Congratulations to our 2022 ANZET Prize winners
Geoff Mews Memorial ANZET Fellows Prize
Winner: Dr Farrah Othman
Early Career Investigator Prize
Winner: Dr Ehsan Khan
Best Interventional Imaging Prize
Winner: Dr Ganeev Malhotra
The role of Street Side Medics for Australians experiencing homelessness
Cardiovascular disease in the Australians experiencing homelessness, and the role of Street Side Medics
“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.
– World Health Organisation
Over 100 million people are experiencing homelessness globally, with an estimated 1.6 billion living under inadequate shelter. As of the 2016 Census, there were 116, 427 Australians characterised as homeless(1). Whilst this figure represents less than 1% of Australia’s total population, people experiencing homelessness are over-represented in health statistics, particularly in relation to cardiovascular disease.
Status of CVD in homeless Australians
Cardiovascular disease (CVD) affects 17% of all Australians(2), and is the leading cause of mortality, accounting for a quarter of all deaths in 2019(3). Compared to the general population, CVD amongst those experiencing homelessness has a higher prevalence and mortality, as well as a greater burden of contributing risk factors, and an earlier age of onset (4-6). Whilst Australian data is scarce, international studies have shown a similar or slightly higher prevalence of hypertension, diabetes, and dyslipidaemia in those experiencing homelessness (7-10), and these statistics do not account for the likely under-diagnosis of these conditions. Substance use, particularly tobacco, is significantly more prevalent, with local data demonstrating that up to 81% (11, 12) of those who experience homelessness smoke cigarettes, compared to 15% of the general Australian population(13). Alcohol dependence, as well as cocaine and methamphetamine usage, all of which are detrimental to long-term cardiac health, are more prevalent in the Australian homeless population (14). Similarly, mental health disorders are three times more likely in the homeless population(15), and these have also been linked to poorer cardiovascular outcomes(16), reduced engagement with health services(17) and lower medication adherence(18).
There are various obstacles to delivering healthcare to Australians experiencing homelessness, which can be categorised into personal, practical and relationship barriers (19). Personal barriers refer to competing priorities such as shelter and food instead of medicine or appointments, which lead to many homeless Australians only seeking medical attention in perceived emergencies. Practical barriers refer to the concrete obstacles of finances, transport, and medication security. Finally, relationship barriers encompass the stigmatisation and lack of trust in the healthcare system, arising from prior negative experiences or perceived clinician bias(20).
The role of Street Side Medics
Accessible, opportunistic, and tailored care is essential. Tackling the increased burden of CVD in Australia’s homeless population requires focus on primary and secondary prevention, but also the development of pragmatic interventions which consider and address the underlying social determinants.
One promising strategy is through “drop-in” outreach clinics which make healthcare considerably more accessible. This was the vision of Dr. Daniel Nour, who founded Street Side Medics in August 2020, and for which he won Young Australian of the Year in 2022, recognising the early success of the service. Street Side Medics is a drop-in clinic service, operated from a mobile medical van, which delivers targeted healthcare at homeless food services, shelters, temporary accommodations, and disaster-affected zones in New South Wales. It is a bulk-billed, volunteer run GP led service, which does not require Medicare or identification, and utilises modern medicine technology including point of care testing, portable ultrasound, echocardiography, and spirometry, within a custom-built mobile clinic to provide opportunistic access to healthcare. In doing so, the model strives to alleviate the personal, practical and relationship barriers, which those experiencing homelessness face. This initiative has recently received Australian Federal Government funding in 2022(21)to help expand and adequately deliver its primary care service to homeless Australians. Professor Ravi Bhindi, head of department of the Royal North Shore Cardiology Department has also been involved since conception and has recently initiated a research arm of Street Side Medics, aiming to better understand the burden of cardiovascular disease in Australians experiencing homelessness.
To learn more: www.streetsidemedics.com.au/what-we-do
Moving forward, we need continued government proactivity with increased supply of social and affordable housing. Healthcare services must be adaptive and holistic and involve collaboration with the local community. It is imperative that we continue to spread awareness, not only in the medical fraternity, but within all levels of society. We hope to improve the general understanding of the challenges faced by our homeless population, to facilitate constructive conversations towards a more compassionate and caring society.
Dr. Karan Rao
On behalf of Dr. Daniel Brieger, Dr. Daniel Nour, Ms. Alex Baer & Professor Ravinay Bhindi
StreetSide Medics Homeless Health Research Group
References
- Australian Bureau of Statistics. Census of Population and housing: Estimating homelessness, 2016. In: Government A, editor. Canberra2018.
