Book of Abstracts 2023

HSM MEDICAL AND POSTGRADUATE STUDENTS RESEARCH CONFERENCE

ENTERING A NEW AGE

Embracing Digital Health: Innovations for Better Care

Tuesday, 10 October, 2023

Acknowledgement of Country

In the spirit of reconciliation, Bond University acknowledges the Traditional Owners and Custodians of the land on which the university now stands. The Kombumerri people have walked and cared for this land and wildlife for thousands of years, and their descendants maintain spiritual connection and traditions. We thank them for sharing their cultures, spiritualities and ways of living with the land and wildlife in this place we all now call home. We pay respect to Elder’s past, present and emerging.

0900 - 0905

INTRODUCTION – Dr Paul Dunn (MD Portfolio Co-convenor, Faculty of Health Sciences & Medicine, Bond University)

0905 - 0915 WELCOME & OPENING ADDRESS

0915 - 1000 KEYNOTE PRESENTATION - Professor Lyle J Palmer PhD FRSS (Professor of Genetic Epidemiology, Senior Research Fellow, Australian Institute for Machine Learning, University of Adelaide)

1000 - 1055 PANEL DISCUSSION – Assoc/Prof Justin Keogh (Associate Dean of Research, Faculty of Health Sciences & Medicine, Bond University)

Dr Victoria Brazil, Dr Megan Crichton, Dr Ben Hindle, Dr Nicolas Harvey, Dr Michael Todorovic

1055 - 1100 OVERVIEW OF CONFERENCE PROCESS – Dr David Waynforth (MD Portfolio Co-convenor, Faculty of Health Sciences & Medicine, Bond University)

Building 6, Basil Seller Theatre

1100 - 1130 Morning Break

1130 - 1300 CONCURRENT SESSION 1

Stream 1. Paediatrics Stream 2. Planetary Health Stream 3. Medical Ethics Stream 4. Medical Education Stream 5. Medical Education Stream 6. Mental Health

Chair: Joan Roehl Chair: Michelle McLean Chair: Richard Matthews Chair: Tanisha Jowsey hair: Sujani Gamage/Paul Dun Chair: David Pache

Co-chair: Nicolene Lottering Co-chair: Catherine McDermott Co-chair: Hayley O'Neill Co-chair: David Waynforth Co-chair: Megha Shah Co-chair: Jo Bishop

1300 - 1400 Lunch Break

Building 5, Gregor Heiner Foyer

1400 - 1530

CONCURRENT SESSION 2

Stream 7. Surgery/Obstetrics/Oncology Stream 8. Planetary Health Stream 9. Health Research Stream 10. Internal Medicine Stream 11. Clinical Audits

Chair: Jane Smith

Co-chair: Donna Sellers Location: 5_3_53

1530 - 1600 Afternoon Break

Chair: Michelle McLean Chair: Joan Roehl Chair: Tracy Neilson

Co-chair: Neelam Maheshwari Co-chair: Sule Gunter Co-chair: Sacha Kennedy

Posters (Ignite)

Marker: Matthew Links

Marker: Mustafa Asil

Gregor Heiner Foyer

Posters (Ignite)

Chair: Mina Bakhit Marker: David Waynforth

Co-chair: Treasure McGuire Marker: Richard Matthews Location: 5_3_ 40 Location: 5_3_35 Location: 5_3_04 Location: 5 _3_27

Gregor Heiner Foyer

1600 - 1645 AWARDS & CLOSING OF CONFERENCE - Assoc/Prof Justin Keogh (Associate Dean of Research, Faculty of Health Sciences & Medicine, Bond University) Building 5, Gregor Heiner Foyer

Message from the Dean of Medicine

Congratulations on completing your MD Project and presenting your work at the 2023 HSM Medical and Postgraduate Students Research Conference.

The breadth and high standard of projects to be presented at this year’s annual conference highlights the strength of collaboration and the importance of medical research to improve the health status and longevity of the population. Your involvement in these projects allowed for diversity in experiences and acquirement of skills that reflects the clinical environment and will support you on your journey as a medical doctor.

Lessons learned from the COVID-19 pandemic are still highly relevant as we move forward because new challenges will continue to arise which will require flexibility and adaptability on the part of the medical workforce and healthcare educators.

As developing medical researchers, either as clinicians or a focussed career in medical research, formal education is just the start. You need to have effective communication, critical thinking, decision-making and observational skills. These skill sets will enable you to create a competitive edge in the research industry. Most importantly never let go of that inner child’s desire to explore. It may just lead to a breakthrough in medical knowledge.

Professor Kirsty Forrest

MBChB, BSc Hons, FRCA, MMEd, FAcadMEd, FANZCA

Faculty of Health Sciences and Medicine Bond University

“Every day brings new choices.” Martha Beck

Message from the Associate Dean of Research

The HSM Medical & Postgraduate Students Research Conference is an annual showcase and celebra�on of student research within the Faculty of Health Sciences and Medicine. The conference enables student researchers at all levels of experience an opportunity to present their research discoveries as well as listen to a range of exci�ng presenta�ons from their peers. Work presented at the conference includes MD projects, Masters and PhD studies and other faculty-supervised research ac�vi�es.

To me, this year's research theme – ‘Entering a New AgeEmbracing digital health: innova�ons for beter care' encompasses many of the transi�ons and novel solu�ons that have occurred across many areas of society including healthcare over the last few years, many as a result of the covid pandemic and the widespread accessibility of genera�ve ar�ficial intelligence. While these changes have brought many challenges and dangers, these challenges should encourage evidence-based prac��oners to look for new ways to improve outcomes for their pa�ents, clients, athletes and/or students. Embracing digital innova�ons is one way to improve these outcomes, as long as we can demonstrate the evidence suppor�ng their u�lisa�on across different se�ngs.

The diversity of research topics and designs is a key focus of this conference and congratula�ons to all of you on the progress you have made, in conjunc�on with the support provided by your supervisors. I hope you con�nue to look for innova�ons that will result in beter care for the people that you work with every day, and where possible, add to the evidence base on how these innova�ons can be best used in prac�ce.

I wish everyone a great conference experience and thank you for your outstanding contribu�on to our faculty and university.

Assoc/Prof Jus�n Keogh Faculty of Health Sciences and Medicine Bond University

Conference Organising Committee

Chairs:

Paul Dunn (MD Por�olio Co-convenor)

David Waynforth (MD Por�olio Co-convenor)

Jus�n Keogh (Associate Dean, Research)

Conference Organising Commitee Members:

Julia Byrne (Manager, Assessment)

Dena Bird (MD Administra�on Officer)

Sonia Berry-Law (Conference Organiser)

Carly Hudson (HDR Representa�ve)

Final Year Medical student representa�ves:

o Lauren Canning

o Milica Milosavljevic

o Lilly Steinberg

o Juliette Stephens

Peter Marendy (Business Services Officer, Research Support)

Special Thanks

We would like to acknowledge and thank all supervisors and Bond academic staff who voluntarily supervised these projects. Without your support and guidance, these projects would not have come to frui�on.

We also acknowledge and thank our academic and professional staff who have greatly assisted the organisa�on of this conference.

ABSTRACTS

STREAM 1 PAEDIATRICS

OP1: Applicability of the �bial apophysis as a maturity indicator on magne�c resonance imaging of modern Australian children.

Swart, Taliah HSM postgraduate student, Health Sciences and Medicine, Bond University

Lottering, Nicolene Assistant Professor, Health Sciences and Medicine, Bond University

Introduction

The skeletal apophysis of the knee follows an identifiable developmental process involving appearance and fusion of the secondary ossification centre (SOC) to the proximal tibia. Quantification of this process may assist in estimating age in living individuals without identification as well as in clinical settings to monitor growth in paediatric patients. Magnetic resonance imaging (MRI) is a non-invasive, ethical alternative that precludes radiation exposure associated with standard radiographs, however, its reliability in assessing tibial apophysis skeletal maturity remains unexplored. This study aimed to document maturation patterns of the tibial apophysis on MRI scans of modern Australian children.

Methods

Apophyseal ossification was assessed on a subset of cases (n = 120) from a paediatric cohort aged between 8-19 years from T2-weighted, proton-density MRI scans conducted between 2010 and 2020 at the Department of Medical Imaging and Nuclear Medicine, Queensland Children’s Hospital. An ordinal scoring protocol classified development across five stages, ranging from non-appearance of the SOC to complete fusion of the tibial apophysis to the tibia proper. Reliability was quantified using an intraclass correlation coefficient (ICC) approach, where a score above 0.9 indicated excellent agreement between assessments (Koo & Li, 2016). Transition analysis elicited maximum likelihood estimates for age-at-transition, and posterior distributions for age was conducted using multivariable Bayesian modelling in R.

Results

The protocol indicated excellent intra-observer agreement (ICC: 0.96-1.0), on this modality. The anterior tibial apophysis appeared earlier in females (8-10 years) than males (8-11 years), with fusion commencing at 11-13 years in females and 12-14 years in males. The tibial apophysis was completely fused to the tibial shaft in both groups between 17 and 19 years of age.

Conclusion

A reproducible morphological assessment protocol to quan�fy ontogeny of the �bial apophysis on MRI assisted with the construc�on of updated reference standards compared to prior literature (O’Connor et al. 2013; Ogden et al. 1975) in Australian children, using a mul�variable sta�s�cal approach.

PB1: Morphometric analysis of juvenile bone development from radiographs and popula�on survey data

Arma�, Charlote, 5th Year Medical student, Health Sciences and Medicine, Bond University

Boyce, Lachlan, 5th Year Medical student, Health Sciences and Medicine, Bond University

Layt, William, 5th Year Medical student, Health Sciences and Medicine, Bond University

Odish, Dana, 5th Year Medical student, Health Sciences and Medicine, Bond University

S�rling, Allan, Associate Professor, Health Sciences and Medicine, Bond University

Moro, Chris�an, Associate Professor, Health Sciences and Medicine, Bond University

Introduc�on

Anthropological studies such as the Interna�onal Biological Programme can provide rare insights into the skeletal development of children. Recent studies have suggested the metacarpals to be par�cularly accurate when determining the height and nutri�onal status of a child. The objec�ve of this report was to define the rela�onship between second and third metacarpal morphometrics and stature.

Methods

Anthropometrics and hand-wrist X-rays were taken from 2-3 year-old males, 8 year-old males, and 16-21 year-old males and females. Radiographs were digi�zed, and the length, width, cortex thickness and intramedullary diameter of the metacarpals compared to individuals height, weight and age. Correla�ons were analysed using Microso� Excel, and sta�s�cal significance was assessed with Pearson’s correla�on coefficient (p<0.01 or p<0.05).

Results

Sta�s�cally significant correla�ons were found between metacarpal length and height. The second metacarpal was found to be the best indicator of height, and superior to the third metacarpal, except in 8-year-old males. Analysis of metacarpal width showed posi�ve correla�ons for both height and weight in 8-year-old males, while 16-21 year-old males only showed a weak correla�on for height and 3-MTC width. Furthermore, there was a correla�on with metacarpal width and age in 16-21 year-old females. Finally, cor�cal thickness appeared to only have a correla�on in 16-21 year-old males, while medullary cavity diameter and weight were correlated in 16-21 year old females.

Conclusion

The findings of this study support the use of second and third metacarpal length for the determina�on of stature in children with appropriate degrees of accuracy.

PR1: Paediatric audit assessing metabolic disturbances at presenta�on and during management of moderate to severe DKA and analysing for correla�on to refeeding syndrome

Anoop, Ananya, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Gunda, Radhika 5th Year Medical Student, Health Sciences and Medicine, Bond University

Tung Vu, Gold Coast University Hospital

Peter Jones, GCUH; Professor, Health Sciences and Medicine, Bond University

Belinda Craig, Assistant Professor, Health Sciences and Medicine, Bond University

Background

Diabe�c ketoacidosis (DKA) is a major cause of morbidity and mortality in paediatric pa�ents with Type 1 Diabetes Mellitus (T1DM). A paucity of data has been published assessing the occurrence of Refeeding Syndrome (RS) in these pa�ents.

Aims

To iden�fy post-feeding metabolic imbalances that occur in moderate and severe DKA and to assess if these disturbances were consistent with RS.

Methods

A retrospec�ve audit of pa�ents admited to Gold Coast Health between 2020 to 2022 coded with a diagnosis of ‘T1DM’. The primary outcome was the occurrence of RS in the post-feeding electrolyte disturbances in moderate and severe DKA.

Results

Forty-nine pa�ents were eligible for the biochemical criteria for moderate and severe DKA; At presenta�on, the median age was 12 years, median BMI of 0 (z-score) and 59.2% had severe DKA. Overall 14.3% of pa�ents with moderate and severe DKA had presented with metabolic disturbances consistent with RS. Presence of RS was not significantly different between DKA severity groups (P=1). Supplementa�on other than potassium administered included magnesium (16.3%) and phosphate (32.7%).

Conclusion

Current DKA guidelines should consider the substan�al incidence of RS in post-feeding electrolytes. Metabolic imbalances were similar to other studies. This study does not suggest rou�ne supplementa�on of magnesium and phosphate but rather supplementa�on as required. Of this small cohort, only a subset had electrolyte abnormali�es and required supplementa�on. Clinicians should implement vigilant surveillance of RS, careful monitoring of electrolytes and an increased considera�on for potassium supplementa�on in DKA pa�ents.

PR2: Aten�on Deficit Hyperac�ve Disorder and Polypharmacy Prescribing Trends in South-East Queensland

Sachidanandan, Hridya, 5th Year Medical student, Health Sciences and Medicine, Bond University

Singh, Shweta, 5th Year Medical student, Health Sciences and Medicine, Bond University

Bala, Ravi, Paediatrician, Gold Coast University Hospital

Jones, Peter, Professor of Paediatric Medicine, Health Sciences and Medicine, Bond University

Introduction/ Background

Attention Deficit Hyperactive Disorder (ADHD) is a prevalent neurodevelopmental condition affecting paediatric populations, with a substantial impact on functioning and development. Management involves multimodal intervention, combining psychotherapy with pharmacotherapy. Polypharmacy, the concurrent use of multiple psychotropic drugs, is common due to comorbid psychiatric conditions. However, regional variations and the safety of such combinations are understudied.

Methods

This clinical audit investigated ADHD medication prescribing and polypharmacy trends in 408 paediatric patients attending Child Development Services (CDS) clinics in South-East Queensland (SEQ), Australia over two months. Patient demographics, prevalence of polypharmacy, medication combinations, and adverse effects were extracted from electronic medical records.

Result

Among patients diagnosed with ADHD, 23% received polypharmacy, most frequently involving stimulant and alpha-2 agonist combinations. Male gender and ages 6-7 were associated with a higher likelihood of polypharmacy. The most prevalent psychotropic polypharmacy combination involved ADHD medications and SSRIs. Adverse effects, including

sleep disturbance, appetite suppression, and aggression/outbursts, were commonly reported.

Conclusion

Polypharmacy is prevalent in managing paediatric ADHD, with stimulant and alpha-2 agonist combinations being the most frequent. The study’s findings align with existing literature and emphasize the importance of safe medication prescribing. More research is needed to explore the safety and efficacy of various combinations and their adverse effects. Further investigations should consider the role of psychotherapy, regional variations, and standardised tools for assessing adverse effects.

PR3: Paediatric Audit for Queensland Early Onset Group B Streptococcal Disease

Guidelines: inves�ga�ng the efficacy of predictors for Neonatal Sepsis

Tan, Zoe, 5th Year Medical student, Health Sciences and Medicine, Bond University

Tipirneni, Sai, 5th Year Medical student, Health Sciences and Medicine, Bond University

Schmidt, Peter, Director and Senior Staff Specialist, Gold Coast University Hospital Neonatal Intensive Care Unit

Jones, Peter, Professor of Paediatric Medicine, Health Sciences and Medicine, Bond University

Introduc�on

Neonatal Sepsis is a major cause of morbidity in newborns. This retrospec�ve audit aims to iden�fy if the following predictors (raised C-Reac�ve Protein (CRP> 20mg/L), intrapartum maternal fever (IMF) > 38 degrees, prolonged rupture of membranes (PROM) > 18 hours and chorioamnioni�s, are accurate in predic�ng early or late onset neonatal sepsis. Addi�onally, this study discusses the significance of cerebrospinal fluid (CSF) findings and its usefulness in aiding a diagnosis.

Methods

Two studies were conducted. Both studies defined posi�ve sepsis cases as cases with a posi�ve blood culture (BC). Study 2 defined CSF posi�ve cases as a posi�ve culture result and/ or elevated WCC (leucocytosis) > 30 x 10^6/L. Quan�ta�ve data on risk factors and laboratory results were analysed from 138 suspected neonatal sepsis cases over three years (July 20192022) at Gold Coast University Hospital. Sta�s�cal comparisons were made using Chi-squared and Fisher’s exact test calculators with a p-value <0.05 to iden�fy significant correla�ons.

Results

IMF and CRP value > 20mg/L were found to be sta�s�cally significant predictors of neonatal sepsis. There was no significant concordance between posi�ve BC and CSF results. 24.53% asep�c meningi�s cases were iden�fied. 71.7% of cases that had an LP reported no posi�ve findings. No significant risk factors for late onset sepsis were iden�fied.

Conclusion

IMF and raised CRP are reliable predictors for early onset neonatal sepsis; they can enhance diagnos�c accuracy and op�mise clinical outcomes. Further discussion and improvement regarding the use of lumbar punctures and its indica�ons are recommended.

PR4: The Reliability of the Gilsanz and Ra�b Atlas in Es�ma�ng the Skeletal Age of New Mexican Females

Ketheesan, Yathurshika 5th Year Medical student, Health Sciences and Medicine, Bond University

Swart, Taliah, Research Student in Forensic Anthropology, Health Sciences and Medicine, Bond University

Roehl, Joan, Assistant Professor in Medicine, Health Sciences and Medicine, Bond University Lotering, Nicolene, Assistant Professor in Medicine (Anatomical Sciences), Health Sciences and Medicine, Bond University

Introduc�on/ Background

The Gilsanz-Ra�b1 (GR) atlas is an age es�ma�on tool for digital paediatric hand and wrist radiographs developed from a European-descended popula�on. This study assessed the accuracy and applicability of the Gilsanz-Ra�b Hand-Wrist atlas on skeletal age es�ma�on in modern New Mexican females aged 0 to 18 years.

Methods

Post-mortem mul�planar computed tomography scans of the le� hand and wrist (n = 65) from the New Mexico Decedent Image Database were analysed by one blinded independent observer in the Horos DICOM viewer. The error between es�mated and chronological age was analysed on the basis of bias, inaccuracy and standard error of the mean.

Results

The GR atlas underes�mated the skeletal age from ages 3 to 7 by -1.42 ± 1.30 years (p = 0.183). The skeletal age was overes�mated for ages 8 to 13 by 1.18 ± 1.87 years (p = 0.010), ages 14 to 15 years by 2.25 ± 1.91 years (p = <0.001) and ages 16 to 18 years by 0.63 ± 0.87 years (p = <0.001). This was associated with the delayed appearance of the triquetrum (age 4) and the ulnar epiphysis (age 8). Bone matura�on then accelerated as the metacarpals, distal and proximal phalanges fused from ages 10 to 13 years, and the distal radius and ulna fused from ages 11 to 17.

Conclusion

These results demonstrate a high degree of error; thus, the GR method should be used with cau�on. Further research regarding the accuracy of age es�ma�on methods in different ethnici�es needs to be conducted.

PR5: The Reliability of the Tibial Apophysis in Es�ma�ng the Skeletal Age of New Mexican Children

Nitchingham, RohanPR5: , 5th Year Medical student, Faculty of Health Sciences and Medicine, Bond University

Swart, Taliah, Master of Science by Research, Faculty of Health Sciences and Medicine, Bond University

Roehl, Joan, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University

Lotering, Nicolene (supervisor), Assistant Professor, Faculty of Health Sciences and Medicine, Bond University

Introduc�on/Background

This study examined the �bial apophysis as a landmark for es�ma�ng bone age in modern children due to limited evidence sugges�ng this site can be used in bone age assessment. Computer topography (CT) was chosen to assess this landmark as it offers a three-dimensional view which is useful in visualising fusion of the �bial apophysis.

Methods

The study used 119 retrospec�ve CT scans of the right knee of males and females aged 8 to 22 years from the New Mexico Decedent Image Database (NMDID). An ordinal scoring system was developed using a 4-stage protocol on mul�planar CT to assess the development of the �bial apophysis and the proximal �bial epiphysis. The scoring system evaluated the development of a secondary ossifica�on centre and whether there is recent, par�al, or complete fusion with the proximal �bia. An intraobserver and interobserver error study was undertaken to measure reliability of the scoring protocol which produced excellent reliability.

Results

Results showed that the earliest age complete fusion occurred was 13 years old, the average age was 18 years old, and the maximum age was 22. The earliest age fusion commenced was 10 years old and the maximum was 14 years old. Addi�onally, an independent sample T-test showed females complete ossifica�on earlier than males which may be atributed to estrogen playing a role in skeletal matura�on.

Conclusion

This study suggests the �bial apophysis could be a useful clinical landmark for es�ma�ng chronological age from bone age es�ma�on. Addi�onal research would help validate the results of this study.

PR6: Evalua�ng the accuracy of the CRITOL acronym in assessing elbow ossifica�on sequence and skeletal age in modern children

Powell, Chelsea, 5th Year Medical student, Health Sciences and Medicine, Bond University

Page-Stephens, Solange, 5th Year Medical student, Health Sciences and Medicine, Bond University

Swart, Taliah, BHSc (Biomedical Science; Health Sta�s�cs), Health Sciences and Medicine, Bond University

Roehl, Joan, BSc, MSc, PhD, FHEA, Health Sciences and Medicine, Bond University Lotering, Nicolene, BForSc(Anat), BAppSc(Hons), PhD, AFHEA, Health Sciences and Medicine, Bond University

Background

Estimating bone age provides helpful information in forensic and clinical settings.1 Many bone estimation techniques exist; however, limited evidence supports a simple tool using the elbow joint to estimate age in pre-pubertal children. In practice, the CRITOL acronym is used to assess the ossification sequence and appearance of the elbow’s six ossification centres.2 There is limited research to support this acronym. This study aims to evaluate the accuracy of the CRITOL acronym in predicting elbow ossification sequence and skeletal age in modern New-Mexican children using computed tomography (CT) scans.

Methods

191 thin-slice CT scans were obtained from individuals aged zero to twelve from the New Mexico Decedent Image Database. The scans were selected using eligibility criteria and visualised with Horos® software. Each scan was aligned following the alignment protocol and scored based on the presence or absence of the six ossification centres.

Results

The intra- and interobserver study showed excellent agreement between scorers and attempts, supporting the reliability of the scoring method. The ossification sequence from the study sample aligned with the CRITOL sequence for 99% of males and 98% of females. In

males, the ages of appearance matched the CRITOL-associated ages for all sites, excluding the capitulum, which appeared earlier. In females, the method appears to overestimate skeletal age in all sites.

Conclusion

Our results suggest, using CT imaging, the CRITOL method accurately predicts the sequence and age of appearance of elbow ossification centres in male children. However, this technique is not clinically applicable to female children.

STREAM 2 PLANETARY HEALTH

LP1: Develop a Human Iden�fica�on Assays for Nanopore Sequencing and Expl ore Its Performance with Degraded DNA Samples.

Tang, Jie , HSM postgraduate student, Health Sciences and Medicine, Bond University

Ashton, Kevin, Professor, Health Sciences and Medicine, Bond University

Connell, Jasmine, Research Fellow, Queensland University of Technology

Dunn, Paul, Assistant Professor, Health Sciences and Medicine, Bond University

Background

During mass fatality events that generate a large number of vic�ms, there is a humanitarian and legal responsibility to iden�fy the vic�ms so they can return to their families. However, the extreme environment during these events may damage vic�ms' remains and apply challenges to human iden�fica�on. The tradi�onal PCR-based that inves�gates STRs markers are high in accuracy but expensive, low in mul�plex poten�al, and require a specialised laboratory environment. Next-genera�on sequencing can inves�gate different types of markers but has high up-front costs. The most recent technology, Third-genera�on sequencing developed by Oxford Nanopore Technologies, provided a lost-cost, portable, fast and real-�me sequencing alterna�ve to resolve the limita�ons. This study aims to develop a novel human iden�fica�on assay using ONT sequencing devices and test its performance on ar�ficially degraded DNA.

Methods

To complete this, a scoping review will be conducted to identify current best practices used in genetic human identification makers research and forensic laboratories. Following this, we will design and test a novel human identification gene panel that relies on nanopore sequencing. Previously characterised reference DNA obtained from the Coriell Institute will be used to validate this test. Finally, artificial degradation of the DNA samples will be conducted to identify the panel's limits of detection.

Result

It is expected that the novel, portable, rapid and cost-effective human identification assay using the ONT MinION device will be developed by the end of this study.

