RESEARCH AUSTRALIA MEMBER MAGAZINE
SUMMER 2015
Contents RESEARCH AUSTRALIA AWARDS 17 2015 Award Winners
AUSTRALIAN HEALTH & MEDICAL RESEARCH 4
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Message from the CEO
Nessa Banville’s personal 15,000km journey from lab to industry
What’s the Fuss?
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Bowel Cancer Australia sponsors inaugural global standard in bowel cancer patient care
6 The World Needs Science – Science Needs Women
8 How Australian smartphones are helping fast track cancer research
10 Global collaboration for Sanfilippo gene therapy trial
12 The Bioreactor: An Innovative PhD program at Swinburne University of Technology
15th Anniversary Research Australia Awards
22 Prof Peter Colman wins Outstanding Achievement in Diabetes Research Award
24 Bupa Health Foundation celebrates the bright future of health research
26 Unique reaction underpins why breast is best for baby
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32 Hobart Method Goes Global
34 The Biobank that Philanthropy Built
37 Australia plays pivotal role in world-first research revolution for brain cancer
39 Australia Speaks! Research Australia Opinion Polling 2015 grassROOTS | SUMMER 2015
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Australia plays pivotal role in world-first research revolution for brain cancer (continued)
Cancer test predicts treatment outcome
$2.5 million grant for breakthrough cancer research technologies to advance treatments
45 Collaborating to drive change for older people
48 Mental health research, the last frontier in medical research
50 Prostate Cancer Foundation of Australia and Movember Foundation fund ground breaking prostate cancer scientists
52 Alzheimer’s disease and nutrition; another piece of the puzzle?
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56 Disease in the dust
58 The Coopers Brewery Foundation backs South Australian cystic fibrosis research
60 Nursing researcher shines light on ethics
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68 Researchers honoured for work that delivers real-world results
70 Psychiatric Epidemiology and Burden of Disease research at the Queensland Centre for Mental Health Research
72 Is Food Addiction real?
New Bone Alliance Announced
64 A mathematical weapon in the fight against neglected diseases grassROOTS | SUMMER 2015 3
Message from the CEO For fifteen years, Research Australia has been a whole of community voice striving to increase investment in health and medical research, innovation and development in Australia. GrassROOTS is a major vehicle for that community voice, and a celebration of the broad church that is the Research Australia membership. Now entering its fifth year, we have introduced a new look for the e-magazine, allowing articles to be more in-depth, and of course more photographs! This edition includes an extract from our recently published polling, highlighting Australians’: • Ranking of priorities for the Federal Government • Their willingness to participate in clinical trials
Publisher Research Australia Ltd Advertising & Sponsorship Marketing and Communications Coordinator Danijela Krha danijela.krha@researchaustralia.org (02) 9295 8546 Research Australia online www.researchaustralia.org ^pwitter.com/ResAustralia facebook.com/ResearchAustralia linkedin.com/company/research-australia grassROOTS online issuu.com/researchaustralia
• Support for taxing sugary soft drinks • Use of ‘Dr Google’. The full polling report ‘Australia Speaks’ can be found on our website. 2015 marked the largest attendance for our Annual Awards night in the five years. Our Chair Christine Bennett announced the appointment of the new CEO, Nadia Levin. Nadia was most recently an executive leader at the Australian Nuclear Science and Technology Organisation (ANSTO) and brings a wealth of communications, media and government relations experience to the role. She will commence in mid-January. Our annual report will be sent out this month, marking the 15 year anniversary of the organisation NHMRC funding has doubled twice over that time, and with the establishment of the MRFF in August, Australian Government investment in Health and Medical Research is set to more than double again over the next decade. However, our advocacy role is certainly not over, and we are already preparing our Pre-Budget Submission for the 2016/17 Federal Budget. With a federal election looming next year, Research Australia will have a very full ‘dance card’ in 2016! With that in mind, we wish you all the very best for the feastive season and 2016, and hope you will take time to read this Summer Edition of GrassROOTS. ELIZABETH FOLEY
grassROOTS is a publication of Research Australia Ltd ABN 28 095 324 379 384 Victoria Street Darlinghurst NSW 2010 Who can submit articles? Any current member of Research Australia who would like to share a relevant story that affects their organisation including, philanthropic donations and their outcomes, research findings, and any other related Health and Medical Research topic that affects the Australian population. Submission guidelines & deadlines For information regarding how to submit and publishing deadlines, visit www.researchaustralia.org/advocacypublications/grassroots
Research Australia does not warrant or guarantee the accuracy, quality, completeness, currency, or validity of any information in grassROOTS. All articles are supplied by member organisations and are edited for readability only and are not fact checked. Neither Research Australia nor the contributors to grassROOTS make any representations as to the accuracy or integrity of the information. They disclaim all express, implied, and statutory warranties of any kind, including warranties as to accuracy, timeliness, completeness, merchantability, or fitness for any particular purpose. Neither Research Australia nor its contributors will be liable for any damages of any kind incurred as a result of the information contained within this magazine.
Research Australia Advocacy Award Winner, Samuel Johnson with Karen Livingstone, Arthritis and Osteoporosis Australia, Mara-Jean Tilley, Head of Philanthropy and Andrew Giles, CEO, Garvan Research Foundation
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grassROOTS | SUMMER 2015
Celebrating
Annual Report 2015
years
To read and download Research Australia’s 15th Anniversary Annual Report visit our website.
The World Needs Science – Science Needs Women Dr Muireann Irish, Conjoint Senior Research Officer at NeuRA (Neuroscience Research Australia) and Research Fellow in the School of Psychology at UNSW, received a 2015 L’Oréal UNESCO For Women in Science Fellowship in recognition of her outstanding contribution to her field of cognitive neuroscience.
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he L’Oréal Australia and New Zealand For Women in Science Fellowships were created to help early career women scientists to consolidate their careers in science and rise to leadership positions. The Fellowships are awarded to women who have shown scientific excellence in their field and who can serve as positive and accessible role models to younger girls to pursue careers in the sciences. Here Dr Irish explains her journey through the award process and reflects on what the Fellowship means to her… What do you think of when you hear the word ‘scientist’? For many, the word conjures up images of predominantly male researchers in white lab coats. I recently had the honour of being selected as one of the 2015 L’Oréal UNESCO For Women in Science Fellows, joining the ranks of a growing pool of incredibly talented women in science. This award is particularly meaningful to me as, aside from providing a research fellowship of $25,000, the campaign seeks to raise the visibility of female scientists working at the forefront of their respective fields. At my side were the other L’Oréal award winners – Dr Jodie Rummer, a marine biologist at James Cook University, Dr Shari Breen, an astronomer at CSIRO, and Dr Christina Riesselman, a geologist at the University of Otago, NZ. Not a lab coat in sight. Rather, we show just how far the field of science has evolved and the importance of providing accessible, eloquent, and confident
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female role models to shatter the outmoded views of what a scientist looks like. The L’Oréal UNESCO For Women in Science program represents one of the proudest achievements in my scientific career to date. Having taken time off last year following the birth of my son, I struggled with the very real challenges of balancing motherhood with a competitive research career in science. The underrepresentation of women in science at senior levels is palpable. Too often we witness the ‘leaky pipeline’ phenomenon, whereby talented female scientists, brimming with potential, fall out of the system when they take a career break to have a family. Currently, women make up just 20% of professorial appointments at the university level, despite equal representation with men at undergraduate level. Initiatives that seek to promote and retain women in science following such career breaks are urgently needed. One of the highlights of my L’Oréal UNESCO Fellowship experience was to participate in the Girls in Science forum held at UNSW this year. This initiative provides high school students with an opportunity to interact with the L’Oréal Fellows to hopefully inspire them to pursue a career in the sciences. Too often, misconceptions, and the lack of confidence that seems particularly rife in younger girls, hold them back from considering science as a viable career path. The Girls in Science forum was truly inspirational. We had the privilege of sharing our stories with 300 high school students from across Sydney, all of whom were selected based on their academic potential. It was incredibly humbling to look across the sea of eager
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Dr Muireann Irish
faces and to realise our responsibility to break down the barriers that impede young girls from choosing science careers.
possible to sustain a successful career in science whilst also raising a family.
The girls were engaged and curious, asking insightful and probing questions regarding our career paths, the frustrations we encounter as scientists, and what our most inspiring moments have been to date. For me, the most telling question however came from a girl who asked, “What is the best area of science for me to get a job in?” All of us were rather taken aback and keen to challenge this viewpoint. At the age of 15, this girl had already limited her options, closing off potential avenues, and believing that she could not work in an area that she was genuinely passionate about. The resounding response was to work in a field that you are interested in and to keep all options open. We advised the girls to put their hands up, push past their feelings of anxiety, and start to look for strong female mentors that can help them along the way. It was a question that resonated with all of us and reminded us of how crucial accessible female role models are for the next generation of scientists.
At the end of the day, one teacher informed us that her top student had said, “This is the most exciting day of my life.” As a woman in science, you really cannot ask for more than that.
Following the forum, we mingled with the girls outside and posed for the obligatory ‘selfie’ or two. The girls continued to ask questions regarding motherhood, balancing family with career, and what other interests I have outside of science. Their enthusiasm was contagious and we all felt uplifted following the event.
NeuRA (Neuroscience Research Australia) is an independent medical research institute that undertakes health and medical research on the brain and nervous system in order to enhance human health and well being. It’s researchers and clinicians work on ageing and neurodegenerative disorders; movement, sensation and balance; mental illness; advanced brain mapping and imaging; and neural injury and its prevention. Read more at neura.edu.au. The L’Oréal Australia & New Zealand For Women in Science Fellowships are intended to help early career women scientists to consolidate their careers and rise to leadership positions in science. The Fellowships are awarded to women who have shown scientific excellence in their career to date and who have an appropriate research plan that will be assisted by the oneyear Fellowship. Read more at loreal.scienceinpublic.com.au.
As the L’Oréal campaign asserts, “The world needs science – Science needs women”. As one of the 2015 L’Oréal UNESCO Fellows, I feel a strong responsibility more than ever to promote science to the younger generations coming through the ranks. Young girls need to have accessible role models who show that it is
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How Australian smartphones are helping fast track cancer research ‘DreamLab’ the Garvan Institute of Medical Research and Vodafone Foundation launch Australia’s first smartphone supercomputer for cancer research.
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odafone Foundation and the Garvan Institute of Medical Research have launched ‘DreamLab’, an Android smartphone app that gives Australians the power to help fast track a cure for cancer while they sleep at night.
Taking the fight against cancer from the laboratory to the humble smartphone, DreamLab works by pooling the processing power of Australian mobile devices to create the nation’s first smartphone supercomputer for cancer research. This in turn will help speed up Garvan’s research into some of Australia’s biggest killers including breast, ovarian, prostate and pancreatic cancer. While a smartphone is plugged in and fully charged, the DreamLab app automatically downloads and solves a small cancer research problem, and then sends the result back to Garvan researchers via the Amazon cloud – like a giant crossword puzzle, with each user solving a different clue. For Garvan cancer researchers, DreamLab not only provides free access to a crucial computing resource, it also has the potential to greatly speed up cancer research by the institute. With 100,000 users, researchers will be able to crunch data approximately 3,000 times faster than the current rate. With five million users, that increases to 150 thousand times faster than the current rate.* Vodafone will kick start Australia’s first smartphone supercomputer by offering its five million prepaid and postpaid customers free data usage when using DreamLab on the Vodafone network in Australia. Vodafone customers will only use their data for the initial download of the DreamLab app, and a very small amount for other functions of the app. With more smartphones than there are people in Australia, cancer researchers at the Garvan Institute of Medical Research have dubbed DreamLab a “game changer” for its potential to speed-up their processing of research data. One of the research teams set to benefit from DreamLab is the breast cancer unit at the Garvan Institute of Medical Research, led by Dr Samantha Oakes. “The Garvan Institute of Medical Research in Australia is at the forefront of a revolution in cancer research,” said Dr Oakes. “With the help of game-changing innovations like DreamLab, I am hopeful that we will see cures of certain types of cancer in our lifetime.” Dr Oakes, who like many Australians is no stranger to the overwhelming and indiscriminate nature of cancer, is urging Australians with compatible smartphones to download the free app.
Alyssa Jones, Head of the Vodafone Foundation Australia, said it’s never been easier for Australians to give back to a cause that means so much, to so many. “Almost every Australian has a heartbreaking story to tell about cancer,” said Ms. Jones. “We all want to play a part in the fight against this disease and now, with more smartphones than people, we have an opportunity to make a tangible difference. DreamLab is free and incredibly easy to use. Download the app and charge your phone at night. It’s really that simple.” The DreamLab app was built by b2cloud, with Amazon Web Services Australia generously powering the DreamLab server. DreamLab is part of a three-year partnership between Garvan and the Vodafone Foundation. DreamLab turns idle smartphones into a virtual supercomputer: DreamLab works by combining and harnessing the collective power of idle smartphones to build Australia’s first smartphone supercomputer for cancer research. Solve your piece of the big research puzzle: Each night, your phone will be given small research problems to solve – think of it as a giant crossword puzzle with each user solving a different clue. Choose how you want to help: Once the DreamLab app has been downloaded, you will be prompted to pick a research project (breast, prostate, ovarian and / or pancreatic cancer research) to support. Nominate your data contribution: You can nominate how much data you would like to contribute via your mobile network (50MB, 250MB or 500MB a month), or home Wi-Fi network (250MB, 500MB or 1GB a month). For Vodafone Australia customers, the data used for solving research problems is totally free on the Vodafone network in Australia (but if you’re also contributing over Wi-Fi, you’ll be charged as per your Wi-Fi plan), however other functions in the app might use a very small amount of data which you will be charged for. Use while roaming incurs your usual data roaming charges. Charge up to power medical research: Once your smartphone is charged (over 95%), the application goes to work. DreamLab won’t drain your battery or access your private information and you can still use your smartphone as usual. DreamLab is a free app available from the Google Play Store for all Australian Android users. For more information, visit vodafone.com.au/dreamlab. To find out more about the Garvan Institute of Medical Research visit www.garvan.org.au
“I was six years old when my brother was suspected of having bone cancer, so I understand the toll this disease takes on patients and their friends and family. The worst thing for those touched by cancer is fear; the fear of the unknown and of what’s to come,” she said. “As a nation who loves their smartphones, we now have a tremendous opportunity to put them to good use and help find a cure for cancer. Together, we can come to a greater understanding of how to treat it more swiftly.” Cancer is a disease that touches all Australians. Before the age of 85, the chances of developing the disease are one in three for Australian women, and one in two for Australian men.***
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Global collaboration for Sanfilippo gene therapy trial Australia has been selected as one of three international clinical sites for Abeona Therapeutic’s gene therapy trials for the treatment of Sanfilippo Syndrome, a rare, genetic and fatal childhood disease. It’s an inspiring story of how patient groups, researchers and clinicians can work together to accelerate an emerging treatment through the translational pipeline, overcoming traditional challenges posed by clinical drug development.
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n a global collaborative effort to accelerate drug development and approval, US-based biopharmaceutical company Abeona Therapeutics Inc. (NASDAQ: ABEO) will conduct the Australian clinical trials in conjunction with trial sites in both Bilbao, Spain and in Ohio in the USA.
As a pioneering example of when patient groups and biotech companies collaborate, Abeona Therapeutics has bridged original funding from 12 international Sanfilippo foundations, including from the USA, Spain, Canada, Switzerland, and Australia. The Australia-based Sanfilippo Children’s Foundation is one of those groups and has played a key part in helping Abeona bring these clinical trials to Australia In early November this year, Abeona president and CEO, Tim Miller Ph.D, and Michelle Berg, Vice-President Patient Advocacy, visited Australia to perform due diligence on the trial site and meet faceto-face with Australian clinicians as well as children affected by Sanfilippo and their families. For Australian families with children battling this devastating neurodegenerative disease, clinical trial participation offers an opportunity to access a novel, experimental therapy, giving children with this aggressive condition the hope of an effective treatment. There are currently no approved treatments available for Sanfilippo Syndrome. The Abeona program is an intravenously delivered adenoassociated virus gene therapy for Sanfilippo Syndrome Type A and Type B. The adeno-associated virus is the only viral serotype currently known to cross the blood brain barrier, a critical determinant in developing a gene therapy for a lysosomal storage
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disease. Abeona’s approach delivers the gene therapy as an intravenous injection to treat both the central nervous system and peripheral manifestations of Sanfilippo. “The field of gene therapy is very exciting right now,” says Miller. “We are seeing the emergence of many gene therapy companies seeking to focus on the advantages genetically modified adenoassociated viruses provide.” Gene therapy is a technique that introduces a healthy version of a gene into cells to correct the underlying deficit in genetic disorders and potentially correct disease manifestations. Typically, a nonpathogenic viral vector (virus) is used as a means of gene transfer to deliver the genetic material. In a family information session, Miller explained to families of Australian patients how gene therapy is mainly focused on delivery, indicating: “You’ve got to get the right thing (a gene) to the right place (the correct tissue) at the right time”. In the case of Sanfilippo, that place is the central nervous system and systemic organs. The pre-clinical data (animal testing) has shown promising treatment outcomes and reassuring safety profiles with normalisation of memory dependent behavior, neuro-motor function and survival in treated animals, in association with correction of glycosaminogylcans storage – an effect that has proved sustained in the animal experiments at endpoint analysis. Dr Nicholas Smith, a Neurometabolic Neurologist with clinical and research experience in gene-based therapies for neurodegenerative
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disease, was encouraged by the preclinical data presented. In a family information session, he told parents he was supportive of increasing access to gene transfer therapies for Australian patients. “This proposed trial is an experiment with no guarantees, however, one that is predicated on some very encouraging preclinical data and supported by an expanding global experience with gene transfer therapies.” Miller says drug production is one of the biggest challenges facing the gene therapy field with many companies trying to address the large amount of viral vector needed to treat patients but indicated that Abeona Therapeutics is advancing these trials simultaneously in multiple countries in an attempt to bring a potential therapy to as many patients as possible. “We could have rolled it out in the US first, waited a few years for data, and then internationally start successive trials but our vision is to accelerate access to these therapies worldwide. We are in the process of seeking regulatory allowance to start the trials in the USA and get patients enrolled, and while that happens, we will be working on the regulatory process in Spain and Australia.” In its 25-year history, gene therapy has gone through ups and downs with the field slowing significantly for at least a decade following the death of a patient in 1999. According to The Journal of Gene Medicine, as of July 2015 more than 2,200 gene therapy trials are being conducted or completed worldwide. We are seeing a surge in interest in gene therapy from the commercial sector, says Professor Ian Alexander, Head of the Gene Therapy Unit at the Children’s Medical Research Institute. He adds Australia still has a relatively small bio-medical research community and says the majority of gene therapy clinical activity in Australia is almost always company-sponsored. Pharmaceutical companies view Australia as a suitable trial centre and have growing respect for Australia’s high standards of healthcare and robust regulatory systems, he says.
“The history of the field tells us to be cautious…Gene therapy does offer hope but it has to be cautious hope.” But for the families with children battling Sanfilippo today, hope is all they have. For the first time, Australian children with Sanfilippo and their families have a glimmer of hope they might face a different future from the one handed to them upon diagnosis.
Sanfilippo Syndrome explained • Sanfilippo is a rare genetic condition that causes fatal brain damage. • It is also known as MPSIII and is part of a wider condition referred to as Mucopolysaccharidosis. • Affected children have a life expectancy of 12-20 years. • Sanfilippo is caused by a single gene mutation resulting in an enzyme deficiency. • Children experience hyperactivity, sleeplessness, loss of speech and cognitive skills, mental retardation, cardiac issues, seizures, loss of mobility, dementia and finally death usually before adulthood. • The Sanfilippo Children’s Foundation is dedicated to funding medical research in to the effective treatment of Sanfilippo. • The Foundation was founded in 2013 by Sydney mother, Megan Donnell, following the diagnosis of both her children with Sanfilippo. For more about the Sanfilippo Children’s Foundation visit www.sanfilippo.org.au
He agrees such trial activity in Australia provides “important opportunities” and says developing our domestic skill base in the field of gene therapy can only be a good thing. “It’s certainly positive to see Australian hospitals and physicians get involved in this type of trial activity.” Speaking about gene therapy in a general sense, however, he says in any trial it’s important to exercise “cautious optimism”.
