Volume 210 Issue 1

How is Australia responding to the trends in pharmaceutical opioid utilisation and opioid harms?

Gabrielle Campbell · Nicholas Lintzeris · Natasa Gisev · Briony Larance · Sallie Pearson · Louisa Degenhardt

Children need outdoor play but safety standards alone will never prevent all injuries; robust data are required to guide risk minimisation strategies

Ruth A Barker · David Eager · Lisa N Sharwood

Although medicinal cannabis can now be prescribed for CINV, high quality clinical trial evidence is required to determine its efficacy and safety

Antony J Mersiades · Martin R Stockler · Ian N Olver · Peter Grimison

The Timed Up and Go test provides a quick and valid way to estimate an older person's risk of falls, as well as other adverse outcomes

William Browne · Balakrishnan (Kichu) R Nair

A 42-year-old man presented to our emergency department with sudden bilateral visual loss

Tanya Kowalski · Jitin Verma · Shaun L Greene · Jeremy Curtin

A 52-year-old woman presented with symptomatic iron deficiency anaemia …

Varitsara Mangkorntongsakul · Cecily J Forsyth

Stopping bisphosphonate therapy in people at risk of bone fractures must be carefully considered

John A Eisman · Christopher P White

Questions about current social circumstances and stressors, social and family support are also needed

Philip M Boyce · Fiona Judd

The known: Rehabilitation reduces the patient's risk of death and disability after a stroke.

Elizabeth A Lynch · Shylie Mackintosh · Julie A Luker · Susan L Hillier

The known: Recent advances in digital infrastructure in Australia allow linkage of administrative and clinical datasets.

Monique F Kilkenny · Joosup Kim · Nadine E Andrew · Vijaya Sundararajan · Amanda G Thrift · Judith M Katzenellenbogen · Felicity Flack · Melina Gattellari · James H Boyd · Phil Anderson · Natasha Lannin · Mark Sipthorp · Ying Chen · Trisha Johnston · Craig S Anderson · Sandy Middleton · Geoffrey A Donnan · Dominique A Cadilhac

The known: Since 2011, Australian clinical guidelines recommend universal antenatal screening of pregnant women with the Edinburgh Postnatal Depression Scale (EPDS).

Macarena A San Martin Porter · Kim Betts · Steve Kisely · Gino Pecoraro · Rosa Alati

Older people face particular barriers obtaining advice or treatment for alcohol-related problems

Ann M Roche · Victoria Kostadinov

Overprescribing of these medications should be reduced, patients at greater risk identified, risk mitigation strategies implemented

Gillian E Caughey · Svetla Gadzhanova · Sepehr Shakib · Elizabeth E Roughead

Early detection of primary melanoma remains an effective strategy to reduce melanoma‐related mortality. This article presents multiple methods of monitoring the skin in patients at high risk of developing melanoma. Determining the relative indications for each method and how each method should be introduced into the surveillance of a patient requires careful consideration and an individualised approach.TBP and SDDI provide different methods for the detection of change in the context of melanoma surveillance and, therefore, these methods should be applied to different, but overlapping (ie, non‐mutually exclusive), settings. TBP permits identification of most new or changed lesions on the skin surface. TBP is particularly suited to patients at elevated risk with high naevus counts and multiple dysplastic naevi. SDDI fulfils a different need for monitoring one or many individual flat lesions of concern that lack diagnostic clinical or dermoscopic features of melanoma. Of note, both TBP and SDDI rely on patient adherence to follow‐up appointments, and poor compliance would thus compromise the benefits that these methods confer. It is therefore crucial to emphasise to patients the importance of regular follow‐up.Much of the existing literature has been conducted in high risk patient cohorts; however, these techniques, particularly TBP, are less tested in lower risk populations and may not have the same value. To undertake a randomised controlled trial evaluating these methods in high risk patients would present ethical difficulties; nevertheless, a randomised controlled trial of TBP and SDDI in a large cohort of lower risk individuals might be justifiable. Further research is needed to elucidate the optimal risk thresholds for the introduction of both TBP and SDDI to surveillance programs. Research regarding cost‐effectiveness for the above‐mentioned diagnostic aids in different risk cohorts is also required. Specialised surveillance with TBP and SDDI has been shown to be a cost‐effective strategy for the management of individuals at high risk of melanoma. Notwithstanding the demonstrated cost‐effectiveness in high risk patients, these modalities are not currently reimbursed by the Australian Medicare system.Furthermore, RCM may be used to assist with the identification of melanoma for suspicious lesions located on the head and neck, lesions in areas that are subject to chronic sun exposure, lesions dermoscopically typified by regression and amelanotic tumours. At present, there is insufficient evidence to recommend the routine use of automated instruments for the clinical diagnosis of melanoma. Nonetheless, the use of both automatic instruments and of artificial intelligence for the clinical diagnosis of melanoma represents an exciting area for future research. Further research should also be directed at assessing the performance of new methods of skin imaging, such as three dimensional imaging, the role of teledermatology using TBP, dermoscopy and SDDI, and skin self‐assessment of suspicious lesions using smartphone applications. Of note, TBP also has the potential to aid skin self‐examination; yet, evidence to date would appear to indicate limited uptake by consumers. An important area for future research might also be to explore barriers to and determinants of skin self‐examination, and to investigate appropriate methods of educating consumers with respect to melanoma surveillance.

