Journal articles on the topic 'Art, Abstract Victoria Melbourne'

Abstract In September 2018, the Federal Court of Australia found that a Victorian woman did not need her estranged husband’s consent to undergo in vitro fertilisation treatment (IVF) using donor sperm. The woman, who was 45 years of age, made an urgent application to the Court for permission to undergo IVF using donor sperm. In a single judge ruling, Griffiths J held that the requirement in the Assisted Reproductive Treatment Act 2008 (Vic) (‘ART Act’) for a married woman to obtain the consent of her husband discriminated against the woman in question on the basis of her marital status in contravention of the Commonwealth Sex Discrimination Act 1984 (Cth) (‘SD Act’). His Honour declared the Victorian law in this instance ‘invalid and inoperable’ by operation of section 109 of the Commonwealth Constitution to the extent it was inconsistent with the Commonwealth law. Although the declarations by the Federal Court were limited in their terms to the circumstances of the case, the judgment raises broader issues about equity of access to assisted reproductive treatment (ART) in Victoria. The issue of partner consent as a barrier to access to ART was specifically raised by an independent review of the ART Act in Victoria. The Victorian Government released an interim report late last year as a first stage of the review, which canvasses some options for reform. This raises a broader question as to whether prescriptive legislation imposing detailed access requirements for ART is necessary or even helpful.

Many triplets are conceived as a consequence of assisted reproductive technology (ART). Concerns have been raised that triplet pregnancies conceived by ART are more complicated than those conceived spontaneously. The purpose of this study was to evaluate all triplet pregnancies managed over a 12-year period to determine if there were any differences in outcome based on the mode of conception. All triplet pregnancies between 1999 and 2011 that reached at least 20 weeks’ gestation and that were managed at the Royal Women's Hospital (RWH), Melbourne, Victoria were identified. Maternal and neonatal outcomes were compared between ART conceived and spontaneously conceived triplets. In the study period, 53 sets of triplets managed in our institution met the eligibility criteria. Twenty-five triplet sets were conceived by ART and 28 were conceived spontaneously. More ART conceptions resulted in trichorionic triamniotic (TCTA) triplets than did spontaneous conceptions (p= .015). There were no differences between ART and spontaneously conceived triplets for any of the maternal or neonatal complications studied. Trichorionic (TC) triplets delivered at a later gestation than other triplets: 32.1 (SD2.9) versus 30.4 (SD3.9) weeks (p= .08). TC triplets were significantly less likely to die than monochorionic (MC) or dichorionic (DC) triplets: 3/93 (3%) versus 13/66 (20%) (p= .025). In conclusion, triplets conceived by ART are more likely to have TCTA placentation and TCTA triplet sets had lower mortality rates than other triplet combinations. Outcomes for triplets conceived by ART were similar to those of triplets conceived spontaneously.

Abstract The presence of greenspace, its profound impact and association with physical and mental health, biodiversity, and aesthetical pleasure has been delineated abundantly. Contrarily, there is a concerning disparity in the accessibility and proximity between affluent and deprived areas in urbanised localities. Existing literature prioritised distribution and proximity domains when assessing inequitable greenspace and consequently has catalysed a research gap in greenspace quality domains. This paper endeavours to fill this gap through a case study in Melbourne, Australia using a quantitative method to extract findings and policy analysis to generate recommendations. Socioeconomic data from deprivation indexes systematically defined low and high SES (socioeconomic status). A GIS (Geographical Information System) observation of greenspaces scored spaces according to a scoring criterion contingent on safety/security, environmental elements, accessibility, maintenance/cleanliness, facilities/amenities, and aesthetic facets. Statistics were then synthesised to produce a Cohen effect score highlighting disparities in each facet between the two contrasting SES groups. Findings affirmed an existent disparity between the high and low SES spaces and contributed to existing strands of literature surrounding unjust quality distribution. Ultimately, findings will serve as invaluable evidence regarding policy implications, current opportunities under the ‘Plan Melbourne’ policy, and the need to facilitate intervention in those underprivileged settings.

Abstract Enriching BioScience's role as a Forum for Integrating the Life Sciences, Arts in Science provides an occasional venue for poems, visual art, and other forms of artistic expression that explore and enliven our understanding of life. Through the contributions in this section, we hope to share with our readers the passion for nature that science inspires. This contribution is from Ian Wicks, Head of the Inflammation Division at the Walter and Eliza Hall Institute of Medical Research and Professor/Director of the Rheumatology Unit at the Royal Melbourne Hospital and University of Melbourne.

Abstract Fog events occur at Melbourne Airport, Melbourne, Victoria, Australia, approximately 12 times each year. Unforecast events are costly to the aviation industry, cause disruption, and are a safety risk. Thus, there is a need to improve operational fog forecasting. However, fog events are difficult to forecast because of the complexity of the physical processes and the impact of local geography and weather elements. Bayesian networks (BNs) are a probabilistic reasoning tool widely used for prediction, diagnosis, and risk assessment in a range of application domains. Several BNs for probabilistic weather prediction have been previously reported, but to date none have included an explicit forecast decision component and none have been used for operational weather forecasting. A Bayesian decision network [Bayesian Objective Fog Forecast Information Network (BOFFIN)] has been developed for fog forecasting at Melbourne Airport based on 34 years’ worth of data (1972–2005). Parameters were calibrated to ensure that the network had equivalent or better performance to prior operational forecast methods, which led to its adoption as an operational decision support tool. The current study was undertaken to evaluate the operational use of the network by forecasters over an 8-yr period (2006–13). This evaluation shows significantly improved forecasting accuracy by the forecasters using the network, as compared with previous years. BOFFIN-Melbourne has been accepted by forecasters because of its skill, visualization, and explanation facilities, and because it offers forecasters control over inputs where a predictor is considered unreliable.

To present-day astronomers the name of Robert Ellery, by which our newly established lectureship is to be known, means little. A century ago it was a different story. Ellery was then one of the most respected scientists in the country, a leading astronomer who had been director of the Melbourne Observatory since it was founded in 1853, and who had taken it to a prominent position in international astronomy. Besides this he was a man of parts who spread his talents widely. He was a founder and long-term president of the Royal Society of Victoria, treasurer of the University Council, chairman of the committee of the Alfred Hospital, Trustee of the Public Library, the Art Gallery and the Museum, and he was an active member, latterly commander, of the local Torpedo and Signal Corps, a coastal defence unit manned by citizen soldiers. Late in life he became the first president of the Beekeepers’ Club. He was elected to the Royal Society and awarded a CMG: all in all, a man of character and achievement.

Abstract: This article examines the process and impact of an artist-in-residence program in Art Education at the University of Victoria. After an open call to artists, contemporary Upper Tanana visual artist, Teresa Vander Meer-Chassé, member of the White River First Nation of Beaver Creek, Yukon and Alaska was selected as the inaugural artist-in-residence. Through research-creation and qualitative methods this research examines the artist’s artistic process and the impact of an artist-in-residence on students’ and faculty’s perception of artistic practice and their experience working with an artist-in-residence within a post-secondary space of learning. Through photographic documentation, reflections and interviews by participants, the article examines ways the artist-in-residence enriched student and faculty learning in a Faculty of Education. Keywords: Artist-in-residence; Post-secondary education; Artistic inquiry; Indigenous pedagogy; Beading. Résumé : Cet article s’intéresse au processus et à l’impact d’un programme d’artiste en résidence dans le domaine de l’enseignement des arts à l’Université de Victoria. Suite à une audition ouverte d’artistes, l’artiste visuelle contemporaine du Haut Tanana Teresa Vander Meer-Chassé, membre de la Première Nation de White River de Beaver Creek, du Yukon et de l’Alaska, a été choisie artiste-résidente inaugurale. La présente recherche utilise des méthodes quantitatives et de recherche-création pour étudier la démarche artistique de l’artiste et l’impact d’une artiste-résidente sur la perception de la pratique artistique chez les étudiants et le corps enseignant. On y analyse aussi l’impact de collaborer avec une artiste-résidente en milieu d’apprentissage postsecondaire. Documentation photographique, réflexions et entrevues des participant.e.s sont mises à profit pour déterminer de quelles façons l’artiste- résidente a enrichi l’apprentissage étudiant et du corps enseignant au sein de la Faculté d’éducation. Mots-clés : artiste-résidente, enseignement postsecondaire, recherche artistique, pédagogie autochtone, perlage.

An actual dinner party is nearly always characterized by the presence of three central elements: a meal, a table, and a gathering of people, who usually converse. In this article Campion Decent considers the dinner party as a social event and questions how artists draw on its elements to inform artistic representations of dinner. He examines the use of dining events in drama, notably in five texts authored by women between the late 1970s and the present day–Tina Howe's The Art of Dining (1979) and One Shoe Off (1992), Caryl Churchill's Top Girls (1982), Moira Buffini's Dinner (2002), and Tanya Ronder's Table (2013). These texts share an emphasis on the symbolic idea of food or dining, feature tables with a woman at their centre and offer dialogue allied to the experiences of women. While the dining events that they depict are populated with vastly different characters and distinct conversations, the tables nevertheless function as potent yet ambiguous symbols both of women's oppression and of the potential for creative freedom. This article draws on research in anthropology, sociology, food studies, theatre and performance studies, and women's studies to illustrate the fertile complexity of ideas involved in the symbolic dinner. Campion Decent has recently completed his doctoral studies at La Trobe University, Melbourne. He is an award-winning playwright, with productions at Sydney Theatre Company, the Griffin Theatre, and the National Institute of Dramatic Art, Sydney. He has presented papers at Stanford University, Shanghai Theatre Academy, and Victoria University of Wellington.

Abstract. Lake Victoria is the largest lake in Africa and one of the two major sources of the Nile river. The water level of Lake Victoria is determined by its water balance, consisting of precipitation on the lake, evaporation from the lake, inflow from tributary rivers and lake outflow, controlled by two hydropower dams. Due to a scarcity of in situ observations, previous estimates of individual water balance terms are characterized by substantial uncertainties, which means that the water balance is often not closed independently. In this first part of a two-paper series, we present a water balance model for Lake Victoria, using state-of-the-art remote sensing observations, high-resolution reanalysis downscaling and outflow values recorded at the dam. The uncalibrated computation of the individual water balance terms yields lake level fluctuations that closely match the levels retrieved from satellite altimetry. Precipitation is the main cause of seasonal and interannual lake level fluctuations, and on average causes the lake level to rise from May to July and to fall from August to December. Finally, our results indicate that the 2004–2005 drop in lake level can be about half attributed to a drought in the Lake Victoria Basin and about half to an enhanced outflow, highlighting the sensitivity of the lake level to human operations at the outflow dam.

Abstract A 4-day photochemical smog event in the Melbourne, Victoria, Australia, region (6–9 March 2001) is examined to assess the performance of the Australian Air Quality Forecasting System (AAQFS). Although peak ozone concentrations measured during this period did not exceed the 1-h national air quality standard of 100 ppb, elevated maximum ozone concentrations in the range of 50–80 ppb were recorded at a number of monitoring stations on all four days. These maximum values were in general very well forecast by the AAQFS. On all but the third day the system predicted the advection of ozone precursors over Port Phillip (the adjacent bay) during the morning, where, later in the day, relatively high ozone concentrations developed. The ozone was advected back inland by bay and sea breezes. On the third day, a southerly component to the background wind direction prevented the precursor drainage over the bay, and the characteristic ozone cycle was disrupted. The success of the system's ability to predict peak ozone at individual monitoring stations was largely dependent on the direction and penetration of the sea and bay breezes, which in turn were dependent on the delicate balance between these winds and the opposing synoptic flow.

This paper gives a personal perspective on the application and relevance of generative processes to art production. This view is that of a computer programmer, rather than that of a user of computer programs written (or hardware constructed) by others. The programmer is in the unique position of being able to describe and manipulate abstract processes which may be used as a unique means of artistic expression. This gives a greater amount of freedom to the programmer/artist than is the case when he or she is limited by programmed procedures defined by others.Prior to the development of a formal means of specifying visual and aural events, a concrete machine or set of rules for their manipulation and a means of bringing these representations back into the world as physical events, abstract processes were things to be contemplated but not experienced. Musical and spatial notations employed by artists, engineers and others, in concert with the programming of computing hardware, have opened the way for those who wish to manipulate processes in their artistic practice.In order to focus study and practice in the area of such generative computer art, the Center for Electronic Media Art (CEMA) has been established in Melbourne, Australia. The Center has spawned an international conference series on generative/process-based electronic art called Iteration. The perceived roles of the Center and Iteration conferences are discussed in this paper.

Abstract In this roundtable, four curators of exhibitions showcasing sexual archives and histories—with a particular focus on queer and trans experiences—were asked to reflect on their experiences working as scholars and artists across a range of museum and gallery formats. The exhibitions referred to below were Bring Your Own Body: Transgender between Archives and Aesthetics, curated by Jeanne Vaccaro (discussant) with Stamatina Gregory at The Cooper Union, New York, in 2015 and Haverford College, Pennsylvania, in 2016; Odarodle: An imaginary their_story of naturepeoples, 1535–2017, curated by Ashkan Sepahvand (discussant) at the Schwules Museum (Gay Museum) in Berlin, Germany, in 2017; Queer, curated by Ted Gott, Angela Hesson, Myles Russell-Cook, Meg Slater (discussant), and Pip Wallis at the National Gallery of Victoria, Melbourne, Australia, in 2022; and TransTrans: Transatlantic Transgender Histories, curated by Alex Bakker, Rainer Herrn, Michael Thomas Taylor, and Annette F. Timm (discussant) at the Schwules Museum in Berlin, Germany, in 2019–20, adapting an earlier exhibition shown at the University of Calgary, Canada, in 2016.

Abstract This article explores how the category “Chinese art” was articulated and consolidated in the early twentieth century by focusing on Stephen Bushell's Chinese Art, the first book in English defined in terms of this category. Bushell's monograph highlights the intercultural character of the category, which was transformed in its content and cultural significance, when ostensibly the same authentic knowledge, articulated in verbal and visual representations, was moved from China to Europe and back again. The article starts by examining how Bushell's insider knowledge of Chinese art was transformed to fit the institutional setting of the Victoria and Albert Museum. It then explores how the authoritative knowledge of Chinese art communicated in Bushell's book was appropriated in China by the journal Guocui xuebao 國粹學報 (Journal of National Essence) in the context of attempts to revive national culture. Both cases involved hitherto unnoticed repetitions of text and images. By analyzing the mechanism informing these repetitions, this article reveals the entangled history behind the distinctive articulations of “Chinese art” in Britain and in China. Moreover, the analysis shows how the same elements, whether words or pictures, acquired a substantially different significance as they moved between cultures. This is exemplified by the formulation of the newly emergent classifying category Zhongguo meishupin 中國美術品 (“Chinese art objects”) in Guocui xuebao.

