Inside this Issue: Volume 19, Issue 2, June 2009

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1 Volume 19, Issue 2, June 2009 Inside this Issue: Rob Pierce Grant-in-Aid Subcommittee - ERS Report TSANZ Swine Flu Update ASM Awards Branch in the Spotlight: NZ Advanced Trainee Course Report APSR Update

2 Contents Volume 19, Issue 2, June 2009 Inside this Issue: Page Message from the President 3 Rob Pierce Grant-in-Aid 4 Subcommittee - ERS Report 5 TSANZ Swine Flu Update ASM Prize Winners 8 Advanced Trainee Course Report - Darwin 11 Report from the Executive Committee 12 Branch in the Spotlight: New Zealand 13 APSR Update Report 14 Jenny s Corner 15 ALF Update 17 NAC Update 18 Book Review & Calendar of Events 19 Brochures and/or flyers mailed with this newsletter have not been endorsed by the TSANZ unless the Society s logo is displayed. The Thoracic Society of Australia and New Zealand Inc Newsletter 145 Macquarie St, Sydney NSW 2000 Telephone: Fax: Internet:

3 Message from the President, Professor Philip J Thompson Phil Thompson Welcome to our Winter Newsletter, I trust you are all well. A lot has happened in the last three to four months. Christine Jenkins has stepped down as President after two years of working tirelessly on behalf of the Society; our ASM in Darwin was an outstanding success and exposed the Society to some of the important social issues of our time; and Swine Flu is upon us. At our last Executive meeting in May we took an extra half day to look at how we are managing the Society s affairs and also focussed on some of the more strategically important issues for the year ahead. It is anticipated this will become an annual event. Emerging from this half day there were a number of important issues. There was a strong appreciation that the Society s Rules are due for a major review and a subcommittee will be formed to address this in the year ahead, ready for the next AGM. The Special Interest Groups have the potential to add much more to the Society s activities particularly at the grass root level if resourced and empowered appropriately. The Honorary Secretary will now take on the role of liaising with SIGs and she will work with them to develop ways in which the Executive, SIGs and members can gain much more from each other. In future all Executive-SIG related matters will be managed and co-ordinated by the Hon Secretary and the Society s Rules will be changed to reflect the role of SIGs which are currently not catered for. As part of our review of the resources needed to run the Society we have appointed a part time computer and communications expert, Jenny Bridge, and we will be employing a part time Personal Assistant to support the Executive Officer and the President to perform their duties more effectively. David Serisier will head up a group to review our office space and physical resources and produce a discussion document on the merits of the TSANZ owning its own office space or not. In terms of strategic issues for the year ahead: working closer with the RACP, ANZSRS and the ALF and TSANZ branches, indigenous lung health, better co-operation between the various respiratory organisations, the development of a standards of respiratory care document, working within our international region, and better communication both internally within the Society and externally with the broader community were some of the more important issues discussed. Communication is an area the Executive would like to enhance. As well as appointing a new staff member to focus on this, we have also formed a communications subcommittee headed by David Fielding. The subcommittee will primarily address better use of electronic communication and will focus on our website and our communication as well as other areas such as podcasting. As part of this initiative a monthly electronic news sheet is in the wings and hopefully will reach fruition shortly. The quarterly printed newsletter will remain under the auspices of the Office and we have started to enhance this with a new look and greater diversity of content. We welcome your feedback and any ideas you may have on how this can be made better still. At the Executive level the office bearers and the Executive Officer have formed a Management Group to assist communication and to give more immediacy to decision making but not at the expense of the broader Executive being involved in important and relevant issues. We are looking to enhance our communication with SIGs and Branches and in addition Christine Jenkins will be our major communication bridge with the College. We anticipate this becoming an established role for the Immediate Past President. For issues of critical importance we will form specific task forces either reporting to the President/Executive or to other office bearers or to the Standing Subcommittees as is appropriate. We moved quickly to form a Swine Flu task force and I was delighted that Tom Kotsimbos agreed to head up this group. It is important that we keep our membership well informed but it is also important we are visible externally with respect to important respiratory issues. It has been a very busy period for all concerned but particularly for the Executive, its subcommittees and the Office and all have worked well beyond normal hours to support the Society s multiplicity of activities. I look forward to a very productive and stimulating year ahead and enhancing what is a already a very special organisation. Phil Thompson 3

4 Rob Pierce Grant-in-Aid The TSANZ s Executive Committee is please to announce the establishment of a new TSANZ grant-in-aid, to honor the memory of the late Professor Rob Pierce. Prof Pierce died tragically on February 7th 2009, defending his home at St Andrews, Victoria, against the Black Saturday firestorm. Details of the grant-in-aid are as follows: Title: The Robert Pierce Grant-in-aid for indigenous lung health research. This grant-in-aid shall be awarded for a project focused on understanding and improving the lung health of indigenous people in either Australia or New Zealand. It will usually be awarded annually, to a value of $15,000, to enable the recipient to undertake research which addresses lung health in indigenous Australians or New Zealanders. It is expected that this work would result in an abstract submission to the TSANZ Annual Scientific Meeting in the year following its completion. A supplementary travel grant to a value of $2,000 may be awarded under specific circumstances where the research is undertaken in remote or regional communities. Documentation of travel and provision of receipts will be required for this to be considered. The award is open to all members of the TSANZ and aims to promote research into the lung health of indigenous Australians and New Zealanders. Full details of the application process for this award will be published in the September 2009 issue of the TSANZ Newsletter. Donations to support this award are warmly welcomed and will be acknowledged appropriately. Strengthening Insomnia Research - Workshop Mark this date in your diary - 31st July, 2009 The Australasian Sleep Trials Network is hosting the Strengthening Insomnia Research workshop in Sydney on Friday 31st July, The workshop will be held at the Woolcock Institute of Medical Research in Glebe (10am-3pm) and will be facilitated by Professor Dan Buysse from the School of Medicine at the University of Pittsburgh. All interested researchers are welcome. Registration is free and a travel subsidy will be available to all interstate attendees. For further information contact Anthony Williams at:

