long-term icu patients: functional outcomes and health...long-term icu patients: functional outcomes...

ACT HEALTH RESEARCH REVIEW 2011 & 201280

Long-term ICU patients: functional outcomes and discharge destinations. Observational study of ICU patients with length of stay > seven days (completed and presented at ESCISM conference 2012): M Green, A Leditschke, N Williams, B Bissett. 2011-2012

Effectiveness of a physiotherapy-intitiated telephone triage of orthopaedic waitlist patients. Observational study of the effects of a physiotherapy-initiated telephone triage approach on waitlist times, costs and patient outcomes: J Morris, K Grimmer-Somers, S Kumar, K Murphy, L Gilmore, B Ashman, C Perera, K Vine, C Coulter (completed and published 2011). 2011-ongoing

Skills escalator in allied health: a time for reflection and refocus. A descriptive study of the process of establishing extended scope physiotherapists within an emergency department: L Gilmore, J Morris, K Murphy, K Grimmer-Somers, S Kumar, (completed and published 2011). 2010-2011

Rehabilitation after elective total hip replacement. A randomised trial of rehabilitation following discharge after hip replacement, comparing standard practice with independent practice: C Coulter, J Scarvell, P Smith. 2009- 2014

Non-Medical Prescribing by Physiotherapists: Issues Reported in the Current Evidence. A targeted literature review was undertaken through EBSCO Host, Cochrane, Medline, SportsDiscus, Cinahl, Healthsource and Google.com using broad search terms to identify peer-reviewed and grey literature pertaining to Non-Medical Prescribing by physiotherapists, nationally and internationally (paper submitted to the Manual Therapy journal): J Morris, K Grimmer-Somers. 2012-2013

Physiotherapy prescribing in Australia - The lessons learnt. This paper presents the summary of ACT Health Directorate’s experiences in Physiotherapy prescribing. A final draft of this paper is being endorsed by the authors and will then be submitted to the Rural and Remote Health Journal: J Morris, K Grimmer-Somers, K Vine, K Murphy. 2012- 2013

pRESEnTATIonSThreshold inspiratory muscle training is safe in ED ventilated patients, B Bissett, Canberra Hospital Annual Research Meeting, Canberra Australia 2011

Threshold inspiratory muscle training is safe in ED ventilated patients, B Bissett, European Society of Intensive Care Medicine Conference, Berlin, Germany 2011

Threshold inspiratory muscle training is safe in ED ventilated patients, Australian Physiotherapy Association Conference, Brisbane, Australia 2011

Barriers to early mobilisation in ICU patients, M Green, Australia and New Zealand Intensive Care Society Annual Scientific Meeting, Brisbane, Australia 2011

A framework for post-graduate training for extended scope physiotherapists, J Morris, Australia and New Zealand Association of Health Professional Educators Conference, Alice Springs, Australia 2011

‘How much puff is enough? ’ Inspiratory muscle training for ventilated patients, B Bissett, College of Intensive Care Medicine Annual Scientific Meeting, Canberra, Australia 2011

Longterm ICU patients: functional outcomes and discharge destinations, M Green, European Society of Intensive Care Medicine, Lisbon, Portugal 2012

AWARDSProfessor Guan Chong Prize for Best Clinical Research Oral Presentation - B Bissett. Threshold inspiratory muscle training is safe in ED patients who are ventilated, Best Clinical Research Oral Presentation

ACT HEALTH RESEARCH REVIEW 2011 & 2012 81

RENAL MEDICINE

bRIEf SUMMARyThe Department of Renal Medicine is committed to providing excellence in the care of people with renal impairment. Its research interests include basic immunology, clinical renal research focused on cardiovascular disease, sleep disorders and micronutrient deficiency in patients with advanced kidney disease. The Department has expertise and involvement in Cochrane Systematic reviews in Clinical Nephrology, Immunology and Transplantation. The Department is involved in health and medical education research focussing on approaches to support student and patient learning. The Department, as a member of the Australasian Kidney Trials Network (AKTN), is involved in a number of AKTN multicentre clinical intervention studies.

STAffDr Girish Talaulikar, Clinical Director

Dr Giles Walters, Senior Staff Specialist

Dr Michael Falk, Staff Specialist

Dr Krishna Karpe, Staff Specialist

Dr Richard Singer, Staff Specialist

Dr Anna Sampson, Australian National University Research Fellow

Dr Shahadat Hossain, Advanced Trainee in Nephrology

Dr Ubaidullah Dawood, Advanced Trainee in Nephrology

Ms Barbara Harvie, Nurse Practitioner, Chronic Kidney Disease

Ms Chari Mercado, Clinical Nurse Consultant (CNC), Acute Haemodialysis Unit

Ms Anne Maguire, CNC, Renal Home Therapies

Ms Joyce Thanabal, CNC, Canberra Community Dialysis Centre

Ms Patricia Johnson, Research Officer

CoLLAboRATIVE ASSoCIATESProf Paul Gatenby, Director of Research, ACT Health Research Office, Canberra Hospital, Professor of

Immunology, Australian National University Medical School (ANUMS)

Prof Carola G Vinuesa, Head, Department of Pathogens and Immunity, John Curtin School of Medical Research, Australian National University

Prof Leonard Arnolda, Director, Cardiology, Canberra Hospital, Professor of Cardiology, Australian National University

A/Prof Matthew Cook, Clinical Director, Immunology, Canberra Hospital, Associate Professor of Immunology, Australian National University Medical School

Dr Mark Hurwitz, Clinical Director, Thoracic Medicine, Canberra Hospital

Dr Michael Pidcock, Clinical Director, Haematology, Canberra Hospital

Dr Ahmad Farshid, Staff Specialist, Cardiology, Canberra Hospital

Dr Carol H.C Huang, Staff Specialist, Respiratory & Sleep Medicine, Canberra Hospital

A/Prof Alison Kent, Staff Specialist, Neonatology, Canberra Hospital

Mr Derek Figurski, Laboratory Manager, Sleep Disorders Unit, Canberra Hospital

Ms Annette Paul, Senior Sleep Scientist, Sleep Disorders Unit, Canberra Hospital

Cochrane Renal Group, Westmead Hospital, Sydney, NSW

Australasian Kidney Trials Network (AKTN)

The George Institute for International Health

European Union Vasculitis Group


RESEARCH pRojECTSSHARP-ER: Study of Heart And Renal Protection - Extended Review. The SHARP study had 9438 participants (CKD Stage 4 or 5) randomised to combination simvastatin/ezetimibe or placebo. Active treatment lowered LDL cholesterol by >1mmol/L and lowered risk of a major vascular event by 17% compared to placebo. SHARP-ER will follow consenting participants of SHARP without any intervention, to determine whether this beneficial effect persists in the longer term: G Talaulikar, G Walters, K Karpe. 2012-2016

Cholecalciferol supplementation in kidney failure study: Effect on quality of life and muscle strength. This study will enrol about 80 subjects with calcidiol 50 nmol/L or less and randomly assign to supplementation or placebo. Target calcidiol level is >80 nmol/L. Outcome measures are quality of life and handgrip strength: R Singer. 2011-2014

A randomised trial to assess antibody response to hepatitis B vaccine in patients with chronic kidney. This study compares two vaccine doses, 20ug vs 40 ug. It also looks at immunological predictors for sero-conversion: M Cook, K Karpe, B Harvie. 2011-2013

PEXIVAS: Plasma exchange and glucocorticoid dosing in the treatment of ANCA-associated vasculitis: a multi-centre randomised trial. This study investigates whether the addition of plasma exchange to immunosuppressibe therapy and glucocorticoids will reduce death and development of severe kidney failure due to vasculitis. It also compares the effectiveness of a reduced dose of glucocorticoids with the current regime: G Walters, & Euron Vasculitis Group. 2011-2017

Dialysis and sleep apnoea study. This study aims to identify the incidence of sleep apnoea in the dialysis population and examines the association between excess body water & sleep apnoea. It also seeks to validate the use of the ApnoeaLink machine as a tool for diagnosing the condition by comparing its results with standard ambulatory polysomnography test results: C Huang, R Singer, G Talaulikar, G Walters, K Karpe, M Hurwitz, D Figurski, A Paul. 2010-2013

ACTIVE Dialysis – a clinical trial of intensive dialysis: a multicentre unblinded RCT to assess quality of life clinical outcomes and cost utility of extended vs standard duration of dialysis in patients with end stage kidney disease. The aim of this study is to determine whether a regime of extended dialysis (>24hrs/wk) improves quality of life of dialysis patients when compared to standard dialysis treatment (<18hrs/wk): G Talaulikar as member of the Active Dialysis Investigator Team. 2009-2013

The FAVOURED Trial (Fish oil and aspirin in vascular access outcomes in renal disease) AKTN Trial Number 06.01. This study will determine whether use of anti-platelet agents aspirin and omega-3 fatty acids, either alone or in combination (factorial design) will effectively reduce the risk of early thrombosis in de novo arterio-venous fistulae (AVF). Primary outcome is patency of AVF at three months: K Karpe as a member of the Favoured Investigator Team. 2008-2016

The Honeypot Trial: A Randomised Controlled trial of exit site applicaton of MediHoney antibacterial wound gel (AKTN trial Number 06.02). This study examined whether MediHoneyTM is more effective at preventing infection of peritoneal dialysis catheters than the standard antibiotic ointment mupirocin, which is recomended by national guidelines: Richnger as a member of the Honeypot Investigator Team. 2008-2012

MYCYC (A trial of mycophenolate mofetil versus cyclophosphamide for the treatment of vasculitis. Standard treatment for ANCA-associated vasculitis combines cyclophosphamide with prednisolone but is associated with a high proportion of severe adverse events (early mortality, malignancy and infertility). Open label studies and retrospective surveys point to the efficacy and low toxicity of mycophenolate mofetil (MMF) in vasculitis. Study hypothesis for this randomised trial is that MMF will be no less effective than cyclophosphamide for remission induction in ANCA-associated vasculitis. Primary endpoint is remission rate by six months; secondary endpoints include relapse rate at 18 months and safety: G Walters, & theropeasculitis Group. 2008-2013


pRESEnTATIonSLong term high dose cholecalciferol supplementation in patients with heavy proteinuria, R Singer, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Successful pregnancy in advanced CKD - Case Report, S Hossain, Australia and New Zealand Society for Nephrology (ANZSN) Annual Scientific Meeting, Adelaide, Australia 2011

No room at the Inn: Satellite Dialysis centre expansion and the change management process, A Maguire, The Renal Society of Australasia, Annual Conference, Adelaide, Australia 2011

A single centre experience of rituximab as rescue therapy in ANCA associated systemic vasculitis, P Gatenby, M Cook, M Falk, K Karpe, R Singer, G Talaulikar, G Walters, Canberra Health Annual Research Meeting, Canberra, Australia 2011

The use of alternative therapies to clear vancomycin resistant enterococcus (VRE) in haemodialysis clients, C Mercado, J Harburg, Canberra Hospital staff of the 8A Haemodialysis Unit and Infection Prevention & Control Unit, Renal Society of Australasia Annual Conference, Adelaide, Australia 2011

Improve the continuity of documentation between the Acute Haemodialysis Unit and the ward areas to ensure timely detection and action of deteriorating patients, G Talaulikar, B Hall, M Jordan, N Aviga-Smith, C Mercado, M Smyth, H McKacy, P Tozer and staff, Renal Society of Australasia Annual Conference, Adelaide, Australia 2011

Clinical variables predictive of mortality in ESRD patients, R Pathak, M Alasady, G Talaulikar, A Farshid, Aardilogy Society of Australia & New Zealand, Annual Scientific Meeting, Perth, Western a 2011

Spontaneous renal vein thrombosis in a previously healthy woman, U Dawood, The Renal Society of Australasia Annual Conference, Adelaide, Australia 2012

Pre-emptive vascular access for haemodialysis, K Karpe, ANZSN Annual Scientific Meeting, Auckland, New Zealand 2012

Elderly patients should have pre-emptive vascular access created for chronic haemodialysis, K Karpe, ANZSN Annual Scientific Meeting, Auckland, New Zealand 2012

Neonatal hypertension: A long term follow-up study, T Chaudhari, M Falk, R Jyoti, A Kent, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Sleep Apnoea is common and symptoms are under reported in Haemodialysis patients, R Singer, ANZSN, Annual Scientific Meeting, Auckland, New Zealand 2012

Use of regional citrate therapy in Haemodialysis, C Mercado, Renal Society of Australasia, Annual Conference, Melbourne, Australia 2012

Rhabdomyolysis: A retrospective case series:causes and outcomes, A Sampson, Thoracic Society of Australia & New Zealand Annual Scientific Meeting, Canberra, Australia 2012

Walking with the dialysis client: Pastoral Care project, A Maguire, G Marshall, C Hochstetler, ANZSN Annual Scientific Meeting, Auckland, New Zealand 2012

3YearFollowupofVitaminDDeficiencyinprevalentAustralian Dialysis patients, R Singer, ANZSN Annual Scientific Meeting, Auckland, New Zealand 2012

Sleep Apnoea is common and symptoms are under reported in Haemodialysis patients, C Huang, G Talaulikar, G Walters, K Karpe, D Figurski, M Hurwitz, R Singer, ANZSN Annual Scientific Meet-ing, Auckland, New Zealand 2012


bRIEf SUMMARyThe Trauma and Orthopaedic Research Unit (TORU) was established in 1999, and is located within the Division of Surgery. TORU undertakes a range of clinical and laboratory studies aimed at advancing the body of knowledge and improving the clinical treatment of musculoskeletal disease(s). TORU’s clinical research incorporates aspects of arthroplasty, trauma and fractures, medical imaging and joint kinematics. TORU’s collaborative laboratory facilities at Canberra Hospital and the John Curtin School of Medical Research at Australian National University facilitate TORU’s studies on osteoimmunology and molecular medicine. TORU’s combined clinical and laboratory based research continues to make a significant contribution to advances in translational medicine; bridging medical science and clinical practice.