Abstract ContextBird–aircraft collisions impose an economic cost and safety risk, yet ecological studies that inform bird hazard management are few, and to date no study has formally compared species’ strike profiles across airports. In response to strike risks, airports have implemented customised management on an airport-by-airport basis, based on the assumption that strike risk stems from prevailing local circumstances. We tested this assumption by comparing a decade of wildlife–aircraft strikes at three airports situated in the same bioregion (likely to have similar fauna) of Victoria, Australia. AimTo compare the assemblage of wildlife struck by aircraft at three major airports in the same bioregion. MethodStandardised wildlife strike data were analysed from three airports (Avalon, Melbourne and Essendon Airports), in the Victorian Volcanic Plains bioregion, central Victoria, Australia. Ten discrete 1-year sampling periods from each airport were compared, spanning the period 2009–19. Bird data were comparable, and data on mammals were considered less reliable, so emphasis was placed on birds in the present study. ResultsIn total, 580 bird strikes were analysed, with the most commonly struck species being Australian magpie (Cracticus tibicen; 16.7%), Eurasian skylark (Alauda arvensis; 12.2%), Australian pipit (Anthus australis; 12.1%), masked lapwing (Vanellus miles; 5.9%), nankeen kestrel (Falco cenchroides; 5.0%), house sparrow (Passer domesticus; 4.8%), welcome swallow (Hirundo neoxena; 4.3%) and tree martin (Petrochelidon nigricans; 4.0%). The assemblage of birds struck by aircraft over the decade of study differed between airports. The most commonly struck species drove the assemblage differences between airports. Conclusions and implicationsIn the present study system, airports experienced discrete strike risk profiles, even though they are in the same bioregion. The airports examined differed in terms of air traffic movement rates, aircraft types, landscape context and bird hazard management effort. Given that strike risks profiles differ among airports, customised management at each airport, as is currently the case, is supported.

Abstract This study investigates achievement in second language learning (Chinese) in primary school in relation to learner variables such as amount and duration of instruction and home language background.1 Currently in the State of Victoria it is recommended that all students learn a second language from the beginning of primary school to the end of Year 10. As the majority of students in some LOTE (Languages Other Than English) classes such as Chinese are background speakers, some parents and teachers are concerned that non-background learners can be disadvantaged compared with classmates who have some exposure to the LOTE outside school. In order to examine whether home language use has any impact on achievement, we developed a test of four skills and administered it to Year 6 students in two primary schools in Melbourne. The results showed that Chinese background students scored much higher than non-Chinese background students in all four areas. However a close examination of the data revealed that other variables such as Chinese study outside school and the number of years of study at school also influenced the test scores. This research has strong implications for developing a LOTE curriculum for both background and non-background speakers.

ABSTRACT Marjorie Barnard (1897–1987) and Flora Eldershaw (1897–1956) were prolific Australian authors who co-wrote, under the pseudonym “M. Barnard Eldershaw,” five novels and four works of nonfiction published between 1929 and 1947. Their final collaboration, a future fiction entitled Tomorrow and Tomorrow, first appeared in Melbourne in 1947 and was reissued by the London feminist publisher Virago in 1983. Lyman Tower Sargent’s bibliography of Australian utopian fiction describes the novel thus: “Dystopia. Public opinion sampling used to limit liberty.” This is a reasonable enough shorthand description of the novel’s frame narrative, set in the “Tenth Commune” located somewhere in what is now the Riverina district on the border of New South Wales and Victoria, at some time in the twenty-fourth century. This article will argue, however, that the Tenth Commune is closer to a flawed eutopia than an outright dystopia; and that the novel’s truly dystopian content lies in its core narrative, Knarf’s novelistic account of mid-twentieth century Australia, which culminates in a quasi-apocalyptic destruction by fire of the city of Sydney. The extraordinary violence of this account will be contrasted to the essentially nonviolent character of the Tenth Commune and both will be situated in relation to Barnard’s growing involvement in the pacifist Peace Pledge Union.

Abstract Lay Health Worker (LHW) programs have been shown to be effective in engaging community members in health promotion. While successful LHW program implementation requires an understanding of factors influencing program effectiveness, evidence informing such understanding is lacking for empowerment and ecological theory-based LHW programs. This descriptive study explores how enablers and barriers, identified from LHW literature apply (from the LHWs’ perspective) in the context of implementing an empowerment and ecological theory-based LHW model in Melbourne, Victoria. A qualitative case study was carried out. Data were collected from participating LHWs (n = 11) via anonymized online activity logs (n = 7) and semi-structured interviews (n = 7). Deductive-inductive thematic analysis was guided by five a priori themes identified from the literature: community relationships; intrinsic traits, values and motivations; capacity building; program design; and work conditions. Data supported the enablers and barriers to program effectiveness and implementation reported by previous research. Subthemes identified the importance of the LHW bridging role; the empowerment model; integrating the program; and program inclusiveness. This research contributes to the growing practice literature regarding how to effectively implement diverse LHW models in diverse settings. It also contributes to social ecological and complex systems-based health promotion practice evidence in suggesting LHWs to be potentially useful elements which may add to the effectiveness of ecologically based health promotion interventions.

Abstract STUDY QUESTION Is ART related with the association of American Heart Association (AHA) ideal cardiovascular health score and markers of subclinical atherosclerosis? SUMMARY ANSWER The associations between AHA score and markers of subclinical atherosclerosis in ART and non-ART groups were similar in magnitude. WHAT IS KNOWN ALREADY Long-term consequences of ART on cardiovascular health are unknown. STUDY DESIGN, SIZE, DURATION The study cohort for the cross-sectional analyses consisted of 172 ART-conceived and 78 non-ART conceived individuals of same age (range 22–35 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Cardiovascular risk factor status was evaluated with American Heart Association (AHA) ideal cardiovascular health score consisting of seven factors (body mass index, blood pressure, total cholesterol, glucose, diet and physical activity, non-smoking). Carotid artery intima-media thickness (cIMT), arterial pulse-wave velocity (PWV) and retinal microvascular parameters were evaluated as markers of early atherosclerosis. Group comparisons in continuous variables were performed with t-tests. For categorical variables, comparisons were performed with chi-square tests. The relationships between AHA score and the markers of atherosclerosis were examined with linear regression analyses adjusted for age and sex. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in AHA ideal health score between the ART and non-ART groups; mean (SD) scores were 4.1(1.4) versus 4.0(1.5), respectively, P = 0.65. No differences were observed between groups for any individual ideal health metric (P always >0.2). AHA score was not associated with cIMT or retinal measures in either group (P always >0.05). An inverse association was observed between AHA score and PWV in the ART group (beta (95% CI) −0.18(−0.26 to −0.10)). A numerically similar relationship was observed in the smaller non-ART group (−0.19(−0.39 to 0.01)). LIMITATIONS, REASONS FOR CAUTION Even though this cohort is among the largest ART studies with extensive cardiovascular data, the sample is still relatively small and the statistical power is limited. As the study population was still in early adulthood, we were not able to evaluate the associations with clinical cardiovascular events, but utilized non-invasive methods to assess early markers of subclinical atherosclerosis. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that ART-conceived individuals do not have increased vulnerability for cardiovascular risk factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a National Health & Medical Research Council Project Grant (APP1099641), The Royal Children’s Hospital Research Foundation, Monash IVF Research and Education Foundation, and Reproductive Biology Unit Sperm Fund, Melbourne IVF. The authors have no conflicts of interest relevant to this article to disclose.

Abstract This article reflects upon a mobile art ethnography that sought to understand and rethink some of the tensions around regional/rural experiences of the digital. Using creative practice-based methods, it provides new insights into this regional/urban divide through the motif of working mother commuter as digital wayfarer, a term used to define on/offline digital entanglement through the lived experience of quotidian wayfaring. It contributes to debates around mobile communication and mobile media studies by connecting conceptual analysis of mobilities and its relationship to regional commuting with a creative approach to movement, play and a sense of place. Much of the academic research on mobile media and internet studies stems from an urban focus rather than engaging in the unevenness of the online as is much of the experience in the rural region of North Central Victoria, Australia. Being a working mother commuter for almost a decade, the researcher also took an autobiographical approach to aspects of this project through the lens of digital wayfaring. The artefact used ethnographic case study methods and is a creative non/ fiction sound and moving imagery work made using the mobile phone, within the context of the regional Vline train. Utilising sonified global positioning system (GPS) data as part of the soundscape, it addressed problems in the production of this train activity (i. e. work, creativity, play, rest and playbour) regarding social and material participation of the commute infrastructure and overlaid internet connections. It showed how multisensorial art-making highlights the commute to be a journey to and from - and of - work, within the ecology of the Vline train, and therefore provides new ways of perceiving this copresent, mediated and entangled digital experience.

Abstract. The purpose of this work is determine the extent of closure between measurements and models of UV irradiances at diverse sites using state of the art instruments, models, and the best available data as inputs to the models. These include information about aerosol optical depth (unfortunately not extending down as far into the UVB region as desirable because such information is not generally available), ozone column amounts, as well as vertical profiles of ozone and temperature. We concentrate on clear-sky irradiances, and report the results in terms of UV Index (UVI). Clear-sky data from one year of measurements at each of four diverse sites (Lauder – New Zealand, Mauna Loa Observatory – Hawaii, Boulder – Colorado, and Melbourne – Australia) have been analysed in detail, also taking account of different measurements of ozone, including satellite-derived values, as well as ground measured values, both from Dobson instruments and as retrieved from the UV spectra under study. Previous studies have generally focussed on data from a single site, and for shorter periods. Consequently, this study is the most comprehensive of its kind to date. At Lauder, which is the cleanest low altitude site, we obtained agreement between measurement and model at 5% level, which is consistent with the best agreement found previously. At Mauna Loa Observatory, similar agreement was achieved, but model calculations need to allow for reflections from cloud that are present below the observatory. At this site, there are occasional problems with using satellite-derived ozone. At Boulder, mean agreements were similar but the dispersion around the mean was slightly larger, corresponding to larger uncertainties in the aerosol inputs to the model. However, at Melbourne, which is the only non-NDACC (Network for the Detection of Atmospheric Composition Change) site, there remain unexplained discrepancies. The measured values are significantly lower than the calculated values. We investigate the extent to which this discrepancy can be explained by incomplete knowledge of aerosol extinctions in the UV at this site. We conclude that further information about aerosol optical depth and single scattering albedo in the UVB region is needed to resolve the issues. At the three NDACC sites, the closure provided by the study gives confidence in both the measurements and our ability to model them. The study revealed a limitation in the use of PTFE diffusers when temperatures are lower than approximately 20°C. It also documents the range of clear sky UVI values expected at these diverse sites.

Abstract Background and Aims The detection of sequence variants and copy number changes can improve diagnosis, inform prognosis and guide treatment in patients with bone marrow failure syndromes (BMFS). We aimed to establish and prospectively assess the impact of comprehensive genomic evaluation on diagnostic categorisation and clinical outcomes in patients with genomically uncharacterised BMFS. Methods Eligible patients were recruited from four participating institutions across Victoria, Australia. Inclusion criteria were (i) age >3 months (ii) clinicopathological diagnosis or suspicion of either acquired aplastic anaemia (AA), inherited BMFS, hypoplastic myelodysplastic syndrome (hMDS) or a BMFS with marrow hypoplasia/aplasia not able to be definitively categorised. Patients initially underwent 90-gene targeted sequencing (Peter MacCallum Cancer Centre PanHaem and Myeloid Amplicon next generation sequencing [NGS] panels) for rapid turnaround of accredited results for clinical decision-making. In addition, whole exome sequencing (WES), whole genome copy number analysis, NGS T-cell receptor β (TRB) repertoire assessment and longitudinal monitoring of selected mutations by digital droplet PCR (ddPCR) were performed. All patients received pre-test counselling and assessment. Genomic results were reviewed in centralised multidisciplinary case conferences including the treating clinician, molecular haematopathologists, medical scientists, clinical geneticists and genetic counsellors. Results 100 patients were enrolled. Median age was 25 years (range 3 months - 80 years); 39% were under 18 years. Detection of sequence variants or copy number abnormalities led to or confirmed a diagnosis of either an inherited or acquired BMFS in 36 patients. In 17 patients a diagnosis of an inherited BMFS was positively made by detection of pathogenic sequence variants or copy number changes in FANCA(1 patient [pt]), FANCM(1 pt), FANCI(1 pt), RAD51C(1 pt), HAX1(1 pt), SBDS(1 pt), DNAJC21(1 pt), RPS19(5 pts), RPL35A(1 pt), TERT(1 pt), TINF2(1 pt) and SAMD9L(1 pt). In five patients the clinical BMFS was considered undifferentiated without a clear candidate gene suspected on phenotypic features prior to genomic evaluation. Importantly, an established diagnosis of AA was altered to an inherited BMFS by genomic characterisation in two patients (SAMD9L, FANCA). In 19 patients pathogenic sequence variants or copy number changes were detected either leading to or confirming a diagnosis of an acquired BMFS (paroxysmal nocturnal haemoglobinuria, hMDS or AA). Pathogenic sequence variants were detected in TET2(n=5), RUNX1(n=4), ASXL1(n=3), PIGA(n=3), DNMT3A(n=3),CBL(n=2), and BCOR/IDH2/SF3B1/SRSF2/TP53/U2AF1(n=1 each). Sequencing-detected copy number abnormalities included loss of chromosome 7 (n=6), losses on chromosome 5q (n=2) and copy number loss of ETV6(n=2). Longitudinal monitoring of an acquired truncating RUNX1 mutation by ddPCR resulted in one patient undergoing allogeneic bone marrow transplant for a progressively rising allelic burden. There was a trend towards more restricted TRB diversity in patients with genomically-defined acquired BMFS versus inherited BMFS (normalised Shannon index ≤0.85, 36.4% vs 0%, p=0.09). Conclusion We have established and evaluated a model of comprehensive multimodal genomic characterisation and multidisciplinary care for 100 patients with BMFS. Our results demonstrate a significant contribution to diagnostic categorisation and patient care in this area of clinical need. Disclosures Lieschke: CSL Behring Australia: Consultancy. Tam:Janssen: Honoraria, Research Funding; Gilead: Honoraria; AbbVie: Honoraria, Research Funding; Pharmacyclics: Honoraria, Travel funding; Pharmacyclics: Honoraria; Beigene: Honoraria, Other: Travel funding; Roche: Honoraria; Beigene: Honoraria, Other: Travel funding; Gilead: Honoraria; Roche: Honoraria; AbbVie: Honoraria, Research Funding.