5 Subcommittee - ERS Report The Education and Research Subcommittee (ERS) is the largest of the of four standing subcommittees of TSANZ, drawing its broad membership from scientists, clinicians, nurses, physiotherapists, advanced trainees and PhD students. The current committee comprises Jane Bourke Dr Jane Bourke Chair, ERS representative on TSANZ Executive and Council Prof John Upham Member, ERS representative on Australian Lung Foundation Council Dr Greg King - Member Dr Suzanne Marsh - Member Dr Melanie Matheson - Member Dr Jodie Simpson - Member Ms Tod Adams - representing Respiratory Nurses Dr Deborah Burton - representing ANZSRS Dr Wai Kuen Chow - representing Advanced Trainees Dr Sandra Chuang representing Paediatric Advanced Trainees Dr Anne Holland representing Physiotherapists A/Prof Adam Jaffe - representing Paediatric SIG Dr Andrew Tai - representing PhD students The ERS undertakes several major tasks for the benefit of TSANZ members. Core business includes initiating educational endeavours and continuing professional development for members through promotion and organisation of educational activities, particularly at the Annual Scientific Meeting (ASM). In addition to providing advice to the Central Programme Subcommittee, ERS members are responsible for the coordination of the Short Course for Advanced Trainees in Respiratory Medicine and the Short Course for Respiratory Research. The Advanced Trainees Course has been under the auspices of the ERS since 2001, with the record number of 70 trainees attending in The convenors, Andrew Tai, Greg King, Suzanne Marsh and Wai Kuen Chow, have provided a report on the Darwin course published elsewhere in this newsletter. This course continues to be well received by attendees and certainly provides a wonderful entre e to the ASM. The most recent Short Course for Respiratory Research, convened by Jane Bourke and Melanie Matheson, was held at the Melbourne ASM in 2008, following earlier courses presented in 2004 and The one-day workshop covered the following topics of interest: How to plan your career academic and research career options How to fund your research - focusing on opportunities for students/early career researchers and building a track record How to do your research focusing on translational research How to present your research at meetings poster and orals The next course will be held at the Brisbane ASM in 2010, with planning already underway by convenors Melanie Matheson and Jodie Simpson to establish a stimulating and relevant curriculum for attendees. Other integral tasks undertaken by the ERS related to the ASM include assessment of abstracts prior to the meeting for consideration for travel awards. In 2009, there were over 50 TSANZ Travel Awards made for the Darwin meeting, reflecting increased access of members to this support, with the salary limit for eligibility raised to NHMRC PSP3 (currently $64,700 AUS). ERS Report continued page 6 5

6 Subcommittee - ERS Report (continued) Abstracts submitted for presentation at the ASM are also eligible for certain international travel awards, as reviewed by ERS members. Some of these awards are for attendance at specific meetings (e.g. TSANZ / Japanese Respiratory Society Early Career Development Award; Slater & Gordon International Mesothelioma Travel Grant), while others offer applicants the opportunity to nominate the most appropriate meeting to present their work or to propose a trip that will more broadly benefit their research (Maurice Blackburn Lawyers International Travel Awards; Peter Phelan Travel Fellowship (Paediatric)). At the Meeting, the ERS interacts with the Special Interest Groups, especially in relationship to the awards for the best presentation from each SIG, and for the Best Poster Prize given to most outstanding contribution to respiratory research, irrespective of discipline, presented as a poster at the ASM. The ERS is also responsible for the shortlisting of abstracts and the judging of the Ann Woolcock Young Investigator Award, made for excellence in the conduct and presentation of scientific research during the recipient's first substantive research project or program. This plenary session provides one of the major highlights of the ASM, with the winner of the Award receiving $1,500, and a Travelling Fellowship to the Annual Scientific Meeting of the Asia-Pacific Society of Respirology (APSR). The other major role of the ERS is to maintain panels of referees for and oversee the review process for the numerous competitive awards of the Society ( azawardslisting.html), with applications closing in late October each year. These awards include prestigious fellowships, namely the Australian Lung Foundation / Boehringer Ingelheim Chronic Obstructive Pulmonary Disease Research Fellowship ($75,000/year for 1 or 2 years) and the TSANZ/Allen & Hanburys Respiratory Research Fellowship ($70,000 for 2 years). Research grants awarded following consideration by the ERS include TSANZ / Allen & Hanburys Paediatric Respiratory Medicine Career Development Grant-in-Aid ($40,000/year for 2 years) and the Australian Lung Foundation / Slater & Gordon Asbestos Research Grant-in-Aid ($30,000). Numerous smaller grants including the Australian Lung Foundation / Ludwig Engel Grant-in-Aid for Physiological Research ($5000) and the TSANZ / Eli Lilly Research Grant-in-Aid (Respiratory Nurses) ($1500), offer additional opportunities for TSANZ members to obtain support for their research activities. In addition to these TSANZ awards, a recent Memorandum of Understanding between TSANZ and the Workers Compensation Dust Diseases Board of New South Wales (DDB) has been established for the ERS to provide independent scientific evaluation of research grant applications submitted to the DDB. The review process has now been completed for this year, and the contribution of numerous TSANZ members external to the ERS for their expert evaluation in addition to the work of Committee members is acknowledged here. In summary, the ERS contributes to TSANZ through their co-ordination of educational activities at the ASM and through reviewing the numerous fellowships, grants and awards available to members. I have no doubt that the support for advanced trainees and researchers through the Short Courses will continue, and it is to be hoped that the levels of funding can be maintained to support career development and research endeavours of TSANZ members. As Chair of ERS for 2009/10, I would like to acknowledge the contribution of the other members of this hardworking committee and would welcome any suggestions from TSANZ members on how the ERS can further support their professional development in respiratory medicine and research Jane Bourke ERS Chair