Conclusion

With all the characteristics, this assay can potentially improve and replace other standardised genomic techniques and assays.

PR7: Addressing the Dispropor�onate Effect of Extreme Weather upon Rural and Remote Indigenous Communi�es in Australia

Doss, Shibi – 5th Year Medical Student, Health Sciences and Medicine, Bond University

McLean, Michelle, Supervisor, Health Sciences and Medicine, Bond University

Introduc�on

The Triple Planetary Crises presents unique challenges to Sustainable Health Care. It is impera�ve to consider how this crisis affects the Australian Health System and how the Sustainable Development Goals (SDGs) can be tailored more specifically to the Australian Health Consumer. Rural and Remote Indigenous Communi�es are a vulnerable group and face an increasingly dispropor�onate burden of disease possibly exacerbated by extreme weather events such as bushfires, floods and drought. Viable Solu�ons to this problem must be implemented.

Methods

A Cri�cal Reflec�on was writen a�er a Rural Paediatrics Rota�on was undertaken in Lismore, New South Wales. The literature review examined 28 ar�cles and 1 Government Health Page. A PubMed search using MeSH terms “Indigenous” and “Health” and “Climate Change” was conducted. The search was ini�ally yielded 257 results in English and Abstracts were then included or excluded by a single examiner. A video addressing solu�ons was created using Systems and Design Thinking.

Results

The literature highlighted that Indigenous Peoples are more likely to live in areas with more variable rainfall and higher temperatures. Indigenous Peoples were also more likely to experience adverse physical, mental and spiritual health outcomes in response to extreme weather events. Climate Change remains a profound, prolonged and damaging consequence of Colonisa�on.

Conclusion

The evidence suggests a requirement for solu�ons to overcome the growing effects of Climate Change upon Rural and Remote Indigenous Health. These solu�ons must be mul�-faceted and include input from Indigenous Communi�es.

PR8: Impact of the obesity-undernutri�on-climate change Syndemic on Australian children.

Khagram, Sheetal 5th Year Medical student, Health Sciences and Medicine, Bond University Professor Michelle McLean, Health Sciences and Medicine, Bond University

Introduc�on

Obesity, undernutri�on, and climate change are interdependent, inter-related and co-exist in every popula�on. Together, they cons�tute the Global Syndemic, which is predicted to have life-threatening consequences if urgent ac�ons are not taken. This literature review aims to understand the impact of the global syndemic on Australian children, iden�fy common drivers, discuss evidence -based solu�ons, and how implemen�ng them can help achieve the selected Sustainable Development Goals (SDGs) 2,12, and 13.

Methods

An extensive literature search was conducted using Cochrane, Google Scholar, and PubMed. Relevant journal ar�cles and book chapters since 2015, government reports and website documents were reviewed. All grey literature was excluded.

Results

Our current ea�ng behaviours and agricultural prac�ces significantly threaten human health and our environment. Some common drivers of the Global Syndemic are car dependence, food behaviours, agricultural systems, and global economic condi�ons. A systems-based approach is required to address these causes and transi�on to sustainable and resilient food systems. Double- and triple-duty ac�ons such as popula�on interven�ons, programs, and policies are recommended to address the common drivers of obesity, undernutri�on, and climate change syndemic.

Conclusion

There is a growing consensus that sustainable ea�ng paterns and food systems are vital for ataining several SDGs simultaneously and is the only way to mi�gate the global syndemic of obesity, undernutri�on, and climate change. Effec�ve interven�ons targe�ng school-age children have the poten�al to change their thinking, behaviours, and ac�ons at a young age to promote sustainable living, combat climate change, protect nature and preserve biodiversity.

PR9: Malawi and the Loss of Biodiversity

Musaddiq, Fazel Azim 5th Year Medical student, Health Sciences and Medicine, Bond University

McLean, Michelle, Professor Health Sciences and Medicine, Bond University

Introduc�on/ Background

In Malawi, renowned for its rich biodiversity, escala�ng biodiversity loss is a cri�cal issue. The na�on’s ecosystems, home to unique flora and fauna, are threatened by deforesta�on, unsustainable agriculture, and illegal wildlife trade. These issues are intertwined with the livelihoods of Malawi's lower socioeconomic popula�ons, who depend heavily on environmental resources. Addressing this loss is a mul�faceted challenge involving environmental, social, and economic dimensions. Sustainable Development Goal (SDG) 15: Life on Land offers a framework to address these interconnected challenges. This project explores community-centred solu�ons empowering Malawi’s vulnerable popula�ons to become environmental stewards, aligning with SDG 15.

Methods

Our research employed Systems Thinking and Design Thinking. Systems Thinking included a literature review, stakeholder mapping, causal loop diagrams, and scenario modelling to understand biodiversity loss and socioeconomic context in Malawi. Design Thinking itera�vely developed poten�al solu�ons, beginning with empathy mapping through interviews with community members and stakeholders, which informed idea�on and prototyping sessions. Solu�ons aligning with SDG 15 were refined based on community feedback, and pilot implementa�ons were evaluated where possible.

Results

The project revealed that Community-Based Natural Resource Management (CBNRM) ini�a�ves empower lower socioeconomic popula�ons, enhancing stewardship over local ecosystems. These ini�a�ves led to decreases in deforesta�on and poaching. Adop�ng

agroforestry and conserva�on agriculture improved soil health, increased crop yields, and diversified income. Furthermore, eco-tourism projects, anchored in community ownership, emerged as sustainable income sources, promo�ng economic growth and biodiversity conserva�on.

Conclusion

Empowering Malawi's lower socioeconomic communi�es through CBNRM ini�a�ves, agroforestry, and eco-tourism is a promising approach towards achieving SDG 15. These strategies foster environmental stewardship, improve livelihoods, and promote sustainable land use. Key implica�ons include the necessity for suppor�ve policy frameworks and community educa�on. The take-home message: Community-led, integrated approaches can effec�vely combat biodiversity loss in Malawi, aligning environmental restora�on with socioeconomic advancement.

PR10: A ques�on of sustainable development: A mix of rapid urbanisa�on, pollu�on and poverty in India

Nigam, Avik, 5th Year Medical Student, Health Sciences and Medicine, Bond University

McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

Introduc�on

Countries scramble to meet the UN Sustainable Development Goals (SDG) by 2030. This review focuses on the impact of air and water pollu�on on impoverished slum dwellers in India. With the country's rapid urbanisa�on, inequality in access to safe living condi�ons exposes the vulnerable popula�on to dangers. Air pollu�on in Indian urban ci�es is the leading cause of respiratory illnesses, co-morbidi�es, and premature deaths. On the other hand, water pollu�on propagates toxic by-products of waste and bacteria such as Escherichia coli, leading to malnutri�on and death.

Methods

The community chosen are the impoverished and vulnerable living in India, a country with a popula�on of 1.4 billion; 17% live in designated city slums. Air and water pollu�on have been one of the cri�cal focuses of developing countries due to the increased co-morbidi�es and mortality rates. The chosen SDGs are; 6: Ensure availability and sustainable management of water and sanita�on, and 11; Make ci�es and human setlements inclusive, safe, resilient and sustainable.

Results

Respiratory condi�ons such as asthma, bronchi�s and chronic obstruc�ve pulmonary diseases are common amongst slum-dwellers exposed to NO2 and CO gases in the atmosphere around the clock. A solu�on to this is ver�cal greenery systems in urban setlements. Contaminated water plays a substan�al role in propaga�ng diseases such as cholera and typhoid; a solu�on is bio-sand filtra�on systems.

Conclusion

Urgent aten�on is required to meet the SDG by 2030. Sustainable measures must be priori�sed to expand urban green spaces and access to clean drinking water.

PR11: Indigenous Wisdom & Modern Strategies: Comba�ng Climate Change Impacts on Aboriginal and Torres Strait Islander Communi�es

Nguyen, Chi Jus�n Hong, 5th Year Medical Student, Health Sciences and Medicine, Bond University

McLean, Michelle, Planetary Health Supervisor, Health Sciences and Medicine, Bond University

Background

Climate change, a global crisis, dispropor�onately affects Indigenous communi�es. In Australia, the Aboriginal and Torres Strait Islander popula�ons are par�cularly vulnerable to the rising temperatures and subsequent adverse events, impac�ng their well-being and tradi�onal ways of life. Given the magnitude of the challenge, it is impera�ve to address these impacts and develop adap�ve strategies.

Methods

The study undertook a comprehensive analysis of the issue by iden�fying key problems faced by these communi�es, focusing on the Torres Strait Islander community as a primary case study. The Sustainable Development Goals (SDGs), par�cularly SDG 13, served as a framework to align poten�al solu�ons with global benchmarks. Both quan�ta�ve and qualita�ve data were sourced, with substan�al emphasis on community consulta�ons.

Results/Discussion

Our findings emphasize the urgent need for ac�on. There's a clear indica�on of adverse health, socio-cultural, and economic impacts of climate change on these communi�es. However, solu�ons lie within the communi�es themselves. Indigenous knowledge, especially regarding land management and conserva�on, has been iden�fied as instrumental in climate ac�on. Collabora�ve approaches, involving community engagement, adequate governance, financial investments, and focused educa�on, offer a pathway forward. Furthermore, integra�ng tradi�onal prac�ces with modern conserva�on methods can provide sustainable solu�ons.

Conclusion

The resilience of the Aboriginal and Torres Strait Islander communi�es, combined with their vast tradi�onal knowledge, posi�ons them uniquely in the fight against climate change. However, collabora�on, respect for indigenous knowledge, and proper investment are key. This study underscores the urgency and provides a roadmap for inclusive climate ac�on.

PR12: A planetary health approach to Koala conserva�on

Pearcy, Joshua, 5th Year Medical student, Health Sciences and Medicine, Bond University

McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

Background

In our complex, changing world, climate change is a formidable and mul�faceted challenge, exer�ng profound effects on the Earth's delicate ecological balance. As the planet faces unprecedented levels of greenhouse gas emissions from burning fossil fuels, deforesta�on, and industrialisa�on, the resul�ng accumula�on of heat-trapping gases in the atmosphere has set a cascade of consequences (Head et al., 2014). Koala popula�ons in Australia are facing a rapid and alarming decline, primarily due to environmental pressures and human ac�vi�es. One of the key drivers of the decline is habitat loss and fragmenta�on (Gonzalez-Astudillo et al., 2017). As both human and urban popula�ons expand, na�ve forests and eucalyptus woodlands, which are cri�cal habitats for Koalas, are cleared for agriculture, logging, and urban development. This destruc�on and fragmenta�on of their natural habitats result in limited access to suitable food sources and breeding grounds, making it challenging for Koalas to find viable living spaces (McAlpine et al., 2015)

Methods

A systems-based approach was used to iden�fy cri�cal issues. which were aligned with sustainable development goals (SDGs), to provide solu�ons that encompass the values of a planetary health approach.

Results

The key issues leading to koala popula�on decline included fragmenta�on and loss of habitat due to rapid urban expansion, agriculture and industry combined with ineffec�ve climate and wildlife policy.

Conclusion

Koala popula�on decline needs to be urgently addressed through strong poli�cal commitment to koala conserva�on and global frameworks such as the SDGs.

PR13: Air Pollu�on in Egypt

Razkala, John, 5th Year Medical student, Health Sciences and Medicine, Bond University McLean, Michelle, Professor, Project supervisor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

Air pollu�on is a planetary crisis that affects millions of people worldwide. It is es�mated that 99% of the human popula�on resides in areas that do not meet the interna�onal air quality guidelines. The purpose of this research is to iden�fy a popula�on vulnerable to air pollu�on, research its causes and explore possible solu�ons using the relevant sustainable development goals set by United Na�ons.

Methods

It was found that Egypt had one of the highest air pollu�on levels in the world. This is mainly caused by the emissions from heavy industries and outdated vehicles that predominantly rely on fossil fuels for power. Also, poor regula�ons and environmental prac�ses, such as burning agricultural waste, play a cri�cal role in air pollu�on. The relevant SDGs that address air pollu�on are SDG 3, 11 and 7. Theses SDGs aim to reduce the number of deaths and illnesses from air pollu�on, reduce the environmental impact of ci�es and promote the use of clean energy respec�vely.

Results

Possible solu�ons include Educa�on and raising awareness, which can empower behavioural change and public policy support to adopt eco-friendly prac�ces. Moreover, reducing transport emissions by suppor�ng electric vehicles adop�on can improving air quality. This also requires the embracing of renewable energy sources such as solar power to prevent air pollu�on and global warming.

Conclusion

In conclusion, Air pollu�on is a significant planetary crisis that need the collec�ve efforts of both the Egyp�an popula�on and the interna�onal community to address.

PR14: Food Waste’s Impact on the Triple Planetary Crisis and How This Influences the Health and Well-Being of Rural and Remote Australians

van den Berg, PJ, 5th Year Medical student, Health Sciences and Medicine, Bond University

McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

Technological and scien�fic advancements in the last century have greatly improved global human health and wellbeing. In many aspects, there has never been a beter �me to be alive. The same technological and scien�fic advancements that have made these incredible achievements possible have also led to an exponen�al increase in our global ecological footprint. The enormous global ecological footprint has led to changes in climate, biodiversity, pollu�on and biophysical changes which are endangering most dimensions of human health. Food waste is a major contributor to climate change, pollu�on and biodiversity loss and the primary purpose of this project was to iden�fy solu�ons to reduce food waste and its impact on the health and well-being of rural and remote Australians.

Methods

A literature review was undertaken to iden�fy the impact of food waste on the triple planetary crisis and how this affects the health and well-being of rural and remote Australians.

Results

Australians waste approximately 7.6 million tonnes of food every year which produces 3% of Australia’s annual greenhouse gas emissions. Food waste leads to climate change, pollu�on and biodiversity loss which directly impacts the health and well-being of rural and remote Australians.

Conclusion

Food waste solu�ons such as food rescue ini�a�ves, educa�onal programs and repurposing food waste for insect feed should be implemented to reduce the environmental impacts of food waste. We have a moral obliga�on to promote planetary health as the health of our planet and human health are intricately linked.

STREAM 3 MEDICAL ETHICS

PB2: Ethical and Prac�cal Considera�ons in the Liberalisa�on of Voluntary Assisted

Dying: A Focus on Queensland's Emerging Landscape

Casagrande, Renee - 5th Year Medical student, Health Sciences and Medicine, Bond University

Comb, Sara - 5th Year Medical student, Health Sciences and Medicine, Bond University

Edirisinghe, Vinuri - 5th Year Medical student, Health Sciences and Medicine, Bond University

Mathews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Introduc�on

Voluntary Assisted Dying (VAD) cons�tutes a paradigm wherein individuals afflicted by illness are afforded the op�on to solicit medical interven�on to peacefully conclude their lives. Despite its legalisa�on across several na�ons, the nascent adop�on of this prac�ce in Queensland merits aten�on. This presenta�on serves as a cau�onary discourse against the liberalisa�on of VAD within the Queensland context, focusing on its impact on pallia�ve care and vulnerable popula�ons; namely the paediatric popula�on and those with psychiatric considera�ons - notably borderline personality disorder. In doing so, the presenta�on will delve into the prospec�ve assimila�on of VAD as a conceivable remedial avenue.

Methods

The triumvirate of presenters systema�cally executed literature searches across a myriad of databases with the aim of discerning ar�cles of relevance. Following this they curated ar�cles using predetermined criteria.

Results

A lax in regula�ons and safeguards abroad have exposed vulnerable popula�ons to coercion and disadvantages in their pursuit for end-of-life care. In the Netherlands and Belgium, requests for psychiatrically mo�vated assisted dying are chiefly voiced by women, o�en marked by a concurrent diagnosis of post-trauma�c stress disorder and a background of significant childhood abuse. Redirec�ng resources towards VAD ini�a�ves leads to the diminishment of pallia�ve care funding.

Conclusion

Expanding the VAD policy will perpetuate ableism and s�gma�se individuals with disabili�es and / or mental health disorders. Extending VAD to minors without addressing research gaps is premature. Cau�on is needed when labelling women with borderline personality disorder. Integra�ng VAD into pallia�ve care brings advantages: curbing liberalisa�on risks, informed choices, funding protec�on, and balanced autonomy.

PR15: Ethical and ecofeminist perspec�ves on the impact of climate change on women’s health in low-and-middle-income countries

Chahal, Harpreet, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Mathews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Introduc�on

Climate change is the greatest public health threat facing the world today. However, the adverse impacts of climate change are not equally distributed with vulnerable popula�ons bearing the worst effects. Of those, women are par�cularly vulnerable. The aim of this literature review is to apply an ethical and ecofeminist lens to the impact of climate change on women in low-and-middle-income countries (LMICs), and to highlight the urgency of this issue to healthcare professionals.

Methods

A qualita�ve literature review was conducted using PubMed (with set inclusion and exclusion criteria) and various other grey literature. Literature a�er 2010 was priori�sed, unless seminal. A total of 53 publica�ons were included in this review.

Results

Climate change serves as a risk-amplifier to exis�ng health inequi�es. Women experience lower life expectancy, obstetric complica�ons, mental health condi�ons, malnutri�on, and gender-based violence.

Conclusion

Climate change is not gender-neutral, therefore gender-specific solu�ons are required moving forward, across grassroots, na�onal, and interna�onal levels. Healthcare workers must understand the impacts of climate change on health for the wider community to be able to provide competent care. They also hold an important role at the intersec�on between pa�ents and science for dissemina�on of informa�on and advocacy. It is important to adopt an ethical lens considering planetary jus�ce and ecofeminist perspec�ves to ensure disadvantaged and marginalised popula�ons are not ignored.

PR16: Xenotransplanta�on – An Ethical Literature Review

Haris, Fondas, 5th Year Medical Student, Health Sciences and Medicine, Bond University Mathews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Introduction/Background

In Australia, in 2021, there were more than 1,903 patients on the organ transplant waiting list, yet there were only 421 organ recipients. The allograft shortage is an obstacle that has led to numerous lives being lost, and xenotransplantation may be a promising unorthodox alternative to this problem. Xenotransplantation is the transplantation of interspecies cells, tissues, and organs into humans. Numerous ethical considerations coalesce as xenotransplantation gradually matures into a viable allotransplantation solution. Such considerations include the welfare and treatment of animals; genetic interference of animals; xenozoonosis; religious views towards xenotransplantation; and the allocation and access to xenografts.

Methods

To identify relevant literature on xenotransplantation, databases were systematically searched, these included: PubMed, Scopus, ScienceDirect, Medline, Hastings Centre Report, Wiley Online Library and Google Scholar. The search was performed from the inception of the databases until May 2023. A combination of MeSH and free-text terms were used to capture all relevant literature. The keywords used included: “xenotransplantation”, “xenograft”, “pig”, “porcine”, “ethics”, “genetic modification”, “CRISPR”, “transgenic”, and “xenozoonotic infection”. Literature was included if they were original research articles, reviews, commentaries, and editorial letters published in English and discussing XTx. Articles were excluded if they were not available in full text, were not published by a reputable journal, or did not focus on XTx. Overall, 54 articles were collected, and 33 articles were utilised within this literature review.

Results

Nil. Conclusion

This review aims to present and analyse current literature on the developments of ethical considera�ons concerning xenotransplanta�on.

PR17: The explora�on of neuroethical issues of humanity, personhood and autonomy rela�ng to brain-computer interface use in medicine

Singh, Gobind Deep, 5th Year Medical Student, Faculty of Health Sciences and Medicine, Bond University

Mathews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

The development of brain-computer interfaces (BCIs) is a rapidly advancing field that has made significant strides in crea�ng technology that allows direct communica�on between the brain and machine. While this technology can poten�ally treat a diverse array of chronic and debilita�ng brain and spinal cord condi�ons, its careful ethical administra�on is vital in maximising the benefit and minimising the harm of this technology. This paper focuses on the psychological neuroethical considera�ons of humanity, personhood and autonomy that are medically relevant and pa�ent-centred.

Methods

The journal ar�cles found on PubMed and Google Scholar provided valuable neuroethical arguments, viewpoints, and pa�ent interviews which elucidated the benefits and risks of BCI to pa�ents' humanity, personhood, and autonomy

Results

It was found that while BCI can create nega�ve feelings around "cyborgiza�on" and cause estrangement, loss of control, and distress in a pa�ent, the BCI can also empower many pa�ents by improving their self-image, independence, self-confidence, and control of external devices, hence, effec�vely restoring a pa�ent's humanity, autonomy, and personhood.1,2,3

Conclusion

In a nutshell, this paper acknowledges the psychological risks of medical BCI while supporting the positive impact this technology can have on restoring patients’ humanity, personhood, and autonomy. However, this conclusion is based on limited evidence from small patient cohorts and further research with larger patient cohorts is required to establish these correlations confidently. Furthermore, it is crucial to consider the other neuroethical considerations under physical and social factors before deeming this technology safe for medical administration.

PB3: The Methodologies of Teaching and the Influence of the Hidden Curriculum within Medical Ethics Educa�on

Pei, Helen, 5th Year Medical student, Health Sciences and Medicine, Bond University

Karpin, Tiffany, 5th Year Medical student, Health Sciences and Medicine, Bond University

Reeves, Meg, 5th Year Medical student, Health Sciences and Medicine, Bond University

Matthews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Hamlin, Gary, Associate Professor, Health Sciences and Medicine, Bond University

Introduction

Ethics education during medical school aims to equip future health professionals with the competencies necessary to navigate healthcare’s moral ambiguities professionally, empathetically and ethically. There is significant diversity in the teaching modalities universities utilise, raising the question of their efficacy. Furthermore, external factors that influence ethics education must also be considered; in particular, the ‘hidden curriculum’ profoundly shapes behaviour.

Methods

The three students conducted literature searches across several databases to identify relevant articles. Researchers then selected articles based on predetermined eligibility criteria.

Results

HP examined the efficacy of lectures and small group learning for teaching and discovered that students' personalities influence their preferences for teaching strategies. The study highlighted the power of group discussion with passionate facilitators and the struggle to relate ethics discussions to clinical applications. TK analysed lectures, small group learning, case studies, reflective exercises and experiential learning to determine which teaching modality would produce a transformative ethics program. It was determined that no single teaching medium could adequately encompass the broad teaching required to achieve longterm behavioural change. MR explored how the hidden curriculum can act as both a barrier

and a facilitator to medical ethics education. Whilst the hidden curriculum presents challenges, it also can positively reshape the culture of medicine.

Conclusion: The three literature reviews specified the need for multiple teaching methods to be integrated into ethics educational programs to impart knowledge and drive behavioural change. It also highlighted the significance of the hidden curriculum in shaping future doctors and cautioned educators to consider its harms seriously.

PR18: Is medical ethics educa�on effec�ve in producing well-prepared students and junior doctors?

Nagy, Grace, 5th Year Medical student, Health Sciences and Medicine, Bond University

Zaka, Nida, 5th Year Medical student, Health Sciences and Medicine, Bond University

Mathews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Hamlin, Gary, Associate Professor, Health Sciences and Medicine, Bond University

Introduc�on

The overarching goal of medical educa�on is to ensure that students acquire the knowledge, skills and professional behaviours which prepare them to become competent junior doctors. A fundamental component of the medical curriculum is ethics. This review aimed to understand the efficacy of medical ethics teaching by assessing students’ self-percep�ons of preparedness, to ensure all graduates are equipped with the necessary knowledge and skills for future clinical prac�ce.

Methods

A comprehensive search of the literature was conducted using major databases to iden�fy relevant studies. Eligible ar�cles were judged against a set of inclusion and exclusion criteria.

Results

The literature overwhelmingly demonstrates that medical students feel unprepared to face ethical issues. This lack of preparedness is expected to nega�vely impact students and their prospec�ve pa�ent/s. Several contribu�ng factors influencing the perceived lack of student preparedness have been explored within this review, including barriers to ethics educa�on, a lack of student engagement, the power hierarchy in the workplace, and underes�ma�ons of self-assessed preparedness. The findings ul�mately highlighted an inadequacy within the current medical curriculum. This review proposed solu�ons to address the lack of student preparedness, such as the implementa�on of case-based content and the incorpora�on of ethics educa�on throughout all stages of learning, with an aim to improve the efficacy of teaching.

Conclusion

Future research into the self-assessment of preparedness would be beneficial to support the findings of this review, and to understand the efficacy of medical ethics educa�on in preparing students to become well-rounded and accomplished future doctors.

PR19: An Evalua�on of the Ethical Dilemmas of De-Prescribing in Geriatric Popula�ons

Hun�ngton, River 5th Year Medical Student, Health Sciences and Medicine, Bond University

Mathews, Richard, Associate Professor Health Sciences and Medicine, Bond University

Schweitzer, Daniel, Mater Hospital Brisbane

Pache, David, Assistant Professor Health Sciences and Medicine, Bond University

Introduc�on

Deprescribing refers to the process of withdrawing prescrip�on medica�on from a treatment plan. According to the Australian Commission of Safety and Quality, it is es�mated that 49% of Australians 75 and over have had seven or more medicines dispensed. The Pharmaceu�cal Society of Australia addi�onally state that there were 400,000 medica�on related admissions to the emergency department in 2017. This indica�on suggests that polyprescribing poses a significant burden to today’s society. In the Journal of Bioethical Inquiry, Dr Emily Reeves describes how deprescribing offers a way to mi�gate the impact of polyprescribing such as adverse medical events or drug interac�ons.