Nikki R Adler · John W Kelly · Pascale Guitera · Scott W Menzies · Alex J Chamberlain · Paul Fishburn · Alison E Button‐Sloan · Clinton Heal · H Peter Soyer · John F Thompson

At present, high level evidence for the safety and efficacy of radiotherapy and immunotherapy still need to be demonstrated clinically; therefore, the combination cannot be recommended outside of clinical trials. It is also currently unclear which patients will benefit from the combination. However, due to the increased number of clinical trials investigating radiotherapy as a mean to antitumour immunity, it is likely that the evidence will emerge shortly.40,41 In 2016, a study presented a list of 93 active trials combining radiotherapy with an antibody inhibiting CTLA‐4, PD‐1 and PD‐L1, transforming growth factor β‐cytokine, or other immune molecules.40 ClinicalTrials.gov now reports at least 200 completed or recruiting trials evaluating the new combination. Box 1 lists investigator‐initiated clinical trials combining radiotherapy and immunotherapy in Australia. If positive, the results of these trials are likely to lead to a paradigm shift in the use of radiotherapy, which would certainly be a cost‐effective and low toxicity mean to enhance the response to immune agents in addition to its well established role of killing tumour cells. 3 Trial name (trial registration no.) Phase Disease (stage) Radiotherapy dose Immunotherapy Question SABRSeq (NCT03307759) 1b (randomised) NSCLC (IV) 18–20 Gy/1 fraction to 1–3 metastases, 7 days before ICIs 18–20 Gy/1 fraction to 1–3 metastases, 7 days after ICIs Pembrolizumab Safety profile of SABR with ICIs when given before or after SABR RAPPORT (NCT02855203) 1b/2 (single arm) RCC (oligometastatic IV) 18–20 Gy/1 fraction to 1–5 metastases, 5 days before ICIs Pembrolizumab Safety profile of SABR with pembrolizumab BOSTON‐II (closed) (NCT02303366) 1b (single arm) Breast (oligometastatic IV) 20 Gy/1 fraction to 1–5 metastases Pembrolizumab Safety profile of SABR with pembrolizumab AZTEC (TROG 17.05) 2 (randomised) Breast triple negative (IV with ≥ 2 metastases) 20 Gy/1 fraction to 1–4 metastases 24 Gy/3 fractions to 1–4 metastases Delivered before ICIs Atezolizumab Efficacy and safety of two SABR fractionation with atezolizumab ICE‐PAC (ACTRN12618000954224) 2 (single arm) Prostate (mCRPC) (IV) 18–20 Gy/1 fraction to 2–3 metastases, 5 days before ICIs Avelumab rPFS at 24 weeks NIVORAD (TROG 16.01) 2 (randomised) NSCLC (IV) 18–20 Gy/1 fraction to ≥ 1 metastases 14 days after ICIs No radiotherapy Nivolumab PFS at 6 months SABR‐IMPACT I (ACTRN12616001064493) (U1111‐1185‐5624) 1 (multilevel) Melanoma (non‐oligometastatic IV) 10–30 Gy/1 fraction to single metastasis, before or during ICIs Ipilimumab, nivolumab or pembrolizumab Maximum tolerated dose of SABR with ICIs PCR‐MIB (NCT02662062) 2 (single arm) Bladder (II–III post‐TURBT) 64 Gy/32 fractions + concurrent cisplatin + ICIs Pembrolizumab Grade 3 or 4 acute toxicities (excluding urinary) ABC‐X Study (NCT03340129) 2 (single arm) Melanoma (brain metastasis IV) SRS: 16–22 Gy/1 fraction or 30 Gy/10 fractions whole brain Ipilimumab and nivolumab Intracranial response to immunotherapy Ave‐Rec (NCT03299660) 2 (single arm) Rectal carcinoma (III) 50.4 Gy/28 fractions + 5FU, before ICIs Avelumab Pathological response rate ICIs = immune checkpoint inhibitors. 5FU = fluorouracil. mCRPC = metastatic castration‐resistant prostate cancer. NSCLC = non‐small cell lung cancer. PFS = progression‐free‐survival. RCC = renal cell carcinoma. rPFS = radiological progression‐free survival. SABR = stereotactic ablative radiotherapy. TURBT = transurethral resection of bladder tumour. ◆ Much needs to be understood to optimise the complex immunological effect of radiotherapy and its interaction with ICIs. Histological subtype, target organ (bone, visceral, brain), immunotherapy molecule, volume of irradiation, radiotherapy dose and sequence are hypothesised to have different effects. Radiotherapy pulsing, in which doses of radiation are delivered regularly (eg, monthly) throughout the ICI therapy, has also been proposed.64In conclusion, ICIs result in impressive clinical responses in select groups of patients, but optimal results in larger populations will require combination with other therapies. Radiotherapy will certainly be part of this arsenal, but fundamental questions about mechanisms of treatment non‐redundancy, tumour resistance and patients’ tolerance are to be answered. Preclinical studies to direct informed clinical trial design are needed to determine how best to integrate these modalities and optimise their synergistic effect.

