Volume 209 Issue 5

It is essential that any clinician who orders breast cancer genetic testing understands the complexities and implications

Judy Kirk · Kristine K Barlow-Stewart · Nicola K Poplawski · Margaret Gleeson · Kathy Tucker · Michael Friedlander

The higher cost of whole genome sequencing is justified through better diagnostic yields and the potential for future analysis

John S Mattick · Marcel Dinger · Nicole Schonrock · Mark Cowley

More than a building: a change in direction of medical education

Catherine E Storey

Learning to navigate the complexities of professional identity formation should benefit the profession and in turn improve the safety and effectiveness of patient care

Charlotte E Rees · Lynn V Monrouxe

By establishing well functioning internal procedures and by informing patient expectations as to how their information is managed and by whom, the aftermath of a data breach may be reduced in severity

David J Carter · Samuel Hartridge

A benchmark for the referral rate to inpatient rehabilitation could reduce the evidence–practice gap

Justine M Naylor · Richard Walker

A cautious response to public interest in medical uses of cannabis products remains appropriate

Wayne D Hall · Michael Farrell

Consumer perspectives of medical cannabis and preferred models of availability differ from those of professional medical groups

Nicholas Lintzeris · Jessica Driels · Natalie Elias · Jonathon C Arnold · Iain S McGregor · David J Allsop

Cannabidiol as an adjunct treatment had some subjective benefit and a manageable adverse event profile

Kerrie-Anne Chen · Michelle Farrar · Michael Cardamone · Deepak Gill · Robert Smith · Christopher T Cowell · Linda Truong · John A Lawson

Substantial variation in inpatient rehabilitation rates is unexplained by patient factors, suggesting some low value care

Chris Schilling · Catherine Keating · Anna Barker · Stephen F Wilson · Dennis Petrie

Cannabidiol has potential benefits, but also short term adverse effects that must be understood and mitigated

Jeremy L Freeman

We need to reduce the barriers to primary care access for people experiencing homelessness to stop the costly revolving door between homelessness and the hospital system

Andrew Davies · Lisa J Wood

To the Editor: The recent guideline review by Almeida and colleagues1 coincides with an international call for action to address the burden of low back pain.2 Low back pain is a major societal problem and the number one cause of disability internationally. Recent guidelines prioritise advice, reassurance and self-management as first line care. Implementing these simple, high value interventions is important in populations, such as Aboriginal Australians, where there has been limited previous recognition of low back pain as a problem. A recent systematic review of musculoskeletal pain among Aboriginal Australians3 summarised that the prevalence of low back pain is higher among Aboriginal Australians and has disproportional impacts. Qualitatively, low back pain has multidimensional effects, including functional, cultural and emotional. Access to both primary and specialist level care is lower for some musculoskeletal pain conditions such as osteoarthritis, and there may be parallels for low back pain. Worryingly, there is evidence that the health care that Aboriginal people receive for low back pain is worse than that received by non-Aboriginal Australians, including care with the potential to cause iatrogenic harm. These include higher rates of opioid prescribing and unhelpful low back pain information. Low back pain is associated with a higher number of comorbid health issues, psychological stress and income poverty, and may contribute to the complex milieu of health burden and disadvantage for some Aboriginal communities. The implementation of effective, high value, first line care described by Almeida and colleagues1 is critical for Aboriginal people with low back pain; however, it needs to be adapted so that it is acceptable, accessible and appropriate. For example, advice and education to reassure patients and encourage self-management may need to be supported by culturally appropriate low back pain information. This could include visual, story-based information that has been developed with input from Aboriginal people.4 Implementing successful self-management requires doctors to develop trusting relationships with patients in services that are culturally secure for Aboriginal people. Effective communication is critical.5 The provision of evidence-informed low back pain care to Aboriginal patients requires better recognition of low back pain as a health issue affecting Aboriginal Australians, and a greater understanding of how such care can be best implemented in Aboriginal communities.