Methods

This ar�cle provides an evalua�on of the ethical dilemmas surrounding deprescribing with a focus on geriatric popula�ons. It incorporates both data sources and qualita�ve research into a four-topic approach, including medical indica�ons, contextual features, pa�ent preferences, and quality of life, these categories may assist in guiding treatment. They encompass the four ethical pillars of medicine: beneficence, non-maleficence, autonomy, and jus�ce.

Results

Despite the inherent benefit of deprescribing there are a number of ethical issues raised in its delivery and barriers to its implementa�on. The op�miza�on of medical regimes is influenced by personal preferences, interpersonal doctor-pa�ent rela�onships, healthcare equality and the goals of treatment.

Conclusion

Through deprescribing in conjunc�on with clinical guidelines, improved health policy, and increased pa�ent centred care, the lives of older individuals can be enhanced. Overall the deprescribing process was found to promote posi�ve health outcomes in reducing the burden of polypharmacy and should be considered by physicians around Australia.

STREAM 4 MEDICAL EDUCATION

OP2: Designing selec�ve Poly(ADP-ribose) polymerase member 14 (PARP14) cataly�c domain inhibitors

Jaiswal, Pooja, Health Sciences & Medicine Honours student, Bond University

Schweiker, Stephanie S, Associate Professor, Faculty of Health Sciences & Medicine, Bond University

Levonis, Stephan M, Associate Professor, Faculty of Health Sciences & Medicine, Bond University

Introduc�on and Aim

Poly(ADP-ribose) polymerase (PARP) is an enzyme consis�ng of 17 members, and they are divided into DNA-dependent, CCCH (Cys-Cys-Cys-His) PARP, Tankryase, MacroPARP, and Others subclasses. One of them is PARP14, a MacroPARP. PARP14’s structure comprises a cataly�c, three macro, and a WWE domain. The enzyme can modify DNA and other proteins for the survival and prolifera�on of tumour cells. Inhibi�on of the enzyme has poten�al as a therapeu�c target. Currently, there are no clinically approved PARP14 inhibitors.1 The project's current aim is to design a library of novel molecules inhibi�ng the PARP14 cataly�c domain.

Methods

To design a library of novel small molecules, ChemSketch and SwissADME will be used. Chimera, AutoDock Vina, and PyRx so�ware will be used for computa�onal molecular docking.2 PARP14’s cataly�c domain crystal structure 3SMJ will be used for docking.

Results

PyRx docking results found that out of the nine compound structures, all compounds fall between –8.5 and –9.5 kcal/mol binding affinity. According to SwissADME, there were zero viola�ons of Lipinski’s rule of five. All nine compounds have high gastrointes�nal absorp�on and are blood-brain barrier permeant. The docked pose of these compounds shows interac�on with the essen�al amino acid residues found in the literature.1

Conclusion

The larger the nega�ve magnitude, the beter the affinity of the novel compound to bind to the cataly�c domain of PARP14.1 Interes�ng finding - the result of this project depicts a high probability of selec�ve inhibi�on in the cataly�c domain of PARP14 if synthesized. The results show significance as they add to the exis�ng literature, including the Structure-Ac�vity Rela�onship (SAR) profiling. Hundreds of compound designs are rejected for one drug to become commercially available. It highlights the importance of further research in the field.

PR20: Simulated Par�cipants in Health Professionals’ Educa�on

Weissenberger, Emily, 5th Year Medical Student, Health Sciences and Medicine, Bond University

De’Ambrosis, Isabella, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Stokes-Parish, Jessica, Assistant Professor, Health Sciences and Medicine, Bond University

Gough, Suzanne, Associate Professor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

Simulated par�cipants (SPs) play a vital role in enhancing medical educa�on and preparing students for prac�cing within the healthcare industry. This scoping review aims to assess the extent of literature focusing on simulated par�cipants within health professionals’ educa�on, specifically focusing on the student perspec�ve. Current research in the field of SPs focuses on their validity, reliability and feasibility as opposed to the student perspec�ve.

Methods

An ini�al search of PUBMED and CINAHL was undertaken to iden�fy ar�cles on the topic. The text words contained in the �tles and abstracts of relevant ar�cles, and the index terms used to describe the ar�cles were used to develop a full search strategy for PUBMED, CINAHL, EMBASE, Web of Science and Scopus. Following this, the �tles and abstracts were screened using the eligibility criteria before reviewing the en�re text.

Results

Following data extrac�on, a total of 12 papers were included within the study. The Kirkpatrick evalua�on model was then used to standardise and compare the level that each study was aimed at.1 The model follows four levels: reac�on, learning, behaviour, and results. Results found that SPs had a posi�ve outcome on student learning, however, most studies only addressed levels 1 and 2 of the framework.

Conclusion

This review provides evidence that the use of simulated par�cipants in health professionals educa�on is perceived as beneficial. Findings suggest SPs improve students’ overall

confidence, knowledge and communica�ons skills immediately post simula�on, with further research required to inves�gate the long-term effects of SPs as an educa�onal tool.

PR21: An explora�on of Bond University Simulated Par�cipants’ experiences with moulage in simulated environments, for the educa�on of health professionals. Xiao, Katrina, 5th Year Medical student, Health Sciences and Medicine, Bond University Kaya, Nivan, 5th Year Medical student, Health Sciences and Medicine, Bond University

Gough, Suzanne, Associate Professor of Physiotherapy, Associate Dean Learning and Teaching Stokes-Parish, Jessica, Academic Lead, Simulated Par�cipant Program, Faculty of Health Sciences and Medicine Bond Transla�onal Simula�on Centre

Background

This report reflects on the challenges encountered during a research project on moulage in simulated environments for healthcare educa�on. The use of moulage on simulated par�cipants has revolu�onised healthcare educa�on, providing an immersive learning experience for students and healthcare professionals alike 1 However, limited research has been conducted on the poten�al psychological impacts of moulage on simulated par�cipants. This project aims to u�lise focus group interviews to inves�gate these impacts. This report explores some hypotheses of poten�al psychological impacts, but focuses on our experience with planning the project, submi�ng an ethics protocol for approval and the various challenges encountered.

Methods

Research regarding conduc�on of an effec�ve focus group was completed. Based on this, a focus group template par�cipant informa�on sheet, consent form and withdrawal of consent form was created. These documents were used to create our ethics applica�on for this research.

Results

The reflec�on highlights the complexi�es and �me-consuming nature of the ethics approval process, including the development of a comprehensive ethics protocol and effec�ve communica�on with supervisors and the ethics commitee. The importance of careful planning in naviga�ng ethical considera�ons is emphasised. Preliminary data indicated that poten�ally nega�ve impacts could be easily mi�gated by fostering a suppor�ve environment for simulated par�cipants and ensuring that all moulage is effec�vely removed prior to the end of a shi�.

Conclusion

While the absence of focus group data is a limita�on, this inves�ga�on provides valuable insights into the intricacies of conduc�ng research projects and offers a deeper understanding of the challenges involved, contribu�ng to our growth as a future medical professional.

PR22: Inclusive Communica�on to improve health outcomes for people with intellectual disability: Evalua�on of the DSA Health Ambassador Program

Sedara, Kate – 5th Year Medical student, Health Sciences and Medicine, Bond University

Jones, Cindy, Associate Professor, Health Sciences and Medicine, Bond University

Matthews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Graham, Natalie, Health Program Manager, Down Syndrome Australia

Background

The literature indicated that healthcare workers do not have adequate knowledge, posi�ve a�tudes, and communica�on skills when it comes to people with intellectual disabili�es. This is due to a lack of educa�on and training in intellectual disability care which leads to inadequate care and nega�ve experiences for this popula�on.

Method

The study included Year 1 Bond medical students who were 18 years or older and enrolled in the MEDI11-102 Health & Well-Being Across Genera�ons course during either Semester 223 (May cohorts) or 231 (September cohort). Par�cipants were required to have atended the DSA Health Ambassador program. The data collec�on involved the administra�on of pre- and post-surveys to par�cipants before and a�er their par�cipa�on in the DSA Health Ambassador Program.

Results

The comple�on of the DSA Health Ambassador Program resulted in clear improvements in medical students' knowledge of intellectual disabili�es, communica�on approaches, and a�tudes. Addi�onally, it posi�vely influenced their perceived change in future prac�ce towards people with intellectual disabili�es, ul�mately contribu�ng to improved health outcomes for this popula�on. Moreover, it was noted that the importance of prior experience as a contribu�ng factor to par�cipants' posi�ve a�tudes and knowledge in this domain.

Conclusion

Hence, it is impera�ve to con�nue taking necessary steps, such as providing workshops during the early years of medical school, to enhance medical students' knowledge, a�tudes, and communica�on skills when interac�ng with individuals with intellectual disabili�es. This proac�ve approach will significantly contribute to improving overall health outcomes and the delivery of effec�ve care for this popula�on.

PB4: Can a robot make us more pa�ent-centred? Exploring the impact of ar�ficial intelligence on teaching communica�on in Medicine

Tran, Albertine 5th Year Medical student, Health Sciences and Medicine, Bond University

Henderson, Jasmine 5th Year Medical student, Health Sciences and Medicine, Bond University

Lee, Jordan, 5th Year Medical student, Health Sciences and Medicine, Bond University

Links, Matthew, Health Sciences and Medicine, Bond University

Bannatyne, Amy, Health Sciences and Medicine, Bond University

Morgan, Mark, Health Sciences and Medicine, Bond University

Introduction

ChatGPT utilises large language models to rapidly provide human-like responses to userprompted questions. Although there are critical questions regarding its place in medical practice, the ability to provide answers to naturalistic queries combined with the capacity for ongoing improvement makes it inevitable that it will have a place in delivering person-centred communication. The question becomes, how does this change the way we teach communication to future clinicians?

Aim

To explore the role of ChatGPT in facilitating enhanced patient-centred communication and to identify implications on the curriculum for medical students.

Methods

The research team consisted of two medical doctors, a psychologist and three final-year medical students with recent experience being taught patient-centred communication. A rapid literature review of PubMed was supplemented by a grey literature review about Artificial intelligence in Medicine.  Findings informed the design of five prompts emblematic of a simulated patient’s interactions with clinicians when seeking medical care for their melanoma. The answers provided by ChatGPT were then compared to established standards used in routine clinical practice. Implications for the medical student curriculum were developed by consensus within the research group.

Results

Medical schools must recognise the importance of digital health and responsible use of internet-based resources such as ChatGPT. Its role in clinical practice remains uncharted, its responsible use has the potential to significantly improve person-centred care and patient outcomes. However, its potential to perpetuate biases and inaccuracies, including hallucinations; and privacy concerns, are factors that prevent the widespread use of this tool. Further research in this rapidly emerging and improving field is recommended.

PR23: Simula�on Based Educa�on

Arora, Rahul, 5th Year Medical student, Health Sciences and Medicine, Bond University

Burton, Tehlia, 5th Year Medical student, Health Sciences and Medicine, Bond University

Brazil, Victoria, FACEM, Gold Coast University Hospital (Supervisor)

Introduc�on/ Background

Simula�on based educa�on (SBE) is a method of experien�al learning which aims to replicate scenarios that arise in many different disciplines. It aims to create situa�ons which are immersive, and conducive to the predefined learning outcomes for the target par�cipants.

Methods

During our seven-week placement in SBE, we rotated through Robina hospital, Gold Coast University Hospital, and Bond University, and assisted running simula�ons (referred to as sims) aimed towards staff in the Emergency Department, Intensive Care Unit, and maternity ward, as well as Bond Virtual Hospital, and sims for medical students. Ac�ve par�cipa�on as part of a delivery team in simula�ons for Bond medical/HSM students and post-graduate GCHHS learners enabled the acquisi�on and refinement of prac�cal skills in scenario management, teamwork, and effec�ve communica�on.

Results/Conclusion

This report details our learning outcomes for this MD project, the ac�vi�es we undertook to achieve these outcomes, and our key takeaways from this placement. Consistently throughout this rota�on, par�cipa�on at EDGE mee�ngs challenged preconceived ideas about effec�ve methods to produce learning, and we saw these no�ons being implemented sims in various departments. Engaging in a wide range of simula�ons, including emergency department, trauma, and intensive care scenarios, provided hands-on experience in u�lising simula�on technology. Observa�on, prebriefing, and debriefing sessions facilitated the development of techniques crucial for the successful execu�on of simulated medical scenarios

Conclusion

In summary, this project fostered a comprehensive understanding of simula�on-based educa�on and its prac�cal applica�ons. The integra�on of theore�cal knowledge and prac�cal skills successfully met the project’s objec�ves.

PR24: Simula�on Based Educa�on

Garg , Ri�ka, 5th Year Medical student, Health Sciences and Medicine, Bond University

Brazil Victoria, Director of Simula�on and Professor of Emergency Medicine, Gold Coast Health, Health Sciences and Medicine, Bond University

Introduc�on

The use of simula�on-based educa�on (SBE) in healthcare has proven to be successful in facilita�ng the learning of knowledge and prac�cal skills. The aim of this project was to gain a deeper understanding of the founda�onal theories and prac�cali�es of SBE. Key objec�ves included gaining competency in designing and delivering simula�ons as well as enhancing communica�on and collabora�on skills.

Methods

A seven-week rota�on was conducted within the Simula�on Department of the Gold Coast Health Service (GCHS), and it encompassed ac�vi�es and experiences that aligned with the intended objec�ves. This included Bond Virtual Hospital (BVH) facilitated tutorials, weekly simula�ons across various departments and several workshops on de-briefing and simula�on delivery. Knowledge of the best prac�ces in SBE was acquired from atending the ‘Educatorsge�ng-Educated’ (EDGE) mee�ngs.

Project Outputs

The key outputs of this project included the moulage project and the logbook, which can be found in appendices 3 and 5 respec�vely. The logbook includes a recount of the rota�on and the moulage project details the skills acquired in the moulage workshop.

Discussion and Conclusions

The primary objec�ve of this project was met as the rota�on provided insight into the theory and prac�cal aspects of SBE. Ac�ve par�cipa�on within the simula�on delivery team and in the addi�onal ac�vi�es also fulfilled the other learning outcomes, as I gained experience designing and delivering simula�ons through mul�ple modali�es. Overall, this project contributed significantly to my professional development as it enhanced my communica�on and collabora�on skills, which are essen�al to being an effec�ve clinician.

PR25: Simula�ons-Based Educa�on

Saeed, Antony 5th Year Medical student, Health Sciences and Medicine, Bond University Brazil, Victoria, Professor Emergency medicine, Bond University and Gold Coast University Hospital

Introduc�on/ Background

An integral part of healthcare educa�on is simula�ons. This is an opportunity for par�cipants to learn new skills and knowledge, both clinical and teamwork, and for students to prepare for the clinical world, in a safe and low risk environment. There are several facets to simula�ons which includes the various modali�es and technology, crea�ng the cases, the prebrief, delivery and debrief of simula�ons, and applying moulage to either mannikins or simulated pa�ents to further enhance the realism of simula�ons. The aim is to help par�cipants to be ac�vely engaged with their surroundings in order to acquire the appropriate knowledge, which will in turn help them in their clinical prac�ce as they translate their learning from simula�ons into their clinical prac�ce.

Method

The intended strategy for the seven-week rota�on included atending as many simula�ons as possible, as well as workshops that aimed to further develop skills required in simula�onsbased educa�on, and Bond Virtual Hospital sessions.

Results

Over the seven-week simula�on-based educa�on elec�ve rota�on, I had the chance to be involved in several simula�on-based ac�vi�es across Bond University and Gold Coast University Hospital. It involved par�cipa�ng and observing in simula�ons across a variety of disciplines, faculty development workshops on simula�ons, Bond Virtual Hospital, as well as a moulage workshop.

Conclusion

By par�cipa�ng and observing the various simula�ons-based ac�vi�es, I have been able to gain a beter apprecia�on for simula�ons-based educa�on and develop my skills in prebriefing and debriefing as well as simula�ons delivery and ‘moulaging’.

STREAM 5 MEDICAL EDUCATION

PB5: Guideline on the improvement of mentor programs in Bond University ’s Medical Program

Gadgil, Aditya, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Madas, Vamshi 5th Year Medical Student, Health Sciences and Medicine, Bond University

Bajra, Jay 5th Year Medical student, Health Sciences and Medicine. Bond University

Bishop, Jo, Health Sciences and Medicine, Bond University

Szkwara, Jaclyn, Health Sciences and Medicine, Bond University

Introduc�on/Background

Educa�on in the medical field has always been a mul�faceted domain, in which mentoring is a significant vehicle to foster skills and develop junior doctors. In medical school, it provides great opportuni�es for junior students to get support from their peers, and for mentors to grow into the roles of helping their colleagues.

Methods

The aim of this guideline is to bolster the support available to students within the Bond University Medical Program (Bond MD) by sugges�ng recommenda�ons to improve the preexis�ng mentoring programs. The two programs in ques�on are the eMentor and the Learning Coaches programs. Furthermore, a blueprint for an academic elec�ve has been dra�ed that will allow students in Phase 2 of the Bond MD to pass their experience onto their juniors. The guideline was writen using research curated by previous medical students and interviews with faculty members and MD students. Further research was conducted into the social benefits of peer mentoring.

Results

The first recommenda�on involves the Medical Student Society of Bond University (MSSBU) collabora�ng with the medical faculty to reinstate a student tutoring service. The second recommenda�on suggests that the eMentor program adopt a more formal structure and introduce a minimum number of mee�ngs to improve mentor/mentee engagement. The final recommenda�on is that the Learning Coach program introduces a formal feedback protocol to improve engagement with feedback and create opportuni�es for improvement.

Conclusion

These recommenda�ons highlight the need for improvements in the Bond MD’s current programs, as well as giving an opera�onal perspec�ve into how these programs run.

PR26: Qualita�ve Research Study to determine the usefulness of The Opacity Chart Tool for the assessment of placental membrane translucency

Subhaharan, Kanishaa, 5th Year Medical student, Health Sciences and Medicine, Bond University

Saweris, Mary, 5th Year Medical student, Health Sciences and Medicine, Bond University

Green, Patricia, Assistant Professor, Health Sciences and Medicine, Bond University

Wright, Gordon, Hon. Adjunct Professor, Health Sciences and Medicine, Bond University

Rathbone, Evelyn, Health Sciences and Medicine, Bond University

Introduction/ Background

The assessment of placental membranes is not routinely undertaken and often subjective to perform, particularly in low resource settings. The gross presence of placental membrane translucency has been clinically correlated with histopathological chorioamnionitis (Horikoshi et al, 2020). However, to our understanding, there is currently no method of measuring this correlation that has been trialled and approved for use in clinical environments. The Opacity Chart Tool was designed to measure placental membrane translucency for early detection of chorioamnionitis, particularly in low resource settings where diagnostic facilities are not available (Green et al, 2023). Our study aims to evaluate the usefulness of The Opacity Chart Tool for its intended design purpose.

Methods

This study concentrates on the qualitative component of our mixed-methods analysis, which involves focus group methodology. We utilised The Opacity Chart Tool during routine placental examinations at John Flynn Private Hospital, recruiting a cohort of 17 midwives who we trained on using the tool and then asked to participate in focus group discussions. Data collection was obtained by recording and transcribing the discussion audio, which was then qualitatively analysed.

Results

The transcripts revealed posi�ve responses from the midwives, showing they found the tool easy and simple to use. The data further suggests the tool can be used in various clinical se�ngs and improve overall pregnancy outcomes.

Conclusion

The results from this study have demonstrated the usefulness of The Opacity Chart Tool during routine examination of placental membranes and provides evidence for its potential application in low resource settings.

PR27: Best Prac�ces for Health Professionals Using Social Media

Malik, Italia, 5th Year Medical student, Health Sciences and Medicine, Bond University

Carter, Lucy, 5th Year Medical student, Health Sciences and Medicine, Bond University

Hope, Nicole, Supervisor, Health Sciences and Medicine, Bond University

Stokes Parish, Jessica, Supervisor, Health Sciences and Medicine, Bond University

Objective

This scoping review aims to assess the evidence regarding best practices for health professionals (HPs) using social media (SoMe).

Introduction

With the increasing use of SoMe among health professionals, it offers numerous benefits, such as enhancing networking and patient care. Conversely, SoMe poses risks to health professionals and their patients if not used in a professional and ethical manner. To counteract these, there are various concepts surrounding “best practice” for health professionals to uphold when using SoMe. Current research focuses on the harms of SoMe, but does not provide strategies on how to avoid these harms. In this scoping review we explored best practice strategies in health professions literature.

Methods

A librarian guided search strategy will be used to source the literature. We will search a minimum of 4 databases (e.g. CINAHL, Embase, PubMed, Scopus, PsychInfo and ProQuest). We will use librarian guided search terms appropriate for the concepts of SoMe, best practice and health professional. We will include papers that are; Published within the last 15 years, review articles and research articles only, Full text available and in English. We will exclude; grey literature, opinion pieces, texts written in languages other than English, literature older than 15 years old and articles in which the full text is unavailable. Data will be presented in tabular form, using the extraction template as a guide.

Results

We anticipate the results will highlight how SoMe improves professional networking, communication, education opportunities for the clinical and patient, professional development and the patient-physician interaction.

PR28: What mo�vates individuals to use social media to seek informa�on about endometriosis?

A scoping review

Sodum, Raga – 5th Year Medical student, Health Sciences and Medicine, Bond University

Menon, Sanjana – 5th Year Medical student, Health Sciences and Medicine, Bond University

Stokes-Parish, Jessica, Assistant Professor, Health Sciences and Medicine, Bond University

Hope, Nicole, Assistant Professor, Health Sciences and Medicine, Bond University

Background

The advent of social media (SM) has resulted in a recent influx of online health informa�on, par�cularly about condi�ons such as endometriosis, which is typically associated with s�gma and taboo. However, there is a paucity in data on uses, risks and benefits of using SM to communicate informa�on about endometriosis.

The objec�ve of this scoping review is to assess the extent of the literature available regarding mo�va�ng factors behind using SM and demographic characteris�cs of those using SM to seek informa�on about endometriosis.

Methods

We used the PRISMA checklist to systema�cally search six databases using search terms related to three concepts: endometriosis, internet, and mo�va�on. Papers included were published in English, peer-reviewed empirical work, specific to endometriosis and women’s habits on SM.

Results

9 studies were included in the review. The most common pla�orms explored were Facebook and Instagram. Most of those using SM for endometriosis informa�on were female, young,

educated and employed. Three prominent themes related to mo�va�ons for SM use were: informa�on seeking, emo�onal support, and community building.

Discussion

There was high demand for up-to-date informa�on and consistent support on online pla�orms. SM pla�orms were noted to contribute to seeking an endometriosis diagnosis and empower pa�ents to be equal stakeholders in their health decisions. Controversial topics garnered significant aten�on online, in which SM aided to preserve anonymity.

Conclusion

Our research provides further insight for healthcare prac��oners, as they con�nue to promote health literacy amongst pa�ents and empower them to access high-quality, evidence-based informa�on on SM.

PR29:

Fourth Trimester Resources

Mikhail, Mirabel, 5th Year Medical student, Health Sciences and Medicine, Bond University

Powell, Ka�e, Supervisor, Health Sciences and Medicine, Bond university

Stephens, Alexandre, Supervisor, Health Science and Medicine, Bond University

Introduc�on/ Background

The period immediately following childbirth, known as the 4th trimester, is a cri�cal phase during which newborns transi�on to life outside the womb and parents acclimate to the responsibili�es of caring for their new baby. Educa�onal resources are essen�al during this �me, as they empower parents with reliable informa�on to navigate this phase successfully. This research report focuses on examining the currently available resources for parents during the 4th trimester.

Method

To analyse the current available resources, a scoping review was conducted on reputable medical databases like PubMed and Cochrane, while an environmental scan was executed on Google. These resources were me�culously assessed to determine their nature, characteris�cs, and quality.

Results

The findings derived revealed a concerning inadequacy of easily accessible and clear informa�on for parents during the 4th trimester. While numerous resources might exist, they appear to lack user-friendliness, clarity, and reliability. This deficit highlights a significant gap in the provision of suppor�ve materials for parents during this cri�cal phase.

Conclusion

This research report highlights the significance of addressing the prevailing informa�on gap surrounding resources available to parents during the 4th trimester. The lack of easily accessible, high-quality informa�on results in undue stress on parents during an already demanding period. By shedding light on this issue, the report emphasises the pressing need for crea�ng educa�onal resources that can empower parents with the requisite tools to navigate the challenges of the 4th trimester. Ul�mately, the goal is to enhance the well-being of both parents and newborns during this crucial phase of early parenthood.