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(L to R) Sanfilippo siblings Jude (4) and Isla Donnell (6) together together with their friend Kyuss Johnson (3) who also has Sanfilippo Syndrome. Without treatment none of these children will make it to adulthood.
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The Bioreactor: An Innovative PhD program at Swinburne University of Technology The Swinburne Bioreactor is an ARC Training Centre with a focus on embedding an international cohort of students within industry to create the next generation of entrepreneurs and medical technology innovators within Australia.
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he ARC Training Centre in Biodevices—also known as the Bioreactor—at Swinburne University of Technology is an exciting new program that takes 10 PhD candidates from across the globe and places them in an industry-centric research and development setting. The overarching aim of the Centre is to produce transdisciplinary, industry-ready PhD graduates who can either go straight into an industry role or alternatively create their own med-tech startup, further contributing to the emerging high-tech industries both in Australia and around the world. The students were selected from over sixty applicants from across the globe through a grueling application process in which novel techniques—such as the creation of a short YouTube video detailing their motivation—were used to gain further insight to their personality and drive to undertake the program. The final ten candidates were chosen from fields such as biomedical engineering, e-health, industrial design, medical practice, mechanical engineering and bioethics and from countries as diverse as Switzerland and Ghana. This multinational and multidisciplinary team was then placed into three groups with a mixture of diverse skills and experiences to foster collaboration and a sense of esprit de corps amongst the team members. Supporting the students are three post-doctoral fellows; their role is to help oversee and mentor the students, with their discipline specialties being business, materials science and design. The post-doctoral fellows also conduct independent research with the industry partners, allowing a constant flow of knowledge and innovation to occur within the centre.
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The industry partners in the program are equally diverse; Aqua Diagnostic, Blamey Saunders Hears, Grey Innovation, MiniFAB, Optotech, Small Technologies Cluster, St Vincent’s Hospital Melbourne, Streamline Solutions and the Victorian Centre for Advanced Materials Manufacturing. Each of these partners has contributed to the running costs of the Centre and has provided a significant amount of time and mentorship to the candidates to help them understand their market sector, the user group and problems surrounding their particular sphere of research. As opposed to a more traditional PhD investigation, each candidate was tasked to generate one hundred ‘needs’, which were identified through interviews and observations with clinicians, end users and industry partners in concert with a traditional literature review, as opposed to being given a prescriptive topic. Various metrics, such as potential market size, scale of the problem, suitability for a PhDlevel investigation, etc. were undertaken to then filter the ideas to initially ten needs, with a final level of filtering providing each student with three strong needs that have been identified. Within these three needs, a business case—alongside an understanding of the regulatory framework—is presented to the industry partner in a ‘Shark Tank’ style pitch. This pitch also allows the industry partner to contribute to the proposed investigation and understand where support can be given to the student. Following this pitch session, the students and industry partner proceed on one concept and this forms the basis of their PhD. Their experience will be slightly different from the more traditional, labbased PhD program; they will be embedded within industry and will
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The Bioreactor students within the Factory of The Future at Swinburne University of Technology, home of the ARC Training Centre in Biodevices
spend around a year working within their industry partner’s firm to fully grasp the opportunities and issues related to the space. Their supervision team is broad; they each have a Swinburne academic, a discipline specialist, an industry supervisor and importantly, a mentor from outside of the program and a dedicated PhD coach. The mentorship program allows the students to access informal counseling, self-reflection and advice with selected industry experts who can assist the students through their network of contacts and strong knowledge of their chosen area. The PhD coach assists the student from a more personal perspective, assisting and ensuring that the PhD candidate does not have some of the feelings of isolation that occasionally arise when one is undertaking a program as intensive as this. This unique arrangement ensures that our candidates are performing at their peak and ensures that they receive a high level of support through the process.
in addition to their own dedicated biodevice innovation studio within the Factory of the Future at Swinburne. This high level of involvement has already demonstrated significant benefits to cross-Faculty and cross-School collaboration, with new projects commencing independent of the Bioreactor initiative due to the increased levels of communication. The Bioreactor is being watched very closely by the University, many large industry bodies and the Australian Research Council; it is our hope that its success is measured in the outputs of our students; not just in terms of high ranking research publications, but in contributions to industry, contributions to the economy and a significant contribution to the quality of life to the end users that they have chosen. For more information about Swinburne University visit www.swin.edu.au
From a university perspective, the program has significant merits. Firstly, the students are industry engaged and have an element of entrepreneurship embedded within their learning—this is a crucial part of Swinburne’s DNA and part of our drive to help promote Australia as a high-tech hub. Secondly, the Bioreactor crosses the three Faculties of the University and helps break down the ‘silos’ that can arise with such a program. Each Faculty is equally represented in the management of the Centre—as well as the principle investigators—ensuring that there is genuine buy in from the various areas of the university. One key advantage of this program is that the students also have effectively free reign of the various laboratories and manufacturing facilities of the University,
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Nessa Banville, Medical Science Liason, GSL
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Nessa Banville’s personal 15,000km journey from lab to industry It sounds like a big decision to move from working in a lab to the medical affairs department of a global leader in pharmaceuticals, but for me it’s been a progressive and fascinating journey.
My interest in science began in high school in Ireland, where I was ravenously studying biology. I had a hunger for learning about the human body and all things cell biology related. The nation has an annual ‘Irish Young Scientist Award’. My friend Orla and I were total nerds who wanted to be the first in our school to ever make the national finals, and we did! Albeit with a pretty mundane project where we assessed the local eateries standards of cooking their red meat, by doing lots of microbiological analysis of many, many burgers from local takeaways! Although we didn’t win – we had a lot of fun travelling to Dublin, meeting many other budding scientists and also, getting a feel for where science can take you in life. I decided to study Biochemistry in University College Cork, here I broadened my knowledge by doing things such as taking a part time job washing the glassware from the research labs in the Biochem’s department. This gave me a nice sideline view of life in a research lab. I also won a Science Foundation Scholarship which allowed me to do a summer research project in one of the research labs. This led to my first publication, in the Journal of Food Protection, which felt pretty good at the time! This scholarship was fundamental in being offered a PhD in National University of Ireland, Maynooth. I began working in Dr. Kevin Kavanagh’s lab on a project comparing the insect immune system to the human immune system. This was a bid to further justify the use of insects as model organisms (rather than more expensive and ethically challenging vertebrate like mice or primates). I completed my PhD in three years with a wealth of knowledge gained on things like lab techniques, teaching students and project management. Also, I gained a few more publications and even got to speak at Oxford University, which was pretty amazing. It was difficult finishing a biology PhD in 2008 when Ireland was in economic crisis. Luckily I landed a post-doctorate position in Prof Gerry McElvaney’s group at Beaumont Hospital, Dublin, where I began to work on a project assessing neutrophil dysfunction in respiratory diseases like cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). This was a revolutionary time in treatment of these diseases, especially CF where our lab had patients who were trialling what turned out to be a breakthrough medicine for the condition. However like many other Irish people, my partner and I wanted to give ‘Aussie life’ a go so I began to look for respiratory post-doctorate positions in Sydney I was offered a role at the Woolcock Institute of Medical Research and I began in the cell biology group in January 2013. This was a wonderful experience. I was taken completely out of my comfort zone and began to work on a rare lung condition called
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lymphangioleiomyomatosis (LAM). This group also had access to ex-transplant lungs from patients who had conditions like COPD, interstitial lung diseases, rare lung diseases and even those who passed away from acute asthma attacks. I got to dissect a few of these lungs and that process really drives home the importance of pursuing science. Without improving the science of understanding the mechanisms behind these diseases, treatments will not improve and people will continue to require transplants and many will continue to die from these diseases. After a year of this, I needed to make a decision about what to do. I was on my second post-doc and my publication record was decent but not tremendous. Government funding of early career researchers is incredibly difficult and the pharmaceutical industry became more appealing. In 2014, around the time I was contemplating my future career and getting on a plane for a conference in Chicago, the talent acquisition team at GSK Australia called me. They had spotted my LinkedIn profile and saw that I had some experience in respiratoryturns out they were looking for a respiratory medical science liaison. After a few coffee meetings with individuals from the medical team, along with a number of interviews, I landed the job! Wow – the power of LinkedIn! Almost 18 months later in the medical directorate and I am still reading respiratory journals with a constant hunger from more information, but now I am part of a team in a global industry leader in respiratory medicine. I still feel that I am part of the research world. GSK plays a strong role in furthering medical research with initiatives such as the Award for Research Excellence which provides an $80,000 grant to outstanding Australian researchers and their teams to help them continue their work. Not only does the award allow scientists’ research career to develop but it also fosters further world leading research in Australia. My transition from life in a white coat to working at GSK has been a long and windy road. It has been an interesting journey. I would encourage anyone with an interest in science to consider industry as an avenue to find a fulfilling role for a curious mind. It is a wonderful feeling to be part of a company who provides medicines that can help to change people’s lives; GSK is a science-led company who constantly strives to better the management of disease and it is a privilege to be part of this matrix. For more information about GSK visit www.gsk.com
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15th Anniversary Research Australia Awards On Wednesday 18th November the 13th annual Research Australia Awards Dinner was held in Melbourne to acknowledge and celebrate leaders who have made invaluable contributions to Australian health and medical research, be it through groundbreaking research and discovery, ongoing advocacy or generous philanthropic donations that make innovation possible.
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esearch Australia Awards are presented for discovery (by an early career researcher no more than five years past PhD), advocacy, philanthropy and lifetime achievement. For only the second time, an Award was also presented to recognise achievements in health services research, reflecting the importance of research that improves the efficiency, safety and delivery of healthcare in Australia. Now in its 13th year, the Research Australia Awards saw a number of outstanding Australians celebrated including Connie and Sam Johnson, Founders of the Love Your Sister campaign, who are joint winners of the 2015 Advocacy Award. Connie received a standing ovation for her passionate speech calling for more research, emphasising that advocacy is as important as fundraising in raising awareness about breast cancer and the role of research in finding a cure. The recipient of Research Australia’s most prestigious Award – the Peter Wills Medal for outstanding work that has built Australia’s reputation in health and medical research – went to Professor Sharon Lewin from The Peter Doherty Institute for Infection & Immunity. Professor Lewin’s leadership in science and her HIV research is renowned globally as the world continues its search for a cure. Elizabeth Foley, CEO and Managing Director of Research Australia, said Research Australia, in its 15th year of operations, is proud to continue to celebrate the nation’s best in health and medical research.
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“For thirteen of our fifteen years Research Australia has recognised those Australians who have continuously contributed to, and advocated for, the health and medical research sector in Australia through the Research Australia Awards. This year was no different; we received an impressive number of award nominations and continue to be so inspired by those put forward. “Our sector is fortunate to have so many worthy individuals, teams and organisations who continue to work relentlessly to ensure that health and medical research continues to push the boundaries of discovery, improve the health outcomes of Australians and better healthcare delivery in this country,” said Ms. Foley. “We congratulate all of the recipients of this year’s awards for their pioneering efforts and their ongoing commitment to advancing the health and medical research industry in this country, inspiring many along the way. Given the complexity of the issues facing the health of Australians, health and medical research has never been so important.” Research Australia recognises the valuable support and generosity of the 2015 Awards’ sponsors: AskRIGHT, Cook Medical, Griffith University, GlaxoSmithKline, Diabetes Australia and the Victorian Government. The following pages celebrate the 2015 winners.
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The Peter Wills Medal This Award recognises an Australian who has made an outstanding contribution to building Australia’s international reputation in the area of health and medical research, and for harnessing government, research, industry and philanthropic collaborations to promote better health
Professor Sharon Lewin, Director, The Peter Doherty Institute of Infection & Immunity Sharon Lewin is the inaugural Director of the Peter Doherty Institute for Infection and Immunity, a joint venture between the University of Melbourne and Royal Melbourne Hospital; Professor of Medicine, The University of Melbourne; consultant infectious diseases physician, Alfred Hospital, Melbourne, Australia; and an Australian National Health and Medical Research Council (NHMRC) Practitioner Fellow. She is an infectious diseases physician and basic scientist. Sharon completed her medical training (MB, BS (Hons) 1986) and her PhD (1996) in Microbiology at Monash University, Melbourne Australia. She was trained in clinical infectious diseases in Melbourne (FRACP 1996) and did her post-doctoral fellowship with Professor David Ho at the Aaron Diamond Research Centre at the Rockefeller University, New York (1997– 1999). David Ho was named Time Man of the Year in 1996 for his major contribution to discovering successful antiviral therapy for HIV. She was Director, Department of Infectious Diseases, Alfred Hospital and Monash University (2003 – 2014) and co-head of the Centre for Biomedical Research at the Burnet Institute (2011– 2014), Melbourne, Australia. Sharon leads a large multi-disciplinary research team that focuses on understanding why HIV persists on treatment and developing clinical trials aimed at ultimately finding a cure for HIV infection. Her other research and clinical interests include understanding how the immune system recovers following treatment of HIV and the interaction between HIV and other important co-infections including hepatitis B virus. She is widely recognised for her innovative work in understanding how HIV hides on treatment using novel laboratory models and leading several early phase clinical trials of cancer drugs that alter HIV genes. Prof Lewin has published over 200 publications and her laboratory receives funding from the NHMRC, the National Institutes for Health (NIH), the Wellcome Trust and the American Foundation for AIDS Research. She has extensive collaborations in Asia including Thailand, Malaysia, China and India as well as collaborations with investigators throughout the US and Europe. She is a co-principal investigator for the Delaney AIDS Research Enterprise to find a Cure – a $25 million NIH funded program grant of over 30 investigators working on immunological interventions to develop a cure for HIV. She was the local co-chair of the XXth International AIDS Conference (AIDS2014) that was held in Melbourne July 2014, which attracted over 14,000 participants and was the largest health conference ever held in Australia. In 2015, she became a member of the council of the NHMRC and chairs the newly established NHMRC Health Translation Advisory Committee. In 2014 Sharon was named Melburnian of the Year. This is an award made each year by the City of Melbourne to an inspirational role model who has made an outstanding contribution to the city in their chosen field. This was the first time the award was made to a physician or scientist. Sharon is married to Bob Milstein, a health lawyer. They have two adult sons, Alex and Max who are mad Essendon supporters. She is a passionate Melburnian!
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Cook Medical Lifetime Achievement Award Honours a significant lifetime commitment to supporting and promoting health and medical research
Professor Perry Bartlett, Professor of Molecular Neuroscience, Queensland Brain Institute Professor Perry Bartlett is the founding director of the Queensland Brain Institute (QBI) at The University of Queensland and is an internationallyrenowned neuroscientist doing ground-breaking research into the fundamental mechanisms that underpin brain function. During his 30-year career, his research and discoveries have overturned existing dogma and led to new understanding, particularly in the areas of neuronal precursor regulation and neuron survival in the developing and adult nervous system. Most prominent among these has been his pioneering role in the discovery and characterisation of neuron-producing stem cells in the adult brain, which has resulted in an entirely new view of the adult brain’s restorative capacity and, more importantly, to the realisation that cognitive functions such as learning and memory appear to be regulated, at least in part, by the production of new neurons. This is leading to the development of new therapeutic strategies to stimulate functional recovery following stroke, ageing dementia and depression. This is of vital importance as the Australian community confronts the growing social and economic cost of neurological and mental health conditions, which account for almost 50 per cent of this nation’s burden of disease. Professor Bartlett has published more than 240 papers, many of which have appeared in the world’s most influential journals and have attracted more than 13,000 citations and an h-index of 60. One of the most remarkable aspects of Professor Bartlett’s career has been his ability to correctly identify new mechanisms and concepts even though they appear to contradict the prevailing view. This speaks to an intellectual prescience and experimental ingenuity possessed by only a few scientists. One of the cornerstones of Professor Bartlett’s career is the building of QBI in 2003. Since then he has grown the Institute from a fledgling operation with several of the world’s best neuroscientists to an international research hub with 500 staff dedicated to to finding out more about debilitating diseases of the brain. Beyond that, his achievements in neuroscience research and neuroscience leadership have been recognised with several prestigious awards. This year he received the CSL Florey Medal and Prize, for significant achievements in biomedical science and the advancement of human health, which has been awarded just seven times since its inception in 1988. Previous winners include Professor Barry Marshall, Professor Jacques Miller and Professor Ian Frazer. He was also recently awarded the Australian Neuroscience Society’s Distinguished Achievement Award for an outstanding contribution to neuroscience in Australian and New Zealand, which has just six prior recipients since its inception in 1993.
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Griffith University Discovery Award Recognises an early career researcher (anytime from qualification but no more than 5 years past PhD or research higher degree) whose paper/patent/discovery has already demonstrated its importance or impact. For the first time in 2015, this Award comes with a $2,000 travel scholarship provided by Research Australia
Dr Andrew Gardner, PhD candidate, Centre for Translational Neuroscience and Mental Health, Calvary Mater Hospital, Newcastle Dr Gardner has conducted research in the field of sports concussion for the past eight years. He received first class honours in Psychology (University of New England) and subsequently completed a Doctor of Psychology (Clinical Neuropsychology) degree at Macquarie University, Sydney, where he conducted research in to the acute and cumulative neuropsychological consequences of sport-related concussion. His thesis received the prestigious award for the Most Outstanding Dissertation for 2011 from the National Academy of Neuropsychology (USA). During his post-graduate studies he also pioneered and managed the Macquarie University Sports Concussion Clinic. Following this Dr Gardner completed his PhD at Newcastle University, studying the potential long-term consequences of participation in collision sports. He has published 16 peer review articles, two book chapters, presented at numerous national and international conferences, and has contributed to the policy papers of Brain Injury Australia and Alzheimer’s Australia (NSW). In 2013 he was invited as a leading early career researcher to contribute to the Australian Academy of Science Theo Murphy High Flyer’s Think Tank on ‘inspiring smarter brain research in Australia’. He was also awarded an Australian Endeavour Research Fellowship to visit Harvard Medical School for four months in 2014. He is the Co-Director of the Hunter New England Sports Concussion Clinic.
Advocacy Award Recognises an Australian from either the media, celebrity or a member of the community who has raised community awareness about the benefits of H&MR
Connie and Sam Johnson, Founders of Love Your Sister Connie is vibrant, loving, compassionate, tough and inspiring. She’s a mother of two beautiful boys. She’s 35 years old. And she’s dying of Breast Cancer. This is her third battle with cancer. At the age 11 Connie, with the help of early detection and chemotherapy, fought off a very rare and aggressive bone tumour in her leg. At 22, she overcame a tumour in her womb, again with the help of early detection and treatment. This time Connie has Breast Cancer. It has spread to her lungs, liver, pelvis, spine and knee. This time it’s terminal and she has a life expectancy of 6 – 12 months. Nothing can prepare you for to say goodbye to your kids at such a young age. That’s why Connie is hard at work to raise Breast Cancer awareness. Early detection is the key to survival and Connie wants everyone to know it. Samuel is one of Australia’s most recognisable personalities in the Australian entertainment industry. He’s best known for his roles on The Secret Life of Us, Crackerjack, Underbelly II and Network Ten’s Rush. He’s made a number of TV guest appearances... and he’s the voice of Vodafone, Suzuki and Pedigree. Plenty of career accolades have come his way. He’s enjoyed multiple Logie nominations, an AFI Award and an Australian Centenary Medal in the 2000 Queens Honours list. He’s very proud of all of this, but none of it is as important to him as his sister.