STAffProf Paul Smith, Director Trauma and Orthopaedic Research Unit, Clinical Director Orthopaedics, Professor, Australian National University

A/Prof Rachel Wei Li, Senior Scientist and Laboratory Research Coordinator, Adjunct Associate Professor, University of Canberra

Dr Diana Perriman, Clinical Research Coordinator

Dr Claire Bolton, Research Fellow

Dr Laura Gladkis, Post Doctoral Research

Ms Ruidang Wang, Database Architect

Ms Rebekah Ogilvie, NP, Shock Trauma Service Coordinator

Mr John Warmenhoven, Research Officer

Ms Mona Singhal, Research Officer

Ms Christine Hanrahan, Data Manager

Ms Sue Duggan, Research Nurse

Mrs Kylie McKay, Office Manager

Mr Jian Wang, Laboratory Assistant

STUDEnTSMr Ben Serpell, PhD, Australian National University Supervisors: P Smith, N Ball, J Scarvell

Mr Jonathon Slater, PhD, Australian National University. Supervisors: D Perriman, P Smith

Mr Song Chen, PhD, Australian National University. Supervisors: R Li, P Smith

Dr Sumedha Amarasekara, MPhil, Australian National University. Supervisors: P Smith, D Perriman

Mr Tim Maher, M Phil, Australian National University. Supervisors: D Perriman, P Smith

Dr Claire Bolton, MPhil, Australian National University. Supervisors: D Perriman, P Paul Smith

Ms Rebekah Ogilvie, PhD, University of Sydney. Supervisor: K Foster

Ms Corinne Coulter, MPhil, Australian National University. Supervisors: P Smith, J Scarvell

Dr David Owen, MPhil, Australian National University. Supervisors: D Perriman, P Smith

Mr Andrew Griffin, MBBS, Australian National University. Supervisors: P Smith, D Perriman

Mr John Au, MBBS, Australian National University. Supervisors: P Smith, D Perriman

Ms Allirra Selkirk, MBBS, Australian National University. Supervisors: P Smith, D Perriman

Mr Michael Ardern, MBBS, Australian National University. Supervisors: P Smith, D Perriman

Mr Michael McLelland, MBBS, Australian National University. Supervisors: P Smith, D Perriman

Mr Sam Harkin, MBBS, Australian National University. Supervisors: P Smith, D Perriman

Dr Donghai Zhang, PhD, Shandong University

Dr Maoyuan Xin, PhD, Shandong University

CoLLAboRATIVE ASSoCIATESProf Graham Buirski, Professor of Radiology, College of Medicine Biology and Environment, Australian National University

TRAUMA AND ORTHOPAEDIC RESEARCH UNIT


A/Prof Peter Hickman, Pathology, Canberra Hospital, Australian National University Medical School

Prof Chris Parish, Australian National University, Department of Immunology, John Curtin School of Medical Research

Prof Christian Lueck, Department of Neurology, Canberra Hospital, Australian National University Medical School

Prof Shen Lu, Department of Pathology, Dalian Medical University, Dalian, China

Prof Xiaomin Wang, Capital Medical University, Beijing, China

Prof Dongsheng Zhou, Department of Trauma & Orthopaedics, Shandong University, Jinan, China

Prof Qinghua Qin, Associate Dean, Research School of Engineering, College of Engineering and Computer Science, Australian National University

Prof Jiake Xu, President, School of Pathology and Laboratory Medicine, Head of Molecular Laboratory, University of Western Australia, Australia New Zealand Orthopaedic Research Society

Prof Julio Licinio, Medical Director, John Curtin School of Medical Research, Australian National University

Prof Ma-Li Wong, Pharmacogenomics Group, John Curtin School of Medical Research, Australian National University

Prof David Little, Orthopaedic Research and Biotechnology Department, The Kids Research Institute, The Children’s Hospital Westmead

Prof Brett Kirk, Associate Deputy Vice Chancellor, Supervisor of 3D Imaging and Bioengineering Laboratory, Department of Mechanical Engineering, Curtin University Research Office of Research and Development

A/Prof Jennie Scarvell, University of Canberra

A/Prof Mark Pickering, School of Information Technology and Electrical Engineering, University of New South Wales, Canberra

A/Prof Alex Fisher, Geriatric Medicine, Canberra Hospital, Australian National University Medical School

A/Prof Peng Wang, Beijing Union University, China

A/Prof Heiko Timmers, School of Physical and Mathematical Sciences, University of New South Wales, Canberra

A/Prof Lun Lui, Research School of Chemistry, Australian National University

A/Prof David Nisbet, College of Engineering and Computer Science, Research School of Engineering, Australian National University

Dr Camilla Smith, Intern, Department of Orthopaedics, Canberra Hospital

Dr Bryan Ashman, Clinical Director of Surgery, Canberra Hospital

Dr Kevin Woods, Orthopaedic Surgeon, Canberra Hospital

Dr Teresa Neeman, Statistical Consulting Unit, Australian National University

Dr Bruce Shadbolt, Centre for Advances in Epidemiology and IT, Canberra Hospital

Dr Tom Ward, Medical Officer, Canberra Hospital

Dr Claudio Mastonardi, Pharmacogenomics Group, John Curtin School of Medical Research, Australian National University

Dr Jian-Ping Wu, Research Fellow, Deputy Supervisor of 3D Imaging and Bioengineering Laboratory Department of Mechanical Engineering, Curtin University

Dr Craig Freeman, John Curtin School of Medical Research, Department of Immunology, Australian National University

Dr Lyndall Russell, Visiting Research Fellow, Prince of Wales Hospital

Prof Walter Abhayaratna, Director, Clinical Trials Unit, Cardiologist, Canberra Hospital, Australian National University

Dr Peter Subramaniam, Cardiac Surgeon, Cardiothoracic Surgery, Canberra Hospital

Dr Peter Bissaker, Director, Cardiothoracic Surgery, Canberra Hospital

Dr Steven Weiss, John Curtin School of Medical Research, Australian National University

Ms Di Lane, Radiographer, Medical Imaging, Radiography, Canberra Hospital

Mr Adrian Meyer, Radiographer, Medical Imaging, Radiography, Canberra Hospital

Ms Linda Crawford, Radiographer, Medical Imaging, Radiography, Canberra Hospital

Ms Jennifer Truong, Australian National University

Mr Nick Baxfield, Australian National University

Mr Blaise Wardell, Australian National University

Mr Jonathan Sen, Australian National University


RESEARCH pRojECTSMRI kinematics of the posterior cruciate ligament deficient and reconstructed knee. There is controversy surrounding the indications and outcomes of reconstruction of acute or chronic posterior cruciate ligament (PCL) injuries. This prospective study compares the kinematics of the knees of healthy and PCL deficient subjects using MRI. It aimed to investigate how motion is altered in PCL injuries. The findings of this study showed that there was a significant difference in the medial compartment sagittal plane articulation of the tibiofemoral joint in subjects with an isolated PCL injury: S Chandrasekaran, J Scarvell, P Smith, K Woods. 2008-2011

Stryker triathlon knee study. This study measured the range of movement in this high flexion design: J Scarvell, B Serpell, J Wilson, D Perriman, P Smith. 2007-2011

Femoral-component rotation in total knee replacement. Alignment of the knee prosthesis is critical to form and function. This study used CT to image alignment after knee replacement. The data collection for this study is now complete: M Ahmed, P Smith, J Scarvell. 2009-2011

Journey knee study. This three year study was part of a multi-centre surveillance trial. It is now complete and will undergo a final audit in February 2012: J Scarvell, E Bennett, B Serpell, J Wilson, D Perriman, P Smith. 2007-2012

Rehabilitation after total hip replacement. Randomised controlled trial of group physiotherapy (current practice) and home based unsupervised exercises after hip arthroplasty: C Coulter, J Scarvell, P Smith. 2010-2013

Fractured neck of femur outcomes. The fractured neck of femur outcomes database was established in 2002. It has developed into a detailed source of information for exploring quality of care and research questions such as the impact of delays to theatre, fluid resuscitation, outcomes by type of fixation, complications, and haemostasis. We are currently analysing data from the fractured neck of femur database to explanation a spike in pneumonia rate: P Smith, S Duggan, A Fisher, R Orefice, D Perriman. 2008

Knee kinematics and knee function following total knee replacement. Knee kinematics is an area of specific research focus for TORU. Prospective longitudinal studies examine knee kinematics using fluoroscopy and flexible electrogoniometry for gaining a better understanding of the kinematics of osteoarthritic knees as well as comparing prosthesis

designs. TORU has recently developed its RSA capacity for the most accurate analysis of knee kinematics and wear: B Serpell, T Ward, J Scarvell, P Smith. 2011- 2014

2D to 3D image registration in medical imaging. This project involves merging the dynamic imaging of functional activities enabled by fluoroscopy with the 3D detail provided by MRI or CT, providing the most rapid and accurate analysis of bony kinematics, using commonly available imaging tools. This technology has been successfully applied to the knee. Further proof of concept studies are planned for the hip: M Pickering, J Scarvell, P Smith. 2011-2014

Prospecitive imaging of cruciate knee ligament stabilising study (PICKLeS Study). A Prospective study of 3-dimensional knee kinematics of PCL retaining and substituting arthroplasty designs.TORU has been successful in a bid for a TCH private practice fund grant for this study which examines pre and post-op kinematics in people receiving knee replacements compared to an age matched normal population using image registration technology developed by TORU: J Scarvell, M Pering, P Smith. 2011-2014

Pelvic fractures and fixation. This study collects data on traumatic pelvic injuries and provides information on incidence, management and outcomes so as to better inform practice. A longitudinal outcome study using patient reported outcomes in planned: P Smith, J Warmenhoven, E Abbott, D Perriman. 2007- 2012

Effectiveness of side impact air bags in side impact collisions. This is an epidemiological study which aims to evaluate the effectiveness of side impact air bags during motor vehicle accidents: J Slater, J O’Neil, P Smith. 2010-2013

The R3 outcome study. TORU is one of the sites involved in this study which aims to evaluate physical and kinematic outcomes in people receiving the


Smith and Nephew R3 hip replacement: P Smith, A Burns, E Bennett, J Scarvell, D Perriman. 2010-2017

The exeter hip outcome study. This study uses the Canberra Arthroplasty Outcomes Project database to retrieve data related to outcomes of the Exeter Hip Replacement System in Canberra: P Smith, D Perriman, C Hanrahan. 2011- 2012

The RBK outcome study. This study uses the Canberra Arthroplasty Outcomes Project database to retrieve data related to outcomes of the RBK Knee Replacement System in Canberra: P Smith, J Scarvell, D Perriman, C Hanrahan. 2009-2012

The supercable study. This study aims to evaluate the behaviour of supercable fixation of midshaft femur fractures compared to traditional plate and stainless steel cables for fixation under cyclical mechanical testing, in terms of migration, stabilisation and failure: S Amarasekara, P Smith, D Perriman. 2011-2013

Major traumatic injury in young people aged 16-24 years: a mixed methods study. It is clear that while trauma survival rates are increasing, little is known about the long term outcomes following a life threatening traumatic injury for young people. The aim of this mixed methods study is to examine the characteristics of injury and explore the experience of young trauma survivors and their families within the first 6 months following the event: R Ogilvie, K Foster, A McCloughen, K Curtis. 2011- 2014

Does pelvic bony injury complex predict pelvic organ injuries? Injury to the vagina, bladder, rectum occurs in association with pelvic fractures after blunt trauma. When the diagnosis of this injury is delayed the consequences can be devastating. This project aims to retrospectively compare the types of pelvic bone fractures that occur in association with pelvic organ and soft tissue injury to determine if the presence of certain bone injury predicts the presence of those pelvic organ injuries: A Ford, D McMahon, R Ogilvie

Cardioprotection by riluzole in cardiac bypass surgery. This prospective randomised double-blinded controlled trial evaluates the cardioprotective effects of the drug Riluzole, versus placebo, in preventing hypoxia and subsequent myocardial damage during Coronary Artery Bypass Graft (CABG) surgery. This study has been closed: P Smith, P Bissaker, P Subramaniam, W Abhayaratna, S Weiss, T Brussell, P Hickman, T Neeman, J Scarvell, A Leditschke, C Smith, L Russell

The fracture surveillance database. TORU is undertaking the design of a unique fracture database.

This database will utilize a web-based platform to accumulate longitudinal data about specific fracture management and patient-assessed outcomes. The unique data-set which will result from this project will be used for retrospective cohort studies and surveillance, but the design will also have capacity to incorporate data collection for specific prospective designs as required. It is envisaged that the interface for this data-base will facilitate efficient, accurate and timely data collection: P Smith, D Perriman, R Wang

Compartment syndrome. A retrospective analysis of the incidence and outcomes of patients with compartment syndrome after lower limb fracture has been conducted. This project involved prospectively assessing outcomes after tibial fracture with compartment syndrome compared to tibial fracture without compartment syndrome and the effect of detection time. In association with this study we are exploring non-invasive methods of assessing intracompartmental pressure: C Dore, P Smith, D Perriman

Kinematic evaluation of hip replacement bearing systems during high flexion – resurfacing vs THA. A Prospective study of 3-dimensional hip kinematics in native resurfaced hips and total hip replacement. People with hip replacements commonly complain of lack of sufficient flexion for activities such as donning shoes. This study utilizes the 2D to 3D image registration technology previously developed within the unit, to examine the kinematics of the native vs prosthetic hip during these high flexion activities. We will commence with a cadaveric study to ascertain the accuracy of the technique in the hip by comparing with RSA. Pilot validation studies have commenced: P Smith, M Pickering, D Perriman, J Scarvell, T Ward

Standing and supine x-rays after total hip arthroplasty. The stability and resilience of a hip implant is reliant on correct positioning of the acetabular component in relation to the hip and femur. Currently orhthopaedic surgeons plan and assess the orientation of the acetabular component based on supine x-rays. Because the tilt of the pelvis is different in standing, this study aimed to investigate how much the position in which an X-ray is taken influences the perceived orientation of the acetabular component. The results indicate that pelvic tilt has a profound effect on acetabular version after Total Hip Replacement: J Au, D Perriman, T Neeman, P Smith

Using the transverse acetabular ligament for acetabular alignment in total hip arthroplasty. When the hip is replaced, the correct alignment and orientation of the acetabular component is crucial


to a stable and functional hip joint. There is some contention as to whether the acetabular rim or the transverse acetabular ligament should be used as a reference by which the surgeon should determine how to orientate the acetabulum. This study utilised a novel approach to measure and compare the angles that the TAL and the acetabular rim makes relative to the sagital plane. The results confirmed that the TAL is a good anatomical reference for acetabular positioning in Total Hip Replacement: A Griffin, M Irani, D Perriman, T Neeman, P Smith

Comparisons of clinical outcomes of birmingham resurfacing and total hip arthroplasty. Resurfacing operations are used in younger patients because they allow the preservation of more native bone stock. However, there have been reports of negative implications from resurfacing operations such as metalosis and thinning or the femoral neck with potential subsidence. This study aimed to compare the clinical outcomes in patients who have received resurfaced hips compared to total hip replacement after 10 years. Patients with BHR or THA had no significant differences in short term and long term clinical outcomes. Age only was an important determinant of clinical outcome: K Hang Wong, D Perriman, P Smith, B Shadbolt, T Neeman

Surgical outcomes of tibio-femoral dislocations. Tibio-femoral dislocation (TFD) is a very severe injury about which very little is known because of its rarity. This study aimed to identify all of the cases of TFD treated at the Canberra Hospital, describe their management and measure their outcomes via questionnaire survey instruments in order to evaluate the effectiveness of the Canberra Hospital Orthopaedic team in treating these patients and to add to the limited literature describing these patients. Outcomes after knee dislocation showed a large variability, with some patients continuing to experience the impact of their injury on their everyday lives. The severity of the injury may impact outcomes, as may patient factors and the treatment approach adopted. It is important that medical staff rule out these injuries after trauma to ensure prompt evaluation and management, and that this management is based on the best available evidence: S Wood, D Perriman, T Neeman, P Smith

Comparison of patient outcomes for exeter hip replacements with cemented versus uncemented acetabular components. There is an increasing trend to use uncemented acetabular components in hip replacements because the error tolerance is higher and the procedure is faster. However, the clinical outcomes of cemented vs uncemented procedures has not been reported. This study aimed to compare

10 year outcomes in these two groups of patients. Uncemented acetabular components resulted in lower rates of multiple revisions but the cohort was not large enough to provide conclusive evidence: J Robusto D Perriamn, B Shadbolt, T Neeman, P Smith

Neurological symptoms in hip arthroplasty. The specific aims of this study are:

1. To ascertain whether the incidence of diffuse neurological symptoms reported to be associated with ‘cobaltism’ in patients with hip resurfacing arthroplasty is greater than that reported by a matched cohort of patients who have had a total hip arthroplasty.

