101Pre-onset sun exposure significantly associated with risk of primary biliary cirrhosis

Background Primary biliary cholangitis (PBC) is an autoimmune destructive condition of the gall bladder, with environmental factors like sun exposure implicated in its aetiology, similar to multiple sclerosis. Using a case-control study design, we assessed sun exposure across the life course prior to PBC diagnosis between PBC cases and age/sex-matched healthy controls. Methods Cases with definite/probable PBC were recruited, these having been identified from a PBC prevalence study. Age/sex matched controls were recruited from the electoral roll or at the Austin Hospital. Pre-onset sun exposure behaviours were queried at baseline by questionnaire and life calendar, this combined with ambient UVR data to estimate total UVR load. Relationships with case status were assessed using conditional logistic regression. Results 200 cases and 200 age/sex-matched controls were recruited. 91% of the cases were female and the mean age was 63.6 years. Increasing sun exposure was associated with significantly lower odds of being a case, robust to adjustment for birthplace, education and smoking, the strongest associations seen for summer exposure in 6-10yo (OR = 0.39), 11-16yo (OR = 0.44), and 16-20yo (OR = 0.47). Similar results were seen for ambient UVR. Conclusions Higher pre-onset sun exposure and UVR load were associated with a decreased risk of primary biliary cholangitis. This is the first study that has examined the environmental risk factors of sun exposure and UV radiation with regard to PBC. Key messages In line with the observation of a significant latitudinal gradient in PBC prevalence, this work shows that pre-onset sun exposure is significantly lower among PBC cases compared to matched controls, suggesting sun exposure has an aetiological relationship with PBC risk.

Vale Kevin Walsh, 1925–2017

Australasian Society for the Study of Brain Impairment (ASSBI) is deeply saddened by the death of Dr Kevin Walsh, at the age of 92, on 4 December 2017. Kevin has been one of the grandfathers of clinical neuropsychology and was the founder of ASSBI. After serving in the RAAF, he completed a medical degree in 1951 and went straight on to pursue his interest in the study of psychology, by completing Bachelor's and Master's degrees. Whilst assisting in psychosurgery, Kevin wrote his Master's thesis on the assessment of the effects of frontal lobe dysfunction, based on his studies of patients undergoing frontal leucotomies in the 1950s, a truly seminal work in elucidating frontal lobe functions. In 1961, he joined the Department of Psychology at the University of Melbourne. He taught neuropsychology and, forging a close collaboration with neurologist, Dr Peter Bladin, he established the first neuropsychology clinic at the Austin Hospital in Melbourne in 1974.

Implementing Scanned Medical Record Systems in Australia

In recent years, influenced by the pervasive power of technology, standards and mandates, Australian hospitals have begun exploring digital forms of keeping this record. The main rationale is the ease of accessing different data sources at the same time by varied staff members. The initial step in this transition was implementation of scanned medical record systems, which converts the paper based records to digitised form, which required process flow redesign and changes to existing modes of work. For maximising the benefits of scanning implementation and to better prepare for the changes, Austin Hospital in the State of Victoria commissioned this research focused on elective admissions area. This structured case study redesigned existing processes that constituted the flow of external patient forms and recommended a set of best practices at the same time highlighting the significance of user participation in maximising the potential benefits anticipated. In the absence of published academic studies focused on Victorian hospitals, this study has become a conduit for other departments in the hospital as well as other hospitals in the incursion.

Austin Health Celebrates Collaboration with Aboriginal People during NAIDOC Week in 2006

Austin Health is one of Victoria's largest health care providers. It is a 950-bed major teaching and research hospital affiliated with the University of Melbourne. Austin Health employs more than 6,500 staff over three sites (the Repatriation Hospital, the Royal Talbot, and the Austin Hospital), and is renowned for providing high quality, comprehensive public health services. These services are provided to a significant number of the Aboriginal and Torres Strait Islander (ATSI) population. Throughout Australia, Aboriginal people are dying at almost three times the rate of other Australians and have a life expectancy 17 years lower than the rest of the population. All State-funded hospitals are required to give special attention to the needs of ATSI people by ensuring services are provided in a culturally appropriate way and meet the needs of ATSI people.