7 TSANZ Swine Flu Update I decided that we needed to establish a TSANZ task force for H1N1 influenza 09 (Human Swine Influenza) to provide the TSANZ membership with timely and accurate advice regarding Human Swine Influenza and to provide a ready response team to represent the Society and its membership in all matters relating to Human Swine Influenza, including dealing with other professional organisations, arms of government, the media and the general community. Relevant information has been sent to members and is posted on our website. The task force members are Tom Kotsimbos (chair), Christine Jenkins, Grant Waterer, Simon Bowler, Graeme Maguire, Louis Irving, Richard Wood-Baker, Mark Holmes, Stephen Brady and Bob Hancox**. The Task Force has provided below their current summary of the situation and will also be publishing a very thorough overview of Swine Flu, written in conjunction with the Australasian Society for Infectious Diseases in the MJA. Phil Thompson Current Status Report: June 5th, 2009 Tom Kotsimbos Chair Swine Flu Task Force 1. The TSANZ continues to closely monitor local and global developments regarding the novel Influenza virus - H1N1 influenza 09 (Human Swine Influenza) as they occur. 2. Since the outbreak of H1N1 influenza 09 (Human Swine Influenza) was first identified there have been 882 confirmed cases identified in Australia (as of 05/06/09) with 752 cases occurring in Victoria, 74 cases in NSW, 32 cases in QLD, 9 cases in SA, 5 cases in Tas, 5 cases in ACT, 3 cases in the NT and 2 cases in WA. Over the last week there has been a significant increase in case numbers particularly in Victoria with increasing community transmission including in schools, relatively few hospitalisations and some cases in health care workers reflecting the increased community case load. 3. At a global level WHO has confirmed 62 countries have officially reported 19,273 cases of Human Swine Influenza with 117 deaths (97 from Mexico and 17 from the USA). In keeping with the widespread community transmission of this virus around the world we are now in WHO Pandemic stage 5. This staging system is largely a function of spreadability of a novel Influenza virus as compared to its severity. 4. On the 22nd May Australia moved their pandemic response phase from delay to contain. In keeping with the epidemiological pattern of H1N1 09 spread across Australia, the pandemic response phase in Victoria has moved from contain to modified sustain on 3rd June whereas the response in the remainder of Australia remains unchanged. Changing from contain to sustain signals a change in focus from extensive testing of all Influenza Like Illness (ILI) with a positive travel/contact history, treating all cases, contact tracing and prophylaxis to prevent transmission to testing selected ILI cases, treating severe cases, limited contact tracing and prophylaxis to protect at risk household members. 5. Despite the increasing number of cases, the clinical profile of Human Swine Influenza remains similar to seasonal influenza. The vast majority of Human Swine Influenza cases continue to be relatively mild and the relatively few deaths and cases requiring hospitalisation globally have been generally associated with co-morbidities including asthma, chronic cardiorespiratory disease, diabetes as well as pregnancy and infancy. Specific TSANZ Issues 6. As community transmission of Human Swine Influenza continues to widen during Australia and New Zealand s winter season then the case definition will generally default to any influenza-like illness which of course has significant clinical and logistic implications. 7. The interaction between Influenza and Respiratory disease can occur at many levels including the full spectrum of respiratory viral syndromes, community and hospital acquired pneumonia syndromes, acute exacerbations of asthma and COPD and destabilisation of patients with Cystic Fibrosis, Idiopathic Pulmonary Fibrosis and Lung Transplant Recipients. Patients with respiratory disease are a major at risk group for Influenza and its complications. 8. All at risk groups and health care workers should minimise both their exposure risk to ILI and their Influenza transmission potential as much as possible by adhering to current infection control guidelines and be offered Oseltamavir for treatment or post-exposure prophylaxis as soon as possible. 9. As always during our influenza season, all severe community-acquired pneumonia cases requiring hospitalisation will need to be considered for anti-viral treatment for influenza and similarly all influenza-like illnesses associated with pneumonia will require specific attention to appropriate antibacterial treatment including antibiotics to cover pneumococcus, staphylococcus and atypical bacteria in relatively healthy hosts (these will need to be broadened to cover a wider range of potential bacterial super infections in at risk hosts). In addition, viral exacerbations of underlying cardiorespiratory disease including asthma and COPD will need to be considered for anti-viral treatment on a case-by-case basis. 10. It is suggested that nebuliser treatments in patients with respiratory disease requires a risk stratified approach in the first instance. Specifically, those patients with influenza symptoms or unidentified febrile respiratory illness should use spacers if required and avoid nebulisers. Where this is not practical / possible, the nebuliser should be used in a well ventilated space, with 0.8m minimum distance between beds designed to minimise both staff and patient exposure. Nebulised antibiotics in those with bronchiectasis should be withheld and IV preparations used for respiratory virus associated exacerbations until found to be clear of H1N Swine Flu Virus 11. Other respiratory invasive procedures (suction, intubation, positive pressure ventilation) were associated with significant risk of increased transmission of SARS, and should be undertaken with maximum precautions for infection control to minimise droplet and aerosol transmission of virus. 12. Human Swine Influenza (H1N1 09) has a higher transmission rate (secondary attack rate 22 30%) than seasonal flu (usually 5 15%) at present. It is not known whether this is due to low immunity in the community or specific virulence characteristics of the virus. 13. Although the initial information on the severity of the symptoms of Human Swine Influenza has suggested that the illness is relatively mild, it remains possible that the virus may mutate during the year and become more virulent. Therefore, there needs to be ongoing monitoring of HIN1 09 associated severe respiratory complications particularly during our current southern hemisphere influenza season. Continued Page 16 7