Abstract. The purpose of this work is determine the extent of closure between measurements and models of UV irradiances at diverse sites using state of the art instruments, models, and the best available data as inputs to the models. These include information about aerosol optical depth (unfortunately not extending down as far into the UVB region as desirable because such information is not generally available), ozone column amounts, as well as vertical profiles of temperature. We concentrate on clear-sky irradiances, and report the results in terms of UV Index (UVI). Clear-sky data from one year of measurements at each of four diverse sites (Lauder – New Zealand, Mauna Loa Observatory – Hawaii, Boulder – Colorado, and Melbourne – Australia) have been analysed in detail, also taking account of different measurements of ozone, including satellite-derived values, as well as ground measured values, both from Dobson instruments and as retrieved from the UV spectra under study. Previous studies have generally focussed on data from a single site, and for shorter periods. As such, it is the most comprehensive study of its kind to date. At Lauder, which is the cleanest low altitude site, we obtained agreement between measurement and model at 5% level, which is consistent with the best agreement found previously. At Mauna Loa Observatory, similar agreement was achieved, but model calculations need to allow for reflections from cloud that are present below the observatory. At this site, there are occasional problems with using satellite-derived ozone. At Boulder, mean agreements were similar but the dispersion around the mean was slightly larger, corresponding to larger uncertainties in the aerosol inputs to the model. However, at Melbourne, which is the only non-NDACC (Network for the Detection of Atmospheric Composition Change) site, there remain unexplained discrepancies. The measured values are significantly lower than the calculated values. We investigate the extent to which this discrepancy can be explained by incomplete knowledge of aerosol extinctions in the UV at this site. We conclude that further information about aerosol optical depth and single scattering albedo in the UVB region is needed to resolve the issues. For more polluted sites (the four considered locations show in general small aerosol load), the uncertainties in the aerosol input parameters would lead to less confidence on the modelling approach. At the three NDACC sites, the closure provided by the study gives confidence in both the measurements and our ability to model them. This study revealed a limitation in the use of PTFE diffusers when temperatures are lower than approximately 20°C. It also documents the range of clear sky UVI values expected at these diverse sites.

Abstract Myeloperoxidase (MPO) is an unequivocal marker of myeloid differentiation and is used routinely in the diagnosis of acute myeloid leukaemia (AML). Cytochemistry (CC), flow cytometry (FCM) and immunohistochemistry (IH) are three routine techniques used to demonstrate MPO positivity. As FCM techniques have improved, IH and CC are being performed less frequently. However, very few reports comparing combinations of these modalities have been published, and to our knowledge none comparing all three. We have reviewed 158 bone marrow biopsies of patients diagnosed with AML between 2000 and 2007 at the Royal Melbourne Hospital, Victoria, Australia. A comparison of MPO positivity using CC, FCM and IH was performed. In 101/158 biopsies all three methods were performed, while the remaining 59 cases had only 2 of the 3 performed. 76 (75%) of these 101 cases showed MPO positivity by all three modalities, defined as at least 3% MPO positive cells on cytochemistry or IH, and at least 10% MPO positive cells by FCM. A further 2 biopsies were negative for MPO by all three techniques. In 23/101 (23%) biopsies in which all three methods were performed, discrepancies occurred between the different modalities (Table 1). The largest group (11/23, 48%) was positive by FCM and IH but negative by CC. A further 7/23 (30%) cases were positive by IH only. Four (17%) cases were positive by CC and IH in the presence of negative FCM, and there was a single case in which FCM was positive when CC and IH were negative. In three cases of AML minimally differentiated (FAB-M0), IH was the only modality able to identify MPO positivity. CC was the least sensitive with no cases of detection of MPO positivity in the presence of negative results by FCM and IH. However there were still 4 cases where FCM was negative in the presence of a positive CC result. These results confirm the importance of employing more than one method of detecting MPO, particularly in cases where FCM and CC are negative or discrepant. In our study, IH was the most sensitive marker for demonstration of MPO. Despite the widespread use of FCM for typing AML, CC and IH still have an important role to play in the demonstration of MPO positivity in these cases. Table 1. Detection of MPO by cytochemistry, flow cytometry and immunohistochemistry in discrepant cases. Cytochemistry Flow Cytometry Immunohistochemistry Number of cases (n=23) + MPO positive, − MPO negative − + + 11 − − + 7 + − + 4 − + − 1

Abstract. Lakes are of fundamental importance in the Earth system as they support essential environmental and economic services, such as freshwater supply. Streamflow variability and temporal evolution are impacted by the presence of lakes in the river network; therefore, any change in the lake state can induce a modification of the regional hydrological regime. Despite the importance of the impact of lakes on hydrological fluxes and the water balance, a representation of the mass budget is generally not included in climate models and global-scale hydrological modeling platforms. The goal of this study is to introduce a new lake mass module, MLake (Mass-Lake model), into the river-routing model CTRIP to resolve the specific mass balance of open-water bodies. Based on the inherent CTRIP parameters, the development of the non-calibrated MLake model was introduced to examine the influence of such hydrological buffer areas on global-scale river-routing performance. In the current study, an offline evaluation was performed for four river networks using a set of state-of-the-art quality atmospheric forcings and a combination of in situ and satellite measurements for river discharge and lake level observations. The results reveal a general improvement in CTRIP-simulated discharge and its variability, while also generating realistic lake level variations. MLake produces more realistic streamflows both in terms of daily and seasonal correlation. Excluding the specific case of Lake Victoria having low performances, the mean skill score of Kling–Gupta efficiency (KGE) is 0.41 while the normalized information contribution (NIC) shows a mean improvement of 0.56 (ranging from 0.15 to 0.94). Streamflow results are spatially scale-dependent, with better scores associated with larger lakes and increased sensitivity to the width of the lake outlet. Regarding lake level variations, results indicate a good agreement between observations and simulations with a mean correlation of 0.56 (ranging from 0.07 to 0.92) which is linked to the capability of the model to retrieve seasonal variations. Discrepancies in the results are mainly explained by the anthropization of the selected lakes, which introduces high-frequency variations in both streamflows and lake levels that degraded the scores. Anthropization effects are prevalent in most of the lakes studied, but they are predominant for Lake Victoria and are the main cause for relatively low statistical scores for the Nile River However, results on the Angara and the Neva rivers also depend on the inherent gap of ISBA-CTRIP process representation, which relies on further development such as the partitioned energy budget between the snow and the canopy over a boreal zone. The study is a first step towards a global coupled land system that will help to qualitatively assess the evolution of future global water resources, leading to improvements in flood risk and drought forecasting.

Abstract. Conventional integration of Earth system and ocean models can accrue considerable computational expenses, particularly for marine biogeochemical applications. Offline numerical schemes in which only the biogeochemical tracers are time stepped and transported using a pre-computed circulation field can substantially reduce the burden and are thus an attractive alternative. One such scheme is the transport matrix method (TMM), which represents tracer transport as a sequence of sparse matrix–vector products that can be performed efficiently on distributed-memory computers. While the TMM has been used for a variety of geochemical and biogeochemical studies, to date the resulting solutions have not been comprehensively assessed against their online counterparts. Here, we present a detailed comparison of the two. It is based on simulations of the state-of-the-art biogeochemical sub-model embedded within the widely used coarse-resolution University of Victoria Earth System Climate Model (UVic ESCM). The default, non-linear advection scheme was first replaced with a linear, third-order upwind-biased advection scheme to satisfy the linearity requirement of the TMM. Transport matrices were extracted from an equilibrium run of the physical model and subsequently used to integrate the biogeochemical model offline to equilibrium. The identical biogeochemical model was also run online. Our simulations show that offline integration introduces some bias to biogeochemical quantities through the omission of the polar filtering used in UVic ESCM and in the offline application of time-dependent forcing fields, with high latitudes showing the largest differences with respect to the online model. Differences in other regions and in the seasonality of nutrients and phytoplankton distributions are found to be relatively minor, giving confidence that the TMM is a reliable tool for offline integration of complex biogeochemical models. Moreover, while UVic ESCM is a serial code, the TMM can be run on a parallel machine with no change to the underlying biogeochemical code, thus providing orders of magnitude speed-up over the online model.

Abstract Background: Tertiary lymphoid structures (TLS) are vascularized lymphocyte aggregates in the tumor microenvironment (TME) that correlate with better patient outcomes. Previous studies identified a 12 chemokine gene expression signature associated with disease progression and the type and degree of TLS. These signatures could provide insight important for clinical decision making during pathologic evaluation, but predicting gene expression from whole slide images (WSI) may be impeded by low prediction accuracy and lack of interpretability. Here we report an artificial intelligence (AI)-based, state-of-the-art workflow to predict the 12-chemokine TLS gene signature from lung cancer WSI, and identify histological features relevant to model predictions. Methods: Models were trained using 538 cases of paired lung cancer WSI and mRNA-seq expression data (The Cancer Genome Atlas). Cell and tissue classifiers, based on convolutional neural networks (CNN) were trained on WSI, and a graph neural network (GNN) model that leverages the relative spatial arrangement of the CNN-identified cells and tissues was used to predict gene expression. GNN predictions of TLS signature genes were compared with the predictions of models trained using hand-crafted, task-specific features (TLS feature models) describing the number, size, and cellular composition of identified TLS. The Pearson correlation coefficient was used to assess the accuracy of GNN and TLS feature model predictions. GNNExplainer1, a tool that simultaneously identifies a subgraph and a subset of node features important for predictions, was applied to interpret the GNN model predictions. Results: GNN model predictions show reasonable accuracy: GNN models significantly predicted mRNA expression of all 12 genes (p<0.05), and the predicted expression of six genes was moderately correlated with ground-truth measurements (Pearson-r>0.5). The correlation of GNN predictions was higher than that of the TLS feature models for all 12 signature genes. The GNNExplainer identified relevant features including the mean and standard deviation of lymphocyte count, and fraction of lymphocytes in cancer stroma. Subgraphs selected by the GNNExplainer focus on, but extend beyond, regions of human-annotated TLS objects, indicating that TLS may influence gene expression and the TME in regions beyond their immediate vicinity. Conclusion: Here, we show a comparison of two interpretable AI methods for the prediction of TLS-induced gene expression from WSI. The outperforming GNN-based approach is highly reproducible and accurate, predicting histopathology features relevant to TLS that may be used to inform patient prognosis and treatment. These methods could be applied to predict additional clinically relevant transcriptomic signatures. 1. ​​Ying, R, et al. 2019. arXiv:1903.03894v4 Citation Format: Ciyue Shen, Collin Schlager, Deepta Rajan, Maryam Pouryahya, Mary Lin, Victoria Mountain, Ilan Wapinski, Amaro Taylor-Weiner, Benjamin Glass, Robert Egger, Andrew Beck. Application of an interpretable graph neural network to predict gene expression signatures associated with tertiary lymphoid structures in histopathological images [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1922.

Abstract Targeting cytosolic nucleic acid sensing pathways to activate the Type I interferon (IFN) response is an emerging therapeutic strategy being explored in oncology. The PARP family consists of seventeen enzymes that regulate fundamental biological processes including response to cellular stress. PARP7 (TIPARP) is a stress-induced mono-ART that catalyzes the transfer of a single unit of ADP-ribose onto substrates (MARylation) to regulate their function and plays a role in suppressing the Type I IFN response in tumor cells (Gozgit 2021 Cancer Cell). RBN-2397 is the first potent and selective small molecule inhibitor of PARP7 catalytic function. To investigate the cell autonomous effects of PARP7 inhibition, we performed a cell line screen to identify PARP7 dependent cancer cell lines. We found that treatment of a subset of lines across several cancers led to a robust decrease in cell viability. Additionally, dosing of tumor bearing mice led to complete regressions in NCI-H1373 lung cancer xenografts. To investigate the mechanism of action (MOA) leading to decreased cell viability, we treated NCI-H1373 cells with RBN-2397 and found accumulation of cells in the G0/G1 phase of the cell cycle indicative of a cell cycle arrest. This arrest in NCI-H1373 cells was associated with the induction of senescence and increased mRNA expression of senescence associated secretory phenotype (SASP) genes. To evaluate the in vivo MOA, we performed an NCI-H1373 xenograft study and collected tumors after 7 days of RBN-2397 treatment. PARP7 inhibition led to decreased expression of Ki67, and increased expression of P21 and cleaved caspase-3, suggesting decreased proliferation and increased apoptosis. Increased expression of SASP genes was also observed in RBN-2397 treated tumors. Finally, we investigated transcriptional changes after RBN-2397 treatment by RNA sequencing. In addition to the effects observed in Type I IFN signaling, we also observed differential expression of genes associated with other pathways including autophagy and energy metabolism. Further evaluation of key autophagy proteins revealed that RBN-2397 affects autophagy flux and leads to a decrease in the oxygen consumption rate of cells and reduced ATP production from the mitochondria, suggesting that a change in energy metabolism may be related to the tumor intrinsic effect of RBN-2397. In summary, we show treatment of cancer cells with RBN-2397 not only leads to activation of tumor cell IFN signaling, but also causes G1 arrest and senescence, and changes in cancer cell autophagy and energy metabolism. In vivo, RBN-2397 treatment leads to complete tumor regressions in xenografts accompanied by decreased proliferation and increased apoptosis of tumor cells. RBN-2397 is currently being evaluated in the clinic as single agent in selected cancer types (NCT04053673) and in combination with anti-PD-1 therapies. Citation Format: Jennifer R. Molina, Joseph M. Gozgit, Melissa M. Vasbinder, Ryan P. Abo, Kaiko kunii, Kristy G. Kuplast-Barr, Bin Gui, Sunaina P. Nayak, Elena Minissale, Kerren K. Swinger, Tim J. Wigle, Alvin Z. Lu, Danielle J. Blackwell, Christina R. Majer, Yue Ren, Ellen Bamberg, Mario Niepel, Jan-Rung Mo, William D. Church, Ahmed S. Mady, Jeff Song, Zacharenia A. Varsamis, Luke Utley, Patricia E. Rao, Timoty J. Mitchison, Kevin W. Kuntz, Victoria M. Richon, Kristen McEachern, Heike Keilhack. PARP7 inhibitor RBN-2397 increases tumoral IFN signaling leading to various tumor cell intrinsic effects and tumor regressions in mouse models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2154.