2. To ascertain whether the reported symptoms are associated with anxiety and depression.

3. To investigate whether there is a correlation between the presence of neurological symptoms and blood cobalt chrome levels: S Barrett, D Perriman, P Smith, T Neeman

Pelvic discontinuity. This study aims to measure functional outcomes after surgical intervention for pelvic-discontinuity patients in Canberra since records have been available and to evaluate the stability of the fixation achieved using x-ray images: J Sen, P Smith, D Perriman, T Neeman

Ten year review of periprosthetic fractures of the hip. This study aims to assess the quality of life, pain and function in people who have been treated for periprosthetic fracture of the hip at Canberra Hospital over the past 10 years: S Amarasekara, P Smith, D Perriman

Whiplash anatomy and clinical outcomes study. Injuries to the neck following whiplash trauma (whiplash injury) are one of the most common causes of neck pain and disability in the developed world. The purpose of this study is to investigate the use of magnetic resonance (MR) imaging in combination with physical and psychological measures, to identify structural lesions of the neck following whiplash injury. The ability to identify and differentiate the relationship between structural lesions and physical and psychosocial measures in whiplash patients will potentially enable more specific and timely management thereby potentially reducing the number of patients who develop chronic symptoms: A Webb, G Buirski, M Hall, R Jyoti, P Smith, D Perriman

Pelvic fracture classification study. This study aims to evaluate the accuracy with which orthopaedic registrars are able to classify a range of different pelvic fractures and evaluate the effect of an


e-learning package on the accuracy of classification both immediately and over time: J Au, D Perriman, P Smith

Cobalt chrom study. The objective of this study is to investigate whether there is a relationship between blood metal-ion levels and functional outcome and quality of life scores in people who have received a Birmingham hip resurfacing arthroplasty: M McLelland, D Perriman, P Smith

Hip dislocation. The aim of this study is to investigate:

1. What specific factors predict dislocation after total hip replacement?

2. How are patients with dislocation after total hip replacement managed at Canberra Hospital with respect to examination and treatment?

3. Which patients that suffer a dislocation require surgical revision?: M Ardern, D Perriman, P Smith

Outcomes after compartment syndrome in lower limb fracture patients. To assess to what extent (if any) compartment syndrome after tibial and fibular fracture affects long-term patient outcomes: S Harkin, D Perriman, P Smith

Mechanism of hamstring. A Pilot study of a method for using video recordings of hamstring injuries to identify common biomechanical features. The findings indicate that injury occurs when the Hamstring function changes from speed to strength modes: V Vetrivel, B Serpell, D Perriman, P Smith

Unicompartmental vs total knee replacement. The aims of this study are:

1. To identify how many unicompartmental replacements are done in Canberra each year and describe who receives them.

2. To examine the survivorship of the prostheses (time to revision) and compare it to the national data in the joint replacement registry.

3. To examine the functional outcomes and quality of life (including pain status) of the patients who have received a unicompartmental replacement compared to age matched normative data.

4. To examine the degree of patient satisfaction with both unicompartmental and total knee replacements with respect to pain relief and performance: A Selkirk, D Perriman, P Smith

Echelon stem study. The Echelon Hip Revision system has been used extensively worldwide for revision surgery of the hip, however little is published on it. The ACT has a large cohort of patients with over 140 implanted in the last 10 years. The study

involves clinical and radiographic evaluation of the patients with view to quantify the performance and survivorship of this prosthesis. The Echelon Hip Revision system has been used extensively worldwide for revision surgery of the hip, however little is published on it. The ACT has a large cohort of patients with over 140 implanted in the last 10 years. The study involves clinical and radiographic evaluation of the patients with view to quantify the performance and survivorship of this prosthesis: R Dawra, D Perriman, P Smith

Ultrasound ankle fractures. The aim of this study is to:

1. Examine how well ultrasound imaging of the ankle predicts the degree of ankle instability and need for surgical fixation as assessed by imaging while undergoing a manipulation under anaesthetic.

2. Measure the functional outcome of patients with varying ligamentous injuries as identified by US and their outcomes over 12 months: R Orefice, J Tobin, G Buirski, D Perriman, P Smith

Leg stiffness kinematics. Leg stiffness refers to the legs ability to resist movement while walking or running. It is possible that leg stiffness may help to prevent some common lower limb musculoskeletal injuries in field and court sports, particularly at the knee joint. However, leg stiffness is typically measured from tasks which are not specific to when injuries occur. Therefore, the aim of this study is to determine if measures of stiffness are also valid for tasks typically required in field and court sports. We intend to recruit 20 athletes from teams who compete in field or court sports at an elite level. Co-researcher (BS) will approach athletes, with permission from their coaches, to invite them to participate. We believe that findings from this study will enable us to further investigate the role of leg stiffness in preventing some common lower limb musculoskeletal injuries: B Serpell, J Scarvell, N Ball, P Smith

Validity of biomechanical models for knee kinematics. Knee joint motion is commonly measured using ‘special’ cameras which monitor movement of reflective balls (also known as skin markers) attached to the body. However, some inherent problems with those systems remain. For example, measurements taken from those motion analysis systems typically infer movement of the femur (thigh bone) in relation to the tibia (largest bone in the leg below the knee) from movement of skin markers. However, given they are attached to the skin and the thigh and leg are not perfectly cylindrical, the markers are often some distance


away from the bone and separated from each other disproportionately. Therefore their accuracy in describing knee joint motion is questionable. Another limitation is that there are a number of different ways in which those reflective balls can be attached (that is, a number of different biomechanical models). Therefore, the aim of this study is to compare a skin marker motion analysis system and several different biomechanical models to a ‘gold standard’ which measures femur movement relative to the tibia with high precision directly from bone. We intend to recruit up to 20 athletes from teams who compete in field or court sports at an elite level at various points throughout this project. Co-researcher (BS) will approach athletes, with permission from their coaches, to invite them to participate. We believe that findings from this study will inform future research about valid and reliable methods of measuring knee joint motion: M Pickering, B Serpell, J Scarvell, N Ball

CROSSBAT (Combined Randomised and Observational Study of Type B Ankle Fracture Treatment). This is a multi centre study. Ankle fractures are common and are increasing in incidence. The most common of these, using AO classification, are type 44-B1 fractures. Treatments vary and there is no clear consensus of the ideal approach to these fractures. Treatments range from open reduction and internal fixation to wearing below-knee walking plaster. This study will determine whether operative management confers improved

short and long-term outcomes for patients with isolated AO type 44-B1 distal fibula fractures when compared with non-operative management: I Harris, R Mittal, P Smith, D Perriman

Reliability and validity of KT1000. Joint laxity can be defined as the amount of ‘free movement’ at a joint which is unopposed by structures such as ligaments and skeletal muscle. In research joint laxity it is often used to predict injury, and in clinical settings it may be used to measure rehabilitation progress. Joint laxity is typically measured using a device called an arthrometer while a person is relaxed and lying down. However, use of arthrometers can be difficult and therefore the accuracy and reliability of measurements recorded using these devices can be questionable. We intend to recruit up to 6 participants to measure their knee joint laxity in both their left and right knees in view of a video x-ray. We will compare the amount of ‘free movement’ measured using the arthrometer, to the amount of free movement measured on the video x-ray. Co-researcher (BS) will approach athletes from sporting clubs who compete in a field or court sport to invite them to participate. We believe that findings from this study will inform future research about valid and reliable methods of measuring knee joint motion, and may inform clinical practice to more objectively interpret measurements recorded using arthrometers: B Serpell, J Scarvell, N Ball, P Smith

Osteo-network. This project will address a fundamental unanswered question in bone


metabolism – namely how different sets of genes interact among multiple systems. We, clinicians, mathematician and bone researchers are developing a multi-scale, quantitative and computational model of how bone works. This development will enhance our understanding of the complex network of interactions in bone metabolism and advance potential treatment of bone diseases: R Li, Q Singhua, P Smith, J Xiu

microRNA sequencing in revision surgery 10 years follow up plan. This study aims to identify microRNAs variant expression and expression pattern in wear particle associated osteolytic tissues. The identified aberrant microRNAs may serve as specific biological or genetic markers of osteolytic loosening that may predispose individuals to a heightened risk of failure progression, worsening, and severity: R Li, H Patel, D Perriman, P Smith

Biodegradable alloys in osteoconductivity. Recently, magnesium (Mg) alloys have been identified as potential candidates for biomedical implantable devices, particularly in the area of orthopaedics. This project investigates the ability of Mg-alloys to safely biodegrade and the potential functional ability of the degradation products to influence osteoconductivity and osteogenesis: R Li, D Nisbet, P Smith

Overexpression of interleukin 1 receptor antagonist influences bone remodelling. Experimental evidence has implicated the proinflammatory cytokine IL-1 in the bone remodelling. This project is to investigate the effects of IL-1 blocker, IL-1 receptor antagonist (IL-1ra), on the regulation of bone remodelling, using varying exposure to IL-1ra in mice based on the number of copies of the IL-1ra gene and µ-CT techniques: R Li, C Mastronardi, P Smith, J Licinio, ML Wong

High sensitivity biocompatible materials for orthopaedic applications. This project aims to develop a high performance, in vivo sensor system for orthopaedicclinicalapplications:RLi,PSmith,YLiu

Activated T cells and osteogenic differentiation of MSCs. Mesenchymal stem cells (MSCs) are currently strong candidates for cell-based therapies, based on differentiation potential and immunoregulatory properties. This study aimed to investigate the influence of T cell exposure on the osteogenic differentiation of MSCs and the possible mechanisms: R Li, B Quah, P Smith, C Parish

Bone tissue engineering combines to anabolic drug for bone regeneration. This project is to develop a reagent using a bioactive and anabolic molecules carried by novel nanostructured scaffolds. We are investigating the formula in vitro and in vivo for it anabolic effects in fracture healing process: R Li, D Nisbet, B Quah, P Smith, C Parish

Mismatch repair gene hMLH1 and EGFR mutation in exon 19 and 21 in cancer. Genetic instability caused by the dysfunction of mismatch repair (MMR) plays a pivotal role in carcinogenesis. This clinical pharmacogenetic study is to investigate whether gene mutations in NSCL cancer are caused by MMR dysfunction. Identified new molecular markers may predict how NSCL cancer patients will respond to tyrosine kinase inhibitors: R Li, S Lu.

Effect of stress, antidepressant and obese on bone. This study is to investigate the impacts of phenotypic difference between stress-antidepressant-diet induced obesity and solely diet induced obesity on bone microstructure, and osteogenesis: R Li, C Mastronardi, P Smith, J Licinio, Ma-Li Wong

10 years follow up and sample collection. This project is to examine heparanase (HPSE) activity, expression and its correlation with angiogenic gene expression in plasma and synovium of patients with rheumatoid arthritis (RA), with an ultimate goal to develop HPSE as a potential predictor of RA progression and a new target of therapeutics: R Li, X Wang, P Gatenby, J Scarvell, D Zhou, P Smith, C Parish.

pRESEnTATIonS3D/2D Registration Software for Kinematic Analysis of Human Joints, M Abdullah, Australian and New Zealand Orthopaedic Research Society 17th Annual Scientific Meeting, Brisbane, Australia 2011

Image assisted biomechanical analysis for total knee arthroplasty patients, M Abdullah, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Greater trochanteric pain syndrome is as painful and functionally debilitating as severe OA of the hip, a prospective case control study, A Fearon, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Greater trochanteric pain syndrome is as painful and functionally debilitating as severe OA of the hip, a prospective case control study, A Fearon, Australian Orthopaedic Association (AOA) New Zealand Orthopaedic Association (NZOA) Combined Annual Scientific Meeting, Rotorua, New Zealand 2011

Assessment of bursae from gluteal tendon reconstruction and total hip arthroplasty surgery. Are there histological or histopathological differences? A Fearon, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Can gait assessment distinguish between people with hip osteoarthrisis, greater trochanteric pain syndrome or an asymptomatic group? A Fearon, Physiotherapy Conference, Brisbane, Australia 2011


Are child bearing hips a risk factor for greater trochanteric pain syndrome? A Fearon, Physiotherapy Conference, Brisbane, Australia 2011

Inter-adispose septa in busa stroma may explain ultrasound reports of bursa thickening, A Fearon, European Orthopaedic Research Society, Vienna, Austria 2011

Shape versus size relationship of prosthetic UHMWPE wear particles, L Gladkis, 35th Annual Condensed Matter and Materials Meeting, Charles Sturt University, Wagga Wagga, Australia 2011

Wear rates and wear morphology of knee prosthesis: a 3D study, L Gladkis, Australian and New Zealand Orthopaedic Research Society 17th Annual Scientific Meeting, Brisbane, Australia 2011

Morphology of UHMWPE debris: a walking and running study using a PROSIM knee simulator, L Gladkis, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Osteoimmunological response to nanoscale wear particles, R Li, Australian and New Zealand Orthopaedic Research Society 17th Annual Scientific Meeting, Brisbane, Australia 2011

Precision analysis of an intelligent skin marker for non-invasive kinematic analysis of knee joints, A Masum, International Symposium on Biomedical Imaging (ISBI), Barcelona, Spain2011

Back extension exercises in prone lying may increase thoracic kyphosis - a preliminary study, D Perriman, Australian Physiotherapy Association Conference, Brisbane, Australia 2011

A randomised controlled trial of strengthening versus postural re-education for age-related thoracic hyperkyphosis, D Perriman, Australian Physiotherapy Association Conference, Brisbane, Australia 2011

A randomised controlled trial of strengthening versus postural re-education for age-related thoracic hyperkyphosis, D Perriman, Canberra Health Annual Research Meeting, Canberra, Australia 2011

The relationship between age-related hyperkyphosis and the frequency of movement in the thoracic spine, D Perriman, Canberra Health Annual Research Meeting, Canberra, Australia 2011

The effect of progressive resisted strengthening of the thoracic extensors in stroke - A single case study, D Perriman, Australian Physiotherapy Association Conference, Brisbane, Australia 2011