Ivan Lin · Donna B Mak · Juli Coffin · Peter O'Sullivan

In reply

Matheus Almeida · Bruno Saragiotto · Chris G Maher

This calendar will be updated regularly. 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 September 9-12 Fertility Society of Australia Annual Conference 2018, Melbourne, VIC 9-13 Australia and New Zealand Forensic Science Society 24th International Symposium on the Forensic Sciences, Perth, WA 10-12 BMJ International Forum on Quality & Safety in Healthcare, Melbourne, VIC 11-13 GPTEC 2018: Switch on, Adelaide, SA 12-14 Australia and New Zealand Child Neurology Society 7th ASM 2018, Perth, WA 13-14 NOSA Annual Meeting 2018, Melbourne, VIC 13-15 57th Annual Scientific Meeting (ASM) of the International Spinal Cord Society (ISCoS), Sydney, NSW 13-15 SARRAH National Conference for Rural and Remote Allied Health Professionals, Darwin, NT 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 14-16 39th Australasian Dermatopathology Society ASM, Adelaide, SA 14-16 Australian Psychosis Conference, Sydney, NSW 15-16 Neurovision, Melbourne, VIC 15-16 RANZCOG 2018 Aboriginal and Torres Strait Islander Women’s Health Meeting: Turning Tides, Adelaide, SA 16-19 RANZCOG 2018 Annual Scientific Meeting, Adelaide, SA 17-18 PharmaAus18, Canberra, ACT 17-19 Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, Adelaide, SA 18-19 Consumers Health Forum of Australia Inaugural Youth Health Forum, Canberra, ACT 19-21 23rd Hospice NZ Palliative Care Conference, Auckland, NZ 20-23 Australasian Society of Cosmetic Dermatologists Symposium, Melbourne, VIC 21 Pain Interest Group Nursing Issues Professional Development Day, Sydney, NSW 21 2nd Australasian Neurofibromatosis Conference 2018, Melbourne, VIC 21-23 ANZCA Combined SIG Meeting, Byron Bay, NSW 21-23 RCPA New Zealand Committee of Pathologists ASM 2018, Wellington, NZ 24 The 6th Australian Health Economics Doctoral Workshop, Hobart, TAS 24-26 Australasian HIV and AIDS Conference 2018, Sydney, NSW 25-26 The 40th Annual Australian Health Economics Society Conference, Hobart, TAS 26-28 AIDA Conference 2018: Vision into action, Perth, WA 26-28 Australian Public Health Conference, Cairns, QLD 27-28 National Eating Disorders and Obesity Conference, Tweed Heads, NSW 29 Sep-1 Oct Australian and New Zealand Society for Vascular Surgery 2018, Auckland, NZ OCTOBER 2-4 National Aboriginal and Torres Strait Islander Health Worker Association 2018 Symposium, Alice Springs, NT 2-5 SSEM 2018: Peripheral Hospitals Emergency Medicine Conference, Daydream Island, QLD 2-6 32nd International Papillomavirus Conference, Sydney, NSW 4-6 International Society for Hip Arthroscopy 2018 ASM, Melbourne, VIC 5 Quality Improvement Scientific Symposium 2018, Wellington, NZ 5-6 ANZCA Cardiac Thoracic Vascular and Perfusion SIG Meeting, Adelaide, SA 5-6 Australasian Melanoma Conference 2018, Melbourne, VIC 5-7 Australasian Trauma Society 22nd ASM, Perth, WA 6-8 MRI – Upper and Lower Limb Interpretation Workshop 2018, Sydney, NSW 6-9 Australian Society of Anaesthetists National Scientific Congress 2018, Adelaide, SA 7-10 Australian and New Zealand Society of Occupational Medicine (ANZSOM) Annual Scientific Meeting 2018: Perspectives in Occupational Health, Melbourne, VIC 7-11 Australian Orthopaedic Association ASM 2018: Better Patient Outcomes, Perth, WA 8-9 Australia and New Zealand Gastric and Oesophageal Surgery Association and the Australia and New Zealand Hepatic, Pancreatic and Biliary Associated Combined Meeting 2018, Wellington, NZ 10-12 IHF World