2010 Annual Research Report, Princess Alexandra Hospital

184 Pages·2011·7.84 MB·English

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D IMPLEMENTATI O N
Translating discoveries
to better health
T1 – Translation to first in humans:
Findings from basic research are tested for clinical effect and/or applicability.
T1 research yields knowledge about human physiology and the potential for
intervention.
T2 – Translation to patients (refer page 17)
T3 – Translation to clinical practice (refer page 23)
T4 – Translation to population health (refer page 134)
Translation to
Community
T4 Practice to
Population
T1 Translation
to Patients
Translation
Application to to Practice
Evidence
Evidence to
Health Practice
T2
T3
© Centres for Health Research Annual Research Report 2010.
This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part of
this publication may be reproduced by any process without prior written permission from the Princess
Alexandra Hospital Centres for Health Research. Enquiries should be directed to the Director, Research
Development & Ethics, Centres for Health Research, Princess Alexandra Hospital.
ISSN 1833-6574
Contents
02 Message from the District 41 Centre for Functioning 107 Physiotherapy
CEO and PAH Executive and Health Research 109 Plastics & Burns
Director 44 Centre for Integrative 110 Queensland Clinical Trials
04 Message from the Director Clinical and Molecular & Biostatistics Centre
Research Development Medicine 112 Queensland Melanoma
& Ethics 46 Centre for Kidney Project
06 Translating our research Disease Research 114 Queensland Spinal Cord
into practice 52 Centre for Liver Injuries Service
10 The University of Disease Research 117 Radiation Oncology (PAH)
Queensland at the Princess 54 Centre for Research in 119 Radiation Oncology (Mater)
Alexandra Hospital Geriatric Medicine 120 Radiology
12 Queensland University of 57 Clinical Governance 122 Respiratory and Sleep
Technology at the Princess 59 Clinical Pharmacology Medicine
Alexandra Hospital 61 Dermatology Research 124 Speech Pathology
14 Postgraduate Research Centre 126 Therapeutics Research
64 Diabetes & Endocrinology Centre
17 Committee Reports 66 Diamantina Institute 129 Trauma Service
69 Ear Nose Throat 131 Upper Gastrointestinal
18 Human Research Ethics 71 Emergency & Soft Tissue
Committee 72 Endocrine Hypertension 133 Vascular Medicine
20 Health Practitioner Research Centre
Research Collaborative 75 Gastroenterology & 134 Publications, Major
22 The PA Research Hepatology Grants & People
Foundation 77 Haematology
81 Infection Management 135 Journal Articles
23 Group Reports Services 156 Books & Book Chapters
82 Intensive Care Unit 158 Abstracts & Conference
24 Acquired Brain Injury 84 Internal Medicine & Clinical Proceedings
Outreach Service Epidemiology 163 Accepted for Publication
26 Alcohol and Drug Research 86 Medical Oncology (In Press)
27 Anaesthetic Department 88 Mental Health 167 Summary of Publications
28 Australian Prostate 90 Microbiology and Postgraduate Students
Cancer Research Centre - 91 Neurosurgery 168 Major Grants
Queensland 92 Nursing Practice 172 Committees
32 Brain Injury Development Unit 173 Research Staff by
Rehabilitation Unit 94 Nutrition & Dietetics Department
33 Breast & Endocrine 98 Occupational Therapy 179 Postgraduate Students
Surgery Unit
101 Older Persons Mental
35 Cardiology Health
37 Cardiothoracic Surgery 102 Ophthalmology
39 Cardiovascular Imaging 103 Pathology Queensland
Research Centre
105 Pharmacy
Message from the District CEO
and the PAH Executive Director
It is with great pleasure that we present the Princess Alexandra Hospital
(PAH) Centres for Health Research Annual Research Report for 2010. We
are delighted to reflect on another year of outstanding achievements.
The year has been productive for researchers on the campus with a large
proportion of translational research undertaken.
This translation of research into better patient health is what we are
all aspiring to and, indeed, expecting. We are committed to continuing
to achieve this by working in partnership with our universities and in
collaboration securing and growing a critical mass of high-calibre scientists
David Theile and clinicians, and contributing to state-of-the art infrastructure.
All achievements in research should Increase in Research Performance
be celebrated. This report showcases As highlighted in this report our research
the breadth of achievements and performance on campus continues
commitment of researchers on to increase. The NHMRC awarded
this campus. These are evidenced grants totalling over $8.8M to twelve
by prestigious grants, research chief investigators based at the PAH.
breakthroughs and awards. The benefits In addition, eight PAH Private Practice
of our academic health partners are Grants; four Smart State Grants and
becoming evident and will be further four Health Research Fellowships were
amplified with the opening of the awarded. This funding is vital for our
Richard Ashby
Translational Research Institute in 2012. investigators to continue their valuable
research. The number of world-class
In this annual report, we are delighted to
publications featured in high calibre
reflect on the extraordinary success and
journals such as Nature Genetics also
achievements of our research scientists
increased.
and clinicians.
