorders, Auckland, NZ 6-7 Australian Association of Developmental Disability Medicine 2018 Conference, Sydney, NSW 6-8 Triennial Masters' Symposium on Functional and Aesthetic Rhinoplasty, Sydney, NSW 10-12 BMJ International Forum on Quality & Safety in Healthcare, Melbourne, VIC 11-13 GPTEC 2018: Switch on, Adelaide, SA 13-14 NOSA Annual Meeting 2018, Melbourne, VIC 13-16 Neuro-Ophthalmology Society of Australia (NOSA) 34th Clinical & Scientific Meeting and NeuroVision Training Weekend, Melbourne, VIC 14 ASID/ESCMID Course on Infectious Diseases in Pregnant Women, Fetuses and Newborns, Sydney, NSW 14-16 Internal Medicine Society of Australia and New Zealand (IMSANZ) Conference 2018, Hobart, TAS 14-16 General Practice Conference and Exhibition, Brisbane, QLD 15-16 Neurovision, Melbourne, VIC 16-19 RANZCOG 2018 Annual Scientific Meeting, Adelaide, SA 21-23 ANZCA Combined SIG Meeting, Byron Bay, NSW 24 The 6th Australian Health Economics Doctoral Workshop, Hobart, TAS 25-26 The 40th Annual Australian Health Economics Society Conference, Hobart, TAS 26-28 AIDA Conference 2018: Vision into action, Perth, WA OCTOBER 2-5 SSEM 2018, Daydream Island, QLD 5-6 ANZCA Cardiac Thoracic Vascular and Perfusion SIG Meeting, Adelaide, SA 6-9 ASA National Scientific Congress 2018, Adelaide, SA 7-11 Australian Orthopaedic Association ASM 2018: Better Patient Outcomes, Perth, WA 10-12 IHF World Hospital Congress 2018, Brisbane, QLD 11-13 ANZICS/ACCCN Intensive Care ASM, Adelaide, SA 11-14 RACGP: GP18, Gold Coast, QLD 16-19 71st Annual General and Scientific Meeting of the New Zealand Society of Otolaryngology Head and Neck Surgery, Queenstown, NZ 21 Pain Interest Group Nursing Issues Professional Development Day, Sydney, NSW 21-24 Combined ASM of the Haematology Society of Australia and New Zealand, the Australian and New Zealand Society of Blood Transfusion and the Thrombosis and Haemostasis Society of Australia and New Zealand, Brisbane, QLD 24-27 27th National Conference on Incontinence, Hobart, TAS 25-27 ANZCA Perioperative Medicine SIG Meeting, TBA 25-28 2018 RANZCR ASM, Canberra, ACT 26-28 Australian College of Rural and Remote Medicine and Rural Doctors Association of Australia: Rural Medicine Australia 2018, Darwin, NT NOVEMBER 2-3 Australasian Gynaecological Endoscopy and Surgical Society Focus Meeting, Canberra, ACT 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 16-18 General Practice Conference and Exhibition, Melbourne, VIC 17-21 50th Annual Scientific Congress of the Royal Australian and New Zealand College of Ophthalmologists, Adelaide, SA 18-22 Australasian College for Emergency Medicine, 35th ASM, Perth, WA 21-23 11th Hospital in the Home ASM, Brisbane, QLD 21-24 6th Asia-Oceanian Conference of Physical and Rehabilitation Medicine combined with the Rehabilitation Medicine Society of Australia and New Zealand's 3rd Annual Scientific Meeting, Auckland, NZ 23-25 Queensland Hand Surgery Society Conference, Noosa, QLD 26-28 1st International Motor Impairment Conference, Sydney, NSW DECEMBER 1 Australasian Gynaecological Endoscopy and Surgery Society Pelvic Anatomy Dissection Cadaveric Workshop, Brisbane, QLD 2019 MARCH 1-2 Australia and New Zealand Strabismus Society Meeting (Squint Club), Parkville, VIC 22-24 ASOHNS 69th Annual Scientific Meeting, South Brisbane, QLD 25-30 International Neuromodulation Society 14th World Congress, Sydney, NSW 27-30 8th World Glaucoma Congress, Melbourne, VIC MAY 18-21 Australasian College of Dermatologists Annual Scientific Meeting, Melbourne, VIC SEPTEMBER 29 Sep-2 Oct 18th Biennial Clinical Neurophysiology Workshop, Gold Coast, QLD NOVEMBER 17-19 10th World Congress of Itch, Sydney, NSW 2020 MAY 16-18 Australasian College of Dermatologists Annual Scientific Meeting, Adelaide, SA 2021 NOVEMBER 10-13 XIII International Congress of Dermatology, Melbourne, VIC DECEMBER TBA FIGO World Congress of Gynaecology and Obstetrics, Sydney, NSW

Cate Swannell

Next Issue Volume 208 Issue 7

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Mja cover 160418
News 16 April 2018 Free

News briefs

Cate Swannell

Perspectives 16 April 2018 Free

Tackling the worsening epidemic of Buruli ulcer in Australia in an information void: time for an urgent scientific response

Daniel P O'Brien · Eugene Athan · Kim Blasdell · Paul De Barro

Previous Issue Volume 208 Issue 5

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Mja cover 190318
News 19 March 2018 Free

News briefs

Cate Swannell

Perspectives 19 March 2018 Free

The gaps in specialists’ diagnoses

Ian A Scott · Donald A Campbell

Perspectives 19 March 2018 Free

Will Australia have a fit-for-purpose medical workforce in 2025?

Roger P Strasser

Medical education 19 March 2018 Clinical skills Free

Bedside cognitive assessment

Lorenzo Norris · Elizabeth L Cobbs

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