BackgroundImmune checkpoint inhibitors (ICIs) have revolutionized cancer therapy but can result in toxicities, known as immune-related adverse events (irAEs), due to a hyperactivated immune system. ICI-related inflammatory arthritis has been described in literature, but herewith we introduce and characterize post-ICI activated osteoarthritis (ICI-aOA).MethodsWe conducted a multi-center, retrospective, observational study of patients with cancer treated with ICIs and diagnosed with ICI-aOA by a rheumatologist. ICI-aOA was defined by (1) an increase in non-inflammatory joint pain after ICI initiation, (2) in joints characteristically affected by osteoarthritis and (3) lack of inflammation on exam. Cases were graded using the CTCAE (Common Terminology Criteria for Adverse Events) V6.0 rubric for arthralgia. RECIST (Response evaluation criteria in solid tumors) V.1.1 (v.4.03) guidelines determined tumor response. Results were analyzed using Chi-squared tests of association and multivariate logistic regression.ResultsThirty-six patients had ICI-aOA with mean age at time of rheumatology presentation of 66 years (51–81yrs). Most patients had metastatic melanoma (10/36, 28%) and had received a PD1/PDL1 inhibitor monotherapy (31/36, 86%) with 5/36 (14%) combination therapy. Large joint involvement (hip/knee) was noted in 53% (19/36), small joints of hand 25% (9/36), and spine 14% (5/36). Two-thirds (24/36) suffered multiple joint involvement. Three of 36 (8%) had CTCAE grade 3, 14 (39%) grade 2 and 19 (53%) grade 1 manifestations. Symptom onset ranged from six days to 33.8 months with median of 5.2 months after ICI initiation; 5 patients suffered ICI-aOA after ICI cessation (0.6, 3.5, 4.4, 7.3 and 15.4 months after ICI cessation) (figure 1). Most common form of therapy was intra-articular corticosteroid injections only (15/36, 42%) followed by NSAIDs only (7/36, 20%) (figure 2). Twenty patients (56%) experienced other irAEs, with rheumatic and dermatologic being the most common. All three patients with high-grade ICI-aOA also had another irAE diagnosis at some point after ICI initiation.ConclusionsICI-aOA should be recognized as an adverse event of ICI immunotherapy. Early referral to a rheumatologist can facilitate the distinction between ICI induced inflammatory arthritis from post-ICI mechanical arthropathy, the latter of which can be managed with local therapy that will not compromise ICI efficacy.Ethics ApprovalCollection of patient data was approved by local Institutional Review Boards at respective institutions: Hospital for Special Surgery in New York (HSS IRB # 2017–1898), University of Chicago in Chicago, Illinois (IRB150837) and Austin Health in Melbourne, Victoria, Australia (HREC/18/Austin/102).Abstract 817 Figure 1Incidence of ICI-aOA (activated osteoarthritis after immune-checkpoint inhibitor) ranged from the first month after ICI initiation up until month 22 after ICI initiation, with most cases occurring in the first 6 months after start of ICI. Five of 36 patients experienced ICI-aOA after ICI cessation (0.6, 3.5, 4.4, 7.3 and 15.4 months after ICI cessation), corresponding to presentation after ICI initiation as follows: 2.0, 9.6, 19.1, 8.7 and 16.1 months after ICI initiation, respectively (as denoted in darker color). ICI: Immune-checkpoint inhibitor, NSAIDs: Non-steroidal anti-inflammatory drugs, DMARDs: Disease modifying anti-rheumatic drugsAbstract 817 Figure 2Therapeutic option most used was local or intra-articular corticosteroid therapy, followed by conservative management with physical therapy only then NSAIDs. Most patients experienced improvement in signs and symptoms with treatment. ICI: Immune-checkpoint inhibitor, NSAIDs: Non-steroidal anti-inflammatory drugs, DMARDs: Disease modifying anti-rheumatic drugs

Abstract. 2003 was a record year for wildfires worldwide. Severe forest fires killed four people, displaced 20 500 others and burnt 260 000 ha in South-East Australia in January 2003. The uncontrolled fires ignited in early January 2003 as a result of a prolonged El Niño drought in South-East Australia. Severe weather conditions resulted in a fast spread of the fires and poor air quality in a region where 70% of the population of Australia lives. We use state-of-art global chemistry and transport model GEOS-Chem in conjunction with ground- and space-based observations to study the ozone (O3) and aerosol enhancement due to fires. Firstly, the monthly mean surface O3 and Aerosol Optical Depth (AOD) in January 2003 are compared to January 2004 and, secondly, from sensitivity model simulations, four episodes are isolated and an attempt is made to quantify the contribution of the fires to air quality in south and South-East Australia. In January 2003 the observed monthly mean afternoon surface O3 in Victoria (VIC) and South Australia (SA) reached 27.5 ppb, which is 6.5 ppb (i.e. 30%) higher than in 2004. The simulated O3 is 29.5 ppb, which is 10 ppb higher than in 2004. While the model tends to overestimate the observed peak O3, it exhibits very good skill in reproducing the O3 temporal variability in January 2003 with a correlation of 0.83. In VIC, the air quality 4-h ozone (O3) standard exceedences are reported on 17, 24 and 25 January. On 12, 17, 24–25 and 29 January 2003, the observed O3 peaks above 40 ppb and the simulated fire contribution is higher than 10 ppb. During these 4 episodes, the range of observed O3 enhancement due to fires is 20–35 ppb, which is a factor of 3 to 5 higher than the monthly mean. The simulated fire O3 enhancement is in the range 15–50 ppb with a factor of 1.5 to 5 higher than the monthly mean. During two episodes, a well-formed surface wind channel stretches across the Tasman Sea facilitating the long range transport to New Zealand contributing to a 10% increase of surface O3. During the four episodes in January 2003, the observed AOD was up to a factor of five higher that the monthly mean AOD. The simulated and observed AODs agree on the spatial structure. Despite the model tendency to underestimate the AOD, it proves a useful tool in reconstructing the mostly patchy observations.

Abstract Introduction The CHaDOx1 nCov-19 AstraZeneca (AZ) vaccination has been associated with an antibody-mediated prothrombotic syndrome, termed "Thrombosis with Thrombocytopenia Syndrome" (TTS)[1-3]. The current diagnostic criteria for TTS are thrombosis (venous or arterial) within 4-42 days of AZ vaccine, thrombocytopenia and presence of an antibody to platelet factor 4 (PF4)[4, 5]. TTS commonly presents with cerebral venous sinus thrombosis (CVST) or splanchnic vessel thrombosis (SVT), but outside of TTS, CVST and SVT are uncommon, with an overall incidence of less than 0.5 per 100,000 [5-7]. Deep vein thrombosis (DVT) and pulmonary embolism (PE) are also associated with TTS, however the background incidence of venous thromboembolism (VTE) is much higher, with 1-2 events per 1000 patients per year[7, 8]. Therefore, many patients will present with new VTE and a recent exposure to the AZ vaccine, requiring consideration of investigation for TTS. Recent data suggests that PF4 antibodies can be seen in up to 8% of patients without thrombosis but following AZ vaccination[9]. We hypothesised in patients with recent AZ vaccination, new VTE but with a normal platelet count, that the incidence of a PF4 antibody is similar to this background rate of PF4 positivity. If confirmed, then presence of a normal platelet count despite new VTE and recent vaccination may exclude TTS without the need for PF4 antibody testing. We present our preliminary data on the rates of PF4 antibody positivity amongst patients with VTE, recent AZ vaccination and a normal platelet count at presentation. Aim and Methods To assess the incidence of PF4 ELISA positive results in patients with confirmed VTE, recent vaccination (within 4-42 days) with the first dose of AZ vaccine, and platelet count greater than 150x10 9/L. A retrospective audit of cases referred with suspected TTS to Monash Pathology, Melbourne, Victoria, and New South Wales Health Pathology at Royal Prince Alfred Hospital and St George Hospital sites Sydney, New South Wales, Australia, for testing for anti PF4 antibodies from 1 st April to 31 st July 2021. Patient sera were tested for the Anti-PF4 antibody using the STAGO Asserachrom HPIA IgG ELISA (Asnières sur Seine, France). For patients with a positive PF4 antibody test additional testing was sought for either the presence of platelet activating antibodies with a flow cytometry-based assay or the presence of spontaneous serotonin release without heparin in the serotonin release assay. Results From April 1 st to July 31 st 350 tests were run on 332 patients. 91 patients met our criteria, of whom 51 were female and 40 male, with a median age of 73 years. Median platelet count at presentation was 226x10 9/L, and median D dimer values were 10 times the upper limit of normal. 86 patients had either DVT, PE or both, including 2 with upper limb DVT, and 5 patients had PE with concurrent arterial events (1 axillary artery thrombosis, 3 arterial strokes, 1 coronary artery thrombosis). Further details are presented in table 1. 82 patient samples tested negative for anti-PF4 antibodies by ELISA, 5 were positive, and were 4 weak positive/equivocal (see table 2 for further details). Of the positive results, 3 had functional testing available, of which 2 were negative, and 1 showed discordant results, with a positive SRA but negative flow cytometry. None of the weak positive/equivocal cases had functional testing results available. Of the negative ELISA results, 5 patients had functional testing results available, of which 4 were negative. One of these cases had positive testing by flow cytometry, but negative by SRA (case included in table 2). Conclusion In our Australian cohort of patients with their first dose of AZ vaccine and new VTE within 4-42days, but a normal platelet count (therefore not fulfilling the clinical criteria of TTS), the incidence of a positive PF4 antibody test was 9/91 (9.9%, 95% CI 3.7-15.9%) and only one had evidence of platelet activating antibodies. This observed rate is similar to that observed in healthy patients without thrombosis who received AZ vaccination as described by Thiele et. al., 2021. Further confirmation in a larger cohort of VTE patients is required, but if confirmed, then PF4 ELISA testing in patients with VTE and normal platelet count post AZ vaccine may not be required, and should give clinicians confidence to institute routine management. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

PurposeThis paper focuses on the donation in 1888 of a Sèvres Vase to the Education Department of Victoria after the International Exhibition in Melbourne. Using the vase as its focus the paper reflects on what this donation may be able to tell us about the impact, primarily on education, of a series of International Exhibitions held both in Australia and internationally between 1851 and 1900. The life of the Sèvres vase highlights the potential of the Exhibitions for the exchange of ideas internationally, the influence of the International Exhibition movement on education and the links between a 19th-century gift and the teaching of Art in 1930s Melbourne.Design/methodology/approachThe paper examines one object in relation to education in its wider historical context through a reading of the archival records relating to the Melbourne Teacher’s Training College and Melbourne High School.FindingsThe influence of the educational exhibits of the 1888 Centennial International Exhibition held in Melbourne are shown to have had an impact on the design of the Melbourne Teachers Training College.Originality/valueThis paper provides a new and original perspective on the Melbourne Teachers Training College and its foundation through its library and museum collections.

This study aims to understand how people engage with art in the era of selfies, digital devices, and social media. It examines the audience experience of an art exhibition, where visitors are encouraged to use social media to share their art experience, to understand how such an approach might change the nature of visitor engagement with art. Arguably, selfies taken in the art space enrich the visitor’s experience and engagement with art and function as co-creational, empowering, and authentic marketing tools for museums. Data for this research were collected through non-participant observation (ethnography) and netnography at the National Gallery of Victoria, in Melbourne, Australia. The results show that rather than promoting disengagement from the art piece, selfies in the art space become “networked material-discursive entanglements” empowering art consumers to co-create value and arts organizations to reduce their distance from consumers and reproduce the iconic authenticity of the artwork in the virtual space. The article contributes to selfie theory by overcoming the traditional view of selfies as manifestation of narcissistic self-expression. Instead, it promotes an interpretation of selfies as an empowering and democratizing means used by art consumers to develop narratives and identity projects in a context such as the museum where traditionally the development of the narrative is apanage of an elite. A further contribution provided by this research stems from the identification of clusters of visitors (i.e., reality escapers, art lovers, photoholics, and selfie lovers), placed on a continuum of value co-creation, which arts administrators need to be conscious of as they enter a more dynamic era of art consumption. By outlining managerial implications, this study provides an initial reflection on how arts managers can navigate the emerging era of the selfie in the museum context.

Abstract Objective: ‘Food deserts’ and ‘food swamps’ are food retail environment typologies associated with unhealthy diet and obesity. The current study aimed to identify more complex food retail environment typologies and examine temporal trends. Design: Measures of food retail environment accessibility and relative healthy food availability were defined for small areas (SA2s) of Melbourne, Australia, from a census of food outlets operating in 2008, 2012, 2014 and 2016. SA2s were classified into typologies using a two-stage approach: (1) SA2s were sorted into twenty clusters according to accessibility and availability and (2) clusters were grouped using evidence-based thresholds. Setting: The current study was set in Melbourne, the capital city of the state of Victoria, Australia. Subjects: Food retail environments in 301 small areas (Statistical Area 2) located in Melbourne in 2008, 2012, 2014 and 2016. Results: Six typologies were identified based on access (low, moderate and high) and healthy food availability including one where zero food outlets were present. Over the study period, SA2s experienced an overall increase in accessibility and healthiness. Distribution of typologies varied by geographic location and area-level socio-economic position. Conclusion: Multiple typologies with contrasting access and healthiness measures exist within Melbourne and these continue to change over time, and the majority of SA2s were dominated by the presence of unhealthy relative to healthy outlets, with SA2s experiencing growth and disadvantage having the lowest access and to a greater proportion of unhealthy outlets.