Dr Gardner is now focusing on the potential long-term consequences of participation in collision sports. He is attempting to delineate the effect of head trauma as a risk factor for later life neurodegenerative disease by undertaking neuropsychological testing and neuroimaging investigation in active and retired athletes. His current research includes working on assessing retired rugby league players to determine their cognitive, neurological, psychiatric and psychological profiles. He is also currently also working on the video analysis of concussion in the National Rugby League, the first time this has ever been conducted. Dr Gardner created a tool, the Observational Research Analysis of Concussion in League Evaluation (ORACLE), that he is validating to assist club medical staff with recognising/detecting players who may have sustained a concussion (and should be removed from play for further assessment). The results of the video analysis and the use of the ORACLE will hopefully help prevent concussions by identifying at-risk behaviour, in addition to detecting concussion, which will significantly improve player welfare. He is currently involved with a consortium of researchers from Cardiff University Brain Imaging Research Centre (CUBRIC) in research discussion with the Welsh Government and Welsh Rugby Union to monitor and examine concussed active and retired players.
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AskRIGHT Great Australian Philanthropy Award
Victorian Government Health Services Research Award
Recognises and encourages personal philanthropic donations over a period of time by an individual or family to Australian H&MR
This Award is for an individual who has made an outstanding contribution to the field, provided research leadership, undertaken research that has led to a significant improvement in healthcare, and/or has championed the development of the health services research field
John Gandel AO and Pauline Gandel, Gandel Philanthropy Gandel Philanthropy is one of Australia’s largest independent family philanthropic funds. Gandel Philanthropy has been the vehicle for charitable giving by the extended Gandel family since its formation as the Gandel Charitable Trust back in 1978. John Gandel AO and Pauline Gandel are actively involved in the philanthropic work and they are universally recognised for their generosity and commitment to both Jewish and general Australian causes. Through Gandel Philanthropy, over the years they channeled tens of millions of dollars towards supporting various charitable causes in the community. While they provide support for a range of programs and fields, including arts, education, Jewish identity and leadership, youth at risk and Indigenous programs, their support for health and medical research has always been one of the strongest interests. While direct financial support for research and other medical programs has always been important, both John and Pauline have over the years also been passionate advocates for the sector, taking a handson approach to a range of initiatives. One such activity was the Alfred Hospital Appeal, which John Gandel chaired from 1987 to 1991, raising nearly $6 million to establish the William Buckland Radiotherapy centre. John also served on the hospital Board of Management for several years. Subsequently in 2002, on the 10th anniversary of the centre and the opening of the new $93 million research centre, John was appointed Life Governor of the Alfred Hospital. Pauline, on the other hand, has been the Patron of Emmy Monash Aged Care for many years and more recently she supported The Women’s Hospital with the establishment of the Pauline Gandel Women’s Imaging Centre which at the time helped revolutionise care for women and newborn babies. Most recent support for medical research projects includes some innovative and cross-sectoral partnerships aimed at tackling complex medical conditions or challenges. A recent example of this is the grant awarded to Neuroscience Research Australia (NeuRA), for the research project titled “A Multifaceted Intervention Using iPad Technology to Prevent Falls, Reduce Fear of Falling and Increase Physical Activity in Older People: a Double-blind, Randomised Controlled Trial”. This was a “challenge grant” for the trial stage, allowing NeuRA to raise the remainder of the funds from other donors, as well as help build a case for support from government. Together John and Pauline have supported a whole range of research projects and initiatives that span different medical fields and conditions, including but not limited to diabetes, ageing-related research, mental health, Crohn’s and Colitis, cancer-related research and allergies.
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Professor Jeffrey Braithwaite, Founding Director, Australian Institute of Health Innovation, Macquarie University Professor Jeffrey Braithwaite, BA, MIR (Hons), MBA, DipLR, PhD, FAIM, FCHSM, FFPH RCP (UK) is Foundation Director, Australian Institute of Health Innovation, Director, Centre for Healthcare Resilience and Implementation Science, and Professor of Health Systems Research, Faculty of Medicine and Health Sciences, Macquarie University, Australia. His research examines the changing nature of health systems, particularly patient safety, standards and accreditation, leadership and management, the structure and culture of organisations and their network characteristics, attracting funding of more than AUD$59 million. Professor Braithwaite has published extensively (over 600 total publications) and he has presented at international and national conferences on more than 780 occasions, including over 75 keynote addresses. His research appears in journals such as British Medical Journal, The Lancet, Social Science & Medicine, BMJ Quality and Safety, International Journal of Quality in Health Care, Journal of Managerial Psychology, Journal of the American Medical Informatics Association, and many other prestigious journals. Professor Braithwaite has received numerous national and international awards for his teaching and research. He has conducted large-scale research over two decades on clinical and organisational performance, health systems improvement and patient safety. Professor Braithwaite was author of a major study into health care inquiries, Patient safety: a comparative analysis of eight inquiries in six countries, UNSW, 2006 and another on the appropriateness of care in Australia (BMJ Open, 2012 and Medical Journal of Australia, 2012). Noteworthy projects in recent times include the CareTrack study, which found that 57% of care delivered to Australians is in line with level 1 evidence or consensus based guidelines. This was described by the editor of the Medical Journal of Australia when it was published in 2012 as the most important publication in that journal for the last 10 years. This study has been very influential amongst policy makers, managers, clinicians and patient groups in Australia and internationally. Another key project is the work he did with 30 countries, culminating in a book published in 2015. He included low, middle income and rich countries, looking at their reform activities and their quality and safety initiatives. This work shows that reform is not an episodic activity. Every health system is continuously reforming and attempting to improve the care that is delivered. This work suggests that insufficient resources are allocated to evaluating reform measures and improvement activities.
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GSK Award For Research Excellence The GSK Award for Research Excellence is one of the most prestigious awards available to the Australian medical research community. It has been awarded since 1980 to recognise outstanding achievements in medical research and facilitates career development with potential importance to human health and Australian research
Professor James McCluskey, University of Melbourne Professor Jamie Rossjohn, Monash University GSK’s prestigious Award For Research Excellence, now in its 35th year, was presented at the Research Australia Awards Dinner for the third time. The co-winners of the 2015 Award for Research Excellence are Professor James McCluskey and Professor Jamie Rossjohn, who will share the $80,000 prize to continue their groundbreaking work on how the immune system identifies and fights disease. Professors McCluskey and Rossjohn have made surprising discoveries about how vitamin B2 is made by microbes, and this research could be the starting point in better understanding our body’s first line of defence. Professors McCluskey and Rossjohn have uncovered insights into how the immune system recognises pathogens (harmful germs) such as salmonella and tuberculosis. Professor James McCluskey explains that their recent breakthrough shows how the immune system uses the building blocks in Vitamin B2 production to recognise bacteria. “Bacteria, not humans, manufacture vitamins, which is why we rely on our diet to provide vitamins. We have learnt that the manufacture of vitamin B2 or riboflavin, plays an extremely important and protective role in alerting the immune system to foreign bacteria,” he says.
Diabetes Australia’s Outstanding Achievement in Diabetes Research Award Diabetes Australia’s Outstanding Achievement in Diabetes Research Award was presented at the Research Australia Awards Dinner for the second time. This Award honours an individual who has made an outstanding contribution and shown leadership in diabetes related research over a long period of time. The recipient acts as an ambassador for diabetes research and for Diabetes Australia over a one year period
Professor Peter Colman, Director, Dept of Diabetes & Endocrinology, Royal Melbourne Hospital After three decades of exceptional research and clinical practice in the field of diabetes, Peter Colman is the thoroughly deserving recipient of this valued award. His diabetes leadership in Australia encompasses an extensive research contribution, head of department at a prominent tertiary hospital, many advisory committees and key board positions at the Australian Diabetes Society, Diabetes Australia and Diabetes Victoria. His work has led to enhanced diabetes knowledge and care both nationally and internationally. In addition, his selfless and tireless work for diabetes education, charity and as a leading clinician and researcher has changed the lives of many people with diabetes. He is well regarded as a mentor and role model for clinical researchers in diabetes. Read more about Professor Colman on page 22.
“This work is but the tip of the iceberg in understanding the role of certain cells in the immune system,” McCluskey says. “It’s a great example of curiosity-led science and could lead to new ways of diagnosing and treating inflammatory bowel disease, peptic ulcers and even tuberculosis – it could also lead to novel protective vaccines.” Professor Jamie Rossjohn says winning the GSK Award for Research Excellence will help both teams nurture new talent in their laboratories and play an important role in publicising their long-term work. “Winning the GSK Award for Research Excellence places our work in the public eye. It’s early days, but the public can rest assured that our teams are working extremely hard to see where this discovery will take us. The best fundamental science will lead to the best innovative therapeutics,” he says.
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Prof Peter Colman wins Outstanding Achievement in Diabetes Research Award Teacher, mentor, clinician and researcher, Professor Peter Colman wins the Outstanding Achievement in Diabetes Research Award at the annual Research Australia Awards held in Melbourne in November. The award recognises Professor Colman’s three decades of exceptional research and clinical practice in the field of diabetes.
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n accepting the Diabetes Australia Outstanding Achievement in Diabetes Research Award, Professor Colman said, he was honored to receive the award and warned that with the rates of diabetes increasing in Australia and world-wide the need to focus attention on diabetes was never more pressing. “All types of diabetes continue to increase in prevalence. In Australia 280 people develop diabetes every day. All people living with diabetes are at risk of serious complications. We must double our efforts. We need to prevent the development of diabetes, better manage the care of those who have diabetes, and of course, research should lead the way at every step.” Diabetes Australia’s CEO Adjunct Professor Greg Johnson, who presented the award, said, “Peter is not only an exceptional researcher, he’s an exceptional role model for clinical researchers in diabetes. His passion to improve the care of those with diabetes has been the driving force behind his work as a teacher, mentor, clinician and researcher. He is a wonderfully caring and humble person.” “Peter’s contribution goes beyond his role in research, he is considered an expert in global diabetes understanding and is responsible for over 200 peer-reviewed publications,” said Professor Johnson. Professor Colman’s major research interests now centre on the prediction and prevention of type 1 diabetes. This has led to his involvement with an international trial of a nasal vaccine which aims to prevent people from developing type 1 diabetes. Trials have so far shown the vaccine can switch off the body’s immune response to insulin in adults. Professor Colman and Professor Len Harrison run the trial which involves collaborators all over Australia, New Zealand and Germany. Professor Colman
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and Dr John Wentworth also run the Australian/New Zealand Type 1 TrialNet International Centre which aims to predict risk, preserve insulin production and eliminate type 1 diabetes. Professor Colman describes these trials as the culmination of 25 years of collaboration with the international research community. For the future, Professor Colman believes more work needs to be done in the prevention area. He also believes there is a lot of scope for improvements in the treatment of people at diagnosis to help preserve their insulin function and reduce the future complications. “Treating people before it starts and at diagnosis is the future,” said Professor Colman. In terms of a new technology, Professor Colman points to the combination of an insulin pump and a continuous glucose monitor, and the move toward an “artificial pancreas” which is getting closer. In terms of islet transplants – while islet and whole transplants work, they are problematic, he says. “Firstly, there is the supply of cells. There needs to be a quantum breakthrough of stem cells readily available. Then, with transplants, there’s the need to suppress the immune system, which can also be a burden for recipients.” Professor Colman is reticent about predicting when a cure may be found. “What I will say is that the pace of research is breathtaking and I strongly believe that prediction and cure are within our reach.” Professor Colman’s leadership contribution to the diabetes world has been extensive. He is a past president of the Australian Diabetes Society and has been on the board of Diabetes Australia and Diabetes Victoria for a number of years. Since 1988, Professor Colman has been the head of the Endocrinology Laboratory and since 1991, the Director of
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Award winner Professor Peter Colman.
the Department of Diabetes and Endocrinology at Royal Melbourne Hospital.
programs and promotes participation and connection of people with diabetes in research.
He has also been the Honorary Professorial Associate at the Walter and Eliza Hall Institute and the Clinical Professor at the University of Melbourne at the Department of Medicine.
“Our research program owes its existence to the generosity of its sponsors and donors; we hold donations received for research in trust and 90% of the donations support research grants,” said Prof Johnson. The major contributors to the Diabetes Australia Research Program include:
Professor Colman is Chairman of Melbourne Health Human Research and Ethics Committee. Over the next year, Professor Colman will be an Ambassador for Diabetes Australia and support the Diabetes Australia Research Program and strategic partnerships. The Diabetes Australian Research Program (DARP) provides funding towards the prevention, management and cure of diabetes, as well as enabling and fostering young and upcoming researchers in the field of diabetes research. Diabetes is fast becoming the major threat to human health and productivity and according to Greg Johnson, “Here in Australia, around 1.7 million people are living with diabetes and this costs Australia over $14.6 billion annually. By 2017, diabetes will overtake heart disease as the leading cause of disease burden in Australia.”
• Diabetes Australia Member Organisations in the states and territories, most notably Diabetes Victoria and Diabetes Queensland • Australian Diabetes Society • Kellion Diabetes Foundation • Underworks Socks • Individual donors, bequests and charitable foundations The 2017 Diabetes Australia Research Program Grant Round is expected to open in March 2016. For more information www.diabetesaustralia.com.au
“New research must lead the fight against diabetes. The Diabetes Australia Research Program has invested $23 million in 335 diabetes research projects across Australia over the past eight years. In 2015 we committed more than $3.8 million,” he said. The research program covers basic science, clinical research, social and behavioural research, self-management research, and translation and implementation. Applications are considered across all diabetes research areas including type 1 diabetes, type 2 diabetes, gestational diabetes, and pre-diabetes. Diabetes Australia also partners with universities and institutes in diabetes research
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Bupa Health Foundation celebrates the bright future of health research An inspiring health researcher working to identify ways to improve health outcomes in Indigenous communities has been named the Bupa Health Foundation Emerging Health Researcher of the Year.
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r Gabrielle McCallum, an early-career clinical researcher from the Menzies School of Health Research, received the 2015 Bupa Health Foundation Emerging Health Researcher Award in recognition of her work to find ways to provide early treatment, and prevent recurring lung infections and lung damage, in Indigenous children.
Winner: Dr Gabrielle McCallum, Menzies School of Health Research
“In the Northern Territory, we face among the highest rates of respiratory disease in the world with our Indigenous children and I’m really passionate about finding different ways to treat and help manage these lung conditions so we can prevent this for generations to come,” said Dr McCallum.
Area of research: Identifying interventional targets to improve lung health and management of respiratory disease in Indigenous children, through long term follow-up studies
“The support of the Bupa Health Foundation will help me improve the future lung health and quality of life among Australian Indigenous children, and broaden our understanding of clinical factors impacting the management of acute and chronic respiratory illness.” First held in 2012, the Award celebrates gifted early-career health researchers committed to improving health and care outcomes of Australians in the near future. Bupa Health Foundation Executive Leader Annette Schmiede said the Award supports the bright future of Australia’s health researchers, and recognises the tangible benefits they bring to the community. “The Emerging Health Researcher Award is about supporting the determination of these incredible researchers to convert their findings into improving the delivery and efficiency of our health system,” said Ms Schmiede. “Year on year, our winner and finalists demonstrate that early career achievement can be of world class importance. Supporting this translational focus is at the heart of the Foundation’s philosophy, and I congratulate Dr McCallum and our 2015 finalists.” Dr McCallum was awarded $25,000 towards furthering her research career, while the other four finalists each received $5,000. The Bupa Health Foundation 2015 Emerging Health Researcher Award winner was announced at the VIP Cocktail function preceding the Research Australia Awards dinner on 18 November 2015. Since its establishment in 2005, the Bupa Health Foundation has supported more than 100 initiatives nationally, focused on translating Australian research into real health and care improvements. 24 WWW.RESEARCHAUSTRALIA.ORG
Nominator: Professor Anne Chang, Child Health Division Leader, Menzies School of Health Research
Dr McCallum is an early-career clinical researcher in the Northern Territory. Her project aims to identify ways to provide early treatment, and prevent recurring lung infections and lung damage, in Indigenous children. The burden of ill health from respiratory disease remains high among the Indigenous population, with those living in the Northern Territory 5-times more likely to be hospitalised with ongoing lung infections and lung damage compared with nonIndigenous children. For the first time, the research will identify ways to optimise clinical care, improve long-term respiratory outcomes and broaden the understanding of the clinical factors impacting lung health in this population.
Finalist: Dr Tracey-Lea Laba, The George Institute for Global Health Nominator: Professor Stephen Jan, Head, Health Economics and Process Evaluation Program, Professor, Sydney Medical School, University of Sydney and NHMRC Senior Research Fellow Area of research: Evaluating the effectiveness of patientdirected financial incentives to promote the cost-effective use of medicines in practice Medication non-adherence is a major contributor to the high burden of long-term illness worldwide. This project will investigate using financial incentives directed at patients, to promote the costeffective use of medicines in practice. Dr Laba leads a program of research that promotes decision-making and investment by policymakers and healthcare providers, and is designed to test a broad range of affordable, patient-focused and evidence-based solutions to the problem of medication non-adherence.
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L-R Associate Professor Steven Lane, Dr Tracy-Lea Laba, Dr Gabrielle McCallum, Dr Jocasta Ball.
Finalist: Dr Jocasta Ball, Mary MacKillop Institute for Health Research, Australian Catholic University
Finalist: Dr Karen Gardner, Centre for Primary Health Care and Equity University of New South Wales
Nominator: Professor Simon Stewart, Director, Mary MacKillop Institute for Health Research
Nominator: Professor Mark Harris, Scientia Professor and Executive Director Centre for Primary Health Care and Equity and Director of COMPaRE-PHC (Centre for Obesity Management and Prevention Research Excellence in Primary Health Care)
Area of research: Risk stratification to optimise the management of patients with atrial fibrillation and improve health outcomes Atrial fibrillation is the most common irregular heartbeat observed in clinical practice, and is closely linked to stroke and heart failure. Dr Ball recently published findings in the prestigious medical journal The Lancet that demonstrated the potential of an AF-specific, nurse-led model of care. She is now focused on identifying new ways to assess at-risk patients and individualise their management, to reduce hospitalisations, and improve the health and quality of life of Australians living with this condition.
Finalist: Associate Professor Steven Lane, QIMR Berghofer Medical Research Institute
Area of research: Improving implementation of evidence based primary health care This project is focused on addressing the barriers to implementing primary health care programs. This includes designing and testing new approaches in order to improve quality and reduce variations in health outcomes between programs in different settings. Dr Gardner’s research specialises in three areas: the quality and performance of primary healthcare; increasing the evidence base for quality improvement programs particularly in Aboriginal and Torres Strait Islander communities; and evaluating implementation of complex interventions. For more information about Bupa Health Foundation visit www.bupa.com.au/foundation
Nominator: Professor Frank Gannon, Director, QIMR Berghofer Medical Research Institute Area of research: Finding new ways to beat blood cancers, including acute myeloid leukaemia Dr Lane is an early-career medical researcher and clinical haematologist driven to find new ways to beat blood cancers including acute myeloid leukaemia. Despite most patients responding to chemotherapy, survival rates in myeloid leukaemia remain low because the disease invariably comes back (relapses) after treatment. There is an urgent, unmet clinical need for new treatments that prevent this relapse. His work has identified a new way of targeting and destroying the cells within the leukaemia that give rise to relapse. It is hoped that this work will lead to new clinical trials and treatments for patients with myeloid leukaemia, and potentially many other cancers.
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Unique reaction underpins why breast is best for baby A breakthrough study led by University of Queensland researchers, in collaboration with Mater Hospital and Queensland University of Technology (QUT), has shown that dangerous bacteria in babies are held at bay by a unique chemical reaction that occurs between breast milk and baby saliva.
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Q researchers, including neonatal care specialist and researcher Associate Professor Helen Liley, found that bacteria established in the mouth and intestines of babies have lifelong effects on health.
“We knew for a long time that breast is best, but hadn’t demonstrated why before,” Dr Liley said. “This research discovered a previously unknown interaction between milk and saliva that appears to provide a unique biochemical mechanism in mammals to boost early immunity. It helps select good bacteria while stopping dangerous bacteria.” Microbiology studies, led by the QUT team under Associate Professor Christine Knox, demonstrated that breast milk and baby saliva mixtures inhibited the growth of harmful bacteria Staphylococcus and Salmonella, while promoting natural bacteria such as Lactobacillus.
