UNSW in the South West 2011-2013

Never Stand Still Faculty of Medicine South Western Clinical School Acknowledgment of Country We would like to acknowledge the traditional custodians of the lands on which the south western Sydney UNSW campuses are located including the Darug, Gandangara and Tharawal peoples. We offer our sincere respect to Elders both past and present.

Acknowledgments Thank you to all the staff, students and patients who have contributed content to this report.

Photography: Craig Smith, Christopher Shain (2008), Bubblegum Films (2011 and 2012), SnappedbyKai (2012 and 2013) and Photograph My House (2014). DESIGN: Melinda Jenner, P3 Design Studio PRINTING: Fuji Xerox

ISBN 978-0-7334-3520-1

South Western Sydney Clinical School Locked Bag 7103 LIVERPOOL BC NSW 1871 T: +61 2 8738 3844 F: +61 2 8738 3850 E: [email protected] U: http://swscs.med.unsw.edu.au table of contents

03 Short 04 Our 22 Teaching in 36 Research in 152 Staff History of People the South the South UNSW in West West the South West 22 Undergraduate 36 Our Groups Coursework 54 Ingham 26 Ingham Institute Institute for Clinical Skills Applied Medical and Simulation Research Centre 57 Grants 30 Prizes and Awards 63 Postgraduate Students 32 Building Academic 73 Independent Infrastructure Learning Projects and Honours 80 Research Outputs 148 Papers of the Year 02  UNSW in the South West 2011-2013  

Emeritus Professor Ian Webster   Short History of UNSW in the South West  03

Short History of UNSW in the South West

UNSW established its presence in south western Sydney in 1989 following an agreement signed by the Vice Chancellor of UNSW and the Chairman of the Board of the South Western Sydney Area Health Service (SWSAHS). The agreement was to create a teaching Area Health Service and not simply a teaching hospital. It included the public hospitals of Liverpool, Fairfield,B ankstown, Campbelltown and Bowral as well as the associated community and public health services.

In 1990, the first students commenced terms in One of the most important early tasks was south western Sydney as an integral part of their to promote resources to support research fourth year program involving community medicine development. This was achieved through and general medicine and surgery. All of UNSW’s collaboration of academics with the Area medicine students rotated for a period of six weeks Health Service in founding the Health Research and were accommodated on the campuses across Foundation Sydney South West and the Ingham the south west. In 1991, approximately 20 students Institute. There were other initiatives in medicine, were allocated for all of their clinical teaching in cancer, trauma, epidemiology, general practice, fourth, fifth and sixth years. Up to one hundred health services research and psychiatry. students were accommodated in facilities at any time in the south west. The Area Board of Directors were enthusiastic about research and sponsored many community UNSW made a number of appointments including events to raise funds for research. Also, there were professorships in community medicine, pathology joint arrangements with the University of Western (conjoint), psychiatry, medicine, surgery, obstetrics Sydney to share teaching areas and to support and gynaecology and intensive care. The first research. The teaching efforts were supported by UNSW Chair in General Practice was established the establishment of an excellent medical library, a in an academic unit at Fairfield Hospital. This was Clinical Skills Centre and audiovisual resources. followed by appointments of senior lecturers in medicine and surgery and conjoint appointments Since this time, the presence of UNSW in the at senior academic levels in all the disciplines. south west has grown significantly with numerous research groups based at the Ingham Institute The initial organisational steps involved joint for Applied Medical Research and a number of planning and management committees with the academic positions hosted by the hospitals across Area Health Service and within the Clinical School south western Sydney. Staff from south western and establishment of a Clinical School Committee, Sydney play an expanding role in the research a committee for teaching, a Board of Medical output of UNSW Medicine. Studies and a Research Advisory Committee. The Board of Medical Studies was responsible In 2014, the South Western Sydney Clinical School for oversight of undergraduate and postgraduate will celebrate 25 years since the initial agreement education and the Overseas Doctors Training and continues to work with the South Western Program. Sydney Local Health District to further develop academic medicine in south western Sydney In the early period, Clinical School meetings were including large infrastructure investments in the held on different hospital campuses of the Area Ingham Institute, clinical skills and simulation and Health Service so that the whole of the health videoconferencing equipment to connect the service in the south west of Sydney could be part campuses at Kensington and across south western of the new academic enterprise. Sydney.

The transition from purely clinical services to an environment of teaching, research and clinical endeavour was achieved harmoniously. The leadership and collaboration of senior clinicians was outstanding as they welcomed the new academics and specialists to this part of Sydney. 04  UNSW in the South West 2011-2013  

Our People Senior UNSW appointments have been made across a range of disciplines in the south west of Sydney. Here are a few of their stories and a complete list is available on page 152.

Associate Professor Meera Agar 2011, and a project for which she was the chief investigator won the Palliative Care NSW Innovation Meera Agar leads a research in Palliative Care Award. In 2013 she was awarded team in south west Sydney the Early Career Researcher Award from the in palliative care, delirium European Association for Palliative Care for her in advanced illness and work in delirium. clinical trials. Her delirium research programme will contribute significantly Associate Professor Anders Aneman to the evidence base for delirium care in any health Anders Aneman is the Director of ICU Research, care setting; exploring Liverpool Hospital. His research interests include delirium identification monitoring and management of cardiorespiratory and prediction, role of failure in critically ill patients as well as splanchnic psychoactive medication in physiology and pathophysiology. He is involved delirium causation, and also will in several national and international studies as a provide platform to understand clinical clinical investigator, steering committee member decision-making and delirium therapeutics. and data and safety monitoring board member. He has authored and co-authored 95 papers to Meera completed her doctoral thesis in the area of date that have attracted in excess of 1500 citations delirium in advanced cancer in July 2013. She has and he has written seven book chapters. He is a published 60 papers in the peer-reviewed literature, regular reviewer for major international journals in and has had 50 peer-reviewed conference abstracts the field of intensive care medicine and has been accepted in the last seven years. She has received external reviewer for NHMRC and university grants 26 peer reviewed competitive grants since 2008, outside UNSW. which include NHMRC, Department of Health and Ageing, Cancer Council NSW and , and Cancer Institute NSW funding. She is a chief Professor Minoti Apte OAM investigator for the recently announced NHMRC Partnership Centre - dealing with cognitive and Minoti Apte OAM is the associated functional decline in the elderly Director of the Pancreatic with funding of $25m. She is the Chief Research Group which Investigator A for 11 of those projects with has received consistent grants totalling approximately $32m. research support from the National Health Meera is the chief investigator and and Medical Research Chair for ImPACCT: “Improving Palliative Council (NHMRC)/ Care Through Clinical Trials” (NSW Department of Veterans Palliative Care Clinical Trials Collaborative Affairs (DVA) for over 25 Group). She has several roles as part of years. The Group has also the national Palliative Care Clinical Studies received funding from the Collaborative (PaCSCC): Chair of the Trial Australian Research Council Management Committee, and member of both the (ARC) and the NSW Cancer Council. Scientific Committee and Management Advisory Board; and is the site investigator for one of the Minoti is internationally acknowledged as a national clinical sites. leading researcher in the field of alcohol-induced pancreatic injury, and is particularly recognised for In 2011 the South West Sydney Palliative Care her pioneering work in pancreatic fibrogenesis and Clinical Trials Unit that Meera leads won the stromal-tumour interactions in pancreatic cancer. Premier’s Cancer Research She was the first in the world to develop a method to Award for Innovation in Clinical Trials. She won isolate and culture pancreatic stellate cells (PSCs), a the Palliative Care New South Wales Award technique which provided a much needed research for significance in palliative care research in tool for studying the pathogenesis of pancreatic   Our People  05

HIGH IMPACT PUBLICATION Hardy J, Quinn S, Fazekas B, Plummer J, Eckermann S, Agar M, Spruyt O, Rowett D, Currow DC. Randomized, double-blind, placebo-controlled study to assess the efficacy and toxicity of subcutaneous ketamine in the management of cancer pain. J Clin Oncol. 2012 Oct 10;30(29):3611-7. doi: 10.1200/JCO.2012.42.1081. Epub 2012 Sep 10.

PURPOSE: The anesthetic ketamine placebo-controlled phase III trial, < .001) and throughout the study. is widely used for pain related to ketamine or placebo was delivered Those receiving ketamine were cancer, but the evidence to support subcutaneously over 3 to 5 days. more likely to experience a more its use in this setting is weak. This severe grade of adverse event per study aimed to determine whether RESULTS: In all, 185 participants day (odds ratio, 1.09; 95% CI, 1.00 ketamine is more effective than were included in the primary to 1.18; P = .039). The number of placebo when used in conjunction analysis. There was no significant patients needed to treat for one with opioids and standard adjuvant difference between the proportion additional patient to have a positive therapy in the management of of positive outcomes (0.04; 95% CI, outcome from ketamine was 25 chronic uncontrolled cancer pain. -0.10 to 0.18; P = .55) in the placebo (95% CI, six to ∞). The number Ketamine would be considered of and intervention arms (response needed to harm, because of net benefit if it provided clinically rates, 27% [25 of 92] and 31% [29 toxicity-related withdrawal, was six relevant improvement in pain with of 93]). Pain type (nociceptive v (95% CI, four to 13). limited breakthrough analgesia and neuropathic) was not a predictor of acceptable toxicity. response. There was almost twice CONCLUSION: Ketamine does the incidence of adverse events not have net clinical benefit when PATIENTS AND METHODS: In worse than baseline in the ketamine used as an adjunct to opioids and this multisite, dose-escalation, group after day 1 (incidence rate standard coanalgesics in cancer double-blind, randomized, ratio, 1.95; 95% CI, 1.46 to 2.61; P pain.

fibrosis. The international recognition of her work is Committee of the Gastroenterological Society of reflected in the more than 3400 citations of her papers, Australia from 2008-2013. In 2011, she was invited in the invitations that she has received to speak at as the Comfort Visiting Professor at the Mayo Clinic, meetings worldwide and in the travel and research Rochester USA. She was made a Fellow of the awards that she has received including the prestigious American Gastroenterology Association in February Frank Brooks Memorial lectureship by the American 2011, in recognition of her leading contribution to Pancreatic Association in 2012 and the Distinguished pancreatic research. Research Prize in 2013 from the South Western Sydney Clinical School, UNSW. Most recently, in June 2014, She has been a member and Deputy President of she was awarded the Order of Australia Medal (OAM) the Animal Care and Ethics Committee of UNSW. for her services to medical research, tertiary education She has actively contributed her services to the and the Indian community. University in her positions (2008-2011) as Presiding Member of the Faculty of Medicine, Chair of Minoti is Editor-in-Chief of the journal Pancreatology the Faculty Board, Chair of the Faculty Standing and a member of the Editorial Boards of several Committee, Chair of the Higher Degree Committee eminent journals in the digestive diseases field and member of the UNSW Academic Board and including Gastroenterology (as International continues to serve as Postgraduate Research Consultant), American Journal of Physiology, Coordinator for the South Western Sydney Clinical Journal of Gastroenterology and Hepatology School of UNSW. and World Journal of Gastroenterology. She is a founding member and Past President of the Australasian Pancreatic Club (established in 2002 Professor Bryanne Barnett AM to provide a forum for clinicians and scientists with research interests in pancreatic pathobiology), a Bryanne Barnett AM is a conjoint Professor in the founding member of the Asian Oceanic Pancreatic School of Psychiatry at UNSW, where she previously Association (an organisation committed to fostering held the Chair of Perinatal and Infant Psychiatry. She research and education in the pancreas in the is currently Clinical Director of the St John of God Asia-Oceanic region), a member of the Biological Health Care Raphael Centre (perinatal and infant Subcommittee of the Australian Gastrointestinal mental health service) at Blacktown, NSW. Trials Group (AGITG) and served on the Research 06  UNSW in the South West 2011-2013  

Her key interest in mental health is early Applied Sciences of Oncology for the International intervention, prevention and health promotion to Atomic Energy Agency that has been downloaded enhance the well-being of infants, children and over 2500 times. their parents. To that end, she has established various collaborative programs and services In 2000, Michael received a Professional aiming to identify problems and promote resilience Excellence Award from the New South Wales in primary care and then to provide relevant Cancer Council, Australia, for his work in secondary specialised services. professional education. During 2007, he was appointed as the Rohan Williams Traveling Her research program, developed since her MD Professor by the Royal College of Radiologists, thesis on ‘Maternal Anxiety and its Effects on London, completing a month long lecture tour of Parenting and Child Development’, continues to the United Kingdom in September of that year. focus on developing our understanding of the Michael Barton was awarded a Medal in the place of anxiety and depression in women’s lives; Order of Australia in June 2007 for his service attachment and intergenerational transmission to medicine, particularly radiation oncology, of patterns of behaviour, and early intervention through a range of clinical, research, education strategies. and professional development roles. In 2012, he received the Medical Oncology Group of Australia- Bryanne was for many years a Director and Novartis Oncology Cancer Achievement Award. then Chair of the Board at Karitane. She is a foundation member and Past President of the In 2014 he was appointed the Rouse Travelling Australian Association for Infant Mental Health, Fellow by the Royal Australian and New Zealand the Australian Society for Psychosocial Obstetrics College of Radiologists. and Gynaecology and the Australian Branch of the Marcé Society. She has also been President of the International Marcé Society. She established Professor Christophe Berney the Department of Infant, Child and Adolescent Psychiatry in Sydney’s south west. Christophe Berney is a general surgeon with wide expertise in minimally invasive surgery, especially In 2007, Bryanne was awarded Membership of the in groin hernia repairs. Since his appointment as Order of Australia in recognition of her services to a Visiting Medical Officer at Bankstown-Lidcombe women, families and the profession. Hospital in 2002, Christophe has continued to develop and implement new techniques in the field of advanced laparoscopic surgery and has Professor Michael Barton OAM been at the forefront of practice in a number of areas including the laparoscopic mesh repair of Michael Barton OAM is Professor of Radiation complex abdominal wall or paraoesophagheal Oncology at UNSW, and Research Director of the hernias, but also in the successful implementation Collaboration for Cancer Outcomes Research and of routine laparoscopic appendectomies since Evaluation (CCORE) at Liverpool Hospital. He is 2003, emergency laparoscopic adhesiolysis for the Research Director of the Ingham Institute of small bowel obstruction, laparoscopic Hartmann’s Applied Medical Research which has constructed procedure for perforated diverticulitis or a new five-storey research building, clinical skills laparoscopic repair of perforated peptic ulcer, to and simulation centre and one of the world’s name a few. first MRI-guided research linear accelerators at Liverpool. Christophe has one of the world’s largest series on laparoscopic repair of inguinal hernia using Professor Barton has been involved in state, exclusively fibrin glue for mesh fixation, with over national and international strategic planning 900 cases successfully completed. As Supervisor projects for cancer services. These studies have of Surgical Education and Training for General included the Victorian Cancer Services Framework Surgery, and Committee Member of the New South Report, the Papua New Guinea Cancer Services Wales Regional Board in General Surgery, he has a Report and feasibility studies for radiotherapy strong interest and commitment to the teaching of services in Darwin and in Burnie . laparoscopic skills to our surgical trainees, but also He currently chairs the National Brain Tumour internationally. Guidelines Committee of the Australian Cancer Network which published the first Australian Since being awarded a PhD from UNSW in 1999 guidelines for professionals in 2009 and a patient for research into predictors of liver metastasis and carer version in 2011. in sporadic colorectal cancer, Christophe has maintained strong links with the academic world Michael has a strong track record in of surgery. He still offers his services to UNSW undergraduate and postgraduate education. He through his role as Coordinator of Undergraduate has developed a distance learning course in the   Our People  07

Surgical Teaching at Bankstown-Lidcombe students, paediatric registrars, health service Hospital, and also with his ongoing contribution to employees and research staff. She has made publications in peer-reviewed journals and national a significant contribution to the development of and international surgical conferences. the Centre’s research profile. She has strong methodological and statistical expertise in He is an associate member of the Australian and longitudinal, interventional and cross-sectional New Zealand Endocrine Surgeons, and serves as research methods, in the use of population health a member of several societies including General data collections for research, and in record linkage Surgeons Australia, European Hernia Society, using both probabilistic and deterministic linkage. European Association for Transluminal Surgery, European Association for Endoscopic Surgery and Elizabeth’s research program ‘access to quality the Obesity Surgery Society of Australia and New PHC’ is the overarching focus of her personal Zealand. research. She works with population health data collections to develop methodological approaches, identify measures of quality PHC, and identify Professor Daniel Chan barriers and facilitators to access to PHC with a strong focus on equity and the social determinants Daniel Chan is the Director of Aged Care and of health. Rehabilitation at Bankstown-Lidcombe Hospital and a conjoint Professor of Geriatrics with the Professor Comino is also the foundation leader South Western Sydney Clinical School as well as of the Gudaga Research Program a nationally School of Public Health and Community Medicine. significant study of healthy early childhood among Daniel has multiple qualifications which support his urban children living in an urban community. This current roles – as a manager, a staff specialist and research has received continuous research funding an enthusiastic medical researcher. from the NHMRC and ARC as well as infrastructure support from SWSLHD and Tharawal Aboriginal He has broad research interests ranging from Corporation since 2003. The research began basic science to health care service related topics. as a result of community concerns about the One of Daniel’s main interests is investigating health needs of their children, identified through molecular aspects of the neurobiology of discussions with the community about the issues Parkinson’s disease and vascular dementia. He is they needed addressed to provide opportunities one of the lead investigators for an international for themselves and their families. The program drug trial on vascular dementia. The pilot study began life as a cohort study, and has flourished to was conducted at Bankstown with promising now include the first study of the impact of early results. Other national and international life events on transition to school, an intervention collaborations have been established for studies study exploring impact of sustained nurse home of stroke, falls and dementia. International visiting and a dissemination and implementation research links include China and Hong Kong. program. The study demonstrates the importance He has over 130 peer reviewed publications and of engaging the Aboriginal community in the have published two books. The third edition of his research process from the early beginnings. textbook on geriatrics is underway and the first two editions have been translated and published Elizabeth is the inaugural Director of the Primary in Chinese by Peking University Medical College and Community Health Research Unit (PCHRU) Press. in south west Sydney. PCHRU was established in 2010 and aims to generate research evidence for community health services and translate this Associate Professor Elizabeth Comino evidence into policy and practice. She contributes her expertise to the academy Elizabeth Comino is a leading community and as a reviewer for competitive grants such as the primary health care (PHC) researcher in Australia. NHMRC and regularly reviews contributions to the She is an epidemiologist with the Centre for scholarly literature for a number of national and Health Equity Training Research and Evaluation international journals. She has widely published (CHETRE), a member of the Ingham Institute for in the academic literature. During 2002 Elizabeth Applied Medical Research, and part of the Centre was awarded a Churchill Fellowship and used for Primary Health Care and Equity (CPHCE), this opportunity to study primary care research UNSW. networks and research methods in the United Kingdom. She continues to participate in the Elizabeth leads or participates in a wide range of Churchill Trust activities and is currently the research and evaluation activities within CHETRE; president of the Churchill Fellows Association in provides supervision, mentoring and support NSW. in research, statistical, and epidemiological methods to undergraduate and postgraduate 08  UNSW in the South West 2011-2013  

Professor David Davies Professor Geoff Delaney

David Davies is currently Director Teaching and Geoff Delaney is the Training for New South Wales Health Pathology Director of Cancer having taken up this position from 1st January Services for the South 2014 and has been a conjoint Professor West Sydney Local of Pathology at UNSW since 1995. From Health District and February 1990 until December 2004 he was conjoint Professor Director of the South-Western Area Pathology of Radiation Service (SWAPS) and from January 2005 until Oncology at UNSW. December 2013 he was Co-director of Sydney Geoff has also South West Pathology Service. He continues as been a member Senior Staff Specialist in Pathology concurrently or Chair of many with his new position in New South Wales Health committees involved Pathology. with radiotherapy service delivery at a national and Having studied medicine at the University of international level. Liverpool in the United Kingdom (UK), David has held a number of academic and clinical Geoff also chaired the NSW Cancer Institute appointments in the UK, and NSW. David Clinical Cancer Registry Steering Committee. His is a member of the Panel of Advisers for the main clinical and research interests include breast Health Care Complaints Commission (HCCC) of and lung cancer, effective models in radiotherapy NSW and a councillor on the Australian Council treatment service delivery, patterns of care and the on Healthcare Standards (ACHS). He has also role of information technology in radiation oncology. made a significant contribution to the development of the pathology elements of Phase 3 in the New Medicine Program at UNSW. Professor Hugh Dickson

David has a number of research interests including Hugh Dickson is Director of Ambulatory Care (PIXI) the pathogenesis of renal medullary necrosis and at Liverpool Hospital, a service supporting outpatient its relationship to the cortical lesion of chronic and domiciliary medical procedures, investigations interstitial nephritis; mechanisms of proteinuria and infusions. He has a particular interest in with particular reference to protein overload neuropathic foot disease and lower limb ulceration. proteinuria; and immunopathology, particularly that of necrotising glomerulonephritis and small He is a collaborating researcher with the Braeside vessel vasculitis. In 1981, David was the first to Rehabilitation Research Group which focuses recognise cytoplasmic anti-neutrophil cytoplasmic on basic measurement in rehabilitation and the antibody (cANCA) in microscopic polyarteritis psychometric properties of measurement scales. nodosa. This has now become a test in general He is currently assisting in a project with the WHO use internationally for diagnosis of small vessel to develop a core set for amputees using the vasculitis. International Classification of Functioning, Disability and Health. Since 2004 he has been Chair of the National Quality Assurance Program in Anatomical He has served two terms as President of the Pathology provided by RCPA Quality Assurance Australian Faculty of Rehabilitation Medicine and Programs Pty Ltd and has retired from this positon as a member of the Board of Directors of the Royal in September 2014. As a consequence of this Australasian College of Physicians. He has been activity he was responsible for introduction of Chairman of the Human Research Ethics Committee Whole Slide Imaging (Digital microscopy) for use of the South Western Sydney Local Health District, in quality assurance and has developed methods as well as being a member of Hospital and District for evaluation of professional performance in in administrative committees. diagnostic histopathology.

In recognition of his efforts, David was awarded Associate Professor Rebecca Dignan the Centenary Medal in 2003 for services to Australian society and medicine, in 2011, the Rebecca Dignan is a senior staff specialist in UNSW Faculty of Medicine named David the Cardiothoracic Surgery and Supervisor of Training Overall Conjoint Tutor of the Year in recognition of with an active practice at Liverpool Hospital. She his commitment to training medical students, junior has supervised medical students during their doctors and senior staff. In 2012 he received the cardiothoracic surgery rotation since 2004, including Distinguished Fellow Award of the Royal College supervision of a student independent learning projects of Pathologists of Australasia for his activities in into pain and chronic pain after cardiothoracic surgery teaching, research, professional practice and and tests to predict bleeding after cardiac surgery. administration.   Our People  09

Rebecca has been the principal investigator for Living with Autism. She has published over of a recently completed large, multicentre 150 peer reviewed journal articles as well as 5 controlled trial into patient home testing and self books, 15 book chapters and over 100 conference management of warfarin in collaboration with the abstracts. , National Health and Medical Research Council Clinical Trials Centre and Baird Institute. This trial was supported by industry and a Associate Professor John Eastwood grant from the Australian and New Zealand Society of Cardiothoracic Surgery. The data have been John Eastwood is the Area Director of Community presented and published internationally. Paediatrics for the Sydney Local Health District (SLHD); Chair of the Early Years Research Group; Rebecca has also actively contributed to the Conjoint Associate Professor of Community Child University by lecturing on cardiac surgery and as Health, School of Women’s and Children’s Health, an examiner. She has also supervised honours UNSW; Adjunct Associate Professor, Menzies students whose work has been the basis for Centre for Health Policy, School of Public Health, presentations and manuscripts. , Adjunct Associate Professor, School of Public Health, Griffith University, Queensland, Visiting Paediatrician at Professora V lsamma Eapen the Children’s Hospital at Weastmead and Visiting Academic at the Sydney Children’s Hospital. Valsamma Eapen is Professor & Chair of Infant, Child and Adolescent Psychiatry at the University For the last 20 years John has worked as a of New South Wales (UNSW) and Head of the Senior Health Executive, Public Health Physician, Academic Unit of Child Psychiatry, South West Development Advisor, and Population Child Health Sydney (AUCS) based at Liverpool. Specialist. As Principal Public Health Advisor to the New Zealand Ministry of Health and Director Valsa is known internationally for her research on of Public Health Programmes for the New Zealand neurodevelopmental disorders such as Tourette Public Health Commission, John provided Syndrome and autism. As a child psychiatrist, national level policy advice on public health her other areas of research interest include matters including: general practice and primary neurobiological underpinnings of attachment and care, maternity services, health system reform, separation anxiety disorder as well as metabolic legislative reform, nutrition and food administration, syndrome in adolescents. health promotion, injury prevention, cancer control, crime prevention, screening and immunisation. She is a member of the Executive Committee of the International Neuropsychiatric Association John has represented New Zealand at the World (INA), Founding member of the Australasian Health Assembly and provided technical advice to Society for Autism research (ASfAR); member of the WHO on health promotion and child health and the bi-national committee of the Australia New development. His international development work Zealand Society of Social Psychiatry, Scientific has included primary healthcare, reproductive Advisor to Rett Syndrome Association, India, health, health system institutional strengthening, Medical Publicity Liaison Officer for the Tourette and maternal, child and youth programme delivery Syndrome Association Australia, Member of the in China and the Pacific. Editorial Board of the Journal “Autism Research and Treatment”, Deputy Editor for Asian Journal Since 2003 John has provided leadership to of Psychiatry and Academic Editor for PLOS the design, implementation and evaluation of a ONE; Member of the Working Party on Early number of child public health initiatives including: Developmental Impairment (McGill University, four sustained nurse home visiting programmes, Canada), Member of the Cochrane Developmental, perinatal coordination services, place-based Psychosocial and Learning Problems Group, and initiatives in disadvantaged communities, and Sentinel Reader for the McMaster Online Rating of parenting education and support programmes. Evidence. John’s medical training was at the University of Valsa is also a member of several research Auckland and he has postgraduate diplomas consortia including the Obsessive Compulsive of community health and child health from the Foundation Genetics Collaborative, Psychiatric University of Otago and Masters of Public Health Genomics Consortium, and Autism Homozygosity and Health Management from the University of Mapping Collaborative. New South Wales. John is a Fellow of the Royal Australasian College of Physicians, Fellow of the Professor Eapen holds both Australian Research Australasian Faculty of Public Health Medicine, Council (ARC) and National Health & Medical and Foundation Fellow of the New Zealand College Research Council (NHMRC) grants and is a project of Public Health Medicine. He serves on several theme leader for the Cooperative Research Centre professional college committees including: as 10  UNSW in the South West 2011-2013  

NSW Regional Chair of the Faculty of Public Health Information Audit and Benchmarking initiative Medicine, and as a member of the Chapter of (ANDIAB), that collated diabetes data from Community Child Health and NSW and ACT State specialist diabetes services in Australia and Committees of the RACP. benchmarks results for participants to review their process and outcomes data with peers. ANDIAB John has recently been invited to be on the ran as a pilot in 1998 and again in 1999, 2000, Executive Board of the International Society of 2002, 2004, 2006, 2009 and 2011. ANDIAB2 (a Social Paediatrics. John’s research interests are in more ‘education and patient self-care focussed’ realist research methods, social epidemiology, and initiative than the ‘medically focussed’ ANDIAB), public health policy and programmes including ran as a pilot in 2005, and subsequently in 2010 injury prevention and primary preventative and 2012. child youth and family health. His doctoral and postdoctoral research is in the field of critical Jeff chaired the National Diabetes Data Working realist mixed method social epidemiology with Group (NDDWG) until 2012, the Advisory a focus on the intergenerational, developmental Committee to the National Centre for Monitoring and social determinants of disadvantage and Diabetes (incorporating the National Diabetes psychopathology. Register) at the AIHW and is a former President of the Australian Diabetes Society (2004-2006).