At the start of the twentieth century, many young Australian artists travelled abroad to expand their art education and to gain exposure to the modern art movements of Europe. Most of these artists were active members of artist associations such as the Victorian Artists Society or the New South Wales Society of Artists. Male artists from Victoria were generally also members of the Melbourne Savage Club, a club with a strong association with the arts.This paper investigates the dual function of the club, as a space where the artists felt “at home” in the familiar environment that the club offered whilst they were abroad and, at the same time, a meeting space where they could engage in a stimulating artistic environment and gain introductions to leading figures in the art world. For those artists who chose England, London’s arts clubs played a large role, for it was in these establishments that they discussed, exhibited, shared, and met with their English counterparts. The club environment in London would have a significant impact on male Australian artists, as it offered a space where they were integrated into the English art world, which enhanced their experience whilst abroad.Artists were seldom members of Australia’s early gentlemen’s clubs, however, in the late nineteenth century Melbourne, artists formed less formal social groupings with exotic names such as the Prehistoric Order of Cannibals, the Buonarotti Club, and the Ishmael Club (Mead). Melbourne artists congregated in these clubs until the Melbourne Savage Club, modelled on the London Savage Club (1857)—a club whose membership was restricted to practitioners in the performing and visual arts—opened its doors in 1894.The Melbourne Savage Club had its origins in the Metropolitan Music Club, established in the late 1880s by a group of professional and amateur musicians and music lovers. The club initially admitted musicians and people from the dramatic professions free-of-charge, however, author Randolph Bedford (1868–1941) and artist Alf Vincent (1874–1915) were not content to be treated on a different basis to the musicians and actors, and two months after Vincent joined the club, at a Special General Meeting, the club resolved to vary Rule 6, “to admit landscape or portrait painters and sculptors without entrance fee” (Melbourne Savage Club). At another Special General Meeting, a year later, the rule was altered to admit “recognised members of the musical, dramatic and artistic professions and sculptors without payment of entrance fee” (Melbourne Savage Club).This resulted in an immediate influx of prominent Victorian male artists (Williams) and the Melbourne Savage Club became their place of choice to gather and enjoy the fellowship the club offered and to share ideas in a convivial atmosphere. When the opportunity arose for them to travel to London in the early twentieth century, they met in London’s famous art clubs. Membership of the Melbourne Savage Club not only conferred rights to visit reciprocal clubs whilst in London, but also facilitated introductions to potential patrons. The London clubs were the venue of choice for visiting artists to meet their fellow artist expatriates and to share experiences and, importantly, to meet with their British counterparts, exhibit their works, and establish valuable contacts.The London Savage Club attracted many Australian expatriates. Not only is it the grandfather of London’s bohemian clubs but also it was the model for arts clubs the world over. Founded in 1857, the qualification for admission was (and still is) to be, “a working man in literature or art, and a good fellow” (Halliday vii). If a candidate met these requirements, he would be cordially received “come whence he may.” This was embodied in the club’s first rules which required applicants for membership to be from a restricted range of pursuits relating to the arts thought to be commensurate with its bohemian ideals, namely art, literature, drama, or music.The second London arts club that attracted expatriate Australian artists was the New English Arts Club, founded in 1886 by young English artists returning from studying art in Paris. Members of The New English Arts Club were influenced by the Impressionist style as opposed to the academic art shown at the Royal Academy. As a meeting place for Australia’s expatriate artists, the New English Arts Club had a particular influence, as it exposed them to significant early Modern artist members such as John Singer Sargent (1856–1925), Walter Sickert (1860–1942), William Orpen (1878–1931) and Augustus John (1878–1961) (Corbett and Perry; Thornton; Melbourne Savage Club).The third, and arguably the most popular with the expatriate Australian artists’ club, was the Chelsea Arts Club, a bohemian club formed in 1891 by local working artists looking for a place to go to “meet, talk, eat and drink” (Cross).Apart from the American-born founding member, James McNeill Whistler (1834–1903), amongst the biggest Chelsea names at the time of the influx of travelling young Australian artists were modernists Sir William Orpen, Augustus John, and John Sargent. The opportunity to mix with these leading British contemporary artists was irresistible to these antipodean artists (55).When Melbourne artist, Miles Evergood (1871–1939) arrived in London from America in 1910, he had been an active exhibiting member of the Salmagundi Club, a New York artists’ club. Almost immediately he joined the New English Arts Club and the Chelsea Arts Club. Hammer tells of him associating with “writer Israel Zangwill, sculptor Jacob Epstein, and anti-academic artists including Walter Sickert, Augustus John, John Lavery, John Singer Sargent and C.R.W. Nevison, who challenged art values in Britain at the beginning of the century” (Hammer 41).Arthur Streeton (1867–1943) used the Chelsea Arts Club as his postal address, as did many expatriate artists. The Melbourne Savage Club archives contain letters and greetings, with news from abroad, written from artist members back to their “Brother Savages” (Various).In late 1902, Streeton wrote to fellow artist and Savage Club member Tom Roberts (1856–1931) from London:I belong to the Chelsea Arts Club now, & meet the artists – MacKennel says it’s about the most artistic club (speaking in the real sense) in England. … They all seem to be here – McKennal, Longstaff, Mahony, Fullwood, Norman, Minns, Fox, Plataganet Tudor St. George Tucker, Quinn, Coates, Bunny, Alston, K, Sonny Pole, other minor lights and your old friend and admirer Smike – within 100 yards of here – there must be 30 different studios. (Streeton 94)Whilst some of the artists whom Streeton mentioned were studying at either the Royal Academy or the Slade School, it was the clubs like the Chelsea Arts Club where they were most likely to encounter fellow Australian artists. Tom Roberts was obviously attentive to Streeton’s enthusiastic account and, when he returned to London the following year to work on his commission for The Big Picture of the 1901 opening of the first Commonwealth Parliament, he soon joined. Roberts, through his expansive personality, became particularly active in London’s Australian expatriate artistic community and later became Vice-President of the Chelsea Arts Club. Along with Streeton and Roberts, other visiting Melbourne Savage Club artists joined the Chelsea Arts Club. They included, John Longstaff (1861–1941), James Quinn (1869–1951), George Coates (1869–1930), and Will Dyson (1880–1938), along with Sydney artists Henry Fullwood (1863–1930), George Lambert (1873–1930), and Will Ashton (1881–1963) (Croll 95). Smith describes the exodus to London and Paris: “It was the Chelsea Arts Club that the Heidelberg School established its last and least distinguished camp” (Smith, Smith and Heathcote 152).Streeton, who retained his Chelsea Arts Club membership when he returned for a while to Australia, wrote to Roberts in 1907, “I miss Chelsea & the Club-boys” (Streeton 107). In relation to Frederick McCubbin’s pending visit he wrote: “Prof McCubbin left here a week ago by German ‘Prinz Heinrich.’ … You’ll introduce him at the Chelsea Club and I hope they make him an Hon. Member, etc” (Streeton et al. 85). McCubbin wrote, after an evening at the Chelsea Arts Club, following a visit to the Royal Academy: “Tonight, I am dining with Australian artists in Soho, and shall be there to greet my old friends. How glad I am! Longstaff will be there, and Frank Stuart, Roberts, Fullwood, Pontin, Coates, Quinn, and Tucker’s brother, and many others from all around” (MacDonald, McCubbin and McCubbin 75). Impressed by the work of Turner he wrote to his wife Annie, following avisit to the Tate Gallery:I went yesterday with Fullwood and G. Coates and Tom Roberts for a ramble … to the Tate Gallery – a beautiful freestone building facing the river through a portico into the gallery where the lately found turners are exhibited – these are not like the greater number of pictures in the National Gallery – they represent his different periods, but are mostly in his latest style, when he had realised the quality of light (McCubbin).Clearly Turner’s paintings had a profound impression on him. In the same letter he wrote:they are mostly unfinished but they are divine – such dreams of colour – a dozen of them are like pearls … mist and cloud and sea and land, drenched in light … They glow with tender brilliancy that radiates from these canvases – how he loved the dazzling brilliancy of morning or evening – these gems with their opal colour – you feel how he gloried in these tender visions of light and air. He worked from darkness into light.The Chelsea Arts Club also served as a venue for artists to entertain and host distinguished visitors from home. These guests included; Melbourne Savage Club artist member Alf Vincent (Joske 112), National Gallery of Victoria (NGV) Trustee and popular patron of the arts, Professor Baldwin Spencer (1860–1929), Professor Frederick S. Delmer (1864–1931) and conductor George Marshall-Hall (1862–1915) (Mulvaney and Calaby 329; Streeton 111).Artist Miles Evergood arrived in London in 1910, and visited the Chelsea Arts Club. He mentions expatriate Australian artists gathering at the Club, including Will Dyson, Fred Leist (1873–1945), David Davies (1864–1939), Will Ashton (1881–1963), and Henry Fullwood (Hammer 41).Most of the Melbourne Savage Club artist members were active in the London Savage Club. On one occasion, in November 1908, Roberts, with fellow artist MacKennal in the Chair, attended the Australian Artists’ Dinner held there. This event attracted twenty-five expatriate Australian artists, all residing in London at the time (McQueen 532).These London arts clubs had a significant influence on the expatriate Australian artists for they became the “glue” that held them together whilst abroad. Although some artists travelled abroad specifically to take up places at the Royal Academy School or the Slade School, only a minority of artists arriving in London from Australia and other British colonies were offered positions at these prestigious schools. Many artists travelled to “try their luck.” The arts clubs of London, whilst similarly discerning in their membership criteria, generally offered a visiting “brother-of-the-brush” a warm welcome as a professional courtesy. They featured the familiar rollicking all-male “Smoke Nights” a feature of the Melbourne Savage Club. With a greater “artist” membership than the clubs in Australia, expatriate artists were not only able to catch up with their friends from Australia, but also they could associate with England’s finest and most progressive artists in a familiar congenial environment. The clubs were a “home away from home” and described by Underhill as, “an artistic Earl’s Court” (Underhill 99). Most importantly, the clubs were a centre for discourse, arguably even more so than were the teaching academies. Britain’s leading modernist artists were members of the Chelsea Arts Club and the New English Arts Club and mixed freely with the visiting Australian artists.Many Australian artists, such as Miles Evergood and George Bell (1878–1966), held anti-academic views similar to English club members and embraced the new artistic trends, which they would bring back to Australia. Streeton had no illusions about the relative worth of the famed institutions and the exhibitions held by clubs such as the New English. Writing to Roberts before he joins him in London, he describes the Royal Academy as having, “an inartistic atmosphere” and claims he “hasn’t the least desire to go again” (Streeton 77). His preference lay with a concurrent “International Exhibition”, which featured works by Rodin, Whistler, Condor, Degas, and others who were setting the pace rather than merely continuing the academic traditions.Architect Hardy Wilson (1881–1955) served as secretary of The Chelsea Arts Club. When he returned to Australia he brought back with him a number of British works by Streeton and Lambert for an exhibition at the Guild Hall Melbourne (Underhill 92). Artists and Bohemians, a history of the Chelsea Arts Club, makes special reference of its world-wide contacts and singles out many of its prominent Australian members for specific mention including; Sir John William (Will) Ashton OBE, later Director of the Art Gallery of New South Wales, and Will Dyson, whose illustrious career as an Australian war artist was described in some detail. Dyson’s popularity led to his later appointment as Chairman of the Chelsea Arts Club where he initiated an ambitious rebuilding program, improving staff accommodation, refurbishing the members’ areas, and adding five bedrooms for visiting members (Bross 87-90).Whilst the influence of travel abroad on Australian artists has been noted, the importance of the London Clubs has not been fully explored. These clubs offered artists a space where they felt “at home” and a familiar environment whilst they were abroad. The clubs functioned as a meeting space where they could engage in a stimulating artistic environment and gain introductions to leading figures in the art world. For those artists who chose England, London’s arts clubs played a large role, for it was in these establishments that they discussed, exhibited, shared, and met with their English counterparts. The club environment in London had a significant impact on male Australian artists as it offered a space where they were integrated into the English art world which enhanced their experience whilst abroad and influenced the direction of their art.ReferencesCorbett, David Peters, and Lara Perry, eds. English Art, 1860–1914: Modern Artists and Identity. Manchester: Manchester University Press, 2000.Croll, Robert Henderson. Tom Roberts: Father of Australian Landscape Painting. Melbourne: Robertson & Mullens, 1935.Cross, Tom. Artists and Bohemians: 100 Years with the Chelsea Arts Club. 1992. 1st ed. London: Quiller Press, 1992.Gray, Anne, and National Gallery of Australia. McCubbin: Last Impressions 1907–17. 1st ed. Parkes, A.C.T.: National Gallery of Australia, 2009.Halliday, Andrew, ed. The Savage Papers. 1867. 1st ed. London: Tinsley Brothers, 1867.Hammer, Gael. Miles Evergood: No End of Passion. Willoughby, NSW: Phillip Mathews, 2013.Joske, Prue. Debonair Jack: A Biography of Sir John Longstaff. 1st ed. Melbourne: Claremont Publishing, 1994.MacDonald, James S., Frederick McCubbin, and Alexander McCubbin. The Art of F. McCubbin. Melbourne: Lothian Book Publishing, 1916.McCaughy, Patrick. Strange Country: Why Australian Painting Matters. Ed. Paige Amor. The Miegunyah Press, 2014.McCubbin, Frederick. Papers, Ca. 1900–Ca. 1915. Melbourne.McQueen, Humphrey. Tom Roberts. Sydney: Macmillan, 1996.Mead, Stephen. "Bohemia in Melbourne: An Investigation of the Writer Marcus Clarke and Four Artistic Clubs during the Late 1860s – 1901.” PhD thesis. Melbourne: University of Melbourne, 2009.Melbourne Savage Club. Secretary. Minute Book: Melbourne Savage Club. Club Minutes (General Committee). Melbourne: Savage Archives.Mulvaney, Derek John, and J.H. Calaby. So Much That Is New: Baldwin Spencer, 1860–1929, a Biography. Carlton, Vic.: Melbourne University Press, 1985.Smith, Bernard, Terry Smith, and Christopher Heathcote. Australian Painting, 1788–2000. 4th ed. South Melbourne, Vic.: Oxford University Press, 2001.Streeton, Arthur, et al. Smike to Bulldog: Letters from Sir Arthur Streeton to Tom Roberts. Sydney: Ure Smith, 1946.Streeton, Arthur, ed. Letters from Smike: The Letters of Arthur Streeton, 1890–1943. Melbourne: Oxford University Press, 1989.Thornton, Alfred, and New English Art Club. Fifty Years of the New English Art Club, 1886–1935. London: New English Art Club, Curwen Press 1935.Underhill, Nancy D.H. Making Australian Art 1916–49: Sydney Ure Smith Patron and Publisher. South Melbourne: Oxford University Press, 1991.Various. Melbourne Savage Club Correspondence Book: 1902–1916. Melbourne: Melbourne Savage Club.Williams, Graeme Henry. "A Socio-Cultural Reading: The Melbourne Savage Club through Its Collections." Masters of Arts thesis. Melbourne: Deakin University, 2013.