9 ASM Awards (continued) TSANZ Best Presentation on Interventional Pulmonology Dr Dien Dang TP122 FLEXIBLE FIBEROPTIC BRONCHOSCOPIC PROCEDURES AND PROCEDURALIST-ADMINISTERED SEDATION REMAINS SAFE Respiratory Nurses Special Interests Group Prize Best Poster TSANZ & Eli Lilly Best Presentation on Lung Cancer Ms Morgan Davidson TO 022 IDENTIFICATION OF ABERRANT MICRORNAS IN LUNG CANCER Best Presentation on Occupational and Environmental Lung Disease Dr Graeme Zosky TP139 IN UTERO EXPOSURE TO ARSENIC VIA DRINKING WATER ALTERS POST-NATAL LUNG FUNCTION Best Presentation on OLIV* Orphan Lung Disease / Lung Transplantation / Interstitial Lung Disease / Pulmonary Vascular Disease Dr Monique Malouf TO 057 RAD IN UIP: 3-YEAR RESULTS OF A MULTICENTRE, INVESTIGATOR DRIVEN, RANDOMISED DOUBLE BLIND, PLACEBO CONTROLLED STUDY OF RAD IN SURGICAL LUNG BIOPSY PROVEN UIP Best Presentation on Paediatrics Dr Andrew Wilson TP182 RESPIRATORY SYMPTOMS IN THE FIRST 3 YEARS OF LIFE IN EXPREMATURE INFANTS AND CHILDREN Best Presentation on Physiotherapy Ms Melissa Argent TP209 AN INSPIRED FUTURE THE WORKINGS OF A RESPIRATORY HIGH DEPENDENCY UNIT Respiratory Nurses Special Interests Group Prize Best Oral Presentation Trish Leisfield TO 007 RECOGNISING THE NEED FOR AGE APPROPRIATE INFORMATION FOR CHILDREN WHOSE PARENTS ARE UNDERGOING LUNG TRANSPLANTATION Best Presentation on Sleep & Physiology Jason Amatoury TP215 PERI-PHARYNGEAL TISSUE MOVEMENT WITH TRACHEAL TRACTION Tobacco Control Special Interests Group Prize Michelle Hansen TO 069 THE PROLONGED EFFECTS OF CIGARETTE SMOKE EXPOSURE ON LUNG INFLAMMATION AND SKELETAL MUSCLE WASTING IN MICE TSANZ 2009 Travel Awards Mrs Robin Fowler TO 025 EXERCISE INDUCED PULMONARY ARTERIAL HYPERTENSION IS CLINICALLY IMPORTANT Best Presentation on Primary Care David Currow TO 076 PALLIATIVE OXYGEN VERSUS MEDICAL AIR FOR RELIEF OF DYSPNEA: AN INTERNATIONAL, RANDOMIZED CONTROLLED TRIAL Best Presentation on Respiratory Infectious Diseases Evan Tovey TO 040 RESPIRATORY VIRUSES ARE AEROSOLISED BY BREATHING Dr Jessica Ahern Mr Hatem Alkhouri Dr Katherine Baines Mrs Svetlana Baltic Mr Balarka Banerjee Mrs Anna Berkelmans Mr Luke Berry Mrs Helen Cameron-Tucker Ms Jamie Chan Dr Jin-Gun Cho Ms Chantale Diba Mr Michael Djukic Miss Ama-Tawiah Essilfie Miss Clara Foo Miss Rachel Foong Dr Catherine Gangell Mr Luke Garratt Ms Qi Ge Ms Dianne Goeman Mr Alan Hsu Miss Robyn Jones Miss Rangi Kandane Ms Shenna Langenbach Dr Alexander Larcombe Ms Melanie Manetsch Ms Rosemary Moore Dr Vanessa Murphy Miss Rebecca Oldham Miss Kristy Parsons Dr Naveen Pillatisetti Ms Heather Powell Ms Heidi Schilter Miss Jessica Siegle Mr Sukhwinder Singh Sohal Dr Amir Soltani Dr AndrewTai Mr Xiahui Tan Miss Alison Thorburn Mrs Maureen Vergeggen Dr Jonathan Williamson Miss Casey Wright Dr Wei Xia Dr Graeme Zosky 9

10 ASM Awards (continued) Australian Lung Foundation Awards Australian Lung Foundation / Boehringer Ingelheim Chronic Obstructive Pulmonary Disease Research Fellowship Australian Lung Foundation / Slater & Gordon Asbestos Research Grant-in-Aid Dr Ben Harris THE EFFECTS OF TIOTROPIUM ON THE DISTRIBUTION OF VENTILATION AND COLLATERAL VENTILATION IN COPD MEASURED USING HE3+ MAGNETIC RESONANCE IMAGING (MRI). A/Prof Paul Nigel Reynolds OPTIMISATION OF IMMUNE-VIRAL THERAPY FOR MESOTHELIOMA TSANZ President s Award Australian Lung Foundation / Ludwig Engel Grant-in-Aid for Physiological Research Prof E Haydn Walters THE EPIDEMIOLOGY OF MIDDLE-AGE LUNG HEALTH: A TASMANIAN (TAHS) PROSPECTIVE STUDY FROM CHILDHOOD TO ADULTHOOD ( ). Australian Lung Foundation / Lung Cancer Consultative Group Postgraduate Grant-in-Aid For Lung Cancer Research Renee Bittoun TSANZ Research Medal Ms Morgan Davidson IDENTIFICATION OF ABERRANT MICRORNAS IN LUNG CANCER Prof Peter Bye Wunderly Orator Dr Alex Brown