Professor John French Professor Afaf Girgis John French has been Director of Cardiovascular Research since 2004, and is the director of the Afaf Girgis is the Director of the Psycho-Oncology Coronary Care Unit at Liverpool Hospital; he is a Research Group, Ingham Institute for Applied conjoint Professor at UNSW. After basic physician Medical Research, South Western Sydney Clinical training, he undertook a PhD at the University School, UNSW; and Conjoint Professor at the of Adelaide, further cardiology training at Green University of Western Sydney, Honorary Professor Lane Hospital New Zealand and a Wellcome Trust in the School of Medicine at the University of Postdoctoral Fellowship at University College Queensland and Adjunct Professor in the School of London, UK. Prior to arriving in Sydney, John Psychology at Griffith University. was appointed to Green Lane Hospital and the University of Auckland from 1992-2003. He Afaf has worked for more than 25 years as a has been an investigator and co-investigator in Behavioural Scientist in cancer control and psycho- numerous randomised controlled trials and was oncology. Her national and international standing on the steering committees of the SHOCK, OAT, in behavioural science and psycho-oncology HERO-2 and CRISP-AMI trials. He has also served was acknowledged in 2012 with the award of the on the clinical endpoints committees (CECs) of Clinical Oncology Society of Australia (COSA) several major trials. Inaugural Psycho-oncology Award.

Professor French is the medical co-Chair of the ACI Afaf has published 157 peer-reviewed papers; cardiac network of NSW, and has just finished his 80 peer-reviewed abstracts since 2003, three 3 year term as Chair of the clinical trials council book chapters, co-edited one book and 83 of The Cardiac Society of Australia and New commissioned reports. Many of her publications Zealand (2011-4). He has co-authored more than are in leading psycho-oncology and public 170 peer-reviewed publications and over 250 short health journals, with more than 5760 citations communications. John’s current research interests of her research. Other key publications include include the acute coronary syndromes especially psychosocial chapters of a number of national ST elevation MI, diabetes and coronary heart clinical practice guidelines; the first national disease, and cardiac biomarkers especially high Palliative Care Needs Assessment Guidelines; and sensitivity troponins. communication skills training modules for national training programs.

Afaf has attracted more than $38.1 million Associate Professor Jeff Flack of research funding, successfully applying for 126 grants (including 14 NHMRC grants) Jeff Flack is a Senior Staff Specialist and consultancies. Her work has increasingly Endocrinologist and Director, Diabetes Centre focused on health service research, translation of Bankstown-Lidcombe Hospital. evidence into policy and practice and improving Jeff’s main area of clinical research interest is in needs based care. She also has a demonstrated information technology applications in Medicine, track record of effective engagement with especially data sets and quality audit initiatives service providers, end-users of research and involving diabetes data collection, analysis and the community, to ensure the relevance and reporting. He developed (with Professor Stephen acceptability of interventions aimed at improving Colagiuri) the Australian National Diabetes cancer care and outcomes.   Our People  11

HIGH IMPACT PUBLICATION

Patel MR, Smalling RW, Thiele H, Barnhart HX, Zhou Y, Chandra P, Chew D, Cohen M, French J, Perera D, Ohman EM. Intra-aortic balloon counterpulsation and infarct size in patients with acute anterior myocardial infarction without shock: the CRISP AMI randomized trial. JAMA. 2011 Sep 28;306(12):1329-37. doi: 10.1001/jama.2011.1280. Epub 2011 Aug 29.

CONTEXT: Intra-aortic balloon MAIN OUTCOME MEASURES: proximal left anterior descending counterpulsation (IABC) is an Infarct size expressed as a Thrombolysis in Myocardial adjunct to revascularization in percentage of left ventricular Infarction flow scores of 0 or patients with cardiogenic shock (LV) mass and measured by 1 (46.7% [95% CI, 42.8% to and reduces infarct size when cardiac magnetic resonance 50.6%] vs 42.3% [95% CI, placed prior to reperfusion in imaging performed 3 to 5 38.6% to 45.9%], respectively; animal models. days after PCI. Secondary difference of 4.4% [95% CI, end points included all-cause -1.0% to 9.7%], P = .11; imputed OBJECTIVE: To determine death at 6 months and vascular difference of 4.8% [95% CI, if routine IABC placement complications and major -0.6% to 10.1%], P = .08). At 30 prior to reperfusion in patients bleeding at 30 days. Multiple days, there were no significant with anterior ST-segment imputations were performed for differences between the IABC elevation myocardial infarction missing infarct size data. plus PCI group and the PCI (STEMI) without shock reduces alone group for major vascular myocardial infarct size. RESULTS: The median time complications (n = 7 [4.3%; from first contact to first 95% CI, 1.8% to 8.8%] vs n = 2 DESIGN, SETTING AND coronary device was 77 [1.1%; 95% CI, 0.1% to 4.0%], PATIENTS: An open, multicenter, minutes (interquartile range, respectively; P = .09) and major randomized controlled trial, the 53 to 114 minutes) for the IABC bleeding or transfusions (n = 5 Counterpulsation to Reduce plus PCI group vs 68 minutes [3.1%; 95% CI, 1.0% to 7.1%] Infarct Size Pre-PCI Acute (interquartile range, 40 to 100 vs n = 3 [1.7%; 95% CI, 0.4% Myocardial Infarction (CRISP minutes) for the PCI alone group to 4.9%]; P = .49). By 6 months, AMI) included 337 patients with (P = .04). The mean infarct size 3 patients (1.9%; 95% CI, 0.6% acute anterior STEMI but without was not significantly different to 5.7%) in the IABC plus PCI cardiogenic shock at 30 sites between the patients in the group and 9 patients (5.2%; in 9 countries from June 2009 IABC plus PCI group and in the 95% CI, 2.7% to 9.7%) in the PCI through February 2011. PCI alone group (42.1% [95% alone group had died (P = .12). CI, 38.7% to 45.6%] vs 37.5% INTERVENTION: Initiation [95% CI, 34.3% to 40.8%], CONCLUSIONS: Among of IABC before primary respectively; difference of patients with acute anterior percutaneous coronary 4.6% [95% CI, -0.2% to 9.4%], STEMI without shock, IABC plus intervention (PCI) and continuation P = .06; imputed difference of primary PCI compared with PCI for at least 12 hours (IABC plus 4.5% [95% CI, -0.3% to 9.3%], alone did not result in reduced PCI) vs primary PCI alone. P = .07) and in patients with infarct size.

Professor Girgis has a very strong commitment to Professor Ian Harris teaching, student supervision and mentoring junior researchers; and she has supervised eight PhD Ian Harris is a Clinical and five masters students to completion. Early to Academic based at Liverpool mid-career researchers whom she has mentored Hospital and the South have been awarded Postdoctoral Research Western Sydney Clinical Fellowships. School of UNSW. He is the Her contribution to the broader research Professor of Orthopaedic community includes appointments to undertake Surgery and holds other area- independent scientific reviews of cancer control wide administrative, research programs and behavioural research centres in and clinical positions. Professor Australia and New Zealand. Harris’ research activities are based at Liverpool Hospital and involve clinical research in the field of surgery and clinical epidemiology including multi-centre randomised trials, systematic reviews and patient outcome studies. 12  UNSW in the South West 2011-2013  

Associate Professor Liz Harris internationally for her work on the use of Equity Focussed Health Impact Assessment and recently Elizabeth Harris was the Foundation Director of completed a bibliography on health equity for the Centre for Health Equity Training, Research and Oxford University Press. Evaluation (CHETRE) at Liverpool from 2000- 2011 and is currently the Director of the Sydney Local Health District Health Equity Research and Professor Ken Hillman Development Unit that also sits within the Centre for Primary Health Care and Equity at UNSW. Ken Hillman is Professor of Intensive Care at the South Western Sydney Clinical School, UNSW and She has a strong interest in understanding the Director of the Simpson Centre for Health Services causes of health inequity and action that can be Research. taken to reduce their impact. This includes work on health impacts of unemployment, Aboriginal child Ken remains a practising Intensive Care clinician health, working in disadvantaged communities and which complements his main research interest use of health Impact assessment. She has held which is health services research – developing and $4.5m in Category A funds and $5.5m in Public evaluating new and innovative ways of practising Health Research Capacity Building funds. She health care. Ken has active research interests published extensively in peer review journals. Her in areas such as recognising and responding co-authored book ‘Theory in a Nutshell: a guide to seriously ill hospitalised patients in a timely for Health Promotion Practitioners’ is in its fourth fashion and improving the end-of-life care in edition and translated into at least four languages. acute hospitals. He has published over 140 peer reviewed papers, written 59 chapters, co-written For five years she led the NSW Health Impact and co-edited four textbooks, written a book – Assessment (HIA) Development Project and is Vital Signs: Stories from Intensive Care and has currently the convenor of the International Union of received over $18 million in peer-reviewed grants. Health Promotion and Education’s Global Working Group on HIA. Liz is recognised nationally and

HIGH IMPACT PUBLICATION

Boyes AW, Girgis A, D’Este CA, Zucca AC, Lecathelinais C, Carey ML. Prevalence and predictors of the short-term trajectory of anxiety and depression in the first year after a cancer diagnosis: a population-based longitudinal study. J Clin Oncol. 2013 Jul 20;31(21):2724-9. doi: 10.1200/JCO.2012.44.7540. Epub 2013 Jun 17.

PURPOSE: Few studies have 2) postdiagnosis. Anxiety and depression (87%). While examined psychological depression were assessed psychological morbidity at Time adjustment for cancer survivors by the Hospital Anxiety and 1 was the strongest predictor of in late treatment and early Depression Scale with cases psychological morbidity at Time survivorship stages. Our study identified by a subscale cutoff 2, being diagnosed with lung investigated the prevalence and score ≥ 8. Logistic regression cancer and health risk behaviors short-term trajectories of anxiety, analyses identified Time 1 (smoking, insufficient physical depression, and comorbid characteristics associated with activity) were also strong anxiety-depression among adult anxiety and/or depression at predictors. cancer survivors, and identified Time 2. the individual, disease, health CONCLUSION: Targeted behavior, psychological, and RESULTS: The point prevalence psychological screening of social predictors of chronic and of anxiety (Time 1, 22%; Time vulnerable survivors and early late psychological morbidity. 2, 21%), depression (13% at intervention may prevent the both timepoints) and comorbid onset and/or reduce the severity METHODS: A heterogeneous anxiety-depression (9% at both of psychological morbidity in sample of adult cancer survivors timepoints) was similar at 6 early survivorship. Trials of risk was recruited from two state- and 12 months postdiagnosis. reduction interventions targeting based cancer registries. A total The most prevalent Time 1 to psychological functioning and of 1,154 survivors completed Time 2 trajectory was noncase health risk behaviors seem self-report questionnaires at 6 for anxiety (70%), depression warranted. (Time 1) and 12 months (Time (82%), and comorbid anxiety-   Our People  13

HIGH IMPACT PUBLICATION

Balogh ZJ, Reumann MK, Gruen RL, Mayer-Kuckuk P, Schuetz MA, Harris IA, Gabbe BJ, Bhandari M. Advances and future directions for management of trauma patients with musculoskeletal injuries. Lancet. 2012 Sep 22;380(9847):1109-19. doi: 10.1016/S0140- 6736(12)60991-X.

ABSTRACT: Musculoskeletal fracture healing has created new benefits of early definitive injuries are the most common possibilities for management skeletal stabilisation, and the reason for operative procedures of particularly challenging potentially life-threatening risks in severely injured patients problems, such as delayed union of systemic complications such and are major determinants and non union of fractures and as fat embolism, acute lung of functional outcomes. In large bone defects. Optimum injury, and multiple organ failure. this paper, we summarise timing of major orthopaedic New methods for measurement advances and future directions interventions is guided by of fracture healing and function for management of multiply increased knowledge about the and quality of life outcomes pave injured patients with major immune response after injury. the way for landmark trials that musculoskeletal trauma. Individual treatment should will guide the future management Improved understanding of be guided by trading off the of musculoskeletal injuries.

Professor Bin Jalaludin Professor Jalaludin is also currently a member of an expert panel convened by the WHO Western Bin Jalaludin holds Pacific Regional Office to advise on air pollution a medical degree control in Asia and the Pacific region. His research and a doctorate interests are in air pollution and environmental in air pollution epidemiology, use of linked administrative epidemiology, datasets, spatial epidemiology, neighbourhoods both from the and social determinants of health, as well as in University of translating research into policy. He has published Sydney and over 170 papers in the peer reviewed scientific is currently literature and has been successful in attracting the Director, significant competitive funding for research from Epidemiology, the ARC and the NHMRC, as well as from a range Healthy People and of government and non-government agencies. Places Unit. He has a conjoint Professorial appointment in the School of Associate Professor Craig Juergens Public Health and Community Medicine at UNSW Australia, is an Honorary Senior Research Fellow Craig Juergens is an interventional at the Woolcock Institute of Medical Research, cardiologist at Liverpool University of Sydney, and is the Stream Leader, hospital where he is Head of Population and Health Services Stream, Ingham Department and is a conjoint Institute for Applied Medical Research. Associate Professor with UNSW. Bin is on the scientific committee of the Australian Paediatric Surveillance Unit, Deputy Chair of the After basic cardiology SWSLHD Human Research Ethics Committee, a training at Royal Prince member of the Scientific Advisory Committee of Alfred Hospital in the Ingham Institute for Applied Medical Research, Sydney, he completed an a member of the NSW Chief Health Officer’s Interventional Fellowship at Air Pollution Expert Advisory Committee, an Stanford University, California investigator in the Centre for Air quality and health and returned to Australia in 1997 Research and evaluation (an NHMRC Centre for to establish the coronary interventional Research Excellence) and on the Editorial Board service at Liverpool Hospital. This service has of Environmental Health. subsequently become a centre of training for interventional cardiologists with numerous Australian Fellows and doctors from China, , Singapore, Malaysia, Myanmar and New Zealand learning coronary interventional 14  UNSW in the South West 2011-2013  

techniques under the supervision of Craig and his Associate Professor colleagues. In addition Craig has demonstrated Murray Killingsworth PCI techniques in centres in Taiwan, China, Myanmar and Vietnam. Murray Killingsworth Apart from his interest in Interventional is principal hospital Cardiology, Craig has a major interest in scientist of acute coronary syndromes and has been the Electron involved in a large number of multicentre, Microscopy multinational clinical trials. He has been Laboratory, invited to speak at a number of local and Sydney South international meetings. He has been author West Pathology of over 55 peer reviewed papers in local Service. He and international Journals and he continues completed his to be an active clinician in the Department of PhD in 1990 in the Cardiology at Liverpool Hospital, in addition to School of Pathology providing support for the interventional cardiology (now School of Medical program at Orange Base Hospital. Sciences) and his research interests are in the pathobiology of chronic inflammation in macular degeneration Associate Professor Lynn Kemp of the retina, renal disease and cancer. Murray’s research tools include electron microscopy, Lynn Kemp is Associate Professor and Director of immunocytochemistry and computer-based the Centre for Health Equity Training Research and morphometry. He contributes morphological and Evaluation, part of the UNSW Centre for Primary ultrastructural data to research groups from the Health Care and Equity. Lynn is a nurse researcher University and has more than 1900 citations for his who seeks to develop and implement effective and papers. sustainable interventions to improve outcomes for Since 2011 Murray has been using nanoparticles children living in socioeconomic disadvantage. to probe cellular function in pathology tissue. His Lynn led the Australian randomised trial of the use of quantum dot nanocrystals as cell markers Maternal Early Childhood Sustained Home-visiting has demonstrated the potential of these probes (MECSH) program. She is recognised as one of to extract the maximum amount of information the leading primary health care early childhood from a single tissue sample by allowing analysis researchers in Australia and is a member of by several different microscopy modalities. several key Australian and international committees Previously, each modality required a dedicated on early childhood. sample and correlation of results from each source was difficult. The success of this approach has led Murray to establish the Correlative Associate Professor Norbert Kienzle Microscopy Group at the new Ingham Institute of Applied Medical Research to further explore the Norbert Kienzle is the Manager and Strategic application of nanotechnology to cell visualisation Development Executive for translational cancer in pathology. research at the Ingham Institute for Applied Medical Research. Murray is currently a member of the Board of Education of the Royal College of Pathologists of Norbert has over ten years of leadership and Australasia (RCPA) and is Principal Examiner for management experience in medical research Anatomical Pathology in the College’s Faculty of and biopharmaceutical drug development, based Science. on a scientific research track record in cancer biology, immunology and virology. He has authored more than 40 peer-reviewed publications and Professor Rupert Leong is an inventor on two PCT patent applications in therapeutic drug development. Rupert Leong is a leading figure in the field of Norbert holds a PhD in Biology from the Albert- bowel disease research. He has published a Ludwigs University (Freiburg, Germany); he has a wide range of ground-breaking research and has Conjoint Associate Professor appointment with the pioneered new endoscopic diagnostic techniques. South Western Sydney Clinical School, UNSW. Rupert has been conducting cutting-edge research into IBD biomarkers to translate this into a point-of-care tool. He is currently a senior staff specialist gastroenterologist, conjoint Professor at Bankstown Hospital and the Director of Endoscopy at Concord Hospital, Sydney.   Our People  15

Rupert completed his advanced training in Clinical major national and international meetings of the Immunology and Gastroenterology in 2000 in American College of Cardiology, American Heart and was awarded the Amy Association, European Society of Cardiology, and Athelstan Overseas Research Fellowship of World Congress of Cardiology and the Cardiac University of Western Australia to conduct 2 years’ Society of Australia and New Zealand. research as Visiting Scholar at The Prince of Wales Hospital, Shatin, Hong Kong. He completed his MD Dominic is a regular reviewer for international thesis (2004) on the Epidemiology of Inflammatory journals including the Journal of the American Bowel Diseases in the Chinese Population – the College of Cardiology, Circulation, Cardiovascular first comprehensive series of epidemiological Imaging, American Journal of Cardiology, Heart, studies of IBD in an Asian population. The American Heart Journal, Eurointervention and the novel research subsequently awarded Rupert Journal of American Society of Echocardiography. the Gastroenterological Society of Australia His current research interests include valvular Researcher on the Rise, the Young Achiever Award heart disease, heart failure, exercise physiology, of the Australian Chinese Medical Association exercise echocardiography, diabetic heart and the American Gastroenterological Association disease, microvascular dysfunction, coronary Fellowship by invitation. Leong conducted the first artery disease, acute coronary syndrome and genetic research of IBD genes on the Chinese interventional cardiology. In addition to his busy population. clinical service as a staff cardiologist, he is actively involved in undergraduate and postgraduate Rupert is currently an NHMRC Career medical education and supervises a number of Development Fellow (Clinical Level 2). His research Masters and PhD students. interest and clinical practice is synergistically focused on IBD. In total he has over 100 peer- Dominic has also been able to attract research reviewed publications. He has published on funding from the National Health and Medical a number of occasions in the top ranked Research Council, National Heart Foundation and gastroenterology specialty journal and has been other funding bodies. awarded the UNSW Paper of the Year Award. In addition he has received research awards including the Gastroenterological Society of Professor Siaw-Teng Liaw Australia Career Development Award, AstraZeneca Emerging Leader, the Abbott IBD Research Award, Siaw-Teng Liaw is UNSW Professor of General and the RACP Career Development Award. Practice and Director of the Academic General Practice Unit based at Fairfield Hospital.

Professor Dominic Leung Teng’s research program ‘Information-enhanced integrated care of chronic disease’, funded by a range of agencies including the NHMRC, revolves Dominic Leung is a around primary and integrated care informatics and senior staff cardiologist information quality and clinical decision support, and the Director of focusing on chronic disease management and safety Echocardiography and quality use of medicines in mainstream, CALD at Liverpool and Aboriginal communities. The NHMRC funded Hospital. Dominic project on safety of general practice systems has is a Fellow of the delivered an online critical incident reporting system Royal Australasian (TechWatch) for computer system related incidents in College of clinical care. The NHMRC-funded Cultural Respect Physicians, the Program and Toolkit project, with additional funding Royal College from NSW Health and GP Synergy, has delivered a of Physicians Cultural Respect toolkit. (Edinburgh), the American College of Teng is a Chief Investigator at the NHMRC-funded Cardiology, European Society of Centre for Research Excellence (CRE) on eHealth Cardiology, the Hong Kong College of Physicians, (2012-2016), APHCRI-funded CRE on Obesity and the Cardiac Society of Australia and New in Primary Health Care (2013-2017) and WHO Zealand. Collaborating Centre in eHealth (2013-). He is nationally and internationally recognised as a Dominic is an internationally acknowledged expert leading general practice and health informatics in echocardiography and cardiac imaging and has researcher and has published extensively in his published more than 100 papers in peer-reviewed field. He is also an elected International Fellow of journals, book chapters, editorials, reviews and the American College of Medical Informatics, a invited articles in major national and international Foundation Fellow of the Australasian College of journals. The international recognition of his Health Informatics (ACHI) and was President of work is reflected in more than 2400 citations of AHCI from 2005-2007. his papers and frequent invitations to speak at 16  UNSW in the South West 2011-2013  

HIGH IMPACT PUBLICATION

Ng AC, Yiu KH, Ewe SH, van der Kley F, Bertini M, de Weger A, de Roos A, Leung DY, Schuijf JD, Schalij MJ, Bax JJ, Delgado V. Influence of left ventricular geometry and function on aortic annular dimensions as assessed with multi-detector row computed tomography: implications for transcatheter aortic valve implantation. Eur Heart J. 2011 Nov;32(22):2806-13. doi: 10.1093/ eurheartj/ehr237. Epub 2011 Jul 23.

AIMS: Evaluate changes in aortic preserved (≥ 50%) or impaired annular diameter (26.4 ± 1.9 annular dimensions in relation to (<50%) LV ejection fraction (EF). vs. 24.5 ± 2.1 mm, P < 0.001) severe aortic stenosis (AS) and The influence of LV geometry compared with patients with left ventricular (LV) dysfunction. and function on changes in preserved LVEF. The presence of aortic annular dimensions was LV dysfunction, male gender, and METHODS AND RESULTS: examined. Patients with severe larger BSA were independent Mean aortic annular diameters AS had similar aortic annular determinants of a larger aortic and geometries were compared dimensions and geometries annulus on MDCT. between 90 severe AS compared with controls even patients and 111 controls by after correcting for baseline CONCLUSION: In severe AS multi-detector row computed differences in age and body patients, the presence of LV tomography (MDCT). All surface area (BSA). However, dysfunction, not the presence of severe AS patients were also severe AS patients with LV severe AS, was an independent dichotomized into two groups dysfunction (LVEF <50%) had determinant of a larger aortic based on the presence of significantly larger mean aortic annular diameter.

Teng sits on the NSW Health Acute Care non-allergic inflammatory rheumatic conditions, Taskforce and is currently involved in promoting as well as novel inflammatory pathways in and standardising activities on clinical handover rheumatoid arthritis and autoimmune connective between general practice, community based tissue diseases. He is an author on more than and hospital-based facilities. He also sits on 90 scientific publications in biomedical science, the Research and Teaching Subcommittee and clinical medicine and medical education which a number of service-related committees in have been cited more than 5000 times to date, with South Western Sydney Local Health District and 20 papers cited more than 50 times including nine Medicare Local. papers with over 100 citations.

Professor Liaw is a Board member of GP Synergy Since 2012, Patrick has been the Executive Clinical and the Health Informatics Society of Australia. Director of Liverpool Hospital in which position He sits on the Royal Australian College of General he provides strategic clinical leadership to the Practitioners National Research Committee and is Hospital General Manager and Executive Team. He the current Chair of the RACGP National Research currently chairs the Faculty’s Program Evaluation and Evaluation Ethics Committee. and Improvement Committee.

Internationally, Teng is a member of the editorial Patrick is recognised as a national leader in boards of a number of family/general practice academic rheumatology in Australia and he and health informatics journals, a number of currently Chairs the Board of Arthritis Australia, peer-review panels for national and international the peak national body for consumers with arthritis. competitive grants and scientific conferences. He He has been a long-standing member of Scientific is a Section Editor of the Informatics in Primary Assessment Committees for Arthritis Australia, the Care journal. He is a member of the International Australian Rheumatology Association Research Medical informatics Association (IMIA) Academy Trust, and NHMRC Grant Review Panels. Task Group and co-chairs the IMIA Primary Health Care Informatics Working Group. He sits on the American Medical Informatics Association Professor Guy Marks (AMIA) International Affairs Committee and Ethics Committee. Guy Marks is a respiratory physician at Liverpool Hospital and a respiratory epidemiologist, based at the Woolcock Institute of Medical Research and Professor Patrick McNeil the Ingham Institute. His research interests include obstructive lung disease (asthma and COPD), Patrick McNeil is Professor of Rheumatology at health effects of air pollution and tuberculosis as SWSCS based at Liverpool Hospital. He heads a well as epidemiological research methods. He is research group exploring the role of mast cells in   Our People  17

the Director of the Australian Centre for Asthma heaters. He is Chief Investigator in the Centre for Monitoring, a collaborating unit of the Australian Air quality and health Research and evaluation Institute of Health and Welfare (AIHW) responsible (CAR, an NHMRC Centre for Research Excellence). for collating, reporting and interpreting national data on asthma trends and outcomes. Guy is Chair of the NSW Tuberculosis Advisory Committee and of the NSW Chief Heath Officer’s Guy is the chief investigator on the Childhood Expert Advisory Committee on Air Pollution. Asthma Prevention Study (CAPS), a long- term study investigating risk factors for asthma in children born in south western and Associate Professor Bin Ong western Sydney. His interest in tuberculosis has included policy-related epidemiological Bin Ong is Director of the Ambulatory Care Unit and studies of tuberculosis in NSW and international Medical Assessment Unit in Bankstown Hospital. collaborations, particularly involving Vietnam. He He is also practising as a staff specialist in geriatric is Principal Investigator on two large community and general medicine. He is actively involved in the based studies investigating methods of improving medical undergraduate programs linked with general tuberculosis case finding in Vietnam. He is also medicine, Society and Health and geriatric medicine a Chief Investigator in the Centre for Research in Bankstown-Lidcombe Hospital. Excellence in Tuberculosis. Bin’s main research interests are in acute geriatric He has undertaken a number of studies medicine, thromboembolic disease and models investigating health effects of various air pollution of care including hospital in the home, ambulatory sources including road traffic and unflued gas

HIGH IMPACT PUBLICATION

Ferreira MA, Matheson MC, Duffy DL, Marks GB, Hui J, Le Souëf P, Danoy P, Baltic S, Nyholt DR, Jenkins M, Hayden C, Willemsen G, Ang W, Kuokkanen M, Beilby J, Cheah F, de Geus EJ, Ramasamy A, Vedantam S, Salomaa V, Madden PA, Heath AC, Hopper JL, Visscher PM, Musk B, Leeder SR, Jarvelin MR, Pennell C, Boomsma DI, Hirschhorn JN, Walters H, Martin NG, James A, Jones G, Abramson MJ, Robertson CF, Dharmage SC, Brown MA, Montgomery GW, Thompson PJ; Australian Asthma Genetics Consortium. Identification of IL6R and chromosome 11q13.5 as risk loci for asthma. Lancet. 2011 Sep 10;378(9795):1006-14. doi: 10.1016/S0140-6736(11)60874-X.