Abstract Background Recent rapid growth in urban areas and the desire to create liveable neighbourhoods has brought about a renewed interest in planning for compact cities, with concepts like the 20-minute neighbourhood (20MN) becoming more popular. A 20MN broadly reflects a neighbourhood that allows residents to meet their daily (non-work) needs within a short, non-motorised, trip from home. The 20MN concept underpins the key planning strategy of Australia’s second largest city, Melbourne, however the 20MN definition has not been operationalised. This study aimed to develop and operationalise a practical definition of the 20MN and apply this to two Australian state capital cities: Melbourne (Victoria) and Adelaide (South Australia). Methods Using the metropolitan boundaries for Melbourne and Adelaide, data were sourced for several layers related to five domains: 1) healthy food; 2) recreational resources; 3) community resources; 4) public open space; and 5) public transport. The number of layers and the access measures required for each domain differed. For example, the recreational resources domain only required a sport and fitness centre (gym) within a 1.5-km network path distance, whereas the public open space domain required a public open space within a 400-m distance along a pedestrian network and 8 ha of public open space area within a 1-km radius. Locations that met the access requirements for each of the five domains were defined as 20MNs. Results In Melbourne 5.5% and in Adelaide 7.6% of the population were considered to reside in a 20MN. Within areas classified as residential, the median number of people per square kilometre with a 20MN in Melbourne was 6429 and the median number of dwellings per square kilometre was 3211. In Adelaide’s 20MNs, both population density (3062) and dwelling density (1440) were lower than in Melbourne. Conclusions The challenge of operationalising a practical definition of the 20MN has been addressed by this study and applied to two Australian cities. The approach can be adapted to other contexts as a first step to assessing the presence of existing 20MNs and monitoring further implementation of this concept.

Abstract Sleep disturbances in women with and without polycystic ovary syndrome (PCOS) and their association with lifestyle factors (diet, physical activity and sitting time) Bennett C1, Mansfield DR2, Mo L2, Hodge A3, Joham A4, 5, Cain SW6, Blumfield M1, Teede H4, 5, Moran LJ4 1. Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria 2. Monash Lung and Sleep, Monash Health, Clayton, Victoria 3. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria 4. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 5. Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria 6. Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria Sleep disturbances are a risk factor for poorer lifestyle behaviours. While PCOS is associated with a higher prevalence of sleep disturbances, the relationship between sleep and lifestyle behaviours is unknown in PCOS. Self-reported data from the Australian Longitudinal Study on Women’s Health young cohort (31–36 years, n=6067, n=464 PCOS, n=5603 non-PCOS) were collected on PCOS, anthropometry, physical activity, sedentary behaviour, diet (74-item validated food frequency questionnaire) and sleeping behaviour (sleep quantity and adverse sleep symptoms). Multivariate regression models controlled for sleeping behaviour, BMI, age, marital status, education, income and area of residence. Women with PCOS reported greater adverse sleep symptoms, higher energy intake, diet quality (dietary guidelines index (DGI)), fibre intake and sedentary time and lower glycaemic index, compared to women without PCOS. This was not maintained for energy intake and sedentary behaviour on adjustment for confounders. For diet quality, there was an interaction between PCOS and sleep disturbances. Only for women with fewer sleep disturbances (~8 hours sleep/no adverse sleep symptoms) was PCOS associated with better diet quality (DGI higher by 3.14±0.86, p<0.001), with no differences in diet quality for women with poorer sleep. Lifestyle behaviours in women with PCOS appear to be influenced by sleep quality and quantity. Nothing to disclose: CB, DM, LM, AH, AJ, SC, MB, HT, LM

Abstract Purpose Rail level crossing removals to improve transport performance across metropolitan Melbourne (state of Victoria) resulted in new rail fencing and grade-separation of tracks from the surrounding environment at several sites. These design changes restricted pedestrian access to the rail tracks, which is a countermeasure known to prevent railway suicide in other settings. We examined whether any such suicide prevention effect followed the removals. Methods We used a multiple-arm pre-post design to test whether a decrease in monthly frequency of railway suicides occurred at level crossing removal sites (intervention sites), compared to randomly matched sites where level crossings had not yet been removed (control sites). We used data available in the Victorian Suicide Register covering the period 1st January 2008 to 30th June 2021. Results The mean monthly number of railway suicides decreased by 68% within a 500 m radius of intervention sites (RR: 0.32; CI 95% 0.11–0.74) and by 61% within a 1000 m radius of intervention sites (RR: 0.39; CI 95% 0.21–0.68). There was no evidence that the mean monthly number of railway suicides changed at the control sites, either within a 500 m radius (RR: 0.88; CI 95% 0.47–1.56) or a 1000 m radius (RR: 0.82; CI 95% 0.52–1.26). Conclusion The reduction in railway suicides at locations where level crossings were removed, demonstrates the suicide prevention benefits that can be derived from a major infrastructure project even if not initially intended. Planning for major infrastructure projects should include consideration of these benefits, with designs incorporating features to maximise suicide prevention impact.

Typicals is a series of 12 colour photographs digitally created from photojournalistic images from Colombia combined with "typical" craft textiles and text from guest writers. Typicals was first exhibited as photographs 50cm x 75cm in size, each with their own magnifying glass, at the Contemporary Art Space at Gorman House in Canberra, Australia, in 2000. It was then exhibited in "Feedback: Art Social Consciousness and Resistance" at Monash University Museum of Art in Melbourne, Australia, from March to May 2003. From May to June 2003 it was exhibited at the Museo de Arte de la Universidad Nacional de Colombia Santa Fé Bogotá, Colombia. In its current manifestation the artwork has been adapted from the catalogue of the museum exhibitions. It is broken up into eight pieces corresponding to the contributions of the writers. The introduction by Sylvia Vélez is the PDF file accessible via a link below this abstract. The other seven PDF files are accessible via the 'Supplementary Files' section to the left of your screen. Please note that these files are around 4 megabytes each, so it may be difficult to access them from a dial-up connection.

The 74th Annual Meeting of The Canadian Rheumatology Association was held at the Fairmont Empress, Victoria, British Columbia, Canada, February 26–29, 2020. The program consisted of presentations covering original research, symposia, awards, and lectures. Highlights of the meeting include the following 2020 Award Winners: Distinguished Rheumatologist, Jamie Henderson; Distinguished Investigator, Paul Fortin; Distinguished Teacher-Educator, Rayfel Schneider; Emerging Investigator, Claire Barber; Emerging Teacher-Educator, Dharini Mahendira; Ian Watson Award for the Best Abstract on SLE Research by a Trainee, Kimberley Yuen; Phil Rosen Award for the Best Abstract on Clinical or Epidemiology Research by a Trainee, Kristina Roche and Eugene Krustev; Best Abstract on Research by a Rheumatology Resident, Julie Mongeau; Best Abstract on Basic Science Research by a Trainee, Sonya Kim; Best Abstract by a Post-Graduate Research Trainee, Carolina Munoz-Grajales; Best Abstract on Quality Care Initiatives in Rheumatology, Arielle Mendel; Best Abstract by a Medical Student, Declan Webber; Best Abstract by an Undergraduate Student, Chloe Lee; Best Abstract by a Rheumatology Post-Graduate Research Trainee, Nancy Maltez; Best Abstract on Research by Young Faculty, Lily Lim; Best Abstract on Spondyloarthritis Research, Anas Samman; Practice Reflection Award, Gold, Steven Katz; Practice Reflection Award, Silver, Bailey Dyck. Lectures and other events included Keynote Lecture by Tim Spector: Inflammatory Diets — The Microbiome; Keynote Address by Paul Fortin, Distinguished Investigator Awardee: The Power of Many in Lupus Research; State of the Art Lecture by Dinesh Khanna: Systemic Sclerosis-related Lung Fibrosis: Management in 2020; Dunlop-Dottridge Lecture by Betty Diamond: Neuropsychiatric Lupus from Mechanisms to Treatment; and the Great Debate: To Diagnose or Not to Diagnose: Be It Resolved That It Is Better to Underdiagnose than Overdiagnose in Rheumatology Practice. Arguing for: Kam Shojania and Andrea Knight, and against: Amanda Steiman and Corrie Baldwin. Topics including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren syndrome, psoriatic arthritis, spondyloarthritis, vasculitis, osteoarthritis, fibromyalgia, and their respective diagnoses, treatments, and outcomes are reflected in the abstracts, which we are pleased to publish in this issue of The Journal.

Abstract Background Certain migrant groups are at an increased risk of psychotic disorders compared to the native-born population; however, research to date has mainly been conducted in Europe. Less is known about whether migrants to other countries, with different histories and patterns of migration, such as Australia, are at an increased risk for developing a psychotic disorder. We tested this for first-generation migrants in Melbourne, Victoria. Methods This study included all young people aged 15–24 years, residing in a geographically-defined catchment area of north western Melbourne who presented with a first episode of psychosis (FEP) to the Early Psychosis Prevention and Intervention Centre (EPPIC) between 1 January 2011 and 31 December 2016. Data pertaining to the at-risk population were obtained from the Australian 2011 Census and incidence rate ratios were calculated and adjusted for age, sex and social deprivation. Results In total, 1220 young people presented with an FEP during the 6-year study period, of whom 24.5% were first-generation migrants. We found an increased risk for developing psychotic disorder in migrants from the following regions: Central and West Africa (adjusted incidence rate ratio [aIRR] = 3.53, 95% CI 1.58–7.92), Southern and Eastern Africa (aIRR = 3.06, 95% CI 1.99–4.70) and North Africa (aIRR = 5.03, 95% CI 3.26–7.76). Migrants from maritime South East Asia (aIRR = 0.39, 95% CI 0.23–0.65), China (aIRR = 0.25, 95% CI 0.13–0.48) and Southern Asia (aIRR = 0.44, 95% CI 0.26–0.76) had a decreased risk for developing a psychotic disorder. Conclusion This clear health inequality needs to be addressed by sufficient funding and accessible mental health services for more vulnerable groups. Further research is needed to determine why migrants have an increased risk for developing psychotic disorders.

Introduction: Stroke utilizes a large portion of hospital resources. Little is known about the frequency of contacts with hospitals prior to first-ever stroke and potentially missed opportunities for stroke prevention. In addition, re-admissions may indicate failed secondary prevention. Hypothesis: Many patients have had a presentation or admission to hospital in the year prior to a first-ever stroke event. Methods: Data from the prospective, national Australian Stroke Clinical Registry (AuSCR) obtained between 15 June 2009 and 31 December 2010 from a large hospital in Melbourne, Victoria (Australia) were linked to the Victorian government emergency department (ED) and hospital discharge datasets for a 3 year ‘look-back’ period and any re-presentation up until February 2011 using stepwise deterministic linkage methods. Descriptive statistics are presented. Results: Matched linkage to ED (731/788) and hospital discharge (736/788) datasets was achieved in 93% of AuSCR registrants, of whom 513 were first-ever strokes (51% male, average age 74 [±16] years, 82% ischemic). Prior to the first-ever stroke, 221 (47%) registrants had ED presentations and 283 had a hospital admission on average 2.9 months before stroke. The mean number of ED presentations within 3 years of AuSCR registration for a first-ever event was 2.1 (SD 1.6); and 48/466 (10%) occurred in the month prior to stroke. Among first-ever stroke registrants, 200 were re-admitted on average within 5 months following discharge; 3.5% for recurrent stroke/TIA. Conclusion: Contact with hospitals was common (~50%) before first stroke, raising opportunities to screen and intervene in people at risk of stroke. As one in 5 hospital re-admissions is for recurrent stroke, a closer monitoring of secondary prevention measures in the early post-discharge period may be warranted.

Abstract Background There are more than 7,800 people living with human immunodeficiency virus (HIV) in Victoria, Australia. Crucial in maximising the individual and population level benefits from antiretroviral therapy (ART) is understanding how to achieve patient retention in care and the factors that drive it. This study was an expansion of a 2015 assessment of HIV-care retention in Victoria, which sought out to determine whether the inclusion of a broader range of HIV-healthcare sites would yield more accurate estimates of retention in HIV-care. We aimed to improve our understanding of HIV-care retention in Victoria, Australia, identify people living with HIV (PLHIV) with unknown outcomes, and attempt to re-engage PLHIV in care. Methods A network of 15 HIV-care sites was established in Victoria, Australia across diverse care settings which ranged from low-caseload rural sites to high-caseload metropolitan GP clinics and hospitals. Individuals who had an HIV viral load (VL) performed in both calendar years of 2016 and 2017 were classified as retained in care. Individuals with a VL test in 2016 but not in 2017 were considered to potentially have unknown outcomes as they may have been receiving care elsewhere, have disengaged from care or died. For this group, an intervention of cross-referencing partially de-identified data between healthcare sites, and contact tracing individuals who still had unknown outcomes was performed. Results For 5223 individuals considered to be retained in care across 15 healthcare sites in the study period, 49 had unconfirmed transfers of care to an alternative provider and 79 had unknown outcomes. After the intervention, the number of unconfirmed care transfers was reduced to 17 and unknown outcomes reduced to 51. These changes were largely attributed to people being reclassified as confirmed transfers of care. Retention in care estimates that did not include the patient outcome of confirmed transfer of care ranged from 76.2 to 95.8% and did not alter with the intervention. However, retention in care estimates which considered confirmed transfers and those that re-entered care at a new site as retained in care significantly increased across five of the sites with estimates ranging from 80.9 to 98.3% pre-intervention to 83.3–100% post-intervention. Individuals whose outcomes remained unknown post-intervention were more often men who have sex with men (MSM) when compared to other categories (person who injects drugs (PWID), combined PWID/MSM, men who identify as heterosexual or unknown) (74.5% vs. 53.5%, [p = 0.06]) and receiving ART at their last HIV-care visit (84.3% vs. 67.8% [p = 0.09]). Conclusion This study confirmed high retention in HIV-care and low numbers of people disengaged from HIV-care in Victoria. This was demonstrated across a larger number of sites with varying models of care than a prior assessment in 2015. These data align with national and state targets aiming for 95% of PLHIV retained in HIV-care.