In another positive for breast-feeding the team, led by Professor Nick Shaw from UQ School of Pharmacy, also found that during the early breastfeeding period baby saliva contains natural biochemicals called ‘nucleotides’, which can stimulate the development of a baby’s digestive system. Dr John Duley, a UQ Pharmacy research scientist, used mass spectrometry to measure levels of xanthine and hypoxanthine, crucial in milk-saliva mixing, which were 10 times more concentrated in newborn saliva than in adults. “The interaction of these two nucleotide derivatives with the enzymes in breast milk sets off a reaction that produces natural antibacterial chemicals,” Dr Duley said. “These chemical reactions last in the baby’s mouth for up to an hour after drinking breast milk, and even continue down into the baby’s stomach. The presence of nucleotides in baby saliva mixing is short-lived, for about six weeks after birth. However, it is during this critical period that the baby’s gut becomes colonised with bacteria, and importantly this comes from the mouth downwards. It’s probably no coincidence that most baby formula milks now have nucleotide derivatives, such as hypoxanthine, added to them. But this is not the same as breast-feeding, because formula milk lacks the enzymes that react with the nucleotides, to produce the antibiotic effect.” Researchers from UQ included Dr Amitha Hewavitharana and Associate Professor Bruce Charles, bringing their expertise in chemistry and pharmacology. Professor Shaw said this research effort had put the spotlight on an additional problem.
pasteurisation of the breast milk destroys the beneficial mechanism that we have uncovered. We are now looking at alternative methods of pasteurising breast milk that can preserve the biochemical mechanism and produce an ‘enzyme active’ milk, more like fresh breast milk.” The research, published in PLOS ONE, also co-opted Dr Saad AlShehri, from the city of Taif in the south-western mountains of Saudi Arabia, who worked closely with UQ Associate Professor David Cowley, in the Pathology Department at Mater Health Services. In addition to baby saliva, Dr John Wright, from the UQ School of Veterinary Science, collected saliva from cows, sheep, goats, horses, dogs, cats... and even a camel (which was chosen to symbolise the research and historical connections of Australia to Arabia). “Collecting saliva from some of these animals had its own special problems, and each type of animal required special handling. For example, saliva from herbivores such as cows is green because they constantly chew on grass and on their cud,” Dr Wright said. “I solved the problem with cows by collecting their saliva when they were herded together before milking. Close proximity with each other makes most cows nervous, and they are also anxious to get into the milking shed, so they stop chewing their cud, and their saliva clears up. Analysis of these saliva samples by mass spectrometry showed that each species has its own unique ‘signature’ of nucleotides.” Dr Duley said he found the results fascinating because it emphasizes the important role that milk plays for babies in what is referred to as ‘primal immunity.’ “Babies don’t have all the antibodies and disease-fighting systems that adults have,” he said. “Instead they have to rely on a very primitive system to protect them from being overwhelmed by disease-causing bacteria. At the same time, babies produce a special saliva that stimulates development of their gut. We know that the gut has an important role in the immune system, which protects us from disease. The most amazing thing is that the milk-saliva phenomenon appears to be a biochemical connection between a mother and child that continues beyond birth during breast-feeding. It is part of a unique synergy that defines mammals.” The study was funded by the National Health and Medical Research Council of Australia. For more information about the University of Queensland visit www.uq.edu.au
“This has critical implications for preterm, small and sick newborns,” he said. “Babies who are fed by intubation (gastric tube to the stomach) bypass the milk-saliva interaction, so there should be consideration of this factor. There’s an important aspect for breast milk banking. Increasingly in hospitals, donated breast milk is given to preterm babies rather than using formula milk. But traditional heat
UQ researchers who are among the team involved in the breakthrough study include Professor Nick Shaw, Associate Professor Helen Liley and Dr John Duley.
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What’s the Fuss? It’s rare to have all three major parties speaking in support of the same policy but the nation-building nature of the Medical Research Future Fund (MRFF) was enough to bring Health Minister Sussan Ley, Shadow Health Minister Catherine King and Greens Science & Research Spokesperson Adam Bandt together to launch the new What’s the Fuss campaign.
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c’d by Simon McKeon, Chair, McKeon Review – Strategic Review of Health and Medical Research and former CSIRO Board Chair, the launch at Parliament House on 19 October was attended by MPs, Senators, medical researchers and patients, including Love Your Sister’s Connie Johnson, and of course Research Australia Chair Christine Bennett AO and CEO and Managing Director Elizabeth Foley. What’s the Fuss? is a community-driven campaign highlighting why medical research is important to Australia. It features patients and researchers, along with passionate advocates for medical research such as Carrie Bickmore, Ita Buttrose, Natasha Stott Despoja and Sir Gus Nossal. The campaign includes a television advertisement, currently airing pro bono on commercial television networks, and an online campaign of videos and other web content for sharing on social media, hosted at www.whatsthefuss.org.au. We’re pleased to say many of the campaign participants are Research Australia members. With an election looming we need to do everything we can to keep medical research on the political agenda, and to ensure the MRFF reaches its full potential, so the timing of the campaign is ideal. The campaign is already gaining traction on social media, with the hashtag #WTFuss even trending Australia-wide on Twitter during the campaign launch. We encourage all Research Australia members to share their stories about why medical research is important to them and to Australia via the What’s the Fuss website. Highlights of the campaign launch can be viewed on YouTube.
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About the MRFF For those of you who want some more background on the MRFF we should say that the passing of this legislation in August was a huge win for the health and medical research sector, and the many people in the community who will benefit from the health advancements the fund will support. Research Australia was a key member of the MRFF Action Group, and we are proud to have worked beside other peak bodies in the sector to advocate for this transformational fund. The passing of the legislation was made possible by the Government’s commitment to the MRFF, and the productive negotiations between the Australian Greens and Government to ensure the MRFF Bill incorporated sector feedback on how the MRFF should operate. The MRFF is now established and should deliver its first tranche of $10 million in funding for health and medical research and innovation in 2015-16, followed by a further $400 million over the next three years. Many people were involved in the MRFF Action Group campaign, but we would particularly like to acknowledge the late Alastair Lucas AO (former Research Australia Board Member and Chair, Burnet Institute), Peter Scott (Chair, Baker IDI Heart & Diabetes Institute), Matthew Grounds (Chair, Victor Chang Cardiac Research Institute), and Ian Smith (Board member, Baker IDI Heart & Diabetes Institute). We’d also like to thank all of you who voiced your support for the MRFF in the past year. Whether it was a letter to a Senator, a tweet, a media release, or a submission to the Senate Inquiry, collectively you have helped make the MRFF a reality! It was rewarding to hear
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Pictured L – R: Prof Brendan Crabb, Prof James McCluskey, Prof Nick Fisk, Elizabeth Foley, Peter Scott, Dr Anna Lavelle, Prof Doug Hilton, Prof Christine Bennett, Ian Smith, Connie Johnson and Louise Steinfort.
so many MPs and Senators – particularly cross-bench Senators – raise the important research of a number of our medical research institutes during the MRFF Bill’s debate. This is a testament to the fantastic efforts of medical research institutes and their staff and students in engaging Parliamentarians and the wider community in the importance of health and medical research and the MRFF, and we are proud to call many of them Research Australia members. But we will need to keep our advocacy efforts up in years to come to ensure that the MRFF reaches $20 billion by 2020, as committed by the Government, as the MRFF Bill does not specify the size of the fund. It does, however, ensure that all funds that are put into the MRFF are protected in perpetuity.
How will the MRFF work? The MRFF is projected to build in size over the next five years, starting with $3.4 billion in 2015-16 from uncommitted funds from the Health and Hospitals Fund and budget savings made over the past year. The fund is expected to reach $20 billion by 2020. As an endowment fund, this capital will be protected in perpetuity, and earnings from investing this capital will be allocated to health and medical research and medical innovation.
The MRFF will be broader in its remit than current NHMRC grant programs, funding medical innovation (i.e. commercialisation and translation of research, and the application of research findings in health settings), in addition to health and medical research. It is likely that some, but not all, MRFF disbursements will be allocated by the NHMRC through peer-reviewed processes. There is potential for financial assistance from the MRFF to also be provided directly to government agencies (e.g. CSIRO), state/ territory governments (e.g. hospitals or health departments to help embed research in the health system), as well as businesses (e.g. to support medical research commercialisation activities). These are exciting times for health and medical research in Australia, with not only the MRFF in the picture but also a new Prime Minister advocating for the important role research and innovation have to play in Australia’s future. We hope you will help us tell Australia What the Fuss is about health and medical research to ensure the future health and wealth of our nation. For more information about the Association of Australian Medical Research Institutes visit www.aamri.org.au
The MRFF is expected to deliver $10 million in 2015-16, and around $400 million over the following three years, building to around $1 billion per annum by 2020. This funding will be in addition to National Health and Medical Research Council (NHMRC) funding through the Medical Research Endowment Account, which is projected to be around $0.9 billion per annum by 2020.
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Bowel Cancer Australia sponsors inaugural global standard in bowel cancer patient care Bowel cancer patients are one step closer to a world-first standard in care thanks to an international collaboration between Bowel Cancer Australia and the International Consortium for Health Outcomes Measurement (ICHOM).
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owel Cancer Australia’s sponsorship will support the ICHOM Colorectal Cancer Working Group, which brings together an international team, including Australian health professionals, clinicians and patients, to help establish the global standard. Bowel Cancer Australia’s chief executive Julien Wiggins says the aim of the Working Group is to develop an international set of outcomes that reflect the issues that matter most to bowel cancer patients. “Colorectal (bowel) cancer is the third most common cancer in the world, with around 1.4 million new cases diagnosed each year. The disease therefore requires a global response through one standard set of patient outcomes by which countries can be measured,” he added. “The ultimate objective is to help improve cancer care, leading to better health outcomes for patients. Over time it would be great to see implementation at a country and state level around the world, including in all Australian public and private hospitals.” ICHOM Standard Set for Stroke. Since 2012, ICHOM have developed 12 Standard Sets covering more than one-third of the global burden of disease. Image courtesy of ICHOM.
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Improving patient care The adoption of the Colorectal Cancer Standard Set will enable healthcare providers globally to compare, learn and improve patient care. “By collaborating with our international partners from North America, Europe and Asia we have a unique opportunity to share data and learn from one another through one global standard,” Mr Wiggins said. “This is particularly important in the Australian context where there is an urgent need to increase our understanding of bowel cancer, particularly in its advanced stages. Data on advanced bowel cancer is not routinely kept in Australia, and we do not know what treatment patients receive, how they respond to this treatment and their level of care,” he added. Since July 2015, patients from Australia, the US and Europe have been participating in the working group, alongside health professionals and clinicians specialising in bowel cancer. The Colorectal Cancer Standard Set will be finalised by March 2016.
Global vision Founded in 2012, ICHOM have developed 12 Standard Sets, covering more than one-third of the global burden of disease. By 2017, ICHOM aim to have completed Standard Sets for more than 50 conditions, covering more than half of the disease burden in advanced economies.
Working groups Comprised of physicians, registry leaders, outcomes experts, and patient representatives, ICHOM Working Groups define minimum Standard Sets of outcomes, along with case-mix factors to support risk-adjustment and meaningful comparison. Working Group members participate on a purely voluntary basis; to date, more than 300 individuals from 28 countries have contributed. The standardisation process requires 6-8 months and is driven by an ICHOM project team. All ICHOM Standard Sets and accompanying Reference Guides are freely available for download on our website.
Implementation The second phase of the ICHOM work is facilitating implementation. ICHOM works closely with providers and others around the world to advance awareness of our Standard Sets, spur development of data-collection technologies, align registries, and support pilot implementers. In the long term, ICHOM aim to drive value by enabling international collaboration among providers and engaging payers and governments to promote adoption and outcomes transparency through financial incentives and/or reporting requirements.
Outcomes measurement is the key to unlocking value Although these goals are widely shared, systems have been unable to achieve them. Even as costs skyrocket and wide variation in outcomes across hospitals and countries persist, the value agenda is stalled. The critical missing piece is outcomes measurement. Clinicians today gather more data than ever before, but what we are measuring often has little relationship to outcomes: the results of care that matter most to patients. How soon after treatment can a patient with low-back pain expect to return to work? How likely is a man to experience incontinence or sexual dysfunction after treatment for localised prostate cancer? Will a patient diagnosed with macular degeneration today be able to read normally one year, two years, or five years from now? These are questions about outcomes, and answering them is the key to driving value.
Hear from the ICHOM team May 16, 2016 – May 17, 2016 In May 2016, the ICHOM team will hold their largest conference to date at University College London in the UK. The two-day conference will begin on the morning of Monday, May 16, and will conclude on the afternoon of Tuesday, May 17. The focus will be impact and implementation: the “why” and “how” of outcomes measurement. Over the course of two days of plenary sessions, small-group discussions, and networking events, attendees will have the opportunity to hear from members of the ICHOM team, distinguished guest speakers, and from one another. For more details, visit www.ichom.org/events/2016-ichom-conference
About Bowel Cancer Australia Bowel Cancer Australia is a national charity with a vision to reduce incidence, death and suffering associated with bowel cancer through advocacy, awareness, education, support and research. All information from Bowel Cancer Australia is based on latest, evidence-based research and guidelines, as well as expert advice from our Medical Advisory Board. Bowel Cancer Australia is driven by a small team of staff and volunteers and is proudly 100% community funded. For more information, visit www.bowelcanceraustralia.org. Bowel Cancer Australia would like to acknowledge the generosity of the Tzaneros family which has made sponsorship of the ICHOM Colorectal Cancer Working Group possible as well as the contribution of Australian health professionals and patients in developing the Standard Set of outcomes.
In time, providing risk-adjusted international benchmarks on both outcomes and resource-requirements at the medical condition level will help achieve these objectives.
Health care in a value-based world Health care systems can improve quality and curb inefficiencies by restructuring care-delivery around outcomes. This will benefit every stakeholder across the health care spectrum.
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Hobart Method Goes Global Tasmanian Neonatologist Professor Peter Dargaville is pioneering a new technique to assist lung development in premature babies. Research in this area has grown since its infancy in 2009, aided by clinical grant funding from the Royal Hobart Hospital Research Foundation in 2011 and 2012, and has now led to a NHMRC funded global trial in 20 centres across the globe.
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hen babies are born prematurely their lungs are not fully developed, often leading to respiratory distress and more serious complications. It had been normal practice in premature babies to pass a breathing tube into the windpipe to assist with breathing and to administer a medication called surfactant via the breathing tube to open up the airspaces. But nowadays the breathing tube is less often used for respiratory support, and a system called CPAP is preferred wherever possible, administered via ‘prongs’ placed in the baby’s nostrils. With this new approach comes a new challenge – how to administer surfactant in the absence of a breathing tube for the babies that need it. Professor Peter Dargaville, Neonatologist at Royal Hobart Hospital and Professorial Research Fellow at Menzies Institute for Medical Research, has been engaged in research in this area since 2009, aided by Royal Hobart Hospital Research Foundation clinical grant funding in 2011 and 2012 and also a further grant funded by the MyState Foundation in 2012. The results of his initial studies of a new method for administering surfactant to preterm infants on CPAP have led to success in terms of widely cited peer-reviewed publications, and also in building research capacity. They have ultimately led to the NHMRC-funded clinical trial that Prof. Dargaville is currently undertaking, which is further investigating the new surfactant administration method. Dubbed the Hobart Method, the new technique involves the administration of surfactant using a thin tube briefly placed through the vocal cords, with support with CPAP continuing throughout. The hope is that by administering surfactant in this way, babies will
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not require full ventilation via a breathing tube, and thus avoid the complications that often ensue. The clinical trial, known as the OPTIMIST-A trial, is now being conducted in 20 centres, and will ultimately run in up to 50 centres globally. The active neonatal intensive care units are situated in Australia, New Zealand, United States of America, Turkey, Israel and Slovenia and soon to be including United Kingdom and some European sites. The reason why the trial needs to enrol internationally is that six hundred and six babies are required to participate, which is vital to produce acceptable statistical analysis. This number would not be available in Australia so we must reach out to other centres. This provides further evidence of the worldwide nature of the trial and possibility to change neonatal care around the world. Karen joined the OPTIMIST-A trial management team at the beginning in 2011. She has 13 years clinical trial experience and practiced for 35 years in Neonatal Intensive Care nursing. “As a clinical trial nurse I have found this trial challenging. Prof Dargaville finds the prospective Neonatal Intensive Care Unit and then it is down to work. Email becomes your best friend as communicating with differing times zones can be inherently difficult. We often help complete ethics forms, send generic parent information and consent forms which are then adapted. This form then requires checking to ensure all important details are included, Google translate comes to the fore. We facilitate the negotiation of the clinical trial contract between sponsor and hospitals, enter and maintain our trial on national and international clinical trial registers, organise equipment and supplies. Problem solving, encouragement and assistance is continual.”
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Nicky Stephens joined the trial in 2014 and works in the headquarters of OPTIMIST-A Trial. Nicky is a registered nurse with years of experience in neonatal care. This was the first multicentre international trial she has worked on from the operational centre’s perspective. “I had some research experience when starting this trial, however it has been an amazing learning curve in regards to differences between countries. Each country we have dealt with has required something slightly different to pass the trial through ethics and have it approved so adaptability is key. Before I started work on this trial, I had read about it and thought that it is exactly the type of trial that will help improve patient care for neonates and have a worldwide effect. I am proud to be a part of the OPTIMIST-A Trial!” All prospective neonatal intensive care units must fit the criteria for the OPTIMIST-A trial which includes adequate number of premature baby admissions, use of CPAP after delivery of these babies and good clinical trial practice. After agreement with the neonatal clinicians and OPTIMIST-A trial Steering Committee, the trial must be submitted to the regional Ethics Committee and local Hospital Governance. All ethics and governance committees, who negotiate the hospital’s clinical trial agreements, have a variety of requirements which add a layer of complexity to progress the OPTIMIST-A trial through these regulatory bodies.
Induction or enrolment of the new hospitals involves education in randomisation though a secure website, the intubation procedure, the blinding of the procedure and the paperwork. This is done by personal visit or videoconferencing with the medical clinicians and research nurses. The hope for the future is that the Hobart Method may become part of standard care of infants worldwide. There is incredible potential for further research in this area which, in its infancy, was funded by the Royal Hobart Hospital Research Foundation and envisaged and commenced at the Royal Hobart Hospital by the dedicated research team for the OPTIMIST-A Trial. For more information about the Royal Hobart Hospital Foundation visit www.rhhresearchfoundation.org
Professor Peter Dargaville with one of his young patients in the Neonatal Intensive Care Unit at the Royal Hobart Hospital.
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The Biobank that Philanthropy Built After years of careful planning, Melbourne’s St Vincent’s Institute of Medical Research officially opened the HMSTrust Biobank in September.
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Biobank allows the storage and collection of human blood and tissue samples to help researchers confirm and clarify results in human tissues. The new HMSTrust Biobank will aid research into several diseases, including type 1 diabetes, liver disease including viral hepatitis, cirrhosis and liver cancer, and heart disease. It will contribute to new treatments and allow the application of research knowledge to patient care. “This project wouldn’t have been possible without the support of the Helen Macpherson Smith (HMS) Trust, the Marian and E.H. Flack Trust and our clinical partners, St Vincent’s Hospital Melbourne,” said St Vincent’s Institute of Medical Research Director, Professor Tom Kay. “Their support allowed us to create a ‘home’ for the Biobank, through funding of infrastructure works and equipment to make this vision become a reality.” While it took 5 years to take the idea of a biobank from wish list to completion, the seeds were actually planted more than 100 years ago by three very different individuals—a determined female philanthropist; a racehorse trainer; and an athlete and successful businessman. While born within 6 years of each other, St Vincent’s Institute of Medical Research’s founder, Jack Holt (1879-1951), and philanthropists Helen Macpherson Schutt (née Smith) (1874-1951) and Edwin Flack (1873-1935) followed very different paths in life. However, all three left legacies that have contributed significantly to Victoria and medical research. Professor Kay says that the ‘modern day’ researchers at St Vincent’s Institute of Medical Research look forward to watching
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the HMSTrust Biobank take root and establish itself as a vital contributor to research at the Institute and beyond. At the launch of the Biobank, the Chair of the HMSTrust, Dr Philip Moors, said he was delighted to see the project come to fruition. “We are very careful about the projects we support, but this one ticked all the right boxes. We know in time it will provide researchers and clinicians with the tools needed to benefit and improve the health of patients, which is what medical and clinical research is about.” St Vincent’s Institute of Medical Research hosts one of the largest groups of type 1 diabetes researchers in Australia, and jointly leads the Australian Islet Transplant Program, in which people with difficult-to-treat diabetes are transplanted with insulin-secreting islets: many of these patients have become insulin-independent thanks to the Program, effectively curing their disease. Researchers at the Institute are developing blood tests to monitor the human immune response that destroys insulin-producing cells, and also studying the genes that predispose individuals to develop diabetes to gain a better understanding of how the disease develops. “The new Biobank will capitalise on these strengths, giving our scientists access to essential resources for the conservation and sustainable use of clinical samples from patients with type 1 diabetes. This will help our researchers develop assays to monitor immune function in patients, and to further their research into how and why some people develop type 1 diabetes,” said Professor Kay.