2 research - key to health
Awards and Recognition Increase in Collaborations is a vital part of the commitment
Awards and recognition for researchers It is truly pleasing to see the number of the hospital to further strengthen
based at the hospital is reflected of examples of our researchers and facilitate the integration of
throughout this report. Professor collaborating with local, national and research and teaching with clinical
Ian Frazer, Director, University of international experts to achieve world- care through our partnership in the
Queensland Diamantina Institute, class research outcomes. academic health centre.
was awarded the 2010 Ernst & Young
PAH Week – Leading Health in a Professor Ken Ho has been appointed
Champion of Entrepreneurship
Changing World as the new Chair of the Centres for
(Northern Region) Award in recognition
The Princess Alexandra Hospital Health Research. He will join us full-
of his discoveries that led to the
has been in existence for 54 years time from St. Vincent’s Hospital and
development of the world’s first cervical
and during this time has reached the Garvan Institute in Sydney in early
cancer vaccine. With immunisation
international stature in many 2011. As a successful and influential
programs initiated across the world, this
areas, including liver and kidney clinical researcher, he will make a strong
is a true indicator of translating scientific
transplantation, melanoma treatment, contribution to the research efforts
discoveries to the patient.
laparoscopic surgery, gout research at the PAH. We look forward to his
Professor Matt Brown from the and treatment, cardiovascular disease leadership.
University of Queensland's Diamantina management and the development of
Institute was awarded the prestigious the vaccine for cervical cancer.
2010 Parr Prize from The Australian
In 2010, the hospital successfully hosted
Rheumatology Association recognises
PAH Week bringing together experts
Professor David Theile
outstanding achievement in
from all manner of clinical professions to CEO, Metro South Health
rheumatologic research. Matt's
present their knowledge and experience Service District
research concentrates on identifying
thereby promoting quality care for
AO, PhD (Hon), MBBS (Hons) (Qld), MS, FRACS,
the genetic causes of common forms
patients and improved staff training. FRCS (Eng), FRCS (Ed) (Hon), FANZCA (Hon)
of arthritis, osteoporosis and multiple
Additionally, PA Week showcased the
sclerosis, providing avenues for future
considerable achievements of research
treatment options.
conducted on campus.
Another highlight was the Australian Dr Richard Ashby
Centres for Health Research
Society of Medical Research awarding Executive Director,
The PAH Centres for Health
Dr Maher Gandhi, Clinician Researcher Princess Alexandra Hospital
Research, established by the
of the Year for his work on understanding Princess Alexandra Hospital in 1998, AM, MBBS (Qld), BHA (NSW), FRACGP, FRACMA,
FACEM, FIFEM
the biological features of lymphoma.
Centres for Health Research 2010 Annual Research Report 3
Message from the Director
Research Development & Ethics
2010 has been an outstanding year noteworthy on a number of fronts.
We have continued to build on growing achievements in parallel with
major developments on the PAH campus. The new Translational Research
Institute (TRI) building is emerging from the ground and is on schedule for
occupancy in late 2012. A forum held in September provided an update
on the plans of the development. The TRI is a joint venture between
The University of Queensland, Queensland University of Technology,
Mater Medical Research Institute and the Princess Alexandra Hospital
(Queensland Health). We are poised to leverage the many opportunities of
our partnerships within the TRI.
Areti Gavrilidis
The Princess Alexandra Hospital is appeals to ensure their continuation.
committed to excellence in patient care We congratulate all our researchers and
supported by world’s best research wish and thank the dedicated work of
practice led by the world’s best the foundation and funding team.
researchers. This is truly an exciting time
We have also been very encouraged that
for us working here in an environment
the estimated total research income for
of strengthening of academic health
2010 has increased by over 30%.
partnerships.