A comparison of thoracic and lumbar erector spinae activity during extension in prone lying and sitting, D Perriman, Australian and New Zealand Orthopaedic Research Society 17th Annual Scientific Meeting, Brisbane, Australia

A randomised controlled trial of strengthening versus postural re-education for age-related thoracic hyperkyphosis, D Perriman, AOA NZOA Combined Annual Scientific Meeting, Rotorua, New Zealand 2011

The relationship between age-related hyperkyphosis and the frequency of movement in the thoracic spine, Poster, D Perriman, AOA NZOA Combined Annual Scientific Meeting, Rotorua, New Zealand 2011

Precision analysis of an intelligent skin marker for non-invasive kinematic analysis of knee joints, M Abdullah, Canberra Health Annual Research Meeting, Canberra, Australia 2012

A biomechanical comparison of femoral fracture fixation methods: A model to ensure consistency of fracture patterns and fixation, S Amarasekara, Australian Orthoapedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Standing or supine x-rays after total hip replacement, J Au, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Standing or supine x-rays after total hip replacement, J Au, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

A mathematical model for prediction of intramedullary pressure trend during reaming in vivo sheep model, S Chen, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Evidence of physiotherapy rehabilitation effective-ness for strength and gait after elective total hip replacement: a systematic review, C Coulter, Australian Physiotherapy Association ACT Symposium, Canberra, Australia 2012

Inter-adipose septa in busa stroma may explain ultrasound reports of bursa thickening, A Fearon, European Federation of International Association for the Study of Pain (IASP) Chapters, Hamburg, Germany 2012

Greator trochanteric pain syndrome is as painful and functionally devilitating as OA of the hip, a prospective controlled study, A Fearon, European Federation of IASP Chapters, Hamburg, Germany 2012

Are child bearing hips a risk factor for greator trochan-teric pain syndrome? A Fearon, Third International Fascia Research Congress, Vancouver, Canada 2012

An in vivo comparison of the orentation of the transverse acetabular ligament and the acetaulum, A Griffin, Canberra Health Annual Research Meeting, Canberra, Australia 2012


An in vivo comparison of the orentation of the transverse acetabular ligament and the acetaulum, A Griffin, Australian Orthopaedic Association Annual Scientific Meeting, Sydney, Australia 2012

An in vivo comparison of the orentation of the transverse acetabular ligament and the acetaulum, A Griffin, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

An in vivo comparison of the orentation of the transverse acetabular ligament and the acetaulum, A Griffin, Australian Physiotherapy Association ACT Symposium, Canberra, Australia 2012

ACT Health intellectual property ownership, protection, development and commercialisation, D Kuchler, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Understanding the long term effect of weight gain induced by short term exposure of antidepressants, S Lee, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

MicroRNA profile in trabecular bone of osteolysis from revision surgery of total hip replacement, R Li, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Biocompatibility evaluation of sensor materials on human mesenchymal stem cells and osteoblasts, R Li, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Activated T cells interact with bone marrow mesenchymal stromal cells, R Li, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Which Exercise Leads to Better Back Posture? D Perriman, Canberra Health Annual Research Meeting, Canberra, Australia 2012

The Canberra facture survellance database - progress to date, D Perriman, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Exeter hip replacement outcomes: Cemented versus uncemented acetabular components, J Robusto, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Greater trochanteric pain syndrome: Defining the syndrome, J Scarvell, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Greater trochanteric pain syndrome: Defining the clinical syndrome, J Scarvell, Australian Physiotherapy Association Symposium, Canberra, Australia 2012

The PICKLeS study - A prospective imaging study of cruciate retaining and substituting knee replacement in osteoarthritis and healthy aging. The project and the protocol, J Scarvell, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Cardioprotection by Riluzole in cardiac bypass and aortic valve replacement surgery, C Smith, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Greater trochanteric pain syndrome: Defining the syndrome, P Smith, Australian Orthopaedic Association Annual Scientific Meeting, Sydney, Australia 2012

In vitro and in vivo effects of heperanase in bone metabolism and fracture healing, P Smith, Australian Orthopaedic Association Annual Scientific Meeting, Sydney, Australia 2012

12 year review of Birmingham hip resurfacing arthroplasty, P Smith, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

The diagnosis capacity of ultrasound to determine joint stability in unimalleolar Wber B (UMWB) fractures, J Tobin, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Validation of a method to measure in vivo 3D hip kinematics using computer tomography and flouroscopy, T Ward, Australian Orthopaedic Association ACT Branch Annual Scientific Meeting, Canberra, Australia 2012

Applicability of a 2D video based model for use in ergometer rowing kinematics: Towards screening for injury, J Warmenhoven, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Hip replacement surgery outcomes at 8 years - a comparison of resurfacing and total hip arthroplasty, J Wong, Canberra Health Annual Research Meeting, Canberra, Australia 2012

Tibiofemoral dislocation - a rare but significant injury, S Wood, Canberra Health Annual Research Meeting, Canberra, Australia 2012

AWARDSBest Student Paper - J Au. Standing or Supine X-rays after Total Hip Replacement. Australian Orthopaedic Association ACT Branch Annual Scientific Meeting

Best Laboratory Paper - S Lee. Understanding the Long Term Effect of Weight Gain Induced by Short Term Exposure of Antidepressants. Australian Orthopaedic Association ACT Branch Annual Scientific Meeting,

Best Poster - A Griffin. An in vivo Comparison of the


Orientation of the Transverse Acetabular Ligament and the Acetabulum. Australian Physiotherapy Association ACT Symposium

Runner Up for Best Clinical Research Poster Presentation - D Perriman. Which Exercise Leads to Better Back Posture. Canberra Health Annual Research Meeting

Best Clinical Presentation - T Ward. Validation of a Method to Measure in vivo Three Dimensional Hip Kinematics Using Computed Tomography and Flouroscopy. Australian Orthopaedic Association ACT Branch Annual Scientific Meeting

Team Winner - Trauma & Orthopaedic Research Unit. ACT Health Australia Day Awards 2011

Best Paper - D Perriman. APA Research Symposium, Canberra


RADIATIONONCOLOGY

bRIEf SUMMARyRadiation Oncology is participating in national and international clinical trials. Considerable time and effort has been devoted by personnel within the department in obtaining technical credentialing and training of staff to support participation in Trans Tasman Radiation Oncology Cooperative Group (TROG) trials. In addition Radiation Oncology supports cancer research and has active local translational research studies as well as participating in a national translational research study.

By the close of 2012 two trials have been activated and the Cancer Research Laboratory has made significant progress in its translational research studies.

Two further clinical studies are due for activation in 2013:

STARS. A randomised comparison of anastrozole commenced before and continued during adjuvant radiotherapy for breast cancer versus anastrozole and subsequent anti-oestrogen therapy delayed until after radiotherapy.

CHISEL. A randomised phase III trial of highly conformal hypofractionated image guided (“”stereotactic””) radiotherapy (HypoRT) versus conventionally fractionated radiotherapy (ConRT) for inoperable early stage I non-small cell lung cancer.”

STAffA/Prof Hany Elsaleh, Director of Radiation Oncology, Australian National University

Dr Brandon Nguyen, Radiation Oncologist

Dr Amy Shorthouse, Radiation Oncologist

Dr Lisa Sullivan, Radiation Oncologist

Dr Angela Rezo, Radiation Oncologist

DrYu-YanFang,Co-ordinationOncologist

Ms Leah Oliver, Radiation Therapist

Dr Sophia Ang, Post Doctoral Research Officer

Dr Mhairi Baird, Post Doctoral Research Officer

Dr Idit Ziv, Post Doctoral Research Officer

Mr Brett Fittler, Radiation Therapist

Mr Craig Watson, Radiation Therapist

CoLLAboRATIVE ASSoCIATESDr Doug Taupin, Group Leader, Cancer Research

RESEARCH pRojECTSCirculating Tumour DNA as a marker of complete pathological response and long term outcome for locally advanced rectal cancer treated with pro-operative chemoradiotherapy. The project of ctDNA in locally advanced rectal cancer is a national collaborative study. It is sponsored and coordinated by Walter and Eliza Hall Institute of Medical Research. The aim of the study is to evaluate ctDNA, that is a sensitive and specific biomarker in treatment of locally advanced rectal cancer. The study has been approved by ACT Health Human Research Ethics Committee (HREC) on 18 July, 2012 and the trial was activated on 31 October 2012: H Elsaleh, B Nguyen, DYip,YJChua,SAli,CHemmings.2012-2015

SCORAD III: A Randomised Phase III Trial of Single Fraction Radiotherapy Compared To Multi-Fraction Radiotherapy in Patients with Metastatic Spinal Cord Compression. Spinal cord compression (SCC) is a common complication of metastatic cancer and radiotherapy is the treatment of choice for the vast majority of patients to preserve or recover neurological function. The aim of this trial is to evaluate 8Gy in single fraction, comparing with common practice with 20 - 30Gy in 5 to 10 fractions. This trial is an international multi-centre study and is sponsored by the Trans Tasman Radiation Oncology Group (TROG), a not-for-profit research group involving many cancer researchers in Australia and New Zealand, as well as internationally. The trial has been approved by HREC on 17 October 2012 and the clinical trial agreement signed on 22 October 2012. The trial actived on 13 December 2012: A Shorthouse, L Sullivan. 2012-2016

Endoplasmic Reticulum (ER) stress in Helicobacter-induced Gastric cancer. To demonstrate a causal role for ER stress in promoting development of gastric cancer associated with Helicobacter felis (H. felis)


infection. This project explores whether H. felis induces histopathological changes that lead to gastric cancer and looks at Endoplasmic Reticulum Unfolded Protein response effectors: D Taupin (Gastroenterology), S Ang, M Baird, I Ziv, M Cook (Immunology), H Elsaleh. 2011-2015

pRESEnTATIonThe Unfolded Protein Response Confers Resistance to 5-FLUOROURACIL in Colorectal Cancer, D Taupin, Canberra Health Annual Research Meeting, Canberra, Australia 2011


MEDICALONCOLOGY

bRIEf SUMMARyThe Medical Oncology Research Unit has been conducting a cancer clinical trials program since 1979. It has been involved in the conduct of oncology studies exploring new drugs and treatments across a broad range of different cancers. Partnerships have been formed with pharmaceutical companies, cooperative clinical trials groups and national Collaborative Associates in this research. The unit has participated in many important phase III registration trials of new agents including biologicals that are now standard therapies. The focus on breast and gastrointestinal research reflects the major clinical interests of the consultants.

STAffA/ProfDesmondYip,Director,MedicalOncologyResearch Unit, Senior Staff Specialist Medical Oncology, Associate Professor, Australian National University Medical School

A/Prof Paul Craft, Senior Staff Specialist in Medical Oncology, Associate Professor, Australian National University Medical School

Prof Robin Stuart-Harris, Director, Capital Region Cancer Service Senior Staff Specialist in Medical Oncology, Professor of Medical Oncology, Australian National University Medical School

Dr David Leong, Senior Staff Specialist Medical Oncology, Senior Lecturer, Australian National University Medical School

Dr Alison Davis, Senior Staff Specialist Medical Oncology, Senior Lecturer, Australian National University Medical School

Dr Nicole Gorddard, Staff Specialist Medical Oncology, Lecturer, Australian National University Medical School

Dr Ganesalingham Pranavan, Staff Specialist Medical Oncology, Senior Lecturer, Australian National University Medical School

DrYuJoChua,StaffSpecialistMedicalOncology,Senior Lecturer, Australian National University Medical School

Dr Sayed Ali, Staff Specialist Medical Oncology, Lecturer, Australian National University Medical School

Mrs Olive Doig, Clinical Trials Manager

Mrs Anne Ryan, Clinical Trials Coordinator

Ms Jody Berry, Clinical Trials Coordinator

Mrs Penny Briese, Clinical Trials Administrative Assistant

Mrs Jillian Harrison, Clinical Trials Administrative Assistant

CoLLAboRATIVE ASSoCIATES Prof Jane Dahlstrom, Professor of Anatomical Pathology, Anatomical Pathology, Australian National University, ACT Pathology, Canberra Hospital

Dr Anneke Blackburn, Fellow, John Curtin School of Medical Research, Australian National University

A/Prof Peter Gibbs, Medical Oncologist, Department of Medical Oncology, Royal Melbourne Hospital

Dr Suzy Kosmider, BioGrid Project Manager, BioGrid Australia, Royal Melbourne Hospital

Dr Christine Hemmings, Senior Staff Specialist, Anatomical Pathology, ACT Pathology

Prof David Goldstein, Senior Staff Specialist, Institute of Oncology, Prince of Wales Hospital

Dr Angela Rezo, Staff Specialist, Department of Radiation Oncology, Canberra Hospital

Prof Arlene Chan, Medical Oncologist, Breast Cancer Clinical Trials Unit, Mount Hospital, Perth

Dr Jeanne Tie, Medical Oncologist, Ludwig Colon, Cancer Initiative Biomarkers Laboratory, Ludwig Institute for Cancer Research, Melbourne

Dr Hsiang Tan, Medical Oncologist, Cancer Centre, Royal Adelaide Hospital


STUDEnTSMr Thomas Vien, BMBBS, Australian National University

Ms Ashley Ng, BMBBS, Australian National University

MsYuleiWu,BMBBS,AustralianNationalUniversity

Ms Gemma Curry, BMBBS, Australian National University

RESEARCH pRojECTSMAGE-A3. Double-blind, placebo-controlled, phase III study to assess efficacy of recMAGE-A3+AS15 antigen specific cancer immunotherapeutic as adjuvant therapy in patients with resectable MAGE A3 positive non-small cell lung cancer: D Leong, PCraft,DYip,RStuart-Harris,ADavis,NGorddard,G Pranavan. 2008-2020

CA163-196. A phase III, open label, randomised, 2-arm study of Ixabepilone administered every 21 days vs Paclitaxel or Doxorubicin Administered every 21 days in women with advanced endometrial cancer who have been treated with chemotherapy: A Davis, DYip,PCraft,RStuart-Harris,DLeong,NGorddard,GPranavan,YJChua.2010-2012

MOTIF. Modafinil in metastatic prostate and breast cancerreceivingdocetaxel:PCraft,DYip, R Stuart-Harris, D Leong, A Davis, N Gorddard, YJChua,GPranavan.2009-2011

COU-AA-302. A phase III, randomised, double-blind, placebo controlled study of Abiraterone Acetate plus Prednisone in asymptomatic or mildly symptomatic patients with metastatic castration resistant prostate cancer:DYip,PCraft,RStuart-Harris,DLeong, ADavis,NGorddard,YJChua,GPranavan.2009-2015

GRANITE-1. A randomized, double-blind, multi-center, phase III study comparing Everolimus (RAD001) plus best supportive care versus placebo plus best supportive care in patients with advanced gastric cancer after progression on prior systemic chemotherapy:DYip,PCraft,DLeong, R Stuart-Harris, A Davis, N Gorddard, G Pranavan, H Kleiven, B Shah. 2009-2011