Hospital Congress 2018, Brisbane, QLD 10-13 Sports Medicine Australia 2018, Perth, WA 11-12 Sydney Cancer Conference, Sydney, NSW 11-13 ANZICS/ACCCN Intensive Care ASM, Adelaide, SA 11-13 Melbourne International Breast Congress, jointly held with the Australasian Society for Breast Disease, 4th World Congress on Controversies in Breast Cancer and Breast Surgeons of Australia and New Zealand, Melbourne, VIC 11-14 RACGP: GP18, Gold Coast, QLD 12 VMIAC Consumer Awards, Brunswick, VIC 12-14 Australasian Military Medicine Association 27th Conference: Armistice to Afghanistan: Evolution of military healthcare, Canberra, ACT 14-17 New Zealand Orthopaedic Association ASM 2018, Rotorua, NZ 15-17 10th Australian Rural and Remote Mental Health Symposium, Hobart, TAS 16-19 71st Annual General and Scientific Meeting of the New Zealand Society of Otolaryngology Head and Neck Surgery, Queenstown, NZ 16-19 Australian and New Zealand Burn Association ASM 2018, Brisbane, QLD 16-19 Australian Association of Practice Management Conference, Canberra, ACT 17-20 Australasian Sleep Association Sleep DownUnder 2018, Brisbane, QLD 17-20 Australasian Society of Cataract and Refractive Surgeons 22nd Annual Conference 2018, Noosa, QLD 17-20 Royal Australian and New Zealand College of Psychiatrists’ Faculty of Child and Adolescent Psychiatry Conference 2018, Perth, WA 18-20 Australian and New Zealand Association of Oral and Maxillofacial Surgeons Annual Meeting 2018, Perth, WA 19 Australasian Diabetes Advancements and Technologies Summit, Sydney, NSW 19-20 2018 RACS Victorian Annual Scientific Meeting, Melbourne, VIC 19-20 Paediatric Society of Queensland Annual Scientific and Educational Meeting, Brisbane, QLD 20-21 Australasian College of Legal Medicine 2018 ASM: Personal injury law, 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 22-24 Australasian Epidemiological Association 31st ASM, Fremantle, WA 24-26 44th International Mental Health Nursing Conference: Mental health is a human right, Cairns, QLD 24-26 Urological Society of Australia and New Zealand – New Zealand Section Meeting 2018, Palmerston North, NZ 24-27 27th National Conference on Incontinence, Hobart, TAS 24-27 General Practice and Acute Medicine Update Refresher, Melbourne, VIC 25-26 Emergency Nurse Leadership Program, Melbourne, VIC 25-27 ANZCA Perioperative Medicine SIG Meeting, Melbourne, VIC 25-27 Colorectal Surgical Society of Australia and New Zealand and the Colon and Rectal Surgery Section of the RACS Spring Colorectal Meeting 2018, Fremantle, WA 25-28 2018 RANZCR 69th ASM, Canberra, ACT 25-28 Australian College of Rural and Remote Medicine and Rural Doctors Association of Australia: Rural Medicine Australia 2018, Darwin, NT 26 New Zealand Sports Medicine Conference 2018, Nelson, NZ 26-27 Innovations in Rehabilitation and Mental Health Conference, Melbourne, VIC 26-27 2018 RACP Northern Territory ASM: Vulnerable populations, Darwin, NT 26-28 Australian Anaesthesia Allied Health Practitioners 3rd National Conference, Sydney, NSW 27 Alfred Pain Symposium: Opioids: friends or foes, Melbourne, VIC 27-28 Acute Stroke Treatment Seminar, Sydney, NSW 28 Oct-1 Nov Cutaneous Biology 2018, North Stradbroke Island, QLD 31 Oct-2 Nov 20th Australasian Gastro-Intestinal Trials Group ASM 2018, Brisbane, QLD 31 Oct-1 Nov 2nd Annual National NDIS Mental Health Conference, Melbourne, VIC NOVEMBER 1-3 International Union Against Sexually Transmitted Infections Asia Pacific Sexual Health Congress 2018, Auckland, NZ 1-4 General Practice and Acute