Publications are vital for research to
The research groups at the hospital
be translated into improved health
garnered greater success in securing
outcomes for our community. Our
competitive peer review grant funding
researchers published over 590 papers
(see Group Reports section) in particular
and book chapters, representing about
NHMRC funded fellowships and project
a 25% increase to the 2009 output.
grants. The PA Research Foundation and
The publication profile is likely to
Private Practice boosted their support
continue to increase based on a
of research to $900,000 in 2010 for
25% increase in investigator initiated
research (in 2011), again ensuring that
applications to our Human Research
high quality research is supported. In
Ethics Committee this year.
addition, over $200,000 was provided to
current research projects through direct
4 research - key to health
This year has also seen an increase in doctoral appointment at the University
New Submissions to the HREC
the number of postgraduate students of Sydney. We wish her all the best with 350 2000-2010
totalling 220 students on campus her academic career. We express our
300
from our local and other collaborating appreciation to Associate Professor
250
universities. Carl Kirkpatrick, Dr Eleanor Milligan, Dr
Scott Campbell and Associate Professor 200
A significant achievement for Allied
Richard Roylance for assisting with 150
Health was the founding of the Centre
the Chairing of the HREC meetings
100
for Functioning and Health Research
following Dr Fleming’s departure.
in mid-2010 and the launch in October 50
of the Health Practitioner Research Our appreciation to all those who 0
2000 2002 2004 2006 2008 2010
Collaborative (formerly the Allied Health helped to enhance the research
Year
Research Collaborative) which should performance on the campus particularly
be a further stimulus to enhance the staff of the Centres for Health
Total Publications
research activities across the district. Research. The Centres for Health
700 2000-2010
Research fosters an environment that
There were a number of achievements
facilitates research and will continue to 600
in Nursing including Professor Leanne
add services to support our research ons500
Aitken's membership to the team who community. We look forward to working cati
gained Australia's first nursing-focused with our academic, research and health Publi400
NHMRC Centre of Research Excellence. of 300
care partners in 2011. er
The NHMRC Centre of Research mb200
u
N
Excellence in Nursing Interventions We look forward to Professor Ho’s
100
for Hospitalised Patients (NCREN) will leadership and experience when he
0
focus on generating and implementing moves to Brisbane to take on the ‘00 ‘01 ‘02 ‘03 ‘04 ‘05 ‘06 ‘07 ‘08 ‘09 ‘10
evidence into clinical practice. In leadership role of Chair of the Centres Year
addition the nursing team is leading for Health Research in early 2011.
a randomised-control trial (RCT) on
Higher Degrees
It gives me great pleasure to present
the management of skin grafts and 250 2000-2010
this thirteenth Annual Research Report,
will commence a second RCT on the PhD
management of facial suture lines. which is a summary of what has been 200 Masters
achieved in 2010 through a wealth of
We thank the Human Research Ethics partnerships and collaborations. ber150
m
Committee (HREC), for their tireless Nu
efforts in reviewing the large load Total 100
of research applications. Under the
50
leadership of Dr Jennifer Fleming, the
Ms Areti Gavrilidis
HREC was certified by the NHMRC to 0
‘00 ‘01 ‘02 ‘03 ‘04 ‘05 ‘06 ‘07 ‘08 ‘09 ‘10
conduct single ethical reviews of multi- MBA, Grad Dip Bus Admin, BSc, BAppSc,
Year
Churchill Fellow
centre research. Jennifer stepped down
as Chair in July 2010 to take up a post-
Centres for Health Research 2010 Annual Research Report 5
Translating our research
into practice
Vaccine development leading to
public health policy
HPV vaccine development started with basic research on how HPV works
as a virus to cause cervical cancer, undertaken by Professor Harald zur
Hausen and his colleagues in the early 1980s. Discovery of the technology
for HPV virus like particle production by Jian Zhou and myself in 1991,
which arose from studies on how the virus assembled itself, lead to
preclinical studies of their immunogenicity in animals, to see if they might
Ian Frazer
form the basis of a vaccine to protect against cervical cancer.
By 1995 clinical trials of vaccines based in the developing world, and programs
Vaccination to prevent cervical cancer
on HPV Virus like particles in human of education on vaccine use.
has now become public health policy
subjects were showing immunogenicity
in at least 20 countries world-wide
Vaccination to prevent cervical cancer
with over 70 million doses of vaccine and safety. These findings lead to larger
has now become public health policy
delivered to date. scale vaccine trials over the next 8 years
in at least 20 countries world-wide
to prove efficacy and safety, conducted
with over 70 million doses of vaccine
by the pharmaceutical companies
delivered to date. Large scale studies
who were developing the commercial
to measure the impact of the vaccine
vaccines. Positive findings from these
programs on cervical cancer and
studies were presented to the US and
genital wart incidence in Australia and
Australian regulatory authorities in
elsewhere are now underway.