Guy‐Anne Turgeon · Andrew Weickhardt · Arun A Azad · Benjamin Solomon · Shankar Siva

To the Editor: We write to express our concerns regarding the Clinical Oncology Society of Australia (COSA) position statement on exercise in cancer care published in the MJA1 and promoted in media outlets as a “world‐first” position statement that calls for exercise to be prescribed for all patients with cancer.2 The guideline replicates those first published in Australia in 20093 and in the United States in 20104 as well as by other organisations,5 and are the same as public health recommendations for healthy adults.6 Given the array of cancers, disease stages and treatments and their combinations, it is somewhat surprising that the same general guideline is being prescribed for all patients with cancer and is not differentiated from that for healthy adults — especially, given patient health and comorbidity status and the challenges that a cancer diagnosis and treatment entail. Research in exercise oncology has progressed over the past 9 years, and more targeted and tailored guidelines reflecting the developing evidence base are now required for implementation in this population. Moreover, the majority of patients with cancer are unable to meet the COSA recommendation of at least 150 minutes of aerobic exercise and two to three resistance exercise sessions due to time availability and physical, psychological and financial capacity as well as access, let alone the level of care required for those with advanced disease. It is significant that the COSA recommendation has not been refined through clinical trials in patients with cancer and has the potential to create considerable angst for the patient and raise concerns for clinicians, who know that their patients may not be able to achieve such goals. Moreover, we highlight that there is minimal financial support for patients with cancer to undertake ongoing exercise, making the COSA recommendation somewhat superfluous. When exercise is prescribed, it must be evidenced‐based and tailored to specifically ameliorate adverse health problems, while recognising that certain modes and dosages of exercise may be detrimental. We agree that there is considerable potential for exercise medicine in the management of cancer; however, a more considered approach needs to be implemented rather than the generic exercise recommendations of the COSA statement.