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The philanthropists Born in 1879 in the Victorian town of Berwick, racehorse trainer Jack Holt lived much of his adult life with his two sisters in a small 8-roomed cottage in Mordialloc. Holt’s life was devoted to racing, and he achieved great success and distinction as a trainer and a judge of quality thoroughbreds. The death of his sister Catherine in 1945 inspired him to bequeath the majority of his assets to found a school of medical research at St Vincent’s Hospital, Melbourne. Upon Holt’s death in 1951, the St Vincent’s School of Medical Research was established. Born in Melbourne in 1874, Helen Macpherson Schutt (née Smith) was a remarkable woman. Helen belonged to a prosperous Scottish-Australian family that was active in philanthropy. At a time when Australian women’s philanthropy largely focused on voluntary work, Helen continued a family tradition of generous support in many areas, including the Lost Dog’s Home and the Royal District Nursing Service. Upon her death in 1951, the same year as Jack Holt, the majority of her wealth was used to establish a philanthropic trust to benefit Victorian charities. The Helen M Schutt Trust was renamed the Helen Macpherson Smith Trust in 2001. Born in London in 1873, Edwin Flack’s family migrated to Berwick Victoria, where Jack Holt also spent part of his childhood. Edwin Flack went on to become Australia’s first Olympic champion, winning Gold medals in the 800 and 1500m races at the 1896 Olympic Games in Athens. He followed his Olympic triumph with a successful career in Australia, building up an accounting firm with his father, which later became PricewaterhouseCoopers. Like Jack Holt, Flack died a bachelor, and wanted to dispose of his assets in a way that would benefit those in need. The Marian and E.H. Flack Trust was established upon Flack’s death in 1935. “More than a century after their births, and due to their foresight and generosity, the legacies of Jack Holt, Helen Schutt (Macpherson Smith) and Edwin Flack, live on through the HMSTrust Biobank,” said Professor Kay. “Their lives may have taken different paths, but in this instance their vision led them to the same destination.” For more information about St Vincent’s Institute of Medical Research visit www.svi.edu.au
The HMSTrust Biobank was launched on 29 September 2015
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Australia plays pivotal role in worldfirst research revolution for brain cancer GBM AGILE is a revolutionary new way of testing and developing brain cancer treatments; a world-first global adaptive clinical trial, brought about by the biggest collaboration in the history of brain cancer research.
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Australia plays pivotal role in world-first research revolution for brain cancer (continued)
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150-strong network of some of the world’s brightest minds has united to find a solution to one of the most aggressive forms of brain cancer, glioblastoma multiforme, which kills most people diagnosed within 18 months. Survival rates have remained unacceptably low for 30 years. They have created a global, adaptive clinical trial called GBM AGILE by re-engineering the way clinical trials are conducted to develop more effective treatments faster than ever before, and Australians will be among the first in the world to benefit. “None of us are willing to continue to tolerate the tragic and costly loss of life inflicted on patients who are stricken with GBM… GBM AGILE is truly a coalition of the willing, and it’s always humbling to see the power of a group this committed to changing the world.” Dr Anna Barker, GBM AGILE Project Director and Executive Committee Chair, Director of the National Biomarker Development Alliance (NBDA) and Professor at Arizona State University’s School of Life Sciences. Cure Brain Cancer Foundation and Australian experts are playing a pivotal role in this coalition of neuro-surgeons, neuro-oncologists, basic and clinical investigators and representatives from the GBM advocacy communities, who share the conviction that innovative approaches must be pursued to identify successful therapies.
How is GBM AGILE different? Traditionally, clinical trials are run by biopharmaceutical companies, changing one variable at a time and testing one treatment on many people, irrespective of whether it’s working or not. This takes time, hence it can take up to 12 years to get an experimental drug to market. GBM AGILE is different because it is an ongoing adaptive trial system. It uses modern imaging at regular intervals to show whether a treatment is working and if it isn’t, the insights gained are used to inform and adapt the treatment tested on the next patient who enters the system. Hence it is actually a clinical research system rather than a clinical trial, with new patients and treatments entering it and leaving it as insights are gained, in a much faster timeframe. “I don’t think there has ever been a more exciting time to be working in brain cancer research. All the incredible work done in basic and translational research – and by The Cancer Genome Atlas in particular – has brought us to a point where we are now not only devising innovative treatments for brain cancer, but are able to reimagine the very system through which these innovative therapies are tested. Excitingly we are entering an era where science, technology, data, and a completely new research system will converge to accelerate treatments to patients.” Michelle Stewart, Head of Research Strategy at Cure Brain Cancer Foundation.
right therapy can be tested on the right patients, leading to the development of more effective, personalised medicines. “This new generation of clinical trials will be adaptive based on learning from the patients; global as it is to be performed across the U.S., China, Australia and Europe; and innovative in that it is driven by Bayesian statistics and molecular markers.” Professor Webster Cavenee, GBM AGILE Co-investigator, Executive Committee member and Director, from the Ludwig Institute for Cancer Research and University of California San Diego As well as testing experimental new drugs, this approach will look at repurposing treatments already being tested in other diseases, saving years of development time. Uniquely, GBM AGILE is also agnostic and will be performed using a “master protocol.” This innovative approach, developed by the U.S. Food and Drug Administration (FDA), will centralise a number of functions for the trial and simplify the efforts needed to add new therapies to the ongoing trial process. Because of this ‘continuous learning system’ approach, you don’t have to spend time writing new trial protocols or getting ethics approval every time you want to test something new, saving more time. In short, GBM AGILE will cut red tape, reduce siloed research and, crucially, share knowledge globally in order to accelerate the development of new treatments to patients.
Australia innovates science Australian experts have contributed intellectually to the design of GBM AGILE across multiple areas of expertise. Driven not by financial or egotistical motivation but by fierce compassion, this coalition have come together, stepped out of their hierarchy and volunteered their time to find an innovative solution for GBM. They believe we are on a tipping point in brain cancer research. After GBM, the approach can be used by other diseases using similar protocols, so it has the potential to transform clinical research more broadly. Hundreds of Australians could eventually go through the GBM AGILE system, joining thousands in the USA, China and other parts of the world. Enrolment of the first patients is expected to begin in mid-2016 with the first trial sites being established in Sydney, Melbourne and Brisbane. Find out more at www.curebraincancer.org.au
Patients entering the GBM AGILE system have their individual tumour’s profile identified using molecular biomarkers so that the
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Australia Speaks! Research Australia Opinion Polling 2015 Volume 13
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Priorities for the Australian Government Australians’ top 10 priorities for the Australian Government 2015*
89%
01
Improving hospitals and the health care system
02
Improving education standards and outcomes
03
Improving employment opportunities
04
Keeping the national economy strong
05
Improving national infrastructure, including roads, rail, ports, airports and water quality and supply
82%
06
More funding for health and medical research
81%
07
Providing strong leadership
08
Creating more skilled jobs and apprenticeships
09
Increasing funding and programs for preventive health care
77%
10
Having policies and programs for the aged and ageing, including for pensioners and self-funded retirees
76%
86% 83% 83%
80% 80%
27 priorities for Australian Government spending in the next two to three years were shown to repondents. The above scores reflect the proportion of respondents who rated each priority 7 or above out of a ranking of zero (‘not important’) to 10 (‘extremely important’)
3 of our top 10 priorities for spending relate to looking after our health
Improving hospitals and the health system ranked No.1 over the last decade
More funding for health and medical research moved up from 9 to 6
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From time to time we add or remove some priorities from the list of priorities, to reflect current issues and concerns. In 2015 we included ‘Addressing Domestic and Family Violence’. It was rated 11th out of 27, with a score of 75%. Alcohol abuse, drug addiction and mental illness are all contributors to domestic and family violence, and research into these areas has a role to play in addressing it.
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Willingness to participate in clinical trials Clinical trials are an important way of testing the effectiveness of new drugs and devices and for evaluating the effectiveness of new and existing practices. For people with hard to treat diseases, participation in a clinical trial for a new drug can offer the only promise of a cure, but these new treatments are still experimental- they may not work and they may have unintended side effects. We wanted to know how willing Australians are to participate in clinical trials.
58% would definitely or probably participate in a clinical trial if asked to do so.
1% definitely wouldn’t participate in a clinical trial.
65% of people aged 65 or over would agree to participate.
For the unsure or for whom ‘it depends’, The two most important considerations were: •w hat their other treatment options were; and • how sick they were.
Willing to participate in a clinical trial
62%
53% Women
Men
The most influential reasons for being willing to participate ‘Clinical trials are necessary to develop new medical treatments’ ‘There may be a chance it will save or extend my life’
‘It would give me access to new treatments not yet generally available’ WWW.RESEARCHAUSTRALIA.ORG
93%
‘I want to help those who have health problems even if it might not help me’
88%
92%
‘I trust that my doctor would recommend participation in my best interest’
86%
89%
‘Australia has a well regulated and ethical process for clinical trials’
81%
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Should we tax sugary soft drinks? Currently alcohol and tobacco are taxed, in part, to reduce consumption and therefore reduce the impact on individuals’ health and the cost of poor health to the community. Australians are facing increasing threats from preventable chronic diseases like type 2 diabetes which are linked to obesity. Will a shift in attitudes towards sugar become similar to the movement against tobacco in the 1960s? Mexico introduced a 10% tax on sugar-sweetened drinks in January 2014 and sugary drink consumption has fallen by as much as 12% (1). Research Australia wondered whether there would be support in the Australian community for a similar tax on soft drinks with high levels of sugar. (1. http://uncfoodresearchprogram.web.unc.edu/822/)
Australians support for taxing sugary soft drinks
46%
28%
13%
Definitely yes
Probably yes
Probably no
10%
03%
Definitely no
Can’t say
Support stronger With age 50 – 65 year olds 78% 65 year olds and over 83%
74%
By Women Women 76% Men 72%
of
Australians supported taxing sugary soft drinks
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How do we use the internet for our health? ‘Dr Google’ has become a well know expression, but how prevalent is the use of the internet for health information, and in what ways are Australians using it? Research Australia asked a series of questions to explore how the internet is being used by people in relation to their health and illness.
Before or after seeing a doctor? 78% used the internet
18% used social media
Of the 90% who reported having been unwell at some point in the last 12 months: • 58% used the internet to check their symptoms BEFORE seeing a doctor; while 46% consulted a friend or family member first. • 71% used the internet to seek information AFTER a consultation with a doctor, to learn more about what their doctor told them.
in the last 12 months to obtain information about a health problem for themselves, a friend or a family member.
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Which websites are used / helpful?
Helpful
Not helpful
Can’t say / don’t use them
Health organisations like a cancer council or heart foundation
74%
4%
22%
Government websites (‘.gov’)
64%
8%
28%
Universities (‘.edu’)
55%
6%
39%
Refer to scientific papers and journals
51%
11%
37%
Personal stories and testimonies from people who have been helped or cured
36%
27%
37%
Sell treatments, courses or programs
11%
44%
45%
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RESEARCH AUSTRALIA LIMITED
RESEARCH AUSTRALIA www.researchaustralia.org 384 Victoria Street Darlinghurst NSW 2010 T +61 2 9295 8546 ABN 28 095 324 379
AN ALLIANCE FOR DISCOVERIES IN HEALTH
Sponsor
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Research partner
Supported by
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Collaborating to drive change for older people Older Victorians are set to benefit from the establishment of the Melbourne Ageing Research Collaboration.
The initiative of the National Ageing Research Institute, the Melbourne Ageing Research Collaboration brings together 12 partner organisations, with support from the Victorian Government’s Department of Health, to drive a critical research agenda for policy, dialogue and funding. Dr Frances Batchelor, Director of Health Promotions at the National Ageing Research Institute and Melbourne Ageing Research Collaboration project manager, said: “The initiative emerged from the realisation that many researchers were working on ageing but in a vacuum. Our aim is to join forces in a number of areas in a bid to bring about systemic change to improve the quality of life of older people.” The partners work to a set of principles which include a commitment to sharing of research and data, a shared investment, the importance of providing mentorships to emerging researchers and teaching practitioners, as well as involving older people. The results that the Melbourne Ageing Research Collaboration hopes to achieve include rapid translation of research into practice to bridge the gap between what is known and what is practised in the field of ageing, embed people-centred approaches, cultural and practice change into health, community and aged care to improve outcomes for older people, and influence policy by demonstrating the effectiveness of this new way of working. “Ultimately we want to be able to provide solutions to systemic blocks that exist between health, community and aged care services,” said Dr Batchelor. The Melbourne Ageing Research Collaboration has completed a scoping study of all research that collaborators are working in the
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four priority areas: health ageing, falls, dementia, and end of life and palliative care research. This has paved the way for a series of steps for partners to become involved and learn more about research already underway. The first step was a forum in December which covered falls and older Australians with snapshots of research from Sean Lynch (Inner North West Melbourne Medicare Local), Kristie Mackenzie, Leah Blyth and Annette Lamb (Melbourne Health), Sarah Yallop (Department of Health) and Trentham Furness, (Australian Catholic University). “Preventing falls is a major issue for older people. Many otherwise well older people have not regained independence or have died as a result of a fall,” said Dr Batchelor. “One in three people over the age of 65 fall each year. More people die from falls each year than die in transport accidents. Fall rates in hospitals remain high and have not changed significantly for decades.” The forum paved the way for the Melbourne Ageing Research Collaboration’s first demonstration project, which will look into reducing falls in hospitals. The study is being conducted at two Melbourne Ageing Research Collaboration sites: Royal Melbourne Hospital and Austin Health and involves researchers and clinicians from these two health services as well as the Melbourne Ageing Research Collaboration researchers. And aims to develop and implement a customised falls prevention plan in hospital settings using local data, and to improve staff knowledge and perceptions of falls prevention strategies and embed improved clinical practice.
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Dr Frances Batchelor anticipates that the research will fill gaps in understanding about why some patients fall, as well as the context in which they fall. Researchers will collect and analyse data about individual wards, units and hospital systems, as well as staffing, routines and the hospital environment in order to develop appropriate falls prevention strategies.” The Melbourne Ageing Research Collaboration recently held a forum into dementia, and in May, held a colloquium focussing on the four priority areas. “With over 100 researchers, policy makers and practitioners attending the colloquium, it appears that the Melbourne Ageing Research Collaboration is filling a gap which bodes well for its future,” said Dr Batchelor. On the horizon are plans to embed and train change champions within organisations. The champions will advocate for better care approaches, implement evidence-based best practice for older people and ensure changes are sustained. “If we are going to make a difference, then we need to identify and train change champions across the sectors who can advocate for better care approaches and to ensure evidence emerging from our research are put into action and are sustained,” said Dr Batchelor. “We also want to conduct large and small scale educational programs in the four priority areas for people working in community, aged care and hospital sectors so that existing evidence can be translated rapidly into practice,” she added. And she anticipates more projects coming to the fore which showcase the role of collaboration and the use of technology in identifying and solving problems that affect older people She says that with further funding the Melbourne Ageing Research Collaboration would begin to see initial changes as soon as 18 months, which would move the collaboration’s impact beyond smaller-scale influence to large-scale, longer-term impacts. “Some of those impacts would be achieved through the change champions who would have influenced the system to take on better practice in a sustained way,” Dr Batchelor said. She expects that as the Melbourne Ageing Research Collaboration grows and its work becomes better known, it will increase the number of partners and will link with more national and international networks to share the collaboration’s collective knowledge and experience. “Our work is based on the importance of sharing and learning from each other, as well as disseminating findings to showcase how systems can work well together, how they can be sustained, and how they benefit older people,” Dr Batchelor said. “It is early days but as they say, watch this space.” Current partners are Alzheimer’s Australia Victoria, Australian Catholic University, Austin Health, Melbourne Primary Care Network, Mercy Health, National Ageing Research Institute, Northern Health, Royal Melbourne Hospital, St Vincent’s, Telstra, University of Melbourne and Western Health. For more information about the National Ageing Research Institute visit www.nari.net.au
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Mental health research, the last frontier in medical research Mental illness affects 1 in 2 Australians, and does not discriminate. Yet many face overwhelming barriers and stigma in understanding and seeking support for their illness that are not encountered in other diseases. Research is critical in breaking through these barriers, but faces a similar stigma.
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he mental health sector came out in force on World Mental Health Day, October 10 2015, to celebrate the achievements of the ABC’s Mental As… national campaign to reduce the stigma associated with mental illness in Australia, and to encourage the corporate and public sectors to donate to mental health research. But underneath the glitz and glamour of the event, was a rising desperation at the lack of investment in mental health research, and concerns about what this means for the field more broadly. Less than 10% of medical research funding from the Government is allocated to mental health research, despite these issues affecting every major chronic disease category. It is estimated that 300 times more money is donated from the private and corporate sector to cancer research than to mental health research. In addition, cancer research receives twice the funding from government as opposed to mental health research, yet mental health issues have twice the effect on Australia’s GDP. Thanks to medical research, mortality and recovery rates in other major diseases such as cancer and cardiovascular disease, have significantly improved, there are earlier and improved diagnostics and safer, more personalised treatments that have transformed the lives of people living with these diseases. These battles are yet to be won in mental illness. Leading Australian economists estimate that mental health problems cost our economy more than $60 billion per annum, and 12 million lost working days in reduced productivity. The personal costs are much higher. Fewer than 10% of people with mental health problems actually receive an evidence-based treatment, and we do cannot yet predict with any certainty who will benefit from the myriad of different treatment modalities currently available. Research is the key to changing this situation, and the pathway to better knowledge, detection and treatment for mental ill-health. Just as it is in all serious illnesses, strong research partnerships with the business, community, and government sectors are required to affect change, and to capitalise on the very real opportunity to be global innovators in reducing the considerable burden of mental health disorders. The Society for Mental Health Research is leading the effort in this area, by rapidly establishing itself as the first and only charitable organization devoted entirely and specifically to raising money for mental health research across the lifespan, across disciplines, and across all disease categories. In partnership with the ABC across 2014-2015, the Society has raised close to $2 million for mental health research, channeling these proceeds directly back into investment in leading early career research scientists who are tackling critical questions for the mental health sector with their cutting edge research programs.
real-world outcomes in a short period of time, bridging the typical 14-year gap between research and practice in medical research. “The step from research to implementing research findings, strategies and treatments – the translations – are so important, which is why this funding is so useful,” Simon Rosenbaum, a current SMHR fellow awardee explained. “It’s about being involved in the services and ensuring that we can integrate strategies and not just write clinical research protocols. We integrate what we’re doing as a routine part of treatment. And that involves a culture change within psychiatry and within the treatment of psychiatric services.” Dr Christina Marel is a research fellow at the Centre of Research Excellence in Mental Health and Substance Use (University of New South Wales), whose work is focused on improving our understanding of, and responses to, co-occurring substance use and mental health disorders in complex populations. “I will use my SMHR award to understanding the challenging journeys people make through heroin dependence. This will help us identify specific “at-risk” periods where people who follow particular pathways are more vulnerable to relapse, recovery, overdose and incarceration, which has the potential to guide more effective interventions and public health responses.” Fellow award recipient, Dr Allison Milner, is Senior Fellow at the School of Health and Social Development at Deakin University. Her research focuses on workplace mental health and suicide prevention. “People in Australia work longer hours than any other OECD country,” Milner said. “They invest a lot of their time at workplaces, which are a huge part of their social network and identity.” Milner will investigate whether access to lethal means modifies the risk of suicide in high-risk occupations, and wants to encourage the business community to support mental health funding and initiatives. “Losing someone in the workplace to suicide impacts on others there too. It’s detrimental to their wellbeing and mental health, and from the employer’s perspective it effects productivity through lost work time from staff affected by the loss.” For more information about The Society for Mental Health Research visit www.smhr.org.au
The fellowships awarded to the successful early career scientists to date have been specifically focused on translation; requiring clear
SMHR early career award winners from left, Dr Mark Larsen (Black Dog Institute, UNSW), Dr Christine Marel (CREMS, UNSW), Dr Edwin Lim (Macquarie University), and Dr Simon Rosenbaum (Black Dog Institute, UNSW)
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Prostate Cancer Foundation of Australia and Movember Foundation fund ground breaking prostate cancer scientists Prostate Cancer Foundation of Australia and the Movember Foundation have this year invested over $1 million into a new award category ‘Clinician Scientist Award’. This newly established fellowship provides qualified clinicians the chance to establish their research career in prostate cancer.