2005, resulting in release of a licenced
vaccine in 2006. Since then we have Professor Ian Frazer
been conducting studies in Vanuatu of Director, University of Queensland
Diamantina Institute
uptake and field efficacy of the vaccines
6 research - key to health
Measuring activity of older patients
to reduce cost of hospitalisation
Older patients in hospital quickly of activity of their patients, most often
become deconditioned when they spend over-estimating by 100%.
long periods of inactivity. A common
With the support of an NHMRC
strategy to “prevent” and “treat” this
Project Grant, we are conducting a
deconditioning is to encourage regular
study to investigate if accurate activity
Len Gray sitting out of bed and walking throughout
information about activity (derived
the day. Even though this activity is often
from accelerometers) is offered daily
“prescribed”, no one can be sure that
to patients and their treatment team
anything actually happens. At the Centre
“we plan larger scale studies together with daily targets, then the level

to examine whether an activity for Research in Geriatric Medicine, we of activity increases (T3 translation). We
intervention might either improve the are using accelerometers to monitor plan larger scale studies to examine
patient outcomes or reduce the cost
patients’ daily activities. First we needed whether this intervention might either
of hospitalisation”
to demonstrate that these devices improve patient outcomes or reduce the

actually measure activity accurately cost of hospitalisation (T4 translation).
(lying, sitting, standing, walking) in older
Professor Len Gray
patients, with abnormal gait patterns (T2
Director, Centre for Research in
translation). We also demonstrated that Geriatric Medicine
clinicians have little idea about the level Director, Centre for Online Health
Genetics of common and
rare human diseases
We research genetics of common and ankylosing spondylitis, where I have led
rare human diseases, and investigate the gene-mapping programs that have
the mechanisms by which genes identified all 13 non-MHC genes thus
associated with disease operate in far robustly associated with the disease.
those conditions. We have a particular My group have been at the forefront
Matthew Brown focus on bone and joint diseases, of development of new methods for
but research quite a diverse range mapping human diseases including
of conditions including neurological during the genomewide association
diseases such as multiple sclerosis, study era, and more recently with the
”My main research interest for
the past 15 years has been the schizophrenia, intracranial haemorrhage advent of sequencing based gene-
genetics of ankylosing spondylitis... and motor neurone disease, ocular mapping approaches.
gene-mapping programs that have
diseases, and asthma.
identified all 13 non-MHC genes Professor Matthew Brown
thus far robustly associated with Research Leader Musculoskeletal
Our main research interest for the past
the disease” Genetics Group, Diamantina Institute
15 years has been the genetics of
Centres for Health Research 2010 Annual Research Report 7
Detection of primary aldosteronism
With hypertension being the commonest around the world. Not only has this
chronic condition affecting Western meant improved health outcomes for
countries and usually requiring lifelong those patients, but it has facilitated
medications to prevent complications a flurry of clinical research studies
such as stroke, heart and kidney assessing causes and effects of PA.
disease, detection of underlying causes Examples are work by our Centre and of
such as primary aldosteronism (PA) can others demonstrating that aldosterone
Michael Stowasser
be a major breakthrough for patients, excess has harmful effects that go
bringing with it the chance of more beyond just raising blood pressure,
effective, specific treatment and but which are ameliorated by specific
Excessive aldosterone (PA) findings even cure. surgical and medical treatments
in hypertensive patients have targeting excessive aldosterone action.
“closed the circle” in supporting our Our work demonstrated a previously
These findings have “closed the
recommendation that all hypertensive unrecognised, high prevalence of PA
circle” so that those found to have this
patients should be screened for PA, so
of up to 5-10% among hypertensive
that those found to have this important important condition can benefit from
patients, and its efforts to raise
condition can benefit from the effects of the effects of specific, optimal treatment
specific, optimal treatment approaches. awareness of this nationally and approaches.
internationally, have had major and

widespread clinical impacts, with Professor Michael Stowasser
thousands of patients (who would Director, Endocrine Hypertension
otherwise have been missed) being Research Center
diagnosed among dozens of centres
Asthma and other chronic lung
diseases
workings of the immune system in
Our ultimate goal is to improve the people with asthma and other chronic
existing influenza vaccines and to
lung diseases. Understanding what is
develop a new vaccine for rhinoviruses
that could be used in people with lung going wrong is a first step to keeping
diseases. people well and avoiding the need to
John Upham spend time in hospital. Our ultimate
People with asthma and other chronic goal is to improve the existing influenza
lung diseases can become very unwell vaccines and to develop a new vaccine
when they develop infections caused for rhinoviruses that could be used
Understanding what is going wrong (in by rhinoviruses (the common cold virus) in people with lung diseases.” (T1
people with asthma and other chronic translation)
and influenza. We think this happens
lung diseases) is a first step to keeping
people well and avoiding the need to because the immune system does Professor John Upham
spend time in hospital. not function as well as it should. We Director, Lung and Allergy Research
are performing a detailed study of the Centre
8 research - key to health