BACKGROUND: We aimed to FINDINGS: Two loci were with weak effects that might be identify novel genetic variants confirmed to associate with shared with other immune-related affecting asthma risk, since these asthma risk in the replication diseases, such as NDFIP1, might provide novel insights cohorts and reached genome- HLA-B, LPP, and BACH2. into molecular mechanisms wide significance in the underlying the disease. combined analysis of all available INTERPRETATION: The IL6R studies (n=57,800): rs4129267 association further supports the METHODS: We did a genome- (OR 1·09, combined p=2·4×10(- hypothesis that cytokine signalling wide association study (GWAS) 8)) in the interleukin-6 receptor dysregulation affects asthma risk, in 2669 physician-diagnosed (IL6R) gene and rs7130588 and raises the possibility that an asthmatics and 4528 controls (OR 1·09, p=1·8×10(-8)) on IL6R antagonist (tocilizumab) may from Australia. Seven loci were chromosome 11q13.5 near the be effective to treat the disease, prioritised for replication after leucine-rich repeat containing perhaps in a genotype-dependent combining our results with those 32 gene (LRRC32, also known manner. Results for the 11q13.5 from the GABRIEL consortium as GARP). The 11q13.5 locus locus suggest that it directly (n=26,475), and these were was significantly associated with increases the risk of allergic tested in an additional 25,358 atopic status among asthmatics sensitisation which, in turn, independent samples from four (OR 1·33, p=7×10(-4)), increases the risk of subsequent in-silico cohorts. Quantitative suggesting that it is a risk factor development of asthma. Larger or multi-marker scores of genetic for allergic but not non-allergic more functionally focused studies load were constructed on asthma. Multi-marker association are needed to characterise the the basis of results from the results are consistent with a many loci with modest effects that GABRIEL study and tested for highly polygenic contribution remain to be identified for asthma. association with asthma in our to asthma risk, including loci Australian GWAS dataset. 18  UNSW in the South West 2011-2013  

care and medical assessment units. He has Associate Professor Chris Pokorny published in national and international peer reviewed journals on these topics. He is a member Christopher Pokorny is a practicing of the Australian and New Zealand Society of gastroenterologist and Visiting Medical Officer at Geriatric Medicine, Hospital in the Home Australia Liverpool and Sydney hospitals. He also holds a and American Academy of Home Care Physicians. conjoint appointment as Associate Professor at Bin is also actively involved in the NSW Health UNSW. His clinical and research interests include Alternatives to Acute Hospital Admission Program. inflammatory bowel disease, coeliac disease and iron deficiency anaemia.

Associate Professor Michael Parr Chris is also actively involved in both undergraduate and postgraduate education and currently is a Michael Parr is Director of Intensive Care at member of the senior examining panel of the Royal Liverpool Hospital and trained in Anaesthesia and Australasian College of Physicians, the College’s Intensive Care in the UK, New Zealand, USA and Joint Divisional Continuing Professional Development Australia. Michael is author of two books, numerous Committee and the Specialist Advisory Committee book chapters and scientific papers, and maintains in Gastroenterology. In addition, he is on the editorial Liverpool Hospital Intensive Care Unit as a lead boards of the Internal Medicine Journal and research unit within the Australian and New Zealand Medicine Today. Intensive Care Society Clinical Trials Group.

Michael is an Editor of the journal Resuscitation, an Professor Derrick Silove executive member of the Australian Resuscitation Council, a member of the International Liaison Derrick Silove was appointed to the Foundation Committee on Resuscitation (ILCOR) Advanced Chair in Psychiatry in 1990 soon after the Life Support committee and Past President of establishment of the UNSW Clinical School in the International Trauma Care. south west of Sydney. He established the Psychiatry

HIGH IMPACT PUBLICATION

Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, D’Urso P, Kossmann T, Ponsford J, Seppelt I, Reilly P, Wolfe R, Parr M; DECRA Trial Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med. 2011 Apr 21;364(16):1493-502. doi: 10.1056/NEJMoa1102077. Epub 2011 Mar 25.

BACKGROUND: It is unclear evaluated on the Extended (odds ratio for a worse score whether decompressive Glasgow Outcome Scale 6 in the craniectomy group, 1.84; craniectomy improves the months after the injury. The 95% confidence interval [CI], functional outcome in patients final primary outcome was the 1.05 to 3.24; P=0.03) and a with severe traumatic brain injury score on the Extended Glasgow greater risk of an unfavorable and refractory raised intracranial Outcome Scale at 6 months. outcome (odds ratio, 2.21; 95% pressure. CI, 1.14 to 4.26; P=0.02). Rates RESULTS: Patients in the of death at 6 months were similar METHODS: From December craniectomy group, as compared in the craniectomy group (19%) 2002 through April 2010, we with those in the standard- and the standard-care group randomly assigned 155 adults care group, had less time with (18%). with severe diffuse traumatic intracranial pressures above the brain injury and intracranial treatment threshold (P<0.001), CONCLUSIONS: In adults hypertension that was refractory fewer interventions for increased with severe diffuse traumatic to first-tier therapies to undergo intracranial pressure (P<0.02 for brain injury and refractory either bifrontotemporoparietal all comparisons), and fewer days intracranial hypertension, decompressive craniectomy in the intensive care unit (ICU) early bifrontotemporoparietal or standard care. The original (P<0.001). However, patients decompressive craniectomy primary outcome was an undergoing craniectomy had decreased intracranial pressure unfavorable outcome (a worse scores on the Extended and the length of stay in the ICU composite of death, vegetative Glasgow Outcome Scale than but was associated with more state, or severe disability), as those receiving standard care unfavorable outcomes.   Our People  19

Research and Teaching Unit and later the Centre and Local meetings, including the American Heart for Population Mental Health Research. Derrick has Association, American Society of Echocardiography, had a longstanding interest in the mental health and the Echocardiography Societies of India and several psychosocial well-being of refugees, asylum seekers Asian Pacific nations. Her research has been funded and other populations exposed to mass violence by the NHRMC, the National Heart Foundation, and human rights violations. His focus has extended Cardiovascular Lipid research grants, and other to the development of mental health services in low investigator initiated grants. income countries recovering from conflict such as Cambodia, Vietnam, and Timor Leste where he led Liza is on the Editorial Board of the Journal of the an AusAID funded national program in mental health American Society of Echocardiography and in for five years. 2013 was nominated one of its top 20 reviewers. She is also on the editorial board for Heart, Lung Derrick has attracted numerous NHMRC and ARC and Circulation and is a regular reviewer for grants. Key collaborating centres are the Harvard several journals including JACC Cardiovascular Program in Refugee Trauma, the Karolinska Imaging, European Heart Journal, and Heart. Institute where he is a Visiting Professor, Public Health at UNSW with Professor Anthony Zwi and Liza is integrally involved in teaching and training Sydney University with Professor Adrian Bauman, and supervises several PhD, Masters and ILP and Psychology, UNSW with Richard Bryant. students. Additionally, she has been involved with teaching and non-invasive cardiology training in Derrick has published over 350 journal articles, several Asian countries including in Indonesia and books, book chapters and major reports. Several India. of his publications have appeared in the world’s leading peer review journals such as the Lancet, Professor Thomas has a special interest in the Journal of the American Medical Association, Women’s Cardiovascular Health at a Community the British Medical Journal, the Archives of General level and has been an active participant and Psychiatry, the American Journal of Psychiatry, the supporter of the Heart Foundation’s “Go red for British Journal of Psychiatry and Social Science Women” program. She is involved in The Healthy and Medicine. Heart Forum for Women” in the Liverpool area. She is actively involved in fundraising for charitable Derrick received the Dean’s Award for Lifetime medical services for the Christian Medical College Achievement in 2010 and was awarded the in Vellore, India. inaugural Ingham Institute Distinguished Researcher Award in 2013. Associate Professor Shalini Vinod

Professor Liza Thomas Shalini Vinod is a senior radiation oncologist at the Liverpool Cancer Therapy Centre. Her clinical Liza Thomas is a staff specialist cardiologist interests are in lung and gynaecological cancers. at Liverpool Hospital and conjoint Professor at She leads the Lung Cancer Multidisciplinary Team UNSW. Her research interest is in non invasive at Liverpool & Macarthur Cancer Therapy Centres. cardiology, in particular echocardiography with The prospective data collection she initiated for a focus on the evaluation of atrial dynamics and this group since 2005 has formed the basis for function. She was the recipient of the Gustav many research projects. Nossal NHMRC scholarship for her PhD studies on the echocardiograhic evaluation of atrial function in Since 2010 she has chaired the MRI simulation health and disease. group charged with the procurement and implementation of a MRI scanner for radiotherapy Liza is an established investigator who has simulation. The MRI was finally installed within published extensively and her work has been the radiotherapy department in cited in the program highlights at various meetings June 2013, the first of its kind including of the American Heart Association, the in Australia. This group is American Society of Echocardiography and the currently supervising European Society of Cardiology. Professor Thomas a research program has over 65 original publications, book chapters, evaluating the use of MRI editorials and invited reviews with eight papers in radiotherapy planning cited more than 50 times. and treatment.

More recently, Liza has taken a leading role as a Shalini has a strong member of the Executive and Steering committees commitment to education of the international EchoNormal collaboration that and is an examiner for is undertaking an individual patient meta analysis the final specialist exams of over 29 000 subjects. She leads the EchoNormal in radiation oncology and an analysis of atrial chamber size and function. Liza assessor of overseas trained has been an invited speaker at international, national specialists for RANZCR. She is an 20  UNSW in the South West 2011-2013  

advocate for evidence-based medicine and The Pancreatic Research Group has been the has been involved in writing updated Australian recipient of continuous NHMRC/DVA Project NHMRC Guidelines for the management of lung Grant support since 1987 and more than $17m cancer. in competitive research and infrastructure funds during his career. He has also received Shalini continues to be active in research and has research support from the National Institutes of published on many topics including lung cancer, Health (USA), the Cancer Institute NSW, NSW gynaecological cancers, the use of PET and MRI Cancer Council the Ramaciotti Foundations, the scans in radiotherapy and multidisciplinary care. Australian Brewers Foundation and the RACP as She is currently supervising research undertaken well as internal grant support from Prince Henry by medical students, radiation oncology registrars and Prince of Wales Hospitals and UNSW. He and a PhD student. has supervised or co-supervised a number of candidates for doctoral degrees (MD or PhD).

Professor Jeremy Wilson Jeremy is recognised as an international authority on the pathogenesis of alcoholic pancreatitis Jeremy Wilson founded the and pancreatic stellate cells. He is a member Pancreatic Research Group of Council and the Honorary Secretary of the and has been involved International Association of Pancreatology and in pancreatic research is also a member of the Editorial Board of the for over 25 years. He journal Pancreatology. His work has received more has more than 120 than 3500 citations attesting to his international publications and over 138 recognition in the field. In 2001, he was awarded a abstracts predominately Fellowship by the Royal College of Physicians, UK on the subject of on the basis of his distinguished achievements in the pathogenesis of pancreatology. In 2007, Jeremy was made a Fellow pancreatitis. of the American Gastroenterological Association (AGA) and was one of the first non-American researchers to be awarded this honour.

HIGH IMPACT PUBLICATION

Vonlaufen A, Phillips PA, Xu Z, Zhang X, Yang L, Pirola RC, Wilson JS, Apte MV. Withdrawal of alcohol promotes regression while continued alcohol intake promotes persistence of LPS-induced pancreatic injury in alcohol-fed rats. Gut. 2011 Feb;60(2):238-46. doi: 10.1136/gut.2010.211250. Epub 2010 Sep 24.

BACKGROUND AND AIMS: kg/week for 3 weeks) and then and prevented PSC apoptosis. Administration of repeated either switched to control diet Alcohol and LPS significantly lipopolysaccharide (LPS) or maintained on an alcohol inhibited PSC apoptosis in vitro, injections in alcohol-fed rats diet for 3 days, 7 days or 3 and the effect of LPS on PSC leads to significant pancreatic weeks. Pancreatic sections apoptosis could be blocked injury including fibrosis. However, were assessed for acute tissue by Toll-like receptor 4 small it remains unknown whether injury, fibrosis, PSC apoptosis interfering RNA. alcoholic (chronic) pancreatitis and activation. Cultured rat has the potential to regress when PSCs were exposed to 10 mM CONCLUSIONS: Induction of alcohol is withdrawn. The aims ethanol 6 1 mg/ml LPS for 48 PSC apoptosis upon alcohol of the study were (1) to compare or 72 h and apoptosis was withdrawal is a key mechanism the effect of alcohol withdrawal/ assessed (Annexin V, caspase-3 mediating the resolution of continuation on pancreatic acute and terminal deoxynucleotidyl pancreatic fibrosis. Conversely, injury and fibrosis; and (2) to transferase dUTP nick end continued alcohol intake assess the effects of alcohol ± LPS labelling (TUNEL)). perpetuates pancreatic injury on pancreatic stellate cell (PSC) by inhibiting apoptosis and apoptosis in vivo and in vitro. RESULTS: Withdrawal of alcohol promoting activation of PSCs. led to resolution of pancreatic Characterisation of the pathways METHODS: Rats fed isocaloric lesions including fibrosis and mediating PSC apoptosis has Liebere-De-Carli liquid diets to increased PSC apoptosis. the potential to yield novel ± alcohol for 10 weeks were Continued alcohol administration therapeutic strategies for chronic challenged with LPS (3 mg/ perpetuated pancreatic injury pancreatitis.   Our People  21

As Clinical Associate Dean of SWSCS and Dr Wong is committed to promoting diabetes Professor and Director of Medicine at Liverpool research in south western Sydney and he is keen Hospital, Jeremy has major responsibilities in the to collaborate with other research groups in the area of administration, clinical service, teaching future. (undergraduate and postgraduate) and research at SWSLHD and UNSW. Associate Professor John Worthington In 2004, he led the development of ‘The Way Forward’, the strategic plan for the development of John Worthington is a lead investigator on two clinical services for the south west of Sydney. current NHMRC research projects as well as He is currently involved in a range of strategic on research studies funded by the NSW Office projects for SWSLHD and NSW Health including of Health and Medical Research, the BUPA as a member of the Clinical Council of the Clinical Foundation, Clinical Excellence Commission Excellence Commission and as Co-chair of the (CEC) and UNSW. He is a practising neurologist Acute Care Taskforce of the NSW Agency of with training in sleep and thoracic medicine, and Clinical Innovation which has responsibility for has worked at Liverpool Hospital for the past 16 advising the Ministry on matters relating to best years. Together with Dr Melina Gattellari, John has practice and efficient care of acute medical established the Heart and Brain Collaboration, a patients in the NSW Health system. He is also the research group at the Ingham Institute for Applied Chair of the SWSLHD Human Research Ethics Medical Research. Committee and oversaw the accreditation of John’s current research spans randomised that committee as a Lead HREC with particular control trials to improve stroke prevention in expertise in dealing with research in culturally and atrial fibrillation and neuro-epidemiology studies linguistically diverse populations in 2013. using routinely collected data and data linkage to examine stroke and TIA attack rates, outcomes and health service performance. Current projects Associate Professor Vincent Wong include DESPATCH (NHMRC), OASIS (NHMRC), PRISM (CEC and UNSW), STOP-STROKE (Bupa), Vincent Wong is the Director of Diabetes and Home to Outcomes (OHMR) and CARERA, a study Endocrinology at Liverpool Hospital and a conjoint of innovative bedside monitoring in critical brain Associate Professor at UNSW Australia. He injury. These projects are carried out under the completed his medical degree at University of auspices of the South Western Sydney Clinical Sydney and graduated with first class honours School, UNSW and the Ingham Institute. The in 1994. He undertook his endocrine training at research itself involves extensive collaboration with and pursued his PhD studies cardiologists, general practitioners, neurosurgeons, in the field of diabetes and cardiovascular disease. biostatisticians, academic nurses, epidemiologists Under the supervision of Professor Wah Cheung and public health specialists. and Dr Susie Mihailidou, he was involved in the HI-5 study that examined the role of insulin therapy Dr Worthington is currently the Medical co-Chair following acute myocardial infarction, and he also of Stroke Services NSW, the NSW clinical stroke developed an in-vitro model of regional acute network, a member of the CEC’s eChartbook ischaemia on rabbit hearts. Advisory Group, and provides clinician governance for the Agency of Clinical Innovation’s response Over the years Vincent has received the to unwarranted clinical variation in stroke. He has Cardiovascular Lipid Research Grant, Novo provided educational materials and advice on Nordisk Regional Diabetes and Research Grant safe and effective use of antithrombotics in stroke and Novo Nordisk-ADIPS Grant. He was the prevention for both the National Stroke Foundation recipient of the Young Researcher Award, and the National Prescribing Service and has given International Diabetes Federation – Western Pacific over 40 invited talks on evidence based stroke care Region in 2002. and prevention. He is an active academic reviewer for international scientific journals including BMJ, Since he arrived at Liverpool Hospital in 2006, New England Journal, Hypertension, Stroke, Vincent has developed a new research focus in Neurology, MJA and the Journal of Neurology, diabetes in pregnancy, mainly as a result of the Neurosurgery and Psychiatry (JNNP) and has high prevalence of gestational diabetes in south written invited editorials for both Stroke and JNNP. west Sydney. He maintains a strong interest in cardiovascular disease and works closely with the Department of Cardiology on a number of studies. He is also involved in research projects with the Department of Nuclear Medicine and the Epidemiology Group, Healthy People and Places Unit. 22  UNSW in the South West 2011-2013  

Teaching in the South West

Undergraduate Coursework

UNSW in the south west of Sydney provides learning opportunities across all Phases of the Medicine Program to more than a fifth of all UNSW medical students. Students undertake placements at Liverpool, Bankstown-Lidcombe, Fairfield,B raeside, Campbelltown and the 1st Health Support Battalion hospitals and at a range of primary care and population health services.

In addition a number of south west Sydney based UNSW academics and conjoint appointees contribute to teaching on the Kensington campus in Phase 1 Scenario Facilitation, Phase 2 case method tutorials and the Year 4 biomedical science program.

Medicine and Surgery Aged care and oncology terms also give students exposure to the broad spectrum of medicine, At any given time, Medicine and Surgery have oncology, rehabilitation medicine, palliative approximately 80 Phase 2 and 70 Phase 3 students care, allied health and general surgery. The allocated across the Liverpool, Bankstown and Adult Medicine component of the course also Fairfield campuses. incorporates several skills sessions for students.

Phase 3 teaching consists of student integration The number of Phase 1 students placed in the into the clinical team, weekly therapeutic and south west of Sydney has increased to more technique lectures, professorial viva tutorials, than 140 in 2013. These students, as part of their specialist viva tutorials, bedside tutorials, introduction to the clinical environment, undertake presentation at Grand Rounds and attendance at fortnightly tutorials as part of placements at team meetings. Phase 3 students also undertake Liverpool, Bankstown-Lidcombe and Fairfield a variety of skills sessions during their medical and hospitals. surgical terms.

All final year students also undertake PRINT C ritical Care (Preparation for Internship) which allows students to integrate into a team of their chosen discipline The Critical Care term encompasses emergency and operate at a sub-intern level. During the PRINT medicine, intensive care and anaesthetics with term, various case method tutorials are facilitated students allocated across the hospitals of south and these are aimed at providing students with western Sydney. Each year approximately 46 experiences they can expect to encounter as an Phase 3 students undertake four weeks in the intern. Case method tutorials include topics such Emergency Department, two weeks of intensive as postoperative conditions, medication charts, care and two weeks of anaesthetics. Students are communication with nursing and senior medical expected to integrate into the team and perform at staff and dealing with unexpected deaths. sub-intern level. Teaching within the term includes a weekly tutorial timetable and several clinical skills Phase 2 sees students undertaking various medical sessions. Emergency and anaesthetics exams are and surgical activities during their adult medicine held at the end of the term. This level of integration terms. Weekly themes include exercise and health, ensures that SWSCS critical care terms are highly respiratory medicine, cardiology, nephrology, sought after by students. gastroenterology and trauma. Students gain broad exposure to medicine and surgery during these structured weeks.   Teaching in the South West  23 24  UNSW in the South West 2011-2013  

Obstetrics and Gynaecology Paediatrics

The Discipline of Obstetrics and Gynaecology The number of students allocated to south western facilitates teaching for students across all Phases. Sydney for Phase 3 paediatrics attachments In 2013, more than 60 Phase 3 students undertook remains steady at an average of 71 per year. With an eight week term in south western Sydney. These the implementation of Phase 2, there are also 12 terms included clinical attachments, attendance additional students per term allocated to SWSLHD at antenatal clinics, clinical skills sessions, hospitals. During this term, students spend one attendance at the birthing unit and an end of term week at the Neonatal Intensive Care Unit (NICU), a objective structured clinical examination (OSCE). general paediatrics ward, Fairfield Hospital and a community health setting. Approximately 80 Phase 2 students also undertook a two and a half week term within SWSLHD in 2013.   Teaching in the South West  25

Pathology Psychiatry

Pathology and Therapeutics teaching continues The School of Psychiatry allocates approximately to occur at the south western Sydney hospital 45 Phase 3 students per year for an eight week sites, facilitated mainly by conjoint staff. Alongside psychiatry term in the south western Sydney weekly tutorials delivered to the hospital sites via hospitals. During these eight weeks, students videoconference from Liverpool Hospital, students undertake a full time clinical attachment, receive also attend diagnostic laboratories, dissection weekly tutorials and perform supervised patient of surgical specimens and autopsies in the interviews. Viva and written examinations are held Department of Anatomical Pathology, as well as at the end of the term. scheduled visits to the NSW Institute of Forensic Pathology. Examinations

Primary Care Liverpool Hospital continues to host a range of student examinations throughout the year including Since the introduction of Phase 2, students the Phase 1 Integrated Clinical Examination (ICE), undertaking primary care terms through Society Phase 2 ICE and the Phase 3 Clinical, Viva and and Health have been allocated to Braeside Portfolio examinations. Hospital, 1HSB at Holsworthy, community health and general practices across the south west of The staff at SWSCS thank the academics and Sydney for community clinical attachments and conjoint appointees who have contributed to course tutor sessions. The GP Unit at Fairfield these examinations by acting as examiners and Hospital also makes a very significant contribution supervisors and by helping to recruit patients. to teaching of Phase 1 Clinical and Communication The School is also grateful to the patients and groups allocated to the Hospital. volunteers who have acted as surrogates and the patients who have given their time to assist in the execution of exams in the south west. 26  UNSW in the South West 2011-2013  

Ingham Institute Clinical Skills and Simulation Centre

The Ingham Institute Clinical Skills and Simulation Centre is an interprofessional, state of the art simulation centre that opened in January 2013 and was officially launched by the Federal Minister for Health on the 11th June 2013. The Centre is utilised by a wide range of stakeholders including staff employed by the South Western Sydney Local Health District, health professional students from UNSW Australia and the University of Western Sydney and trainees from a range of professional colleges and associations.

2013 Utilisation of the Centre

32% swslhd/cewd programs

31% Liverpool Hospital clinical teams and services activities 18% UNSW activities across phases and UITCT

12% Others

7% UWS medical and allied health students

Funding support for the centre

17% SWSLHD cleaning, utilities and maintenance

Cleaning and utilities for building; Allied Health contribution to simulation educator staffing

83% UNSW staff, resources and equipment

Reception; managing bookings; set up/tear down; specialist expertise to users on use of simulation; technical support to events

Basic consumables and ongoing enhancement of the equipment pool and audiovisual resources   Teaching in the South West  27

The Clinical Skills and Simulation or cadavers, and thus highly Centre is a teaching resource accurate. The Anatomage for the Liverpool Hospital and Table is the only system that is represented on the hospital can display true human gross Patient Safety and Resuscitation anatomy in real life size, it can be Committees. This enables the used for radiology, surgery case utilisation of simulation as a review, patient consultation, and tool to improve patient care and research purposes as well as identify health system issues anatomy education. that may need to be improved. The Centre works in partnership The Centre has a focus on with the South Western Sydney interdisciplinary team and Local Health District Centre communication skills training for Education and Workforce in the Simulated Learning Development to deliver high Environment particularly for high quality simulation and skills stakes emergency teams. The based programs to staff across Centre Educators are available the LHD. for consultation on simulation scenario development and The Centre is managed day- delivery. There is an Allied Health to-day by the South Western Simulation Educator and there Sydney Clinical School in line are a variety of Allied Health with funding agreements with specific simulation based the Health and Hospitals Fund learning programs. and Health Workforce Australia. Funding Support A Governance, Planning and The Centre received funding Management Committee from Health Workforce Australia, for the Centre with representation by the in 2013, to develop, deliver and many stakeholders in health evaluate an undergraduate UNSW Australia has supported interprofessional team professional education in south the purchase of the majority western Sydney oversees the communication training program, of equipment. It supports the strategic direction of the Centre. U-UTCT. This funding has supported the employment of permanent staffing at the Centre High fidelity equipment facilitates a part time Medical Simulation and funds more than 80% of the delivery of complex clinical Educator, part time Nurse the running costs of scenarios via immersive Simulation Educator and part the Centre. simulation and facilitated time Allied Health Simulation debriefs. Mannequins available Educator for the duration of 2014 in the centre include SimMan for program delivery. 3G, Megacode Kelly, Resusci Anne Simulator, Ambu Airway The Australian National Trauma SmartMan and a variety of part Team Training Program is task trainers and models for delivered by an Interprofessional procedural skills training. faculty in the Centre and the venue is used by the Innovation in education Royal Australian College of delivery within the Centre Surgeons for the EMST – includes the Anatomage Table, Early Management of Severe a technologically advanced Trauma Program. Emergency anatomy visualisation system Medicine Trainees participate in for anatomy education. interprofessional team training The Anatomage Table is a days consisting of 5–6 highly combination of unique hardware immersive clinical scenarios with and software that resembles an themes ranging from trauma operating table or hospital bed through paediatric emergencies, and is able to digitally display medical emergencies and 3D gross body male and female toxicology emergencies. The contents, 3D High Resolution National Simulation Educators regional anatomy with a digital Training Program, NHET-Sim is anatomy library with over 120 also taught in the centre. pathological examples. The data are from real patient scans 28  UNSW in the South West 2011-2013     Teaching in the South West  29

TEACHING FACILITIES AVAILABLE IN THE CENTRE

Two fully simulated Operating Theatre setups, including anaesthetic bays and scrub bays, are available. These two rooms can be reconfigured to represent Resuscitation Bays or Intensive Care Unit bed bays or a combination of all of these clinical spaces.

There are two clinical skills labs for procedural skills teaching that incorporate video recording and videoconferencing. These skills labs can also be opened up for large group teaching or a multiple casualty scenario. Large screen televisions are available in each skills lab and simulation room for power point/ multimedia presentations.

There are eight Outpatient Consultation rooms set up for patient assessment and communications training and these spaces are also used for exams and formal assessments. The consultation rooms have video and audio capability.

There are four debrief/classroom spaces with video live streaming and replay capability as well as videoconference capability and interactive whiteboards. 30  UNSW in the South West 2011-2013  

Prizes and Awards

Between 2011-2013 a number of prizes and awards have been distributed to UNSW staff and students.