COMPLETE. A randomised, open-label, phase III study of Taxane based chemotherapy with Lapatinib or Trastuzumab as first line therapy for women with HER2/neu positive metastatic breast cancer: NGorddard,DYip,RStuart-Harris,ADavis, DLeong,YJChua,GPranavan.2010-2012

INSPIRE. A randomised, multicentre, open label, phase III study of Pemetrexed-Cisplatin chemotherapy, plus Necitumumab (IMC-11F8) vs

Pemetrexed-Cisplatin chemotherapy alone in the first-line treatment of patients with non-squamous stage IV non-small cell lung cancer (NSCLC): D Leong, PCraft,DYip,RStuart-Harris,ADavis,NGorddard,GPranavan,YJChua.2010-2013

SQUIRE. A randomised, multicentre, open label, phase III study of Gemcitabine-Cisplatin chemotherapy plus Necitumumab (IMC-11F8) versus Gemcitabine-Cisplatin chemotherapy alone in the first-line treatment of patients with squamous stage IV non-small cell lung cancer (NSCLC): D Leong, PCraft,DYip,RStuart-Harris,ADavis,NGorddard,GPranavan,YJChua.2010-2012

TyN. Phase II, open label study of Lapatinib and Vinorelbine in patients with previously treated HER2/NEUpositivemetastaticbreastcancer:PCraft,DYip,R Stuart-Harris, D Leong, A Davis, N Gorddard, GPranavan,YJChua.2010-2012

PROSELICA. A phase III, randomised, double blind, placebo controlled trial comparing Capecitabine + Sorafenib vs Capecitabine + Placebo in the treatment of locally advanced or metastatic HER-negative breast cancer:PCraft,DYip,RStuart-Harris,ADavis, NGorddard,GPranavan,YJChua,DLeong.2011-2017

RESILIENCE. Randomised, open-label, multi-centre study comparing Cabazitaxel at 20 mg/m2 and at 25 mg/m2 every 3 weeks in combination with Prednisone for the treatment of metastatic, castration resistant prostate cancer previously treated with Docetaxel-ContainingRegimen:PCraft,DYip, R Stuart-Harris, A Davis, N Gorddard, G Pranavan, YJChua.2011-2013

AA-EAP. An open-label study of Abiraterone Acetate in subjects with metastatic castration-resistant prostate cancer who have progressed after Taxane-basedchemotherapy:PCraft,DYip,RStuart-Harris,ADavis,NGorddard,GPranavan,YJChua,DLeong.2011-2012

ASCENT. An Australian translational study to evaluate the prognostic role of inflammatory markers in patients with metastatic colorectal cancer treated withBevacizumab(AvastinTM):DYip,YJChua, P Craft, S Ali. 2012-2017

CATChEz. Continuous access to advanced and metastatic renal cell carcinoma therapy with Everolimuspostpazopanibtreatment:DYip, G Pranavan, S Ali. 2012-2013

MEK113487. Randomised, double-blind, placebo-controlled, phase II study of the MEK inhibitor GSK1120212 plus Gemcitabine vs. placebo plus Gemcitabine in subjects with metastatic pancreatic


cancer:DYip,PCraft,DLeong,RStuart-Harris, ADavis,NGorddard,GPranavan,YJChua.2010-2012

MEK114267. A phase III, randomised, open-label, study comparing GSK1120212 to chemotherapy in subjects with advanced or metastatic BRAF V600E/K mutationpositivemelanoma:DLeong,PCraft,DYip,R Stuart-Harris, A Davis, N Gorddard, G Pranavan, YJChua.2010-2013

PICASSO. A phase III, multicentre, international, randomized, double blind, placebo-controlled study of Doxorubicin plus Palifosfamide-tris vs. Doxorubicin plus placebo in patients with front-line metastaticsofttissuesarcoma:YJChua,PCraft, DYip,RStuart-Harris,ADavis,NGorddard, G Pranavan, D Leong. 2010-2014

SOFT. A phase III trial evaluating the role of ovarian function suppression and the role of Exemestane as adjuvant therapies for pre-menopausal women with endocrineresponsivebreastcancer:ADavis,DYip, P Craft, D Leong

ACTO. Australian Cancer Trials Online Project: RDear,DYip.2009-2011

PACT. Preferences for adjuvant chemotherapy (ACT) in non-small-cell lung cancer: What makes it worthwhile to patients and their doctors? Observational cohort study of patients, surgeons and oncologists:DLeong,DYip,PCraft,RStuart-Harris,NGorddard,ADavis,GPranavan,YJChua.2008-2011

REGISTER. A multicentre phase II study of risk evaluation in GIST with selective therapy escalation forresponse:DYip,PCraft,RStuart-Harris,DLeong,ADavis,NGorddard,YJChua.2008-2012

SYMPTOM BENEFIT. An observational study measuring subjective patient benefit associated with palliative treatment in platinum resistant ovarian cancer:ADavis,DYip,PCraft,RStuart-Harris, DLeong,NGorddard,YJChua,GPranavan.2009-ongoing

SORCE. A phase III, randomised, double-blind study comparing sorafenib with placebo in patients with resected primary renal cell carcinoma at high or intermediateriskofrelapse:DYip,PCraft, R Stuart-Harris, N Gorddard, D Leong, A Davis, GPranavan,YJChua.2009-2017

SCOT. Short Course Oncology Therapy-a study of adjuvant chemotherapy in colorectal cancer (12 weeksversus24weeksOxaliplatinand5FU):DYip,P Craft, R Stuart-Harris, D Leong, A Davis, NGorddard,YJChua,GPranavan.2010-2017

Testicular Survivor Study. Understanding the long-term psychological sequelae of surviving testicular cancer: P Craft. 2009-2011

GAP. A phase II study of pre-operative Gemcitabine and Nab-Paclitaxel for resectable pancreas cancer: YJChua,DYip,SAli.2011-2015

PAN1. A randomised phase II study evaluating potential predictive biomarkers in the treatment of metastaticpancreaticcancer:YJChua,DYip,PCraft,R Stuart-Harris, D Leong, N Gorddard, G Pranavan, A Davis. 2011-2013

Millennium. A phase III, Randomized, double-blind, multicenter trial comparing TAK-700 plus Prednisone with placebo plus Prednisone in patients with chemotherapy-naïve Metastatic Castration-resistant ProstateCancer:PCraft,DYip,RStuart-Harris, ADavis,NGorddard,GPranavan,YJChua,DLeong.2010-2015

ctDNA. Circulating tumour DNA as a marker of occult disease in stage II colorectal cancer and response to therapy in metastatic colorectal cancer: DYip,PCraft,RStuart-Harris,DLeong,ADavis, NGorddard,GPranavan,YJChua.2011-2016

INTEGRATE. A randomised, phase II, double-blind, placebo-controlled study of Regorafenib in refractory advanced oesophago-gastric cancer (AOGC): YuJoChua,DesmondYip,SayedAli.2012-2015

A retrospective clinical audit comparing neuropathy associated with two different schedules of Oxaliplatin in the treatment of metastastic colorectal carcinoma: DYip,TVien.2011- 2012

Fertility survey of breast cancer survivors: N Gorddard, A Ng. 2011- 2012

CLEARSUN. Predictive value of drug elimination gene polymorphisms on clearance and dose adjustment of Sunitinib in patients with cancer: GPranavan,DYip.2010-2011

BioGrid Australia, (Formerly known as Bio21 Molecular Medicine Informatics Model (MMIM)).Federated database linkage platform to allow collaborative projects to be carried out with a large numberofinstitutionsthroughoutAustralia:DYip, D Taupin, C Hemmings. 2007-2017

Australian Breast Cancer Tissue Bank. Collection of breast breast tissue, serum and clinical data part of collaborative project with Westmead Millenium Institute with six other collection centres in NSW to provide a valuable biospecimen resource for translationalresearch:DYip,JDahlstrom,SJain, P Barry, A Rezo, J Carpenter, C Clarke. 2009-2017


Platinum-based doublet chemotherapy toxicity in elderly patients with advanced non-small cell lung cancer:SAli,YWu.2012-2013

The incidence of Capecitabine related gastrointestinal toxicity among metastatic colon cancer and metastatic breast cancer patients seen in clinical practice: G Pranavan, G Curry. 2012-2013

The cancer journey in regional and rural Australia: A consumer perspective. Scoping of needs of rural patients with cancer in regional centres: P Grimison, P Butow, D Goldstein, L White, B Mann, J Ussher, CUnderhill,DYip,ABoyce,MGeorge.2010-2012

Quality of life of lung cancer patients: Effect of pulmonary function status, dyspnoea, anxiety and supportive care needs. Survey project in lung cancer patients conducted across the Southern Local Health District Cancer Trials Network: V Lopez, D Leong, C Underhill, Q Walker, J Rafferty, D Byrne. 2010-2013

A multicenter audit of the incidence of febrile neutropenia and neutropenia associated with Docetaxel and Cyclophosphamide (TC) chemo-therapy for early breast cancer: R Stuart-Harris, R Lakanpal. 2010-2012

TRACC. Multicentre prospective study of clinical outcomes and analysis of Bevacizumab use in metastatic colorectal cancer as part of BioGrid collaboration:DYip,ZOtty,ACooper,LMalik, S Parakh. 2011- 2015

pRESEnTATIonSFemale breast cancer in the Australian Capital Territory(ACT),CBehm,JLi,YZhang,JDahlstrom, P Craft, J Buckingham, A Rezo, R Stuart-Harris, C Cho, A review of new research, Royal Australasian College of Pathologists Pathology Update, Sydney, Australia 2011

A case series of a potentially overlooked but important clinical syndrome associated with malignancy. Numb ChinSyndrome,ACooper,NTejani,ARezo,DYip,Clinical Oncological Society of Australia Annual Scientific Meeting, Perth, Australia 2011

Serious hepatic complications of radioactive yttrium microspheres (SIR-Sphere) embolisation of liver tumours, Abstract 21, A Tazbirkova, R Allen, SKosmider,PGibbs,DYip,ClinicalOncologicalSociety of Australia Annual Scientific Meeting, Perth, Australia 2011

Improving the Cancer Journey in Rural and Regional Australia, Abstract 387, P Butow, F Phillips, K White, CUnderhill,PGrimison,DYip,DGoldstein,ClinicalOncological Society of Australia Annual Scientific Meeting, Perth, Australia 2011

Modafinil for fatigue associated with docetaxel-based chemotherapy: a randomized controlled trial, T Rapke, P De Souza, G Marx, P Parente, A Hill, A Bonaventura, T Michele, P Craft, E Abdi, A Lloyd, American Society of Clinical Oncology (ASCO) Genitourinary Meeting, San Francisco, USA 2012

Results of Australasian Gastrointestinal Trials Group (AGITG), ARCTIC study: An international audit of raltitrexed for patients with cardiac toxicity induced by fluoropyrimidines (FP), Abstract 13007, D Ransom, DWilson,SBishnoi,JSimes,DYip,CKarapetis, V Gebski, S Gordon, M Fournier, D Ferry, H Abbas, R Midgley, T Price, Proceedings of the American Society of Clinical Oncology. Chicago, USA 2012

Single institutional series of neuroendocrine tumours managed in the Australian Capital Territory, Abstract 14703,LMalik,YJChua,NButt,DYip,Proceedingsof the American Society of Clinical Oncology 2012. Chicago, USA 2012

Modafinil for fatigue associated with docetaxel-based chemotherapy: a randomized controlled trial, E Hovey, P De Souza, G Marx, T Rapke, P Parente, A Hill, A Bonventura A Michele A, P Craft, A Ehtesham, A Lloyd, ASCO Annual Scientific Meeting, Chicago, USA 2012

Prescribing patterns for bevacizumab in first-line metastatic colorectal cancer: Exploring the introduction of a new drug into routine clinical practice, (Poster), K Field, S Kosmider, J McKendrick, DYip,SParakh,MBurge,KMoore,JShapiro, L Nott, M Wuttke, P Parente, S Bae, P Gibbs, Medical Oncology Group of Australia Annual Scientific Meeting, Brisbane, Australia 2012

Patterns of care according to treatment intent for metastatic colorectal cancer (mCRC): A review of routinepractice,(Poster),KField,JShapiro,DYip,


Z Otty, M Burge, A Sharma, L Lim, L Lipton, G Stefanou, J Desai, J Tie, P Gibbs, Medical Oncology Group of Australia Annual Scientific Meeting, Brisbane, Australia, 2012

Cholecystitis as a complication of hepatic implantation of radioactive yttrium resin microspheres for metastatic cancer, S Parakh, S Gananahda, R Allen,DYip,MedicalOncologyGroupofAustraliaAnnual Scientific Meeting, Brisbane, Australia 2012

Breast Cancer Tissue Banking Project in the Australian CapitalTerritory,(Poster),DYip,EBean,ARezo,CCho,YZhang,JTwin,JCarpenter,JDahlstrom,Canberra Health Annual Research Meeting, Canberra, Australia 2012

Filling the Knowledge Void: The BioGrid Facilitated Solution,DYip,SParakh,CHemmings,SKosminder,Canberra Health Annual Research Meeting, Canberra, Australia 2012

The Role of the Pathologist in Diagnosing MFH of Bone, C Hemmings, Australian Sarcoma Group Annual Scientific Meeting, Melbourne, Australia 2011

Chemoprevention with the metabolism modifying drugs dichloroacetate and metformin in Trp53+/- mice, A Blackburn, M Rooke, J Dahlstrom, P Board ,American Association for Cancer Research (AACR) Metabolism and Cancer, Baltimore, USA 2011

Inter-adipose septa in bursa stroma may explain ultrasound reports of bursa thickening, A Fearon, J Twin, J Dahlstrom, J Cook, W Cormick, A Scott, P Smith, European Orthopaedic Research Society, Vienna, Austria 2011

DNA ploidy by Flow Cytometry, a helpful adjunct for the surveillance of Barrett’s Oesophagus? S Gruninger, S Al Jahdhami, S Jain, J Dahlstrom, Australasian Flow Cytometry Group Meeting, Hobart, Australia 2011

Chemoprevention with the metabolism modifying drugs dichloroacetate and metformin in Trp53+/- mice, A Blackburn, M Rooke, J Dahlstrom, P Board, Familial Cancer: Research and Practice, Kingscliff, Australia 2011

Intrauterine growth retardation with high fat diet in rats markedly disturbs islet morphology characterized by peri-islet inflammation, fibrosis and hemosiderosis, V Delghingaro-Augusti, L Madad, C Simeonovic, J Dahlstrom, C Nolan, Diabetes Society(ADS) & Diabetes Educators Association (ADEA) Annual Scientific Meeting, Perth, Australia 2011

Assessment of bursae from gluteal tendon reconstruction and total hop arthroplasty surgery. Are there histological or histopathological differences? A Fearon, P Smith, J Twin, J Dahlstrom, W Cormick,

J Cook, J Scarvell, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Mismatch between decidual DC-sign+dendritic cells and foxp3+ T regulatory cells inpreeclampsia, P Hsu, B Santner Nanan, M Peek, M Fadia, J Dahlstrom, R Nanan, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Increased numbers of podocytes are present in the urine of preterm infants treated with indomethacin suggesting drug induced glomerular injury, A Kena, L Brown, M Broom, J Dahlstrom, Canberra Health Annual Research Meeting, Canberra, Australia 2011

Placental workshop and lecture 2011, J Dahlstrom, 29th Review and Recent Advances in Pathology, Sydney, Australia 2011

Calcification and osseous metaplasia in cervical lymph nodes, J Dahlstrom, Royal College of Pathologists Australia (RCPA) Pathology Update, Melbourne, Australia 2011

Cholecystitis as a complication of hepatic of implantation radioactive yttrium resin microspheres for metastatic cancer, (Poster), S Parakh, S Gananahda, RAllen,DYip,CanberraHealthAnnualResearchMeeting, Canberra, Australia 2012

Filling the knowledge void-the BioGrid facilitated solution,DYip,SParakh,CHemmings,SKosmider,Canberra Health Annual Research Meeting, Canberra, Australia 2012

Final results of Australasian Gastro-Intestinal Trials Group (AGITG) ARCTIC Study. An international audit of raltitrexed for patients with cardiac toxicity (CT) induced by Fluoropyrimidines (FP), T Price, K Wilson, JSimes,DYip,NTebbutt,CKarapetis,VGebski, M Fournier, D Ferry, D Ransom, European Society of Medical Oncology Congress, Vienna, Austria 2012.