11 Advance Trainee Course Report - Darwin 2009 This year, we reached another all-time record with 70 trainees attending the advance trainee course. We are thankful to all Respiratory departments across the nation in allowing their trainees the extra 2 days prior to the Annual Scientific Meeting to receive training, support and build networks with other colleagues. The relationships that we have established with New Zealand also saw Dr Suzanne Marsh contribute as a vital member of the organizing committee, Professor Richard Beasley as an invited speaker and several (16% of those attending) trainees participating in the course. On average, approximately a third of the attending trainees were from each year of advance training. The feedback from trainees this year has been excellent and reflects strongly on the commitment of invited speakers in providing an informative, up to date and succinct educational resource. This year, the theme was suppurative lung disease and as such, we had sessions on cystic fibrosis, non-cystic fibrosis bronchiectasis, approach to lung transplantation, approach to cough, pleural diseases, etc. In addition, there were sessions on venous thrombo-embolism, respiratory physiology, interventional bronchoscopy and practical approaches to the use of non-invasive ventilation. Interactive sessions on chest radiology and tips on research writing/ critical appraisal were also well received. One of the innovations this year was a career research fair which was held at the end of the first day and allowed many established researchers/ clinicians to share information on the strengths of their respective units/ institutes therefore providing opportunities for trainees to consider future higher research degree options. In closing, we would like to thank all the speakers again for their willingness and excellent teaching sessions. We would also like to thank the Education and Research Subcommittee for the ongoing support of this very important segment of the Annual Scientific Meeting. Special thanks to the Thoracic Society, Festival City Conventions and Mr David Begg for assisting in many of the behind-the-scenes preparation to ensure a smooth and successful advance trainee course. We look forward to the next course in Brisbane 2010! Wai Kuen Chow, Suzanne Marsh, Andrew Tai, Greg King Cheryl Salome and Richard Beasley speaking at Advanced Trainee Short Course

12 Report from the Executive Committee To assist in communicating the activities of the TSANZ s Executive a dot point summary of some of the more important issues discussed and/or actioned from meetings held in February and May are listed below. Many other items are not included as they are day to day issues or were of a confidential nature. The Rules of the Organisation The current Rules and the day to day operation of the Society are not well syncronised and the Rules and the mode of operation are in need of review Swine Flu Formation of Swine Flu Task Force and principals involved discussed and reviewed Communication The proposed activities of the Communications Committee reviewed and supported Closer relationship between the leading respiratory organizations in Australia TSANZ discussions with the Presidents of the ALF, NAC, and the ARC TSANZ s Report on Respiratory and Sleep Health in Indigenous Australians Nearing completion, draft report on the Society s website National Registration & Accreditation Scheme for Health Professionals. TSANZ a co-signatory to the AMA s submission Clinical Standards in Respiratory and Sleep Medicine Being progressed Advanced Training Curriculum in Respiratory & Sleep Medicine Survey of Membership undertaken; positive progress with the Australasian Sleep Association. Relationships with the College Discussed. Past President to be liaison person Relationship with the ALF Desire to enhance the relationship between the ALF and the TSANZ and to review each others Rules in terms of the relationship Role of the TSANZ s Hon Secretary reviewed and endorsed Strategies for investing the Society s accumulated surpluses discussed Working group to report on options for purchasing TSANZ office formed Conflict of Interest Policy needed and to be progressed Role of SIGS in the Society Major review to be undertaken Enhancing relationships with the TSANZ Branches to be emphasised TSANZ Office Staff Need to enhance staff numbers and skill sets - endorsed TSANZ award as a tribute to Rob Pierce to be promulgated Renewal of APSR Contract To go ahead with increased advertising in Respirology, via the TSANZ Closer relationships with ANZSRS to be explored ANZSRS rental costs for the 2009 ASM waived. ASM registration fees for joint members of TSANZ & ANZSRS for review TSANZ s consensus paper on Omalizumab Close to being finalized. To be posted on the Society s website British Thoracic Society (BTS) are revising Guidelines for Pleural Diseases. TSANZ s Clinical Care & Resources Sub-Committee to decide if we should endorse Potential liaison with the BTS re collaboration on Guidelines under discussion TSANZ 2009 Advanced Course in Tasmania (from 23rd to 27th August) Discounted registration fee of $500 to the first twenty scientist members Dates for the 2011 ASM in Perth will be from the 8th to the 11th of April Festival City Conventions to continue organizing ASM Allen & Hanburys Paediatric Respiratory Medicine Career Development Grant Conditions are being changed. Aim: encourage more applications TSANZ presence at 2010 World Congress of Internal Medicine in Melbourne Victorian Branch to contribute Andrew Ng be co-opted to TSANZ s Professional Standards Sub- Committee. Accreditation of Sleep Laboratories Five Physiology and Sleep laboratories accreditation approved. ASA to be responsible from 1 July 2009 Interventional Pulmonology course in Perth, in October 2009 TSANZ s interest in promoting the science of this area. TSANZ Advanced Course August at Cradle Mountain, Tasmania Photo courtesy of Terry Dunnett,