I an Webster Medal T eacher of the Year/Denise Lonergan Teaching Prize This medal, named in honour of the inaugural SWSCS Clinical Associate Dean, Professor Ian Each year students are asked to vote to reward Webster, was instituted in 2007 as a means of tutors whom they believe have taken innovative recognising outstanding performance by a student and exciting approaches to enhance their studying medicine, surgery and critical care terms tutorials. During this period, teaching awards in south western Sydney. were presented to:

Each year this medal is presented to the student 2011 Denise Lonergan who achieves the highest grades in the final year 2012 Ricardo Hamilton barrier examinations. Recipients of the award in the period of this report were: 2013 Navin Niles

2011 Benjamin Nham 2012 Joanna Connolly Clinical Dean’s Awards 2013 Mico Chan The Clinical Dean’s Awards are designed to recognise excellence amongst teaching and research staff in the south west. During this period, Tom Gibian Prize Clinical Dean’s Awards were presented to:

The Tom Gibian Prize, named in honour of the 2011 David Davies, Ricardo Hamilton, Hamish foundation warden of the Bankstown campus of Russell South Western Sydney Clinical School recognises 2012 Ken Liu, Michael Maley, Scott Mackenzie, Kent student leadership amongst final year students. Robinson, Saissan Rajendran Recipients of this prize during this period were: 2013 Triet Bui, David Quang Phu Ho, Angela Kwong, Jessica Lai, Jyothi Marry, Carlos Pilasi, Ben 2011 Saissan Rajendran Taylor, James Toh, May Wong 2012 Geoffrey Lee 2013 Patricia Ly T utor of the Year Awards

Prize in Surgery Each year students are asked to vote to reward tutors whom they believe have taken innovative Awarded for the top result in Surgery component of and exciting approaches to enhance their course: tutorials. During this period, teaching awards were presented to: 2011 Pratik Rastogi 2012 Jared Millican 2011 Christophe Berney, Ken Liu, Navin Niles, Eddy Thientosapol, Sanjyot Vagholkar 2013 Greg Kalogeropoulos 2012 Joel Lasschuit, Phillip Malouf, Christian Mussap, Benjamin Nham, Priyantha Wettasinghe Prize in Medicine 2013 Seymour Atlas, Andrew Knight, Blair Munford, Hajir Nabi, David Prince Awarded for the top result in Medicine component of course: Distinguished Research Prize 2011 Benjamin Nham 2012 Michael Krigstein In 2013, the South Western Sydney Clinical 2013 Greg Kalogeropoulos School established a distinguished research prize. Recipients include:

2013 Minoti Apte, Liz Harris   Teaching in the South West  31

Greg Kalogeropoulos receives two prizes at the 2013 student dinner

DENISE LONERGAN, 1953-2012

Associate Professor Denise Lonergan is remembered in the South Western Sydney Clinical School Teaching Prize as a result of the significant contribution made by Denise to teaching across south western Sydney. Associate Professor Lonergan graduated from the developing standards for the accreditation of training University of New South Wales in 1976 and after networks in NSW and a member of the working party working at Sydney and Prince of Wales Hospitals, for the evaluation of the new curriculum for radiation moved to south western Sydney to take up a position oncology training. working at the Macarthur Cancer Therapy Centre in 2006. During her time working at Campbelltown, Denise also won several teaching awards, including the Liverpool and Bankstown Hospitals, Denise made a UNSW Clinical Associate Dean’s Teaching Award, the significant contribution to oncology teaching in both UWS Clinical Dean’s Award and the Royal Australian the UNSW and University of Western Sydney (UWS) and New Zealand College of Radiologists (RANZCR) programs and held the role of coordinator of oncology Faculty of Radiation Oncology Excellence in Teaching teaching at our Clinical School. Award. In 2012, the School named the teaching award which Denise received in 2011 in her honour. Denise was the foundation network director for radiation oncology training in the Southern NSW and ACT Denise is remembered by the School staff and her network and developed an excellent training program colleagues as a caring, thoughtful person, with a keen in this role. She was also a member of the Faculty of sense of humour. Her strengths included her holistic, Radiation Oncology Education Board, the chair of compassionate patient care and the kindness, support the Faculty of Radiation Oncology Training Network and wisdom she gave to her colleagues and the Directors Forum, a member of the working party students who trained with her. 32  UNSW in the South West 2011-2013  

Building Academic Infrastructure

The South Western Sydney Clinical School has undertaken an ambitious program to improve the educational infrastructure in south western Sydney hospitals by attracting funding of more than $12.8m for capital works and major research equipment. This is in addition to a significant direct investment by UNSW in staff and resources to support teaching and research across south western Sydney.

AARNet and Videoconference

In 2010, the South Western Sydney Clinical School was successful in gaining funding from the Department of Education, Employment and Workforce Relations (DEEWR) to expand the UNSW videoconference and data network to hospitals across south western Sydney using the Australian Academic and Research Network (AARNet).

This $3.66m project included the installation of high-speed fibre links to Liverpool, Bankstown-Lidcombe, Fairfield and Braeside Hospitals and the establishment of a network of videoconferencing facilities using this network. A total of eighteen new videoconference units have been connected via this network, along with five additional units being purchased for installation on the University of Western Sydney (UWS) network at Campbelltown and the South Western Sydney Local Health District (SWSLHD) network at Camden and Bowral.

During this report period the videoconference network has been expanded to incorporate a full digital operating theatre at Liverpool Hospital including a camera to broadcast the surgical field; a mobile unit for use in procedural facilities such as cardiac catheter suites, ultrasound facilities and endoscopy; and incorporate of videoconference capacity into the Ingham Institute Clinical Skills and Simulation Centre.

In addition to the videoconferencing network, UNSW has installed wireless access points for the UNSW network in a range of educational and research facilities at each of the south western Sydney hospitals. This network also includes eduroam which makes it possible for students and staff from any university who is a member of the eduroam consortium to access the UNSW network while on any of these campuses.

Anatomage and Clinical Skills

The South Western Sydney Clinical School has been responsible for obtaining the majority of the funding for the construction, fit out and staffing of the new Ingham Institute Clinical Skills and Simulation Centre which opened in 2013 (see page 26). Funding was obtained from the Health and Hospitals Fund (HHF) and Health Workforce Australia (HWA) based on applications for clinical skills and simulation infrastructure authored by UNSW.

Along with additional support from UNSW and the Ingham Institute, the $10m facility now includes key teaching resources for south western Sydney. In 2013, the School also added the Anatomage table, a 3D digital dissection table, as a resource at the Centre. The table provides a unique opportunity for teaching staff to enhance the anatomy knowledge of students in the clinical setting.   Teaching in the South West  33

Ingham Institute for Applied Medical Research

eduroam

UNSW is part of the global eduroam network, so visitors can connect to the internet via eduroam at UNSW and UNSW staff and students can use the eduroam service at participating campuses both in Australia and overseas.

As eduroam is a roaming service, there is no need to register at a particular campus, simply select the eduroam wireless network on your device and use your username in the format [email protected] and zPass credentials to log on.

More information on eduroam is available via the UNSW IT Service Desk. 34  UNSW in the South West 2011-2013  

The South Western Sydney Clinical School Lidcombe and Fairfield Hospitals through the continues to support the Ingham Institute Clinical allocation of block grants each year to support Skills and Simulation Centre. Approximately 80% the purchase of new books or other resources. of the operating costs of the Centre are met by In consultation with the School and local medical UNSW with an annual contribution of more than staff, the libraries utilise these funds to propose $0.46m to support staffing, planning and teaching resources for inclusion as part of this allocation. resources. UNSW also contributed to the Campbelltown Hospital library through the allocation of computers for use by the small number of UNSW students Ingham Institute for Applied Medical Research who undertake placements at Campbelltown.

UNSW continues to be a key partner in the Ingham Institute for Applied Medical Research. During Student Amenities the last three years UNSW has made a significant contribution to the Institute. This includes a more In addition to the expansion of the UNSW network than $2m contribution to the establishment of the to the major south western Sydney campuses, Institute precinct along with more than $1.5m in in- the South Western Sydney Clinical School has kind support to the Institute’s operation and more also invested significantly in the enhancement than $4m in direct contributions to the research of student facilities at Liverpool and Bankstown. groups that operate in the Institute. Renovation of both the Liverpool and Bankstown student common rooms occurred during 2011- 2012. UNSW contributed new computers, Libraries managed print and furniture to these spaces. UNSW also made a considerable investment in The South Western Sydney Clinical School keypad operated lockers which ensured that all continues to provide support to each of the health professional students at the south western medical libraries at Liverpool, Bankstown- Sydney campuses had access to secure locker facilities.   Teaching in the South West  35

INFRASTRUCTURE GRANTS

Capital Development Pool DEEWR 2010-2011 Health Workforce Australia 2012-2013

University of New South Wales $3.66 million University of New South Wales $582 907 Funding for a major information technology upgrade Successfully applied to HWA for funds to furnish, at the south western Sydney teaching hospitals of purchase high fidelity mannequins and expand UNSW including the installation of direct AARNet fibre the audiovisual capacity for the Clinical Skills and optics to connect the hospitals to the main campus Simulation Centre at Liverpool Hospital. of Kensington, renovate the Liverpool Hospital auditorium and install an 18 site videoconference Health Workforce Australia 2012-2013 network across south western Sydney. University of New South Wales $457 673 Health and Hospitals Fund DOHA 2010-2013 Successfully applied to HWA for funds to construct three additional teaching spaces at the Ingham Ingham Institute Clinical Skills and Simulation Institute Clinical Skills and Simulation Centre. Centre $6.38 million As part of a broader Ingham Institute for Applied University of New South Wales 2012 Medical Research ($50.5m) project, funds to develop a 900m2 clinical skills and simulation centre at Faculty IT Infrastructure Grants $30 000 Liverpool Hospital. This facility incorporates seminar Expansion of Uniwide network to the Ingham Institute and tutorial space, simulated operating, critical care Clinical Skills and Simulation Centre. and outpatients space and skills laboratories. University of New South Wales 2012 University of New South Wales 2011 Major Research Equipment and Infrastructure Major Research Equipment and Infrastructure Initiative $99 990 Initiative $99 500 Olympus microscope system. Senior research coordinator for Ingham Institute for Applied Medical Research. Health Workforce Australia 2013-2014

University of New South Wales 2011 University of New South Wales $300 000 Medical, nursing and allied health educator Major Research Equipment and Infrastructure staff to support the pilot of an interdisciplinary Initiative $115 000 communication program amongst health professional Applied Biosystems ViiA7 Real-Time PCR System for students. Ingham Institute for Applied Medical Research. University of New South Wales 2013 University of New South Wales 2011 Major Research Equipment and Infrastructure Major Research Equipment and Infrastructure Initiative $250 000 Initiative $95 250 Circulating turmour cell system for Ingham Institute Guava easyCyte 8HT Flow Cytometry System for for Applied Medical Research. Ingham Institute for Applied Medical Research. University of New South Wales 2013 Health Workforce Australia 2011-2012 Major Research Equipment and Infrastructure University of New South Wales $720 999 Initiative $80,000 As part of a strategy to increase the capacity Near-Infrared Cerebral Ozygenation and Non-Invasive of south western Sydney hospitals to undertake Continuous Blood Pressure Monitoring Equipment for clinical placements for MBBS students, successfully Liverpool Hospital. applied for $721,000 to install an integrated videoconferencing solutions for Liverpool Hospital theatres and the infrastructure for audiovisual control of the Clinical Skills and Simulation Centre. 36  UNSW in the South West 2011-2013  

Research in the South West

Our Groups

UNSW Australia is a research intensive university and member of the Group of Eight (Go8). The university is host to groundbreaking research in a number of areas and researchers in south western Sydney contribute to this research in a number of ways. UNSW has strong collaborative links with industry and business, consistently performing in the top nationally in Australian Research Council Industry Linkage Grants. UNSW expertise is regularly sought by business and government for a wide variety of consultancy and training services.

A number of UNSW affiliated research groups are based in the south west of Sydney with research interests as diverse as basic science, clinical trials and health systems research. Here are a few of them.

Aged Care - Bankstown care in culturally and linguistically diverse (CALD) communities, advance care planning The Aged Care Department of Bankstown- and end-of-life care. Projects include large-scale Lidcombe Hospital, led by Professor Daniel Chan, externally funded studies and unit-based quality has been actively involved in a range of research improvement projects. related to Parkinson’s disease and vascular Highlights during the report period include: diseases including stroke. The main focus of the Department’s Parkinson’s disease research has yyCompletion of an NHMRC-funded grant on been in the molecular aspect of the disease. dementia in CALD communities, focusing on the perspectives of family carers and health Collaborative studies looking at treatment of service providers. The project targeted four vascular dementia with China are also being CALD populations in south western Sydney developed with a pilot study underway at (Arabic, Spanish, Chinese and Italian). Results Bankstown showing promising results. from the project were reported in six peer- reviewed journal papers. Other research projects include models of care for yySecuring a $324,000 grant from Alzheimer’s stroke patients, delirious patients and patients with Australia that involved initiating and leading a behavioural disturbance and projects in the area of consortium of researchers and practitioners falls prevention using video education. from across Australia to develop a nationally- Members: Professor Daniel Chan, Dr Nady focused website and campaign to promote Braidy, Dr Christina Xu, Dr Iveta Valachova, Dr advance care planning. Anita Ko, Dr Frank Liu, Dr Van Nguyen and Dr yyDevelopment of an online education program Gyeong Stroud on behalf of the University of Wollongong to support overseas qualified nurses working in dementia care settings Aged Care Research - Liverpool yyParticipation in a project with the Clinical Excellence Commission called ‘Top 5’ to Research undertaken by the Unit has focused improve care of patients with dementia. on multidisciplinary, clinically based research into The Unit is supplying outcome data on falls, geriatric syndromes, particularly the evaluation complaints, diagnosis of dementia and anti- of cognition in culturally diverse populations. psychotic use. Other areas of interest include the evaluation and management of acutely unwell older people in the yyDevelopment of systems – in collaboration with Emergency Department and inpatient settings, Emergency Department staff – to improve the long-term outcomes of service provision, dementia identification and admission pathways of frail older patients and patients with delirium.   Research in the South West  37

yyAnalyses from the Unit’s comprehensive patient yyHealth services research studying the impact database including coding and casemix review, of electronic medical records on rheumatology falls mapping and review of IIMS data. outpatient work practices. yyParticipation in the Koori Growing Old Well Study Members of the Unit are also involved in – an NHMRC project investigating dementia educational research stemming from design and within Aboriginal communities. evaluation of UNSW’s innovative undergraduate Medicine program. Members: Dr Chris Shanley, Dr David Basic, Dr David Conforti, Dr Angela Khoo, Dr Desiree Leone The Unit’s research program is based in the and Dr Tabitha Hartwell Ingham Institute with collaborations at the IIRC in the School of Medical Sciences at UNSW’s Kensington campus. Arthritis Research Unit

The Arthritis Research Unit within the Rheumatology Department at Liverpool Hospital has three active research programs: inflammation basic science; clinical and health services research relevant to rheumatic and autoimmune diseases and medical education and evaluation research.

The Unit’s research focus is centred on common types of arthritis and related autoimmune diseases, including rheumatoid arthritis (RA), scleroderma, and systemic lupus erythematosus (SLE). It seeks to explore underlying mechanisms operating in these diseases and how they are managed, with the aim of developing new or improved treatments. Members: Dr Katherine Bryant, Associate The Unit has collaborations with basic science Professor Kathy Gibson, Dr Geraldine Hassett, researchers in the Inflammation and Infection Professor Patrick McNeil, Dr Sean O’Neill and Dr Research Centre (IIRC) at UNSW and is part of the Vivek Thakkar Asia Pacific Lupus Collaboration (APLC).

Currently, the following research activities are C entre for Health Equity Training, Research underway: and Evaluation (CHETRE) yyBasic science programs studying how mast cell tryptases cause cartilage damage in arthritis; CHETRE’s mission is to achieve better and fairer structure/function studies of tryptase variants; the health for families and communities in south role of leukocyte immunoglogulin -like receptors western Sydney, and throughout Australia and (LILRs) in RA and SLE; and the significance of internationally, through conducting research that: autoantibodies to lipoproteins in SLE. yyenhances understanding of the needs of yyClinical research, currently developing a clinically vulnerable families and communities; useful low disease activity index for SLE (in collaboration with APLC), examining the place yydevelops and trials interventions to improve of vertebroplasty as a treatment for osteoporotic health and address health inequities; and crush fractures; health literacy of consumers; yydevelops and trials ways to widely and and the evidence base underpinning clinical sustainably implement effective interventions rheumatological practice. and innovations to improve health and health equity in whole populations. 38  UNSW in the South West 2011-2013  

CHETRE conducts world-leading health equity CONCERT is building on the success of the South research with programs of work in children and West Sydney Translational Cancer Research Unit young people research, research with communities (SWS TCRU), established over the past three years and populations, and implementation and through CINSW funding. The proud achievements translational research to support population and of the SWS TCRU include: service system uptake of effective interventions and social innovations to improve health equity. yy Designed the integrated MRI-Linear Accelerator CHETRE is part of Population Health South (MRI-Linac), an Australian-first initiative where Western Sydney Local Health District, the UNSW radiation and imaging of tumours is done both Australia Centre for Primary Health Care & Equity in real-time, more effectively targeting radiation and the Ingham Institute for Applied Medical towards the tumour. Research. yy Established the Translational CTC facility, unique to NSW. Measuring CTC and their genetic profile Members: Ms Cheryl Jane Anderson, Ms Fiona has huge potential for improving prognosis and Byrne, Associate Professor Elizabeth Comino, treatment of cancer patients. Ms Emma Friesen, Dr Rebekah Grace, Ms Fiona Haigh, Associate Professor Elizabeth Harris, yy Built up an inter-regional biobank for cancer Dr Patrick Harris, Dr Iqbal Hasan, Mr Oshana tissue, with more than 3200 bio-specimens now Hermiz, Dr Michiko Hoshiko, Mrs Catherine Kaplun, available for tumour research in the SWSLHD Ms Elizabeth Kemp, Associate Professor Lynn and Illawarra Shoalhaven LHD. Kemp, Dr Jennifer Knight, Ms Mary Knopp, Ms yy Expanded psychosocial research to Fakhra Maan, Mr Harrison Ng Chok, Ms Mellanie enhance cancer patients’ and carers’ coping Rollans, Dr Vanessa Rose, Ms Sheryl Scharkie, mechanisms. Ms Kate Short, Ms Joan Silk, Ms Jaimie Tredoux, yy Developed new preclinical models that more Ms Natasha West, Ms Anna Williams, Ms Siggi closely resembled the clinical situation, for Zapart, Mr Nicholas Rosser, Ms Karla Jaques, Ms testing novel therapies for pancreatic cancer. Brehanna Kaplun yy Developed the first Australian evidence-based guidelines for cancer pain management. CONCERT TCRC yy Demonstrated feasibility for smarter decision- making to improve treatment of lung cancer The Centre for Oncology Education and patients. Research Translation (CONCERT) embeds yy Reduced medication side effects in cancer translational cancer research into clinical patients through electronic record keeping practice, encompassing basic science, clinical, for chemotherapy prescription in the Illawarra psychosocial and health services research. Shoalhaven LHD. CONCERT brings together a diverse consortium of 200+ professional members spanning all aspects yy Trained the next generation of oncologists of cancer research, diagnosis, treatment and care. and medical researchers through clinical and academic programs. CONCERT’s NSW institutional stakeholders include UNSW Australia, the University of Western Sydney, the University of Wollongong, the Ingham Institute C ollaboration for Cancer Outcomes Research for Applied Medical Research, Illawarra Health and Evaluation (CCORE) and Medical Research Institute, and the Illawarra Shoalhaven and South Western Sydney Local The Collaboration for Cancer Outcomes Health Districts (LHD), as well as collaborating Research and Evaluation (CCORE), established partner institutions in the ACT (Health Directorate in 1999, is affiliated with the Cancer Therapy ACT Government, Australian National University Centre, Liverpool Hospital and the Ingham Institute and University of ). for Applied Medical Research. The Liverpool Hospital Cancer Therapy Centre is a tertiary CONCERT’s large demographic footprint serves a referral centre for the treatment of cancer patients population of over 1 million, with a large catchment in south western Sydney. of new cancer cases (16% in NSW), including potentially more vulnerable populations of CCORE aims to improve cancer outcomes culturally and linguistically diverse backgrounds or through research and the implementation of best living in rural/remote areas. practice measures into routine clinical practice in the treatment of cancer. CCORE has particular CONCERT TCRC is funded by Cancer Institute expertise in radiotherapy but also has broad NSW (CINSW) to the tune of $6.5m for five years interests in all areas of cancer management. Staff and was launched in July 2014. UNSW and Ingham members include radiation oncologists, a medical Institute are responsible for administration and oncologist, epidemiologist, data managers and management, respectively, of CONCERT TCRC. project officers.   Research in the South West  39

CCORE has a wide range of activities that CCORE has been very productive with many peer- extend from the individual cancer patient to the reviewed publications, contributions to National organisation of cancer services at state, national Tumour Guidelines and commissioned reports. and international levels. Our research covers Following the publication of a report on the optimal the broad spectrum of clinical cancer including utilisation of radiotherapy as a series of papers surgery, medical and radiation oncology, and in Cancer the benchmark developed is currently is achieving these aims through the following being used and acknowledged worldwide. strategies: Led by Professor Barton, a number of large yy establishment, implementation and evaluation collaborative studies that have had a major impact of best practice guidelines and evidence on policy and practice in relation to state, national summaries; and international strategic planning projects for yy exploration of methods by which best practice cancer services have been completed, including: guidelines may be implemented locally; yy Victorian Cancer Services Framework Report yy cancer clinical outcomes research; yy Applied Sciences of Oncology Course yy refining of methodologies of clinical research yy Papua New Guinea Cancer Services Report including quality of life, economic and qualitative programs; and yy New South Wales Cancer Council’s Radiotherapy Summit and Working Party yy establishment of partnerships and linkages between clinicians, universities and other clinical yy Overview of Cancer Treatment Services in research groups locally and internationally. Western Australia Many members of CCORE hold conjoint yy Optimum radiotherapy utilisation appointments at UNSW and four staff are currently yy A feasibility study of radiotherapy in the enrolled in PhDs under the supervision of Professor Michael Barton OAM. Three PhDs have been awarded in the last year. 40  UNSW in the South West 2011-2013  

yy Radiotherapy in low and middle income visiting program for Aboriginal families living countries in the Liverpool, Fairfield and Bankstown Local yy Southern NSW Radiation Oncology Training Government Areas. Network for Registrars The Departments are also active in the yy Optimal chemotherapy utilisation in cancer development of population child and family health yy Adult Glioma guidelines initiatives and supports Public Health Medicine trainees and through the supervision of medical Members: Professor Michael Barton, Professor student placements by UNSW students. Geoff Delaney, Dr Gabriel Gabriel, Dr Timothy Hanna, Dr Susanna Jacob, Dr Eng-Siew Koh, Dr Early Years research continues to grow across Myo Min, Dr Weng Ng, Dr Trang Pham, Dr Jesmin both SWSLHD and SLHD through the Early Years Shafiq, Dr Mei-ling Yap and Dr Karen Wong Research Group (EYRG), which was established in 2010 under the leadership of Associate Professor John Eastwood. The group brings together C ommunity Paediatrics and Child Health perinatal, paediatric and child health clinical and community health professionals interested in early The Departments of Community Paediatrics years research and is focussed on advancing and Child Health are active participants and the understanding of early developmental origins leaders in state-wide, metropolitan, Area and local of health and disease and to translate research initiatives for children, young people and their outcomes into clinical practice which improves families. The aim of the SWSLHD Departments the prognosis and outcomes of children and the of Community Paediatrics and Child Health is to delivery of better health services to children and ‘Improve and protect the health and development their families. of children, young people and their families in Sydney South West Area Local Health District, A secondary objective of the EYRG is to strengthen through the delivery of population child and youth research capacity and promote collaborative health programmes, service improvement, and research. This is facilitated by the EYRG Research developmental, behavioural, child protection and Coordinator, Dr Alexandra Hendry, who supports “high needs” paediatric clinical services.’ people interested in conducting early years and child health research in the SWSLHD and The services are committed to clinical innovation SLHD and assists them with project design, and service improvement and achieve this ethics applications, project implementation, through a number of population health and clinical data analysis and final dissemination. The EYRG improvement projects which are cross-cutting and ‘flagship’ project is the Maternal and Child Health involve collaborations across agencies and sectors Outcomes Data Project. The EYRG is undertaking of society. These include clinical projects such as epidemiological and health services research to the development of clinical practice guidelines for identify associations between early life experiences clinicians in Emergency Departments to assist them and the health, development and welfare of infants in their assessment and acute management of crying born in SWSLHD and SLHD. This project explores and unsettled infants; supporting the development in detail the maternal and child health situation of LHD guidelines to support the psychosocial in these LHDs, and describes how families with assessment of vulnerable women who are expecting/ young children engage with the available health have a new baby; working with Families NSW to services. This is particularly important to know update the Love Talk Sing Read Play resources and and understand as it will assist with the planning implement and evaluate a social media strategy for and delivery of effective and dedicated health this project. More recently, Community Paediatrics services to support families with young children, and Child Health, together with Families NSW are especially the socio-economically disadvantaged commenced the re-development of the Aboriginal and vulnerable. resource “Deadly Tots” into an interactive phone app which will be subsequently evaluated by our team Members: Dr Sunil Adusumilli, Dr Joanna members. The services are also active in the area of Alexander, Dr Kate Alexander, Dr Indra Alexander, child protection research. Dr Roger Blackmore, Dr Margaret Brown, Dr Lenina Chennariyil, Dr Ritu Datta, Associate Professor The Departments collaborate with the Centre for John Eastwood, Dr Pankaj Garg, Dr Sherly Halim, Health Equity, Training, Research and Evaluation Dr Alexandra Hendry, Dr Romy Hurwitz, Dr Kalpesh (CHETRE) on a number of Aboriginal development Jain, Dr Paul Joshua, Dr Alaric Koh, Dr Jean Lim, projects including the Gudaga Goes to School Dr Jenny McDonald, Dr Ross McLeod, Dr Tania Project and Bulundidi Gudaga – a Closing the Gap May, Dr Justine Nobel, Dr Natalie Ong, Dr Chitra study. Additionally, the New Directions project is Parab, Dr Jacky Pollack, Ms Tracey Popham, Dr being conducted in collaboration with the child Shanti Raman, Dr Amy Rogers, Dr Sanda Smith, Dr and family health nurse who run a sustained home Douglas Thenuwara, Dr Grace Wong, Dr Suky Yim and Dr Terence Yoong   Research in the South West  41

Diabetes and Endocrinology

The overall aim of the research programme at the Department of Diabetes and Endocrinology at Bankstown-Lidcombe Hospital is to investigate clinical aspects of diabetes management and diabetes education that may result in findings of benefit to those who have diabetes and those who suffer from its many complications. Of particular interest to the Department in this regard are the possible applications of computer technology to the assessment and management of diabetes by patients and the health professionals who care for them.

The Diabetes Centre actively encourages teaching, quality audit and research activity and all members of the Department have undertaken in-house and collaborative clinical audit and research work in many aspects of diabetes care. As a multidisciplinary Department all staff are involved in undergraduate and postgraduate education for medical, nursing and allied health disciplines. The Department actively encourages professional development and several members of the Department have undertaken postgraduate degree courses.

The Diabetes Centre has a longstanding interest in information technology applications and significant expertise in data sets and audit activities with a national and international reputation. The Department functioned (until Dec 2012) as the National Benchmarking Centre for Quality Audit Activities in Diabetes and was involved in the coordination of eight Australian National Diabetes Information Audit & Benchmarking (ANDIAB) surveys since 1998. An ANDIAB survey (2011) and an ANDIAB2 survey (2012) were co-ordinated in Electron Microscopy Laboratory 2011-2013.

In 2011-2013, two research funding applications The Electron Microscopy Laboratory (EML) is were successful and research work was accepted primarily responsible for diagnostic examination for presentation at scientific meetings including of surgical specimens in Anatomical Pathology. 37 papers and posters. The unit published nine Research activities include quantification of journal articles and two national reports. Members angiogenesis in prostate cancer, analysis of of the Department have been invited speakers at cell types involved in the pathogenesis of renal national and international meetings, and several fibrosis and ultrastructural characterisation of brain serve on diabetes advisory boards and committees neoplasms. to SWSLHD and to State and Commonwealth Members: Professor David Davies, Professor Jim governments. Yong, Dr Yuri Bobryshev and Associate Professor Members: Dr Sarah Abdo, Ms Robyn Barnes, Ms Murray Killingsworth Nikki Edghill, Associate Professor Jeff Flack, Ms Catherine Finneran, Ms Gael Holters, Dr Min Ling, Ms Jessica MacKenzie, Ms Adedapo Oni, Ms Jane Emergency Medicine Research Unit Payne, Dr Glynis Ross, Mr B Sandiforth, Ms Megan Stephens and Dr Tang Wong Since its establishment in late 2005 the Emergency Medicine Research Unit has (EMRU) undertaken numerous research and academic activities including participation in several multicentre clinical trials, completion of numerous internal research projects, invitations 42  UNSW in the South West 2011-2013  

HIGH IMPACT PUBLICATION

Brown SG, Stone SF, Fatovich DM, Burrows SA, Holdgate A, Celenza A, Coulson A, Hartnett L, Nagree Y, Cotterell C, Isbister GK. Anaphylaxis: clinical patterns, mediator release, and severity. J Allergy Clin Immunol. 2013 Nov;132(5):1141-1149.e5. doi: 10.1016/j.jaci.2013.06.015. Epub 2013 Aug 1.