Robert U Newton · Dennis R Taaffe · Daniel A Galvao

In reply

COSA Exercise and Cancer Group Executive Committee

To the Editor: It was a pleasure reading the 20 August 2018 issue of the Medical Journal of Australia, containing many informative, broad‐ranging articles. However, the absence of the authors’ qualifications, which ultimately establish who the authors actually are — possibly reflecting their credibility — may render an article potentially less valid for the readership. This contrasts with the detailed and impressive qualifications of the MJA staff members, faithfully and appropriately listed in each issue, transparently demonstrating their expertise. No MJA author is awarded such recognition. The perspective by Munk and colleagues1 highlighted the threat posed by predatory journals to researchers and academic literature. The MJA lists only their affiliations; therefore, the readership is unable to establish a frame of reference for their opinions. Cursory investigation reveals lead author, Peter Munk, to be a Canadian radiologist, thereby impressing also as an authority on predatory journals. Rochwerg and colleagues2 discuss clinical decision making with network meta‐analysis. Without their qualifications, the reader is unable to determine whether they are physicians, statisticians, health economists or politicians. In their helpful Editorial, Shorthouse and Stone3 examine the need for additional mental health care training for rural medical practitioners. It turns out that both authors are Australian general practitioners — Molly being a rural generalist, and Louise a professorial medical educator. Interestingly, neither is a specialist psychiatrist. Professor Olver4 discusses B‐cell non‐Hodgkin lymphoma in Queensland. Despite his fame, his Editorial would potentially have been augmented had the readership been presented with his impressive research and clinical credentials. It seems reasonable to raise the notion that the absence of authors’ postgraduate and other qualifications could diminish their contribution to the medical literature. Our group has previously documented the importance of journals publishing authors’ qualifications.5 We published that “if the author qualifications are designated, the reader may be quite sure that the article was not written by the medical records librarian, let alone the hospital trolley boy in a moment of inspiration”.5 This is not to say the hospital trolley boy is not entitled to offer his thoughts on a medical subject. Rather, it provides the readership with perspective concerning authors’ expertise and opinions.