13 Branch in the Spotlight: New Zealand Mike Epton John McLachlan The NZ Branch has published a survey by Jeff Garrett et al in the NZ Medical Journal. This survey of the District Heath Boards analysed their compliance with the NZ Standards of Respiratory & Sleep Medicine as promulgated by the NZ Branch in 2004, and accepted by the Ministry of Health. When evaluated against these minimum standards, the DHB provision of services was found to be severely wanting. Major gaps in service provision have been identified, and access to service is extremely variable & inequitable. The singular lack of leadership from the Ministry, as well as the poor regional organisation, has been identified as real concerns in delivery of Respiratory healthcare. As a result of work by the NZ Executive, this publication has had significant publicity and seems to be engendering some traction at last. The NZ Executive is due to meet the Minister of Health in the near future. In light of previous attempts to gain ground in this area, there is some scepticism in the ranks, but we hope to make some progress in improving delivery of Respiratory & Sleep services. Recruitment and retention remain high on the agenda in NZ. We have a small workforce which is generally overworked and underresourced. We have a major problem of monetary competition with other countries, notably Australia. It has to be recognised that we will never be able to compete on financial grounds, and TSANZ, Ministry of Health and the DHBs need to look at ways of making the workplace and work/life balance more attractive to retain consultants. Swine 'Flu has come and possibly gone in NZ, for now at least. There was a flurry of activity at the onset of this outbreak, with NZ being well represented in numbers of cases. Many organisations including the Ministry came out with action plans, but in general the plans already in place for Pandemic Influenza seem to have worked well and found to be suitable. While the TSANZ put out a notice regarding swine 'flu, and the working group was set up to respond as needed, it is recognised that this covered Australia rather than NZ. The NZ Executive felt that there was not a need to send out a separate NZ notice, as the local pandemic plan was already in place and working. We may need to give some advice for when the traditional 'flu season hits, as we may well have to deal with a resurgence of swine 'flu with some unique problems such as resistance patterns to drugs. The Executive will look at this in the near future. Mike Epton President John McLachlan Honorary Secretary/Treasurer A survey of respiratory and sleep services in New Zealand undertaken by the Thoracic Society of Australia and New Zealand (TSANZ) Jeffrey Garrett, Bob Chen, D Robin Taylor NZMJ 13 February 2009, Vol 122 No 1289; ISSN URL: 13

14 APSR Update Report Norbert Berend As you may know, 2010 has been gazetted as the Year of the Lung (YOTL) and FIRS (the Forum of International Respiratory Societies comprising ATS, ERS, ACCP, APSR, ALAT, PATS and IUATLD) has decided to use this unprecedented opportunity to advocate for international awareness of lung health in order to drive policy and action for lung care. Cancer, cardiovascular disease, obesity and diabetes are currently taking attention away from lung health issues. There are different lung health issues in different parts of the world but in the Asian Pacific region problems such as smoking, air quality and COPD, TB, vavian flu and SARS, HIV and others should be promoted as part of YOTL. A YOTL website and logo is being developed and the Edelman company has been engaged by FIRS to develop promotional materials, the aim of which is to inform the general public, agencies and policymakers. These materials will be reviewed at a FIRS meeting in San Diego in association with the ATS conference, before being disseminated. From the APSR perspective, we are at a disadvantage in talking to policymakers compared to ATS and ACCP which deal with a single government or the ERS which has a European Parliament. In our region it will be up to individual national societies to lobby governments and launch campaigns but the APSR will offer assistance and support. We will also focus a part of the 2010 APSR Congress in Manila on lung health issues relevant to YOTL and will stage press conferences, interviews and engage the media to highlight the YOTL. A spirometry tent in central Manila similar to the ERS spirometry initiative associated with their conference is being considered. There is current discussion about collaborations with GARD (Global Alliance against Respiratory Disease) and the WHO. Can I strongly recommend that you make plans to attend the APSR Congress in Seoul, Korea (Nov 14-18, 2009). This will be a joint meeting with the ACCP, similar to the Congress on the Gold Coast in Kwun Fong (Chairman of the Central Program Committee), Prof Chul Min Ahn (Chairman of the Local Organising Committee) and the ACCP have been developing a very exciting program which will meet the educational needs of clinicians as well as feature the best research conducted in the Asia-Pacific region and elsewhere. The APSR will once again be offering travel awards to assist young researchers to attend the Congress. Hope to see you in Seoul, Norbert Berend Chair, APSR Strategic Planning Committee

15 Jenny s Corner Hi, my name is Jenny Bridge and I have been working in the TSANZ Admin office since the beginning of March. Part of my job is to look at addressing and improving IT and communication issues within the Society. I d like to apologise for the inconvenience some members have experienced in not receiving some of our circulars sent by . Unfortunately with so much spam around these days it is becoming trickier to send and receive legitimate group s! The problem can often be a result of spam filters which reject mail not addressed specifically to you, i.e. your address is in the Bcc field rather than the To or Cc field. This can be avoided by telling your program that s from "" are legitimate. Most programs have a "White List" or "Safe Sender List" which you can add to yourself. The location of this list will vary from program to program. In Microsoft Outlook you will find it under Tools, Options/Preferences, Junk Mail. There will also be options to do such things as automatically trust all addresses in your contact list, and automatically trust addresses to which you send . Depending on the setup of your computer system this may or may not be enough to resolve the problem. If you are part of a network there may be some spam filters that kick in earlier than those on your PC. If you suspect this may be the case please ask your network administrator to add "" to the White List at the server level. * * * * * Another essential part of ensuring good communication is to make sure that we have your correct details in our member database. Whenever you change any of your contact details, please remember to let us know. Drop us a line by to put it on a fax to or give us a call at the office on during business hours. I m happy to assist with any questions or suggestions you may have regarding the website and the use of technology within the TSANZ. * * * * * Some TSANZ Member Trivia (courtesy of our database) Most Common Surnames: Smith (10), Wong, Young (7 each), Jones, Robinson, Williams (6 each), Chan, Martin, McDonald, Thompson, Tran (5 each) The Dust Diseases Board would like to inform members of the TSANZ that the Surveillance of Australian workplace Based Respiratory Events (SABRE) scheme in NSW has ceased operation. The DDB would like to thank all members who have participated in the scheme for their enthusiasm and support. 15