BACKGROUND: Prospective factors and mediator patterns delayed deteriorations (76%) human studies of anaphylaxis associated with reaction severity occurred within 4 hours of and its mechanisms have been and delayed reactions. initial epinephrine treatment. Of limited, with few severe cases or the remaining 7 cases, 2 were examining only 1 or 2 mediators. RESULTS: Of 412 reactions severe and occurred after initially in 402 people, 315 met the severe reactions, within 10 hours. OBJECTIVES: We wanted to definition for anaphylaxis by the All mediators were associated define the clinical patterns of National Institute of Allergy and with severity, and 1 group (mast anaphylaxis and relationships Infectious Diseases/Food Allergy cell tryptase, histamine, IL-6, between mediators and severity. and Anaphylaxis Network. Of IL-10, and tumor necrosis factor 97 severe reactions 45 (46%) receptor I) was also associated METHODS: Data were collected were hypotensive, 23 (24%) were with delayed deteriorations. during treatment and before hypoxemic, and 29 (30%) were Low platelet activating factor discharge. Serial blood samples mixed. One patient died. Severe acetyl hydrolase activity was were taken for assays of reactions were associated with associated with severe reactions. mast cell tryptase, histamine, older age, pre-existing lung anaphylatoxins (C3a, C4a, C5a), disease, and drug causation. CONCLUSIONS: The cytokines (IL-2, IL-6, IL-10), Delayed deteriorations treated results suggest that multiple soluble tumor necrosis factor with epinephrine occurred in inflammatory pathways drive receptor I, and platelet activating 29 of 315 anaphylaxis cases reaction severity and support factor acetyl hydrolase. Principal (9.2%) and were more common recommendations for safe component analysis defined after hypotensive reactions observation periods after initial mediator patterns, and logistic and with pre-existing lung treatment. regression identified risk disease. Twenty-two of the 29

to join several major research bodies, invitations population health programs, and support graduate to speak at national conferences and supervision and postgraduate learning in population health and of medical students in their research activities. epidemiology. The Group has a strong track record The Unit has been successful in applying of collaborating with units within Population Health for funding through the NHMRC, Emergency as well as with other research centres and services Care Institute and the US Food Allergy and within the Local Health District. Anaphylaxis Network to name a few. Current research is focussed in the areas The EMRU was a principal investigator in the of environmental health and air pollution ARISE sepsis study, the largest ever randomised epidemiology, neighbourhoods and health, control trial conducted in Australasian emergency health services utilisation, oral health and in departments which has recently been completed the use of spatial methods and linked data for and accepted for publication in NEJM. The EMRU epidemiological research. has continuing research in the areas of sepsis, procedural sedation and emergency airway Members: Dr Roy Byun, Dr Shanley Chong and management. Professor Bin Jalaludin

Epidemiology Group, Healthy People and Gastroenterology and Liver Services - Places Unit Bankstown

Health outcomes of a community can be Gastroenterology and Liver Services at maximised through effective and efficient Bankstown-Lidcombe Hospital have a strong track population health programs, interventions and record in the areas of radiofrequency ablation of services. Barrett’s oesophagus, endoscopic ultrasound, enteroscopy, confocal endomicroscopy, colorectal The Epidemiology Group conducts research, and pancreatic cancer and inflammatory bowel evaluation and surveillance in population health, diseases management and research. promotes an evidence-based approach to   Research in the South West  43

Established projects include the identification and prevention and management of chronic disease use of protein biomarkers in IBD awarded patents risk factors, health services research and health through UNSW, genetic markers in pancreatic systems with a focus on health informatics and cancer, endoscopic ultrasound and fine needle eHeatlh. The Unit is also examining multidisciplinary biopsy, confocal endomicroscopy and functional primary care, with a focus on the practice nurse, imaging of the gastrointestinal tract, optical and multidisciplinary integrated care, particularly biopsies of dysplasia and clinical drug trials for across the interface between primary and acute care. inflammatory bowel diseases in NSW. Professor Liaw is a chief investigator in the NHMRC Centre of Research Excellence for eHealth, APHCRI Professor Rupert Leong was the supervisor of Centre of Research Excellence in Obesity in Primary two finalist Young Investigator Award researchers Health Care (COMPaRE) and, more recently, the at the AGW conference of 2014 and two Young WHO Collaborating Centre in eHealth. Investigator Award finalists including the eventual runner up at the Institute of Digestive Diseases The communities the Unit has particularly interest conference in Hong Kong. in include Australians of Aboriginal descent and from CALD backgrounds. With funding from GP Genomic sequencing of pancreatic cancer Synergy, the GP Unit has developed and pilot-tested research has been completed by PhD student and a Cultural Respect Program and Toolkit to improve Gastroenterology VMO Dr Jeremy Humphris. Dr ways of thinking and ways of doing cultural respect Sam Al-Sohaily and Dr Ken Koo have completed in general practice. A cluster randomised controlled their PhDs on colorectal cancer biomarkers and trial (RCT) to evaluate this tool definitively. epidemiology. With funding and other support from the UNSW Members: Dr Ahmad Alrubaie, Dr Sam Al-Sohaily, Faculty of Medicine, MREII and South Western Professor Andrew Biankin, Dr Rhys Butcher, Sydney Local Health District, the Unit has Dr David Chang, Dr Jeremy Humphris, Dr Ken established an eResearch facility (infrastructure Koo, Professor Rupert Leong, Dr Chris Meredith, and protocols) - the UNSW electronic Practice Associate Professor Neil Merrett, Dr Darren Pavey, Based Research Network (ePBRN) - in the Fairfield Professor Shan Rajendra and Ms Diane Redmond health neighbourhood.

The ‘community laboratory’ to support translational General Practice Unit health services research and clinical trials is currently represented by 10 general practices, The academic General Practice Unit is an Fairfield Diabetes Service and Fairfield Hospital. independent teaching general practice situated in The ePBRN extracts and links routinely collected Fairfield Hospital, providing services to health service data from electronic information systems of staff, refugees and the local community. The Unit participating general practices and health service works closely with the Medicare Local to support units. The ePBRN supports our current research local general practices and develop, implement and program in integrated care research, translational evaluate innovative and culturally appropriate models (T2 and T3) research, clinical trials, cohort studies, of care at the primary-secondary care interface. association studies and longitudinal studies in the context of high prevalence chronic diseases The GP Unit are an integral part of the UNSW South (including cancer) and acute health problems such Western Sydney Clinical School, School of Public as infectious diseases. The ePBRN currently also Health and Community Medicine (SPHCM) and supports the development of ‘virtual case-control Centre for Primary Health Care and Equity (CPHCE). studies’ to examine determinants of good diabetes We teach in all three Phases of the UNSW Medicine cycle of care as well as the use of the ‘big data’ program. The Unit has also completed, with funding to develop predictive models, with funding from from the Sydney ICTN, a pilot study and developed the HCF Research Foundation, for admission/re- online resources to support inter-professional admission of patients with diabetes. teaching and learning at Fairfield. Members: Dr Sarah Dennis, Dr Dayna Griffen, The Unit has an emphasise on cultural respect in Dr Fatema Khatun, Dr Andrew Knight, Mr Alireza all they do with the communities and as part of Rahimi Khorzoughi, Professor Siaw-Teng Liaw, Mr undergraduate and GP registrar training. As part M Mohammed, Dr Nala, Ms Jane Taggart , Dr Thi of the Primary Health Care Research Unit (PHCRU) Nguyen, Dr Sanjyot Vagholkar, Dr Hairong Yu the Unit focuses on building the research capacity of primary care professionals.

Research and evaluation activities, with funding from agencies such as the NHMRC and ARC, are focused on the systematic and integrated care of high prevalence chronic illness (including cancer), 44  UNSW in the South West 2011-2013  

Hepatitis Research Group papers have been published and grants secured in this field and work is ongoing.

The busy clinical hepatitis service at Liverpool The Group is very involved in patient health Hospital has formed the platform for significant literacy, and has produced novel tools for patients clinical hepatitis research and the establishment of to understand their hepatitis, including YouTube the Hepatitis Research Group (HRG) under the videos and mobile apps. The production and leadership of Associate Professor Miriam Levy. evaluation of these materials forms part of our Research has included investigation of hepatitis research. B Virus (HBV) infection in pregnancy, where The Group also utilises cutting edge technology we are international leaders. The HRG has including Fibroscan and Shear Wave ultrasound defined, for the first time in Australia, the rate to non-invasively identify liver fibrosis for clinical of HBV perinatal transmission despite passive/ and research purposes. We use these tools to active immunoprophylaxis and identified that further characterise our viral hepatitis B cohort and high maternal load is the most significant risk for determine its role in algorithms of chronic HBV. transmission. The Group has demonstrated that the use of antiviral therapy in the last trimester can The HRG is also participating in a number of reduce the transmission of HBV infection. clinical drug trials using new agents for chronic HBV and HCV infection. This reflects the rapid The safety and efficacy of different agents is under changes in therapeutics in this field and will allow examination in collaboration with the national patients to access new therapies. virological reference laboratory, VIDRL. The impact of pregnancy, and the postpartum period, because A study by Associate Professor John Quin of its unique immunological and hormonal milieu, examining the role of immune stimulation in on HBV replication is under examination. The inducing HBV treatment responses is currently HRG has examined the rate and character of underway. postpartum flares of hepatitis, to understand their impact on the natural history of HBV infection in Members: Associate Professor Miriam Levy, Dr pregnancy which is suspected to be different from Scott Davison, Ms Anne Glass, Ms Heidi Lord, that described in standard liver clinic cohorts, Associate Professor John Quin and all members of which are dominated by males. A number of the hepatitis allied health team

HIGH IMPACT PUBLICATION

Greenup AJ, Tan PK, Nguyen V, Glass A, Davison S, Chatterjee U, Holdaway S, Samarasinghe D, Jackson K, Locarnini SA, Levy MT. Efficacy and safety of tenofovir disoproxil fumarate in pregnancy to prevent perinatal transmission of hepatitis B virus. J Hepatol. 2014 May 5. pii: S0168-8278(14)00301-8. doi: 10.1016/j.jhep.2014.04.038. [Epub ahead of print].

BACKGROUND AND AIMS: of treated and untreated cohorts 3% and 18% respectively. Perinatal transmission of were compared. Congenital abnormality rate hepatitis B virus still occurs and neonatal growth centiles despite immunoprophylaxis in RESULTS: 120 women with were similar across cohorts. approximately 9% of children 130 pregnancies used TDF Perinatal transmission reduced from highly viraemic mothers. (58), lamivudine (52 including significantly to 2% and 0% in Antiviral therapy in this setting four who switched due to TDF TDF and lamivudine cohorts, has been suggested, however intolerance) and no therapy compared with 20% in untreated. with limited evidence to direct (20). 96% were HBeAg positive, agent choice. with baseline viral load mean CONCLUSIONS: TDF in this 7.8logIU/ml (±0.72) and ALT setting is safe, effective and METHODS: We conducted a median 25U/L (18.75-33). more potent than lamivudine. multi-centre, prospective, opt-in Duration of antiviral theraphy Antiviral therapy did not observational study of antiviral before birth was mean 58days adversely impact obstetric or safety and efficacy in pregnant (±19) TDF and 53 (±14) infant parameters. More TDF women with high viral load lamivudine. Viral load declined intolerance occurred than (>7logIU/ml); lamivudine was by 3.64logIU/ml (±0.9) TDF and expected. Perinatal transmission used from 2007 to 2010 and 2.81logIU/ml (±1.33) lamivudine. was significantly reduced in tenofovir disoproxil fumarate Virologic failure (birth viral antiviral therapy cohorts. (TDF) from late 2010. Outcomes load >7IU/ml) occurred in   Research in the South West  45

Inflammatory BowelD isease Research Group The group is currently collaborating with Royal Adelaide Hospital and Flinders Medical Centre The Inflammatory Bowel Disease (IBD) in Adelaide to assess longer term outcomes of Research group is in its infancy being established thiopurine metabolite monitoring in IBD patients. following the employment of an IBD nurse in In addition, biologic level testing is in the process August 2011. The research group has been a of being established at Liverpool Hospital in member of the Australian and New Zealand IBD collaboration with the Department of Immunology. (ANZIBD) consortium since 2011 and is working in The research group is also involved in the FOCUS collaboration with eleven other IBD centres across study (faecal microbiota transplantation FMT) New Zealand and Australia to accurately genotype in chronic active ulcerative colitis). The group and phenotype all IBD patients under our care. is also interested in health literacy and patient empowerment with design of specific patient Research currently being undertaken in centred tools. This is being done in collaboration collaboration with the ANZIBD consortium include: with other members of the ANZ consortium, Afaf genomic predictors of refractory ulcerative Girgis at the Ingham Research Institute and Corey colitis and response to treatment, use of biologic Siegel at Dartmouth-Hitchcock Inflammatory Bowel agents in IBD pregnancies: patient and physician Disease Centre. perceptions and biologic levels in the neonate, rectal tacrolimus in distal ulcerative colitis, Members: Dr Susan Connor, Dr Watson Ng, Dr patient outcomes on anti-TNF agents in Crohn’s Alexandra Sechi, Dr Elise Sawyer and all members disease in Australia. The ANZIBD consortium of IBD allied health team also collaborates with the International Genetics Consortium. The IBD research group is also interested in therapeutic optimisation through therapeutic drug monitoring of both thiopurine and biologic agents. 46  UNSW in the South West 2011-2013  

Intensive Care The group of ICU specialists has established research collaboration within Australia as well as Research at the Intensive Care Unit (ICU), the UK and Scandinavia and authored 39 papers Liverpool Hospital, is focused on multi-centre in the last year. clinical trials coordinated via the Australia and Members: Professor Ken Hillman, Associate New Zealand Intensive Care Society Clinical Trials Professor Michael Parr, Associate Professor Anders Group (ANZICS CTG) as well as single-centre Aneman, Ms Sharon Micallef, Dr Satyadeepak studies designed and performed within the unit. Bhonagiri, Dr Kanaka Rachakonda, Dr Antony The collaboration with the ANZICS CTG over the Stewart, Dr William O’Regan, Dr Victor Tam, Dr last decade has resulted in several landmark Amjed Aziz, Dr Ross Calcroft, Dr Patrick Liston, studies that have been pivotal in defining best Dr Monique Leijten, Dr Craig Hore, Dr Ritesh clinical practice in fluid resuscitation, renal Sanghavi, Dr Rangappa Ranganatha. replacement therapy, glucose control and sepsis management.

The Unit has made significant contributions Neurology to international multi-centre studies of fluid resuscitation, blood transfusion as well as Clinician researchers in Neurology and Stroke at management of patients following trauma and Liverpool and Bankstown-Lidcombe Hospitals are cardiac arrest. Examples of single-centre studies chief investigators in several competitively funded within the Unit include prediction models for research projects based in South Western Sydney intra-abdominal hypertension, measurements of Clinical School and Ingham Institute for Applied cerebral autoregulation and clinical audits. Finally Medical Research. the Unit has been instrumental in developing rapid Several studies are in partnership with general response systems and continues to research best practitioners, cardiologists, neurosurgeons and practice models, monitoring strategies and clinical public health specialists. These have included outcomes in this area. collaborative research in primary care, the BUPA

HIGH IMPACT PUBLICATION

Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, Glass P, Lipman J, Liu B, McArthur C, McGuinness S, Rajbhandari D, Taylor CB, Webb SA, Parr M, Aneman A, Aziz A; CHEST Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med. 2012 Nov 15;367(20):1901-11. doi: 10.1056/NEJMoa1209759. Epub 2012 Oct 17.

BACKGROUND: The safety and days. Secondary outcomes 38.0% of patients, respectively efficacy of hydroxyethyl starch included acute kidney injury and (P=0.005), and renal failure (HES) for fluid resuscitation failure and treatment with renal- occurred in 10.4% and 9.2% of have not been fully evaluated, replacement therapy. patients, respectively (P=0.12). and adverse effects of HES on HES was associated with survival and renal function have RESULTS: A total of 597 of significantly more adverse events been reported. 3315 patients (18.0%) in the HES (5.3% vs. 2.8%, P<0.001). group and 566 of 3336 (17.0%) METHODS: We randomly in the saline group died (relative CONCLUSIONS: In patients in assigned 7000 patients who had risk in the HES group, 1.06; 95% the ICU, there was no significant been admitted to an intensive confidence interval [CI], 0.96 difference in 90-day mortality care unit (ICU) in a 1:1 ratio to 1.18; P=0.26). There was no between patients resuscitated to receive either 6% HES with significant difference in mortality with 6% HES (130/0.4) or saline. a molecular weight of 130 kD in six predefined subgroups. However, more patients who and a molar substitution ratio Renal-replacement therapy was received resuscitation with of 0.4 (130/0.4, Voluven) in used in 235 of 3352 patients HES were treated with renal- 0.9% sodium chloride or 0.9% (7.0%) in the HES group and replacement therapy. (Funded by sodium chloride (saline) for 196 of 3375 (5.8%) in the saline the National Health and Medical all fluid resuscitation until ICU group (relative risk, 1.21; 95% Research Council of Australia discharge, death, or 90 days CI, 1.00 to 1.45; P=0.04). In the and others; CHEST ClinicalTrials. after randomization. The primary HES and saline groups, renal gov number, NCT00935168.). outcome was death within 90 injury occurred in 34.6% and   Research in the South West  47

funded STOP-STROKE and NHMRC funded amongst general practitioners; and the quality DESPATCH projects to reduce stroke risk in atrial of life measures for older people living in the fibrillation, the UNSW and Clinical Excellence community with essential tremor. Commission supported Program of Research Informing Stroke Management (PRISM) which uses Members: Associate Professor Dennis Cordato, routinely collected data linkage to assess care Mr Chris Goumas, Associate Professor Matthias and outcomes in ischaemic stroke, intracerebral Jaeger, Professor Bin Jalaludin, Professor Dominic haemorrhage, subarachnoid haemorrhage and Leung, Associate Professor Mark Sheridan, transient ischaemic attack and the OASIS (Sub-) Dr Melina Gattellari, Associate Professor John Study. Worthington and Professor Nick Zwar

OASIS is state-wide study of subarachnoid haemorrhage supported by the NHMRC. More Orthopaedics recently the group has attracted Office and Health and Medical Research funding for the Home to Research activities are conducted through the Outcome (H2O) Study examining the impact of Whitlam Orthopaedic Research Centre (WORC) the wider implementation of stroke thrombolysis - part of the Ingham Institute for Applied Medical in NSW and the introduction of new stroke units Research. WORC has research expertise in multi- and one investigator is leading the Agency of centre randomised controlled trials, in the fields Clinical Innovation’s response to recently reported of trauma surgery, joint replacement surgery and Unwarranted Clinical Variation in stroke care. rehabilitation.

The Departments have also worked with the Although most of the WORC’s research activities Department of Aged Care at Bankstown- relate to musculoskeletal conditions, they are Lidcombe Hospital on a number of projects also involved in research in other areas including addressing stroke risk factors and outcomes in the outcome registries, methodological studies, elderly; the South-West Sydney TIA study (SWS- surveys and systematic reviews. TIA), anticoagulation usage for stroke prevention 48  UNSW in the South West 2011-2013  

There are also many collaborative projects Projects conducted within SWSLHD or with both locally and nationally. WORC supervises contribution from our researchers during this many post-graduate (Masters and PhD) and period have included: undergraduate (UNSW ILP) students each year. 1. Cluster randomised controlled trial of facilitated Members: Professor Ian Harris, Associate case conferencing versus usual care for Professor Justine Naylor, Ms Elizabeth Armstrong improving end of life outcomes in aged care and Dr Pooria Sarrami residents with advanced dementia and their families (IDEAL trial)

Palliative Care 2. Examining Organisational Complexity to Improve Hospital Patients’ Safety-Healing The research team for SWSLHD Palliative Care Environments services spans projects based in acute care, 3. Efficacy of Elastic Compression Stockings in community based care and palliative care inpatient Treatment of chronic oedema in Palliative Care services. Its aim is to undertake research which Patients. directly informs the provision of care to those living with advanced life limiting illness and their families. 4. Strategies to decrease pain through implementing a dual clinical pain pathway In the period of 20011-2013, expansion of research activity and funding has occurred 5. Carers views of home oxygen use across clinical sites and disciplines. The team has received over $32 million in competitive 6. Advance care planning in the emergency research funding. Importantly, the team has been department: identification of barriers, instrumental in the development and support facilitators and technological solutions of ImPaCCT (Improving Palliative Care through 7. A randomised controlled trial of structured Clinical Trials), the NSW collaborative trials group, home-based support and education for carers which was successful in securing a further 3 years of people with high grade glioma of funding from Cancer Institute New South Wales. 8. Self-reported evaluation of the adverse effects of Dexamethasone. The SEED study   Research in the South West  49

9. The Measurement of function limited The team has continued to be a lead site for by breathlessness in advanced cancer: the Palliative Care Clinical Trials Collaborative Comparison of the 6-minute walk test, 2-minute (PaCCSC) recruiting actively to six randomised walk test, isometric arm exercises and reading control clinical trials in the areas of ketamine for numbers cancer pain, octreotide for bowel obstruction, risperidone for delirium, sertraline for dyspnoea, 10. Randomised double blind placebo controlled morphine and oxycodone for dyspnoea, and pilot phase II trial of oral melatonin for the megestrol acetate for appetite. Two of these trials, prevention of delirium in hospital in people with ketamine for cancer pain and octreotide for bowel advanced cancer obstruction are now complete.

HIGH IMPACT PUBLICATION

Luckett T, Goldstein D, Butow PN, Gebski V, Aldridge LJ, McGrane J, Ng W, King MT. Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncol. 2011 Dec;12(13):1240-8. doi: 10.1016/S1470- 2045(11)70212-1. Epub 2011 Oct 11.

BACKGROUND: Ethnic minority mean scores adjusted for -0·87 to -0·03; p=0·035), and is associated with higher cancer socioeconomic status and other overall HRQoL (-0·49, -0·78 to incidence and poorer survival sociodemographic and clinical -0.20; p=0·0008). Results were than is being in the majority variables, where available. Effect significantly heterogeneous group. We did a systematic sizes greater than 0·5 and 95% for overall HRQoL and all review and meta-analysis to CI that included 0·5 or -0·5 were domains. Tests for interaction, assess whether psychological deemed clinically important, with for adjusted versus unadjusted morbidity and health-related negative values indicating worse and comparisons of high-quality, quality of life (HRQoL) were outcomes in minority patients. medium-quality, and low-quality affected by minority status. We assessed publication bias articles, were generally non- by estimating the number of significant, which suggests no METHODS: We searched potential unpublished studies bias. We found no evidence of Medline, AMED, PsycINFO, and the number of non- any substantive publication bias. Embase, CENTRAL, CINAHL, signficant studies with p=0·05 PubMed, Sociological Abstracts, required to produce a non- INTERPRETATION: Hispanic and Web of Science for English- significant overall result. cancer patients in the USA, language articles published but not other ethnic minority between Jan 1, 1995, and FINDINGS: We identified 21 groups, report significantly October, 2009. Articles were eligible articles that included 18 worse distress, depression, eligible if they reported original datasets collected in the USA social HRQoL, and overall data on anxiety, depression, and one in each of Canada, HRQoL than do majority patients, distress (for psychological Romania, and the UK. Ethnic of which all but depression morbidity), or HRQoL in minority minority groups were Hispanic, might be clinically important. and majority cancer patients or Asian or Pacific Islander, or Heterogeneous results might, survivors. Minority status was Hungarian (one dataset). Overall, however, have limited the defined as being an immigrant we found minority versus majority interpretation. Data for other or having an ethnic, linguistic, groups to have significantly minority groups and for anxiety or religious background worse distress (mean difference are scarce. More studies are different to the majority of the -0·37, 95% CI -0·46 to -0·28; needed from outside the USA. population in the country where p<0·0001), depression (-0·23, Future reports should more the research was done. We -0·36 to -0·11; p=0·0003), and clearly describe their minority excluded African Americans overall HRQoL (-0·33, -0·58 group samples and analyses and indigenous groups. Eligible to -0·07; p=0·013). Further should control for clinical and articles were rated for quality analyses found disparities to sociodemographic variables of reporting, external validity, be specific to Hispanic patients known to predict outcomes. internal validity, sample size, in the USA, in whom poorer Understanding of why outcomes and power. Each quality criterion outcomes were consistent with are poor in US Hispanic patients was rated independently by potentially clinically important is needed to inform the targeting two reviewers until inter-rater differences for distress (effect of interventions. reliability was achieved. In a size -0·37, 95% CI -0·54 to -0·20; meta-analysis we compared p<0·0001), social HRQoL (-0·45, 50  UNSW in the South West 2011-2013  

Other investigator led collaborative clinical Pancreatic Research Group trials which the unit is recruited during this period include methylphenidate for fatigue, The major research interests of the Pancreatic levomepromazine versus ondansetron for Research Group include alcohol-induced refractory nausea in palliative care; a NHMRC pancreatic injury, pancreatic stellate cell biology, funded cluster randomized control trial comparing pancreatic fibrosis and tumour-stromal interactions the severity of constipation symptoms experienced in pancreatic cancer. The Pancreatic Research by palliative care patients receiving usual care Group has been consistently supported by the compared to those diagnosed and managed NHMRC/DVA for over 25 years and has also according to the underlying pathophysiology, received grant support from the Australian randomised control trial of the timing of dosing of Research Council and the Cancer Council of dexamethasone and effect on sleep, randomised New South Wales. The Group is internationally control trial of oral melatonin controlled release for acknowledged as the leading research group in the prevention of delirium in cancer patients and the field of alcoholic pancreatitis and pancreatic a NHMRC funded randomized controlled trial of fibrogenesis. guideline driven treatment for nausea versus single agent haloperidol. Associate Professor Agar is also This Group was the first in the world to develop a an investigator for the recently funded NHMRC method to isolate and culture pancreatic stellate Partnership Centre dealing with cognitive and cells (PSCs), now established as key effector cells associated functional decline in the elderly. in pancreatic fibrosis. This technique provided a much needed in vitro model for research into The ongoing priority is continued development the pathogenesis of pancreatic fibrosis, and has of research capacity with the multidisciplinary provided impetus for worldwide studies on stromal clinical team, and increasing interest in palliative biology in chronic pancreatitis and pancreatic and supportive care research. The group works cancer. with the Psycho-oncology Co-operative Research Group (PoCoG), the Cooperative Trials Group for The international recognition of the Group’s Neuro-Oncology (COGNO), Palliative Care Clinical work is reflected in the over 3400 citations of its Studies Collaborative and the South West Sydney papers and in the invitations that the Group’s Translational Cancer Research Unit. members have received to speak at international meetings worldwide. The impact of the Group’s Members: Associate Professor Meera Agar, Dr research is also reflected in the visits to the PRG Tim Luckett, Ms Aileen Collier, Ms Jane Hunt, Ms laboratory by overseas scientists for training and Nichole Petrie, Ms Julie Wilcock, Ms Janeane in the collaborations established with renowned Harlum, Ms Natalie Ohrynowsky, Dr Jennifer researchers in Australia as well as in the United Wiltshire, Dr Rebecca Strutt, Dr Lynne Kuwahata, States, UK and Germany. Dr Louise Elliott, Dr Fiona Stafford-Bell, Dr Elspeth Correy, Dr Jackie Kerfoot, Ms Edite Tang, Dr Rajesh Members: Professor Minoti Apte, Professor David Aggarwal, Dr Thang Huynh, Dr Amanda Fernando, Goldstein, Adjunct Professor Ron Pirola, Mr Sri Dr Jessica Lee and Mr Mark Buhagiar Pothula, Dr Murty Suri, Professor Jeremy Wilson, Mr Zhihong Xu

HIGH IMPACT PUBLICATION

Apte MV, Wilson JS, Lugea A, Pandol SJ. A starring role for stellate cells in the pancreatic cancer microenvironment. Gastroenterology. 2013 Jun;144(6):1210-9. doi: 10.1053/j. gastro.2012.11.037.