Medicine Update Refresher, Brisbane, QLD 2 2018 RACP Tasmanian Conference, Burnie, TAS 2-3 Australasian Gynaecological Endoscopy and Surgical Society Focus Meeting, Canberra, ACT 2-3 2018 New Zealand Melanoma Summit, Auckland, NZ 3-4 14th National Laser and Cosmetic Medicine Conference 2018, Brisbane, QLD 4-7 Australasian Genomic Technologies Conference, Glenelg, SA 6-9 5th National Indigenous Drug and Alcohol Conference, Adelaide, SA 7-9 Nepean Blue Mountains Local Health District Together Achieving Better Health Conference, Penrith, NSW 7-9 Paediatric Society of New Zealand 70th ASM 2018, Nelson, NZ 7-9 Australian Association for Adolescent Health 2018 Youth Health Conference, Gold Coast, QLD 7-10 RANZCP Faculty of Psychiatry of Old Age and the Asian Society Against Dementia Conference 2018, Melbourne, VIC 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 9 Health Information Technology, Perth, WA 10-17 2018 IEEE Nuclear Science Symposium and Medical Imaging Conference, Sydney, NSW 11-14 11th International Conference on Frontotemporal Dementias, Sydney, NSW 13-15 Clinical Oncology Society of Australia 2018 ASM, Perth, WA 16-18 General Practice Conference and Exhibition, Melbourne, VIC 17-18 Critical Care Imaging Interpretation 2018, Noosa Heads, QLD 17-21 50th Annual Scientific Congress of the Royal Australian and New Zealand College of Ophthalmologists, Adelaide, SA 18-20 Australian and New Zealand Falls Prevention Society Conference, Hobart, TAS 18-22 Australasian College for Emergency Medicine, 35th ASM, Perth, WA 20-21 Food Futures Conference, Brisbane, QLD 20-21 2nd National Aboriginal and Torres Strait Islander Suicide Prevention Conference, Perth, WA 21-22 2nd Australasian FASD Conference 2018, Perth, WA 21-23 11th Hospital in the Home ASM: LEARN: Lead, engage, aspire, research, negotiate, Brisbane, QLD 21-23 Australian Association of Gerontology Conference 2018, Melbourne, VIC 21-23 New Zealand Society of Gastroenterology ASM 2018, Dunedin, NZ 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 21-24 Australian and New Zealand Association of Psychiatry, Psychology and Law 2018 Annual Conference: Sins of the past: reflections and future directions, Hobart, TAS 21-24 General Practice and Acute Medicine Update Refresher, Sydney, NSW 22-23 New Zealand Respiratory Conference 2018, Auckland, NZ 22-23 2nd World Indigenous Suicide Prevention Conference, Perth, WA 23-25 Queensland Hand Surgery Society Conference, Noosa, QLD 23-25 Australia and New Zealand Conference on Sarcopenia and Frailty 2018, Dunedin, NZ 26-28 1st International Motor Impairment Conference, Sydney, NSW 26-29 8th Gathering of Healing Our Spirit Worldwide, Sydney, NSW 27 Osteoarthritis Summit, Canberra, ACT 27 2nd Annual Conference of the Alliance for the Prevention of Mental Disorders, Noosa, QLD 27-28 7th Annual NHMRC Symposium on Research Translation: Ensuring value in research, Sydney, NSW 28-30 40th Annual Society for Mental Health Research Conference: Collaboration, Noosa, QLD 29 Nov-1 Dec ASID New Zealand Annual Meeting, Dunedin, NZ 30 2018 International Indigenous Allied Health Forum, Sydney, NSW DECEMBER 1 Australasian Gynaecological Endoscopy and Surgery Society Pelvic Anatomy Dissection Cadaveric Workshop, Brisbane, QLD 1 RACP South Australian ASM, Adelaide, SA 2-6 Australasian Society for Immunology 47th ASM 2018, Perth, WA 3-4 Stop Domestic Violence Conference, Gold Coast, QLD 2019 TBA World Congress on Inflammation, Sydney, NSW JANUARY TBA 12th Australasian Conference on Health