PR30: Improving our understanding of 4th trimester resources – a scoping review and environmental scan of the maternal and infant outcomes impacted by 4th trimester resources

Wan, Hui Yin, 5th Year Medical student, Health Sciences and Medicine, Bond University Stephens, Alexandre, Director of Research, Northern NSW Local Health District Powell, Ka�e, Research Laboratory Manager, Faculty of Health Science and Medicine, Bond University

Introduc�on

Fourth trimester resources are vital to educa�ng new parents about the crucial three months postpartum and beyond. This scoping review and environmental scan will iden�fy the number of fourth trimester resources, their nature, maternal and infant outcomes impacted, with a specific focus on the use of validated tools. Despite the importance of the fourth trimester, there is a surprising lack of resources compared to the first three trimesters, hence this review aims to synthesise a range of resources both scien�fic and ar�cles aimed at the general public. It also aims to improve maternal/infant outcomes postpartum via further explora�on into the use of validated tools and its contribu�on to the idea of a standardised tool-set u�lised during the four trimesters.

Methods

The scoping review was conducted by selec�ng and summarising the relevant ar�cles from PubMed, Cochrane database and the environmental scan with the first five ar�cles on Google search engine which are most likely to be chosen by parents when researching.

Results

It was concluded that overall, most ar�cles suggested that mothers and infants would greatly benefit from more research into fourth trimester resources about common issues and topics such as postnatal mental health, injuries from birth and Caesareans, breas�eeding and infantcare. The results were synthesised into an easy-to-digest table which also outlines any validated tools used.

Conclusion

Ideally this review aids in bringing awareness to the importance of fourth trimester educa�on, the use of validated tools and assesses and provides an easily accessible, diges�ble resource for new parents.

PR31: Simula�on-Based Educa�on

Simjanovski, Dimitrij, 5th Year Medical student, Health Sciences and Medicine, Bond University

Brazil, Victoria Supervisor Gold Coast University Hospital

Introduc�on

Simula�on-Based Medical Educa�on (SBME) has emerged as an invaluable tool in modern medical training, seamlessly linking theore�cal knowledge with prac�cal applica�on, ensuring uncompromised pa�ent safety. This project delved into the theory and applica�on of SBME, inves�ga�ng elements such as scenario construc�on, moulage crea�on, and the art of effec�ve debriefing among many others.

Methods

Driven by a series of faculty development workshops, simula�ons, and discussions, the project explored the intricacies of SBME, highligh�ng its role in developing cri�cal thinking, enhancing technical and non-technical skills, and promo�ng reflec�ve prac�ce among medical

prac��oners. From debriefing frameworks in ICU and Emergency Department simula�ons to the opera�onal aspects of se�ng up simula�ons, the project traversed the breadth of SBME. The Educators Get Educated (EDGE) weekly mee�ngs highlighted the importance of con�nued self-development and reflec�on in prac�ce in educa�on all in the se�ng of psychological safety. This in conjunc�on with the Bond Virtual Hospital tutorials allowed me to further delve into the learning objec�ves.

Outputs

Noteworthy outputs included the crea�on of simulated wounds demonstrated in a moulage workshop and the compila�on of a detailed logbook reflec�ng the learning journey.

Conclusion

Conclusively, this project not only met its intended outcomes of honing specific skills and understanding in SBME but also reinforced the significance of con�nuous learning, reflec�on, and adapta�on in medical educa�on. The insights gathered are an�cipated to shape a holis�c approach to medical prac�ce, emphasizing the dual role of a clinician as both a caregiver and an educator, ready to evolve in the dynamic environment that is medicine.

PR32: Simula�on Based Educa�on: experien�al learning for healthcare professionals and students

Quinn, Emily, 5th Year Medical Student, Health Sciences and Medicine, Bond University Steinberg, Lilly, 5th Year Medical Student, Health Sciences and Medicine, Bond University Brazil, Victoria, Professor of Emergency Medicine, Medical Director Simulation Service Gold Coast University Hospital.

Introduction

Simulation-based education (SBE) is a rapidly developing educational tool in medicine. Simulation aims to facilitate learning through practice and repetition, leading to improvement in clinical reasoning, decision making, team-based communication and procedural skills. The purpose of this professional project was to apply a theoretical understanding of experiential learning to the practical delivery of simulation-based education. This report aims to highlight the value of medical simulation and identify factors that contribute its effectiveness as an educational tool.

Method

Over the course of seven weeks, a broad range of simula�on-based ac�vi�es were undertaken; project outputs included a moulage workshop.

Discussion

Simula�on increases par�cipant sa�sfac�on, self-reported improved knowledge, and work performance. The learning poten�al of simula�on is influenced by learning outcomes, prebriefing, simulator modality and de-briefing. Evidence supports that simula�ons are an effec�ve learning tool for any educa�onal level, regardless of the degree of realism or facilitator experience. Understanding the impact of these factors has the poten�al to advance simula�on design and delivery and enhance par�cipant engagement in simula�on.

Conclusion

The professional project emphasised the value of simula�on in medical educa�on in bridging the gap between the classroom and real-life, promo�ng safe clinical prac�ce.

STREAM 6 MENTAL HEALTH

LP2: Nanopore Sequencing of the Vaginal Microbiome as a Predictor of IVF Success

Davidson, Isabella

Ashton, Kevin J, Professor, Health Sciences and Medicine, Bond University

Lui, Yanhe

Dunn, Paul, Assistant Professor, Health Sciences and Medicine, Bond University

Introduc�on/ background

The use of assisted reproduc�ve technology (ART) has increased by 5-10% but has a success rate of ~30% in women aged 34 years old and under (Atwooll, 2021). The vaginal microbiome (VM) has become an emerging area of interest as a poten�al influencer in ART outcomes. In par�cular, some studies have iden�fied a poten�al link between the VM and in vitro fer�lisa�on (IVF) success. Our work aims to inves�gate this link in an Australian popula�on undertaking ART to measure the effects in rela�on to the probability of pregnancy.

Methods

To complete this, a scoping review (study 1) will be conducted to iden�fy the best prac�ces in inves�ga�ng the VM, then following this we will complete develop and op�mise the methodologies using n= 4 control samples using material sourced from cheek swabs (study 2), and pilot study (study 3). Finally, study 3 will complete sequencing on n=40 IVF pa�ent derived samples taken from a specialist IVF clinic. A retrospec�ve audit will be conducted at 3- and 6month periods to iden�fy pregnancy success.

Results

Preliminary results iden�fied from study 1 highlighted problems in primer as primers under and over represent certain microbes skewing results as well as the bioinforma�c pipeline for nanopore studies that will be used in further studies. Interes�ngly, study 1 found that sta�s�cal significance in any study regarding the microbiome influencing IVF outcomes, however, this was o�en linked to limited sample size and these studies o�en did not exclude the VM as a poten�al contributor to IVF success.

Conclusions

Once completed, findings may influence clinical prac�se to test and treat pa�ents prior to fer�lity treatment to increase pregnancy chances.

PR33: Individual-based strategies for tackling academic burnout and encouraging helpseeking behaviour in medical students

Patel, Aayush, 5th Year Medical student, Health Sciences and Medicine, Bond University

Bishop, Jo, Associate Dean, Student Affairs & Service Quality, Associate Professor (Anatomy), Health Sciences and Medicine, Bond University

Craig, Belinda, Assistant Professor, Health Sciences and Medicine, Bond University

Introduc�on

The prevalence of depression, anxiety, burnout and suicidality are significantly higher amongst medical students than the general popula�on. Academic burnout and the barriers to seeking help have been iden�fied as two key contributors to this psychological distress. These issues should be addressed earlier in medical school as they are detrimental to students but may also compromise pa�ent care later when the students become prac�cing physicians.

Aim

To develop an easily distributable and evidence-based resource that presents strategies to tackle academic burnout and lower barriers to seeking help. This resource will largely be aligned with the goals of Pillar Two within the “Every Doctor, Every Se�ng” na�onal framework.

Methods

A literature review was conducted to find evidence-based strategies to address academic burnout and lower barriers to seeking help among medical students. Consulta�ons with key stakeholders at Bond University were conducted to guide resource development. These stakeholders included the Academic Director of The Surgical Society, the President of The Psychiatry Society and the HSM Student Counsellor.

Project Outcomes

A PowerPoint advoca�ng evidence-based strategies to manage academic burnout and promote help-seeking behaviour was developed for distribu�on amongst Bond medical students. Strategies to tackle academic burnout included lowering maladap�ve perfec�onism, increasing emo�onal resilience, increasing academic self-efficacy along with regular exercise and mindfulness. The prominent barriers to seeking help included s�gma, cost, lack of awareness and self-neglect. Strategies to lower these barriers included providing educa�on around ‘mandatory repor�ng’ and promo�ng free counselling services at Bond. All the strategies men�oned were incorporated into the PowerPoint.

PR34: Disordered ea�ng screening tools in the pregnancy cohort: A systema�c review

Stephens, Juliete, 5th Year Medical Student, Bond University, Health Sciences and Medicine

Branjerdporn, Grace, Service Development and Research Coordinator, Gold Coast Hospital and Health Service

Roberts, Susan, Clinical Lead Lavender Mother and Baby Unit Perinatal Psychiatrist, Gold Coast Hospital and Health Service

Bannatyne, Amy, Assistant Professor of Psychology, Bond University

Ellis, Aleshia, Senior Die��an, Gold Coast Hospital and Health Service

Introduc�on

Pregnancy represents a crucial �mepoint for screening of ea�ng disorders (ED) and disordered ea�ng behaviours (DEB) due to the significant adverse impact on the woman and her infant. Iden�fica�on of possible ED symptoms informs further assessment and treatment provision targeted to the woman’s needs. Following on from a previous systema�c review (Bannatyne et al., 2021) encompassing literature un�l April 2019, this systema�c review summarises and assesses the screening tools used for ED and DEB in pregnancy from April 2019 to December 2022.

Methods

Seven databases were searched systema�cally, and relevant data were extracted from papers that met eligibility criteria. Studies were included if: (i) the sample were pregnant at �me of collec�on, (ii) published in English, and (iii) the reliability and/or validity of the measure was reported. Studies were excluded if (i) review ar�cle, (ii) retrospec�ve study in the postnatal period, and (iii) longitudinal design that did not discern prepartum from postpartum datasets. The modified QUADAS and psychometric performance criteria were u�lised for quality assessment.

Results

398 studies were screened, and 13 studies met the inclusion criteria a�er full-text review. 10 psychometric tools were iden�fied: nine exis�ng tools and one new tool with valida�on.

Conclusion

This review highlights new screening tools, including the valida�on of exis�ng tools for use in the pregnant popula�on. The Prenatal Ea�ng Behaviour Screening Tool (PEBS) shows promising results for use in the pregnant popula�on, with further valida�on required before recommenda�on. Further research is required to provide psychometric evidence for screening instruments for ea�ng disorders in pregnancy.

PR35: Every Doctor Every Se�ng: The Bond Se�ng (secondary preven�on) - Impact of rural placement on the mental health of medical students

Ekdawi, Mina, 5th Year Medical student, Health Sciences and Medicine, Bond University Craig, Belinda, Assistant Professor, Health Sciences and Medicine, Bond University

Bishop, Jo, Associate Dean, Student Affairs and Service Quality, Associate Professor (Anatomy), Health Sciences and Medicine, Bond University

Introduction

This MD project will explore the potential impact on mental health that may accompany being in a rural or remote area and potential strategies to mitigate these. The approaches employed by other universities will be explored and evaluated for feasible application for the India placement offered by Bond University. This project will focus on research of pillar 2 of Every Doctor Every Setting which involves secondary prevention of mental illness in medical students.

Methods

To assist my search, several medical databases including EMBASE, Cochrane Library, PubMed and BMJ were used. The sources selected were written in the English language and published in the last 10 years to ensure relevance and recency of the data.

Results

Overall, the results demonstrated how establishing good peer relationships and other support were vital in being protective for loneliness. In addition, permeated throughout the literature is that mental health stigma may represent a barrier to seeking help. Filtering students who are most compatible for these rural and remote placements in terms of protective and negative characteristics may prove useful in selection.

Conclusion

The literature is demonstrative of the need to create an open, non-judgemental space for medical students to discuss their mental health struggles and alleviate any attached stigma. Ongoing provision of information, resources and financial reimbursement can provide adequate emotional support and care for those studying in rural and remote areas.

PR36: Impact of physical ac�vity on suicide atempt in children: A systema�c review

Patel, Marissa, 5th Year Medical student, Health Sciences and Medicine, Bond University. Branjerdporn, Grace, Honorary Adjunct Associate Professor, Health Science and Medicine, Bond University. Service Development and Research Coordinator, Mental Health and Specialist Services, Gold Coast Health.

Woerwag-Mehta Sabine, Associate Professor, Health Sciences and Medicine, Bond University. Consultant Child & Adolescent Psychiatrist & Head of Research for Child and Youth Mental Health and Specialist, Gold Coast Health and Hospital Services.

Introduc�on

Physical ac�vity (PA) has been linked to improvements in all aspects of health, whereas suicide atempts (SA) are a health concern associated with impaired physical, mental, and social wellbeing. Evidence suggests that PA may reduce SA in adults. This systema�c review examined the impact of PA on SA in children.

Methods

Eight electronic databases were systema�cally scanned. References were transferred to Covidence so�ware for �tle and abstract screening and full text review was performed by two independent reviewers. Inclusion criteria were: (1) children aged 6-18 years old; (2) par�cipa�on in PA; and (3) studies that examined SA as a dependent variable. This systema�c review was registered with PROSPERO: CRD42023389415.

Results

Of the 2322 studies iden�fied, 21 were included in the review. 20 studies were cross sec�onal in design and one implemented a prospec�ve study design. 13 studies (61.9%) showed that increased PA par�cularly team sport, significantly reduced the likelihood of SA. Certain intensi�es and frequencies of PA may be beneficial to some and detrimental to other subgroups of children.

Conclusion

SA are reduced in children who engage in PA in par�cular team sport. Future research is required which: (1) uses standardised outcome variables; (2) adopts longitudinal and experimental study designs; (3) explores qualita�ve research to determine dis�nc�ve factors that influence par�cipa�on in PA not captured by quan�ta�ve research; and (4) examines specific target popula�ons such as children with severe mental health issues.

PR37: Facilitators and barriers to medical students seeking help for mental health: A rapid review

Darnell, Madison, 5th Year Medical student, Health Sciences and Medicine, Bond University

Craig, Belinda, Assistant Professor, Health Sciences and Medicine, Bond University

Forrest, Kirsty, Professor and Dean of Medicine, Health Sciences and Medicine, Bond University

Introduction/ Background

Medical students have significantly higher rates of mental illness than the general population. This could be attributed to the increased pressure of medical school’s workload and assessments, among other inter and intrapersonal factors.

Methods

This review aimed to gather and synthesise current research into the facilitators and barriers to medical students seeking mental health care during their medical education to identify potential areas of future research. Following systematic screening of articles, 21 underwent data extraction, synthesis and analysis to ultimately be included in this report.

Results

Many students do not seek the necessary treatment or help for their mental health due to barriers such as stigma, fear of career repercussions or perceived lack of access to services. While factors such as integrated mental health programmes, open dialogue between students

and superiors, fostering of supportive peer and faculty relationships, and the development of compassionate values can facilitate help seeking behaviours in this population, medical students still appear to be seeking low rates of care.

Conclusion

It is essential to determine the factors that drive help seeking behaviours, and identify those that may be preventing medical students from seeking help for mental health to avoid medical students suffering unassisted leading to negative outcomes for the individual and their future patients.

PR38: Retrospec�ve analysis of selec�ve serotonin reuptake inhibitor (SSRI) prescribing in a metropolitan ter�ary hospital

Panos, Dean, 5th Year Medical student, Health Sciences and Medicine, Bond University

Pache, David (PhD) Senior Pharmacist at Mater Health, Lecturer at Bond University

Schweitzer, Daniel Staff Specialist, Neurologist, Mater Hospital Brisbane

Methods

Deiden�fied hospital pa�ent data were retrieved from the epoch spanning from July 2021 to June 2022. The frequency of SSRI prescribing was determined according to each individual SSRI. Discharge summaries were collated and scored using a 5-point discharge scoring system. Indica�ons listed in the discharge summaries were collated and compared to licensed indica�ons to determine the off-label usage of SSRIs.

Results

1,011 pa�ents were prescribed an SSRI following discharge with most prescrip�ons for sertraline (31%) and escitalopram (29%) The least prescribed SSRI was fluvoxamine (3%). 93.9% of discharge summaries did not include any informa�on regarding the SSRI prescribed. The usages iden�fied included anorexia, anxiety, behavioural and psychological symptoms of demen�a, bulimia, major and minor depression, behavioural disturbances, postnatal depression, pruri�s, cannabis abuse, drug-induced psychosis, and emo�onal distress.

Conclusion Improving communica�on between the hospital and community care is a significant factor for a successful healthcare system. Using the scoring system, this study highlighted an area of poten�al underperformance in the discharge process in so far as SSRI prescrip�ons were largely omited. This inves�ga�on noted that there are various off-label usages for SSRI medica�on and prescrip�on trends that are worth studying in more depth as part of future studies.

PR39: Diagnos�c Challenges in Discerning Paroxysmal Nocturnal Events

Wallace, Fraser, 5th Year Medical student, Health Sciences and Medicine, Bond University

Pache, David, Senior Pharmacist in Prac�ce and Development, Mater Health Services

Schweitzer, Daniel, Neurologist, Mater Health Services

McGonigal, Aileen, Hon. Prof. Neurologist and Epileptologist, Queensland Brain Ins�tute, The University of Queensland

Over the past 50 years, neurologists and sleep physicians alike have faced the stubborn task of diagnosing and trea�ng sleep-related, nocturnal motor disturbances. O�en brought to the aten�on of medical professionals by their bed-partner, these condi�ons can have significant biopsychosocial consequences for those who suffer from them. These diseases can be categorised into two broadly similar but historically excusive areas of medicine – neurology, focusing on epilep�c sleep disturbances and sleep medicine which deals with parasomnias

like somnambulism and night-terrors. Tradi�onally there has been considerable difficulty in diagnosing and differen�a�ng sleep-related hypermotor epilepsy (SHE) and specific parasomnias due to the similarity in symptoms and lack of specific, cost and �me-effec�ve diagnos�c tes�ng. This narra�ve review explores the history of these condi�ons and aims to inform a general medical audience of the reali�es of managing a pa�ent with a sleep-related motor disturbance and how these obstacles can be overcome, as well as the aims for future research into this unique area of medicine.

PR40: Melatonin prescrip�on paterns at a major metropolitan hospital in Queensland, Australia: impact of prolonged release formula�on inclusion in the prescribing medica�on formulary

Patel, Kush A, 5th Year Medical student, Health Sciences and Medicine, Bond University

Pache, David, Senior Pharmacist in Prac�ce and Development, Mater Health Services

Schweitzer, Daniel, Neurologist, Mater Health Services

Mathews, Richard, Associate Professor, Health Sciences and Medicine, Bond University

Importance and Objec�ve

Melatonin addresses a pharmacological gap in the management of sleep disorders without the downsides of tradi�onal hypno�c medica�ons. This study aims to profile melatonin prescribing trends before and a�er introducing Circadin® to the hospital formulary.

Design, Se�ng, and Par�cipants

It was conducted at a major metropolitan hospital in Queensland, Australia. It examined the prescribing data across non-iden�fiable pa�ent records of two epochs: January to June 2021 and January to June 2022. The popula�on included all pa�ents prescribed melatonin during their hospital stay across surgical and medical wards, and the emergency department, excluding pa�ents under 18.

Main Outcomes and Measures

It assessed (1) the melatonin prescribing profile and (2) the quality of melatonin pharmacotherapy communica�on in medical discharge summaries over the epochs.

Results

Of 287 admissions mee�ng criteria, 108 were from the pre-introduc�on epoch and 179 from post-introduc�on. The number of melatonin dispensa�ons per admission was sta�s�cally significantly greater for the post-introduc�on epoch (M=2) than for the pre-introduc�on epoch (M=1), U = 4256.5, z = -2.344, P = .02. Most discharge summaries omited men�on of prescribed melatonin (first epoch: 106/108, 98.1%; second epoch: 176/179, 98.3%).

Conclusions and Relevance

The post-introduc�on epoch showed a no�ceable change in melatonin prescribing paterns, likely due to increased accessibility. The generalizability of these findings to other se�ngs requires further research

STREAM 7 SURGERY OBSTETRICS ONCOLOGY

PR41: Orthopaedic referral triaging: a scoping study on repeatability, agreement and compliance

Penwarn, Braiden, 5th Year Medical student, Health Sciences and Medicine, Bond University

Sullivan, Luke, 5th Year Medical student, Health Sciences and Medicine, Bond University

Walsh, Tom, Podiatrist, Gold Coast University Hospital

Plat, Simon, Orthopaedic surgeon, Gold Coast University Hospital

Introduc�on

Foot and ankle pain leads to a significant economic burden in Australia, commonly resul�ng in referrals to orthopaedic specialists. Referrals are categorised as urgent, semi-urgent or nonurgent based upon pa�ent clinical findings. Literature indicates that decision fa�gue may influence referral triaging, which could lead to worse outcomes for pa�ents. This study inves�gates the repeatability of orthopaedic surgeons in determining referral urgency, the influence of �me of day on their decisions, and whether clinical priori�sa�on criteria guides decision making.

Methods

We recruited three foot and ankle orthopaedic surgeons in Phase 1 to triage 30 de-iden�fied referrals obtained from the Gold Coast University Hospital. Following this, we proceeded to Phase 2 - a randomised controlled trial where surgeons will triage 100 de-iden�fied referrals and a�er six months will repeat this either before or a�er clinic/theatre.

Results

In Phase 1, surgeons exhibited par�al agreement on 97% of referrals, and they found the online survey so�ware user-friendly. However, full consensus was only observed in 20% of the referrals, poten�ally indica�ng differences in experience or workload.

Conclusion

Preliminary results from Phase 1 suggest that non-clinical factors might influence decisionmaking. However, conclusive insights require the comple�on of Phase 2. Future research is encouraged to delve into current clinical guidelines, exploring decision fa�gue and its poten�al recurrence in different surgical fields. Limita�ons include poten�al bias and restric�ve inclusion criteria delaying the finalisa�on of Phase 2.

PR42: The efficacy of transversus abdominis plane and rectus sheath blocks in reducing postopera�ve opioid use in laparoscopic appendicectomy - retrospec�ve cohort study

Mansoor, Mathew, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Patel, Riya, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Cooper, Michelle MBBS, FRACS, Gold Coast University Hospital

Jordan, Stephanie BMedSt, MD, Gold Coast University Hospital

Background

Laparoscopic appendicectomy is a common procedure in Australia, with challenges regarding post-opera�ve pain and opioid consump�on. The country's alarming rate of opioid use makes finding effec�ve pain management strategies crucial. This study combines a retrospec�ve

cohort study and narra�ve review to examine poten�al benefits of transversus abdominis plane (TAP) and rectus sheath (RS) blocks as analgesic op�ons for laparoscopic appendicectomy.

Methods

90 adult pa�ents who underwent laparoscopic appendicectomy at Gold Coast University Hospital (GCUH) from April 2022 to February 2023 were reviewed retrospec�vely. Pa�ents that received TAP and RS blocks (n=42) were compared to those who received port-site local anaesthe�c (n=48). The primary outcome measure was postopera�ve opioid consump�on. The narra�ve review searched PubMed, Medline, and Embase, and evaluated pain severity, postopera�ve opioid consump�on, and hospital dura�on.

Results

The narra�ve review showed a consistent benefit with TAP and RS blocks in reducing postopera�ve opioid consump�on. The results at GCUH were variable and not sta�s�cally significant (p<0.05). Oxycodone and tramadol usage in PACU was reduced in the TAP/RS group by 0.81mg and 6.25mg, and fentanyl usage was raised by 5.20mcg. Oxycodone and tramadol usage on the ward was raised in the TAP/RS group by 0.50mg and 23.55mg, and fentanyl usage was reduced by 0.52mg.

Conclusion

Integra�on of TAP and RS blocks as part of mul�modal pain management for laparoscopic appendicectomy shows promising outcomes in the reduc�on of postopera�ve opioid consump�on. Due to the variable results, no conclusions can be drawn yet. Larger studies exploring op�mal admixture and dosage of anaesthe�c blocks are needed.