ABSTRACT: Pancreatic ductal ignored. The focus of pancreatic recent preclinical studies have adenocarcinoma is a devastating cancer research began to reported encouraging results disease, and patient outcomes change with the identification of with approaches designed to have not improved in decades. pancreatic stellate cells, which target pancreatic stellate cells Treatments that target tumor produce the pancreatic tumor and the stroma. We review cells have largely failed. This stroma. There is compelling the background and recent could be because research has in vitro and in vivo evidence advances in these areas, along focused on cancer cells and the for the influence of pancreatic with important areas of future influence of the stroma on tumor stellate cells on pancreatic research that could improve progression has been largely cancer development; several therapy.   Research in the South West  51

Psychiatry Research and Teaching Group Psycho-Oncology Research Group

The Psychiatry Research and Teaching Unit In July 2011, Professor Afaf Girgis was appointed (PRTU) was established in 1991, following the to develop and lead the Psycho-Oncology appointment of the Foundation Chair in Psychiatry, Research Group, under the umbrella of the UNSW and SSWAHS, in 1990. The Centre is Translational Cancer Research Unit, funded by the regarded nationally and internationally as a leading Cancer Institute NSW. research and training centre in the interrelated fields of transcultural, refugee, post-conflict, Cancer is a life-changing diagnosis that will affect post-traumatic and disaster mental health and the one in three men and one in four women living mental health of developing countries. Aboriginal in Australia before the age of 75 years. Both mental health, the impact of gender-based the incidence of and survival from cancer are violence on mental health and perinatal aspects of expected to increase. Australia’s cancer survival separation anxiety are more recent areas of study. rates are amongst the best in the world and it is estimated that there were 655 000 cancer survivors Members: Dr Lorraine Ivancic, Ms Ana Ladesic, in Australia at the end of 2004. Psycho-oncology is Ms Claire Marnane, Ms Thuy Phan, Dr Susan Rees, becoming more important as a research area due Professor Derrick Silove, Associate Professor to the rising prevalence of cancer, both in Australia Zachary Steel, Mr Alvin Tay and Ms Qing Xia and worldwide.

The Psycho-Oncology Research Group investigates the psychological, social and behavioural aspects of cancer, from the time of a cancer diagnosis until end of life. This research program is translational in 52  UNSW in the South West 2011-2013  

its focus, with its priority research areas informed Cancer Institute NSW funding to develop and by the challenges faced by those providing and implement an integrated e-health platform to receiving cancer care; application of the most support and enable cancer survivors to achieve stringent research methods to develop evidence- and maintain improved health and wellbeing based practice; and early engagement with key and better cancer outcomes. This work is highly stakeholders and policy makers to maximise translational and is expected to influence the evidence-informed cancer care. delivery of cancer care in NSW.

The team has a strong track record in undertaking Members: Professor Afaf Girgis, Dr Sylvie health services research, as reflected by the award Lambert, Dr Janelle Levesque, Professor Geoff of two Cancer Institute NSW Translational Health Delaney, Ms Jennifer Jacobs, Ms Margaret Crowley, Service Research Grants to study the feasibility of Ms Hayley Candler and Ms Eleanor Law an oncology nurse practitioner model of care in a rural cancer setting (2010-2012), and the feasibility of an integrated, patient-centred psychosocial care R espiratory Medicine model for patients with urological and head and neck cancers (2012-2014). Researchers within the Department of Respiratory Medicine at Liverpool Hospital are working on a The Psycho-Oncology Group also has an wide-range of problems in respiratory and sleep international standing in survivorship research. medicine and science including asthma, COPD, Recent research on the impact of cancer on sleep disorders and tuberculosis. Research on caregivers has been widely cited internationally, tuberculosis has examined the outcomes of with one of the key publications awarded treatment for tuberculosis in NSW, the risk for Paper of the Year 2013: Health Services and tuberculosis among people with diabetes and with Epidemiological, South Western Sydney Clinical renal failure in Australia and the effectiveness of School, UNSW Medicine, UNSW. The group’s contact tracing in people exposed to patients with particular focus on illness self-management and tuberculosis in south-western and western Sydney. eHealth strategies is reflected in the award of a 4-year NHMRC grant to develop and trial a The Childhood Asthma Prevention Study, a self-management coping intervention for couples long-term clinical trial of preventive interventions affected by cancer. In 2013, the team was awarded for asthma implemented in a high-risk birth

HIGH IMPACT PUBLICATION

Ayer JG, Belousova E, Harmer JA, David C, Marks GB, Celermajer DS. Maternal cigarette smoking is associated with reduced high-density lipoprotein cholesterol in healthy 8-year-old children. Eur Heart J. 2011 Oct;32(19):2446-53. doi: 10.1093/eurheartj/ehr174. Epub 2011 Jun 21.

AIMS: Smoking in pregnancy >36 weeks and birth weight After adjustment for maternal is common. Its effects on >2.5 kg) data were collected passive smoking, post-natal ETS lipoprotein levels and arterial prospectively by questionnaire exposure, gender, breast feeding structure in childhood are not on smoking in pregnancy and duration, physical inactivity, well characterized. We aimed ETS exposure in childhood. and adiposity, smoking in to determine the effects of At age 8-years, 405 of the pregnancy remained significantly maternal smoking in pregnancy children had measurements of associated with lower HDL on lipoprotein levels and arterial lipoproteins, blood pressure cholesterol (difference = -0.22 wall thickness in healthy pre- (BP) and carotid intima-media mmol/L, 95% CI -0.36 to -0.08, pubertal children. thickness. Children born P = 0.003) but not with higher to mothers who smoked in systolic BP. Neither smoking in METHODS AND RESULTS: A pregnancy had lower HDL pregnancy nor post-natal ETS community-based longitudinal cholesterol [1.32 vs. 1.50 exposure was associated with study with prospective mmol/L, 95% confidence interval alterations of carotid artery wall ascertainment of exposure (CI) for difference -0.28 to -0.08, thickness. to smoking in pregnancy P = 0.0005], higher triglycerides and environmental tobacco (1.36 vs. 1.20 mmol/L, 95% CI CONCLUSION: Smoking in smoke (ETS) since birth and for ratio 1.01-1.30, P = 0.04) pregnancy is independently then lipoprotein and arterial and higher systolic BP (102.1 associated with significantly measurements at age 8 years. In vs. 99.9 mmHg, 95% CI for lower HDL cholesterol in healthy 616 newborn infants (gestation difference 0.6-3.8, P = 0.006). 8-year-old children.   Research in the South West  53

cohort, continues as a cohort study and is now The Centre also developed and evaluated the investigating changes in respiratory, allergic and first rapid response system for seriously ill at- cardiovascular characteristics during puberty. risk patients – the MET system. The Centre has published over 160 peer-reviewed articles, A number of clinical trials are underway including been successful in achieving over $18 million in investigations of new treatments to prevent peer-reviewed grants and has supervised many exacerbations of chronic obstructive pulmonary postgraduate students. disease, for severe asthma and for bronchiectasis. Clinical research also includes a randomized study Members: Dr Hassan Assareh, Associate of reslizumab in eosinophilic asthma, an open label Professor Jack Chen, Dr Roberto Forero, Professor study of reslizumab in asthma, a randomised study Ken Hillman, Dr Stephanie Hollis, Ms. Brydan of macrolide therapy in asthma; a multicentre trial Lenne, Dr Lixin Ou and Dr Fenglian Xu utilising a pulmonary hypertension patient registry; and prophylactic treatment of latent (dormant) tuberculosis infection in New South Wales.

Researchers within the Department are also leading the development of the Australasian Severe Asthma Network and are developing a new research collaboration with the Mongolian National Tuberculosis Program to determine the effectiveness of community-based tuberculosis treatment programs in Mongolia. The Department is also active in supervising Independent Learning Project students who have focussed their work on health care workers’ experiences with tuberculosis screening services and the epidemiology of lymph node tuberculosis in south-western Sydney.

In sleep medicine, researchers are engaged in studies on new approaches to early diagnosis of obstructive sleep apnoea. Researchers will also be examining methods for early detection of mesothelioma.

Members: Dr Melissa Baraket, Dr Peter Buchanan, Dr Hamish Crawford, Dr Peter Collett, Dr Claudia Dobler, Ms Karen For, Dr Zinta Harrington, Dr Anthony Johnson, Ms Christina Madzinga, Professor Guy Marks, Dr Stephen Parsons, Dr Graham Radford, Dr Hima Vedam, Mr Craig Wainwright and Dr Jonathan Williamson

Simpson Centre for Health Services Research

The Simpson Centre for Health Services Research was one of the first centres to be established in Australia to conduct research around health services or systems. This type of research involves reorganising the way we deliver health services. The Simpson Centre developed the concept of day-of-surgery admission and the perioperative ward which has changed the way elective surgery is conducted by preparing patients for surgery in the community rather than as a hospital inpatient and admitting them on the day of surgery, even for major surgery requiring several days or weeks of hospital admission. 54  UNSW in the South West 2011-2013  

Ingham Institute for Applied Medical Research

The Ingham Institute for Applied Medical Research is the premier health and medical research precinct based in south western Sydney and is home to more than 200 researchers and scientists from over 30 research groups, partnering with the South Western Sydney Local Health District, the University of Western Sydney (UWS) and UNSW Australia.

The Ingham Institute was officially opened in high-quality medical research. Located on the October 2012, by then Prime Minister, the Hon. grounds of Liverpool Hospital, the Institute Julia Gillard MP and has established itself has fast built its reputation as the central as a leading and innovative state-of-the-art research hub for south western Sydney research facility. It comprises both clinical and and brings together clinicians, students, laboratory-based research areas that promote academics for the purpose of research, the sharing and collaboration needed to deliver teaching and translation.   Research in the South West  55

The Ingham Institute’s mission is to change the Over the past two years, the Ingham Institute’s way medical research is done in Australia by research programs have grown significantly transferring research into practice across its six with research groups conducting high-calibre research streams, enabling the swift transfer of research and attracting funding from government, findings into day-to-day medical practice. The pharmaceutical sponsors and philanthropic Institute’s research teams are focused on exploring supporters. In 2012, the Centre for Health Equity new medical approaches for a range of critical Training Research and Evaluation’s Maternal Early diseases across the following core research areas: Childhood Sustained Home-Visiting (MECSH) program was licensed by UNSW Australia. The yy Cancer MECSH Program was initially purchased by three yy Clinical Science (including Cardiovascular sites in the UK. Since then, the program has now Disease And Infectious and Inflammatory been implemented in sites across south western Diseases) Sydney, other parts of NSW, Victoria, Tasmania, South Korea and the United Kingdom, providing yy Community & Population Health quality, evidence-based home visiting for more yy Early Years/Childhood Health than 10,000 vulnerable families worldwide. yy Injury and Rehabilitation yy Mental Health 56  UNSW in the South West 2011-2013  

The Ingham Institute engages and fosters a strong collaborative culture which is evident from its links to a number of internationally renowned research studies. The Institute’s pioneering MRI-Linac, which is set to launch in 2015, is the result of collaboration with nine other affiliates including cancer specialists at the Stanford University USA. The $16 million project will be housed in the Research Bunker on the campus of Liverpool Hospital’s Cancer Therapy Centre. The MRI-Linac is set to revolutionise and improve the treatments of a range of cancers including lung, prostate, brain and head and neck, by coupling a MRI with a Linear Accelerator. This new area of technology will be the first in Australia, with only three other such prototypes in the world having the ability to precisely target radiation towards the tumour.

To assist and train Australia’s next generation medical talent, the Ingham Institute’s Clinical Skills and Simulation Centre was opened on 11 June 2013. The Centre serves as the education hub for students and medical professionals to help them build successful careers in health and medical research. Managed by UNSW Australia, the unique centre has a focus real-life, simulated learning and boasts the latest high-tech simulation equipment including ‘Sim-Man’, a high-fidelity robotic patient mannequin. It also encompasses two fully simulated operating theatres, to enable ‘mock’ operations.

Another prominent technology acquisition for the Ingham Institute was the purchase of the Circulating Tumour Cells (CTC) assay machine in May 2013 as a result of grant funding from UNSW Australia. A first for NSW, the CTC can identify single cancer cells in the blood so that they can be isolated and their genetic make-up studied, revealing why cancers spread and identifying patients who are most at risk of cancer spreading. Currently, studies are underway at the Ingham Institute to evaluate CTCs in colorectal cancer, with future studies planned targeting lung, breast, melanoma and ovarian cancers.   Research in the South West  57

Grants

Projects with participation by south western Sydney conjoints and academics that operated during 2011-13

NHMRC UNSW CI: Comino (2008-2012) UNSW CI: Ward (2009-2013) Gudaga Project: Understanding the Neurocognitive correlates of UNSW CI: Jalaludin (2007-2012) health, development and service transition from ultra-high risk mental use of Aboriginal children in an state to schizophrenia Understanding the impact of urban environment $305 000 social, economic and geographic $1 339 125 disadvantage on the health of Australians in mid to later life: Where UNSW CI: Kemp (2010-2014) UNSW CI: Silove (2009-2011) are the opportunities for prevention? Closing the Gap: Early childhood $1 800 000 The role of trauma related anger sustain home visiting for families and the cycle of violence in post of Aboriginal infants in an urban UNSW CI: Barton (2008-2011) conflict countries: a follow up study community in Timor Leste $2 135 875 Modelling multiple radiotherapy $540 125 treatment episodes for benchmarking and service UNSW CI: Leung (2010-2014) UNSW CI: Adie (2009-2013) planning. (Retreatment) Left ventricular contractile reserve $503 415 The association between quality and microvascular disease and effect estimate in surgical trials in diabetic cardiomyopathy - UNSW CI: Harris (2008-2011) (Scholarship) (Scholarship) $120 000 $116 582 Early childhood sustained home visiting: Outcomes at 4 years and the transition to school UNSW CI: Apte (2009-2013) UNSW CI: Silove (2010-2014) $452 900 Alcoholic chronic pancreatitis: Posttraumatic mental health: induction, progression and reversal advancing understanding $609 500 of diagnosis, treatment and mechanisms $7 060 000 58  UNSW in the South West 2011-2013     Research in the South West  59

UNSW CI: Ward (2011-2012) UNSW CI: Girgis (2011-2015) UNSW CI: Barton (2013-2015) Impaired anticipation of sensory Coping-Together: A randomised The Australian MRI-linac Program: events in schizophrenia controlled trial of a self-directed Improving cancer treatment through $132 032 coping skills intervention for patients real-time image guided radiotherapy with cancer and their partners $5 705 380 UNSW CI: Worthington $718 022 (2011-2012) UNSW CI: Hodgkinson UNSW CI: Marks (2012) (2013-2015) Patterns of care and outcomes for subarachnoid haemorrhage: a data Understanding and ameliorating the Studies on induction of antigen linkage study human health effects of exposure specific T regulatory cells to control $122 904 to air pollution from knowledge to autoimmunity policy and public health practice. $340 932 UNSW CI: Chen (2011-2013) $ 2 411 828

The impact of introducing medical UNSW CI: Apte (2012-2014) emergency team on the reduction of Targeting microtubules to overcome hospital mortality and other adverse ARC events in NSW chemoresistance in pancreatic $581 827 cancer $573 675 UNSW CI: Silove (2009-2011) UNSW CI: Eapen (2011-2013) Enhancing mental Health in UNSW CI: Barton (2012-2014) Aboriginal children Universal surveillance of developmental disorders Improving radiation therapy of $1 021 140 $890 598 static and moving targets using high spatial resolution realtime UNSW CI: Silove (2009-2013) dosimeters (University of UNSW CI: Lambert (2011-2013) Understanding anger and its Wollongong) consequences amongst women Coping-together: A randomised $524,000 in conflict-effected Timor Leste: controlled trial of a self-directed Implications for enhancing coping skills intervention for patients UNSW CI: Chen (2012-2014) sustainable development with cancer and their partners $634 220 $210 000 The evaluation of a statewide innovative patient safety improvement system on reducing UNSW CI: Harris (2010-2011) UNSW CI: Lambert (2011-2013) hospital mortality and other adverse The effectiveness of health impact RCT of a self-directed coping skills events - a population based mixed Assessments conducted in Aust. intervention for patients with cancer method study & NZ and their partners $724 555 $190 000 $292 317 UNSW CI: Mittal (2012-2014) UNSW CI: Silove (2010-2012) UNSW CI: Marks (2011-2013) CROSSBAT Building resilience in Aceh Practitioner Fellowship Level 2 $109 358 $630 000 $514 465 UNSW CI: Nguyen (2012-2014) UNSW CI: Apte (2011) UNSW CI: Steel (2011-2013) Prediction and prevention of sudden Accessing the third dimension in Ethnographic, treatment, and policy cardiac death following acute scanning electron microscopy for responses to patients presenting myocardial infarction rapid, high resolution tomography of for care with chronic medically $111 244 large samples unexplained symptoms in Viet $250 000 Nam: a randomised control trial UNSW CI: Comino (2012-2015) of cognitive behaviour therapy, structured care and treatment as The Gudaga Study: Describing UNSW CI: Eapen (2011-2013) the health, developm,ent, early usual Australia and Vietnam Separation anxiety in pregnancy: education, family environment $471 278 associations with oxytocin release, and service content of Aboriginal attachment styles and mother-infant children aged five to nine years in UNSW CI: Kaduppa (2011-2014) interactions an urban location $232 767 Cardiovascular risk in CKD $1 525 060 (Scholarship) UNSW CI: Kemp (2012-2014) $80 938 UNSW CI: Forero (2012-2015) An ecological study of school Validation and impact of the UNSW CI: Leong (2011-2014) transition and the early years of four hour rule in the emergency school for Aboriginal children in an Proteomics and confocal department: a large data linkage urban community endomicroscopy in the evaluation of study $357 535 inflammatory bowel diseases $1 712 864 $424 900 60  UNSW in the South West 2011-2013  

Cancer Australia UNSW CI: Girgis (2012-2014) UNSW CI: Smith (2011-2013) Feasibility study of an integrated, Ingham Institute Clinical Skills and UNSW CI: Holloway (2012-14) patient-centered psychosocial care Simulation Translational Research model for patients with urological Facility Quantifying the impact of and head and neck cancers $6 377 393 imaging choice for breast cancer $580 955 radiotherapy $391 596 UNSW CI: Girgis (2012-2014)

Feasibility study of an oncology Health Workforce Australia nurse practitioner model of care in a rural cancer setting Cancer Council of NSW $347 989 UNSW CI: Smith (2011-2012) SLE Translational Research Facility UNSW CI: Apte (2011-2015) UNSW CI: Girgis (2013) $720 999 Genotype guided cancer therapy Patient reported experience (Genomic theragnostics) collaborative project UNSW CI: Smith (2011-2012) $1 500 000 $200 000 SLE Translational Research Facility – Slippage UNSW UNSW CI: Apte (2009-2011) UNSW CI: Knight (2013) $91 880 Inhibition of growth factor function Towards seamless cancer care: as a therapeutic approach in what do GPs in South West Sydney UNSW CI: Smith (2011-2012) pancreatic cancer need to facilitate better integration SLE Translational Research Facility – with cancer services? $97 987 Slippage SWSLHD $54 588 $116 027 UNSW CI: Phillips (2009-2012) UNSW CI: De Souza (2013) Role of heat shock proteins in UNSW CI: Smith (2012-2013) tumour-stromal interactions in An integrated molecular platform SLE Translational Research Facility – pancreatic cancer for profiling circulating tumour cells Stage II Capital (CTCs) and DNA (ctDNA) in cancer $598 507 patients $457 673 $155 000 UNSW CI: Apte (2013-2015) UNSW CI: Smith (2012-2013) Targeting the stroma in pancreatic UNSW CI: Agar (2013-2015) SLE Translational Research Facility – cancer – a novel therapeutic Stage II Non-Capital Improving Palliative Care through approach focusing on the HGF/c- $375 000 MET pathway. Clinical Trials (ImPaCCT) - the NSW collaborative trials group in palliative $360 000 care. Cooperative clinical trial grant. Cancer Institute NSW $294 484 UNSW Australia Cancer Institute NSW UNSW CI: Apte/McNeil (2011)

UNSW CI: Agar (2009-2013) MREII: Salary for Senior Research C ommonwealth Government Coordinator, Ingham Institute NSW Palliative Care Clinical Trials $99 500 Collaborative Research Group 09/ UNSW CI: Barton (2008-2011) CIG/1-01 Modelling multiple radiotherapy UNSW CI: Apte/Bryant/McNeil $528 507 treatment episodes for (2011) benchmarking and service planning UNSW CI: Lee (2011) MREII: Applied Biosystems ViiA7 $457 650 Real-Time PCR System Investigation of biomarkers for $115000 the diagnosis and prognosis of UNSW CI: Smith (2010-2012) common cancers in the community UNSW CI: Apte/Bryant/McNeil such as breast, colorectal, prostate Medical and Nursing Education and head and neck cancers Network (2011) $227,921 $3 666 270 MREII: Guava® easyCyte™ 8HT Flow Cytometry System UNSW CI: De Souza/Apte/Agar UNSW CI: Eapen (2010-2013) $95 250 (2011-2014) Autism Specific Early Learning & UNSW CI: Smith (2012) South Western Sydney Translational Care Centre Cancer Research Unit $346 698 IT: Uniwide Expansion to SWS $1 673 333 Research Facilities $30 000   Research in the South West  61

UNSW CI: Apte/McNeil (2012) subcutaneous interferon beta-1a UNSW CI: Rose (2011-2013) (Rebif) in patients with relapsing- MREII: Olympus Microscope System Liverpool City Council remitting multiple sclerosis who have $99 990 relapsed on therapy Develop a sustainable training and research centre in Community 2168 $159 000 UNSW CI: Apte (2012) $285 497 MREII: IncuCyte-FLR in vitro live-cell UNSW CI: Apte (2010-2012) imaging system UNSW CI: Hodgkinson Amgen Incorporated $160 000 (2011-2014) Growth factor receptor inhibitors: potential therapeutic agents in Mereck Serono UNSW CI: Apte (2013) pancreatic cancer Clinical Trial: characterization of MREII: Circulating Tumour Cell $215 433 activated regulatory T cells in MS System $38 000 $250 000 UNSW CI: Hogkinson (2010-2012) UNSW CI: Grace (2012-2014) UNSW CI: Jaeger (2013) Benevolent Society Novartis MREII: Near-Infrared Cerebral Clinical Trial: A double-blind, Volunteer Family Connect: RCT Ozygenation and Non-Invasive randomized, multicneter, placebo- of volunteer home visiting in early Continuous Blood Pressure controlled, parallel-group study childhood Monitoring Equipment comparing the efficacy and safety $205 000 $80 000 of 0.5 mg FTY720 administered orally once daily versus placebo in UNSW CI: Kemp (2012-2014) patients with primary progressive Australian Research Alliance for multiple sclerosis Children and Youth (ARACY) $45 000 O ther Research MESCH licence and service agreement with ARACY UNSW CI: O’Neill (2010-2012) UNSW CI: Hodgkinson $440 000 Royal Australasian College of (2006-2012) Physicians UNSW CI: Wong (2012-2014) Novartis S100 proteins A8, A9 and A12 Australasian Diabetes in Pregnancy in patients with systemic lupus Clinical Trial: A 12-month double- Society blind, randomized, multicentre, erythematosus RAW-GDM-PET Study: retinal active-controlled, parallel-group $20 000 assessment of women with study comparing the efficacy gestational diabetes or pre- and safety of 0.5mg and1.25mg UNSW CI: Apte (2011-2012) eclampsia (Pilot Study) fingolimod (FTY720) administered orally once daily versus interferon Abraxis Bioscience $6 000 B-1a (Avonex) administered i.m. Does nab-Paclitaxel cause stromal once weekly in patients with depletion in pancreatic cancer by UNSW CI: Hodgkinson relapsing-remitting multiple sclerosis targeting pancreatic stellate cells? (2012-2015) $340 000 $110 065 Biogen Idec Australia Clinical Trial: An open-label, UNSW CI: McNeil (2011-2012) UNSW CI: Chia (2008-2011) multicenter, multinational study National Heart Foundation Arthritis Foundation of Australia to assess the effect of long-term prolonged-release fampridine Right ventricular size, dynamics & Tryptase-mediated aggrecanolysis (BIIB041) 10 mg twice daily on function: Its relevance in health & in rheumatoid and osteoarthritis quality of life as reported by disease (Scholarship) $50 000 subjects with multiple sclerosis $95 500 $51 330 UNSW CI: McNeil (2011-2012) UNSW CI: McNeil (2008-2012) Rebecca L Cooper Medical UNSW CI: Kemp (2012-2015) Arthritis Foundation of Australia Research Foundation Various Trusts, NHS Mast cell proteases in experimental Mast cell tryptases and articular MECSH-UK: local adaptation and inflammatory arthritis cartilage catabolism implementation of the MECSH $16 000 $50 000 prorgam $324 200 UNSW CI: Hodgkinson UNSW CI: O’Neill (2011-2012) (2009-2015) Arthritis Foundation of Australia UNSW CI: Comino (2013) Sanofi-Aventis Leucocyte immunoglobulin-like South Western Sydney Local Clinical Trial: A phase 3, receptors in patients with systemic Health District lupus erythematosus randomised, rater-and dose-blinded PCHRU: Contribution to the study comparing two annual cycles $15 000 development of PCHRU through of intravenous low-and high-dose oversight of programs and Alemtuzamab to three-times weekly development of activities $101 688 62  UNSW in the South West 2011-2013  

UNSW CI: Kemp (2013) NSW Ministry of Health An equity analysis and strategy for the NSW Health Workers Initiative $59 915

UNSW CI: Kemp (2013) Seoul National University MECSH-Seoul: local adaptation and implementation of the MECSH program $150 000

UNSW CI: Kemp (2013) NSW Department of Premier and Cabinet Provision of ongoing professional support to the ‘Keep Them Safe’ Evaluation Steering Committee $13 750

UNSW CI: Liaw (2013) KPMG The GP-RACF interface in aged care $20 000

UNSW CI: Liaw (2013) National Prescribing Service Assessing the accuracy and reliability of data extraction tools for Medicine Insight $55 000

UNSW CI: Worthington (2013) Office for Health and Medical Research NSW H20 Home to Outcome Study $307 461

UNSW CI: Harris (2013) South Western Sydney Local Health District Health Impact Assessment ‘Learning by Doing’ training program $24 794

UNSW CI: Comino (2013-2014) South Western Sydney Local Health District and Tharawal Gudaga Research Dissemination Officer $120 000   Research in the South West  63

Postgraduate Students

SWSCS offers a number of degrees by research including MSc, BSc (Honours), MD and PhD. In 2013, SWSCS had a total of 35 enrolled postgraduate research students.