Introduction: Multiple data collections can be a burden for clinicians. In 2009, the Australian Stroke Clinical Registry (AuSCR) was established by non-government and research organizations to provide quality of care data unavailable for acute stroke admissions. We show here the reliability of linking complimentary registry data with routinely collected hospital discharge data submitted to governmental bodies. Hypothesis: A high quality linkage with a > 90% rate is possible, but requires multiple personal identifiers common to each dataset. Methods: AuSCR identifying variables included date of birth (DoB), Medicare number, first name, surname, postcode, gender, hospital record number, hospital name and admission date. The Victorian Department of Health emergency department (ED) and hospital discharge linked dataset has most of these, with first name truncated to the first 3 digits, but no surname. Common data elements of AuSCR patients registered at a large hospital in Melbourne, Victoria (Australia) between 15 June 2009 and 31 December 2010 were submitted to undergo stepwise deterministic linkage. Results: The Victorian AuSCR sample had 818 records from 788 individuals. Three steps with 1) Medicare number, postcode, gender and DoB (80% matched); 2) hospital number/admit date; and 3) ED number/visit date were required to link AuSCR data with the ED and hospital discharge data. These led to an overall high quality linkage of >99% (782/788) of AuSCR patients, including 731/788 for ED records and 736/788 for hospital records. Conclusion: Multiple personal identifiers from registries are required to achieve reliable linkage to routinely collected hospital data. Benefits of these linked data include the ability to investigate a broader range of research questions than with a single dataset. Characters with spaces= 1941 (limit is 1950)

Abstract Background Nearly 50% of men living with HIV in many countries are unaware of their HIV status; men also have lower uptake of HIV treatment and pre-exposure prophylaxis (PrEP). In SSA, highly mobile men such as those working in fishing communities alongside Lake Victoria have low uptake of HIV testing and low rates of linkage to HIV treatment and PrEP, despite increasing availability of these services. HIV self-testing (HIVST) kits hold promise for overcoming barriers to HIV testing and linkage to services for HIV-positive and HIV-negative men. We describe here a protocol for an HIV status-neutral, social network-based approach to promote HIV testing, linkage to care and prevention, and better health outcomes, including adherence, in fishermen around Lake Victoria. Methods Utilizing beach management unit (BMU) registries of fishermen operating in three Lake Victoria fishing communities in Siaya County, Kenya, we completed a census and social network mapping to identify close social networks of men. Network clusters identified by a socially-central lead (“promotor”) and selected to ensure maximal separation between treatment and control will be randomized. Promotors in both arms will receive basic HIV training; intervention promotors are further trained in HIVST to distribute kits to their cluster, while control promotors will distribute to their cluster vouchers for free HIVST at nearby clinics. We will test whether these promoters can enhance linkage to ART and PrEP after self-testing, thereby addressing a key limitation of HIVST. We will also measure 6- and 12-month viral load in those living with HIV and PrEP adherence among those without HIV via urine tenofovir levels as objective markers of adherence. Discussion This study has the potential to improve HIV health and promote HIV prevention among a hard to reach, at-risk, and highly mobile population of men in Western Kenya—a critical population in Kenya’s HIV prevention and treatment program. Further, if successful, this innovative social networks-based model could be scaled at the regional level to address HIV prevention and care among similarly at-risk populations of men in eastern Africa and inland fisheries settings across the continent. Trial registration Self-Test Strategies and Linkage Incentives to Improve ART and PrEP Uptake in Men, registered on February 26, 2021, registration #NCT04772469.

IntroductionAustralia is at a particular point in its history where there is a noticeable diaspora of artists and creative practitioners away from the major capitals of Sydney and Melbourne (in particular), driven in no small part by ballooning house prices of the last eight years. This has meant big changes for some regional spaces, and in turn, for the face of Australian cultural life. Regional cultural precincts are forming with tourist flows, funding attention and cultural economies. Likewise, there appears to be growing consciousness in the ‘art centres’ of Melbourne and Sydney of interesting and relevant activities outside their limits. This research draws on my experience as an art practitioner, curator and social researcher in one such region (Castlemaine in Central Victoria), and particularly from a recent interview series I have conducted in collaboration with art space in that region, Wide Open Road Art. In this, 23 regional and city-based artists were asked about the social, economic and local conditions that can and have supported their art practices. Drawing from these conversations and Bourdieu’s ideas around cultural production, the article suggests that authentic, diverse, interesting and disruptive creative practices in Australian cultural life involve the increasingly pressing need for security while existing outside the modern imperative of high consumption; of finding alternative ways to live well while entering into the shared space of cultural production. Indeed, it is argued that often it is the capacity to defy key economic paradigms, for example of ‘rational (economic) self-interest’, that allows creative life to flourish (Bourdieu Field; Ley “Artists”). While regional spaces present new opportunities for this, there are pitfalls and nuances worth exploring.Changes in Regional AustraliaAustralia has long been an urbanising nation. Since Federation our cities have increased from a third to now constituting two-thirds of the country’s total population (Gray and Lawrence 6; ABS), making us one of the most urbanised countries in the world. Indeed, as machines replaced manual labour on farms; as Australia’s manufacturing industry began its decline; and as young people in particular left the country for city universities (Gray and Lawrence), the post-war industrial-economic boom drove this widespread demographic and economic shift. In the 1980s closures of regional town facilities like banks, schools and hospitals propelled widespread belief that regional Australia was in crisis and would be increasingly difficult to sustain (Rentschler, Bridson, and Evans; Gray and Lawrence 2; Barr et al.; ABS). However, the late 1990s and early 21st century saw a turnaround that has been referred to by some as the rise of the ‘sea change’. That is, widespread renewed interest and idealisation of not just coastal areas but anywhere outside the city (Murphy). It was a simultaneous pursuit of “a small ‘a’ alternative lifestyle” and escape from rising living costs in urban areas, especially for the unemployed, single parents and those with disabilities (Murphy). This renewed interest has been sustained. The latest wave, or series of waves, have coincided with the post-GFC house price spike, of cheap credit and lenient lending designed to stimulate the economy. This initiative in part led to Sydney and Melbourne median dwelling prices rising by up to 114% in eight years (Scutt 2017), which alone had a huge influence on who was able to afford to live in city areas and who was not. Rapid population increases and diminished social networks and familial support are also considered drivers that sent a wave of people (a million since 2011) towards the outer fringes of the cities and to ‘commuter belt’ country towns (Docherty; Murphy). While the underprivileged are clearly most disadvantaged in what has actually been a global development process (see Jayne on this, and on the city as a consumer itself), artists and creatives are also a unique category who haven’t fared well with hyper-urbanisation (Ley “Artists”). Despite the class privilege that often accompanies such a career choice, the economic disadvantage art professions often involve has seen a diaspora of artists moving to regional areas, particularly those in the hinterlands around and train lines to major centres. We see the recent ‘rise of a regional bohemia’ (Regional Australia Institute): towns like Toowoomba, Byron Bay, Surf Coast, Gold Coast-Tweed, Kangaroo Valley, Wollongong, Warburton, Bendigo, Tooyday, New Norfolk, and countless more being re-identified as arts towns and precincts. In Australia in 2016–17, 1 in 6 professional artists, and 1 in 4 visual artists, were living in a regional town (Throsby and Petetskaya). Creative arts in regional Australia makes up a quarter of the nation’s creative output and is a $2.8 billion industry; and our regions particularly draw in creative practitioners in their prime productive years (aged 24 to 44) (Regional Australia Institute).WORA Conservation SeriesIn 2018 artist and curator Helen Mathwin and myself received a local shire grant to record a conversation series with 23 artists who were based in the Central Goldfields region of Victoria as well as further afield, but who had a connection to the regional arts space we run, WideOpenRoadArt (WORA). In videoed, in-depth, approximately hour-long, semi-structured interviews conducted throughout 2018, we spoke to artists (16 women and 7 men) about the relocation phenomenon we were witnessing in our own growing arts town. Most were interviewed in WORA’s roving art float, but we seized any ad hoc opportunity we had to have genuine discussions with people. Focal points were around sustainability of practice and the social conditions that supported artists’ professional pursuits. This included accessing an arts community, circles of cultural production, and the ‘art centre’; the capacity to exhibit; but also, social factors such as affordable housing and the ability to live on a low-income while having dependants; and so on. The conversations were rich with lived experiences and insights on these issues.Financial ImperativesIn line with the discussion above, the most prominent factor we noticed in the interviews was the inescapable importance of being able to live cheaply. The consistent message that all of the interviewees, both regional- and city-based, conveyed was that a career in art-making required an important independence from the need to earn a substantial income. One interviewee commented: “I do run my art as a business, I have an ABN […] it makes a healthy loss! I don’t think I’ve ever made a profit […].” Another put it: “now that I’m in [this] town and I have a house and stuff I do feel like there is maybe a bit more security around those daily things that will hopefully give me space to [make artworks].”Much has been said on the pervasive inability to monetise art careers, notably Bourdieu’s observations that art exists on an interdependent field of cultural capital, determining for itself an autonomous conception of value separate to economics (Bourdieu, Field 39). This is somewhat similar to the idea of art as a sacred phenomenon irreducible to dollar terms (Abbing 38; see also Benjamin’s “aura”; “The Work of Art”). Art’s difficult relationship with commodification is part of its heroism that Benjamin described (Benjamin Charles Baudelaire 79), its potential to sanctify mainstream society by staying separate to the lowly aspirations of commerce (Ley “Artists” 2529). However, it is understood, artists still need to attain professional education and capacities, yet they remain at the bottom of the income ladder not only professionally, but in the case of visual artists, they remain at the bottom of the creative income hierarchies as well. Further to this, within visual arts, only a tiny proportion achieve financially backed success (Menger 277). “Artistic labour markets are characterised by high risk of failure, excess supply of recruits, low artistic income level, skewed income distribution and multiple jobholding” (Mangset, Torvik Heian, Kleppe, and Løyland; Menger). Mangset et al. point to ideas that have long surrounded the “charismatic artist myth,” of a quasi-metaphysical calling to be an artist that can lead one to overlook the profession’s vast pitfalls in terms of economic sustainability. One interviewee described it as follows: “From a very young age I wanted to be an artist […] so there’s never been a time that I’ve thought that’s not what I’m doing.” A 1% rule seems widely acknowledged in how the profession manages the financial winners against those who miss out; the tiny proportion of megastar artists versus a vast struggling remainder.As even successful artists often dip below the poverty line between paid engagements, housing costs can make the difference between being able to live in an area and not (Turnbull and Whitford). One artist described:[the reason we moved here from Melbourne] was financial, yes definitely. We wouldn’t have been able to purchase a property […] in Melbourne, we would not have been able to live in place that we wanted to live, and to do what we wanted to do […]. It was never an option for us to get a big mortgage.Another said:It partly came about as a financial practicality to move out here. My partner […] wanted to be in the bush, but I was resistant at first, we were in Melbourne but we just couldn’t afford Melbourne in the end, we had an apartment, we had a studio. My partner was a cabinet maker then. You know, just every month all our money went to rent and we just couldn’t manage anymore. So we thought, well maybe if we come out to the bush […] It was just by a happy accident that we found a property […] that we could afford, that was off-grid so it cut the bills down for us [...] that had a little studio and already had a little cottage on there that we could rent that out to get money.For a prominent artist we spoke to this issue was starkly reflected. Despite large exhibitions at some of the highest profile galleries in regional Victoria, the commissions offered for these shows were so insubstantial that the artist and their family had to take on staggering sums of personal debt to execute the ambitious and critically acclaimed shows. Another very successful artist we interviewed who had shown widely at ‘A-list’ international arts institutions and received several substantial grants, spoke of their dismay and pessimism at the idea of financial survival. For all artists we spoke to, pursuing their arts practice was in constant tension with economic imperatives, and their lives had all been shaped by the need to make shrewd decisions to continue practising. There were two artists out of the 23 we interviewed who considered their artwork able to provide full-time income, although this still relied on living costs remaining extremely low. “We are very lucky to have bought a very cheap property [in the country] that I can [also] have my workshop on, so I’m not paying for two properties in Melbourne […] So that certainly takes a fair bit of pressure off financially.” Their co-interviewee described this as “pretty luxurious!” Notably, the two who thought they could live off their art practices were both men, mid-career, whose works were large, spectacular festival items, which alongside the artists’ skill and hard work was also a factor in the type of remuneration received.Decongested LivingBeyond more affordable real estate and rental spaces, life outside our cities offers other benefits that have particular relevance to creative practitioners. Opera and festival director Lindy Hume described her move to the NSW South Coast in terms of space to think and be creative. “The abundance of time, space and silence makes living in places like [Hume’s town] ideal for creating new work” (Brown). And certainly, this was a theme that arose frequently in our interviews. Many of our regionally based artists were in part choosing the de-pressurised space of non-metro areas, and also seeking an embedded, daily connection to nature for themselves, their art-making process and their families. In one interview this was described as “dreamtime”. “Some of my more creative moments are out walking in the forest with the dog, that sort of semi-daydreamy thing where your mind is taken away by the place you’re in.”Creative HubsAll of our regional interviewees mentioned the value of the local community, as a general exchange, social support and like-minded connection, but also specifically of an arts community. Whether a tree change by choice or a more reactive move, the diaspora of artists, among others, has led to a type of rural renaissance in certain popular areas. Creative hubs located around the country, often in close proximity to the urban centres, are creating tremendous opportunities to network with other talented people doing interesting things, living in close proximity and often open to cross-fertilisation. One said: “[Castlemaine] is the best place in Australia, it has this insane cultural richness in a tiny town, you can’t go out and not meet people on the street […] For someone who has not had community in their life that is so gorgeous.” Another said:[Being an artist here] is kind of easy! Lots of people around to connect—with […] other artists but also creatively minded people [...] So it means you can just bump into someone from down the street and have an amazing conversation in five minutes about some amazing thing! […] There’s a concentration here that works.With these hubs, regional spaces are entering into a new relevance in the sphere of cultural production. They are generating unique and interesting local creative scenes for people to live amongst or visit, and generating strong local arts economies, tourist economies, and funding opportunities (Rentschler, Bridson, and Evans). Victoria in particular has burgeoned, with tourist flows to its regions increasing 13 per cent in 5 years and generating tourism worth $10 billion (Tourism Victoria). Victoria’s Greater Bendigo is Australia’s most popularly searched tourist destination on Trip Advisor, with tourism increasing 52% in 10 years (Boland). Simultaneously, funding flows have increased to regional zones, as governments seek to promote development outside Australia’s urban centres and are confident in the arts as a key strategy in boosting health, economies and overall wellbeing (see Rentschler, Bridson, and Evans; see also the 2018 Regional Centre for Culture initiative, Boland). The regions are also an increasingly relevant participant in national cultural life (Turnbull and Whitford; Mitchell; Simpson; Woodhead). Opportunities for an openness to productive exchange between regional and metropolitan sites appear to be growing, with regional festivals and art events gaining importance and unique attributes in the consciousness of the arts ‘centre’ (see for example Fairley; Simpson; Farrelly; Woodhead).Difficulties of Regional LocationDespite this, our interviews still brought to light the difficulties and barriers experienced living as a regional artist. For some, living in regional Victoria was an accepted set-back in their ambitions, something to be concealed and counteracted with education in reputable metropolitan art schools or city-based jobs. For others there was difficulty accessing a sympathetic arts community—although arts towns had vibrant cultures, certain types of creativity were preferred (often craft-based and more community-oriented). Practitioners who were active in maintaining their links to a metropolitan art scene voiced more difficulty in fitting in and successfully exhibiting their (often more conceptual or boundary-pushing) work in regional locations.The Gentrification ProblemThe other increasingly obvious issue in the revivification of some non-metropolitan areas is that they can and are already showing signs of being victims of their own success. That is, some regional arts precincts are attracting so many new residents that they are ceasing to be the low-cost, hospitable environments for artists they once were. Geographer David Ley has given attention to this particular pattern of gentrification that trails behind artists (Ley “Artists”). Ley draws from Florida’s ideas of late capitalism’s ascendency of creativity over the brute utilitarianism of the industrial era. This has got to the point that artists and creative professionals have an increasing capacity to shape and generate value in areas of life that were previous overlooked, especially with built environments (2529). Now more than ever, there is the “urbane middle-class” pursuing ‘the swirling milieu of artists, bohemians and immigrants” (Florida) as they create new, desirable landscapes with the “refuse of society” (Benjamin Charles Baudelaire 79; Ley New Middle Class). With Australia’s historic shifts in affordability in our major cities, this pattern that Ley identified in urban built environments can be seen across our states and regions as well.But with gentrification comes increased costs of living, as housing, shops and infrastructure all alter for an affluent consumer-resident. This diminishes what Bourdieu describes as “the suspension and removal of economic necessity” fundamental to the avant-garde (Bourdieu Distinction 54). That is to say, its relief from heavy pressure to materially survive is arguably critical to the reflexive, imaginative, and truly new offerings that art can provide. And as argued earlier, there seems an inbuilt economic irrationality in artmaking as a vocation—of dedicating one’s energy, time and resources to a pursuit that is notoriously impoverishing. But this irrationality may at the same time be critical to setting forth new ideas, perspectives, reflections and disruptions of taken-for-granted social assumptions, and why art is so indispensable in the first place (Bourdieu Field 39; Ley New Middle Class 2531; Weber on irrationality and the Enlightenment Project; also Adorno’s the ‘primitive’ in art). Australia’s cities, like those of most developed nations, increasingly demand we busy ourselves with the high-consumption of modern life that makes certain activities that sit outside this almost impossible. As gentrification unfolds from the metropolis to the regions, Australia faces a new level of far-reaching social inequality that has real consequences for who is able to participate in art-making, where these people can live, and ultimately what kind of diversity of ideas and voices participate in the generation of our national cultural life. ConclusionThe revival of some of Australia’s more popular regional towns has brought new life to some regional areas, particularly in reshaping their identities as cultural hubs worth experiencing, living amongst or supporting their development. Our interviews brought to life the significant benefits artists have experienced in relocating to country towns, whether by choice or necessity, as well as some setbacks. It was clear that economics played a major role in the demographic shift that took place in the area being examined; more specifically, that the general reorientation of social life towards consumption activities are having dramatic spatial consequences that we are currently seeing transform our major centres. The ability of art and creative practices to breathe new life into forgotten and devalued ideas and spaces is a foundational attribute but one that also creates a gentrification problem. Indeed, this is possibly the key drawback to the revivification of certain regional areas, alongside other prejudices and clashes between metro and regional cultures. It is argued that the transformative and redemptive actions art can perform need to involve the modern irrationality of not being transfixed by matters of economic materialism, so as to sit outside taken-for-granted value structures. This emphasises the importance of equality and open access in our spaces and landscapes if we are to pursue a vibrant, diverse and progressive national cultural sphere.ReferencesAbbing, Hans. Why Artists Are Poor: The Exceptional Economy of the Arts. Amsterdam: Amsterdam UP, 2002.Adorno, Theodor. Aesthetic Theory. London: Routledge, 1983.Australian Bureau of Statistics. “Population Growth: Capital City Growth and Development.” 4102.0—Australian Social Trends. Canberra: Australian Bureau of Sttaistics, 1996. <http://www.abs.gov.au/ausstats/abs@.nsf/2f762f95845417aeca25706c00834efa/924739f180990e34ca2570ec0073cdf7!OpenDocument>.Barr, Neil, Kushan Karunaratne, and Roger Wilkinson. Australia’s Farmers: Past, Present and Future. Land and Water Resources Research and Development Corporation, 2005. 1 Mar. 2019 <http://inform.regionalaustralia.org.au/industry/agriculture-forestry-and-fisheries/item/australia-s-farmers-past-present-and-future>.Benjamin, Walter. Charles Baudelaire: A Lyric Poet in the Era of High Capitalism. London: NLB, 1973.———. “The Work of Art in the Age of Mechanical Reproduction.” Illuminations. Ed. Hannah Arendt. Trans. Harry Zohn. 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New York: Columbia UP, 1993.Brown, Bill. “‘Restless Giant’ Lures Queensland Opera’s Artistic Director Lindy Hume to the Regional Art Movement.” ABC News 13 Sep. 2017. 10 Mar. 2019 <https://www.abc.net.au/news/2017-09-12/regional-creative-industries-on-the-rise/8895842>.Docherty, Glenn. “Why 5 Million Australians Can’t Get to Work, Home or School on Time.” Sydney Morning Herald 17 Feb. 2019. 10 Mar. 2019 <https://www.smh.com.au/national/why-5-million-australians-can-t-get-to-work-home-or-school-on-time-20190215-p50y1x.html>.Fairley, Gina. “Big Hit Exhibitions to See These Summer Holidays.” Arts Hub 14 Dec. 2018. 1 Mar. 2019 <https://visual.artshub.com.au/news-article/news/visual-arts/gina-fairley/big-hit-exhibitions-to-see-these-summer-holidays-257016>.Farrelly, Kate. “Bendigo: The Regional City That’s Transformed into a Foodie and Cultural Hub.” Domain 9 Apr. 2019. 10 Mar. 2019 <https://www.domain.com.au/news/bendigo-the-regional-city-you-didnt-expect-to-become-a-foodie-and-cultural-hub-813317/>.Florida, Richard. “A Creative, Dynamic City Is an Open, Tolerant City.” The Globe and Mail 24 Jun. 2002: T8.Gray, Ian, and Geoffrey Lawrence. A Future For Regional Australia: Escaping Global Misfortune. Cambridge: Cambridge University Press, 2001.Hume, Lindy. Restless Giant: Changing Cultural Values in Regional Australia. Strawberry Hills: Currency House, 2017.Jayne, Mark. Cities and Consumption. London: Routledge, 2005.Ley, David. The New Middle Class and the Remaking of the Central City. Oxford: Oxford University Press, 1996.———. “Artists, Aestheticisation and Gentrification.” Urban Studies 40.12 (2003): 2527–44.Menger, Pierre-Michel. “Artistic Labor Markets: Contingent Works, Excess Supply and Occupational Risk Management.” Handbook of the Economics of Art and Culture. Eds. Victor Ginsburgh and David Throsby. Amsterdam: Elsevier, 2006. 766–811.Mangset, Per, Mari Torvik Heian, Bard Kleppe and Knut Løyland. “Why Are Artists Getting Poorer: About the Reproduction of Low Income among Artists.” International Journal of Cultural Policy 24.4 (2018): 539-58.Mitchell, Scott. “Want to Start Collecting Art But Don’t Know Where to Begin? Trust Your Own Taste, plus More Tips.” ABC Life, 31 Mar. 2019 <https://www.abc.net.au/life/tips-for-buying-art-starting-collection/10084036>.Murphy, Peter. “Sea Change: Re-Inventing Rural and Regional Australia.” Transformations 2 (March 2002).Regional Australia Institute. “The Rise of the Regional Bohemians.” Regional Australia Institute 24 May. 2017. 1 Mar. 2019 <http://www.regionalaustralia.org.au/home/2017/05/rise-regional-bohemians-painting-new-picture-arts-culture-regional-australia/>.Rentschler, Ruth, Kerrie Bridson, and Jody Evans. Regional Arts Australia Stats and Stories: The Impact of the Arts in Regional Australia. Regional Arts Australia [n.d.]. <https://www.cacwa.org.au/documents/item/477>.Simpson, Andrea. “The Regions: Delivering Exceptional Arts Experiences to the Community.” ArtsHub 11 Apr. 2019. <https://visual.artshub.com.au/news-article/sponsored-content/visual-arts/andrea-simpson/the-regions-delivering-exceptional-arts-experiences-to-the-community-257752>.