Final results of Australasian Gastrointestinal Trials Group (AGITG) ARTIC Study. An international audit of raltitrexed for patients with cardiac toxicity (CT) induced by fluropyrimidines (FP). D Ransom, KWilson,JSimes,DYip,NTebbutt,CKarapetis,M Fournier, D Ferry, T Price, Clinical Oncological Society of Australia Annual Scientific Meeting, Brisbane, Australia 2012

A retrospective clinical audit comparing neuropathy associated with two different schedules of oxaliplatin in the treatment of metastastic colorectal carcinoma, (Poster),TVien,DYip,ClinicalOncologicalSocietyof Australia Annual Scientific Meeting, Brisbane, Australia 2012

Is there a role for chemotherapy in metastatic colorectal cancer patients with a poor performance


status? (Poster), H Wong, K Field, J Tie, S Kosmider, JShapiro,JMcKendrick,PParente,LLipton,DYip,S Parakh, L Nott, P Gibbs, Gastrointestinal Cancers Symposium, San Francisco, USA 2012

First-line clinical trials and metastatic colorectal cancer: How selected are clinical trial participants? (Poster), K Field, J McKendrick, J Shapiro, J Tie, S Bae, MBurge,DYip,LNott,PGibbs,GastrointestinalCancers Symposium, San Francisco, USA 2012

Metastatic colorectal cancer and management in public versus private hospitals: Similarities and differences (Poster), K Field, J Shapiro, J McKendrick, HL Wong, J Desai, L Lipton, S Kosmider, L Nott, G Stefanou, P Parente, A Zimet, L Lim, R Jennens, DYip,MBurge,PGibbs,GastrointestinalCancersSymposium, San Francisco, USA 2012

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bRIEf SUMMARyThe Academic Unit of Psychiatry and Addiction Medicine has an active and broad research program, covering all aspects of psychiatry across the lifespan. Key areas of research include: population mental health; disasters; climate change; trauma, loss and grief; neuropsychiatry; cognitive neuroscience; health risk perceptions; perinatal mental health and childhood adversity. The team is integrated with Mental Health ACT and provides high level research and policy advice to ACT Health and a range of external organisations. The Unit also oversees the development and research extension of the Australian Child and Adolescent Trauma, Loss and Grief Network (ACATLGN).

STAffProf Beverley Raphael, Director and Professor of Psychiatry and Addiction Medicine

A/Prof Jeffrey C.L. Looi, Deputy Head, Academic Unit of Psychiatry and Addiction Medicine and Senior Specialist

Dr Jeff Cubis, Senior Lecturer and Senior Specialist

Dr Daniel Bonner, Lecturer and Staff Specialist

Dr Melanie Jones, Fellow

Dr Rajeev Kumar, Senior Lecturer and Senior Consultant Psychiatrist

Dr Virginia McAndrew, Lecturer and Staff Specialist

Dr Paul Maguire, Senior Lecturer and Staff Specialist

Dr Raj Parige, Clinical Lecturer, Alcohol and Drug Program

Dr Rebecca Reay, Senior Research Officer and Lecturer

Dr Michael Tedeschi, Lecturer and Staff Specialist, Alcohol and Drug Program

Dr Diana Tracey, Lecturer and Staff Specialist

Mr Michael Woodward, Discipline Principal of Social Work, Mental Health Justice Health Alcohol and Drug Services (MHJHADS)

Dr Peter Norrie, Director of Clinical Services

Dr Zarrar Chowdary, Lecturer, Alcohol and Drug Program

Ms Peggy Craigie, Executive Assistant to Prof Raphael and A/Prof Looi

STUDEnTSMs Margaret Moreton, PhD, Australian National University. Supervisor: B Raphael

Ms Maree Livermore, PhD, Australian National University. Supervisor: B Raphael

Mr Michael Woodward, PhD, Australian National University. Supervisor: B Raphael

Dr Paul Maguire, PhD, Australian National University. Supervisor: B Raphael

Dr Matthew D. Macfarlane, MPhil, Australian National University. Supervisor: J Looi

Ms Fiona A. Wilkes, MPhil/PhD, Australian National University. Supervisor: J Looi

Dr Rosa Molina-Ruiz, PhD, Complutense University, Madrid. Co-supervisor: B Raphael

Ms Daniella Bulic, PhD, UNSW. Co-supervisor: B Raphael

CoLLAboRATIVE ASSoCIATESA/Prof Christer Nilsson, Department of Geriatric Psychiatry, University of Lund, Lund, Sweden

Prof Paul Thompson, Professor of Neurology and Psychiatry, Laboratory of Neuro Imaging, UCLA School of Medicine, Los Angeles, USA

Dr Rosa Molina-Ruiz, Hospital Clinico San Carlos, Complutense University, Madrid, Spain

Prof Lars-Olof Wahlund, Department of Neuro-biology, Division of Clinical Geriatrics, Karolinska Institute, Huddinge, Stockholm.


Dr Olof Lindberg, Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institute, Huddinge, Stockholm

Dr Gabriela Spulber, Department of Neurobiology, Division of Clinical Geriatrics, Karolinska Institute, Huddinge, Stockholm

Dr Leif Svensson, Hospital Physics and Radiology, Karolinska University Hospital, Huddinge, Stockholm

A/Prof Mark Walterfang, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne

Prof Dennis Velakoulis, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne

Prof Louise Newman, Director, Monash University Centre for Developmental Psychiatry and Psychology, Monash University, Victoria

Prof Justin Kenardy, Deputy Director, Centre of National Research on Disability and Rehabilitation Medicine, University of Queensland

A/Prof Brett McDermott, Director, Mater Child and YouthMentalHealthService,Queensland

Mr Mal McKissock, Co-Clinical Director, National Centre for Childhood Grief, NSW

Dr Bruce Shadbolt, Senior Lecturer, Director, Centre for Advances in Epidemilogy and IT, Australian National University Medical School, Canberra Hospital

Dr Ross Wilkinson, Senior Lecturer, Research School of Psychology, Australian National University

Dr Rhiannon Mulcahy, PhD candidate, Psychologist, Research School of Psychology, Australian National University

A/Prof Ng Tze Pin, Director, Gerontological Research Program, Psychological Medicine, National University of Singapore

Prof Kua Ee Heok, Professor of Psychiatry, Psycho-logical Medicine, National University of Singapore

Prof Dilip V. Jeste, Professor of Psychiatry and Neurosciences, Director, Sam and Rose Stein Institute for Research on Aging, UCSD, California, USA

A/Prof Martin Styner, Department of Psychiatry and Department of Computer Science, University of North Carolina, Chapel Hill, USA

Prof Kaarin J Anstey, Professor of Psychology, Director, Centre for Research on Aging, Health and Wellbeing, Australian National University

Prof Nellie Georgiou-Karistanis, Professor of Psychology, School of Psychology and Psychiatry, Monash University

Dr Danielle van Westen, Director, Neuroradiology, Department of Clinical Sciences, Lund University, Sweden

RESEARCH pRojECTSDevelopment and validation of cerebellar segmentation for structural MRI in PSP. To determine if differences are detectable in the volume of the cerebellum (and/or subregions of the cerebellum) on MRI scans of those with progressive supranuclear palsy relative to healthy controls. Correlations to clinical features will be investigated where possible: E Schofield, J Looi, D van Westen, C Nilsson, SYe-GiKim.2012-2014

Cognitive and psychosocial assessment of mechanically ventilated intensive care patients: does an dxperience of delirium make a difference? The aim of this study is to investigate cognitive and psycho-social function of patients who are critically ill and mechanically ventilated in ICU. The proportion of these patients develop ICU delirium, the condition that is promoted as a result of the management of critical illness in ICU, including mechanical ventilation, sedation, multiple medications, combined with patients’ metabolic disturbances, underlying infections and multiple organ failure. ICU delirium may exacerbate existing or introduce new cognitive impairment, including a poor functional and cognitive recovery and or long term cognitive impairment following hospital discharge: D Bulic, F van Haren, J Looi, M Bennett, H Rodgers, E Fulton: 2010-2016

Improving the delivery of Child and Adolescent Mental Health services to children and young people who have been exposed to trauma and adversity. There is strong evidence that adverse childhood experiences (ACEs) contribute to increased vulnerability to mental health problems and disorders in children, adolescents and adults. The aim of the study is to investigate the proportion of children and young people who have experienced potentially traumatic and adverse life events and whether they can be better identified using a simple questionnaire. Ultimately, the project endeavours to improve the recognition, treatment and management of this vulnerable population of children and adolescents: B Raphael, J Cubis, V McAndrew, R Reay, D Riordan, W Preston: 2010-2014

The prevalence of trauma and posttraumatic stress disorder symptoms in mothers attending a perinatal mental health service. This project will investigate the extent to which mothers who attend the Child and


Adolescent Mental Health Service (CAMHS) Perinatal Mental Health Consultation Service and have been exposed to potentially traumatic events and have developed post traumatic stress disorder symptoms. Furthermore, we will follow-up the participants at six-months to investigate factors associated with recovery. The pilot revealed high rates of exposure to potentially traumatic events (57%) and high rates of possible PTSD symptoms (57%) amongst mothers attending the mental health service: R Reay, J Cubis, B Raphael, C Ringland, K Carnall, R Morrison. 2011-2014

Qualitative study of the experiences of dealing with disaster among adults affected by the 2003 Canberra bushfires and the 2004 tsunami in Aceh. Adults affected by the 2003 Canberra bushfire and the 2004 tsunami in Aceh were interviewed to develop an explanatory framework of the processes of dealing by disasters from the perspective of the people affected. This is also the first part of a cross-cultural research project to identify how language, cultural norms, and social constructions determine perceptions and expressions of experiences of dealing with disaster: T Citraningtyas, B Raphael. 2008-2012

Pandemic influenza: risk perception and protective behaviours in people with schizophrenia. The aim of this study was to reduce the negative impact of a pandemic influenza on people with schizophrenia and assist with their preparedness and response planning. A cross-sectional survey was performed during the 2009 “swine influenza” pandemic on their:

1. Use of, and level of trust in, various health information sources,

2. Risk perception

3. Willingness to adopt protective measures and

4. Perceived barriers to carrying out protective measures:

P Maguire, R Reay, B Raphael. 2008-2013

Singapore study of successful aging (SSOSA). This study evaluated the prevalence and correlates of successful aging in 65 years and older Singaporeans living in the community. About 500 subjects comp-leted the survey on questions related to biological, psychological and social aspects of aging. The data are being analysed and papers are currently being published/submitted/prepared: R Kumar, Kua Ee Heok, Ng Tze Pin, D Jeste. 2008-2011

Personality and total health through life (PATH) 60+ study. Longitudinal study started in 2001 to evaluate the risk and protection factors in normal aging, mild cognitive impairment and dementia. This is an ongoing project; so far three waves have been

completed: K Anstey, H Christensen, S Esteal, R Kumar. 2012-2016

Investigation of 3 dimensional shape analysis in the IMAGE-HD cohort. To characterise subcortical shape changes occurring in presymptomatic and symptomatic HD patients compared to controls, and to map the trajectory of these changes over time in each group and their relationship with illness variables: J Looi, F Wilkes, M Walterfang, D Velakoulis, N Georgiou-Karistanis. 2012-2016

Longitudinal volumetry of the striatum in a cohort with leukoaraiosis: a pilot study. The aim of the proposed study is to assess neostriatal (caudate and putamen) volume and shape as a measure of frontostriatal circuit integrity in a cohort of elderly people with leukoaraiosis (diffuse age-related white matter disease), to test whether leukoaraoisis also disrupts these circuits as measured by the occurrence of striatal atrophy: J Looi, M Macfarlane, M Walterfang, D Velakoulis, LO Wahlund, G Spulber, M Crisby, LADIS study group. 2011-2013

Manual segmentation of the striatum in progressive supranuclear palsy and controls. To determine if the morphology of the striatum differs between those with PSP, a disease affecting the frontostriatal neural circuits, and healthy controls; and if so, does morphology relate to clinical features: J Looi, M Macfarlane, C Nilsson, D van Westen, M Walterfang, D Velakoulis. 2010-2011

Automated segmentation of the corpus callosum in frontotemporal lobar degeneration. We are interested in the analysis of corpus callosum shape and correlation with clinical features/differentiation of subgroups. This dataset is comprised of persons with FTLD (36), AD (34) and controls (41) from our collaborators (PI Lars-Olof Wahlund) at the Karolinska Institute (total n=122): J Looi, M Walterfang, E Luders, D Velakoulis, A Toga, P Thompson, LO Wahlund. 2010-2013

Study of the morphometrics and correlates of the neostriatum in neurodegenerative disorders. To assess correlates of morphometric change in the neostriatum (caudate and putamen), hippocampus, cerebellum, corpus callosum and thalamus within the FTLD, CHAC, HD, OCD, NPC, PSP cohorts and healthy controls us structural MRI: J Looi, M Walterfang, D Velakoulis, M Macfarlane, VBaskaran,SYe-GiKim.2008-2017

Emotional regulation in eating disorders. This research has focused on the structural integrity, as measured by volume and shape (morphometry), of the striatum, as a substrate of frontosubcortical neural circuits implicated in the pathophysiology of eating


disorders. Together with Dr Molina-Ruiz, we have been examining striatal morphometric differences among subtypes of eating disorders and healthy controls: R Molina-Ruiz, J Looi, M Diaz-Marsa, Fiona Wilkes, LL Liu. 2010-2014