The following projects have recently been completed:

Doctor of Philosophy (PhD) LA volumes and strain were examined in normal subjects from decade three to eight. LA volume increased with age, but only became significant Left atrial size and function: in the eighth decade. Therefore, any significant physiological and pathological increase in LA size that occurs before advanced changes age likely represents latent or undiagnosed Anita cardiovascular pathology. Additionally, with BOYD Supervisors: Liza Thomas, David normal aging, changes in atrial strain and strain Richards and Dominic Leung rate occurred earlier than changes in volume measurements, suggesting that strain changes The thin walled left atrium (LA) is may be a sensitive indicator of subclinical atrial sensitive to diastolic changes within the dysfunction. left ventricle (LV), enabling it to be a robust marker of cardiovascular function and outcomes. In patients with non-ST elevation myocardial However, there remain significant limitations in our infarction (NSTEMI), LA volumes were significantly understanding of atrial function. This research greater than normal controls at baseline, and aimed to evaluate phasic atrial function by analysis continued to increase at 12 months. Thus the of volumes and strain in normal subjects and in measurement of LA volumes post NSTEMI may patients with cardiovascular conditions associated be useful to monitor chronic diastolic dysfunction with LV diastolic dysfunction. resulting from ischaemia. 64  UNSW in the South West 2011-2013  

The predictors of LA appendage thrombus in After correcting for birthplace and demography, patients with persistent atrial fibrillation were the poorer screening participation was primarily examined. The significant univariate predictors attributed to the absence of a medical practitioner included ischaemic heart disease, LV mass and recommendation, and to a lesser extent decreased LA and right atrial spontaneous echo contrast media exposure and poorer perception of CRC. (SEC). Increased LV mass was the strongest Knowledge, attitudes and barriers towards CRC predictor of thrombus, supporting the link between and screening tests were also significantly poorer hypertension and the development of atrial among immigrants. Medical practitioners’ CRC fibrillation and consequent thrombus formation. screening practices varied according to their ethnicity and that of their patients, resulting in Mild or moderate hypertension resulted in lower screening recommendations to immigrant increased LA volumes as early as decade four. patients. These studies identified disparities based Thus, hypertension accelerates the normal aging on demography, and provided specific directions process of LA remodelling which may then result to improve the participation of screening tests in the development of atrial fibrillation. and outcomes from CRC. Additionally, compared with Australia, countries in the Asia-Pacific Patients with Fabry disease had significantly region reported significant variations in the CRC increased LA volumes and reduced atrial reservoir screening participation, knowledge, attitudes and function, independent of LV hypertrophy. Conduit barriers towards CRC. Deficiencies in participation function was selectively reduced only in Fabry of screening tests were evident even among patients with hypertrophy. These results suggest countries with existing population screening that Fabry disease results in fibrosis of the LA as programs. Medical practitioner recommendation well as the LV. was again the most important predictor of The increased understanding of both physiological screening participation in all participating and pathological changes in LA function may be countries. Finally, younger women had improved useful to predict adverse cardiovascular outcomes survival from CRC compared with men, suggesting and target and monitor therapy in these specific that oestrogen improved CRC-related survival and high risk groups of patients with cardiovascular supporting the importance of oestrogen in the involvement. pathogenesis of CRC.

Colorectal cancer in Evaluation of clinical Ken Sydney South West Area Danforn efficacy and investigation Health Service of mechanism of action KOO LIM of acupuncture treatment Supervisors: Rupert Leong in the management and Susan Connor of polycystic ovarian syndrome Colorectal cancer (CRC) is a major health problem. It is the second leading Supervisors: Felix Wong and Anthony O’Sullivan cause of cancer and cancer-related death in Australia. The effect of demography, specifically Polycystic Ovarian Syndrome (PCOS) has the birthplace on the clinical presentations, screening clinical manifestations of irregular menstrual and treatment utilisation, and pathological cycles, anovulatory infertility, amenorrhoea, characteristics of CRC in an ethnically diverse insulin resistance, polycystic ovaries, androgen community is not well described. Participation in disturbance, hirsutism and/or acne. The condition CRC screening tests, knowledge and awareness affects an estimated 5 to 10% of women of of CRC and available tests may also be influenced reproductive age (Hull 1987; Polson 1988; Lo by patients’ birthplace. In addition, medical 2006), although this varies depending on the practitioners’ screening practices are largely diagnostic criteria used (Michelmore 1999). unknown, and whether these practices differ Farquhar et al. (1994) suggested the prevalence according to their or their patients’ birthplace, of PCOS to be 21% in a New Zealand study. Due thereby affecting the likelihood of patients to the lack of uniformed definition of PCOS, the receiving screening recommendations need prevalence of PCOS can have a ‘highly variable immediate evaluation. prevalence estimates, ranging from 2.2% to 26%’. (Nidhi 2011) Research conducted in this thesis revealed few immigrants, especially those from Asia and Middle- East, had CRC detected through screening.   Research in the South West  65

Through researches, evidence suggests the medicine syndrome differentiation for PCOS or potential usefulness of acupuncture in the otherwise an inaccurate clinical response may treatment of the PCOS disorder (Ku 2001; Petti be obtained. This was achieved by utilising a 1998; Ulett 1998). It was postulated that beta- questionnaire (Stage III) as a tool development endorphin and various neuropeptides (like protein in this study. In addition to understanding pro-opiomelanocortin) within the nervous system the needs of Chinese women with PCOS, an may be implicated in producing the effects of epidemiological data was performed in Stage IV, acupuncture. Aleem (1987) revealed the presence so as to attempting to address their needs in the of beta-endorphin in the follicular fluid of both RCT stage. An effective CM treatment protocol normal and polycystic ovaries. Stener-Victorin’s would then be proposed to serve as a guide for the (2000) study suggested that acupuncture may clinical acupuncture management of adult women have a role in ovulation induction. Further details of with PCOS. The findings are promising and further current acupuncture studies in PCOS can be found studies are required. in Chapter Four. The design for this doctoral program study Acupuncture is currently used in public hospitals composed of the following 6 stages: in China for the treatment of PCOS. Clinical studies conducted in China have suggested that 1. Stage I Comprehensive systematic literature the effectiveness of using acupuncture may be review of current acupuncture treatment for significant. However, the methodological quality of PCOS patients in human studies in all available those trials was poor with limited long-term follow-up. Chinese and English Literature. This stage has been published as Cochrane Systematic The present study aimed to evaluate the action of Review paper; body acupuncture on menstrual pattern through a pilot study (Stage II) and a randomised controlled 2. Stage II Pilot Clinical Study involving real body study (Stage V). However, in order to plan the RCT acupuncture group; properly from Chinese medicine point of view, it was important to first standardise the Chinese 66  UNSW in the South West 2011-2013  

MBBS Graduating Class of 2011   Research in the South West  67

3. Stage III Development of Traditional Chinese Based on the results from pilot study in Stage Two Medicine (TCM) Syndrome Differentiation (11 subject recruited) and the RCT in Stage Five Diagnostic Questionnaire (Tool) for PCOS (146 subjects recruited), acupuncture can be according to the results of comprehensive recommended as effective menstrual regulation literature review in stage I and also the National intervention for PCOS. In Stage V, the inter- Disease Criteria set by the State Administration menstrual days in the control group is 302.45 of Traditional Chinese Medicine in the Peoples day and 348.32 days pre and post treatment Republic of China; This is important as to respectively (p=0.001). In the interventional group, standardise the CM diagnosis of PCOS in the mean inter-menstrual days are 297.69 and Stage V; 33.82 days pre and post treatment respectively (p=0.000). There is no menstrual pattern change in 4. Stage IV Collection of Epidemiological data the control group pre and post treatment. among Asian women of PCOS, to ascertain the psychological needs of Chinese women with Acupuncture demonstrated statistically significant PCOS; and to attempting to fulfil this in Stage V; difference toward hormonal profiles before and after the real body acupuncture intervention 5. Stage V Randomised Single Blinded among women with PCOS. Within the interventional Acupuncture Clinical Trial involving a) real group, it can be seen that there are six treatment body acupuncture group; b) placebo (sham) outcomes that were found to have a significant body acupuncture group; For this study, there differences (p<0.0001) pre and post real are two types of outcome measures that are acupuncture intervention. ANOVA was found to be under consideration. The primary outcome highly significance in between the control group measure was the return of menstruation from and intervention group among the 6 treatment amenorrhea while the secondary measures outcomes. These six treatments outcomes were were the changes in LH, FSH concentration, FSH, LH, LH: FSH ratio, Progesterone, FAI, LH: FSH Ratio, Progesterone, Oestrogen and and menstruation days. There are no statistical Androgenic hormone concentration; significances (p>0.05) in prolactin, oestrogen (E2) and testosterone in both control and 6. Stage VI Investigation of the Mechanism of interventional groups. Stage V is aimed to elicit Acupuncture Treatment on the Management of whether acupuncture can assist in return of PCOS. menstruation for lady with PCOS and has complete Based on the findings from Stage One, various amenorrhoea. As this is the initial aim of the study, case studies suggested that there may be a role ovulation was not chosen to be the outcome for acupuncture in regulating menstruation pattern measure for this RCT. This also becomes one of in PCOS but there was nil randomised controlled the limitations for this study as we cannot definitely trial identified to assess the efficacy of action answer whether acupuncture can induce ovulation of acupuncture in treatment of PCOS when this for lady with PCOS, although improvements were project was proposed. Furthermore, preliminary noted in the LH:FSH ratio and progesterone level. evidence from the literature review suggested that It is important to note that menstruation return acupuncture may be useful in regulating menstrual may not necessary to protect the uterus from pattern in women with PCOS. This confirms the hyperplasia. Overall speaking, the results from importance of this research project as to fill in the the statistical analysis and the insights that were gap of current medical understanding of using gathered from those results have proposed the acupuncture in women with PCOS. From the following mechanisms in relation to Chinese and descriptive analysis that was performed in Stage Western medicine perspective: Three, it can be concluded that the syndrome 1. Acupuncture significantly increases diagnostic questionnaire that developed in this β-endorphin levels for periods up to 24 hours project could possibly be a useful tool in Chinese and may have regulatory effect on FSH, LH medicine syndrome differentiation for women with and androgen. PCOS. It is warranted for further analysis and tested for internal validity. In Stage Four, a total of 2. Decrease hypothalamic-pituitary-adrenal 57 patients agreed to participate were interviewed. (HPA) axis activity by inhibiting release All patients responded to all 4 questions of corticotrophin-releasing factor (CRF), (Cronbach’s alpha > 0.9) asked thus for this study causing decreased adrenocorticotrophic it has a 100% response rate. Among all the factors hormone (ACTH) release from the pituitary of concern, most of interviewed subject expressed gland and decreased cortisol and/or problems of having PCOS as : difficulty to control dehydroepiandrostenedione (sulfate) release weight, frustration about difficulty to reduce weight, from the adrenal cortex. frustrated due to PCOS and its related medical problems, unable to conceive and menstrual irregularity, as well as pressure from workplace. 68  UNSW in the South West 2011-2013  

3. β-endorphin increased levels secondary of 2% reflects 1st generation DES, whether similar to acupuncture affects the hyperthalamic- findings occur with 2nd generation use remains to pituitary-adrenal (HPA) axis through promoting be determined. the release of ACTH through stimulation of its precursor pro-opiomelanocortin synthesis. In the emergent setting of STEMI, uncertainty about patients’ ability to comply with 1year DAPT 4. Needle insertion into the skin and muscle may after DES is common, and thus selective BMS stimulate ergoreceptors and initiate afferent deployment could be an attractive strategy if nerves activity. this achieved low TVR rates in large IRAs. BMS deployment in STEMI patients with IRAs ≥3.5mm 5. If acupuncture needles were placed in the was associated with low rates of TVR (2.2%). Their same somatic segment of the ovary, they use in this setting warrants comparison with 2nd may stimulate the oxytocin axis resulting in generation DES deployment in future randomised decreased release and secretion of ovarian clinical trials. androgens. Rescue PCI is guideline-recommended as it In conclusion, the designed acupuncture protocol improves outcomes after failed fibrinolytic therapy. for PCOS proposes that the usage of acupuncture However, these recommendations are based is effective to induce return of menstruation from on data from an earlier era of pharmacotherapy oligomenorrhoea. and procedural techniques. Clinical outcomes following rescue PCI, with high utilization rates of glycoprotein IIb/IIIa inhibitors and stenting, were examined. Mortality rates were comparable to Clinical Outcomes after rates for contemporary primary PCI in patients Percutaneous Coronary without pre-PCI shock (3.2%), especially in early Ibrahim presenters. Whether rates of bleeding can be Interventions: Focusing on SHUGMAN Selective Drug-eluting Stent Use reduced by different pharmacotherapies and interventional techniques, need clarification in Supervisors: John French and Craig future studies. Prospective studies of future Juergens pharmaco-invasive strategies in STEMI patients are warranted. The projects in this thesis aimed to examine issues of management of patients with coronary As peri-procedural MI is an important early heart disease undergoing percutaneous coronary clinical outcome, its diagnosis based on cardiac intervention (PCI). In particular the following were marker levels and their prognostic significance examined: clinical outcomes following PCI with are important. Evaluation of TnT criteria for selective drug-eluting stent (DES) use; clinical periprocedural MI were performed, and the outcomes after bare-metal stent (BMS) deployment association of both TnT and creatine kinase MB in large infarct-related arteries (IRA); clinical level elevations on death and/or MI were examined outcomes following rescue angioplasty for ST- in both stable coronary heart disease and acute elevation myocardial infarction (STEMI) with high coronary syndrome; post-PCI TnT levels were utilisation rates of glycoprotein IIb/IIIa inhibitors; associated with event-free survival at one year troponin T (TnT) criteria for periprocedural only in patients with stable coronary heart disease. myocardial infarction (MI) and its association with In patients with acute coronary syndrome and late clinical outcomes. elevated TnT levels undergoing PCI several days later, criteria of ≥20% increases in TnT were more The introduction of DES has revolutionized common than absolute increments of > 3XURL interventional cardiology by reducing restenosis in TnT or creatine kinase-MB levels. Elevations and thus target vessel revascularization (TVR) of ≥ 20% above elevated pre-PCI levels detects rates. Selective use of DES in those patients at any small peri-procedural MIs of questionable highest risk of restenosis is a potentially attractive prognostic significance though this criteria has not approach as it may allay concerns about the been revised in the recently published revision of risk of late stent thrombosis (ST) and the need the universal definition of MI. for compliance with dual anti-platelet therapy (DAPT), aspirin and clopidogrel for 1 year. Hence, clinical outcomes were examined after adoption of criteria for selective DES use at Liverpool Hospital, Sydney, Australia. Using these criteria which aimed for ~30% DES use in patients at high risk of restenosis, low TVR rates at 1 year of 4.9% were achieved, and rates of death and MI were comparable to those after BMS. Though the ST rate   Research in the South West  69

predict workload to aid in radiotherapy services Estimation of the optimal number planning, and adapted to future changes in cancer incidence, stage distribution and fractionation Karen of radiotherapy fractions for cancer patients: a review of the recommendations. WONG evidence

Supervisors: Michael Barton and Geoff Delaney Investigating strategies in Background: Adequate radiotherapy Victoria rehabilitation after total services provision entails systematic planning knee replacement due to their high capital costs and the KO Supervisors: Ian Harris and requirement for specialised staff. A treatment Justine Naylor attendance (called a fraction) is a fundamental unit of productivity in a radiotherapy department. There is variation in radiotherapy fractionation Total knee replacement (TKR) is widely accepted practices, however, there is no evidence-based as a cost-effective management for the pain and benchmark for appropriate activity. A radiotherapy functional impairment associated with end-stage utilisation model was previously constructed and osteoarthritis. With the number of procedures estimated that 52.3% of cancer patients should performed markedly increasing each year, there is receive external beam radiotherapy at least mounting pressure on physiotherapists to meet a once during their illness. The next challenge is to rising demand for post-operative rehabilitation with translate an overall radiotherapy utilisation rate into existing resources. There is an urgency to identify a more practical estimate of radiotherapy demand. effective, yet resource-efficient rehabilitation Aim: To construct an evidence-based model delivery. Resource-intensive one-to-one therapy to estimate the optimal number of fractions for continues to be the most common mode of the first course of radiotherapy, building on the rehabilitation delivery after TKR in Australia, radiotherapy utilisation model. despite the lack of evidence of its superiority over home-based programmes from the limited Methods: Evidence-based treatment research conducted in this area. The use of guidelines, meta-analyses and randomised group-based therapy, another alternative mode controlled trials were reviewed for fraction of rehabilitation delivery, has not been compared number recommendations for each indication to one-to-one therapy in rehabilitation after TKR. of radiotherapy for notifiable cancers with an The primary aim of this thesis was to compare the incidence of ≥ 1%. The previously published effectiveness of one-to-one therapy, group-based radiotherapy utilisation tree was adapted so therapy and a monitored home programme on that the most appropriate evidence-based improving patient-reported and performance- fraction number was added to each branch. based functional outcomes in the short- and Epidemiological data previously used were long-term, through a randomised, superiority updated. For each cancer type, the optimal fraction trial. In designing this trial the rationale for two number was then calculated using the TreeAge secondary investigations into outcome measures software, taking into account the frequency of used after TKR also emerged. One study specific clinical conditions where radiotherapy investigates the utility of an extended walk test for is indicated and the recommended fraction patients one year after TKR; the other compares number for each condition. One-way sensitivity the responsiveness of two widely used disease- analyses were performed to assess the impact of specific patient-reported outcome measures and uncertainties on the model. a generic health-related quality of life measure during early and longer term recovery after TKR. Results: For each cancer type, the optimal number of fractions for the first course of radiotherapy This thesis has confirmed that outpatient one-to- ranged from 0 to 26.1 per cancer patient, and 0 to one therapy delivered within the first two months 30.8 per course. Head and neck, brain and anal after surgery is not superior to group-based cancers had the highest number of fractions per therapy or a monitored home programme in course. Overall, the optimal fraction number was 9 improving function after TKR, as measured by a per cancer patient and 18 per course. Sensitivity range of patient-reported and performance-based analysis showed that this ranged from 8.6 to 9.6 outcomes. Service providers should consider per cancer patient, and 17.2 to 19.2 per course. adopting these alternative modes of rehabilitation delivery as a viable strategy to meet the needs of Conclusion: These results represent the first increasing patient numbers without compromising evidence-based benchmark for radiotherapy treatment effectiveness and patient satisfaction. services delivery, and allow comparisons with The thesis also provides construct validity for the actual practices. The model can be used to 70  UNSW in the South West 2011-2013  

Six-minute walk test as a measure of functional factors at the same time. Whether factors such ambulation after TKR which, surprisingly, has been as ethanol and cytokines may exert synergistic lacking up till now. Finally, the thesis provides effects on PSC activation has not been fully psychometric evidence for patient-reported studied. outcome tools that are relevant for evaluating yy ECM plays a central role in the maintenance rehabilitation after TKR and in a time frame that is of normal tissue architecture and regulates relevant to short-term rehabilitation. cell function. In health, PSC are surrounded by normal basement membrane comprising collagen IV, laminin, fibronectin, proteoglycans Masters (Research) and growth factors. However, during pancreatic injury, PSCs are activated and secrete excessive amount of ECM proteins such as collagen I that Pancreatic stellate cells in comprise fibrous tissue. However, the influence chronic pancreatitis of ECM components on PSC gene expression Lu Supervisors: Minoti Apte, Phoebe profiles has not been previously studied. Phillips and Jeremy Wilson YANG Specific aims: The overall hypothesis for the studies 1. Synergistic effect of ethanol and cytokines on described in this thesis was that alcohol PSC activation induced pancreatic fibrosis is a result of excessive extracellular matrix (ECM) synthesis In vitro studies designed to address this aim by pancreatic stellate cells (PSCs) activated involved: i) treatment of rat PSCs alone or in synergistically by alcohol and cytokines and that combination with ethanol and cytokines (TNFα the composition of ECM, in turn, influence gene and IL-1); ii) and assessment of PSC activation expression patterns of PSCs during the activation (αSMA expression and collagen expression). process. These studies demonstrated that:

Three specific aims for this study were addressed: i. at very low doses, ethanol (5mM, a dose seen with social drinking) and cytokines 1. The synergistic effect of low concentrations of individually had negligible effects on PSC ethanol and cytokines on PSC activation; activation. ii. however, the combination of ethanol with 2. The influence of extracellular matrix (collagen IL-1 or TNFα activated PSCs by significantly I, MatrigelTM and plastic) on PSC gene increasing αSMA expression and/or expression patterns; collagen expression. 3. The influence of the most highly dysregulated 2. The influence of ECM on PSC gene gene transgelin on PSC function. expression patterns

Background to work: These experiments involved the assessment of gene expression patterns in PSCs cultured yy Pancreatic fibrosis is a characteristic on MatrigelTM (mimicking normal basement histological feature of two major pancreatic membrane) and collagen I (mimicking fibrotic diseases - chronic pancreatitis and pancreatic pancreas) by a microarray experiment. These cancer. PSCs play a major role in pancreatic studies demonstrated that gene expression fibrogenesis. patterns of PSCs are influenced by ECM yy During pancreatic injury, PSCs undergo composition. activation. This is accompanied by the following changes: loss of cytoplasmic vitamin A 3. Characterisation of specific genes involved in containing lipid droplets, transformation into PSC activation a myofibroblast-like phenotype, increased These experiments involved: proliferation, increased expression of the a. i) analysis of microarray results and cytoskeletal protein alpha-smooth muscle actin selection of genes (transgelin, lumican, ( SMA) and increased synthesis and secretion α Fos, and IL-1α) that are highly dysregulated of ECM proteins that comprise fibrous tissue. in cells cultured on different matrices; ii) yy Factors known to activate PSCs in vitro further validation of these genes at mRNA include alcohol and its oxidative metabolite and protein levels; iii) functional studies acetaldehyde, oxidant stress and cytokines of one of the genes, namely transgelin, and growth factors that are synthesised and by assessing the effect of modulating secreted at increased levels during pancreatic transgelin expression on PSC function. injury. However, during pancreatic injuries in Transfection of PSCs with small interfering vivo, PSCs are likely to be exposed to several RNA (siRNA) for transgelin resulted in decreased PSCs proliferation.   Research in the South West  71 72  UNSW in the South West 2011-2013  

The potential value of this work lies in the Results: S epidermidis: MBEC of PI against possibility of determining the molecular S. epidermidis lay between 0.078 mg/ml and mechanisms responsible for mediating PSC 0.156 mg/ml while the MEC was 4.883 μg/ml. activation. This could lead to the development of The MBEC of HA against S. epidermidis was therapies that target PSC activation, in order to between 0.025 mg/ml and 0.05 mg/ml while the retard or reverse pancreatic fibrosis. MEC was 3.125 μg/ml. Increasing frequency of antiseptic instillations without TNP resulted in a reduction in bacterial load ranging from 0.5 to 1.5 log10 reduction. Combining antiseptic instillations with TNP resulted in a greater To evaluate the effect of decrease in bacterial numbers, ranging from Rajat topical negative pressure 0.5 to almost 2.5 log10 reduction. PI instillation dressings in combination 12 times per day in combination with TNP was MITTAL with antiseptic instillations the most effective and resulted in an almost 2.5 log10 reduction in bacterial numbers. The SEM Supervisors: Karen Vickery and images complemented the results observed with Anand Deva colony counts. P aeruginosa: MBEC of PB against Introduction: Chronic wounds are costly to treat and P. aeruginosa lay between 0.05 mg/ml and 0.20 are an increasing health problem. The aetiology of mg/ml while the MEC was 0.2mg/ml. The MBEC chronic wounds is multi-factorial, but recent evidence of HA against P. aeruginosa was > 0.05 mg/ml suggests that bacteria play an important role and while the MEC was < 3.125 μg/ml. Similar to the be responsible for a majority of chronic infections. results observed with S. epidermidis, increasing S. epidermidis and P. aeruginosa are commonly frequency of antiseptic instillation resulted in associated with chronic wounds. A major part of an increased reduction in bacterial numbers. the virulence is their ability to form biofilms. Biofilms Combining TNP with PI instillation resulted in a are a complex community of bacteria adhering to greater decrease in bacterial numbers (7 log10 surfaces and imbedded in a biopolymer matrix that reduction) compared with PI instillation alone (5 aids the bacteria in surface attachment, has water, log10 reduction). 3 times per day PB instillation nutrient and oxygen channels and protects the resulted in approximately 0.5 log10 reduction in bacteria from host and antimicrobial agents. This bacterial numbers. Addition of TNP to 3 times per high resistance of biofilms presents challenges to the day PB instillation resulted in a greater decrease in medical community for fighting infections. Recently, bacterial numbers (1.5 log10 reduction). Although topical negative pressure (TNP) dressings have been higher frequency of PB instillation resulted in a used in chronic wounds to aid healing. Although greater decrease in bacterial load, the additive there is some research evaluating the effect of TNP effect of TNP to PB instillation was not present. The dressings on biofilms, there is no research on the SEM complemented these findings. efficacy of a combination of TNP dressings and Conclusion: MBEC of PI against S. epidermidis lay antiseptic instillation. between 0.078 mg/ml and 0.156 mg/ml while the Aims: Our aims were to identify the minimum MEC was 4.883 μg/ml. The MBEC of HA against S. eradication concentration (MEC) and the minimum epidermidis was between 0.025 mg/ml and 0.05 biofilm eradication concentration (MBEC) of S. mg/ml while the MEC was 3.125 μg/ml. MBEC of epidermidis and P. aeruginosa against a range of PB against P. aeruginosa lay between 0.05 mg/ antiseptics and use sub-inhibitory concentrations ml and 0.20 mg/ml while the MEC was 0.2mg/ml. of antiseptics in an in vitro wound model to assess The MBEC of HA against P. aeruginosa was > 0.05 the efficacy of TNP dressings in combination with mg/ml while the MEC was < 3.125 μg/ml. The use antiseptic instillation. of TNP in combination with antiseptic instillation resulted in a greater reduction of bacterial Method: Biofilms were generated in a biofilm numbers when compared with instillation alone. generator (24 coupons at a time) with a 24 hour batch phase and a 24 hour flow-through phase. Coupons were then transferred to an in vitro wound chamber. Each wound chamber had 6 coupons. Wound chambers were subjected to various frequency of antiseptic instillation with and without TNP. 5 coupons were prepared for quantitative measurements using standard microbiological methods, while 1 coupon was prepared for scanning electron microscopy.   Research in the South West  73

Independent Learning Projects and Honours

The Independent Learning Project (ILP) or Honours projects, undertaken by all Phase 2 students, aims to enable students to gain some insight into how medical knowledge is acquired through the completion of a research-related project.