Informatics and Knowledge Management 14-16 31st Australian Council for Health, Physical Education and Recreation International Conference, Canberra, ACT FEBRUARY TBA The Australian and New Zealand Glaucoma Society ASM 8-10 Australasian College of Sport and Exercise Physicians Annual Scientific Conference, Queenstown, NZ 23 Australasian Faculty of Rehabilitation Medicine NZ Symposium 2019, Waipuna, NZ 25 Feb-1 Mar Leadership and Innovation in Health, Melbourne, VIC MARCH TBA Medical Parents of Australia and New Zealand Conference, Gold Coast, QLD TBA Australasian Academy of Cerebral Palsy and Developmental Medicine 10th Biennial Scientific Conference, Perth, WA 1-2 Australia and New Zealand Strabismus Society Meeting (Squint Club), Parkville, VIC 6-8 International Medicine Society of Australia and New Zealand Autumn Scientific Meeting 2019, Auckland, NZ 7-10 New Zealand Pain Society ASM, Christchurch, NZ 17-20 Perinatal Society of Australia and New Zealand Annual Congress, Gold Coast, QLD 22-24 ASOHNS 69th Annual Scientific Meeting, South Brisbane, QLD 24-27 15th National Rural Health Conference, Hobart, TAS 25-30 International Neuromodulation Society 14th World Congress, Sydney, NSW 25-26 No More Harm National Conference: Bullying, Harassment and Discrimination, Gold Coast, QLD 27-28 9th Annual Australian Healthcare Week, Sydney, NSW 27-30 8th World Glaucoma Congress, Melbourne, VIC 29 Mar-2 Apr Annual Scientific Meetings of The Australia and New Zealand Society of Respiratory Science and The Thoracic Society of Australia and New Zealand, Gold Coast, QLD APRIL 7-10 2019 Australian Pain Society 39th ASM, Gold Coast, QLD 11-13 Biennial meeting of the Asia Pacific Society of Sexual Medicine, Brisbane, QLD 12-15 ISN World Congress of Nephrology 2019, Melbourne, VIC 13-16 Urological Society of Australia and New Zealand 72nd ASM, including the ANZUNS 24th annual meeting, Brisbane, QLD 30 Apr-3 May Australasian College of Emergency Medicine Winter Symposium 2019, Rotorua, NZ MAY TBA RACP Congress 2019, Auckland, NZ 5-7 20th Annual Scientific Meeting of the Australasian College of Phlebology, Cairns, QLD 13-15 Australian and New Zealand Addiction Conference: Prevention, treatment, recovery, Gold Coast, QLD 16-18 ASID Annual Scientific Meeting 2019, Darwin, NT 18-21 Australasian College of Dermatologists Annual Scientific Meeting, Melbourne, VIC 25-30 International Neuromodulation Society 14th World Congress, Sydney, NSW JUNE 17-20 Lowitja Institute International Indigenous Health and Wellbeing Conference, TBC 18-20 Global Health Security 2019, Sydney, NSW 25-28 International Society on Early Intervention Conference 2019: Research to practice in early intervention: an international perspective, Sydney, NSW JULY 27-30 Transplantation Society of Australia and New Zealand PGC and ASM, Sydney, NSW AUGUST 3-6 Human Genetics Society of Australasia 43rd ASM, Wellington, NZ 12-16 17th Deaf Blind International World Conference 2019, Gold Coast, QLD SEPTEMBER 7-8 Rural Dermatology Meeting, Orange, NSW 15-19 14th World Congress on Inflammation, Sydney, NSW 29 Sep-2 Oct 18th Biennial Clinical Neurophysiology Workshop, Gold Coast, QLD OCTOBER TBA RACGP conference, GP19 14-18 World Congress of Intensive Care, Melbourne, VIC 20-23 11th Development Origins of Health and Disease World Congress, Melbourne, VIC NOVEMBER 17-19 10th World Congress of Itch, Sydney, NSW 2020 APRIL 2-4 Exercise and Sports Science Australia Research to Practice 2020, Perth, WA 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