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wo top Australian clinicians, Dr Kate Mahon and Dr Ian Vela have been the first to be awarded the fellowships. They will work closely with laboratory scientists and further their careers in prostate cancer research. Each award recipient receives up to $450,000 to support research into prostate cancer biology, treatment, diagnosis, survivorship and prevention. Dr Ian Vela from the Princess Alexandra Hospital Department of Urology and Queensland University of Technology, won for his work into precision medicine in advanced and oligometastatic prostate cancer, where prostate cancer has spread from the prostate and currently remains incurable and lethal. The concepts of both “precision medicine” and “liquid biopsies” in advanced prostate cancer are rapidly gaining interest and attention. Precision medicine is the notion of treating each patient on the basis of genetic changes specific to the individual’s cancer which can be targeted, or which may indicate response or resistance to various treatments. Cancer cells from the patient can also be treated with drugs in the laboratory to assess responses prior to treatment in the patient. The aim is to improve outcomes by using the right treatment, at the right time, in the right patient. Liquid biopsies from sources such as circulating tumor cells in patient’s blood (cancer cells found in the blood) may allow minimally invasive methods to access cancer cells in order to perform such precision medicine approaches.
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Technology developed by Dr Vela and his colleagues has allowed for the first time, reproducible growth of metastatic prostate cancer and circulating tumor cells from patients. Utilising novel culture and imaging (PSMA PET) technologies, a precision medicine program will be established for men with advanced and metastatic disease to identify potential effective treatment strategies based on the genetic analyses of individual patient’s cancers and the response of their cancer to various treatments in the laboratory in order to direct treatment or identify appropriate specific clinical trials. Dr Kate Mahon from the Garvan Institute of Medical Research was awarded for her work in Docetaxel (chemotherapy) resistance in advanced metastatic prostate cancer. In the setting of metastatic prostate cancer, in which cancer has spread to other parts of the body, chemotherapy improves symptoms and survival, however, around half of all patients do not improve with chemotherapy. Patients receive around 9 weeks of chemotherapy treatment before their response can be determined, which means that half of all patients potentially suffer significant side effects for no benefit. Dr Mahon’s research group has identified blood markers that can determine if chemotherapy is not working at an earlier stage, after around 3 weeks, saving patients from side effects and allowing them to go on to receive other treatment options sooner. This project aims to test these markers in much larger groups of patients in order to verify that they work and allow them to be used in the clinic to benefit many more people.
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Obesity has been linked to aggressive prostate cancer and poor outcomes, however, this association remains poorly understood. Dr Mahon’s team also aim to identify if changes in body fats after chemotherapy are related to how chemotherapy works in prostate cancer and use these changes to predict who will benefit from chemotherapy. This will also provide opportunities to test new drugs which may help chemotherapy work more effectively. Overall, her project aims to improve the outcomes of patients with advanced prostate cancer. Paul Villanti, Executive Director at the Movember Foundation, is excited to offer clinicians a chance to secure a new fellowship in prostate cancer research. “The Clinician Scientist Award aims to bridge the gap between clinical and laboratory work. We are proud to have given two outstanding clinicians the chance to advance their careers and continue their valuable research into prostate cancer,” said Mr Villanti.
in prostate cancer research. We are looking forward to offering more clinicians funding opportunities in the near future and giving them a chance to work more closely with laboratory scientists to improve clinical practice in the prostate cancer field,” said Associate Professor Anthony Lowe. Prostate Cancer Foundation of Australia will announce winners in the Clinical Trials, Young Investigator and New Concept Grants category in late November. Prostate Cancer Foundation of Australia and the Movember Foundation continue to work collaboratively to offer research grants to Australian scientists. More than $50 million has been invested nationally into prostate cancer research since 2004 For more information about the award recipients and the Prostate Cancer Foundation of Australia and Movember Foundation research grants, visit www.pcfa.org.au
Associate Professor Anthony Lowe, Chief Executive Officer of Prostate Cancer Foundation of Australia, says the clinicians who have been awarded the fellowships have demonstrated promising work into treatment of prostate cancer at different stages. “Prostate Cancer Foundation of Australia and the Movember Foundation are committed to supporting Australia’s clinicians and scientists, and creating new ways to encourage development
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Alzheimer’s disease and nutrition; another piece of the puzzle? Emerging evidence of a positive link between nutritional-tailored diets and AD prevention or treatment in seniors.
We often talk about conducting meaningful research and translating it into practice, but we don’t always have the time, resources or opportunity to do so. This is a tale of three studies that sought to: synthesise the best available evidence; use this to inform end-user driven research; and then translate the findings into practical outcomes directly relevant to seniors at high risk of developing Alzheimer’s Disease. It is about fitting another piece into the very complex puzzle that is Alzheimer’s Disease.
Study 1: Is Alzheimer’s Disease and nutrition related? Alzheimer’s Disease is a chronic and progressive neurodegenerative disease affecting memory, reasoning, language and emotions resulting in total dependence at the end-stage of the disease. There is currently no cure for Alzheimer’s Disease.
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In Australia, around 300 000 people are currently living with Alzheimer’s Disease at an estimated annual direct cost to the health care system of $3.2 billion. This cost is expected to double within five years. The picture is no different worldwide with almost 36 million people currently living with Alzheimer’s Disease. This figure could rise to 104 million by 2050 if no effective treatments are found. Several key nutrition-related factors have been identified that impact on either the time to onset to Alzheimer’s Disease, or the progression of Alzheimer’s Disease. In short, Study 1 found that nutritional status together with genetics and the presence of chronic metabolic disease, impact adversely on the progression of Alzheimer’s Disease. Thus one piece of the Alzheimer’s Disease puzzle strongly supported by evidence is related to nutrition and diet.
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Understanding Alzheimer’s disease – a complex puzzle
Study 2: Can diet help to prevention or delay the onset of Alzheimer’s Disease? Study two sought to determine if there was sufficient evidence to support a nutrition-based initiative to assist in the prevention or treatment of Alzheimer’s Disease. Omega 3 fatty acids, particularly DHA (docosahexaenoic acid (DHA – found in fish and seafood) was strongly linked to healthy brain function, with post-mortem examinations showing that the brains of those with Alzheimer’s Disease contained lower amounts of DHA than people who did not have Alzheimer’s Disease. There was also strong evidence supporting a diet high in fish, nuts, fruit, fibre and vegetables (particularly dark leafy vegetables) to lower the risk of Alzheimer’s Disease. However there was a lack of evidence around how much of what nutrients we should be eating as we age even though our ability to absorb and utilise nutrients change dramatically, particularly after 50 years of age.
Study 3: Translating research into practice – healthy meals for seniors We know that maintaining a healthy diet is essential to the prevention and management of Alzheimer’s Disease. The table below lists foods that current evidence says we should eat and those we should avoid or limit to minimise the risk of Alzheimer’s Disease.
Table 1. Nutrition and Alzheimer’s Disease Beneficial foods – Fish/ other seafood Lean red meat ( Eggs
Vegetables – Fruit – berries, grapes Green tea Low-fat dairy Turmeric Water Foods to avoid/ limit Fatty meats Cheese Processed foods Soft drinks Diet drinks Excess alcohol Refined grains/ sugars
Reason protein, omega-3 fats, VitB2 B3 B12, VitD, calcium protein, iron, VitB group, magnesium, sulphur, selenium, zinc protein, VitA B D, calcium, iodine, iron, potassium, selenium, sulphur, zinc, choline leafy green and cruciferous (folic acid, potassium, calcium, sulforaphane anthocyanidins, polyphenols, Vits, minerals, polyphenols, fibre catechins calcium, probiotics curcumin hydration
However, even with an ‘apparently’ adequate diet, it is common for seniors to be nutritionally compromised (malnourished) due to a number of complex reasons. Following consultation with free-living seniors, their preferences for the types of meals, main protein sources, cost and whether preferred cooking at home or purchasing ready-made meals were gleaned. The availability of ready-made, affordable meals for seniors that contained the right balance of nutrients to service their needs was also assessed. Unfortunately there was a clear gap in the market for these foods. Using this information and the findings from previous studies, 14 meals were developed tailored to the nutritional needs of seniors. Each meal took less than 20 minutes from preparation to plate and cost less that $5 per serve (as per senior preferences). A total of 110 seniors participated in sensory testing of the meals.
So what did we find? • There is a significant market gap in the availability of affordable, nutritionally specific, ready-meal meals for seniors in Australia. • Although the majority of seniors in this study preferred cooking at home, 40% said they would purchase ready-made meals if available. • Given the benefits of omega-3 fatty acids to seniors, there is an opportunity to provide smaller chilled or frozen portions (80100gms) of seafood aimed at the seniors market. • Flavour pouches could also be developed to add to two or three basic ingredients to create an affordable meal that can be readily prepared at home. • It is important to ensure ready-made meals or recipes aimed at the seniors market are nutritional balanced and bioavailable to the target market and are ‘tasty’. • Salt is not the only additional flavour that should be considered. The addition of ingredients with stronger flavours such as garlic, ginger, herbs, spices, citrus juice, seeds, or onion should be considered. Given the expected exponential growth in seniors worldwide in the next 5-10 years (and beyond) plus the related increase in Alzheimer’s Disease, it is essential to find effective strategies to address Alzheimer’s Disease until a cure is found. This research provides emerging evidence of a positive link between nutritional-tailored diets and Alzheimer’s Disease prevention or treatment in seniors. The next step is to conduct a population-based study combined with other effective therapies to combat this debilitating disease until a cure is found. For further information about Curtin University visit www.curtin.edu.au
high in saturated fats and cholesterol high in saturated fats and cholesterol high – GI/GL, trans fats, saturated fats, sugar, salt; low in fibre high – sugar, fructose – can cause loss of calcium artificial sweetener asparatame linked to adverse health effects increases cholesterol, impairs liver detoxification high gGI/GL
Source: Creegan and McManus in Understanding Alzhiemer’s 2013
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Cancer test predicts treatment outcome University of Queensland researchers have announced a new tool in the fight against cancer with the development of a world-first test that will direct treatment choices for patients with some forms of blood cancer.
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he test, developed by the UQ Diamantina Institute’s Professor Maher Gandhi, can predict how patients with a specific form of non-Hodgkin lymphoma will respond to standard treatment.
Professor Gandhi said results from a landmark study regarding the tool would help clinicians identify the best course of action for patients with diffuse large B-cell lymphoma (DLBCL), giving patients more certainty about their treatment options. Leukaemia Foundation of Queensland CEO Bill Petch said the test could help patients access newer drugs in the future. “This isn’t just another test. It’s a game changer,” Mr Petch said. “Professor Gandhi’s discovery will mean patients get access to the best treatment for them, first time, every time. It will significantly reduce relapse rates and have a significant impact on how drugs are funded and delivered into the healthcare system. The implications for this country’s health economics are enormous but, most importantly, patients will get access to the best treatments more quickly. If this test can then translate to other medicines and blood cancers, it could open the door to new drugs from overseas by shedding more light on their potential here in Australia.” Professor Gandhi said this type of non-Hodgkin lymphoma was the sixth most common form of cancer, with up to 2000 Australians diagnosed each year. “It can be fast growing and aggressive, so early diagnosis is vital, as is swift treatment,” he said. “Fortunately, the majority of cases respond very well to the current first line treatment, called R-CHOP, which is a combination of chemotherapy and immunotherapy. However, some patients do not respond, and for these people the prognosis is poor. My team has developed a test that will allow clinicians like myself to determine
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which patients are unlikely to respond well to standard treatment, thus avoiding ineffective and unnecessary chemotherapy and prompting consideration of other treatment options.” Professor Gandhi said patients undergo R-CHOP treatment for around four months and if it is not successful this delay can be lifethreatening. In addition, new immunotherapies are very expensive and have their own range of side-effects. “As such, clinicians need good cause to choose this course of action for a patient over standard treatment,” he said. “To make this decision, we need to be able to identify at an early stage which patients will respond to R-CHOP and are likely to be cured by it, and which patients won’t.” The test works by revealing how a patient’s immune system has responded to lymphoma; a very strong response suggests the patient is highly likely to be cured with conventional therapy, and a weak response predicts a less favourable outcome. “That might sound like common sense but until now there’s been no accurate, fast, easy and reliable way in which to quantify the immune system,” Professor Gandhi said. “We know that tumour cells can recruit a patient’s normal immune cells to protect it and help it grow, by turning some of the patient’s immune cells against the rest (becoming ‘tumour-friendly’ cells). Recent studies in solid tumours have also revealed a remarkable effect whereby the ability to turn the immune system against itself is not weakened in response to treatment, instead it gets stronger. How well a tumour does this can determine the outcome for the patient.” Professor Gandhi wondered if this was also happening in DLBCL and if so, whether this effect is responsible for why some people respond well to R-CHOP and some don’t.
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Professor Maher Gandhi and his team at the UQ Diamantina Institute in Brisbane have developed a simple laboratory test that can predict how patients with an aggressive form of non-Hodgkin lymphoma will respond to standard treatment.
Professor Gandhi and his colleagues worked closely with biostatisticians and patient groups in Australia and around the world, analysing samples of patient tumours.
Mr Petch said the Leukaemia Foundation was able to fund groundbreaking research projects thanks to the ongoing support of the community.
“Our team discovered that DLBCL tumours do in fact ramp up their defence in response to treatment, turning more of the patient’s immune cells into tumour-friendly cells. We next looked at whether the proportion of tumour-friendly immune cells to antitumour immune cells would indicate how well the patient ultimately responded to treatment. By analysing the relative numbers of each immune cell type before treatment begins and then monitoring patient outcomes, we discovered that there was a direct link. Moreover, this could be quantified in a straightforward formula: patients with a high ratio of anti-tumour to pro-tumour immune cells have a greater than 90% chance of being cured by standard treatment (R-CHOP); patients with a low ratio are unlikely to benefit from standard treatment.”
“There’s no doubt we’re in exciting times for blood cancer research with huge steps being taken towards more effective treatments for patients due to a better understanding of how blood cancers develop,” he said. “Progress is being made with targeted treatments tailored to individuals and the gap is well and truly closing between the laboratory bench and the patient’s bedside thanks to the efforts of researchers like Professor Gandhi and his team. We are closer to beating blood cancers than ever before and our supporters in the community are helping to make this possible.” For more details about the work of the Leukaemia Foundation, please visit www.leukaemia.org.au
Professor Gandhi believes that this approach will now provide clinicians with a valuable tool that will help them identify who should continue standard treatment and who should be eligible for new clinical trials. His next goal is to determine whether this approach could be used in a similar manner to predict whether a patient is likely to benefit from the new wave of drugs targeting PD-1 and PD-L1, which are now major targets in anti-cancer therapies. Professor Gandhi is optimistic that collaborations such as the current one will continue to yield vital information about the intricate dynamics between cancer, the immune system, and treatments. The research, published in a recent edition of the Lancet Haematology journal, was partly funded by the Leukaemia Foundation.
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Disease in the dust Every year in Australia, over 300 people are reported as suffering from a debilitating disease known as Q-fever. The Australian Red Cross Blood Service (Blood Service) is playing a pivotal role in a study to understand the true size of Q fever infection in Australia to ensure the ongoing safety of the blood supply.
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fever has special significance for Australia, where the causative organism Coxiella burnetii (C. burnetii) was discovered, and the only available vaccine for humans was licensed in 1989. Once thought to be restricted to abattoir and farm workers, the disease has gained attention recently after an epidemic in the Netherlands, where more than 4,000 people were reported as being infected. This was the largest outbreak of Q fever ever recorded. People can become infected with C. burnetii from animals such as sheep, goats and cattle by breathing in infected particles of fluid or dust. In the Netherlands, the epidemic centred on a number of infected dairy goat farms, but many of the people infected had no direct contact with the animals. Because C. burnetii can survive being dried out, infection can spread for some distance on dust that has been contaminated with animal matter. Dry, windy weather may provide ideal conditions for the spread of Q fever, meaning that drought conditions can present a higher risk of disease spread. This resilience has contributed to it being classified by the United States Centers for Disease Control and Prevention as a category B bioterrorism agent. A Q fever vaccination program was in place in Australia from 1991 to 2007, initially in a small number of abattoirs. During 2001 and 2006 it was extended to sheep, dairy, cattle and beef farmers, and later to those who work with kangaroos and their products. The total number of infections reported more than halved as a result of this campaign. Exposures in other occupations, and
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non-occupational exposures, then began to make up a larger proportion of the reported cases. Despite the fact that the vaccine is no longer sponsored by the government, it is still available on the private market to a growing list of at risk groups. The vaccination process consists of an initial serological or skin test for prior exposure, followed by vaccination during a second medical visit one week later. The impact of Q fever infection can be long-lasting, and the costs to the community and the government are considerable. Although the vast majority (around 60 per cent) of people who are infected with C. burnetii will show no symptoms, others go on to develop short or long-term illness, and it is only these patients who are recorded in official statistics. In some people the disease can be severe, with aches, pains, fevers, chills, blurred vision and extreme tiredness and confusion. Chronic disease, particularly endocarditis, can occur months or years later and can be fatal. A number of people who have suffered through the disease develop a long-term condition known as post-Q fatigue syndrome. These people have difficulty carrying on normal work and their quality of life can be severely affected for as long as 10 years after the infection. If someone with an asymptomatic infection is a blood donor, it may be possible for them to pass on the infection through the blood supply, because our current screening systems may not detect all infected people. Today, we are not sure how many people are carrying the infection in Australia, and a project has been funded by
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the National Health and Medical Research Council and the National Blood Authority to address these uncertainties. The Blood Service’s research into Q fever involves the coordination of medical and scientific experts from universities and health services throughout New South Wales and Queensland. Blood Service researcher, Dr Helen Faddy explains the study: “We are trying to understand how many of our donors may be unknowingly affected by C. burnetii. “We have enlisted the help of some loyal donors in New South Wales and Queensland to provide extra blood samples and answer a few questions for us,” said Dr Faddy. “We will compare the results for city dwelling donors with those from areas of Queensland and New South Wales known to be hot spots for Q fever transmission. We will be able to measure their past exposure to the disease, as well as whether they are currently infected .We hope to identify groups who are most at risk by matching our testing blood sample testing data with information from donors about their lifestyles and occupation.
scientists located in Melbourne, Sydney and Brisbane. Research projects at the Blood Service cover a broad spectrum of blood banking activities, from donor behaviour, through to production and storage methods for blood products, the biology of transfusion reactions and monitoring emerging infectious diseases. As part of the research program, R&D scientists mentor a number of research students every year. Outcomes from our research projects provide evidence to inform decision making and help drive best practice in Australia and internationally. Further information about our research projects can be found at donateblood.com.au/research Acknowledgement: Australian governments fund the Australian Red Cross Blood Service for the provision of blood, blood products and services to the Australian community.