PR43: Evalua�on of peripheral nerve blocks in lowering incidence of post-opera�ve narco�c use in laparoscopic cholecystectomy – a retrospec�ve cohort study

Malhotra,Tanishk , 5th Year medical student, Health Sciences and Medicine, Bond University

Vemuru, Ujvala, 5th Year medical student, Health Sciences and Medicine, Bond University

Cooper, Michelle, MBBS Hons FRACS, Clinical Director GSGCUV, Clinical Lead Acute Surgical Unit

Albarqouni, Loai, Assistant Research Professor, Health Sciences and Medicine, Bond University

Background

Laparoscopic Cholecystectomy (LC) is a common procedure for symptoma�c gallstone disease, but post-opera�ve pain, nausea and vomi�ng (PONV) remain a concern. This study combines a retrospec�ve cohort study with a narra�ve review to determine if transversus abdominis plane (TAP) and rectus sheath (RS) blocks reduce postopera�ve opiate consump�on than local anaesthe�c (LA) infiltra�on at the port sites in LC.

Methods

95 pa�ents undergoing laparoscopic cholecystectomy at Gold Coast University Hospital (GCUH) between June 2022 to December 2022, were enrolled in this study. 77 pa�ents were included in the analysis. Pa�ents either received LA at port sites, or laparoscopic-guided TAP or RS blocks, appropriate to their allocated groups. Mul�ple parameters were recorded during periopera�ve periods. The review searched for RCT, Systema�c Reviews, and Cohort studies. Outcomes searched included pain, PONV, opioid consump�on, complica�ons, and more.

Results

Postopera�vely, LA group required significantly more immediate pain relief than TAP/RS group ( p < 0.05). Post-opera�ve oxycodone consump�on was observed significantly more in the LA group (mean (SD); LA = 3.8 (4.55)mg, TAP/RS = 2.07 (3.55)mg; p = 0.04). More metoclopramide was required in LA group ( p = 0.03 ). Literature revealed TAP Blocks as the superior analgesic technique, reducing relevant post-opera�ve complica�ons.

Conclusion

In pa�ents undergoing laparoscopic cholecystectomy, laparoscopy-guided TAP and RS blocks proved to have greater analgesic benefits than port site LA, reducing narco�c requirements. The study’s findings paralleled with literature review findings. Further studies on RS blocks efficacy in reducing pain outcomes past the 24-hour period is required.

PR44: How I developed a surgical professional iden�ty: a narra�ve interview study of younger fellows in surgery (I-SPI)

Hensen, Isabella, 5th Year Medical student, Health Sciences and Medicine, Bond University

Do, Victor, 5th Year Medical student, Health Sciences and Medicine, Bond University

Liang, Rhea, Principal Inves�gator, Associate Professor, General Surgeon

Chan, Rosalinda, Doctor, Gold Coast University Hospital.

Khanna, Sachleen, Doctor, Gold Coast University Hospital.

Introduc�on/ Background

The theory of surgical iden�ty has evolved from a set of fixed psychological ideal characteris�cs of the stereotypical surgeon, to a broader perspec�ve that acknowledges the impact of diverse factors within the surgical environment. Available literature on the development of the surgical professional iden�ty notably omits the influence of individual characteris�cs such as race and gender, despite the acknowledged significance of sociocultural factors in the process of professional iden�ty forma�on The objec�ve of the ISPI project is to explore development of professional surgical iden�ty throughout the RACS Surgical Educa�on and Training Program (SET) and explicate the contexts and strategies for successful naviga�on, par�cularly in diverse and non-privileged popula�ons.

Methods

The study will be conducted through narra�ve interviews of young fellows in surgery, and their responses will be analysed using Van Manen’s Six Step analysis to iden�fy common hermeneu�c themes. Naviga�ng ethics approval has added further complexity to the project and prompted a reflec�on on the nature of ethical reviews of qualita�ve research, and the ethical framework used to evaluate research.

Results

This analysis expounded that discourses of health/medical research ethics and those of social research are divergent and when ethics commitees align themselves closely with the quan�ta�ve medical model of ethical decision-making, qualita�ve research methodologies are disadvantaged.

Conclusion

By ataining understanding of ethical philosophy, and its applica�on in ethical reviews, we hope to assist the I-SPI project’s progression through the ethical approval process, and into the ac�ve interview stage, to gain knowledge on the development of professional surgical iden�ty

PR45: How surgeons address lateness with pa�ents through interac�on

Maini, Kushagar, 5th Year Medical student, Health Sciences and Medicine, Bond University White, Sarah, Senior Lecturer, University of NSW, Medicine and Health

Liang, Rhea, General and Breast Surgeon, Robina Hospital

Background

There is a paucity of research on how surgeons address the issue of lateness with pa�ents. Pa�ents can o�en feel unimportant and a lack of respect for their �me when the surgeon’s lateness is not effec�vely communicated.1 This study aims to observe and analyse how surgeons address lateness via conversa�onal analysis.

Methods

Two authors systema�cally reviewed 52 total consulta�on video recordings. Four recordings were iden�fied where lateness was raised by the surgeon or pa�ent. From these, a total of six sequences were extracted and transcribed using the Jeffersonian transcrip�on system and analysed using conversa�on analysis.

Results

Complaints for lateness were infrequently observed. When observed, the issue of lateness was always raised early in the interac�on and prior to Ac�vity 1 of the consulta�on framework described by White et. al,2 where a mutual understanding of the referral normally occurs. All sequences had the surgeon offer an apology plus a resolu�on that was eventually accepted by the pa�ent to allow progression of the consulta�on.

Conclusion

The purpose of an apology is mul�faceted. It can aid rapport building, and when accompanied by a resolu�on that is accepted by the pa�ent can allow progression of the consulta�on. The results of the study have important clinical implica�ons as it can aid surgeons in the recogni�on and naviga�on of complaints rela�ng to lateness in future prac�ce.

PR46: A retrospec�ve audit analysing adherence to Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium in the post-partum period

Rehman, Arham, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Mayooran, Seraman, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Ha�ngh Lae��a, Senior Pharmacist, Gold Coast University Hospital

McGuire, Treasure, Associate Professor of Pharmacology, Bond University, Health Sciences and Medicine

Introduc�on/Background

Pregnancy is associated with a 5-10-fold increased VTE-incidence,1 with VTE contribu�ng to 10-15% of maternal deaths.2 As appropriate prophylaxis can reduce VTE risk,3 the primary aim of this audit was to determine clinician adherence to venous thromboembolism (VTE) prophylaxis guidelines in pregnancy and the puerperium in the post-partum period at the Gold Coast University Hospital (GCUH).

Methods

A one-year retrospec�ve audit of 190 women delivering at GCUH (January 2022 to February 2023) was conducted. Data sources employed included the GCUH integrated electronic Medical Record (ieMR) and datasheets atained from the hospital Health Analy�cs team. Adherence rates with Queensland Health guidelines were conducted for vaginal and

caesarean deliveries (subsequently comparing emergency caesareans with elec�ve), preeclamp�c pa�ents, and for key risk factors including smoking, pre-exis�ng diabetes and previous VTE.

Results

While this audit recorded only one VTE event, a ‘guideline’ adherence rate of 52.5% for vaginal deliveries and 12.1% for caesarean sec�ons was observed, specifically with 22.5% and 5.8% for elec�ve and emergency caesareans respec�vely. Furthermore, a 20% adherence rate was observed for mul�ple deliveries, 23.3% for pre-eclamp�c pa�ents, 20.0% for smoking, 33.3% for pre-exis�ng diabetes and 0% for previous VTE.

Conclusions

Adherence to guidelines in this audit is subop�mal and to address this, recommenda�ons include educa�ng clinicians regarding adherence-importance and improving documenta�on methods through a variety of strategies including con�nuous monitoring and regularly upda�ng records. It is cri�cal to address these low adherence rates with educa�on and reaudit to reduce mortality and morbidity risk associated with VTE.

LP3: Mast cells and their response to myeloabla�ve radia�on in the urinary bladder

Smith, Jessica

Jonathan Kah Huat Tan2 , Christie Short2, Helen O’Neill2, Christian Moro1*

1. Faculty of Health Sciences and Medicine, Bond University

2. Clem Jones Centre for Regenerative Medicine, Bond University, Queensland 4229, Australia

Introduc�on

Abdominopelvic and myeloabla�ve radiotherapy can cause urinary bladder inflamma�on. Research shows mast cells may contribute to bladder damage from radia�on, but current research mainly focuses on abdominopelvic radiotherapy, and not myeloabla�ve radiotherapy. Thus, we explored how myeloabla�ve radiotherapy affects mast cells in the bladder.

Method

C57BL/6J mice received 9.5Gy split dose of total body radia�on and received bone marrow cells from B6.SJL mice. Flow cytometry and toluidine blue staining was used to analyse changes to mast cell prevalence and distribu�on, respec�vely.

Results

One week a�er irradia�on, host leukocytes exhibited a significant decrease (P=0.0018) compared to non-irradiated samples, though there was no significant difference between control and irradiated bladders a�er four weeks. Mast cell frequency significantly increased in broader leukocyte popula�ons one week a�er irradia�on compared to non-irradiated bladders (P=0.0011) but did not differ between non-irradiated and irradiated bladders four weeks following irradia�on. In live singlet popula�ons, mast cell frequency did not differ between non-irradiated and irradiated urinary bladder samples. This finding was supported by toluidine blue staining, which indicated no changes to mast cell density in the urinary bladder overall, and no changes throughout the bladder layers except for in the adven��a between one- and four-weeks following irradia�on (P=0.0167). A significant decrease was also observed in mast cell diameter between non-irradiated and irradiated urinary bladders four weeks following radia�on injury (P=0.0068).

Conclusion

This study indicates that mast cells cons�tute a significant por�on of the remaining leukocyte popula�on following radia�on injury, with changes to mast cell distribu�on and diameter observed at four-weeks post-irradia�on.

OP3: Phosphodiesterase Isoenzymes in Isolated Porcine Urethral Smooth Muscle and Mucosal Layers: A Func�onal Study

Burovski, Eriq , HSM student, Health Sciences and Medicine, Bond University

Iris Lim, Assistant Professor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

Previous research has suggested a role for phosphodiesterase (PDE) isoenzymes in the control of the urethral smooth muscle (1) (2) (3). The present study aimed to inves�gate the func�onal role of PDE-4 and PDE-5 isoenzymes in the isolated porcine urethral smooth muscle and mucosal layers to iden�fy poten�al targets for SUI treatment.

Methods

Using an organ bath setup, the effects of roflumilast (PDE4) and sildenafil (PDE5) (0.1 nM – 10 μm) on isolated porcine urethral mucosa-intact smooth muscle, denuded smooth muscle and mucosal layer were inves�gated. Unpaired Student’s t-tests or a one-way ANOVA followed by a Dunnet’s mul�ple comparisons test was performed to iden�fy sta�s�cally significant differences. A p-value of < 0.05 was considered sta�s�cally significant.

Results

The dose-dependent relaxa�on by roflumilast in urethral smooth muscle �ssue strips with mucosa-intact was significantly enhanced compared to the denuded strips (p<0.05). Inversely, the relaxa�on induced by sildenafil was greater in denuded strips (p<0.05). In the presence of nitric oxide (NO) donor sodium nitroprusside (SNP), the atenua�on effect of sildenafil in the denuded strips was enhanced (p<0.05). Sildenafil, in the presence of SNP, was more potent than roflumilast in atenua�ng the contrac�le response within urethral smooth muscle strips (45% vs 24%). In the urethral mucosal strips, roflumilast (10 nM and above) and sildenafil (1 µM) significantly reduced the rate of spontaneous contrac�on (p<0.05)

Conclusion

The results from the study suggest a poten�al role of the cAMP pathway in modula�ng spontaneous contrac�ons within the mucosa, while the NO / cGMP pathway appears to be important in modula�ng urethral smooth muscle tonic concentra�ons. Addi�onally, the findings also suggests that the presence of the mucosa may inhibit endogenous NO produc�on. The complex interplay between the cAMP and cGMP pathways could be further inves�gated and iden�fied as poten�al targets for SUI treatments.

STREAM 8 PLANETARY HEALTH

PR47: Addressing the Inequi�es of Access to Healthcare in Rural and Remote Communi�es in Australia

Giuffrida, Damian, 5th Year Medical student, Health Sciences and Medicine, Bond University McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

Introduc�on/Background

This academic review explores the inequi�es associated with healthcare access in rural and remote Australia. These regions face significant challenges due to vast geography, limited healthcare infrastructure, and a shortage of medical professionals, leading to dispari�es in healthcare access, delayed diagnoses, and poorer health outcomes. Unique healthcare challenges, higher rates of chronic diseases, and socio-economic factors further complicate the issue. This review underscores the pressing need to address healthcare access issues in Australia to ensure equitable and resilient healthcare services for rural communi�es.

Methods

Comprehensive qualita�ve and quan�ta�ve evidence was used to iden�fy the mul�-faceted issues associated with healthcare access in rural and remote communi�es in Australia.

Results

The results of this review highlight the mul�-faceted approach required to address healthcare access inequi�es. Strategies include improving healthcare infrastructure, atrac�ng and retaining professionals, and expanding telehealth services. Collabora�ons between urban and rural healthcare providers are crucial for specialized care delivery in remote regions. Targeted interven�ons are needed to promote equitable healthcare services and beter health outcomes in under-served areas. However, challenges like limited resources, financial constraints, technological limita�ons, and the need for poli�cal will must be overcome for successful implementa�on.

Conclusions

Overall, this review emphasizes the importance and complexity of healthcare access inequi�es in rural and remote Australia. A comprehensive approach involving infrastructure improvements, a strong healthcare workforce, telehealth services, and urban-rural collabora�ons is essen�al. Resolving these dispari�es is vital to ensure equitable healthcare services and improve the health outcomes of all Australians.

PR48: The mul�dimensional impact of Air pollu�on on health in Sydney Davis, Eleanor, 5th Year Medical student, Health Sciences and Medicine, Bond University McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

Introduc�on

Planetary health is the concept that humans are interconnected with the natural environment and the health of the planet inevitably determines our human health. The Triple Planetary crisis, which is the triad of biodiversity loss, air pollu�on and climate change, is exacerba�ng climate injus�ce. Air pollu�on “shortens people’s life expectancy by up to six years” (1) and in Sydney costs “$48 billion each year causing 603 premature deaths.” (2) Air pollu�on in Sydney is worsening due to natural disasters such as bushfires, resul�ng in hazardous pollutants exceeding na�onal standards.

Methods

This literature review was a qualita�ve study on air pollu�on in Sydney. This involved research on PubMed for systema�c reviews about the composi�on of air pollutants and the effects of hazardous pollutants on health.

Results

The most hazardous pollutants in Sydney were ozone, par�culate mater and nitrous dioxide, which impacted human health by accelera�ng cardiovascular disease and predisposing to

stroke, MI, demen�a and birth defects. Consequently, new technologies have been invented to help reduce pollu�on levels like renewable energy, air purifiers, smog free towers and biotechnological moss trees.

Conclusion

There is hope for the future of planetary health if people are willing to change. We live in a complex changing world where there is great climate injus�ce because despite wealthier na�ons having the highest emission levels, it is the poorer underprivileged na�ons that suffer the most. Air pollu�on poses a major threat to health as the Earth’s carbon footprint exponen�ally increases causing unsustainable levels of pollu�on.

PR49: The Biodiversity Crisis and First Na�ons’ Health

Morahan, Anastasia 5th Year Medical Student, Health Sciences and Medicine, Bond University

McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

Background

First Na�ons Australians have been preserving biodiversity for millennia through their deep knowledge of the rela�onships between humans and other species. However, Australia and the global popula�on are currently undergoing a biodiversity crisis. This presenta�on aims to inves�gate the impact of the crisis on First Na�ons Australians and their health, and in par�cular, the effect on mee�ng Sustainable Development Goal (SDG) 3, Good Health and Wellbeing. Addi�onally, a systems-based approach will be used to explore poten�al solu�ons to the crisis.

Methods

The biodiversity crisis was iden�fied as the problem for review, with the chosen community being First Australians. SDG 3 was selected as the focus, with Target 3.4 “Promote mental health and well-being” and Target 3.5, “Prevent and manage substance abuse” used to determine the extent of the impact on health outcomes.

Discussion and conclusions

Biodiversity loss may exacerbate mental health problems among First Na�ons communi�es

A strength based approach seems to be key to reducing biodiversity loss, and subsequently improving First Na�ons’ health outcomes, as well as the atainment of SDG 3. This may involve including First Na�ons elders in governance, community led conserva�on programs with an emphasis on tradi�onal land management, media awareness campaigns and increased green spaces.

PR50: Preserving Planetary Health: Biodiversity Loss and the Vulnerable Indigenous Communi�es of the Amazon Rainforest

Natsioulas, Elena, 5th Year Medical student, Health Sciences and Medicine, Bond University

McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

Background

Biodiversity loss is a cri�cal concern with far-reaching implica�ons for planetary health. It is notably evident in the Amazon rainforest, where escala�ng threats of deforesta�on, habitat degrada�on, and pollu�on endanger the rich diversity of species and the well-being of Indigenous communi�es. Through my assignments, I focus on the Indigenous popula�ons of

the Amazon, delving into the intricate rela�onship between biodiversity loss, human health, and cultural heritage. By analysing the nexus of Indigenous determinants of health and the Sustainable Development Goals (SDGs), par�cularly SDG 3 (Good Health and Well-being) and SDG 15 (Life on Land), I highlight the vulnerabili�es and resilience of these communi�es within the context of environmental degrada�on.

Solu�ons

Two primary solu�ons emerge as key strategies to address this complex challenge. The first involves community-based conserva�on ini�a�ves that empower Indigenous communi�es to ac�vely protect their ancestral territories. By directly involving these communi�es as stewards of the land, these ini�a�ves aim to safeguard biodiversity and cultural tradi�ons. The second solu�on revolves around promo�ng sustainable agriculture and agroforestry prac�ces. By incorpora�ng Indigenous knowledge and tradi�onal crops, this approach seeks to preserve biodiversity while ensuring food security and nutri�on.

Conclusion

In conclusion, this explora�on underscores the urgency of acknowledging the interconnectedness between biodiversity preserva�on, the well-being of Indigenous communi�es, and the broader concept of planetary health. Through the implementa�on of community-driven conserva�on efforts and sustainable land use prac�ces, a harmonious future can be envisioned where the Amazon rainforest thrives alongside the communi�es that have nurtured it for genera�ons.

PR51: Impact of Air Pollu�on on the Health and well-being of Children: A review of the literature

Tyagi, Jay, 5th Year Medical student, Health Sciences and Medicine, Bond University

McLean, Michelle, Medical Educa�on and Assessment Planetary health and environmental sustainability Ph.D. Supervisor for the Doctor of Medicine Bond University.

Introduc�on/ Background

We currently are facing three planetary crises, this is basically a triple crisis affec�ng humans and is mainly due to climate change, pollu�on, and biodiversity loss which are all interlinked. Each of these must be resolved looking deep into their causes and effects in order to have a viable future on this planet. Air pollu�on is one of the largest causes crea�ng burden on health, unfairly impac�ng on children.

The Sustainable Developmental Goal focused on will be SDG 3, which is to ensure healthy lives and promote well-being for all at all ages. It includes incidences to decrease mortality of mothers, newborns and children, especially under five years for all countries. Mortality rate atributed to household and ambient air pollu�on (Target 3.9.1).

Indoor air pollu�on lead to a focus on smoking cigaretes/electronic cigaretes as it produces carcinogens leading to the impact on child mortality.

Conclusion

Indoor air pollu�on can be reduced by using indoor air filtra�on units, cu�ng down sources of indoor pollu�on in par�cular tobacco smoke, by increased awareness and using quit smoking campaigns.

PB6: Orthopaedic Opera�ng Room Surgical Waste: Sustainability Ini�a�ve

Chen, Beiling, 5th Year Medical student, Health Sciences and Medicine, Bond University

Dhaliwal, Sonu, 5th Year Medical student, Health Sciences and Medicine, Bond University

Belt, Hollie, 5th Year Medical student, Health Sciences and Medicine, Bond University

Modhia, Gunj, 5th Year Medical student, Health Sciences and Medicine, Bond University

Abdeen, Sabriya, 5th Year Medical student, Health Sciences and Medicine, Bond University

Ilanko, Swathi, 5th Year Medical student, Health Sciences and Medicine, Bond University

Maheshwari, Neelam, Microbiology Consultant, Gold Coast University Hospital; Associate Professor, Bond University

McLean, Michelle, Professor, Health Sciences and Medicine, Bond University

S�rling, Allan, Associate Professor, Health Sciences and Medicine, Bond University

Background

The contribu�on of Australia’s healthcare system on climate change is an important issue, as it accounts for 7% of the country’s total carbon dioxide emissions, with surgical waste contribu�ng significantly. This study sought to evaluate the surgical waste and equivalent carbon emissions generated by orthopaedic surgeries performed within the Gold Coast healthcare sector.

Methods

This mul�-centre study was undertaken from February 2023 to April 2023 in public and private hospitals across the Gold Coast. This project inves�gated surgical waste from orthopaedic surgeries across six joints: hip, knee, foot/ankle, shoulder, elbow and wrist/hand. Waste was manually segregated into five categories: tex�les, so� plas�cs, hard plas�cs, paper/cardboard, and metals. Weight (kg) and volume (L) of waste was measured before and a�er segrega�on. The results were applied to a waste calculator to determine the equivalent annual carbon emissions.

Results

From 68 surgeries inves�gated, the average waste produc�on per surgery for upper and lower limb orthopaedic surgeries was 5.4kg and 7.9kg, respec�vely. The combined annual waste produc�on was es�mated to be 27,489.6kg, based on 3818 of these surgeries performed annually at the hospitals atended. The disposal of this waste was calculated to contribute 392,449.9kg of CO2 emissions per year.

Conclusion

This study quan�fies the significant amount of surgical waste generated from orthopaedic surgeries and the associated carbon footprint. The findings reinforce the environmental impact of surgical waste and the lack of sustainable waste management prac�ces in the opera�ng room, highligh�ng the need to adopt the ‘5R’ principle to achieve more environmentally sustainable healthcare.

LP4: Differen�al Alterna�ve Splicing of Skeletal Muscle Following Two Weeks Limb Immobiliza�on in Young Men

Aziz, Aliah

Vernon Coffey, Associate Professor, Health Sciences and Medicine, Bond University

Kevin Ashton, Professor, Health Sciences and Medicine, Bond University

Paul Dunn, Assistant Professor, Health Sciences and Medicine, Bond University

Background

Muscle atrophy caused by decreased skeletal muscle contrac�le ac�vity (disuse) or unloading, can o�en be a result of recovery from injuries or extended illnesses. While previous studies have characterised large-scale differen�al gene expression (DGE) responses in skeletal muscle induced during atrophy, the contribu�on of other regulatory mechanisms such as differen�al alterna�ve splicing (DAS) during skeletal muscle atrophy caused by disuse has yet to be determined. This study aimed to iden�fy global changes in DAS genes associated with disuseinduced muscle atrophy.

Method

Twenty-one male par�cipants (25.4 ±5.5 y, 81.2 ±11.6 kg) underwent 14 days of unilateral knee-brace immobiliza�on with dietary provision and following four-weeks of standardised exercise training. RNA-sequencing was performed at vastus lateralis muscle preimmobiliza�on and at day 3 and day 14 of immobiliza�on. Several bioinforma�cs methods were used to iden�fy differen�al alterna�ve splicing events and determine their gene func�ons including the rMATS so�ware.

Results

DAS events mainly occurred in the gene's coding domain sequence region, specifically caused by the skipped exon mechanism. A�er filtering, 699 DAS events were found at day 3 and 1005 DAS events were found at day 14 compared to baseline. The genes from these events were enriched in mul�ple pathways related to muscle atrophy.

Conclusion

The study iden�fied differen�al splice-site events in skeletal muscle genes that regulate the (mal)adapta�on response to disuse-induced muscle atrophy as alterna�ve splicing plays an important role in regula�ng the quality and quan�ty of muscle proteins by genera�ng different isoforms that exhibit divergent physiological and func�onal proper�es. Imbalance of RNA splicing is associated with pathological changes in skeletal muscle that directly lead to muscle was�ng which impacts a person’s quality of life by reducing ability to perform daily task.

LP5: Are mitochondrial DNA variants associated with weight-loss, metabolic adapta�on and other markers of obesity in women undergoing dietary interven�on?

Louw, Dominique

O’Neill, Hayley, Assistant Professor, Health Sciences and Medicine, Bond University

Dunn, Paul, Assistant Professor, Health Sciences and Medicine, Bond University

Introduc�on

Obesity is a complex, mul�-factorial disease increasingly burdening society in terms of poor physical, mental, social, and financial health. Despite obesity prevalence more than doubling since 1980, non-surgical weight-loss solu�ons remain ineffec�ve, encouraging metabolic inefficiency and weight-regain. Less than 15% of die�ng individuals see permanent weightreduc�on and long-term health improvements. Gene�c varia�on is one of the major factors impac�ng successful long-term weight-loss, accoun�ng for 40-70% of BMI heritability. One gene�c pathway to blame may be within mitochondrial DNA (mtDNA), in charge of intracellular energy provision and systemic metabolic regula�on. However, due to the small sample

sizes, low-power and narrow approaches of current analyses, knowledge of mtDNA variants and their effect on dietary-weight-loss is limited.