Abstract Background Opioid analgesia remains the mainstay of pain management in acute coronary syndromes (ACS). Significant sex differences persist in ACS presentation, management and outcomes, but the impact of sex-differences on pre-hospital pain management of ACS with opioids is unknown. There is increasing awareness of the importance of pre-hospital factors in ACS, as well as emerging concerns with opioid use impairing the gastrointestinal absorption of oral P2Y12 inhibitors. Purpose This study examined if sex-differences in pre-hospital pain scores, opioid administration and clinical outcomes exist in ACS patients. Methods Patients presenting with ACS via ambulance (2014–2018) that underwent percutaneous coronary intervention (PCI) were prospectively collected via the Victorian Cardiac Outcomes Registry (VCOR), the Melbourne Interventional Group (MIG), and linked to the Ambulance Victoria database. The primary outcome was 30-day major adverse cardiac events (MACE). Secondary outcomes were descriptive analyses of pre-hospital pain score, intravenous morphine equivalent analgesic dosing, plus predictors of MACE and Thrombolysis In Myocardial Infarction (TIMI) 0–1 flow pre-PCI using logistic regression. Results 10,547 patients were included (female: 2,775 [26.3%]). Opioids were administered to 1,585 (57%) females and 5,068 (65%) males (p&lt;0.001). Adjusted 30-day MACE was similar between opioid groups in both sexes (female: OR 1.21, CI 0.82–1.79, p=0.34; male: OR 0.89, 0.68–1.16, p=0.40). Median pain score at presentation was 6 (IQR 4,8) for both sexes. Median opioid dose was 2.5 mg (IQR 0,10) in females and 5 mg (IQR 0,10) in males (p&lt;0.001), with similar pain relief achieved. Adjusted rates of TIMI 0–1 pre-PCI were higher in patients administered opioids (female: OR 2.83, CI 2.14–3.56, p&lt;0.001; male: OR 2.95, CI 2.49–3.49, p&lt;0.001). Conclusions Female patients undergoing PCI received less opioid analgesia, but no sex-differences in pre-hospital pain scores were seen. Opioid administration was associated with impaired antegrade flow in the culprit artery in both sexes, but not short-term MACE. Randomised trials evaluating the clinical implications of opioid administration in ACS with sex subgroup analyses are needed to guide clinical practice. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Melbourne Interventional GroupVictorian Cardiac Outcomes Registry

Abstract Background Each year, there are approximately 5,000 out-of-hospital cardiac arrests (OHCAs) in the state of Victoria, Australia (population 6.4 million, state healthcare budget AUD$2.9 billion / €1.8billion). Mortality from OHCA approaches ninety percent. High mortality rates and survivors not returning to work is likely to have an adverse effect on the Victorian economy but this has not been previously investigated. Purpose To model the economic impact of OHCA mortality and survivors not returning to work. Methods Data on all OHCAs transported by Ambulance Victoria from July 2017- June 2018 in Victoria, Australia was collected, including age, gender, survival to hospital, survival to discharge, and survival to 12 months. Cases were excluded if arrest was precipitated by trauma, exsanguination, overdose, terminal illness, hanging, SIDS, electrocution, sepsis, respiratory causes, drowning, or neurological causes. Pre-arrest employment status of patients was modelled using the Australian Bureau of Statistics Economic Security dataset, which provides contemporary employment rates for gender-matched five-year cohorts for Australians aged 15–79 years. For survivors to 12 months, pre-arrest and post-arrest work status were confirmed. Economic impact was then calculated to a five year horizon utilizing a Markov model with probabilistic sensitivity analysis. Results 4,934 arrests meeting the inclusion criteria were transported by Ambulance Victoria in twelve months, of whom 4,639 were determined to be cardiac arrests without any exclusion criteria as a precipitant. 695 patients survived to hospital (15.0%), and 325 to discharge (7.0%). At 12 months, 303 patients were alive (6.5% of overall cases, 93.2% of those discharged from hospital). Economic modelling of age and gender-matched data indicated that 1516 patients (35%) would have been employed pre-cardiac arrest, but only 216 survivors (4.7%) would be employed at five years post-arrest. Using Markov modelling incorporating estimated earnings and the pre-determined value of a statistical life, the annual economic burden of cardiac arrest approximated AUD$4 billion (€2.5 billion) at a five-year horizon. Conclusion The annual economic impact of cardiac arrest in Victoria, Australia is approximately AUD$4 billion (€2.5 billion) in a five-year horizon. As the annual Victorian state budget for all healthcare is AUD$2.93 billion (€1.8 billion), our data suggests that the economic impact of cardiac arrest is under-appreciated. Therefore, research in this area and providing state-of-the-art care for all cardiac arrest patients should be a healthcare priority. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC/NHF Postgraduate Scholarship, RACP JJ Billings Scholarship

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Abstract Background South Asian women are at a high risk of developing gestational diabetes mellitus than other women in Australia. Gestational diabetes affects up to 14–19% of all pregnancies among South Asian, South East Asian, and Arabic populations placing women at risk of adverse pregnancy outcomes. Although, gestational diabetes resolves after childbirth, women with gestational diabetes are up to seven times more likely to develop type 2 diabetes within five to ten years of the index pregnancy. Increasingly, South Asian women are being diagnosed with gestational diabetes in Australia. Therefore, we aimed to gain a better understanding of the lived experiences of South Asian women and their experiences of self-management and their health care providers’ perspectives of treatment strategies. Methods Using an ethnographic qualitative research methodology, semi-structured one-on-one, face-to-face interviews were conducted with 21 health care providers involved in gestational diabetes management and treatment from the three largest tertiary level maternity hospitals in Melbourne, Victoria, Australia. In-depth interviews were conducted with 23 South Asian women post diagnosis between 24–28 weeks gestation in pregnancy. Results Health care providers had challenges in providing care to South Asian women. The main challenge was to get women to self-manage their blood glucose levels with lifestyle modification. Whilst, women felt self-management information provided were inadequate and inappropriate to their needs. Women felt ‘losing control over their pregnancy’, because of being preoccupied with diet and exercise to control their blood glucose level. Conclusions The gestational diabetes clinical practice at the study hospitals were unable to meet consumer expectations. Health care providers need to be familiar of diverse patient cultures, rather than applying the current ‘one size fits all’ approach that failed to engage and meet the needs of immigrant and ethnic women. Future enabling strategies should aim to co-design and develop low Glycaemic Index diet plans of staple South Asian foods and lifestyle modification messages.