Hippocampal morphology in temporal lobe epilepsy. This project will develop measures to track disease progress in hippocampal sclerosis as a cause of epilepsy. We will measure the shape of the hippocampus, in persons with epilepsy, to relate the shape measures to the symptoms of the disease, before surgical treatment as clinically indicated. These measures will help in understanding the brain structural basis of symptoms in temporal lobe epilepsy:JLooi,DvanWesten,KKallen,JGYoo.2012-2014

Community recovery after natural disaster. The aim of this research is to focus on the community perspective and experience of natural disaster and community recovery, with a particular emphasis on the community’s perception and understanding of its own recovery. The research will identify and analyse the actions, activities, individuals and groups that emerge from within a disaster affected community after a natural disaster, and will assess how these contribute to that community’s recovery and ongoing resilience: M Moreton, B Raphael. 2012-2016

pRESEnTATIonSFearscapes, Ghettos and resilient urbanisation, B Raphael, 4th Healthy Cities: Making Cities Liveable Conference, Noosa, Australia 2011

Mood disorders section free papers, B Raphael, Chair, scientific session, Royal Australian and New Zealand College of Psychiatrists (RANZCP) Congress Darwin, Australia 2011

The impact on mental health of natural disasters “Implications for policy development and service delivery”, B Raphael, Statewide Mental Health Network, Brisbane, Australia 2011

Novel neuroimaging biomarkers in neurodegenerative and neuropsychiatric disease, J Looi, Invited presentation, Department of Psychiatry, Hospital San Carlos, Madrid, Spain 2011

Neuropsychiatry of frontotemporal lobar degeneration and movement disorders, J Looi, Invited presentation, Department of Psychiatry Hospital Madrid, Spain 2011

The Power of More than One: Facilitating effective postnatal depression support groups, R Reay,

Annual Post and Antenatal Depression Support and Information Inc (PANDSI) Twilight Seminar, Canberra, Australia 2011

Clinical update on frontotemporal lobar degeneration, J Looi, Keynote Presentation, Faculty of Psychiatry of Old Age Meeting, Brisbane, Australia 2011

Differential putaminal morphology in frontotemporal dementia, Huntington’s disease, Alzheimer’s disease, J Looi, Royal Australian and New Zealand College of Psychiatrists New Zealand Annual Meeting, Queenstown, New Zealand 2011

Health Emergency Crisis Intervention Disaster and Health Impacts, B Raphael, University of Peking, Beijing, China 2012

Why don’t mothers go for help? Barriers to treatment for postnatally depressed mothers, R Reay, S Matthey, D Ellwood, poster presentation, International Bienial Congress of the Marce Society (Childbirth and Mental Health), Paris, France 2012

Screening for posttraumatic symptoms in an Australian perinatal mental health consultation service, R Reay, J Cubis, C Ringland, poster presentation, International Bienial Congress of the Marce Society (Childbirth and Mental Health), Paris, France 2012

Psychosis with Obsessive-Compulsive Symptoms and Epilepsy, J Looi, Grand Rounds, Canberra Hospital, Canberra, Australia 2012

AWARDSYoungPsychiatristAward2012-JLooi.Striatalmorphology as a biomarker in neurodegenerative disease. Pacific Rim College of Psychiatrists

Canberra Doctor Award 2012 - J Looi. Editorial board member of Canberra Doctor (ACT AMA) - long term service 2012

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bRIEf SUMMARyChronic Disease Management (CDM) is a multi-disciplinary unit of the Division of Medicine in Canberra Hospital and Health Services (CHHS). The focus of CDM is on improving the management of patients with chronic disease, particularly Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF), Parkinson’s Disease and Obesity. We also undertake project work including management consulting, clinical audits, continuous quality improvement, research activities and evaluations to improve the management of chronic disease across the ACT. CDM comprises of the Chronic Disease Management Unit (CDMU) and the Chronic Care Program (CCP). It also works in close collaboration with the Australian National University Centre for Health Stewardship (The Centre). The Centre is part of the Australian National University College of Medicine, Biology and Environment. The Centre’s mission is to conduct research and teaching to improve the understanding of how health systems are governed, and the relations between this governance and the health of the community. The Centre conducts research and teaching about how health departments are organised and operate to fulfil their roles within the national health system. The Centre also examines the areas of clinical governance and the legal basis of health stewardship.

STAffA/Prof Paul Dugdale, Director, Chronic Disease Management & Australian National University Centre for Health Stewardship

Dr Geetha Isaac-Toua, Deputy Director, Chronic Disease Management

Dr Clare King, Medical Registrar, Chronic Disease Management

Dr Stefan Baku, Medical Registrar, Chronic Disease Management

Dr Rebecca Phillips (neeTaylor), Postdoctoral Fellow,

Australian National University Centre for Health Stewardship

MsJennieYaxley,SeniorProjectOfficer,ChronicDisease Management

Ms Susan Abbott, Project Officer, Australian National University Centre for Health Stewardship

MsYu-YanFang,Research&ProjectOfficer,ChronicDisease Management

Mrs Tanelle Raines, Research & Project Officer, Chronic Disease Management

Ms Amy Vassallo, Research & Project Officer, Chronic Disease Management

STUDEnTSMs Catherine Settle, PhD, Australian National University. Supervisor: P Dugdale

Ms Joy Pettingel, PhD, Australian National University. Supervisor: P Dugdale

Dr Dominic Rubin Gudam, PhD, Australian National University. Supervisor: P Dugdale

Mr Klein Fernandez, Masters Public Health, Australian National University. Supervisor: P Dugdale

Ms Amelia Scott, B. Dietetics, University of Canberra. Supervisor: P Dugdale

Ms Katie Doherty, B. Pharmacy, University of Canberra. Supervisor: P Dugdale

Ms Joanne Laferty, B. Nursing, University of Canberra. Supervisor: P Dugdale

Ms Ashvini Munindradasa, BMBBS, Australian National University. Supervisor: P Dugdale

CoLLAboRATIVE ASSoCIATESDr Judith Healy, Fellow, Australian National University Centre for Health Stewardship, Regulatory Institutions, Network, Research School of Social Sciences, Australian National University

Dr Olivia Jakobs, Visiting Fellow, Australian National University Centre for Health Stewardship, Office of the Principal Medical Advisor, ACT Health

Dr Anne Hogden, Visiting Scholar, Australian National University Centre for Health Stewardship, Centre for

CHRONIC DISEASE MANAGEMENT & ANU CENTRE FOR HEALTH STEWARDSHIP


Clinical Governance, Australian Institute for Health Innovation, University of New South Wales

Dr Bahareh Tahani, Visiting Fellow, Australian National University Centre for Health Stewardship, University of Tehran

Mr Ross O’Donoughue, Visiting Fellow, Australian National University Centre for Health Stewardship, ACT Health

Dr Brian Richards, Visiting Fellow, Australian National University Centre for Health Stewardship, co-supervisor for Robin Guda, Commonwealth Department of Health & Ageing

pRojECTSEvaluating the impact of the `Patient-as-Professional within a Network’ tool to self-manage chronic disease. This project is investigating three significant issues central to interprofessional learning (IPL), chronic disease and patient self-management.

The project aims are:

1. To evaluate the IPL and community-of-practice/ networking outcomes of professionals, including the patient-as-professional;

2. To investigate the use of chronic disease management tools;

3. To examine the health literacy capacity of the patient-as-professional: D Greenfield, P Dugdale, P Nugus, A Short, R Taylor. 2009-2011

Time and chronic disease management. Developing ways of managing chronic disease that are patient centred and focussed on prevention is proving a difficult challenge for contemporary health policy. It is requiring a major reorientation from the mainstream culture and practices of the present health system. To contribute to this reorientation, we proposed to look at time and time use in chronic disease management in order to inform policy responses to the rising tide of chronic disease that exists today. By gaining an understanding of time and its social arrangement in chronic disease management, we hope to make an innovative contribution to the policy dialogue about health system reform for better chronic disease management: P Dugdale, C Phillips, S Abbott. 2010-2011

A study to guide the design and implementation of a chronic disease management register in a regional health service. The National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Patient Safety is researching the use of disease registers to improve health services. As part of this, the research is examining how to best design and

implement a chronic disease management register in a regional health service (ACT Health) to strengthen chronic disease management.

Specific objectives are:

1. To explore the strategic relevance of registers in relation to CDM interventions in a medium size regional health service organisation;

2. To assess the organisation’s capacity and state of readiness to implement a CDM register to facilitate cooperation between services in the provision of patient care and in support of patient self management;

3. To provide insight into the practical development of a CDM register so it will have a positive impact on the health of people with chronic disease. (Thesis Submitted November 2012): P Dugdale, R Guda. 2007-2012

Citizen engagement: listening to citizens’ views about Australia’s health system and prevention. This collaborative project was developed by the Australian Institute of Health Policy Studies and will provide a comparison of three examples of deliberative methods being implemented across the ACT, South Australia and Queensland. The citizen engagement project aims to apply and evaluate innovative deliberative methods for their effectiveness as a tool in health policy development and as a means for collecting information on citizens’ views on health policy issues. The project will generate information about community values, priorities and preferences, in particular, relating to chronic disease management and preventive health policy: P Dugdale, C Settle, B Oldenburg, V Lin, C Joyce, K Eagar, L Segal, A Mutch, J Hartz-Karp. 2009-2012

Serious and continuing illness policy and practice study (SCIPPS). This study will find policy systems solutions that result in health and quality of life improvements for serious and continuing illness sufferers and see a reduction in avoidable hospital admissions. These issues will be examined through a series of interventions and evaluations. The interventions will be developed by the research team working closely and collaboratively with patients and their carers, either directly (for example, patients, doctors, nurses and other clinicians) or indirectly (e.g. health service managers and policy advisers). Patients range in age from 45 to 85 and have one or more of three prototypical serious and continuing conditions - diabetes, congestive heart failure or chronic obstructive pulmonary disease: S Leeder, R Colagiuri, J Gillespie, S Jan, N Glasgow, J Whitworth, R Wells. 2007-2011


Does HbA1c feedback from a Chronic Disease Management Register to treating General Practitioners (GPs) have an impact on the management of diabetes and increase the proportion of patients with poorly controlled diabetes who achieve good control? The CDMU manages a Chronic Disease Management Register (CDMR). CDMR collects information about patients suffering from chronic diseases such as diabetes in the ACT. This information includes HbA1c results from ACT Pathology. Patients identified as having poorly controlled diabetes (i.e. having a recent HbA1c test result of >7%) will be invited to participate in the study. The primary aim of this study is to use practice visits to determine whether correspondence from the CDMU to GPs identifying patients with poorly controlled diabetes has any impact on the management of their patients diabetes (i.e. by altering thinking, ordering a retest, changing advice or changing medication): P Dugdale, A Munindradasa. 2012-2013

Interprofessional learning in primary health care to encourage active patient self-management of chronic disease. This project designed an education package for group leaders of community activities to welcome people with chronic disease into their social and physical activities. This was a collaborative project between the Australian National University Centre for Health Stewardship, the University of New South Wales Centre for Clinical Governance Research, the ACT Division of General Practice and ACT Health.

The aims of the project were:

1. To design an interprofessional education package to enact patient self-management of chronic disease;

2. To resource a self-sustaining interprofessional patient self-management chronic disease network: D Greenfield, P Dugdale. 2008-2011

Training community leaders on how to include people with chronic disease in community activities project. The aim of the project was to progress the original interprofessional learning in primary health care project to a stage where it could be sustained in the ACT community without continual research funding. This project was funded $52, 000 by ACT Health from the 2009 Budget Initiative `Integrated Prevention of Chronic Disease’. Since this time the project has had great success within the ACT community, including working with CIT to deliver the package on an on-going basis to students studying community development, fitness training and other related courses: S Abbott, D Greenfield, P Dugdale, S Baku, A Vassallo. 2011

Development of a chronic disease self management network. The ACT Division of General Practice provided funding of $10,000 to the Centre for Health Stewardship to develop of a Chronic Disease Self Management Network. The aim of this project was to consult with a range of allied health professionals and community sector representatives to determine one or more interprofesssional collaborative activities in the area of chronic disease self-management and to establish an ongoing working group of allied health and community representatives to support these activities: P Dugdale, S Abbott, T Raines. 2011-2012

Chronic disease self-management tools evaluation network. The Centre for Health Stewardship initiated the Chronic Disease Self-Management Tools Evaluation Network (CDSMTEN). It was formed to promote and improve the quality and impact of projects designed to evaluate chronic disease self-management (CDSM) tools. The network primarily operates through a web-based forum. The forum provides the opportunity to share information on CDSM evaluation methods through the use of a discussion forum. Pages have also been included where upcoming events, and useful links and resources can be posted. The forum is now hosted at http://cdsmtenforum.wikispaces.com/ P Dugdale, R Taylor. 2011

pRESEnTATIonSHow do I choose which chronic disease self-management tool to use? Perspectives of clinicians and clients, R Taylor, A Short, P Dugdale, D Greenfield, Occupational Therapy Australia 24th National Conference, Gold Coast, Australia 2011

Strategies consumers use to improve the safety and quality of their healthcare, A Short, R Taylor, P Dugdale, P Nugus, D Greenfield, 28th International Safety and Quality Conference - patient safety - sustaining the global momentum, Hong Kong, China 2011

Patient and clinicians working in partnership: The patient-as-professional, R Taylor, Australian Disease Management Association Conference, Canberra, Australia 2011

Consolidating perspectives on the evaluation of chronic disease self-management tools, P Dugdale, R Taylor, A Short, P Nugus, D Greenfield, Australian Disease Management Association Conference, Canberra, Australia 2011

Masters of Public Health teaching for doctors wanting to do training in public health medicine, P Dugdale, Council of Academic Public Health Institutions Australia conference, Adelaide, Australia 2012


Chronic Disease Management in Canberra Hospital and Health Services, P Dugdale, Australian Disease Management Association Conference, Melbourne, Australia 2012

Review of Selected Obesity Data 2008-2011 Canberra Hospital and Health Services, K Doherty, PDugdale,JYaxley,CanberraHospitalAnnualResearch Meeting, Canberra, Australia 2012

Consumers’ Voice: A qualitative study of patients with obesity and their carers’ experiences within the Canberra Hospital and Health Services, J Latimer, JYaxley,BBrady,PDugdale,CanberraHospitalAnnual Research Meeting, Canberra, Australia 2012

A Literature review investigating the issues and barriers experienced by General Practitioners and other health professionals when engaging families with overweight or obese children, A Scott, PDugdale,JYaxley,CanberraHospitalAnnualResearch Meeting, Canberra, Australia 2012

A Chronic Disease Management Patient and an Audit of Care Planning, P Dugdale, G Isaac-Toua, C King, W Appleton, D Gibson, Canberra Hospital Grand Rounds, Canberra, Australia 2012