Methods

Aim 1: Phenotypic characterisa�on of women with obesity undergoing 12-week dietary weight-loss interven�on. This has already been completed and phenotypic measurements successful taken.

Aim 2: Iden�fying variants in mtDNA via advanced nanopore sequencing. Using wholegenome sequencing, we take an exploratory approach and eliminate the possibility of biased discovery of obesity-associated variants.

Aim 3: Exploring associa�ons between variants in mtDNA and dietary-induced weight-loss, metabolic adapta�on and key markers of obesity. Our primary outcomes will be mtDNA variant associa�ons to weight-loss outcomes and changes in metabolic rate, while our secondary outcomes will be mitochondrial DNA variant associa�ons to measures of obesity (body composi�on, waist circumference BMI).

Conclusion

Using a wide range of phenotypic data from �ghtly controlled weight-loss trials, advanced techniques and exper�se in the field, this study has poten�al to uncover novel and clinically relevant associa�ons between mitochondrial DNA, metabolism and weight-loss. Inves�ga�on of these associa�ons may encourage research into a new paradigm of obesity-care, defined by customised weight-loss interven�ons specific to an individual’s metabolic needs.

STREAM 9 HEALTH RESEARCH

PR52: Inves�ga�ng visual scene memory accuracy as a predictor of wayfinding performance in older adults

Koong, Danielle, 5th Year Medical student, Health Sciences and Medicine, Bond University

Mia, Parsha, 5th Year Medical student, Health Sciences and Medicine, Bond University

Jones, Cindy, Associate Professor, Health Sciences and Medicine, Bond University

Baumann, Oliver, Assistant Professor, Society and Design, Bond University

Introduc�on

Australia's healthcare system faces a growing burden from dementia, with those living with dementia estimated to increase from 401,300 in 2022 to 849,300 by 2058. Despite being a sensitive marker of preclinical Alzheimer’s disease, spatial navigation proficiency is traditionally neglected from cognitive ageing assessments and evaluated using self-report measures of questionable reliability and validity. This pilot study aimed to ascertain the validity of a novel computer-based visual scene memory task as a predictor of wayfinding ability in older adults (≥ 65 years) without cognitive impairment.

Methods

Participants were recruited from two community aged care facilities in Queensland via convenience sampling. A quasi-experimental pre-post intervention design was used to evaluate the predictive value of the visual scene recognition task, compared to self-reports.

Results and Conclusion

Results from the hierarchical multiple regression analysis found the visual scene memory task to be a highly significant predictor of objective wayfinding ability in older adults, superior to

self-reports. These findings highlight its poten�al clinical u�lity in diagnosing navigationrelated problems, such as Alzheimer’s disease.

PR53: Simula�on Based Educa�on

Lewis, Tynan, 5th Year Medical student, Health Sciences and Medicine, Bond University

Paliwal, Sushank, 5th Year Medical student, Health Sciences and Medicine, Bond University

Brazil, Victoria, FACEM, Gold Coast University Hospital (Supervisor)

Introduc�on/Background

This research project encapsulates an immersive explora�on of Simula�on-Based Educa�on (SBE) within clinical training. The mo�va�on behind undertaking SBE was to applicate theore�cal understanding of experien�al learning to prac�cal educa�on, including me�culous preparatory processes to facilitate effec�ve SBE, and explore technological modali�es which enhance learning outcomes in the clinical se�ng.

Methods

The elec�ve facilitated ac�ve par�cipa�on in various SBE modali�es and fields, spanning ICU, ED, surgical, medical, maternity ward, and Virtual Hospital se�ngs across the Gold Coast University Hospital, Robina Hospital, and Bond University. Specific learning objec�ves were strategically implemented in all the simula�ons to ensure well-defined learning goals, fostering targeted and streamlined sessions that op�mize par�cipants' learning outcomes.

Results/conclusion

The learning objec�ves were explored in-depth through SBE engagement and facilita�on. Simula�on observa�ons provided per�nent insights into team dynamics and their contextual influence in clinical scenarios. The technical dimensions embraced including digital mannequin opera�on, audio-visual technologies, virtual reality, and moulage, provided opportunity for divergent problem-solving approaches to emerge, highligh�ng key team collabora�ve fundamentals including hierarchical structures. Central to the experien�al learning was the cul�va�on of skills per�nent to construc�ng simula�ons mirroring real-life complexi�es. Lucid objec�ves and reflec�ve debriefing were pivotal for simula�on success. The inten�on to consistently engage with simula�ons, deliberate engagement with intricate cases, and a commitment to introspec�on converge to inform ongoing professional growth. As this research bridges the gap between theore�cal founda�ons and prac�cal applica�ons, it paves the way for an enriched approach to clinical educa�on, ensuring adeptness in naviga�ng the intricacies of real-world medical scenarios.

OP4: Predic�ve Modelling in Emergency Mental Health Care: A Scoping Review

Hudson, Carly, PhD Candidate, Faculty of Health Sciences and Medicine, Bond University

Randall, Marcus, Professor of Informa�cs, Bond University, Bond Business School

Todd, James, Assistant Professor of Data Analy�cs, Bond University, Bond Business School

Introduc�on/ Background

Clinical data can be valuable in providing insights into the usage of a healthcare service. Predic�ve modelling, including sta�s�cal and machine learning techniques, can be applied to make predic�ons about largescale clinical datasets, iden�fy paterns, rela�onships, and trends in historical data, and use this informa�on to generate a model which can predict future outcomes on new data. Mental health is a public health priority, with the prevalence of mental health condi�ons growing rapidly worldwide. Given the growing need to support

mental health needs, predic�ve modelling can play a cri�cal role in supplemen�ng clinical care by improving understanding of mental health pa�ents, suppor�ng decision making, and assis�ng with treatment planning. This scoping review aimed to determine what problems have currently been addressed in emergency mental health care using predic�ve modelling techniques.

Methods

Four databases were systema�cally searched to gather ar�cles which applied predic�ve modelling techniques in the context of emergency mental health care. These sources were screened in terms of suitability according to the specified inclusion criteria.

Results

Of the 101 ar�cles, 14 were included in the final review. It was found that these studies applied predic�ve modelling techniques to achieve six key aims: 1) examining the impact of sociodemographic and clinical factors on service usage; 2) iden�fying pa�ents at risk of a mental health crisis; 3) determining a pa�ent profile; 4) assessing quality of care; 5) classifica�on; and 6) predic�ng pa�ents’ behaviours.

Conclusion

This review iden�fies a range of aims which are targeted by predic�ve modelling in the context of mental health care and highlight the benefit of applying predic�ve modelling techniques in this area. The reviewed ar�cles also reveal a range of limita�ons and areas for future inves�ga�on within this field.

OP5: Uncovering Gene�c Varia�on Underlying Divergent Responses to Exercise Training in Selec�vely Bred Rats

Thomas, P.

Ashton, K.J, Professor, Health Sciences and Medicine, Bond University

Dunn, P.J, Assistant Professor, Health Sciences and Medicine, Bond University

Coffey, V, Associate Professor, Health Sciences and Medicine, Bond University

Background

An individual's gene�cs is the most significant contributor to exercise response. However, the exact genomic contribu�ons are unknown. Using a rodent model allows for a more significant interroga�on of genes' effect on aerobic exercise. The genotyping of a heterogenous rat model using specifically bred high response trainers (HRT) and low response trainers (LRT) can allow for a greater understanding of the gene�c components of exercise. The experiment aims to ini�ally map the RNAseq data from the two popula�ons to the rat genome and subsequently iden�fy variants within the data.

Methods

RNA sequence data was obtained from two prior studies on genera�on 19 of the HRT/LRT model. The control samples (12) were u�lised from only one of the studies (3) as they are duplicated, resul�ng in 36 total samples. Star two-pass was used to map the RNAseq data. The subsequent methodology adhered to the gatk best prac�ces for VCF data produc�on and analysis.

Results

The mean quality Phred score across the samples was 34, indica�ng a 99.9% accuracy per sequence, GC content displayed normal distribu�on, and the largest per base N percentage was 0.15%. The sequencing data demonstrates an average of 127.7 million reads per sample, 91.86% mapped to the genome and 83.89% unique reads aligned to the genome.

The number of variants iden�fied within the dataset was 3,322,099. The total number of SNPs iden�fied from the dataset was 2,414,485 a�er filtering and removing other variants, such as indels (897,520) and MASs (98,783).

Conclusion

A significant number of variants have been confirmed within a high-quality dataset, having passed the requisite quality controls. The single-nucleo�de polymorphisms are the largest subset of the variant data, confirming poten�al significant gene�c varia�on between the HRT and LRT groups. The subsequent stage is to perform an associa�on analysis and iden�fy gene regions associated with the variants and their func�on.

PR54: The Role of MMP-14 in the Pathogenesis of Prostate Cancer - A Systema�c Review

Melkonian, Wyat, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Canning, Lauren, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Roehl, Joan, Assistant Professor, Health Sciences and Medicine, Bond University

Introduc�on/Background

Prostate cancer (PCa) remains a significant global health concern, and understanding the underlying mechanisms contribu�ng to its progression and metastasis is essen�al for developing effec�ve therapeu�c strategies. Matrix metalloproteinase-14 (MMP-14), a membrane-associated protease, has gained increasing aten�on due to its crucial role in tumour invasion, angiogenesis, and metastasis in various cancers. This systema�c review aims to comprehensively analyse the exis�ng literature in the involvement of MMP-14 in prostate cancer.

Methods

In January 2023 a search across PubMed, Ovid, Science Direct, Web of Science and Scopus was performed. 1246 articles were initially screened with 245 duplicates removed. The remaining articles were title- and abstract- screened using a set of inclusion/exclusion criteria and then further reduced to 67 articles during full-text screening.

Results

On analysis of the data extraction, it is clear MMP14 plays an important role in prostate cancer pathophysiology. MMP-14 is upregulated in prostate cancer compared to normal prostate tissues. Experimental studies demonstrated MMP14 plays an active role in cell invasion, matrix degradation, adhesion, metastasis and activation of proteases in prostate cancer However, there are inconsistent results when comparing MMP14 expression between benign prostatic hyperplasia (BPH) and PCa samples alongside limited clinical data for MMP14’s use in prognosis, diagnosis and as a therapeutic target.

Conclusion

This systematic review highlights the important role of MMP-14 in prostate cancer progression and metastasis. Further investigation of its mechanisms of action and therapeutic

potential is warranted, with the ultimate aim of developing novel and targeted interventions to improve patient outcomes in prostate cancer.

PB7: The Effect of Intermitent Hypoxia on Cardiometabolic Factors in Pa�ents with Heart Failure

Srinivasan, Haritha, 5th Year Medical Student, Health Science and Medicine, Bond University

Timalsena, Prajwal, 5th Year Medical Student, Health Science and Medicine, Bond University

De Silva, Lashan, 5th Year Medical Student, Health Science and Medicine, Bond University

Michael, Tijono Joanne, 5th Year Medical Student, Health Science and Medicine, Bond University

Oldfield, Kieran, Clinician, Gold Coast University Hospital

Dunn, Paul, Assistant Professor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

Heart failure presents a significant burden to pa�ents and on healthcare with an annual cost of over one billion dollars. Intermitent hypoxia (IH) is a promising non-pharmacological management op�on that decreases several cardio-metabolic factors that could benefit pa�ents with heart failure. This study inves�gated IH’s effect on certain metabolic factors in pa�ents with heart failure.

Method

Following a strict criterion, three pa�ents were selected, screened, and monitored for two weeks. Ini�ally, pa�ents were exposed to normoxic air (sham, FiO2 = 21%) for five days. This was followed by exposure to hypoxic air for five days with FiO2 being �trated to achieve a mean peripheral oxygen satura�on (SpO2) of 85% for 60-70 minutes of cumula�ve minutes daily. Cardiometabolic factors including BNP (brain natriure�c pep�de), le� ventricular ejec�on frac�on (LVEF) and erythropoie�n (EPO) levels were measured pre- and posttreatment.

Results

Results showed no significant difference in BNP, LVEF and EPO levels before and a�er the interven�on of intermitent hypoxia. Furthermore, there was no significant improvement in exercise tolerance post interven�on as evidenced by the results of the 6-minute walk test.

Conclusion

No significant difference was observed in cardiometabolic factors in pa�ents with heart failure post intermitent hypoxia. The study’s limited outcome was likely atributed due to a small sample size from par�cipant atri�on and recruitment difficul�es. Sta�s�cal analysis could not be undertaken, and analysis relied on non-parametric tes�ng. Future studies will require more pa�ent recruitment to ascertain if there is any significant effect of intermitent hypoxia in this pa�ent cohort.

STREAM 10 INTERNAL MEDICINE

PB8: ST – eleva�on in aVR and other ECG features and their collec�ve u�lity in diagnosing clinically significant le�-main disease

Roworth, Dominic, 5th Year Medical student, Faculty of Health Science and Medicine, Bond University

Walisinghe, Lithira, 5th Year Medical student, Faculty of Health Science and Medicine, Bond University

Gorcilov, James, 5th Year Medical student, Faculty of Health Science and Medicine, Bond University

Rahman, A�fur, Cardiologist, Gold Coast University Hospital, Department of Cardiology

Szkwara, Jaclyn, Assistant Professor, Faculty of Health Science and Medicine, Bond University

Introduc�on/Background

The once-forgoten lead aVR has recently been garnering considerable aten�on regarding its poten�al involvement in predic�ng clinically significant, >/50 % occlusion, of the le� main coronary artery (LMCA). This poten�al rela�onship formed the point of interest for this project where authors aim to address the u�lity of ST eleva�on-aVR (STE-aVR) and other ECG features in diagnosing clinically significant le� main (LM) disease.

Method

A literature review was performed, following thorough screening of all surrounding literature as of March 2022, where 52 relevant studies were analysed.

Results

In addi�on to the clear link between STE-aVR >/0.5mm and the incidence of LM disease, STEaVR was found to be a highly specific and accurate predictor of LM disease. Furthermore, these diagnos�c values were improved with increased magnitude of STE in aVR as well as the presence of addi�onal ECG features including diffuse ST depressions (STDs) and longer QRS intervals.

Conclusion

In conclusion, STE-aVR, especially in the presence of the aforemen�oned addi�onal features presents a useful clinical aid in predic�ng clinically significant LM disease. However, given the rela�ve novelty of the concept, and the limited research surrounding the subject, as well as the occasional conflic�ng evidence, more urgent angiographic interven�on is not jus�fied, and STE-aVR should be used merely as an addi�onal tool in conjunc�on with valid clinical judgement.

PR55: The Implementa�on of a Mild Trauma�c Brain Injury Mul�disciplinary Team Clinic at Gold Coast University Hospital

Duton, Alain - 5th Year Medical student, Health Sciences and Medicine, Bond University

Bills, Lillian - 5th Year Medical Student, Health Sciences and Medicine, Bond University

Dungey, Kelly, Gold Coast University Hospital

Introduc�on

This research paper aims to design an evidence-based outpa�ent mul�disciplinary team (MDT) clinic for mild trauma�c brain injury (mTBI) pa�ents at Gold Coast University Hospital (GCUH). Literature review findings are combined with data from exis�ng Australian MDT mTBI clinics to create a model of care (MOC). mTBIs affect a significant number of individuals annually, and although most pa�ents recover within ten days, 20% experience las�ng symptoms. MDT clinics have been shown to be effec�ve in managing mTBI cases.

Methods

The research begins with a literature review, exploring the efficacy of MDT clinics in managing pa�ents with mTBI. Survey data is collected from Australian MDT mTBI clinics, forming the

basis for crea�ng the MOC for GCUH. The MOC is designed to encompass assessments, referrals, interven�ons, and follow-up, involving a range of healthcare professionals.

Results

The literature review reveals the significance of MDT clinics in managing mTBI pa�ents, iden�fying common assessment tools and the importance of referrals. Survey data from twenty Australian clinics offer insights into current prac�ces. This combined data shaped the structure of the GCUH MOC to include a streamlined triage system and telehealth OT assessments.

Conclusion

By incorpora�ng insights from literature review and survey data, the proposed outpa�ent MDT mTBI MOC aims to op�mise pa�ent care, reduce loss to follow-up, and ul�mately improve pa�ent outcomes. Ongoing evalua�on and refinement will further enhance the effec�veness of this model. Successful implementa�on of the MOC at GCUH could serve as a valuable framework for other healthcare ins�tu�ons dealing with mTBI cases.

PR56: An audit and case study of spas�city management at Gold Coast university hospital and comparing to management in literature

Nguyen, Mai, 5th Year Medical student, Bond university, Health Sciences and Medicine, Dungey, Kelly, Supervisor, Gold Coast University Hospital

Background

Spasticity can develop in individuals with neurological disorders such as stroke or spinal cord injuries. Spasticity is most commonly defined as a velocity dependent condition that leads to hyperactivity of the muscle. Its pathophysiology is poorly understood. There are numerous non-pharmacological and pharmacological methods for treating spasticity with no definitive guideline for patient management.

Objective

Study of spasticity management in at Gold Coast university hospital through an audit and case study whilst comparing to common forms of non-pharmacological and pharmacological management in literature.

Methods

To establish research present for comparison, a literature review was conducted using Cochrane, Pubmed and Trip libraries. The audit was conducted during the month of March, 2023, looking at patients admitted to the rehabilitation ward at Gold Coast University hospital with neurological conditions. Data about the development of spasticity and management was gathered. Finally, the case presentation is a detailed study of the patient's journey in the rehabilitation department and an exploration of their management.

Results

11 reviews were included in the literature review, delving into the efficacy of certain spasticity management. These interventions include stretching; orthotics; medications such as baclofen, dantrolene, tizanidine; botulinum injections and intrathecal therapies. The most commonly used forms of spasticity management at Gold Coast university are physiotherapy, orthotic splints and dantrolene.

Conclusion

Spasticity is a complex issue requiring multi-disciplinary management. More trials need to be conducted on non-pharmacological forms of treatment as there is only low quality of evidence available currently supporting the implementation. Hospitals are limited in their management forms of spasticity as each patient requires a full team of a consultant, physiotherapist, occupational therapist and nurses.

PR57: Does BMI Impact Rehabilita�on Gains (FIM efficacy) Following Stroke?

Tan, Andrea, 5th Year Medical student, Health Sciences and Medicine, Bond University

Aroney, Emeil, 5th Year Medical student, Health Sciences and Medicine, Bond University

Dungey, Kelly, Clinician, Gold Coast University Hospital

Corbet, Adrienne, Clinician, Gold Coast University Hospital

Introduc�on/Background

Stroke remains one of the leading causes of death worldwide and associated with high morbidity. It is a disease of immense public health importance with survivors requiring lifelong pharmacotherapy, rehabilita�on and caregiver support to achieve op�mal health outcomes. Post stroke recovery is a complex mul�factorial process and there appears to be conflic�ng consensus on the impact of BMI on func�onal recovery within the current literature. This project inves�gated whether BMI impacts rehabilita�on outcomes in stroke recovery.

Method

A retrospec�ve audit was conducted on pa�ents with an ischaemic or haemorrhagic stroke and were admited to GCUH rehabilita�on unit within a 10 month period. BMI data collected was categorised and length of stay and Func�onal Independence Measure (FIM) efficacy, a marker of rehabilita�on progress, were measured pre and post admission.

Results

Mul� regression analysis found that increasing BMI were associated with longer length of stay with overweight and obese pa�ents recording highest averages of 36 and 52 days. FIM efficacy also decreases as BMI increases, with underweight pa�ents recording the highest average FIM efficacy (0.93), and overweight and obese pa�ents recording the lowest average FIM efficacy at 0.86 and 0.35 respec�vely. Overweight and obese pa�ents were also more likely to be discharged to an aged care or for further rehabilita�on instead of home.

Conclusion

Increasing BMI appears to nega�vely impact rehabilita�on outcomes in par�cular FIM efficacy, length of stay in rehab and discharge des�na�on. Further large-scale mul�centre studies are warranted to yield significant insights into the complex rela�onship between obesity and post stroke rehabilita�on outcomes.

PB9: Inves�ga�ng Paraoxonase Genes in Cerebrovascular and Associated Diabetes

Pathology

Abdallah, Abdallah5th Year Medical Student, Health Sciences and Medicine, Bond University

Nikos, Dimitrios 5th year Medical Student, Health Sciences and Medicine, Bond University

Rattan, Ritwik 5th year Medical Student, Health Sciences and Medicine, Bond University

Chadha, Navya 5th year Medical Student, Health Sciences and Medicine, Bond University

Dunn, Paul, Supervisor, Assistant Professor, Health Sciences and Medicine, Bond University

Introduction/Background

Paraoxonase (PON) genes have been implicated in the pathogenesis of cerebrovascular and associated diabetes pathology, consequently resulting in cognitive decline and mortality. Although there are well established risk factors contributing to their disease burden, the genetic component is often overlooked. As such, the aim of this review is to explore the relationship between PON genes and cerebrovascular disease such as stroke, dementia, atherosclerosis and diabetes.

Methods

The research design of the study is a scoping review that was conducted following the PRISMA framework, using databases such as PubMed, Scopus and Embase to include relevant casecontrol and non-randomised experimental studies.

Results

Multiple PON1 gene polymorphisms were found to have a link to ischaemic stroke, including rs662_G, rs793, rs3917538 CC genotype and the Q192 polymorphism were found to influence atherosclerosis, thus increasing IS risk. The majority of studies endorse the protective role of the 192Q allele as well as the damaging effects of the 192R allele. Additionally, PON1 concentration, activity, and enzymatic changes significantly impact atheroma development and may better predict coronary atherosclerosis and stroke risk than polymorphisms. In the context of diabetes, it was found that PON1 activity was significantly lower in diabetic subjects and could be altered by PON1 polymorphisms (ie. Q192R). In terms of dementia, there is limited evidence suggesting that PON gene polymorphisms; PON1 -108 C/T and PON2 S113C are associated with neurocognitive decline while PON1 L55M, Q192R and -161 C/T are not.

Conclusion

In conclusion, the review found that there is a relationship between PON genes, cerebrovascular disease and associated diabetes pathology. However, there is a need for further investigation into the effects of PON1 polymorphisms in terms of optimising risk assessment strategies and treatment approaches.

OP6: Effect Of Different Visual Presenta�ons On The Public’s Comprehension Of Prognos�c Informa�on Using Acute And Chronic Condi�on Scenarios: Two Online Randomised Controlled Trials

Abukmail, Eman

Mina Bakhit1, Mark Jones1, Chris Del Mar1, Tammy Hoffmann1

1Ins�tute for Evidence Based Healthcare, Bond University

Objec�ves

To assess the effec�veness of bar graph, pictograph and line graph compared with text-only, and to each other, for communica�ng prognosis to the public.

Methods

Two online four-arm parallel-group randomised controlled trials. Sta�s�cal significance was set at p<0.016 to allow for three-primary comparisons. Two Australian samples were recruited from members registered at Dynata online survey company. In trial A: 470 par�cipants were randomised to one of the four arms, 417 were analysed. In trial B: 499 were randomised and 433 were analysed. In each trial four visual presenta�ons were tested: bar graph, pictograph, line graph and text-only. Trial A communicated prognos�c informa�on about an acute condi�on (acute o��s media) and trial B about a chronic condi�on (lateral epicondyli�s). Both condi�ons are typically managed in primary care where ‘wait and see’ is a legi�mate op�on.

The main outcome is comprehension of informa�on (scored 0–6) and secondary outcomes are decision inten�on, presenta�on sa�sfac�on and preferences.

Results

In both trials, the mean comprehension score was 3.7 for the text-only group. None of the visual presenta�ons were superior to text-only. In trial A, the adjusted mean difference (MD) compared with text-only was: 0.19 (95% CI −0.16 to 0.55) for bar graph, 0.4 (0.04 to 0.76) for pictograph and 0.06 (−0.32 to 0.44) for line graph. In trial B, the adjusted MD was: 0.1 (−0.27 to 0.47) for bar graph), 0.38 (0.01 to 0.74) for pictograph and 0.1 (−0.27 to 0.48) for line graph. Pairwise comparisons between the three graphs showed all were clinically equivalent (95% CIs between −1.0 and 1.0). In both trials, bar graph was the most preferred presenta�on (chosen by 32.9% of trial A par�cipants and 35.6% in trial B).

Conclusions

Any of the four visual presenta�ons tested may be suitable to use when discussing quan�ta�ve prognos�c informa�on.

STREAM 11 CLINICAL AUDITS

PR58: Prescribing of monitored medicines for pa�ents while being admited and at discharge: An exploratory study of hospital doctors' perspec�ves on QScript

Bodepudi, Praneethganesh, 5th Year Medical student, Health Sciences and Medicine, Bond University

Nedunchezhian, Vikram, 5th Year Medical student, Health Sciences and Medicine, Bond University

Ha�ngh, Lae��a, Gold Coast University Hospital

McGuire, Treasure, Health Sciences and Medicine, Bond University

Alderson, James, Gold Coast University Hospital

Background

Junior doctors play a crucial role in the medica�on discharge process in a hospital se�ng. With the rela�vely recent introduc�on of the real-�me prescrip�on monitoring program QScript, the responsibili�es of junior doctors to appropriately manage monitored medicines is increasing in the background of Australia’s opioid epidemic. The aim of this study is to gain a comprehensive insight into junior doctors’ experiences using QScript for the prescrip�on of monitored of medicines.