16 TSANZ Swine Flu Update Continued from Page 7... General Information 14. With all the above in mind, it is again emphasised that the steps taken to help protect an individual and the community from influenza viruses and their complications in general include: Annual flu vaccination and an up-to-date pneumococcal vaccination status. Attention to personal hygiene measures and avoiding close contact with others. Anti-viral medications and other treatments including empirical antibiotics and management of underlying co-morbidities as appropriate. 15. In addition, all Respiratory services should continuously be reviewing their protocols and local systems regarding Human Swine Influenza and ensure that these are aligned with local and National guidelines and the latest information from the Chief Medical Officer and the Dept of Health and Ageing. 16. Finally, all health care professionals need to be mindful of following Dept of Health and Ageing guidelines in managing patients that are potentially infected with Human Swine Influenza as well as taking the utmost care with their own health so as to minimise the risks posed to other patients, themselves and their families. 17. As both the global and local situations regarding swine flu have the potential to change on a daily basis, additional regularly updated information is available at the following websites: New Zealand** 18. At this stage it is recognized that the New Zealand Human Swine Influenza situation is very different to the one in Australia. Currently New Zealand has low numbers of confirmed cases of Human Swine Influenza, and is focusing on maintaining adequate border security ("Keep it out and stamp it out"). This strategy has been successful in maintaining the situation in New Zealand, but it remains potentially very fluid. Respiratory Physicians in New Zealand are advised to consult local public health and Ministry of Health guidelines for specific up to date information. Accreditation Update Congratulations to the following laboratories for receiving accreditation: Feb 2009: April: The Alfred Hospital, Sleep Laboratory John Hunter Children s Hospital, Paediatric Sleep Unit KK Women's and Children's, Sleep Disorders Centre Monash Sleep Center & Jessie McPherson Private Sleep Unit South Eastern Sleep Disordered Breathing Unit Box Hill Hospital, Respiratory Laboratory The Executive Committee would like to thank the following accreditation panel members for the time they have given and the expertise they have provided: Jeffrey Bowden Peter Catchside Tom Churchward David Cunnington Anup Desai Paul Guy Sean Homan Mark Howard Jennifer Maul Gillian Nixon Fergal O Donoghue Michael Pain Stephen Stick Bruce Thompson Nicole Verginis Karen Waters John Wheatley Gordon Williams Andrew Wilson

17 The Australian Lung Foundation Update 2009 Memberships: More and more, people are looking to the Lung Foundation as the voice of people with lung conditions. We have worked hard to achieve this in our endeavours with business, industry and government. However, we still have much, much more to do! This year, we celebrate our 18th birthday. In our coming of age, we are entering a new phase of growth. As a Lung Foundation member, you are effectively adding your voice in support of the only Australian charity who advocates to business, industry and government on behalf of all Australians with a lung disease. We are speaking up for people living with lung disease so make your voice count also- join The Australian Lung Foundation! Download the form from www. or phone us toll free on Healthy Active Afternoon: Our inaugural Healthy Active Afternoon at the TSANZ Annual Scientific Meeting in Darwin was a great success! It looks set to be a regular feature of future ASM s, with very positive feedback from participants in the Ambrose golf, fun run / walk and Pilates activities. Ludwig Engel Grant-in-aid for Physiological Research Prof Haydn Waters, Assoc Prof Shyamali Dhargmage and Dr John Morrone We wish awardees success with their projects and look forward to hearing results of their research. Breathe Easy, Walk Easy Stage one of the project is now underway at the Darah Gibinj Medical Centre (Casino, NSW). Eileen Boyle, Project Manager is coordinating the evaluation of the implementation of this training resource. She is receiving terrific assistance from all involved. COPD-X Guidelines: The updated version is available on This very popular website received more than two million "hits" in Advocacy: The Lung Foundation has made a submission to The Henry Review Panel in relation to the Australian tax system. We intend to make a further submission in relation to recently announced review Of the Not-For- Profit sector by the Productivity Commission. Indigenous Lung Health: Progress has been made on the paper authored by the late Robert Pierce et Al and launched at the TSANZ ASM in soft copy for TSANZ members and is accessible on It is hoped that the full paper will be published by next spring. Partnerships: The Lung Foundation has adopted the Community Health Forum Working Together document to guide its relationship with the pharmaceutical industry The Masters winners of the Healthy Golf Tournament at Gardens Park Golf Links Research Awards: you will have received an from David Begg Re: The Australian Lung Foundation 2010 COPD Research Webster Award. Please go to to apply. Please hurry as applications close on 30th June! Our Chairman Dr Bob Edwards presented the 2009 Lung Foundation awards at the Darwin TSANZ ASM. The Australian Lung Foundation / Boehringer Ingelheim COPD Research Fellowship Dr Benjamin Harris Slater and Gordon Asbestos Research Grantin-aid Assoc Prof Paul Reynolds Lung Cancer Consultative Group Awards o Postgraduate Grant-in-aid Ms Morgan Davidson o Cochrane Review Scholarship Mr Robert Smith National Council: The Australian Lung Foundation National Council is seeking nominations for an ACT Representative. Should you be interested, kindly contact CEO of The Australian Lung Foundation The National Council Executive Committee has now begun to meet regularly and the strategic plan is shaping up well. Prof Phil Thompson, the newly appointed President of TSANZ and National Council member, is working with Prof Christine Jenkins to explore ways in which the various respiratory interests in Australia could be integrated in a meaningful manner. In his capacity as Chairman of the COPD Coordinating Committee and National Council member, Prof Peter Frith will represent the Lung Foundation at the mid-june COPD International Patient Organisation Conference in Rome. Date claimer: Charity Golf Day, Robina (Qld) on August 21. Vale: We were saddened by the death of Liz Simon, an enthusiastic patient advocate for those with lung cancer, who passed away in April. 17