Damien L Ling · Anna M Waldie · Ian C Francis

In reply

Nicholas J Talley AC

Updated 29 January, 2019 2019 JANUARY 29-31 12th Australasian Conference on Health Informatics and Knowledge Management, Sydney, NSW 31 Jan-1 Feb Cancer Care at a Crossroads Conference, Wellington, NZ FEBRUARY 6-7 Australasian College of Sport and Exercise Physicians Registrar Conference, Queenstown, NZ 8-10 Australasian College of Sport and Exercise Physicians Annual Scientific Conference, Queenstown, NZ 14 CEDA Mental Health and Wellbeing Panel, Adelaide, SA 14-15 Victorian Alcohol and Drug Association Conference 2019, Melbourne, VIC 15-16 Vitamin C Symposium 2019, Auckland, New Zealand 15-16 3rd Perioperative Patient Blood Management Symposium Perioperative Anaemia: From Basic to Complex, Brisbane, QLD 18-20 2019 Australasian Aid Conference, Canberra, ACT 19-20 Digital Health Transformation Summit, Melbourne, VIC 21-23 Australasian Symposium on Ultrasound and Regional Anaesthesia, Noosa, QLD 21-24 7th World Congress of Asian Psychiatry, Sydney, NSW 22-24 Australian Orthopaedic Association Victoria Branch ASM and AGM, Lorne, VIC 22-24 RCPA Pathology Update: The Power of Personalised Pathology, Melbourne, VIC 23 Australasian Faculty of Rehabilitation Medicine NZ Symposium 2019, Waipuna, NZ 23-24 RANZCR WA Branch Meeting: Thoracic Imaging Update, Perth, WA 23-24 Psychotherapy and Counselling Federation of Australia Conference: Working with trauma, Sydney, NSW 25 Feb-1 Mar Leadership and Innovation in Health, Melbourne, VIC 28 Feb-1 Mar Peripheral Hospitals Emergency Medicine Conference: Evidence Review 2019, Wollongong, NSW 28 Feb-2 Mar 2019 Cornea and Contact Lens Society of New Zealand Conference, Rotorua, NZ MARCH TBA Medical Parents of Australia and New Zealand Conference, Gold Coast, QLD 1-2 Australia and New Zealand Strabismus Society Meeting (Squint Club), Parkville, VIC 1-3 5th International Medicine in Addiction Conference, Melbourne, VIC 4-5 National Disabilities Service Victorian State Conference, Melbourne, VIC 6-7 Medico Legal Society of NSW 2019 Congress, Sydney, NSW 6-8 Internal Medicine Society of Australia and New Zealand Autumn Scientific Meeting 2019, Auckland, NZ 7-8 36th Annual ANZ Corneal Society and Eye Bank Meeting, Adelaide, SA 7-9 New Zealand Pain Society ASM, Christchurch, NZ 7-9 AGES 29th Annual Scientific Meeting: Perfection, professionalism and problems, Perth, WA 9-10 Abdominal Radiology Group of Australia and New Zealand Meeting 2019, Auckland, NZ 9-10 RACGP NSW and ACT Wellbeing Weekend: Led by Doctors, For Doctors, Angourie Resort, NSW 10-14 52nd Annual Meeting of the Pacific Association of Paediatric Surgeons, Christchurch, NZ 12-15 TROG Cancer Research 31st Annual Scientific Meeting, Melbourne, VIC 13-16 12th General Breast Imaging Meeting, Perth, WA 15-16 The Brisbane Functional Colorectal Conference: Dysfunction, Defecation and Devices, Brisbane, QLD 15-16 RANZCP Section of Youth Mental Health Conference 2019, Mornington Peninsula, VIC 16-17 RANZCO NSW Branch ASM, Sydney, NSW 17-19 Australian Private Hospitals Association 38th National Congress, Melbourne, VIC 17-20 Perinatal Society of Australia and New Zealand Annual Congress, Gold Coast, QLD 20-23 International Society for Gastrointestinal Hereditary Tumours (InSiGHT) Meeting, Auckland, NZ 20-23 21st Annual ISBD Conference: Global Advances in Bipolar Disorder and Depression, Sydney, NSW 20-23 ANZGOG ASM 2019: Radical treatments for gynaecological cancer, Sydney, NSW 21-22 10th Australasian Newborn Hearing Screening Conference, Gold Coast, QLD 21-24 Australasian Academy of Cerebral Palsy and Developmental Medicine 10th Biennial Scientific Conference, Perth, WA 22 Tri-Nation Alliance International Medical Symposium, Auckland, NZ 22-24 ASOHNS 69th Annual Scientific Meeting, South Brisbane, QLD 23-24 New Zealand Association of General Surgeons, Christchurch, NZ 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 27-28 Health Facilities Design and Development Conference, Sydney, NSW 27-28 Aged Care Summit, Sydney, NSW 27-29 2nd Australia and New Zealand Refugee Trauma Recovery in Resettlement Conference, Brisbane, QLD 27-30 8th World Glaucoma Congress, Melbourne, VIC 28-29 4th National Cancer Survivorship Conference, Sydney, NSW 28-29 Equally Well National Symposium, Melbourne, VIC 28-31 Australian Society for Colposcopy and Cervical Pathology 2019 Scientific Meeting, Auckland, NZ 29-31 RANZCP Section of Social and Cultural