- Australian Bureau of Statistics. Causes of Death, Australia: ABS Website; 2020 [Available from: https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/2020#content.
- Health AIo, Welfare. Heart, stroke and vascular disease—Australian facts. Canberra: AIHW; 2021.
- Flatau P, Lester L, Seivwright A, Teal R, Dobrovic J, Vallesi S, et al. Ending homelessness in Australi: An evidence and policy deep dive. UWA Business School, The University of Western Australia; 2021.
- Al-Shakarchi NJ, Evans H, Luchenski SA, Story A, Banerjee A. Cardiovascular disease in homeless versus housed individuals: a systematic review of observational and interventional studies. Heart. 2020;106(19):1483-8.
- Nanjo A, Evans H, Direk K, Hayward AC, Story A, Banerjee A. Prevalence, incidence, and outcomes across cardiovascular diseases in homeless individuals using national linked electronic health records. Eur Heart J. 2020;41(41):4011-20.
- Bernstein RS, Meurer LN, Plumb EJ, Jackson JL. Diabetes and hypertension prevalence in homeless adults in the United States: a systematic review and meta-analysis. Am J Public Health. 2015;105(2):e46-60.
- Lee TC, Hanlon JG, Ben-David J, Booth GL, Cantor WJ, Connelly PW, et al. Risk factors for cardiovascular disease in homeless adults. Circulation. 2005;111(20):2629-35.
- Scott J, Gavin J, Egan AM, Avalos G, Dennedy MC, Bell M, et al. The prevalence of diabetes, pre-diabetes and the metabolic syndrome in an Irish regional homeless population. Qjm. 2013;106(6):547-53.
- Kim DH, Daskalakis C, Plumb JD, Adams S, Brawer R, Orr N, et al. Modifiable cardiovascular risk factors among individuals in low socioeconomic communities and homeless shelters. Fam Community Health. 2008;31(4):269-80.
- Nielssen O, Chudleigh A, Chen M, Large M, Markovic T, Cooper L. Results of a metabolic health clinic at a hostel for homeless men. Australas Psychiatry. 2017;25(3):270-3.
- Kermode M, Crofts N, Miller P, Speed B, Streeton J. Health indicators and risks among people experiencing homelessness in Melbourne, 1995-1996. Aust N Z J Public Health. 1998;22(4):464-70.
- Greenhalgh EM BM, Scollo MM. 1.3 Prevalence of smoking – adults Melbourne: Cancer Council Victoria; 2021 [updated December 2021. Available from: http://www.tobaccoinaustralia.org.au/chapter-1-prevalence/1-3-prevalence-of-smoking-adults.
- Scutella R, Tseng Y-P, Wooden M. Journeys Home: Tracking the most vulnerable. 2017. 2017;8(3):17.
- Health AIo, Welfare. Mental health services in Australia. Canberra: AIHW; 2022.
- Correll CU, Solmi M, Veronese N, Bortolato B, Rosson S, Santonastaso P, et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry. 2017;16(2):163-80.
- Resurrección DM, Moreno-Peral P, Gómez-Herranz M, Rubio-Valera M, Pastor L, Caldas de Almeida JM, et al. Factors associated with non-participation in and dropout from cardiac rehabilitation programmes: a systematic review of prospective cohort studies. European Journal of Cardiovascular Nursing. 2019;18(1):38-47.
- Kronish IM, Rieckmann N, Halm EA, Shimbo D, Vorchheimer D, Haas DC, et al. Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes. J Gen Intern Med. 2006;21(11):1178-83.
- Davies A, Wood LJ. Homeless health care: meeting the challenges of providing primary care. Med J Aust. 2018;209(5):230-4.
- Gilmer C, Buccieri K. Homeless Patients Associate Clinician Bias With Suboptimal Care for Mental Illness, Addictions, and Chronic Pain. J Prim Care Community Health. 2020;11:2150132720910289.
- Commonwealth of Australia. Budget 2022-2023. Canberra; 2022 March 29, 2022.
Launch of the Australian Stroke and Heart Research Accelerator (ASHRA)
Thursday 11 August from 5:15pm
CSANZ ASM • Gold Coast Convention and Exhibition Centre • Room 5 (Level 1)
Join us at the CSANZ meeting on the Gold Coast to officially launch the Australian Stroke and Heart Research Accelerator (ASHRA), funded by the MTPConnect Targeted Translation Research Accelerator (TTRA) program.