“We are grateful to all the donors and staff who have helped us with this study. Not only will their donation on the day save up to three lives, but the extra effort involved in participating in this study will help ensure the safety of the blood supply for everyone in the future,” she said. The Q fever project is part of an extensive Research and Development effort at the Blood Service, with over 60 research
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The Coopers Brewery Foundation backs South Australian cystic fibrosis research South Australian based non- profit Cure4CF Foundation was thrilled to be beneficiary of the generosity of the Coopers Brewery Foundation recently, with a donation of $31,900 towards research to cure cystic fibrosis airway disease. A donation which Cure4CF Foundation Chairman, David Coluccio says “Could not have arrived at a better time”.
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very four days a baby is born with cystic fibrosis in Australia and in most cases, to parents who were unaware they were carriers of the defective gene – since carriers can be unaffected.
Cystic fibrosis is the most common inherited disease causing premature death affecting the developed world. Cystic fibrosis is both life impacting, being a multi-organ disease, affecting the lungs, gut, liver, pancreas and reproductive tissues – and life limiting, even with recent medical advances, at present about half of those with cystic fibrosis will die by their late 30s from lung disease. There is currently no cure. But thanks to incredibly generous partners in the community like the Coopers Brewery Foundation, the Cure4CF Foundation aims to change that. Established in 2009, the Cure4CF vision is to find a cure for cystic fibrosis by raising and directing funds to promising avenues of research. To date, this has seen the Foundation support the work of the Adelaide Cystic Fibrosis Airway Gene Therapy Research Group. Over the past 15 years the research group has been working on their unique lentiviral gene vector with the aim of curing the airway disease caused by cystic fibrosis, which is by far the most common cause for early death. The research group employs a world-leading gene transfer approach. They use an specially modified virus to take a correcting
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gene into the airway, supplementing the missing activity of the defective gene that causes cystic fibrosis airway disease. The cell can then take over the job of producing the normal airway physiology. The most exciting aspect of the work is that although this approach should produce long-term gene therapy treatments, it is also a potential cure for the airway disease in cystic fibrosis. It is designed to include correction of airway stem cells. This means that as new airway cells are produced by the body they will have the corrected gene already operating within them. Success in this research area means that people living with cystic fibrosis airway disease will, for the first time, be able to live well with, or even be free of this lung disease. Research undertaken by the team has already shown that their gene transfer approach is successful in several non-human models. The ongoing challenge, in Australia’s severely-restricted medical research environment, is to continue to develop their work to the point where they can commence human clinical trials. If the techniques and strategies being developed by the team are successful, this research has the potential to vastly improve the lives of the 3,000 people living with cystic fibrosis in Australia, and more than 70,000 people worldwide. It was the dedication of the research team and their innovative approach to finding a cure for cystic fibrosis that led the Coopers Brewery Foundation to encourage their shareholders to support this very important project being delivered in South Australia.
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“Since the Foundation’s inception in 2006, we have distributed more than $3 million to support over 200 charitable projects and we look forward to supporting many more in the future” said Melanie Cooper, Coopers Foundation Board Director. For Cure4CF Foundation, this donation arrived at a critical time for the research team. A recent breakthrough in the UK further validated the gene correction research approach of the Adelaide Cystic Fibrosis Gene Therapy Research Group, and highlighted the need for additional funding to fast track this highly promising local program. David Coluccio, Chairman of Cure4CF Foundation said “The Adelaide research team now has independent evidence for the first time, based on human clinical trials conducted in the UK, that a gene therapy can correct cystic fibrosis lung disease.” “The type of treatment the Adelaide group are working on would benefit anyone with cystic fibrosis,” Mr Coluccio said. “Additionally, what is also exciting is that not only will this research contribute to a global cure for cystic fibrosis airway disease, but it also increases the worldwide knowledge on the use of gene therapies and stem cell research, to apply to developing treatments or cures of other genetic diseases.”
time to cure cystic fibrosis; that now is the time to support this world leading research being conducted right here in Adelaide. “Because of partners like the Coopers Brewery Foundation, the research team are able to accelerate their research efforts toward human clinical trials, which we would hope can begin in the next five years. “But ongoing support is vital. To accelerate this research the Adelaide team needs funding, so we are hoping that the backing of an iconic organisation like Coopers Brewery, and the belief of their Foundation in this research will really encourage the community to consider supporting Cure4CF and its effort to find a cure for cystic fibrosis airway disease. “We believe that together this is a disease we can, and will conquer.” For more information about the Cure4CF Foundation visit www.cure4cf.org
“The research team are passionate about finding a cure for cystic fibrosis, and the very generous support of the Coopers Foundation shows that the community feels as strongly as us that now is the
(L-R) Dr Tim Cooper, Coopers Brewery Foundation. Kerry Southwell, Cure4CF Foundation. Linda Jones, Cure4CF Foundation. Melanie Cooper, Coopers Brewery Foundation.
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Nursing researcher shines light on ethics Deakin University’s Professor Megan-Jane Johnstone has cemented her place in nursing ethics, completing two seminal texts.
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t one point early in her career as a nurse, Deakin’s Chair of Nursing, Professor Megan-Jane Johnstone considered giving up the profession. She was unable to give a name to the issues she encountered. It was only when she went to university and discovered “Philosophy 101” that she had her Eureka moment and realised that ethics had been the “elephant in the room.” “I had always had a strong sense of justice,” she said. “Once I discovered ethics, I realised I wanted to make the field of ethics visible and accessible to nurses and to make the ethical issues nurses had to grapple with every day visible to the public. I have now been working on that quest for almost 31 years – which I suspect will remain a lifelong project.” There can be no doubt about her success in achieving this goal. Professor Johnstone is now one of the most respected nurse ethicists in the world. She has just edited a three-volume Sage Major Reference Work “Nursing Ethics” – the first of its kind. She has also just prepared a revised sixth edition of her landmark work “Bioethics: a nursing perspective,” which was first published in 1989 and was the first book on nursing bioethics ever to be written from an Australian perspective. Both works have just been released for worldwide distribution. In its review of “Nursing Ethics,” the International Council of Nurses stated that the Sage major work would “serve as an important resource for ethicists, researchers and nurses in all fields, and is the first of its kind to bring together the foundational ethical articles of the nursing profession.” The three-volume work includes leading articles that have influenced the international development of nursing ethics and also details the history of the development of the “International Council of Nurses Code of Ethics for Nurses,” which “guides action,
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based on social values and needs and serves as the standard for nurses worldwide.” “Bioethics 6” was launched at the 12th Biennial National Enrolled Nurse Association of Australia, Conference, held in Adelaide in October, by Lee Thomas, Federal Secretary of the Australian Nursing and Midwifery Federation. “The fact that Bioethics: A nursing perspective” is still in print 27 years after the first edition is remarkable,” said Professor Johnstone. “I never imagined it would be. The chapter I am most proud of is completely new: ‘Ethics, dehumanisation and vulnerable populations’. The past 125 years of writing on nursing ethics offers a fascinating insight into how nursing as a profession has developed over time and reacted to the ethical questions raised around the role of nurses in health care and their interactions with patients.” Professor Johnstone suggests that, at one level, the ethical issues faced by nurses remain unchanged. For example, “debate is ongoing about nursing codes of ethics – what their content should be, what role they should have in terms of guiding and censuring professional nursing conduct.” On another level, many ethical issues are emerging as a result of 21st century developments, such as the health impacts of climate change, peak petroleum, anti-microbial resistance, growing health inequalities across the globe and the tough moral decisions that will have to be made in relation to these things. Like the pioneering US nursing scholar and social activist, Lavinia Dock, co-founder of the International Council of Nurses (circa 1899), who wrote a foundational essay “Ethics – or a code of Ethics?” decades ahead of its time in 1900, Prof Johnstone is passionate about continuing to improve the calibre and authority of nursing ethics.
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“It does concern me that some nurses have lost sight of the broader issues, despite intellectual developments in the field,” she said. “Some nurses still make decisions based on their personal values and beliefs, rather than through systematic inquiry. Yet peoples’ sincere beliefs can be mistaken. For instance, people once believed that the world was square and if they sailed to the edge they would fall off it. Although sincerely held, that belief was clearly wrong. Educators and researchers have a responsibility to challenge conventional thinking on nursing ethics in undergraduate, postgraduate and professional development programs. Also, thinking needs to extend beyond the issues emerging within the ‘bricks and mortar’ environment of hospitals, to include broader social justice and humanitarian concerns.” In keeping with this view, since 2008, Professor Johnstone has been writing a bi-monthly column on nursing ethics for the Australian Nursing and Midwifery Journal, which has an audited circulation of 94,678 and an audited readership of 120,000 Through this column, nurses have been invited to reflect on a wide range of issues, including: caring about the unbefriended elderly, human vulnerability, poverty ethics, bigotry and racial discrimination, health care and the right to cultural liberty, chronic pain management as a basic human right, the loss of common decency, ethics and public opinion, suffering and altruism, on the matter of human kindness, justice as a basic human need, public health and HIV, the rationing of universal health care, choice and human freedom, moral panics and asylum seekers, and the international call for a convention on the rights of older people. “I feel such an urgency to write about these issues – there are so many issues that still need to be addressed, still so much more that needs to be said and questioned,” said Professor Johnstone. “Nurses have both a civic duty and a moral responsibility to ensure that they are well informed about them. These issues are never ending and there is such a need to develop more rigorous thinking about them all.”
Deakin University’s Chair of Nursing, Professor Megan-Jane Johnstone, has transformed the field of nursing ethics.
In addition to other books, book chapters, many journal articles, invited editorials and commentaries published over the years, in 2013 Professor Johnstone published “Alzheimer’s disease, media presentations and the politics of euthanasia: constructing risk and selling death in an aging society.” This highly provocative and trailblazing work has received glowing reviews in a range of leading journals, including the prestigious US-based journal “Gerontology” Drawing on extensive data, including news media reports and commentaries, documentaries, court reports, films, websites, professional literature and government and non-government reports, the book explores the ‘Alzheimerisation’ of the euthanasia debate, examining the shift in recent years in public attitudes towards the desirability and moral permissibility of euthanasia as an end-of-life ‘solution’ for people living with the disease – not just at its end stage, but also at earlier stages. For more information about Deakin University visit www.deakin.edu.au
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New Bone Alliance Announced The Garvan Institute of Medical Research and Osteoporosis Australia have forged a new Bone Alliance. The partnership will address the major health issue of osteoporosis utilising innovation and education to achieve positive change for bone health.
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n Australia it is estimated 1.2 million Australians are affected by osteoporosis. It is a disease that does not just affect women, men account for up to 30% of all fractures related to osteoporosis and osteopenia, and the cost of fractures is the largest component cost of poor bone health in Australia, presenting a serious burden to the healthcare system. Research released by the Garvan Research Foundation on World Osteoporosis Day (20 October) revealed the majority (58%) of Australians have limited understanding of what Osteoporosis actually is and alarmingly that 60% do not understand who is most at risk. Andrew Giles, CEO, Garvan Research Foundation said, “I am surprised by the extent of the disconnect between the awareness of the disease and a real understanding of the impact osteoporosis can have. These research outcomes point to the need to provide more information and education on the causes of osteoporosis beyond ageing and on lifestyle changes across the generations that will help to minimise the risk of developing the disease.” Osteoporosis Australia Chairman John Hewson welcomed Garvan’s pro-active approach “we know this is an area of healthcare where positive change is possible and this important new alliance will greatly enhance our efforts to achieve better patient outcomes.”
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The initial projects to be developed under the new Bone Alliance will address current gaps in the area of consumer awareness and education and utilise Garvan technology and expertise. “Outside of the Lab we need to create educational resources and tools at a consumer level that will drive a stronger ‘awareness and education’ conversation. Future initiatives of the Garvan and Osteoporosis Australia partnership will focus on the development of state of the art technology to support this conversation,” said Andrew Giles. Osteoporosis Australia CEO Greg Lyubomirsky said, “This is a unique opportunity to partner with Garvan and work together to implement national initiatives to combat osteoporosis and break the cycle of ignorance and to reduce the burden of fractures.” “The impact of fractures on patients is overlooked – we hear many stories of patients unable to work, experiencing functional and emotional decline as they lose independence and becoming fearful of any activity that may be associated with another fracture,” stressed Greg Lyubomirsky. Professor Peter Ebeling, Medical Director of Osteoporosis Australia said, “The burden of osteoporosis in Australia is set to increase as the number of fractures continues to rise. Programs that can change community perceptions are essential. The Bone Alliance can harness research innovations to ensure we capture the attention of at-risk patients to improve health care.”
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Representatives of The Bone Alliance. Back Row L – R: Dr Paul Baldock, Greg Lyubomirsky, Prof John Eisman, Prof Mike Rogers, Andrew Giles. Front Row L – R: Prof Peter Ebeling, Dr John Hewson, Prof Peter Croucher, Prof Jackie Center.
Picture of Osteoporosis in Australia
Garvan Heritage in the Bone Field
A Burden of Disease Report commissioned by Osteoporosis Australia was released in 2013 and reviewed prevalence of poor bone health, fracture numbers and associated costs in Australia from 2012- 2022. The largest component cost of the disease relates to fractures and fracture type has important implications for healthcare costs and patient recovery. Hip fractures remain the most costly and have the greatest impact on patients. Fracture numbers are significant with over 155,000 fractures due to poor bone health estimated in 2016.
Garvan’s Osteoporosis and Bone Biology division combines clinical, molecular and cellular research to explore the links between genetic, hormonal and lifestyle influences on bone mass. Research draws on the Dubbo Osteoporosis Epidemiology Study (DOES) which started in 1989, and is now the world’s longest running largescale epidemiological study of osteoporotic fractures in men and women. Garvan scientists have found that measuring bone density loss can improve the accuracy of fracture risk assessment and help identify who would benefit most from preventative measures.
Importantly hospital costs account for 73% of direct total costs of fractures, representing the largest proportion of direct fracture costs. These findings highlight osteoporosis is a chronic disease that has a big impact on the hospital system and intervention strategies are needed.
National programs under the new The Bone Alliance will commence during 2016.
Several studies have evaluated future fracture risk associated with fractures at various sites, a prior fracture at any site is associated with a doubling of future fracture risk. Secondary fractures can appear to occur rapidly after the initial fracture. Studies from Fracture Liaison Services (both in Australia and overseas) have shown impressive results in capturing patients post-fracture and reducing future fractures. These services currently operate at only limited locations in Australia, but this approach presents an important opportunity to curb fracture numbers. Improved diagnosis and management at the primary care level and improved community awareness of risk factors are also needed.
Osteoporosis Australia is national not for profit organisation committed to improving awareness and understanding of osteoporosis. Our goal is to reduce the incidence of osteoporosis and bone fragility fractures in the Australian community. For more information about Osteoporosis Australia visit www.osteoporosis.org.au
Bone Research Bone research continues to explore the mechanisms of bone remodelling and the impacts of genetics, nutrition and other diseases on bone health. New treatments on the horizon look promising and improvements in diagnostic techniques are evolving. Greg Lyubomirsky CEO Osteoporosis Australia says “we are fortunate in Australia to have world class bone researchers covering both basic science and clinical research. Despite the advances in diagnosis and treatment the key area is to translate the advances in science into real world patient management. This is still a challenge and an integrated effort by all relevant stakeholders is required.”
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A mathematical weapon in the fight against neglected diseases What do mathematics and computer modelling have to do with nine so-called Neglected Tropical Diseases? The answer lies in the growing academic field of infectious disease modelling, in which the interactions between parasites and people are written down as mathematical equations and solved using computers.
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nfectious disease models can be used to forecast the future number of disease cases or to predict the outcome of a community intervention such as the mass treatment of the disease using antibiotics.
The Neglected Tropical Diseases are a group of around 15 infectious diseases that overwhelmingly affect the poorest people in the world, stunting growth, preventing proper cognitive development in children and causing vision loss. Over the past 20 years, the World Health Organisation has issued declarations outlining global goals for the elimination or control of the NTDs by the year 2020. Now one of the largest institutions dedicated to public health in the world, the Bill and Melinda Gates Foundation, is interested in finding out where these goals can be met, where they cannot, and what additional resources are needed to meet them. To answer these questions, the Gates Foundation has established the Neglected Tropical Diseases Modelling Consortium which brings together 12 university research groups from around the world. Australia is represented by Monash University in the Consortium, other esteemed members of the group include: Yale, Princeton, UC San Francisco, Notre Dame, Case Western Reserve, and Johns Hopkins from the USA; and Imperial College London, Warwick, the London and Liverpool Schools of Hygiene and Tropical Medicine, and Erasmus from Europe. The financial commitment to the project from the Gates Foundation is considerable, amounting to several million dollars. There are number of postdoctoral fellows who will receive valuable training from the project, enabling them to use their skills for future work on NTDs or other diseases.
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Dr. Manoj Gambhir and Dr. Amy Pinsent are the mathematical modellers in the School of Public Health and Preventive Medicine at Monash University. They are both currently working on the eye disease trachoma as a part of their work for the Consortium – trachoma also happens to be prevalent in some communities in Australia. Dr. Manoj Gambhir said he and Dr Pinsent are using models to investigate community treatment strategies that will eliminate the severest form of the disease, blinding trachoma. Dr. Gambhir has worked with several international public health agencies including the World Health Organisation and the U.S. Center for Disease Control where, most recently, he spent several months assisting with Center for Disease Control’s modelling efforts for the West Africa Ebola Emergency Response. Dr. Pinsent completed her doctoral studies earlier this year at Imperial College London where she worked on the epidemiological dynamics of the ever-important infectious disease influenza. “We’re incredibly excited to be applying the techniques and knowledge we’ve learned over the years to a project as worthwhile as this one”, said Dr. Gambhir. “The modelling consortium is ground-breaking, because it’s such a large global collaboration, as well as the fact that it applies some of the most cutting-edge mathematical modelling approaches to diseases that affect the world’s poorest billion people.” Nowadays, mathematical modelling is a common activity in a number of domains such as weather and climate forecasting, economic policy formulation, environmental pollutant impact
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Dr. Manoj Gambhir and Dr. Amy Pinsent, mathematical modellers from the School of Public Health and Preventive Medicine at Monash University.
assessment, and even the prediction of political elections (such as, famously, the U.S. Presidential elections of 2008 and 2012). However, the global public health community has been somewhat hesitant to leverage power off this set of tools to help with disease control. This landscape and outlook is now changing, thanks to organisations like the Gates Foundation. This is especially urgent given the proximity of the year 2020, the target for achieving elimination or control for several of the Neglected Tropical Diseases’s as stipulated by the World Health Organisation. The Neglected Tropical Diseases Modelling Consortium is one of several global collaborations that aim to bring together the results of mathematical modellers to reach a consensus on a specific question. Other diseases that have been targeted include malaria, HIV AIDS and tuberculosis; these are sometimes referred to as the ‘big three’. A consortium style approach is a way around a common complaint of public health policy makers that different modelling groups produce results that differ from one another. Differences that can lead to conflicting policy advice. By comparing mathematical approaches and sharing data, a consortium allows modelling groups to reach a consensus and provide a coherent policy direction. This is the kind of approach that was pioneered by the inter-governmental panel on climate change, which publishes periodic climate ‘multimodel ensemble’ forecasts of important quantities, such as the global surface temperature. It has been a point of vigorous scientific discussion and investigation that the inter-governmental panel on climate change’s multimodel ensembles offer not just a coherent policy tool, but are actually better predictors of global surface temperature than any single forecast.