Psychiatry Rustic Retreat, King Island, TAS 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 30-31 Australasian Musculoskeletal Imaging Group ASM, Queenstown, NZ 30-31 NextCare Health Conference, Brisbane, QLD APRIL 3-4 Australian Telehealth Conference, Brisbane, QLD 3-5 ANZICS New Zealand Regional ASM, Auckland, NZ 5 Kidney Supportive Care Symposium 2019, Brisbane, QLD 7-10 2019 Australian Pain Society 39th ASM, Gold Coast, QLD 7-11 23rd World Conference on Health Promotion, Rotorua, NZ 8-11 21st Asia Pacific League of Associations for Rheumatology Conference, Brisbane, QLD 9-10 5th Annual Research Facilities Design and Development 2019, Sydney, NSW 11-13 Biennial meeting of the Asia Pacific Society of Sexual Medicine, Brisbane, QLD 12 ANZ College of Paramedicine Trauma on the Border, Tweed Heads, NSW 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 25-27 APS College of Health Psychologists Conference, Adelaide, SA 28-30 2nd Australasian Diagnostic Error in Medicine Conference, Melbourne, VIC 29-30 2019 Patient Experience Symposium, Sydney, NSW 30 Apr-3 May Australasian College of Emergency Medicine Winter Symposium 2019, Rotorua, NZ 30 Apr-3 May Women in Health Leadership Summit, Sydney, NSW MAY 3-4 RACGP Queensland 61st Clinical Update Weekend, Brisbane, QLD 5-7 20th Annual Scientific Meeting of the Australasian College of Phlebology, Cairns, QLD 5-9 20th International Congress of Cytology, Sydney, NSW 6-8 RACP Congress 2019, Auckland, NZ 7-10 WADEM Congress on Disaster and Emergency Medicine, Brisbane, QLD 9-10 Victorian Integrated Cancer Services Conference 2019, Melbourne, VIC 9-11 Australian Resuscitation Council 12th International Spark of Life Conference, Sydney, NSW 10-11 RANZCO New Zealand Branch ASM, Auckland, NZ 12-16 RANZCP 2019 Congress: Continuity in a World of Change, Cairns, QLD 13-15 Australian and New Zealand Addiction Conference: Prevention, treatment, recovery, Gold Coast, QLD 15-17 14th Behavioural Research in Cancer Control Conference, Perth, WA 16-18 ASID Annual Scientific Meeting 2019, Darwin, NT 17-18 RANZCO WA Branch ASM, Perth, WA 18-19 3rd Molecular Pathology Symposium and 2nd Asia Pacific Molecular Brain Tumour Course, Gold Coast, QLD 18-21 Australasian College of Dermatologists Annual Scientific Meeting, Melbourne, VIC 21-24 Australian and New Zealand Association of Neurologists 2019 ASM, Sydney, NSW 22-24 RANZCOG New Zealand 2019 ASM, Hamilton, NZ 22-25 Arthroplasty Association of Australia ASM, Noosa, QLD 23-24 15th Annual Queensland Emergency Medicine Autumn Symposium, Brisbane, QLD 24-26 9th Australasian Skin Cancer Congress, Gold Coast, QLD 24-26 9th National Histology Conference, Adelaide, SA 25 Melbourne Ophthalmic Alumni Meeting, Melbourne, VIC 25-30 International Neuromodulation Society 14th World Congress, Sydney, NSW 30-31 Nextcare Health Conference, Brisbane, Queensland 30 May-1 Jun Plastic Surgery Congress 2019, Melbourne, VIC 31 May-2 Jun Business for Doctors Annual Conference, Brisbane, QLD JUNE 1-2 Australian and New Zealand Society of Retinal Specialists Meeting, Sydney, NSW 1-3 ABDORAD 2019, Melbourne, VIC 6-8 Rural Doctors Association of Queensland 30th Annual Conference, Cairns, QLD 6-9 College of Intensive Care Medicine of Australia and New Zealand ASM, Cairns, QLD 7-9 Australian Orthopaedic Association Queensland Branch ASM, Noosa, QLD 12-13 CSANZ 3rd Indigenous Cardiovascular Health Conference 2019, Wellington, NZ 12-14 Public Health Prevention Conference 2019, Melbourne, VIC 13-15 CSANZ New Zealand ASM 2019, Wellington, NZ 15-16 Australian Orthopaedic Association Tasmania Branch ASM and AGM, TBA 18-20 Lowitja Institute International Indigenous Health and Wellbeing Conference, Darwin, NT 18-20 Global Health Security 2019, Sydney, NSW 21-23 26th Annual Conference of the Australasian Sonographers Association, Brisbane, QLD 21-23 RANZCO Tasmania Branch ASM, TBA 22-23 Australian Orthopaedic Trauma Society Conference, Cairns, QLD 24-26 10th International Nanomedicine Conference, Sydney, NSW 25-28 International Society on Early Intervention Conference 2019: Research to practice in early intervention: an international perspective, Sydney, NSW JULY 6-10 27th Congress of the International Society on Thrombosis and Haemostasis, Melbourne, VIC 11-13 RANZCO 2019 Paediatric Special Interest Group ASM, Noosa Heads, QLD 18-19 CICM Never Alone: Forging the Community of Critical Care, Darwin, NT 26-27 Australian Orthopaedic Association NSW Branch