Come along and learn about the Centre, some of the early research we are funding, and how you can get involved. We can’t wait to share the exciting details of this collaborative, national centre with the CSANZ community.
Congratulations to our Ralph Reader Finalists in Basic and Translational Science
GOOD LUCK to all our passionate #CSANZ2022 Ralph Reader Prize Finalists presenting in Basic and Translational Science on Friday morning directly after the Opening and R T Hall Lecture.
Miss Connie Jiang presenting: A calibrated functional patch clamp assay to enhance clinical variant interpretation in KCNH2-related long QT syndrome – Victor Chang Cardiac Research Institute
Dr Dinesh Selvakumar presenting: Cellular Heterogeneity of Pluripotent Stem Cell Derived Cardiomyocyte Grafts is Mechanistically Linked to Treatable Arrhythmias – The Westmead Institute for Medical Research
Ms Khalia Primer presenting: Diabetes impairs endothelial cell metabolic reprogramming and angiogenic responses to hypoxia, which are rescued by reconstituted high-density lipoproteins (rHDL) – SAHMRI
Friday 12 August is going to be a big day with a full program of fascinating presentations by experts and young inspiring researchers… and in the evening join the fun Poster Presentations with wine and cheese (from 5.45pm).
Meet all the Young Investigators with Posters on display and discuss their work – it’s a great time for networking.
Congratulations to our Ralph Reader Finalists in Clinical Science
Congratulations to all our CSANZ 2022 Ralph Reader Prize Finalists in Clinical Science.
- Dr Alexandra Murphy presenting: SMARTphone-based cardiovascular risk reduction in BREAST cancer patients [SMART-BREAST]: A randomized controlled trial Austin Health
- Dr Jonathan Ariyaratnam presenting: Invasive Haemodynamic Testing with Fluid Challenge to Explore the Relationship Between Heart Failure with Preserved Ejection Fraction in Atrial Fibrillation The University of Adelaide
- Dr Julia Isbister presenting: “Concealed cardiomyopathy” is an important cause of autopsy-inconclusive sudden cardiac death and diagnosis impacts care of surviving relatives. Centenary Institute
We look forward to seeing your amazing presentations on Saturday morning on 13 August 2022 at the #CSANZ2022 on the Gold Coast.
The CSANZ Prize Ceremony will be held after lunch on Saturday 13 August 2022.
Good Luck to all!
Heart Health for All – 2022 CSANZ ASM Program highlights of Indigenous health and equity sessions
The Cardiac Society of Australia and New Zealand is delighted that the overarching theme for this year’s ASM is Heart Health for All. The Meeting’s Scientific Program Committee has made a fantastic effort to weave heart health equity topics throughout the 2022 Program.
Here are some of the program highlights focusing on Indigenous health and equity issues.
Thursday 11 August 2022
Commencing on Thursday 11 August from 11.30am, the Indigenous Health Council will be holding the Indigenous Health Symposium where Dr Anna Rolleston and Prof Alex Brown will be giving their perspectives from Aotearoa and Australia respectively, on the Importance of doing research in line with Indigenous community expectations and the current principles and guidelines. Followed by examples of good practice and a facilitated panel discussion. See the full Symposium program here.
Friday 12 August 2022
On Friday 12 August, Equity of Care and Indigenous Health Prize Finalists session will take place after lunch, commencing with speakers:
• Dr Karen Brewer – What are the problems and what are the Kiwis doing about it?
• Prof Alex Brown – How is Australia improving equity in healthcare?
The Indigenous Health Prize session will be passionate and inspirational with our four finalists starting from 2.30pm:
• Dr Zara Rolfe, St George Hospital (NSW)
• Dr Nicholas Seton, Gold Coast Hospital and Health Service (QLD)
• Dr Emma Haynes, University of Western Australia (WA)
• Dr Keriana Kingi-Nepe, Hauora Tairawhiti (NZ)
Good luck to all (Read the finalists’ presentation topics here)
There are several other full sessions, individual presentations and topics across the broad spectrum of cardiology that speak to Heart Health for all. Here are just a few highlights.
Don’t miss the Multidisciplinary: Cardiovascular health for all – a global perspective session on Friday afternoon. International presenter, Prof Mariachiara Di Cesare (UK) – Global perspective on inequalities in cardiovascular risk and outcomes; and Prof Gita Mishra – Global issues in women’s cardiovascular health: Results from InterLACE consortium (Read more here).