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Dr. Gambhir and Dr. Pinsent remain optimistic remain optimistic as the 2020 Goals date looms. “It’s amazingly encouraging that big public health organisations like the Gates Foundation and the World Health Organisation are wanting to use the best available quantitative tools to guide their policy”, said Dr Gambhir. “Striving to reach the 2020 Goals will be enormously beneficial for millions of people around the world. We also hope that the methods we develop in the Consortium will prove useful for groups aiming to eliminate these and other diseases beyond 2020.” A special issue of the journal Parasites and Vectors has already been published with early results from the international project. With the pace of meetings and international conference calls increasing between the global network of universities; more forecasts, model comparisons, and policy recommendations should be expected from the Consortium soon. The Neglected Tropical Diseases Modelling Consortium is being funded by The Bill and Melinda Gates Foundation through The Task Force for Global Health, both of which are based in the USA. For more information about Monash University visit www.monash.edu.au
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$2.5 million grant for breakthrough cancer research technologies to advance treatments A new partnership between the Australian Cancer Research Foundation and Melbourne’s Walter and Eliza Hall Institute has led to the establishment of an Australian-first facility to research and develop new treatments for cancer.
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he $2.5 million Australian Cancer Research Foundation Breakthrough Technologies Laboratory was opened in September 2015 by Victorian Parliamentary Secretary for Medical Research, Mr Frank McGuire MP. The new facility is giving researchers new insights into how cancer develops, and how it can be more effectively treated. The Australian Cancer Research Foundation Breakthrough Technologies Laboratory is Australia’s first dedicated cancer laboratory to use ‘CRISPR/Cas9’ technology to target and directly manipulate genes in cancer cells. Until now, genetic manipulation relied either on slow and resource-intensive systems, or on technologies that were neither reliable nor resource efficient. CRISPR/Cas9 technology allows researchers to rapidly test and compare the effects of potential cancer-causing gene changes in cancer cells, as a means to understanding how cancer develops and spreads, as well as modifying cancer cells’ DNA to understand the effects of particular anti-cancer medications. The Australian Cancer Research Foundation Breakthrough Technologies Laboratory will be available for use by more than 1000 cancer researchers from the Walter and Eliza Hall Institute and its Victorian Comprehensive Cancer Centre partners to enhance and accelerate research into many of Australia’s most common, and most deadly, cancers including cancers of the blood (leukaemia, lymphoma), breast, ovary, lung and bowel. The Australian Cancer Research Foundation Breakthrough Technologies Laboratory is also equipped with high throughput research equipment, allowing researchers to conduct experiments
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and compare potential anti-cancer treatments at a much higher rate than ever before, greatly increasing the speed at which new cancer treatments can be discovered and developed. The director of the Walter and Eliza Hall Institute, Professor Doug Hilton, said the ACRF Breakthrough Technologies Laboratory would provide an enormous boost to Australia’s cancer research efforts. “It has become clear that technologies such as CRISPR/Cas9 can accelerate new breakthroughs in understanding cancer and developing new treatments,” he said. “The generosity of Australian Cancer Research Foundation and its donors has allowed us to equip our research teams with precisely the tools they need to advance their research,” Professor Hilton said. “This will ensure our researchers remain at the forefront of the global cancer research sector and continue to make discoveries that benefit people with cancer.” Mr Tom Dery, Chairman of the Australian Cancer Research Foundation Board said the contributions Australian researchers are making to improving the prevention, diagnosis and treatment of cancer are very significant. “More than 14 million people around the world were diagnosed with cancer last year, including more than 125,000 Australians,” he said. “We are proud to enable the groundbreaking research conducted at the Australian Cancer Research Foundation Breakthrough Technologies Laboratory. The facility will help to accelerate new treatments for people with cancer in Australia and worldwide,” Mr Dery said.
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An Australian-first cancer research facility has been established at the Walter and Eliza Hall Institute through a $2.5 million grant from the Australian Cancer Research Foundation
Since its establishment in 1984, Australian Cancer Research Foundation has awarded over $103 million in cancer research grants to leading Australian research initiatives that are leading to more effective treatments and diagnostics for all cancer types. In the past decade, ACRF has contributed almost $6 million to the Walter and Eliza Hall Institute’s cancer research. Cancer has been a research focus throughout the Walter and Eliza Hall Institute’s 100-year history. This research has underpinned advances in cancer diagnosis and treatment, including the discovery and development of colony stimulating factors, which have been used to treat more than 20 million people worldwide, and a potential new class of anti-cancer agents now in phase 3 clinical trials. Australian Cancer Research Foundation-funded research at the institute has already led to significant research advances in understanding how breast cancer develops, with Walter and Eliza Hall Institute researchers showing in 2014 that stem cells within the breast can harbour gene changes that can contribute to the development of breast cancer. As well as improving the understanding of how breast cancer develops, this finding may lead to the development of better diagnostics or treatments for breast cancer.
“The strength of the Victorian Comprehensive Cancer Centre lies in the close ties it fosters between the laboratory-based, clinical and other researchers in its partner organisations. This means that discoveries made in the Australian Cancer Research Foundation Breakthrough Technologies Laboratory will be translated into new treatments for cancer as rapidly in Melbourne as anywhere in the world,” Professor Bishop said. The Walter and Eliza Hall Institute is the research powerhouse of the Victorian Comprehensive Cancer Centre, an alliance of ten successful Victorian organisations committed to cancer care: the Walter and Eliza Hall Institute of Medical Research, Melbourne Health (including The Royal Melbourne Hospital), The University of Melbourne, Peter MacCallum Cancer Centre, The Royal Women’s Hospital, The Royal Children’s Hospital, Western Health, St Vincent’s Hospital Melbourne Austin Health and Murdoch Childrens Research Institute. For more information about the Water and Eliza Hall Institute visit www.wehi.edu.au
Professor Jim Bishop, Executive Director of the Victorian Comprehensive Cancer Centre, said the Australian Cancer Research Foundation Breakthrough Technologies Laboratory represented a critical addition to the Victoria’s cancer research capabilities. “The facility provides our researchers with unparalleled access to world-leading technology,” he said.
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Researchers honoured for work that delivers real-world results Four NSW researchers whose work has changed the way we design and deliver healthcare have been honoured in the Sax Institute’s inaugural Research Action Awards.
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he Sax Institute established the annual awards to recognise research that supports policy decisions that make a real-world difference to people’s health and wellbeing.
“The winning applications are outstanding examples of research that is making a critical contribution to health and health systems,” said Sax Institute CEO Professor Sally Redman. “Our award winners have not only undertaken research about issues of immediate relevance to those who make health decisions, they have also found elegant ways to have their findings acted upon.” The awards were presented at a cocktail reception attended by senior health leaders and members of the public health and health services research community on 15 September. Professor Nicholas Mays, Editor of the Journal of Health Services Research & Policy, was a special guest at the event. “The Research Action Awards send a signal that there is more to having good research than the traditional research career track,” Professor Mays said. “We know how hard it is to take good research and take that into policy and practice. To seize opportunities to move findings into the real world is very difficult.” To do so required skills such as tenacity, diplomacy, humility and communication skills, all of which were all demonstrated by the award winners, he said.
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NSW Chief Scientist Professor Mary O’Kane, who presented the awards, said they would inspire research that focused on finding solutions to real-world problems. The award winners are:
Dr Anne Cust, University of Sydney – sunbeds and melanoma Dr Cust led the first Australian population-based study to establish a link between sunbed use and melanoma, and showed that young people were particularly sensitive to the effects of sunbed UV radiation. She also produced modelling estimates for the Cancer Institute NSW that showed banning sunbeds would reduce the number of melanoma cases in NSW alone by 120 per year and about 26 per year in the 18−29 year age group. The research was pivotal to the NSW Government introducing a total ban on commercial sunbeds in late 2014. Bans have now been rolled out in other Australian states and overseas. “I worked very closely with melanoma patient advocates after this research was published and there was already community awareness around the potential risks of sunbeds so that, in combination with the support of the Cancer Institute, really helped get this work on the agenda,” Dr Cust said.
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Research Action Award winners – Farah Magrabi, Santosh Khanal, Anne Cust and Julie Leask
Associate Professor Julie Leask, University of Sydney – parent attitudes to vaccination Associate Professor Leask has been researching the area of vaccine refusal and acceptance for nearly two decades and has found that strategies to improve vaccination rates should target fence-sitting parents rather than those whose opposition to vaccines is entrenched. Her work has led to an international collaboration to develop a Vaccine Communication Framework, which has been used by healthcare workers in vaccine communication in a number of countries. This is being further developed and evaluated by the Federal Government and National Centre for Research and Surveillance in a three-year project called SARAH – Strategies and Resources to Assist Hesitant parents with vaccination. Associate Professor Leask has provided policy advice to state and federal health ministers and has presented her research to leading international health bodies. “Spending time advising policy makers and practitioners and talking to the media about your research is a tremendous opportunity. But it means you may spend less time on traditional measures of academic success like peer reviewed publications. This award recognises all that effort and time,” she said.
“It is really highly significant to have our research recognised in this way as this is an issue of major significance and urgency. IT systems for pathology, medications, radiology and record-keeping play a mission-critical role in our hospitals and GP surgeries but there is not yet any active surveillance of IT-related harm currently experienced by health systems in Australia or elsewhere.”
Dr Santosh Khanal, NSW Ministry of Health – delivery of childhood obesity programs Dr Khanal, from the Ministry’s Office of Preventive Health, took an evidence-based approach to the policy question his organisation was facing: how to remove barriers to families attending the State Government obesity treatment program Go4Fun. After a review identified that requiring families to attend the 10-week program twice per week was a participation barrier, Dr Khanal led a randomised controlled trial to determine the impact of restructuring the program. The research found the revised program could be delivered weekly without compromising health outcomes or attendance, leading to the program frequency being changed, and resulting in substantial cost efficiencies that allowed savings to be diverted to other health programs. Dr Khanal said the program was now accessible to families, which was a good result. “The question of what is the minimum attendance at paediatric obesity programs is an under-researched area and once this work is published we expect it is going to stimulate more discussion on the topic.”
Associate Professor Farah Magrabi, Macquarie University – tracking IT-related patient harm
The four successful applicants, who each received $3000 towards their professional development, were selected by a panel of national and international experts.
Associate Professor Magrabi has sought to shed more light on the poorly understood area of patient safety risk posed by e-health systems. From her world-first analysis of IT safety incidents, she developed a new classification system for e-health risks which has become the de facto international standard for analysing IT safety incidents.
• Find out more about the Research Action Awards • Watch video interviews with the four award winners • See the Research Action Awards 2015 photo gallery
She has led major pieces of work looking at IT-related safety risks in the US and England and her work is shaping policy to govern e-health safety, including recommendations from the US Institute of Medicine accepted by the US Government. Associate Professor Magrabi has also developed a new IT incident monitoring system that has been tested in general practices across Australia.
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Psychiatric Epidemiology and Burden of Disease research at the Queensland Centre for Mental Health Research Psychiatric Epidemiology and Burden of Disease group is responsible for estimating burden caused by the 20 mental and substance use disorders.
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he Psychiatric Epidemiology and Burden of Disease group is a highly productive research team within Professor Harvey Whiteford’s Policy and Epidemiology Group based at the Queensland Centre for Mental Health Research. It is affiliated with the School of Public Health at the University of Queensland, and works closely with Professor Louisa Degenhardt from the National Drug & Alcohol Research Centre at The University of New South Wales. The Psychiatric Epidemiology and Burden of Disease team, led by Dr Alize Ferrari, works with Professor Theo Vos and staff at the Institute for Health Metrics and Evaluation, University of Washington, Seattle to undertake yearly updates of the Global Burden of Disease studies, the latest of which (Global Burden of Disease 2013) was published in the Lancet this year. Disease burden is measured as disability-adjusted life years, a metric which aggregates both the non-fatal burden (as years lived with disability) and fatal burden (as years of life lost to premature mortality) associated with 306 diseases and injuries. Psychiatric Epidemiology and Burden of Disease group is responsible for estimating burden caused by the 20 mental and substance use disorders included in the study. Importantly, these 20 mental and substance use disorders include mental disorders of childhood and youth such as ADHD, conduct disorder, autism spectrum disorders, and eating disorders. This has been a major addition since the original Global Burden of Disease study conducted in 1990, whereby the burden of these disorders was not considered despite those aged under 25 years making up almost a quarter of the global population. Psychiatric Epidemiology and Burden of Disease group holds upto-date datasets including over 125,000 data sources on the global epidemiology (prevalence, incidence, remission, excess-mortality, risk factors, and outcomes) of mental and substance use disorders
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assembled from systematic reviews of the published and grey literature. Via a specially provided VPN connection to Institute for Health Metrics and Evaluation in Seattle, the team uses a Bayesian meta-regression tool, DisMod-MR 2.0, to meta-analyse the epidemiological data for all disorders. The country, age, sex, and year-specific prevalence derived by DisMod-MR 2.0 is multiplied by a disorder-specific disability weight to estimate years lived with disability. Years of life lost are estimated by multiplying the number of deaths directly attributed to the disorder at a given age by the standard life expectancy at that age. Cause of death estimates are derived from vital registration, verbal autopsy, and other mortality surveillance databases for all countries included in the study. The results from Global Burden of Disease 2013 show that the burden of mental and substance use disorders is rising. Globally, they are the leading cause of disability and rank second after musculoskeletal disorders in Australia. They account for 7% of all burden and 21% of all disability, with depressive disorders contributing over a third of all the burden from this group, followed by anxiety disorders (14%), illicit drug use disorders (10%), schizophrenia (9%) and alcohol use disorders (7%). Comparative data can be found at the Global Burden of Disease Compare site. The Psychiatric Epidemiology and Burden of Disease team also undertakes work to improve the methodology of the Global Burden of Disease studies. For example, the relatively small years of life lost burden attributable to mental and substance use disorders in Global Burden of Disease may incorrectly lead to the interpretation that mental and substance use disorders do not increase an individual’s risk of premature death. There is strong evidence of a significant reduction in life expectancy with risk of mortality increasing with disorder severity. The cause-specific mortality estimated in Global Burden of Disease, which uses the International Classification
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of Diseases cause of death codes, obscures the contribution of underlying causes of death (for example, suicide as a direct result of depressive disorder) and underestimates the true number of deaths attributable to a particular disease. Psychiatric Epidemiology and Burden of Disease group has therefore estimated excess mortality using natural history models (which include deaths from both causal and non-causal origins) and reallocated mortality where causal links are established. Through comparative risk assessment analyses, the Psychiatric Epidemiology and Burden of Disease group has also estimated that approximately 60% of suicide deaths can be re-attributed from injuries (where they are coded to when following ICD protocol) to mental and substance use disorders. This alone elevates mental and substance use disorders from the fifth to the third leading cause of burden. Work showing the high burden of these disorders has been crucial for health policy and planning but it is vital to identify and implement interventions to reduce this burden, including within low and middle income countries. Work done in collaboration with colleagues for the Third Edition of Disease Control Priorities released in Geneva in October 2015 shows the costs of providing a significantly scaled up package of specified cost-effective interventions for prioritised disorders in low-income and low and middle- income countries is estimated at US$3–4 per head of population per year. The Psychiatric Epidemiology and Burden of Disease group also provides technical expertise to national and international mental health epidemiological surveys and burden of disease studies. Examples include: • In Australia, contributing to the Australian Burden of Disease Study being conducted by the Australian Institute of Health and Welfare and the Young Minds Matter survey conducted by the University of Western Australia for the Commonwealth Department of Health. • Internationally, working with the China-India Mental Health Alliance quantifying the changing burden of mental disorders in China and India (Shanghai Jiao Tong University, Shanghai, China, Public Health Foundation of India, Hyderabad, India); working on epidemiological surveys in developing countries to fill data gaps (most recently in Lao PDR); and evaluating the reduction in burden of neuropsychiatric disorders for the Third Edition of the Disease Control Priorities Project (for World Health Organisation and the World Bank). For more information about the Queensland Centre for Mental Health Research visit www.qcmhr.uq.edu.au
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Professor Harvey Whiteford
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Is Food Addiction real? Dr Tracy Burrows from the University of Newcastle has initiated an innovative research program to investigate the neurobiological basis of ‘food addiction’ – Does it exist, and how could it be contributing to the obesity epidemic?
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r Tracy Burrows is a Senior Lecturer at the University of Newcastle and has initiated an innovative research program which includes dietitians, psychologists and imaging specialists to investigate food addiction as an explanatory factor for eating behaviours contributing to obesity and weight regain. Obesity is an international issue. It affects 60% of Australian adults and 25% of children under 18 years old, and costs the nation more than $21 billion each year in direct health care costs. To date, obesity prevention initiatives and interventions have had limited success in the long term because the majority of individuals regain some, if not all, of their lost body weight after the intervention ceases. Consequently there is an urgent need for novel and innovative approaches to prevention, weight loss and long-term weight maintenance. A new perspective on obesity and weight management has recently emerged in the area of ‘food addiction’. Eating behaviours including tolerance to large amounts of food, persistent craving for specific foods, and lack of control over the amount of food consumed are being used in conjunction with the term “food addiction”.These behaviours can become chronic conditions with high rates of relapse, which may explain the failure rates of conventional weight loss and management interventions and policies. While there is a plethora of animal studies related to food addiction, there are relative few in the area of human food dependence and
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addiction. This scarcity is reflected in the extremely limited number of methods available to detect possible indicators of food addiction. To date, food addiction has been a largely self-identified and selfreported condition, which has limitations in regards to the reliability and validity of reporting. One of the few tools available to assess traits and behaviours associated with potential food addiction is the Yale Food Addiction Scale (YFAS), which takes the form of a questionnaire in which individuals self-report their post-food consumption emotional state, physical responses, attitudes towards foods and eating, and potential professional or social implications of addictive food behaviours. There are seven symptoms assessed, and a positive screening on three or more symptoms in an individual indicates addictive behaviours towards certain types of food. Dr Burrows’ research to date has been largely exploratory and has identified, in a cross sectional survey of over 400 young Australian adults aged 18-35 years old, that approximately 15% of this group were deemed to have a food addiction as classified by the YFAS. This was the first Australian study of its type and its results are consistent with international data showing a high prevalence of behaviours which can be associated with food addiction. Interestingly food addiction does not always coincide with being overweight or obese or with clinically diagnosed eating disorders so it is likely that food addiction is affecting a sub group of vulnerable individuals. In other words not all overweight individuals suffer from
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Dr Tracy Burrows, Senior Lecturer, Nutrition and Dietetics, Faculty of Health and Medicine, School of Health Sciences, University of Newcastle
addictive behaviours around food and some who do are not obese. Although addiction can occur independent of weight status there is overlap, with studies showing an increasing tendency towards food addiction with increasing weight. An additional study carried out by Dr Burrows that explored the phenomenon of food addiction in primary school aged children, aged between 5 and 12 years old. This study demonstrated a positive correlation between weight status and food addiction. As an Advanced Accredited Practicing Dietitian, Dr Burrows has focused on what foods are most associated with addiction and concluded that highly processed, energy dense foods are the most likely candidates, which tend to be high in fat, sugar and salt. To better understand the effects these foods have on a neural level, Dr Burrows is employing the use of neuroimaging techniques such as functional magnetic resonance imaging (fMRI) to study the neurobiological mechanisms behind chronic addictive behaviours towards food. fMRI is a technique that shows areas of the brain “lighting up” when they are active and is very innovative in the field of nutritional science. Dr Burrows is placing individuals classified as food addicted into an MRI scanner and showing images of selfselected palatable foods while concurrently monitoring patterns of brain activation and comparing these to healthy controls.
that food addiction could be a missing link in understanding the current rates of obesity and in developing effective weight loss and weight maintenance interventions for the future. If this research confirms that certain foods are capable of hijacking the brain in an addictive manner, it would be a landmark change that could significantly influence weight management interventions and support bold policy approaches focusing on the food environment. Because the research is in its infancy and Dr Burrows is an early career researcher, the research to date has been limited through funding. Any financial assistance to facilitate the progress of research in this area would be greatly appreciated. If you are interested and think you could help please contact: tracy.burrows@ newcastle.edu.au. For more information about the University of Newcastle visit www. newcastle.edu.au
At this point in time, food addiction remains a contentious theoretical construct. However, research and evidence in this area is building at an exponential rate. Results from studies to date suggest
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