Investigating an inter-organisational community based health network, A Short, R Taylor, P Nugus, P Dugdale, D Greenfield, 8th International Organisation Behaviour in Healthcare Conference, Dublin, Ireland 2012

Time use of people with multiple chronic diseases in Australia, T Jowsey, J Gillespie, R Bunton, M Banfield, L Jones, I McRae, P Dugdale, R Taylor, MKljakovic,JMValderas,LYen,WorldCongressonHealthy Ageing, Kuala Lumpur, Malaysia 2012

The Australian Healthcare and Hospitals Association Rural and Remote Health Governance Policy Think Tank, P Dugdale – Facilitator, Canberra, Australia 2012

The Australian Healthcare and Hospitals Association Community and Primary Health Care Policy Think Tank, P Dugdale - Facilitator Melbourne, Australia 2012

Care Coordination for Parkinson’s with Impulse Control Disorder, T Heazlewood, W Appleton, S Wherry, J Ironside, P Dugdale, Australian Disease Management Association Conference, Melbourne, Australia 2012

Development of a Parkinson’s and Movement Disorder Clinical Nurse Consultant Service in ACT, S Wherry, C Das, P Dugdale, J Ironside, B Jones, Parkinson’s Australia National Conference, Brisbane, Australia 2012

Pitfalls in Parkinson’s: A Tale of Two Patients, S Wherry, Southern Medicare Local Conference, Merimbula, Australia 2012

National Health Reform in Rural and Remote Communities: the impact of organisational change and new funding flows, P Dugdale - Facilitator, Canberra, Australia 2012

The Australian Healthcare and Hospitals Association Community and Primary Health Care Policy Think Tank, P Dugdale - Facilitator, Canberra, Australia 2012

The Australian Healthcare and Hospitals Association and Climate and Health Alliance Greening the Health Sector Policy Think Tank, P Dugdale - Facilitator, Sydney, Australia 2012

The Australian Healthcare and Hospitals Association Policy forum: Why has dental health been getting the brush off? P Dugdale - Facilitator, Canberra, Australia 2012

AWARDSViewer’s Choice Poster Award 2012 - Amelia Scott. A Literature review investigating the issues and barriers experienced by General Practitioners and other health professionals when engaging families with overweight or obese children, Canberra Hospital Annual Research Conference

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bRIEf SUMMARyThe Academic Unit of General Practice (AUGP) is involved in, and provides services in, three main areas:

1. Research

2. Education

3. Community service

In relation to research, the AUGP has developed activities that encompass child health, integrated service development, clinical research, individual routes to health and healing, social determinants of medical care, and scholarship in teaching and learning. This report provides an outline of the various research activities undertaken by the AUGP.

The AUGP is both part of the organisational structure of the ACT Health Directorate as well as having strong linkages with the ANU Medical School and the Coast-City-Country Regional Training Program. Accordingly, this overview lists projects that involve all of these institutions.

Specific research projects undertaken include: identifying patient care providers; leadership in General Practice; diagnosis of musculoskeletal problems in General Practice; evaluation of the Benzodiazepine Voluntary Undertaking program; dementia medications in General Practice; practical application of the Glomerular Filtration Rate in General Practice; enhancing vertically integrated General Practice education through understanding the learner’s perspective; assessing learning in the pre vocational General Practice placement program (PGPPP) experience; inter professional learning; how can we best educate GP Registrars in practice management and ownership; increasing the uptake of PAP smears at an urban Aboriginal controlled health service; and forms of address and the doctor-patient relationship.

With the exception of the School Health Check for Kindergarten Children, no other project has direct funding from the ACT Health Directorate. Funding for these projects has been provided primarily by external sources being the ANU and General Practice Education and Training (GPET).

STAffProf Marjan Kljakovic, Director, AUGP

Dr Katrina Anderson, Acting Director, AUGP

Dr Karen Flegg, Senior Lecturer, Australian National University Medical School, Research Nurse, Kindergarten Health Check, Research Manager

Dr Helen Toyne, Lecturer, Australian National University Medical School

A/Prof Jennifer Thomson, Researcher, Australian National University Medical School

Dr Alexander Stephenson, Lecturer, Australian National University Medical School

Dr Elizabeth Sturgiss, Lecturer, Australian National University Medical School

Dr Melanie Dorrington, GP Registrar, AUGP, Australian National University Medical School

Dr Sonia Res, Lecturer, Australian National University Medical School

Ms Emily Haesler, Researcher, AUGP

Ms Karen Ciszek, Research Nurse, Kindergarten Health Check

Ms Lara Bishop, Researcher, AUGP

Mr Carl Brusse, Research Manager, AUGP

STUDEnTMs Kim Biddington, BMBBS, Australian National University. Supervisors: M Sands, K Anderson

CoLLAboRATIVE ASSoCIATESDr Jennifer Bromley, General Practitioner, Private Practice, ACT

Dr Martin Liedvogel, General Practitioner, Private Practice, ACT

Dr Tuck Meng Soo, General Practitioner, Private Practice, ACT

A/Prof Kirsty Douglas, Associate Professor, Clinical Education, Australian National University Medical School

Prof Nicholas Glasgow, Dean of Medicine, Australian National University Medical School

ACADEMIC UNIT OF GENERAL PRACTICE&COMMUNITYHEALTH


Prof Amanda Barnard, Associate Dean (Rural Clinical School), Head, School of General Practice, Rural & Indigenous Health, Australian National University Medical School

Dr Chandi Perera, Rheumatology Staff Specialist, Canberra Hospital

A/Prof Christine Phillips, Associate Professor, Social Foundations of Medicine, College of Medicine, Biology and Environment, Australian National University

Ms Jane Bryson, Associate Researcher

Ms Jane Strang, Chief Pharmacist, ACT Health

Mr Nicholas Baxfield, Medical Student, Australian National University Medical School

Dr Mary-Ann Ryall, Lecturer, Geriatric Medicine, Australian National University Medical School

Dr Kathryn Dwan, Research Fellow, Primary Health Care Research Institute

Dr Kate Molinari, Academic Registrar, Australian National University Medical School

Dr Rod Lambert, Staff Specialist, ACT Health

Ms Sally Hall, Research Manager, Rural Clinical School, Australian National University Medical

Dr Ana Herceg, Medical Officer, Winunga Aboriginal Medical Service

Ms Julie Tongs, Chief Executive Officer, Winunga Aboriginal Medical Service

Dr Marianne Bookalil, Medical Officer, Winunga Aboriginal Medical Service

Dr Mark Sands, Lecturer, Australian National University Medical School

Ms Lesley Piko, Researcher PhD Candidate, Australian National University Medical School

RESEARCH pRojECTSTale of two practices - it’s not just viral URTIs! A review was undertaken of the range of patients and clinical presentations seen by junior doctors in urban general practice over 12 months: K Anderson, S Res, EA Haesler. 2010-2011

Leadership in General Practice. This project seeks to gain an understanding of what general practitioners (GPs) and those who work with GPs know about leadership. The overall goal is to develop a leadership training program for GPs: M Kljakovic, L Bishop, J Bryson, C Brusse. 2009-2011

Diagnosis of musculoskeletal problems in General Practice. The aim of this project is to better understand the diagnosis of musculoskeletal problems in General Practice: M Nguyen, M Kljakovic, D Hurley, C Perera. 2009-2011

Evaluation of the Benzodiazepine voluntary undertaking (BVU) program - a pilot study. The aim of this preliminary evaluation study is to describe and under-stand the day-to-day reality of the Benzodiazepine voluntary undertaking (BVU) program. The study examines what is actually happing in the program and explores different participant’s satisfaction with the program: K Dwan, T Meng Soo, M Kljakovic, J Strang, N Baxfield. 2009-2011

Dementia medications in General Practice. The aim of this project is to identify patterns of use for cholinesterase inhibitors and Memantine in the treatment of AD patients in the ACT and Southern NSW region: H Toyne, M Kljakovic, J Bromley, MA Ryall, S Ashwell, M Robinson, Pharmacist PBS. 2010-2011

The practical application of the estimated Glomerular Filtration Rate (eGFR) in General Practice. This project will look at the often reported but little used test for kidney function, the eGFR test. This value is often abnormal, yet most physicians will not follow up on it as there is nothing that the value will tell them that they do not already know, or not already suspected. We will also be looking to survey physicians in their opinion of the test. We want to see how the test and reported value can be improved so that it is meaningful the majority of the time: M Kljakovic, N Baxfield. 2009-2013

What motivates GPs to teach? This study aims to explore the questions: What motivates GPs to become involved and stay involved with teaching students, interns and registrars? With this knowledge, what can the School of General Practice, Rural and Indigenous Health (SGPRIH) and Coast City Country (CCCT) do to encourage more GPs to teach a range of learners in a vertically integrated practice; to keep GPs teaching?: J Thomson, E Haesler, K Anderson, A Barnard, K Dwan. 2010-2011

Enhancing vertically integrated general practice education through understanding the learner’s perspective. This project aims to explore the impact on learners of the South-Eastern New South Wales and Australian Capital Territory region general practitioner vertical integration (VI) initiative. The ability of an education model to address the needs of the user and achieve competence and confidence in the learner are essential performance indicators. The experiences of, and benefits for students, junior medical officers


and registrars has had minimal focus in the sparse literature evaluating VI. The project seeks to identify the impact of the VI educational experience on participating learners at all levels (medical students, junior medical officers, registrars and supervisors) and encapsulate this data in development of a VI inter-vention. The VI intervention will be delivered and evaluated in participating teaching practices in the region to promote and enhance the experience of learner’s at all stages of the learning continuum: K Anderson, J Thomson, E Haesler, A Barnard, N Glasgow. 2011-2012

Assessing learning in the PGPPP experience. The Prevocational General Practice Placement Program (PGPPP) provides an avenue to expose junior doctors to general practice in their hospital training years. The program therefore lays the foundation from which training doctors can consider general practice as a future career choice and interest for specialty. It is important to evaluate the training experiences provided as part of the PGPPP, particularly in comparison to hospital placement. This research project aims to assess the quality of educational and training experiences provided within the PGPPP and compare the educational experience provided to junior doctors in the PGPPP to those provided within hospital rotations: K Anderson, E Haesler, A Stubbs, K Molinari, R Lambert. 2009-2013

Inter-professional working. Developing and evaluating an educational program to promote teamwork in general practice. Working in general practice increasingly involves inter-professional collaboration, particularly between nurses and doctors. In Australia, the numbers of nurses in general practice has nearly doubled since 2003, and the majority of general practices now have at least one nurse. This rapid increase in nurses in general practice creates both a need and an opportunity to enhance our teaching of inter-professional working for GP registrars, whose professional future is likely to be conducted as members of general practice teams rather than as solo practitioners. This project is investigating the differences in visual conceptualisation between registrars and nurses, how these differences are incorporated in interprofessional education and the effectiveness of different types of collaborative training models: C Phillips, K Anderson, S Hall. 2009-2013

How can we best educate GP registrars on practice management and ownership? At present there is no formal opportunity for GP registrars to acquire skills in practice management and/or practice ownership as a part of their training. Although practice management is part of the Royal Australian

College of General Practitioners curriculum, there are few or no coordinated teaching modules to convey the necessary knowledge through Regional Training Providers for general practitioners in Australia. A recent survey of 63 GP registrar in the Canberra over half (54%) of respondents would like to learn more about how to run a practice during their GP training. This research will explore acceptable and sustainable modes of education delivery for GP registrars who are interested in future practice ownership: E Sturgiss, K Anderson, M Liedvogel, E Haesler. 2012-2013

Increasing uptake of PAP smears at an urban Aboriginal community controlled health service: Translational research. Pap smear rates for Aboriginal and Torres Strait Islander women are low. This is especially concerning given their significantly increased rates of cervical cancer and related mortality compared with other Australians. The measurable rate of Pap smears at our urban Aboriginal Community Controlled Health Service (ACCHS) was 20-25% of adult female clients. Barriers and facil-itators for having Pap smears have been evaluated in many settings, with research showing that addressing these results in short-lived improvements. It has been noted that there are population specific issues that need exploration and response. Methods: A survey was undertaken using convenience sampling. Trans-lational research was implemented with information from previous research at the ACCHS, the survey and a data collection tool used as the knowledge base for PDSA (Plan, Do, Study, Act) cycles. A focus group of health service staff (Aboriginal and non-Aboriginal) decided on changes to implement. These ideas were discussed with a women’s group before being effected: M Dorrington, A Herceg, K Douglas, M Bookalil, J Tongs. 2012-2013

Forms of address and the doctor-patient relationship. This project aims to explore forms of address between patients and general practitioners, and how it impacts upon the doctor-patient relationship via the administration of surveys to patients of general practitioners. In particular, the project will examine how doctors address their patients and whether this influences the patient’s perception of the doctor and the quality of care that they feel they receive. How patients address their doctors and its contribution to the doctor-patient relationship will also be examined: K Biddington, M Sands, K Anderson. 2012

Registrar educational needs for practice management and ownership. Australia has a dwindling GP workforce which results in a workforce shortage unable to meet the primary care needs of Australia. This situation is set to worsen over the


next 5-10 years, with 25% of the medical workforce being over the age of 55. This information highlights the need for effective succession planning for every primary health care providing organisation. Part of the succession planning is the identification of capable person(s) to take over the leadership of the organ-isation, and empowering these people with the skills to make the changeover as smooth as possible. Cen-tral to this are the skills of practice management and practice ownership. This research investigated the current need for practice management education amongst registrars and their level of interest. The findings from this research informed development of recommendations on appropriate educational opportunities and promotion of interest in practice management and long term career planning for GP reg-istrars: K Anderson, M Liedvogel, E Haesler. 2011-2012

General Medical Practitioners: linking life roles, work values and career stage. This pilot project informs a larger study of career decisions which GPs make after working for several years in their chosen profession. The project’s overall aim is to research the connections between work values, stage of career, life roles, gender and age in the decisions GPs make about their clinical work: L Piko. 2010-2011

pRESEnTATIonSBenzodiazepine Voluntary Undertaking (BVU), M Kljakovic, Primary Health Care Research and Information Service (PHCRIS) Conference, Brisbane, Australia 2011

Body Knowledge Project, M Kljakovic, Primary Health Care Research and Information Service (PHCRIS) Conference, Brisbane, Australia 2011

Leadership in General Practice, L Bishop, Primary Health Care Research and Information Service (PHCRIS) Conference, Brisbane, Australia 2011

eGFR, M Kljakovic, Primary Health Care Research and Information Service (PHCRIS) Conference, Brisbane, Australia 2011

Dementia Medications, H Toyne, J Bromley, J Stewart, Primary Health Care Research and Information Service (PHCRIS) Conference, Brisbane, Australia 2011

Career Pathways for General medical Practitioners, Linking Life Roles, Work Values and Career Stage, L Piko, Career Development Association of Australia (CDAA) International Career Conference, Cairns, Australia 2011

long-term icu patients: functional outcomes and health...long-term icu patients: functional outcomes...

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