Concurrently on Friday, the Paediatrics / Adult Congenital stream’s Striving for equity session presentations include:
• Prof Anita Moon-Grady (USA) – Using “big data” to help identify inequities in CHD outcomes.
• Dr Bo Remenyi – Rising inequity in rheumatic heart disease.
• Ms Rhonda Holloway – Improving adherence and health literacy in families faced with chronic health.
• Dr Nikki Earle – Prioritising equity in cardiovascular genomics research: The MENZACS story.
In other streams, Prof Robyn Clark will be presenting, Equity and access to care for patients with heart failure and A/Prof Saurabh Kumar presenting Demand, equity, and access to VT ablation.
Saturday 13 August 2022
Throughout Saturday the Multidisciplinarystream is hosting some interesting topics from addressing health literacy in the breakfast session to Implementation of evidence into clinical practice: challenges and success later in the afternoon. There’s a wide range of presentations including:
• Implementing socially protective factors to reduce CVD incidence in Aboriginal women.
• Delivering cardiovascular care in rural and remote QLD: Heart of Australia service.
• Telemedicine to Timor-Leste: implementing an international cardiac telehealth service during population dislocation, floods and COVID-19.
During the Paediatrics and Adult Congenital Prize Final presentations, we will hear from Dr Belinda Gowen, who will be speaking on Indigenous Paediatric Cardiac Surgical Patient Outcomes.
Also, don’t forget to attend the Women In Cardiology networking event during Saturday’s afternoon tea break out on the South Terrace.
Sunday 14 August 2022
In the Cardiac Imaging Access and Equity session on Sunday morning, there are some thought provoking ideas being presented followed by a panel discussion and Q&A.
Heart Health for All – Program Highlights of the Indigenous health and equity sessions (Download pdf here)
2022 CSANZ New Zealand ASM – a great success!
Thank you to the Convenor and Organising Committee who planned some inspiring sessions including those addressing important equity issues, historical and current Māori relationships within health and specialist services. The faculty, including Dr John Mandrola were impressive.
Congratulations to all the Young Investigator Award Prize Winners:
Evie Templeton – Young Investigator Award for her work on “Harnessing the power of omics: discovering novel microRNZ and protein biomarkers of acute kidney injury in acute heart failure”
Ellen Woodcock – Allied Health Investigator Award for her work on “Spironolactone and atrial remodelling in patients with paroxysmal atrial fibrillation (PAF)”
John Ramos – Nurse Investigator Award for his work on “Hospitalisation during lockdown – Patient’s beds-eye view”
The full recording of the meeting is available for a limited time – access here (NZ members only).
Dive into the Arrhythmia / EP Highlights at the CSANZ ASM 2022.
Check out the highlights for the Arrhythmia/EP Streams at the Meeting. Who are the speakers? Interesting topics to look out for, prize presentations and social activities to look forward to.
Arrhythmia / EP Highlights at the CSANZ ASM 2022.
See the whole Program here, and plan your 2022 CSANZ ASM Gold Coast visit now.
MBS Telehealth Services from 1 July 2022
The Australian Government Department of Health introduced permanent telehealth arrangements on 1 July 2022 following cessation of the temporary telehealth arrangements on 30 June 2022. Information on the permanent telehealth items is available in the new Fact Sheet on the MBSOnline website MBS online – MBS Telehealth Services from 1 July 2022
Members are advised that the Government has indicated it intends to defer to 1 October 2022 the implementation of the telephone specific 30/20 compliance rule which was to take effect on 1 July 2022.
ANZET 2022 Named Lecturers
The ANZET 2022 program is coming together for the Meeting 12 – 14 August 2022.
We are delighted to announce the Named Lecturers for 2022:
The Louis Bernstein Lecture will be presented by Prof John Ormiston, Medical Director INTRA, NZ.
The Paul Yock Innovations in Cardiology Lecture will be presented by Prof Paul Yock, Professor of Medicine, Stanford University, USA (virtual presentation).
Other international faculty presenting at ANZET22 include Prof Vinayak Bapat, Dr Dipti Itchhaporia, MD, Prof Akiko Maehar, Dr Michael J. Reardon, MD and Lauren Connolly, Clinical Nurse Specialist. Register Now!
Submissions for ANZET Prizes close soon, apply now:
The Geoff Mews Memorial ANZET Fellows’ Prize – closing 13 July 2022.
Best Interventional Imaging Competition – closing 13 July 2022.