ASM, Hunter Valley, NSW 27-30 Transplantation Society of Australia and New Zealand PGC and ASM, Sydney, NSW 31 Jul-2 Aug 20th International Mental Health Conference, Gold Coast, QLD AUGUST 1-4 RANZCO Queensland Branch ASM, Gold Coast, QLD 2-3 AGES Focus Meeting 2019, Melbourne, VIC 3-6 Human Genetics Society of Australasia 43rd ASM, Wellington, NZ 5-8 13th National Allied Health Conference: Realising our value, Brisbane, QLD 8-11 67th Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand, Adelaide, SA 9 Australian Orthopaedic Association SA and NT Branch ASM, McLaren Vale, SA 9-11 13th Annual Australia and New Zealand Endovascular Therapies Meeting, Adelaide, SA 10-11 RANZCO SA Branch Biennial Scientific Meeting, Darwin, NT 12-16 17th Deaf Blind International World Conference 2019, Gold Coast, QLD 21-23 2019 Australasian Gastro-Intestinal Trials Group 21st ASM, Adelaide, SA 29-30 2019 APOS ASM, Noosa, QLD 29-30 ANZ College of Paramedicine 2019 Conference, Melbourne, VIC 29-30 Regional Critical Care Conference 2019, Bendigo, VIC SEPTEMBER 4-7 2nd Canada, Australia and New Zealand (CANZ) Combined Spine Society Meeting 2019, Arrowtown, NZ 5-8 Neuro-Ophthalmology Society of Australia 25th Clinical and Scientific Meeting and NeuroVision Training Weekend, Brisbane, QLD 7-8 Rural Dermatology Meeting, Orange, NSW 7-8 Combined Meeting of the Australian Orthopaedic Association Medico-Legal Society and the RACS Medico-Legal Section and the Australian Medico-Legal College, Gold Coast, QLD 15-19 14th World Congress on Inflammation, Sydney, NSW 18-20 RANZCP 2019 New Zealand Conference, Nelson, NZ 19-21 Australian and New Zealand Head and Neck Cancer Society ASM 2019, Adelaide, SA 29 Sep-2 Oct 18th Biennial Clinical Neurophysiology Workshop, Gold Coast, QLD OCTOBER 2-4 Royal Australasian College of Medical Administrators Conference, Adelaide, SA 2-4 AIDA Conference 2019, Darwin, NT 4-5 Australian Orthopaedic Association Registrars 2019, Canberra, ACT 6-10 Australian Orthopaedic Association ASM: Teamwork and engagement, Canberra, ACT 13-16 RANZCOG 2019 ASM, Melbourne, VIC 14-18 World Congress of Intensive Care, Melbourne, VIC 16-19 2019 Society for Paediatric Anaesthesia in New Zealand and Australia ASM: Changing tides, Brisbane, QLD 17-20 Royal Australian and New Zealand College of Radiologists ASM, Auckland, NZ 20-23 New Zealand Orthopaedic Association Annual Meeting, Christchurch, NZ 20-23 11th Development Origins of Health and Disease World Congress, Melbourne, VIC 24-26 Rural Medicine Australia 2019, Gold Coast, QLD 24-26 Spring Colorectal Meeting with General Surgeons Australia ASM, Hobart, TAS 24-26 GP19: Your patients; your community; your solutions, Adelaide, SA 28 RANZCO NSW Branch AGM, Sydney, NSW NOVEMBER 1-2 AGES Pelvic Floor Symposium, Sydney, NSW 8-12 RANZCO 51st Annual Scientific Congress in conjunction with APPOS and APSOS, Sydney, NSW 17-19 10th World Congress of Itch, Sydney, NSW 22 Australian Orthopaedic Association SA and NT Branch ASM, Clovelly Park, SA 22-23 Australasian Doctors’ Health Conference 2019, Perth, WA 22-24 Queensland Hand Surgery Society ASM 2019, Gold Coast, QLD 25-26 ANZ College of Paramedicine Research Symposium, Frankston, VIC 29-30 ANZ Intensive Care Society Patient Deterioration New Zealand, Auckland, NZ 29 Nov-3 Dec World Congress in Paediatric and Adolescent Gynaecology, Melbourne, VIC DECEMBER 5-7 Preventing Overdiagnosis, Sydney, NSW 2020 FEBRUARY 21-22 Australia and New Zealand Glaucoma Society Scientific Meeting, Adelaide, SA MARCH 29 Mar-2 Apr International Neurotrauma Symposium, Melbourne, VIC 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 28-31 WONCA Asia Pacific Regional Conference, Auckland, NZ JUNE 24-27 International Society of Behavioural Nutrition and Physical Activity Annual Meeting, Auckland, NZ JULY 24-25 Australian Orthopaedic Association NSW Branch AGM, Hunter Valley, NSW AUGUST 14 Australian Orthopaedic Association SA and NT Branch ASM, McLaren Vale, SA 2021 FEBRUARY 19-20 Australian and New Zealand Glaucoma Society Scientific Meeting, Hobart, TAS MARCH 13-14 RANZCO NSW Branch ASM, Sydney, NSW NOVEMBER 9-12 2020 Tripartite Colorectal Meeting, Auckland, NZ 10-13 XIII International Congress of Dermatology, Melbourne, VIC 13-16 International Society of Addiction Meeting 2020 Conference, Auckland, NZ DECEMBER TBA FIGO World Congress of Gynaecology and Obstetrics, Sydney, NSW 2022 MARCH 25-28 2022 World Ophthalmology Congress, Melbourne, VIC