Methods

Qualita�ve study design was used to explore junior doctors’ perspec�ves and experiences regarding barriers, enablers, and poten�al improvements of QScript Two independent researchers from Bond University conducted semi-structured interviews with 10 junior doctors from GCHHS between April and June 2023.

Results

The interviews unveiled four main themes: When and how QScript is utilised, barriers when using QScript, benefits of using QScript and impairment on workflow. Most junior doctors use QScript primarily in response to the Integrated Electronic Medical Record (ieMR) prompt. Barriers included lack of integra�on with ieMR, limited access to records beyond Queensland health, and the need for comprehensive educa�on on QScript. Benefits included verifying previously prescribed medica�ons and iden�fying 'doctor shopping,' leading to improved

health outcomes. Workflow enhancement sugges�ons include removing separate logins and pin-numbers for QScript and involving pharmacists more heavily in overseeing the dispensing of medicines.

Conclusion

QScript offers benefits for junior doctors in prescribing monitored medica�ons, but it also has limita�ons. Further research is needed, considering perspec�ves from doctors of various special�es and experience levels across all states and territories.

PR59: Early Rehabilita�on Referrals Post Neck of Femur Fractures: A Narra�ve Review and Service Evalua�on

Movshovich, Jason, DPT, BExSci(Hons). 5th Year Medical student, Health Sciences and Medicine, Bond University

Dungey, Kelly, BSocSc(Psyc), MBA, MIB, MBBS, CIME, FAFRM. Rehabilita�on Medicine Staff Specialist Gold Coast Health

Waynforth, David, PhD. Associate Professor, Health Sciences and Medicine, Bond University

Purpose

The aim of this study was to help establish what is defined as early referral to rehabilita�on and to evaluate the effects of a rehabilita�on blanket referral system on pa�ents that have suffered a neck of femur fracture, and compare these results to pa�ent outcomes prior to an early referral system implementa�on.

Methods

Following a literature review, retrospec�ve data for 371 preblanket and 557 postblanket referral pa�ents were obtained from the Australasian Rehabilita�on Outcomes Centre during the period spanning January 2018 un�l January 2023 at a specific Australian hospital. Data included age, rehabilita�on referral dates, length of stay, and Func�onal Independence Measure score. Kaplan-Meier survival analysis and Cox Regression tests were to iden�fy whether hazards were propor�onal across �me.

Results

General consensus appears to have early referral for rehabilita�on beginning on postopera�ve day 0-1. Cox regression analysis generated for age and pre/post blanket revealed a p > 0.2 for age and p = 0.172 for pre/post blanket which were not sta�s�cally significant. Kaplan-Meier survival plots revealed near iden�cal plots with mul�ple areas of crossover, signifying propor�onal hazards was not met.

Conclusion

When designing a framework for rehabilita�on referral, blanket referral systems may be u�lised to improve administra�ve load and streamline healthcare journeys. At a specific Australian hospital, overall length of stay was unaffected and this finding was non-significant. Further analysis on the effects of pre/postblanket referral on the FIM is an area for future study.

PR60: Implementa�on of stroke guidelines in rehabilita�on

Sidhu, Sherhan, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Dungey, Kelly, Medical Director Rehabilita�on, Gold Coast University Hospital

Waynforth, David, Associate Professor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

Stroke survivors are at an increased risk of developing recurrent stroke. In this two-part study, we reviewed the literature for up-to-date evidence on the effec�veness of six interven�ons recommended by The Stroke Founda�on’s Clinical Guidelines for the secondary preven�on of recurrent ischaemic stroke. We then audited the Rehabilita�on Team at Gold Coast University Hospital (GCUH) for their performance in secondary preven�on against these guidelines.

Methods

We searched PubMed, EMBASE and Cochrane databases for randomised control trials (RCTs) and systema�c reviews that demonstrated secondary preven�on using one of the following interven�ons: blood pressure control, an�hypertensives, sta�ns, an�platelets, an�coagulants and an�diabe�cs. We then conducted a clinical audit of 23 consecu�ve admissions to GCUH Rehabilita�on from January 1st 2021 to April 30th 2021 to evaluate adherence to best prac�ce for stroke care.

Results

Aspirin reduced recurrent ischaemic stroke by 22% (7 RCTs, n=41,042). An�coagulants (28 RCTs, n=23,748) and sta�ns (1 RCT, n=4731) also reduced recurrent ischaemic stroke by 25% and 16%, respec�vely. The evidence for an�hypertensives is inconclusive. Pioglitazone reduced recurrence for any stroke type by 34% (3 RCTs, n=4979). Our clinical audit revealed a 100% adherence to guidelines for an�platelets, an�coagulants and an�diabe�cs at GCUH. In contrast, adherence for sta�ns, blood pressure control and an�hypertensives was subop�mal at 88%, 61% and 72%, respec�vely.

Conclusion

Secondary preven�on with an�platelets, an�coagulants, sta�ns and pioglitazone significantly reduced stroke recurrence in pa�ents with previous ischaemic stroke. However, the benefit of an�coagulants and sta�ns is overshadowed by a high risk of major bleeding. The results from our audit suggest that secondary preven�on is being implemented at GCUH with rela�vely high compliance to guidelines, but improvements are needed for blood pressure management and sta�ns.

PR61: Adherence and therapeu�c efficacy in a government funded CPAP device program

Pathirana, Nuvin, 5th Year Medical student, Health Sciences and Medicine, Bond University Alam, Sarita, 5th Year Medical student, Health Sciences and Medicine, Bond University

Sriram, Bajee Krishna, Senior Medical Officer, Department of Respiratory and Sleep Medicine, Gold Coast University Hospital.

Introduc�on/ Background

Obstruc�ve sleep apnoea (OSA) affects 5-38% of the popula�on and is associated with many adverse outcomes. Con�nuous posi�ve airway pressure (CPAP) is the recommended treatment for pa�ents with OSA. Compliance with CPAP (>4hrs/night for 70% of nights) is subop�mal due to many reasons, including cost of therapy. To alleviate this challenge, the Queensland Health Sleep Disorders Program (QHSDP) introduced a state-wide program, where eligible pa�ents are provided a long-term CPAP device. However, the CPAP compliance of QHSDP pa�ents is currently unknown. The aim of this study was to understand CPAP compliance, benefits, and reasons for non-compliance in QHSDP eligible pa�ents.

Methods

A retrospec�ve audit of 100 pa�ents with OSA from our ins�tu�on was undertaken. Pa�ents with OSA who have received a QHSDP CPAP device and were followed up 6 months post-issue of the device met the criteria for inclusion. Data collected included epidemiological characteris�cs, severity of OSA, compliance data, and reasons for non-adherence. Outcomes were measured by comparing these variables at baseline and 6 months following treatment.

Results

In the cohort, median age was 67 years. 89 pa�ents reported no issue with CPAP therapy. Average CPAP use was 7 hours. There was an improvement in both Epworth Sleepiness Scale (ESS) (baseline 9.8; 6 months: 7.3) and Apnoea-Hypopnoea Index (AHI) (baseline 49/hr; 6 months 5hr). The main reasons provided for non-compliance were mask leak and dry mouth.

Conclusion

This audit confirms clinical improvement is achieved by CPAP and highlights the significance of employing government-funded strategies to encourage sustained compliance.

PB10: An Audit of Screening for Post-Trauma�c Hypopituitarism, Following Trauma�c Brain Injury, in the Gold Coast Hospital Health Service

Yeoh, Alexandra, 5th Year Medical student, Health Sciences and Medicine, Bond University

Kataria, Navya, 5th Year Medical student, Health Sciences and Medicine, Bond University

Feroz, Shania, 5th Year Medical student, Health Sciences and Medicine, Bond University

Leeder, Sarah, Rehabilita�on Physician, Gold Coast Hospital Health Services

Waynforth, David, Associate Professor, Health Sciences and Medicine, Bond University

Background

One of the consequences of a moderate-severe trauma�c brain injury (TBI) is acquired hypopituitarism. The consequences of misdiagnosing post-TBI hypopituitarism include reduced quality of life and poor rehabilita�on outcomes. We reviewed both the prevalence of acquired hypopituitarism as well as the rates of hypopituitary screening in pa�ents across Gold Coast Hospital & Health Service (GCHHS).

Methods

Data was extracted from the GCHHS by a data custodian. Descrip�ve sta�s�cs and a combina�on of point-biserial correla�on and binary logis�c regression were used to analyse the demographics and the associa�on between TBI severity, acquired hypopituitarism and hypopituitarism screening rates on SPSS.

Results

There were a total of 67 par�cipants in the moderate-severe TBI popula�on of this study, most of whom were male and had a previous history of TBIs (74.6%). 6 par�cipants were screened out of 67 par�cipants (8.9%), with 3 diagnosed with hypopituitarism post-TBI. An associa�on was found between hypopituitarism post-TBI and TBI severity, b = 2.828, P <.05, OR = 16.912 (95% CI = 1.758, 162.668).

Discussion

A more proac�ve approach should be taken towards hypopituitary screening, rather than an opportunis�c approach, given that screening was only done when par�cipants re-presented for an unrelated admission.

Conclusion

Hospitals must play a stronger role in screening pa�ents for hypopituitarism post-TBI. More educa�on is needed surrounding protocol and approaches to hypopituitarism screening post-

TBI, par�cularly on how hypopituitary symptoms are not a reliable indicator of true acquired hypopituitarism.

PR62: Motor Neurone Disease: A Quality Improvement Project

Tennyson, Charles 5th Year Medical student, Health Sciences and Medicine, Bond University Sriram, Krishna, Consultant/Staff Specialist, Gold Coast University Hospital

Introduc�on

Due to the absence of established Australian specific guidelines, the management of Motor Neuron Disease (MND) in Australia is rather heterogenous, and ad-hoc. The UK specific NICE guidelines currently guide Australian clinicians. There may be avenues of current pa�ent care where the Gold Coast University Hospital (GCUH) can iden�fy deficits, and as such, ac�on upon them to op�mise care and survival outcomes. This quality improvement project sought to beter understand pa�ent demographic, �me to referral to sleep physician, subsequent management, and clinical outcomes of care at the GCUH respiratory and sleep medicine clinic.

Methods

MND pa�ents seen and managed at the GCUH sleep medicine clinic were retrospec�vely recorded in a database. Pa�ent characteris�cs, symptomatology at �me of diagnosis, aspects of sleep clinic assessment and management and outcomes of care were recorded.

Results/Conclusions

Data from a total of 33 MND pa�ents was collected, referred to the GCUH sleep medicine clinic between 2016 – 2022. The median �me from diagnosis to sleep clinic referral was 3.6 (IQR = 5.5) months. The �me from referral to star�ng non-invasive ven�la�on (NIV) therapy was 3.8 (IQR = 14.1), and the median survival from NIV commencement to death was 12.8 (IQR = 9.9) months. All 33 (100%) pa�ents were commenced on NIV therapy at some point. GCUH appeared to meet most expecta�ons of the NICE guidelines, however, the quality of life and survival benefits of established NIV suggests that a dedicated mul�-disciplinary team for MND pa�ents would iden�fy deteriora�ng pa�ents earlier and further op�mise their care.

PR63: Post Bariatric Care Guideline, audit and review of barriers and enablers

Gazibegovic, Natalia 5th Year Medical student, Health Sciences and Medicine, Bond University

Dunn, Paul, Assistant Professor, MD Academic Coordinator, Faculty of Health Sciences and Medicine, Bond University

Mills, Richard, Senior GP, Clinical Improvement, IUIH

Introduc�on/Background

This quality improvement project aimed to evaluate the implementa�on of post bariatric care guidelines for Aboriginal and Torres Strait Islander people within the Ins�tute for Urban Indigenous Health (IUIH). IUIH has carefully formulated post bariatric care guidelines for all professionals working in the network, as they have a role in implemen�ng care plans. Our project aimed to assess if MMEx care plans are being used in the lifelong metabolic, endocrine, and nutri�onal follow up of clients who have undergone bariatric surgery and provides valuable insight into understanding how post bariatric care guidelines are used within IUIH.

Methods

This study uses an approach that combines quan�ta�ve data analysis with five qualita�ve interviews. Data on pa�ent demographics, type of surgery and whether they had a care plan assigned was collected from the MMEx records. Interviews were conducted with clinicians involved in providing follow-up services to assess their understanding of the available post bariatric surgical care plans, and their challenges when using them.

Results/Conclusion

The research found that out of 409 pa�ents who underwent bariatric surgery, 81% did not have a care plan assigned. When focusing on the 19% of pa�ents with a care plan, Gastric Sleeve pa�ents had the highest number of care plans. Interviews revealed that the MMEx pla�orm was complicated, and some clinicians were unaware of the post bariatric surgical care plans. This suggests there is an urgent need to improve knowledge of post bariatric care plans and their implementa�on within IUIH. It is hoped that this quality improvement project will help inform future policy decisions and provide beter support services to Aboriginal and Torres Strait Islander people who have undergone bariatric surgery.

IGNITE – POSTERS

IG1: Tweed Hospital Audit of Special Care Nursery Admissions between 2020-2021

Menon, Gowri, 5th Year Medical student, Health Sciences and Medicine, Bond University

Abbey, Steve, Obstetrics and Gynaecology Consultant, Tweed Hospital

Green, Patricia, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University.

Rathbone, Evelyne, Senior Research Fellow, Faculty of Health Sciences and Medicine, Bond University

Introduc�on/Background

According to the Australian Ins�tute of Health and Welfare (mothers and babies report, 2022), the Australian na�onal average admission rate for Level 3 and above neonatal care in 2020 was 18%, significantly higher than counterpart developed na�ons such as the UK at 14%. This audit aimed to determine the admission rate in the Tweed local hospital district, compare it to other states and the na�onal average and explore the causes of preventable admissions. A reduc�on in avoidable admissions benefits the neonate, parents, and the greater popula�on. New-borns in NICU and SCN may suffer from the las�ng burden of disease; this may be physical, mental, or developmental.

Methods

The popula�on for the audit was composed of live births in the years 2020 and 2021, with the data collected retrospec�vely from the Ematernity database. Microso� Excel, SPSS, and online so�ware MedCalc were used for data analysis.

Results

The audit discovered an average admission rate of 13.4%, significantly lower than the na�onal average for both 2020 and 2021 and other counterpart states. The two commonest reasons for preventable admissions were clinician recommenda�ons being declined by pa�ents, 13%, and admissions without fulfilling criteria, 4%.

Conclusion

Though results show that excluding neither of these groups significantly decreases the admission rate, methods to improve the shared decision-making process may reduce the rate of clinician recommenda�ons being declined by pa�ents and subsequent nursery admissions.

IG2: Emergency Intuba�ons for Drug Overdoses at Gold Coast Health Service: A

Preliminary Analysis

Kaushal, Aditya, 5th Year Medical student, Health Sciences and Medicine, Bond University

Kinloch, Hope, 5th Year Medical student. Health Sciences and Medicine, Bond

Rahim, Ahmed, 5th Year Medical student, Health Sciences and Medicine, Bond University

Pellat, Richard, Clinician, Gold Coast University Hospital

Dunn, Paul, Assistant Professor, Health Sciences and Medicine, Bond University

Background

Drug overdoses are common reasons individuals present to emergency departments (ED). Many of these pa�ents o�en receive brief suppor�ve care and close monitoring. However, a propor�on becomes acutely unwell, requiring emergency intuba�on and transfer to the Intensive Care Unit (ICU). During emergency intuba�ons, clinicians must act quickly, with o�en litle understanding of the pa�ent due to limited assessment �me.

Methods

The retrospec�ve cohort study aims to discuss the demographic makeup and clinical outcomes of individuals presen�ng to Gold Coast University Hospital (GCUH) and Robina Hospital Emergency Departments requiring emergency intuba�on. The study popula�on comprises pa�ents requiring emergency intuba�on due to a suspected drug overdose. The data was collected manually from iEMR records and de-iden�fied. The data was then input into Excel for analysis to generate descrip�ve sta�s�cs.

Results

The highest overdose cases were observed among individuals aged 25-34 and 35-44. Addi�onally, the age group 45-54 experienced the longest average hospital stays. The presenta�ons with one or two drugs were most common, whereby single-drug inges�on lead to the lengthiest hospital stays. GHB/Fantasy overdose incidents were nearly three �mes more frequent than other drug classes yet resulted in the shortest hospitalisa�on periods. Lastly, the study further divided pa�ents based on �me to extuba�on, specifically less than 24 hours and greater than 24 hours enabling further demographic comparisons.

Conclusion

The trends observed in the results will pave the way for future research regarding which presenta�ons may or may not require intuba�on, and the impact of polypharmacy on overdose outcomes. The preliminary data raises the ques�on of whether certain pa�ent presenta�ons would benefit from conserva�ve management.

IG3: Exploring the impact of in-reach rehabilita�on on length of stay and func�onal status in mental health inpa�ents: a case study

Chen, Jayann, 5th Year Medical student, Health Sciences and Medicine, Bond University

Dungey, Kelly, Rehabilita�on Medicine Physician, Gold Coast University Hospital

Introduc�on

The increasing demand for inpa�ent management of individuals with mental health condi�ons has led to the explora�on of different treatment modali�es. Among these emerging op�ons is in-reach rehabilita�on, which is currently being trialled in select Australian hospitals. Mental health condi�ons are o�en mul�factorial, and in-reach rehabilita�on aims to address this by priori�zing early assessment and engagement with allied health services, thereby enhancing overall func�onal status.

Methods

In this research project, a case study was conducted on a female pa�ent in her 50s with mul�ple psychiatric comorbidi�es to examine the impact of in-reach rehabilita�on on length of stay (LOS) and level of func�on.

Results

The results demonstrated a reduc�on in LOS and an improvement in pa�ent func�on, as evidenced by an increase in the func�onal independence measure (FIM) following rehabilita�on.

Conclusion

Despite the study's limited sample size, these findings present promising implica�ons for future research exploring the u�lity of in-reach rehabilita�on in the management of pa�ents with mental health condi�ons. Further inves�ga�ons with larger cohorts are warranted to provide further evidence of the poten�al benefits of in-reach rehabilita�on in this popula�on.

IG4: Diversity in surgical selec�on (DiSS)

Wu, Isabella, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Sharma, Raghav, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Liang, Rhea, Associate Professor/Clinician, Robina Hospital

Bhagwat, Gayatri, Clinician, Cairns Base Hospital

Introduc�on

This qualita�ve study aims to inves�gate the impact of surgical selec�on requirements on diversity within the surgical workforce. The research gathers insights from surgical trainees who have recently undergone the surgical training selec�on process, to generate recommenda�ons to improve inclusivity and accommodate individuals with diverse background and skills.

Methods

Two phases are conducted: asynchronous online focus groups (Phase I) and semi-structured interviews (Phase II). A framework analysis will be u�lised to conduce a cross-sec�onal analysis that will help iden�fy, describe, and interpret key paterns that will help dis�nguish aspects of diversity relevant to surgical training selec�on.

Result

Findings indicate that surgical selec�on criteria primarily priori�ze clinical skills, leadership, and professionalism. While some colleges consider cultural competency and encourage specific applicant backgrounds, factors such as LGBTQ inclusivity and gender equality receive less aten�on. The research approval process involved careful nego�a�on with the Ethics Commitee, addressing concerns regarding data analysis methods, consent discrepancies, and data management.

Conclusion

The study concludes that while some efforts exist to promote diversity, to promote a more inclusive surgical workforce, a broader range of quali�es and perspec�ves should be considered in selec�on requirements. The process of gaining ethics approval provided insights into the ethical issues surrounding qualita�ve research with human par�cipants. The ethics approval process highlights the need to priori�ze par�cipant protec�on and data privacy. Researchers must clearly define their study design, par�cipant protec�ons, and findings' significance, while jus�fying the relevance of the study within the qualita�ve research context.

IG5: The effects of a pass or fail medical school curriculum on student wellbeing and performance

Maharaj, Nikhil, 5th Year Medical student, Health Sciences and Medicine, Bond University

La, Tai 5th Year Medical student, Health Sciences and Medicine, Bond University

Bishop, Jo, Associate Dean, Health Sciences and Medicine, Bond University

Craig, Belinda, Assistant Professor, Health Sciences and Medicine, Bond University

Introduc�on/ Background

The introduc�on of Every Doctor, Every Setting: A National Framework, 1 has encouraged key stakeholders to act on the poor mental health outcomes associated with medical training and employment. A primary preven�on strategy to consider implemen�ng would be to reevaluate curricula design at medical school.2 The main objec�ve of this review was to therefore determine the poten�al role of a pass or fail (P/F) medical school curricula to reduce mental health burden in students. To determine the validity of this system, the wellbeing and academic differences between a P/F and tradi�onally graded system were compared and discussed.

Methods

A systema�c search of the literature was performed using eight databases: PubMed, Google Scholar, Embase, ERIC, CINAHL, Web of Science, OVID and CKN. Studies included in this review were relevant to the medical school curricula. Papers on nursing and or physician assistant programmes were excluded. Overall, seventeen literature studies were included and a formal analysis was done by categorising relevant findings into two major outcomes: wellbeing (n = 11) and academic (n = 13) (some studies reported on both outcomes).

Results

In the medical school context, the pass-fail system posi�vely impacts well-being, mo�va�on, and collabora�on without compromising academic performance. Students reported increased sa�sfac�on and extracurricular engagement. Academic performance varied across studies.

Conclusion

A P/F medical school curriculum may offer numerous wellbeing benefits without any significant detriments to academic performance or postgraduate ability.

IG6: Clinical U�lity of Prostate-Specific An�gen Tes�ng

Balaji, Nikhil, 5th Year Medical student, Health Sciences and Medicine, Bond University

Badrick, Tony, Chief Execu�ve of The Royal College of Pathologists of Australasia

Lohning, Anna, Assistant Professor, Health Science and Medicine, Bond University

Background

Prostate Specific-An�gen (PSA) tes�ng for prostate cancer screening has been debated for decades due to conflic�ng views and research on the harms and benefits trade-off. This study aims to systema�cally review the clinical u�lity of PSA by looking at the PSA test from an economic, physician and pa�ent viewpoint.

Methods

The design of this review followed the PRISMA guidelines, and databases such as PubMed and Google Scholar were used to iden�fy studies. These studies were then appraised using the MMAT. From the database search, 1062 papers were found, and a�er abstract and full-text ar�cles were reviewed, 26 ar�cles met the inclusion criteria.

Results

Results broadly explored cost-effec�veness analysis and psychological pa�ent effects, while only a small propor�on focused on impacts on the physician. Cost-effec�veness analysis through mainly simula�on studies reflected the struggle in determining the balance between cost savings and maximisa�on of quality of life for pa�ents. There were discrepancies and difficul�es in comparing different study designs and economies to conclude on a single most effec�ve screening program. The psychological struggle with diagnos�c uncertainty and paternalism was evident in the effects on physicians. Results yielded only a few studies on the physical impacts but instead explored the prevalence of anxiety induced by PSA tes�ng. While there were again conflic�ng results, most studies showed negligible anxiety caused by PSA screening.

Conclusion

Screening has been shown to have some more favourable use regarding reduced pa�ent effects. Future studies should explore cost-u�lity analysis to determine an effec�ve screening program.

IG7: Inves�ga�ng the perspec�ve of carers of suicidal children that received suicidal interven�ons: A systema�c review

Erlich, Ferrell, 5th Year Medical student, Health Sciences and Medicine, Bond University

Ponraj, Karthikeyan, 5th Year Medical student, Health Sciences and Medicine, Bond University

Branjerdporn, Grace, Clinician, Gold Coast University Hospital.

Woerwag-Mehta, Sabine, Clinician, Gold Coast University Hospital, Introduc�on/Background

Suicide is the leading cause of death in people aged 15-44 years old in Australia. Inves�ga�on into suicide preven�on interven�ons for children is paramount to ameliorate the risk of suicide. Incorpora�ng carers when children present with suicidal atempts has shown to be beneficial, however, further research is required to synthesise and summarise this evidence. This is the first systema�c review that aims to examine the carer’s perspec�ve of suicidal children that received suicidal interven�ons, with specific focus on the challenges faced by carers in suppor�ng suicidal children and iden�fying effec�ve interven�ons.

Methods

Following PRISMA methodology, databases were searched for relevant publica�ons by abstract and �tle, then full text by two independent reviewers. A total of 13 ar�cles with heterogeneous methodologies were included.