18 National Asthma Council Update May 2009 Asthma Mortality 2007 The Australian Bureau of Statistics released in March the latest mortality figures. The National Asthma Council Australia distributed its usual annual announcement with material prepared by Assoc. Professor Elizabeth Comino, UNSW Research Centre for Primary Health Care and Equity. There were 385 deaths from asthma in This was slightly fewer that reported in 2006 (402) and although more still than in 2005 where 314 deaths were reported. 76% (293) of asthma deaths occurred in adults aged 60 years or more. For the year age group, there were 35 deaths. This rate is higher than in the preceding two years (2005: 25, and 2006: 24) although similar to 2004 (36 deaths). Direct standardisation was used to calculate age standardised mortality for all age groups together and for young people aged years. This is a change from previous reports where the data were reported for young people aged 5-34 years. In addition age standardisation was undertaken for 10 year age groups as the asthma death data were only released for 10 year age groups rather then 5 year groups as in previous years. The following graphs show the age standardised mortality rates for asthma from 1960 to Figure 1 shows the mortality for all people; the curve is overlaid with a curve showing a three year moving average for mortality and gives a better idea of the underlying trends in the data. Figure 2 shows the same information (aged standardised mortality and three year moving average) for young people aged years. For further information refer to the National Asthma Council Australia website.

19 Book Review & Calendar of Events June August September October November Clinical Assessment in Respiratory Care, Sixth Edition Authors: Wilkins, Dexter and Heuer Imprint: Mosby ISBN Pub Date: 2009 RRP: $ (Inc GST) Available from: Elsevier Australia Freecall: Reviewed By: Baerin Houghton Royal Prince Alfred Hospital, NSW The 6th Edition for Clinical Assessment in Respiratory Care by R. Wilkens et al is carefully constructed text specifically designed for Respiratory Therapists (RT. RTs are unique to North America. They were originally the technicians who performed respiratory function tests but have evolved into pulmonary physician aides. If it were to exist, the Australasian equivalent would be similar to a nurse practitioner or clinical nurse consultant. The text gives a basic overview of the skills of communication, history taking, assessing cardiopulmonary symptoms and the understanding of the investigations pertinent to respiratory medicine. It is easy to understand and contains useful highlights of the main points for each chapter. The short quizzes, case studies and subject summaries at the end of every chapter help to reinforce/ solidify the key learning objectives. As a respiratory medicine advanced trainee, the majority of the book is aimed at a level of understanding beneath that required for my training. However, the sections on preparing for the patient encounter (communication skills and techniques), Interpretation of blood gasses, pulmonary function testing and clinical application of the chest radiograph were well presented concise topics that I would have loved to have read at the beginning of my training First World Conference of COPD Patients Organized by ICC and EFA Rome, Italy Treading Softly: Climate Change, Healthcare and Carbon Footprints Sanctuary Cove, QLD TSANZ Advanced Course 2009 Cradle Mountain, TAS European Respiratory Society Congress Vienna, Austria 31-5 November Chest San Diego, USA th APSR Congress Seoul, Korea March TSANZ ASM Brisbane Convention Centre, QLD 19

20 1 SPIRIVA. Adding life to their years... SPIRIVA impacts the clinical course of COPD, helping to change the way patients live with their disease. 5,6 By improving airflow, 4 reducing breathlessness 4 and preventing exacerbations, 7 SPIRIVA helps patients do more 8 and get more out of life. 1 PBS Information: Restricted benefit. Long-term maintenance treatment of bronchospasm and dyspnoea associated with chronic obstructive pulmonary disease. SPIRIVA is not indicated or PBS listed for the treatment of asthma in the absence of co-existing COPD. Please review Product Information before prescribing. Full Product Information is available on request from Boehringer Ingelheim Pty Limited. The clinical course of COPD is characterised by the following clinical outcomes: airflow limitation, 2 air trapping, 3 breathlessness, 4,5 inactivity, 6 exacerbations 7 and disability. 3 Indications: Long-term maintenance treatment of bronchospasm and dyspnoea associated with chronic obstructive pulmonary disease (COPD). Prevention of COPD exacerbations. Contraindications: Hypersensitivity to atropine or its derivatives, or to any component of SPIRIVA. Precautions: Acute bronchospasm, immediate hypersensitivity reactions, renal impairment, hepatic impairment, narrow-angle glaucoma, prostatic hyperplasia, bladder-neck obstruction, micturation difficulty, urinary retention, children, pregnancy, lactation. Avoid powder entering eyes. Interactions: Co-administration with anticholinergic drugs. Adverse Reactions: Dry mouth, urinary difficulty, urinary retention, constipation, throat irritation, paradoxical bronchospasm. Dosage: Inhale the contents of one capsule, once daily using the HandiHaler device, at the same time each day. Presentation: Cartons containing blister packs of 30 capsules. PBS dispensed price: $ For expert medical information on SPIRIVA call Boehringer Ingelheim Pty Limited *, ABN , 85 Waterloo Road, North Ryde NSW Pfizer Pty Limited, ABN , Wharf Road, West Ryde NSW *Sponsor. 1. Price D. Expert Rev. Pharmacoeconomics Outcomes Res 2006;6(4): Buist AS, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease Available at GOLD website (accessed 18 December 2006). 3. Celli B, et al. Chest 2003;124: Casaburi R, et al. Eur Respir J 2002;19: Vincken W, et al. Eur Respir J 2002;19: Casaburi R, et al. Chest 2005;127(3): Niewoehner DE, et al. Ann Intern Med 2005;143: Maltais F, et al. Chest 2005;128: Registered Trademark 12/06 BOE0301/CJB

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