Results

The literature supports that carers are quintessen�al in the management of suicidal children but also suffer a great burden with having to accommodate for these children. This was most evident with a vast majority of suicidal interven�ons u�lising family-based therapy in both suppor�ng the child and the carers. O�en the a�tude of carers towards suicidal interven�ons correlated with the child’s compliance with therapy.

Conclusion

Many of the significant findings dis�lled from the literature are closely aligned with exis�ng strategic frameworks for mental health service provision. However, in review of these frameworks, gaps in literature become more apparent, for instance the lack of rigorous study designs such as random controlled trials, very limited incorpora�on of input from consumers (e.g. carers and pa�ents) on study design, and non-standardised sta�s�cal analysis across studies.

IG8: Systema�c review of educa�onal training provided to healthcare professionals assessing and managing pa�ents with ea�ng disorders

Sardinha, Stephanie, 5th Year Medical student, Health Sciences and Medicine, Bond University

Branjerdporn, Grace, Gold Coast University Hospital

Woerwag-Mehta, Sabine, Gold Coast University Hospital

Background

Ea�ng disorders (ED) are poten�ally life-threatening mental illnesses; many mental health clinicians have limited knowledge and understanding. Con�nuing educa�on is pivotal in ensuring that health prac��oners keep up to date with evidence-based prac�ces. 1

The aim of this systema�c review is to (1) synthesise and summarise the level of educa�on provided about ED to healthcare workers and (2) analyse the effec�veness of these educa�on modali�es

Methodology

Databases (e.g. CINAHL, PubMed, PsychInfo, Scopus, Web of Science) were searched systema�cally using a search strategy comprising of concepts related to ea�ng disorders, educa�on and health professionals. Covidence was used for �tle and abstract screening, full text review and data extrac�on. QuADS assessment tool was used for quality appraisal. 2

Results

Low levels of confidence was reported consistently across all studies, o�en due to lack of clinical guidelines, formal training and clinical exposure. Studies also reported low levels of knowledge across health disciplines, with the excep�on of those who specialise in ea�ng disorders. Three studies evaluated the improvement in knowledge and skills a�er comple�on of an educa�onal modality, with interprofessional educa�on and online training found to be helpful.

Conclusions

Results indicate that there are low levels of confidence and knowledge that warrant increased training on this topic. Scant research has explored the effec�veness of ED educa�on modali�es. Further research is required to examine the poten�al effec�veness of novel educa�onal modali�es, such as simula�on and virtual reality, to support greater knowledge and improved prac�cal clinical skills to manage ED.

IG9: Facilitators and Barriers to Medical Students Seeking Help for Mental Health: A Rapid Review

Leong, Gregory M., 5th year Medical Student, Health Sciences and Medicine, Bond University

Craig, Belinda, Assistant Professor, Health Sciences and Medicine, Bond University

Objective

Medical students encounter substantial stress and are at a heightened risk for various mental health issues, including anxiety, depression, and burnout. The aim of this rapid review is to identify and provide a contemporary understanding of factors influencing medical students' help-seeking behaviours concerning mental health.

Methods

Facilitators and barriers to mental health help-seeking in medical students in three databases: PubMed, PsychINFO and Cinahl. Inclusion criteria comprised empirical research data from all medical school phases and factors influencing medical students' hesitancy to seek mental health support. Qualitative and quantitative studies were included. The search produced 361 articles and 38 articles were included in the final review.

Results

Results showed an interplay of several elements which contribute to the barriers and facilitators to help-seeking, namely, personal attitudes and perceptions, institutional factors, stigma, cultural influences, and knowledge gaps. Help-seeking behaviour is driven by personal experiences concerning mental health, cultural norms and perceived barriers. Key barriers identified were gender, mental health stigma 1; concerns about confidentiality and repercussions on career progression 2; lack of time due to academic pressures; and inadequate awareness of available or level of complexity in navigating support resources. Facilitators included: transparency about mental health; accessible and confidential support services. 3

Conclusion

While the medical education environment can pose challenges to students' mental health, identifying specific barriers and facilitators to seeking help can inform tailored interventions. Results suggest that help-seeking barriers are largely intrinsic in nature. Medical institutions must proactively address these challenges and foster a supportive culture of inclusivity, resilience, and psychoeducation to ensure well-being.

IG10: A Rapid Review on the Facilitators and Barriers to Medical Students Seeking Help for their Mental Health

Wijesekera, Naduni, 5th Year Medical student, Health Sciences and Medicine, Bond University

Craig, Belinda (Supervisor), Assistant Professor of Psychology, Health Sciences and Medicine, Bond University

Forrest, Kirsty (Bond Co-supervisor), Dean of Medicine, Health Sciences and Medicine, Bond University

Background

Mental health disorders have become a prevailing global issue. Existing evidence highlights that medical students are particularly susceptible to poor mental health outcomes due to the arduous and intense nature of medical school. In spite of this, their help-seeking behaviours remain incommensurate with their mental health needs. The accessibility of mental health

services is influenced by numerous factors. Thus, this review aims to establish the facilitators and barriers to medical students seeking help for their mental health.

Method

Rapid search of the literature was undertaken using PubMed and CINAHL databases. One reviewer independently conducted title/abstract screening, assessed full texts of eligible studies and quality appraised each study using the Mixed Methods Appraisal Tool (MMAT v2018).

Results

From 301 citations, nine publications met the inclusion criteria. The included studies were published within the last five years. Four studies addressed barriers to help seeking, four addressed both facilitators and barriers and one focused primarily on facilitators. The results revealed that the most common barriers to help-seeking was stigma, negative career implications, time limitations and financial constraints. Conversely, the presence of depressive symptoms, social encouragement and mentorship appeared to be facilitating factors that may promote mental healthcare access in medical students.

Conclusion

Understanding these factors is imperative in developing appropriate strategies, interventions and support systems that can effectively inspire students to seek the necessary help for their mental health concerns.

IG11: Down Syndrome: Inclusive Communica�on

Khalil, Mark 5th Year Medical Student, Health Sciences and Medicine, Bond University

Jones, Cindy, Associate Professor, Health Sciences and Medicine, Bond University

Mathews, Richard, Associate Professor, Health Science and Medicine, Bond University

Introduc�on

Down Syndrome is a prevailing condi�on in Australia and worldwide, challenging healthcare providers and communica�on norms. Overcoming barriers in pa�ent interac�on is crucial for their well-being. Inadequate prior exposure to Down Syndrome pa�ents contributes to deficient communica�on skills, s�gma�za�on, and nega�ve percep�ons. Improved communica�on strategies and awareness within healthcare se�ngs are pivotal.

Aims

This study endeavours to illustrate that shared experiences can positively impact these attitudes. Through a pre-post quasi-experiment, online surveys were conducted before and after a Down Syndrome Association (DSA) workshop, assessing demographic shifts and attitudes toward Down Syndrome scenarios. Bond Qualtrics and SPSS aided data analysis. Positive changes emerged post-intervention, with reduced belief in supernatural and biomedical causes. The DSA ambassador's workshop ameliorated attitudes, highlighting communication barriers and suitable language. Participants shifted from stigmatization to acceptance, fostering information-seeking mindsets.

Though constrained by sample size and self-reporting, the study's design and medical student sample offered insightful outcomes. Future research and workshops should address educational gaps, enhancing Down syndrome patient care across healthcare settings, encompassing medical errors, social dynamics, and psychological challenges. This comprehensive approach would foster a more inclusive and supportive healthcare environment.

Conclusion

In conclusion, Down Syndrome's impact on healthcare necessitates enhanced communication and awareness. Shared experiences, exemplified by the DSA workshop, display potential in transforming attitudes, promoting inclusivity, and refining patient care practices.

IG12: Surgical Management of Gastroschisis on the Gold Coast from 2013 to 2022

Isaac, Daniel, 5th Year Medical student, Health Sciences and Medicine, Bond University

Short, Melissa, Paediatric Surgeon, Gold Coast University Hospital

Jones, Peter, Professor of Paediatrics, Faculty of Health Sciences and Medicine, Bond University

Background

Information on the aetiology and management of gastroschisis in Queensland is very limited. This study aims to describe the contemporary management of gastroschisis in Gold Coast, Queensland, Australia.

Methods

A retrospective clinical audit was conducted of cases of Gastroschisis seen at Gold Coast University Hospital, between October 2013 and January 2022. These were stratified into simple and complex gastroschisis.

Results

Data was received for 46 cases. 42 of these (91%) had simple gastroschisis while 4 of these had complex gastroschisis (9%). With regards to complex gastroschisis, outcomes were mostly not significant compared to simple gastroschisis, most likely due to the low number of cases. However complex gastroschisis was associated with an increased length of stay (p=0.003). In simple gastroschisis, 18 underwent a staged reduction with the use of a preformed silo, 6 underwent operative primary closure and 1 was managed with a prosthetic patch. For 16 the management is not known.

Conclusions

This study describes the management of gastroschisis at Gold Coast University Hospital. Further state-wide data is needed to provide data which is more valid and generalisable to the Queensland popula�ons. Further study is needed to assess the effect of choice of opera�ve management on length of stay and need for reopera�on.

IG13: Maternal risk factors and infant characteris�cs associated with simple and complex gastroschisis

Kay, Brandon, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Short, Melissa, Supervisor, Gold Coast University Hospital

Jones, Peter, Supervisor, Health Sciences and Medicine, Bond University

Background

Gastroschisis is a rare but increasingly prevalent birth defect that has garnered significant aten�on in recent years due to its rising incidence. The aim of this study was to explore the associa�ons between maternal factors and infant characteris�cs to the occurrence of complex gastroschisis cases.

Methods

We conducted a cohort study on cases at the Gold Coast University Hospital between January 2014 and January 2022.

Results

Forty-six cases of gastroschisis were iden�fied and classified into simple and complex gastroschisis. Twenty-six infants (57%) had simple gastroschisis; 4 (8.5%) infants had complex gastroschisis and for 16 (34.5%) infants the type of gastroschisis was unknown. Of the fortysix cases of gastroschisis there was a significant correla�on between infants with complex gastroschisis and a lower maternal body weight at booking OR 0.97 (95% CI, 0.955-0.989) and lower maternal age OR 0.92 (95% CI, 0.88-0.97). Addi�onally, there was a correla�on with mul�parity and a decrease in likelihood of complex gastroschisis OR, 0.31 (95% CI, 0.100.92). Infants with complex gastroschisis were significantly more likely to have non-bowel herniated contents OR 0.071 (95% CI, 0.009-0.543), weigh less than 2500g OR 0.13 (CI 95%, 0.030-0.58) or be born preterm OR 0.17 (95% CI, 0.049 – 0.57).

Conclusions

In conclusion, maternal weight, age and mul�parity were independent protec�ve factors for complex gastroschisis pregnancies. Infant prematurity and low birth weight were associated with an increased risk of complex gastroschisis.

IG14: A retrospec�ve cohort study of paediatric ea�ng disorder outcomes 0-18 months post-discharge following inpa�ent parent-focused feeding support

Ni, Michael, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Milosavljevic, Milica, 5th Year Medical Student, Health Sciences and Medicine, Bond University

Larcombe, Penny, Staff Specialist Paediatrician, Gold Coast University Hospital

Craig, Belinda, Assistant Professor, Health Sciences and Medicine, Bond University

Introduction/Background

Maudsley’s family-based therapy (FBT) is currently best practice of treatment for adolescents with eating disorders (ED) and has been used to great success in an outpatient setting. It is well known that the highest risk of readmission is within the first few months of discharge and that this wait between discharge and outpatient FBT can be very detrimental. To improve patient outcomes a new model of care (MOC) was implemented with a ‘phase 0’ stage to prepare caregivers for FBT. The primary outcomes for this study were LOS and readmissions over an 18-month period. The secondary outcome was the impact of ED severity on outcomes.

Methods

Patients admitted to the GCUH paediatric ward from 2019 to 2021 (n=78) with an ED and malnutrition were treated with a new MOC. These patients' outcomes were monitored over a two-year follow-up period and were compared to a similar pre-intervention cohort (n=54) admitted to GCUH from 2017 to 2019.

Results

Mild severity patients had significantly fewer readmissions at 0.0556 vs 0.5278 (t = 2.504, p=0.014) and a reduction of LOS of 14 days (t(124)= 2.7473, p = 0.007). There was a decrease in LOS and readmissions across all time points for patients with moderate and severe malnutrition, but it was not statistically significant.

Conclusions

These findings demonstrate the promising medium-term benefits of phase zero inpatient FBT, but more research is needed to target different patient demographics and increase the power of the study.

IG15: Prescribing of Semaglu�de for Weight Management within the Ins�tute for Urban Indigenous Health

Buterfield, Andrew, 5th Year Medical student, Health Sciences and Medicine, Bond University

Mills, Richard, senior GP, IUIH

Dunn, Paul, Assistant Professor – Founda�on Science, Medicine, MD Academic Coordinator, Bond University

Hoy, Mathew, clinic pharmacist, IUIH

Yung, Doris, die�cian, IUIH

Background

Obesity is a global health crisis associated with chronic diseases. Semaglu�de, a glucagon-like pep�de 1 receptor agonist (GLP-1A) is currently approved for the treatment of type 2 diabetes mellitus but holds promise in facilita�ng weight loss. This study aims to review how semaglu�de is being implemented within the Ins�tute for Urban Indigenous Health (IUIH) for weight control among Indigenous communi�es.

Methods

A literature review was performed to explore semaglu�de’s efficacy in facilita�ng weight loss. Clinical data from IUIH iden�fied semaglu�de-prescribed pa�ents and their demographics were recorded. Prescribing clinicians were iden�fied, and a ques�onnaire was developed to interview prescribers based on prescrip�on frequencies. Interviews were interpreted and recommenda�ons were formulated to op�mise GLP-1A prescribing within IUIH.

Results

Demographic analyses revealed clients' broad age distribu�on and varying degrees of obesity. Prac��oners endorsed GLP1-As for weight loss, mul�disciplinary interven�ons, and pa�ent mo�va�on. Strategies to manage adverse effects were discussed and prac��oners expressed commitment to semaglu�de despite supply shortages.

Discussion/Conclusion

Prac��oners demonstrated varying approaches and strategies. Clients' prevalence of obesity highlighted the necessity for weight management. Prac��oners endorsed GLP1-As for weight loss, priori�sing customisa�on, regular follow-ups, and mul�disciplinary interven�ons. Recommenda�ons, including tailored guidelines and enhanced educa�on, emerged from the study. However, limita�ons encompassed the absence of a comparison group and poten�al pa�ent diversity. Semaglu�de presents a promising interven�on for weight management in Indigenous communi�es. Tailoring prescribing prac�ces and ensuring comprehensive pa�ent support is essen�al to harness its poten�al. This study contributes to op�mizing semaglu�de's use as part of a mul�disciplinary approach to combat obesity and associated health risks within IUIH.

IG16: Nature based therapy for health professionals

Jaishankar, Ashwini, 5th Year Medical student, Health Sciences and Medicine, Bond University

Mackenzie-Shalders, Kristen, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University

Bishop, Jo, Associate Dean, Faculty of Health Sciences and Medicine, Bond University

Background

Nature based therapy (NBT) shows promise for enhancing well-being and overall health. Yet, research on NBT for health professionals remains limited. Exploring its use for this group is crucial due to their unique challenges, including high rates of psychological distress and demanding lifestyles.

Methods

This study employed an autoethnographic approach, consistent with Susan O’Hara’s approach. A ter�ary medical student’s firsthand experiences with NBT were recorded and analysed thema�cally using Braune and Clark's approach.

Results

An overarching theme of posi�vity emerged, with four interconnected themes: restora�on, feelings and responses, connec�on, and strength as benefits of NBT to health professionals.

Conclusion

The framework reflects an individual's experience with the benefits of NBT with considera�on of its applica�on to broader health professions. It explored the importance of personalised nature-based therapy approaches and supports need for further research to explore applicability and impact of NBT for healthcare professionals.

IG17: Fever management and poten�al tradi�onal an�pyre�c op�ons for febrile

children: Narra�ve literature review

Cronin, Amelia 5th Year Medical Student, Health Sciences and Medicine, Bond University

Huang, Wilson 5th Year Medical Student, Health Sciences and Medicine, Bond University

Le Plastrier, Kieran, Assistant Professor, Health Sciences and Medicine, Bond University

Smith, Jane, Associate Professor, Health Sciences and Medicine, Bond University

Background

Fever is a common paediatric presenta�on to the general prac��oner. While fever may provide some benefits to immunity, complica�ons such as febrile convulsions and discomfort experienced by pa�ents leads to carer anxiety. In Australia, fever is o�en treated with paracetamol and non-steroidal an�-inflammatory drugs which come with complica�ons and side effects like hepatotoxicity and renal insufficiency. These concerns have raised interest in inves�ga�ng alterna�ve an�pyre�c op�ons, such as tradi�onal medicines.

Aim

Inves�gate the current use and efficacy of tradi�onal medicines in order to establish a basis of future research for paediatric fevers which provides carers alterna�ves to conven�onal an�pyre�c medica�ons.

Method

A literature review examining the efficacy, safety and cons�tuents of tradi�onal medicines most commonly being used as an�pyre�cs was performed. PubMed and Embase databases were searched, and papers were included and excluded based on criteria described in search methods.

Result

The search revealed that tradi�onal medicines are being used extensively as an�pyre�cs worldwide. Most notable were: Prasachandaeng (PSD), Ben-Cha-Moon-Yai (BMY) and

Drymaria Cordata (DC). All results suggest they have a significant (P<0.05) an�pyre�c effect, and that PSD is less hepatotoxic than paracetamol.

Conclusion

Results suggested the an�pyre�c proper�es of PSD, BMY and DC are likely to work through currently understood mechanisms of fever pathogenesis. The researched is limited by only including English studies. Further research is required to inves�gate the outcomes in human trials before their true efficacy and safety is established. Furthermore, cul�va�on and sustainability of these tradi�onal medicines need to be inves�gated before recommending use by medical prac��oners in Australia.

IG18: The ‘Neglected Art of Fundoscopy’: a Scoping Review of Ophthalmic Teaching in Medical Curriculum

Kroger, A , 5th Year Medical Student, Faculty of Health Sciences and Medicine, Bond University

Lehman, Kirk, 5th Year Medical Student, Faculty of Health Sciences and Medicine, Bond University

Moro, C, Associate Professor, Faculty of Health Sciences and Medicine, Bond University

Background and objec�ves

A scoping review was performed, examining ophthalmoscopy in medical training to answer the following ques�on: The ‘art of fundoscopy’ is being forgoten: how should the next genera�on of medical students be learning this essen�al medical skill?

Methods

The inclusion criteria and search strategy, including search terms, were uploaded to Open Science Framework (htps://doi.org/10.17605/OSF.IO/RNFSV), confined to ar�cles from incep�on of database to present day (February 2023), only studies in English and those involving ter�ary medical students and junior doctors (not specialists, allied health or optometry professionals), published as abstracts and full-text worldwide. The review utlised the PubMed, EMBASE and ERIC databases.

Results

38 studies were included. Nine studies applied fundal matching techniques. Seven examined the use of mobile devices for ophthalmoscopy skill acquisi�on. Eight utlised tradi�onal or online assessment tools. Three examined improvements in self-confidence with general scope prac�ce. Eleven employed virtual reality tools. The results of the review suggest that regardless of the format, the interven�ons consistently achieved enhanced post-interven�on scores.

Conclusion

It is evident from the available evidence that medical schools must modernize their curricula to ensure that medical students receive adequate training to diagnose and treat ophthalmic condi�ons and provides evidence for the effec�veness of various novel teaching methods. While tradi�onal direct scope prac�ce should be incorporated in all training, it has been shown that online modules, virtual reality simula�ons (digital or physical models), or mobile device prac�ce greatly augment performance. However, further research is needed to evaluate the efficacy of different teaching methods in teaching ophthalmoscopy.

ALPHABETICAL PRESENTERS INDEX

Abdallah, Abdallah, 64

Abdeen, Sabriya, 55

Abukmail, Eman, 65

Alam, Sarita, 68

Anoop, Ananya, 12

Arma�, Charlote, 11

Aroney, Emeil, 64

Arora, Rahul, 32

Aziz, Aliah, 55

Balaji, Nikhil, 74

Belt, Hollie, 55

Bills, Lillian, 62

Bodepudi, Praneethganesh, 66

Boyce, Lachlan, 11

Burovski, Eriq, 51

Burton, Tehlia, 32

Buterfield, Andrew, 81

Canning, Lauren, 60

Carter, Lucy, 35

Casagrande, Renee, 23

Chadha, Navya, 64

Chahal, Harpreet, 24

Chen, Beiling, 55

Chen, Jayann, 72

Comb, Sara, 23

Cronin, Amelia, 82

Darnell, Madison, 43

Davidson, Isabella, 40

Davis, Eleanor, 52

De Silva, Lashan, 61

De’Ambrosis, Isabella, 29

Dhaliwal, Sonu, 55

Do, Victor, 48

Doss, Shibi, 18

Duton, Alain, 62

Edirisinghe, Vinuri, 23

Ekdawi, Mina, 42

Eriq Burovski, 51

Erlich, Ferrell, 75

Feroz, Shania, 69

Gadgil, Aditya, 34

Garg, Ri�ka, 33

Gazibegovic, Natalia, 70

Giuffrida Damian, 51

Gorcilov, James, 62

Gunda, Radhika, 12

Haris, Fondas, 25

Henderson, Jasmine, 31

Hensen, Isabella, 48

Huang, Wilson, 82

Hudson, Carly, 58

Hun�ngton, River, 27

Ilanko, Swathi, 55

Isaac, Daniel, 79

Jaishankar, Ashwini, 81

Jaiswal, Pooja, 28

Karpin, Tiffany, 26

Kataria, Navya, 69

Kaushal, Aditya, 72

Kay, Brandon, 79

Kaya, Nivan, 30

Ketheesan, Yathurshika, 15

Khagram, Sheetal, 18

Khalil, Mark, 78

Kinloch, Hope, 72

Koong, Danielle, 57

Kroger, A, 83

La, Tai, 74

Layt, William, 11

Lee, Jordan, 31

Lehman, Kirk, 83

Leong, Gregory M , 77

Lewis, Tynan, 58

Louw, Dominique, 56

Madas, Vamshi, 34

Maharaj, Nikhil, 74

Maini, Kushagar, 49

Malhotra,Tanishk, 47

Malik, Italia, 35

Mansoor, Mathew, 46

Mayooran, Seraman, 49

Melkonian, Wyat, 60

Menon, Gowri, 71

Menon, Sanjana, 36

Mia, Parsha, 57

Michael Tijono, Joanne, 61

Mikhail, Mirabel, 37

Milosavljevic, Milica, 80

Modhia, Gunj, 55

Morahan, Anastasia, 53

Movshovich, Jason, 67

Nagy, Grace, 27

Natsioulas, Elena, 53

Nedunchezhian, Vikram, 66

Nguyen, Chi Jus�n Hong, 20

Nguyen, Mai, 63

Ni, Michael, 80

Nigam, Avik, 20

Nikos, Dimitrios, 64

Nitchingham, Rohan, 15

Odish, Dana, 12

Page-Stephens, Solange, 16

Paliwal, Sushank, 58

Panos, Dean, 44

Patel, Aayush, 40

Patel, Kush A, 45

Patel, Marissa, 42

Patel, Riya, 46

Pathirana, Nuvin, 68

Pearcy, Joshua, 21

Pei, Helen, 26

Penwarn, Braiden, 46

Ponraj, Karthikeyan, 75

Powell, Chelsea, 16

Quinn, Emily, 39

Rahim, Ahmed, 72

Rattan, Ritwik, 64

Razkala, John, 22

Reeves, Meg, 26

Rehman, Arham, 49

Roworth, Dominic, 61

Sachidanandan, Hridya, 13

Saeed, Antony, 33

Sardinha, Stephanie, 76

Saweris, Mary, 35

Sedara, Kate, 30

Sharma, Raghav, 73

Sidhu, Sherhan, 67

Simjanovski, Dimitrij, 38

Singh, Gobind Deep, 25

Singh, Shweta, 13

Smith, Jessica, 50

Sodum, Raga, 36

Srinivasan, Haritha, 61

Steinberg, Lilly, 39

Stephens, Juliete, 41

Subhaharan, Kanishaa, 35

Sullivan, Luke, 46

Swart, Taliah, 11

Tan, Andrea, 64

Tan, Zoe, 14

Tang, Jie, 17

Tanishk Malhotra, 47

Tennyson, Charles, 70

Thomas, P., 59

Timalsena, Prajwal, 61

Tipirneni, Sai, 14

Tran, Albertine, 31

Tyagi, Jay, 54

van den Berg, PJ, 22

Vemuru, Ujvala, 47

Walisinghe, Lithira, 62

Wallace, Fraser, 44

Wan, Hui Yin, 38

Weissenberger, Emily, 29

Wijesekera, Naduni, 77

Wu, Isabella, 73

Xiao, Katrina, 30

Yeoh, Alexandra, 69

Zaka, Nida, 27