Between 2011 and 2013, south western Sydney based academics and conjoints hosted 88 ILP and 8 Honours projects, as follows:

yy CARROLL, Emma Elizabeth: The role of 2011 amplitude-integrated EEG in predicting the outcome of infants with Hypoxic Ischaemic Encephalopathy, supervised by Dr John Levison Independent Learning Projects and Dr Ian Callander yy ABDEL MESSIH, Marena: Telephone versus yy CHATTERJEE, Ushmi: Examination of the postal surveys post joint replacement surgery, natural history of chronic HBV infection in young supervised by Professor Ian Harris and women, supervised by Associate Professor Associate Professor Justine Naylor Miriam Levy and Dr Susan Connor yy AHMADI, Navid: Screening for ACS in patients yy CHEN, Jim Yun: Proteomics in inflammatory with ruptured AAA, supervised by Dr Scott bowel disease, supervised by Professor Rupert D’Amours and Dr John Crozier Leong and Dr Valerie Wasinger yy BRENNAN, Xavier John: Impact of diastolic yy CHEUNG, Benson Pun Wang: Epidemiology of function post myocardial infarction, supervised MRSA infection in orthopaedics, supervised by by Professor Liza Thomas and Professor John Professor Ian Harris and Dr Rajat Mittal French yy DUBEY, Ritika: Cystic neoplasms of the pancreas - an evidence based approach to management, supervised by Associate Professor Neil Merrett 74  UNSW in the South West 2011-2013  

yy GHANNOUM, Rola: Expansion of intracoronary yy PHAN, Victoria Anh-Thu: Left ventricular stents by oversizing vs high pressure inflation: a diastolic reserve in patients with diabetes randomised intracoronary ultrasound controlled mellitus, supervised by Professor Dominic study, supervised by Associate Professor Craig Leung and Dr Melissa Leung Juergens and Professor John French yy SIDRAK, Samuel: Iron deficiency in children yy KARUNIA, Michael Justin: Whether propofol is with developmental problems, supervised by Dr a more effective sedative agents in comparison Sue Woolfenden and Dr Terence Yoong to midazolam and fentanyl in endoscopy?, yy TAY, Kwok Ping: Family stress and quality of supervised by Professor Rupert Leong and Dr life in autism families, supervised by Professor Jenn Koo Valsa Eapen and Dr Rudi Crncec yy KATHIRGAMANATHAN, Mithran: Is liver yy TSANG, Chi Fai: Pain experience in head and biopsy an obstacle to treatment for HBV - role of neck cancer outpatients: predictors of adverse Fibroscan?, supervised by Associate Professor pain outcomes, supervised by Dr Anthony Miriam Levy and Dr Susan Connor McGuiness and Dr Rebecca Strutt yy KELLY, James Curran: Timelines in lung yy TSAO, Owen Ao-Yi: A neurophysiological cancer diagnosis and treatment, supervised by investigation of Tourette syndrome prior to and Associate Professor Shalini Vinod and Dr Jesmin following habit reversal therapy, supervised by Shafiq Professor Valsa Eapen and Dr Rudi Crncec yy KINJO, Yu: Adherence to medical therapy in yy WESTON, Melissa Jayne: Biomarkers in the inflammatory bowel disease - a prospective prediction of infliximab efficacy, supervised evaluation, supervised by Professor Rupert by Professor Rupert Leong and Dr Sudarshan Leong and Dr Christian Selinger Paramsothy yy LE, Terry: Paroxysmal atrial fibrillation - its yy WIJERATNE, Viduranga: Pain experience in affects on atrial dynamics and function, head and neck cancer patients attending a supervised by Professor Liza Thomas and Dr multidisciplinary oncology clinic, supervised by Hany Dimitri Dr Anthony McGuinness and Dr Dion Forstner yy LEE, Goeun Grace: Surveillance for lung yy YANG, Anes: Response variations between ethics tumours following treatment for head and committee for multicentre trials, supervised by neck malignancy, supervised by Dr Anthony Professor Ian Harris and Dr Rajat Mittal McGuinness and Dr Dion Forstner yy MADAN, Aman: Levels of evidence-based medicine knowledge amongst surgeons, Honours supervised by Professor Ian Harris and Dr Rajat yy LUU, John: Femoral versus Radial artery Mittal access for coronary interventional procedures yy MANICKAM, Arutchelvan: Association guided by vascular ultrasound, supervised between outcome and patient preference by Associate Professor Craig Juergens and for rehabilitation after total joint replacement, Professor John French supervised by Professor Ian Harris and Associate Professor Justine Naylor yy NGUYEN, Anna Phuong: Anti-serum amyloid 2012 A antibodies in patients with systemic lupus erythematosus, supervised by Dr Sean O’Neill and Professor Patrick McNeil Independent Learning Projects yy PARK, Joo-Mann Calvin: The prognostic yy BAE, Sunna: The role of the unfolded significance of SUV measurements in solitary protein response in sensitivity of myeloma to colorectal liver metastases, supervised by Dr proteasome inhibitors, supervised by Dr Silvia Michael Lin and Dr Weng Ng Ling and Dr Michael Harvey yy PARK, Hyo Jung: Phenotypic characterisation yy CANNON, Christine: Trends in penetrating and social cognition deficits in Tourette chest wounds, supervised by Dr Scott D’Amours syndrome versus Autism Spectrum Disorders, yy CHAMI, Saja: Developmental surveillance in the supervised by Professor Valsa Eapen and Dr 3rd year of life, supervised by Professor Valsa Rudi Crncec Eapen and Dr Rudi Crncec yy PERANANTHAN, Varan: A study of IBD yy CHEN, Ji: Hepatic fibrosis in inflammatory through proteomics, supervised by Professor bowel disease, supervised by Professor Rupert Rupert Leong and Dr Valerie Wasinger Leong and Dr Alice Lee   Research in the South West  75

yy CHUA, Jia Lin: Role of Caesarean section to yy KRISHNAMOORTHY, Roopa: Head and reduce the vertical transmission risk of HPV, neck reconstructive surgery, supervised by supervised by Dr Danforn Lim and Dr Lisa Dr Navindran Niles and Associate Professor Cheng Jonathan Clark yy DIEP, Quoc Hung: BBIF1120 + isoprenylation yy KWEN, Oh Ryong: Mast cell tryptase and inhibition (fluvastatin, atorvastatin), supervised arthritis, supervised by Professor Patrick McNeil by Professor Paul De Souza and Dr Peter and Dr Katherine Bryant Galettis yy LEE, Janette: Cortical inhibition in Tourette yy HO, Khai Ee Evelyn: Acupuncture for syndrome: A neurophysiological investigation depression in end stage cancer patient, , supervised by Professor Valsa Eapen and Dr supervised by Dr Danforn Lim and Dr Lisa Rudi Crncec Cheng yy LI, Matthew Ka Ki: Facial reanimation, yy HUANG, Tony Dazhong: Confocal supervised by Dr Navindran Niles and Dr endomicroscopy in Barretts oesophagus , Jonathan Clark supervised by Professor Rupert Leong yy LIM, Li Chin Deborah: Neurodevelopmental yy HUANG, Yeqian: Benzodiazepine treatment for outcomes in a cohort of children delivered painful neuropathy, supervised by Dr Danforn following significant intra-uterine growth Lim and Dr Lisa Cheng retardation, supervised by Professor John yy KHALIL, Jinan: Lifestyle and genetic factors Smoleniec and Professor Valsa Eapen in vascular dementia, supervised by Professor yy LIN, Richard: Respiratory virus infections in Daniel Chan and Dr Fintan O’Rourke children, supervised by Professor Guy Marks and Associate Professor Euan Tovey 76  UNSW in the South West 2011-2013  

yy LU, Zhou: The use of FDG PET as a prognostic yy YOUNG, Shaun Michael: The role of FDG marker in patients with diffuse large B-cell PET-CT in the gastric cancers, supervised by Dr lymphoma, supervised by Dr Michael Lin and Dr Michael Lin and Dr Weng Ng Silvia Ling

yy MAHMOOD, Alina: Angiogenesis inhibitors Honours + EGFR antagonists in the treatment of brain cancer cell lines, supervised by Professor Paul yy KO, Yanna: Epidemiology of Inflammatory De Souza and Dr Peter Galettis Bowel Disease in Middle Eastern Population in Australia, supervised by Professor Rupert Leong yy MUNSIF, Ashish: Development of a Cochrane protocol to assess the role of pre-operative yy ZENG, Ming Dong: Proteomic profiling in interventions addressing comorbidities in inflammatory bowel diseases in comparison improving outcomes after hip and knee, to other inflammatory diseases and controls, supervised by Professor Ian Harris and supervised by Professor Rupert Leong Associate Professor Justine Naylor yy NAMKOONG, Jenny Youn: Retinal changes in women with gestational diabetes and pre- 2013 eclampsia, supervised by Associate Professor Vincent Wong yy NG, Rachel: Acupuncture for Independent Learning Projects hypercholesterolaemia, supervised by Dr yy AHMED, Taifa: Outcomes of patients Danforn Lim and Dr Lisa Cheng treated with adjuvant radiotherapy for uterine yy ONG, Germane: Typical complications in malignancies, supervised by Associate English and non-English speaking patients at Professor Shalini Vinod and DrJesmin Shafiq 10 weeks post-op, supervised by Professor Ian yy CHAGANTI, Raja: Strain rate imaging during Harris and Associate Professor Justine Naylor dobutamine stress echo for the diagnosis yy PARK, Daniel Jinho: Angiogenesis inhibitors of coronary artery disease, supervised by + mTOR antagonists in the treatment of brain Professor Dominic Leung and Dr Matle Fung cancer cell lines, supervised by Professor Paul yy CHATTERTON, Sophie: Anti-platelet agent De Souza and Dr Peter Galettis sensitivity measured by Verify Now in patients yy PATTERSON, Eliza: PAINLESS trial and chronic with acute coronary syndromes with respect pain substudy: redefining pain management to the risk of bleeding after CAGs and PCI, after cardiac surgery, a randomised trial, supervised by Associate Professor Rebecca supervised by Associate Professor Rebecca Dignan and Professor John French Dignan yy DO, Andrew: Biomarkers for brain cancer, yy PRABHALA, Shreyas: Outcomes of patients supervised by Professor Paul De Souza and Dr discharged from the Emergency Department Eng-Siew Koh with diagnosis of low risk chest pain, supervised yy DUO, Xiz: Proteomics in inflammatory bowel by Dr Kent Robinson and Associate Professor disease, supervised by Professor Rupert Leong Anna Holdgate and Dr Valerie Wasinger yy SIERAKOWSKI, Amy: Developmental yy GHANNOUM, Rola: Can the content of seroma outcomes of monochorionic multiple fluid from mastectomy or axillary clearance pregnancies e.g twins sharing the same wounds predict clinical course?, supervised by placenta, supervised by Professor John Dr Patsy Soon and Dr Dave Segara Smoleniec and Professor Valsamma Eapen yy HOGAN, Jarred: Examining the risk of yy SIOW, Suyi: Acupuncture for type II diabetes cardiovascular morbidity and mortality in mellitus, supervised by Dr Danforn Lim and Dr patients with established CKD, supervised by Lisa Cheng Professor Liza Thomas and Professor John yy WON, Chloe: Anti-HDL antibodies in patients French with SLE, supervised by Dr Sean O’Neill and yy IYER, Dushyant: The natural history of intra- Professor Patrick McNeil abdominal hypertension and abdominal yy WONG, Brendon: The use of confocal compartment syndrome, supervised by Dr Scott endomicroscopy in assessing Crohn’s disease, D’Amours and Dr Pratik Rastogi supervised by Professor Rupert Leong and Dr yy KHANDKAR, Chinmay: Epidemiology and Christian Selinger management of peripheral lymph node yy XU, Ke: Acupuncture for cancer related fatigue, tuberculosis, supervised by Dr Claudia Dobler supervised by Dr Danforn Lim and Dr Lisa and Dr Zinta Harrington Cheng   Research in the South West  77 78  UNSW in the South West 2011-2013  

yy KIM, Hyeon Rae: The effect of outcome yy WANG, Duo: Application of novel quantitative monitoring on intervention rate in spine surgery, techniques for FDG-PET CT in patients with non- supervised by Professor Ian Harris and small cell lung cancer, supervised by Dr Ivan Ho Associate Professor Justine Naylor Shon and Dr Eng-Siew Koh yy LEE, Dior: Comparison of general anaesthesia yy WESTBURY, Sean: The epidemiology of versus combined regional and general inflammatory bowel diseases, supervised by anaesthesia in upper limb surgery, supervised Professor Rupert Leong and Dr Jenn Koo by Dr Alwin Chuan and Professor Ian Harris yy WILKINSON, Angus: Factors predicting the yy LEONG, Kwong Ming: Pre and post operative outcomes of trauma patients who are intubated obesity as a predictor of outocme after joint in the emergency department - a retrospective replacement, supervised by Professor Ian Harris cross-sectional pilot study, supervised by and Associate Professor Justine Naylor Associate Professor Anna Holdgate and Dr Ian yy MANOHARAN, Varun: The use of novel Ferguson biomarkers in predicting prognosis in gastro- yy YANAGISAWA, Waka: Biomarkers for brain oesophageal and colorectal cancer, supervised cancer, supervised by Professor Paul De Souza by Dr Michael Lin and Dr Weng Ng and Dr Eng-Siew Koh yy NG, Ian: Morality after trauma, supervised by yy YANG, Michael: Confocal endomicroscopy Professor Ian Harris and Associate Professor in the study of inflammatory bowel diseases, Justine Naylor supervised by Professor Rupert Leong and Dr yy NGUYEN, Monica: An exploratory investigation Darren Pavey of the regulation of SAP97 as it relates to Tourette Syndrome and ASD, supervised by Honours Professor Valsa Eapen and Dr Raymond Clarke yy CHO, Catherine: Prostaglandin D2 metabolites yy NGUYEN, Tram: Femoral versus Radial Artery as a biomarker of in vivo mast cell activation, Access for Coronary Interventional Procedures supervised by Professor Patrick McNeil and Dr guided by vascular ultrasound, supervised Katherine Bryant by Associate Professor Craig Juergens and Professor John French yy HERLE, Pratima: Randomised trial of tranexamic acid during hip fracture surgery, yy PATHAK, Vidya: Attitudes and beliefs among supervised by Professor Ian Harris hospital staff towards tuberculosis and prophylactic treatment, supervised by Dr yy HOLMES, Lewis: Impact of three different Claudia Dobler and Dr Zinta Harrington glycoprotein IIb/IIIa Antagonists on Glycoprotein IIb/IIIa platelet receptor inhibition, tissue level yy PICK, Anna: Comprehensive Behavioural perfusion and clinical endpoints , supervised by Intervention for Tics (CBIT): Exploring the Associate Professor Craig Juergens mechanism of action using neurophysiological investigation, supervised by Professor Valsa yy LEE, Alexandra: Smoking and pancreatic Eapen and Dr Rudi Crncec stellate cells, supervised by Professor Minoti Apte and Professor Jeremy Wilson yy ROY, Sajeeb: Outcomes of patients with HCC in SSWAHS are we doing better?, supervised by yy PATEL, Mishaal: Interaction of pancreatic Associate Professor Miriam Levy and Dr Scott stellate cells and endothelial cells in pancreatic Davison cancer, supervised by Professor Jeremy Wilson and Professor Minoti Apte yy RYAN, Amitee: The PAINLESS Trial - Painbuster Length of Stay, Randomised Trial, supervised by yy PERERA, Dinushi: Preclinical activity of Associate Professor Rebecca Dignan and Ms phospholipase A2 (PLA2) inhibitors in various Serena Hong cancer cell lines, supervised by Professor Paul De Souza yy SEAGRAVE, Kurt: Predictors of complications after total joint replacement, supervised by yy WONG, Wui-Kwan: Preclinical activity of Professor Ian Harris and Associate Professor phospholipase A2 (PLA2) inhibitors in various Justine Naylor cancer cell lines, supervised by Professor Paul De Souza yy SHAW, James: The use of a risk score in the prediction of colorectal advanced adenomas and cancers at colonoscopy, supervised by Professor Rupert Leong and Dr Jenn Koo yy SINGH, Karan: Outcomes with GIST tumours of the upper gastrointestinal tract, supervised by Associate Professor Neil Merrett and Dr Amithaba Das   Research in the South West  79

RESEARCH OUTPUTS INVOLVING ILP AND HONOURS STUDENTS

Some projects which resulted in yy Leung M, Phan V, Leung DY. Diastolic reserve is publications for the students: an independent predictor of exercise capacity. Eur Heart J. 2013;34:449. yy Brennan X, Hee L, Chen J, Allman C, French J, Juergens C, Thomas L. Long term impact of yy Lim CE, Ho KK, Cheng NC, Wong FW. restrictive filling pattern post acute myocardial Combined oestrogen and progesterone for infarction. Heart, Lung Circ. 2012;21:S42-3. preventing miscarriage. Cochrane Database Syst Rev. 2013 Sep 25;9:CD009278. doi: yy Harris I, Madan A, Naylor J, Chong S. Mortality 10.1002/14651858.CD009278.pub2. rates after surgery in New South Wales. ANZ J Surg. 2012 Dec;82(12):871-7. doi: yy McNeil HP, O’Neill S, Nguyen A. Prostaglandin 10.1111/j.1445-2197.2012.06319.x. Epub 2012 D2 as a biomarker of mast cell activation Oct 22. in rheumatoid arthritis and systemic lupus erythematosus. J Intern Med. 2012;42:12. yy Huang T, Leong RW, Ko Y, Kariyawasam VC. Pilot validation study of the international classification yy Park C, Lin M, Hugh T, Ng W. The prognostic of functioning, disability and health score: a utility of metabolic information provided by novel measure of disability in Crohn’s disease. J FDG PET in the evaluation of solitary colorectal Gastroenterol Hepatol. 2012;27:105-6. hepatic metastases. Ann Oncol. 2012 Sep 9;23:21. yy Kashkooli SB, Selinger C, Weston MJ, Roberts MB, Andrews J, Leong RW, Akbarzadeh S. yy Selinger C, Kinjo Y, McLaughlin J, Robinson Pregnancy-related inflammatory bowel disease A, Leong R. PMO-241 Conveying medication knowledge amongst obstetricians is significantly benefits to ulcerative colitis patients: what lower than gastroenterologists. J Gastroenterol thresholds for adherence are applied? Gut. Hepatol. 2012;27:97. 2012;61(S2):A172-3. yy Kelly J, Vinod SK, Shafiq J. Timelines in lung yy Selinger CP, Kinjo Y, Jones DB, Katelaris P, cancer diagnosis and treatment in south west Chapman G, McDonald C, Lal S, McLaughlin Sydney. Asia Pac J Clin Oncol. 2012;8(S1):302. J, Robinson A, Leong RW. Conveying medication benefits to ulcerative colitis patients yy Lawler J, Glass A, Chatterjee U, Wiseman and effects on patient attitudes regarding E, Davison S, Manoharan S, Smith L, Yeo A, thresholds for adherence. J Crohns Colitis. Ayres A, Locarnini S, Levy MT. Nucleot(s)ide 2013 Sep 1;7(8):e312-7. doi: 10.1016/j. analogues to prevent perinatal transmission of crohns.2012.11.006. Epub 2012 Dec 6. HBV: Lamivudine is effective but Tenofovir may be better. J Gastroenterol Hepatol. 2011;26:100. yy Sidrak S, Yoong T, Woolfenden S. Iron deficiency in children with global developmental yy Leong RW, Chen J, Yeoh KG, Ching J, Sung J, delay and autism spectrum disorder. J Paediatr Corte C. Prospective study of a risk score in the Child Health. 2014 May;50(5):356-61. doi: prediction of colorectal advanced neoplasia in a 10.1111/jpc.12483. Epub 2013 Dec 23. screening population. J Gastroenterol Hepatol. 2013;28:118. yy Tan PK, Chatterjee U, Glass A, Maley MW, Ayres A, Locarnini S, Levy M. Lamivudine yy Leong RW, Wong B, Chen J, Chung E, Mill J, in pregnancy: impact on hepatitis flares Kariyawasam VC, Selinger C, Pavey D, Merrett and HBeAg seroconversion post partum. J N. Intestinal mucosal leakage is detected Gastroenterol Hepatol. 2012;27:181. using in vivo confocal endomicroscopy in macroscopically-normal Crohn’s disease and ulcerative colitis. J Gastroenterol Hepatol. 2012;27:109-10. 80  UNSW in the South West 2011-2013  

R esearch Outputs

Publication articles, books, chapters and abstracts by south western Sydney based UNSW academics and conjoints between 2011-2013

This list of publications is sorted by the School of the affiliation of the first author and alphabetically. Authors with an appointment based in south western Sydney are highlighted in bold.

This list relies on public resources and represents research outputs by UNSW academics and conjoint appointees while working in south western Sydney, but may include work with external partners or in previous appointments. While all care has been taken to ensure that this list is complete, it is reliant on the accuracy of these sources.

Medical Sciences 10. Brooks R, Silove D, Steel Z, Steel CB, Rees S. Explosive anger in postconflict Timor Leste: interaction of socio- 1. Georgiou A, Lang S, Rosenfeld D, Westbrook JI. The economic disadvantage and past human rights-related use of computerized provider order entry to improve the trauma. J Affect Disord. 2011 Jun;131(1-3):268-76. doi: effectiveness and efficiency of coagulation testing. Arch 10.1016/j.jad.2010.12.020. Epub 2011 Feb 18. Pathol Lab Med. 2011 Apr;135(4):495-8. doi: 10.1043/2010- 11. Bryant RA, Brooks R, Silove D, Creamer M, O’Donnell 0286-SO.1. M, McFarlane AC. Peritraumatic dissociation mediates 2. Loo CK, Algar EM, Payton DJ, Perry-Keene J, Pereira TN, the relationship between acute panic and chronic Ramm GA. Possible role of WT1 in a human fetus with posttraumatic stress disorder. Behav Res Ther. 2011 evolving bronchial atresia, pulmonary malformation and renal May;49(5):346-51. doi: 10.1016/j.brat.2011.03.003. Epub agenesis. Pediatr Dev Pathol. 2012 Jan-Feb;15(1):39-44. doi: 2011 Mar 16. 10.2350/11-03-0997-OA.1. Epub 2011 Oct 10. 12. Bryant RA, Creamer M, O’Donnell M, Silove D, McFarlane 3. Loo CK, Pereira TN, Ramm GA. Abnormal WT1 expression AC. Heart rate after trauma and the specificity of fear in human fetuses with bilateral renal agenesis and cardiac circuitry disorders. Psychol Med. 2011 Dec;41(12):2573-80. malformations. Birth Defects Res A Clin Mol Teratol. 2012 doi: 10.1017/S0033291711000948. Epub 2011 Jun 15. Feb;94(2):116-22. doi: 10.1002/bdra.22881. Epub 2012 13. Bryant RA, Creamer M, O’Donnell M, Silove D, McFarlane Jan 13. AC. The capacity of acute stress disorder to predict posttraumatic psychiatric disorders. J Psychiatr Res. 2012 Feb;46(2):168-73. doi: 10.1016/j.jpsychires.2011.10.007. Psychiatry Epub 2011 Nov 14. 14. Bryant RA, O’Donnell ML, Creamer M, McFarlane AC, 4. Aboudan R, Eapen V, Bayshak M, Al-mansouri M, Al- Silove D. A multisite analysis of the fluctuating course shamsi M. Dyslexia in the United Arab Emirates University of posttraumatic stress disorder. JAMA Psychiatry. 2013 - a study of prevalence in English and Arabic. Int J of Aug;70(8):839-46. doi: 10.1001/jamapsychiatry.2013.1137. English Linguist. 2011;1(2):64-72. 15. Chapman C, Mills K, Slade T, McFarlane AC, Bryant 5. Adhikari A, Kalluraya B, Sujith KV, Gouthamchandra RA, Creamer M, Silove D, Teesson M. Remission from K, Jairam R, Mahmood R, Sankolli R. Synthesis, post-traumatic stress disorder in the general population. characterization and pharmacological study of Psychol Med. 2012 Aug;42(8):1695-703. doi: 10.1017/ 4,5-dihydropyrazolines carrying pyrimidine moiety. S0033291711002856. Epub 2011 Dec 14. Eur J Med Chem. 2012 Sep;55:467-74. doi: 10.1016/j. ejmech.2012.07.002. Epub 2012 Jul 20. 16. Charlson FJ, Steel Z, Degenhardt L, Chey T, Silove D, Marnane C, Whiteford HA. Predicting the impact of the 6. Axelsson E, Overs B, Eapen V, Harvey S. Socio- 2011 conflict in Libya on population mental health: PTSD demographic factors and parents’ choice of information and depression prevalence and mental health service sources relaitng to child development: preliminary requirements. PLoS One. 2012;7(7):e40593. doi: 10.1371/ findings from the ‘Watch Me Grow’ study. Aust NZ J Psych. journal.pone.0040593. Epub 2012 Jul 13. 2013;47(S1): 86. 17. Clarke RA, Lee S, Eapen V. Pathogenetic model for 7. Barnett BE, Eapen V. The infant with special meaning. Tourette syndrome delineates overlap with related Contemporary Approaches to Infant and Child Mental neurodevelopmental disorders including Autism. Transl Health, edited by Newman L, Mares S. IP Communications. Psychiatry. 2012 Sep 4;2:e158. doi: 10.1038/tp.2012.75. 2012:10-25. 18. Cohen M, Rasser PE, Peck G, Carr VJ, Ward PB, 8. Bazzana P, Eapen V. Mental health legislation in Australia Thompson PM, Johnston P, Baker A, Schall U. Cerebellar and New Zealand. Psychiatry at a Glance, edited by Katona grey-matter deficits, cannabis use and first-episode C, Cooper C, Robertson M. Wiley-Blackwell. 2012:96-7. schizophrenia in adolescents and young adults. Int J 9. Bertollo N, Matsubara M, Shinoda T, Chen D, Kumar M, Neuropsychopharmacol. 2012 Apr;15(3):297-307. doi: Walsh WR. Effect of surgical fit on integration of cancellous 10.1017/S146114571100068X. Epub 2011 May 4. bone and implant cortical bone shear strength for a porous titanium. J Arthroplasty. 2011 Oct;26(7):1000-7. doi: 10.1016/j.arth.2010.12.007. Epub 2011 Feb 12.   Research in the South West  81

19. Curtis J, Henry C, Watkins A, Newall H, Samaras K, 36. Eapen V, Johnston D, Apler A, Rees S, Silove DM. Adult Ward PB. Metabolic abnormalities in an early psychosis separation anxiety during pregnancy and its relationship to service: a retrospective, naturalistic cross-sectional depression and anxiety. J Perinat Med. 2013 Mar;41(2):159- study. Early Interv Psychiatry. 2011 May;5(2):108-14. doi: 63. 10.1111/j.1751-7893.2011.00262.x. Epub 2011 Apr 7. 37. Eapen V, Kulhara P, Raguram R. Essentials of psychiatry. 20. Curtis J, Lim LX, Roland S, Ward PB. Initiation of cannabis Paras Medical Publisher. 2012. and nicotine use in young people experiencing first- 38. Eapen V, Lee L, Austin C. Health and education: service episode psychosis. Early Interv Psychiatry. 2012;6:114. providers in partnership to improve mental health. Int J 21. Curtis J, Samaras K, Ward P, Watkins A, Newall H. Ment Health Syst. 2012 Sep 20;6(1):19. doi: 10.1186/1752- Metabolic complications in first episode psychosis: defining 4458-6-19. the issues, neural substrates and developing an effective 39. Eapen V, Robertson MM. Whither the relationship between early intervention framework. Aust NZ J Psych. 2011;45:A7. etiology and phenotype in Tourette Syndrome? Tourette 22. Curtis J, Samaras K, Ward PB. HeAL (Healthy Active Syndrome, edited by Martino D, Leckman JF. Oxford Lives): improving physical health in young people with University Press. 2013. psychosis- changing practice to create parity. Aust NZ J 40. Eapen V, Shiers D, Curtis J. Bridging the gap from Psych. 2013;47(S1):18. evidence to policy and practice: reducing the progression 23. Degabriele R, Lagopoulos J, Ward PB. The influence of to metabolic syndrome for children and adolescents on facial emotion processing on auditory sensory gating. antipsychotic medication. Aust N Z J Psychiatry. 2013 Psychophysiology. 2011;48:S89. May;47(5):435-42. doi: 10.1177/0004867412463169. Epub 2012 Oct 9. 24. Degabriele R, Lagopoulos J, Ward PB. Event-related potential correlates of inhibition in bipolar disorder. 41. Eapen V, Silove DM, Johnston D, Apler A, Rees S. Adult Neuroreport. 2011 Jul 13;22(10):484-8. doi: 10.1097/ separation anxiety in pregnancy: how common is it? Int J WNR.0b013e328347e21f. Womens Health. 2012;4:251-6. doi: 10.2147/IJWH.S30981. Epub 2012 May 24. 25. Dudley M, Silove D, Gale F. Mental health and human rights: Vision, praxis, and courage. Oxford University Press. 42. Eapen V, Ward P, Clarke R. Clonidine in Tourette 2012. syndrome and sensorimotor gating. Psychiatry Res. 2014 Feb 28;215(2):494-6. doi: 10.1016/j.psychres.2013.10.009. 26. Dudley M, Steel Z, Mares S, Newman L. Children Epub 2013 Oct 23. and young people in immigration detention. Curr Opin Psychiatry. 2012 Jul;25(4):285-92. doi: 10.1097/ 43. Eapen V. Developmental and mental health disorders: two YCO.0b013e3283548676. sides of the same coin. Asian J Psychiatr. 2014 Apr;8:7-11. doi: 10.1016/j.ajp.2013.10.007. Epub 2013 Oct 18. 27. Dullur P, Eapen V, Trapolini T. Metabolic syndrome in an adolescent psychiatric unit. Australas Psychiatry. 2012 44. Eapen V. Evaluation of weight gain and metabolic Oct;20(5):444-5. doi: 10.1177/1039856212447861. parameters among adolescent psychiatric inpatients: role of health promotion and life style intervention 28. Eapen V, Crncec R, McPherson S, Snedden C. Tic programs. J of Metab Syndr. 2012;1(3). doi:10.4172/2167- disorders and learning disability: clinical characteristics, 0943.1000109. cognitive performance and comorbidity. Aust NZ J Psych. 2012;37(2):162-172. doi:10.1017/jse.2013.2. 45. Eapen V. Genetic basis of autism: is there a way forward? Curr Opin Psychiatry. 2011 May;24(3):226-36. doi: 10.1097/ 29. Eapen V, Crncec R, Walter A. Clinical outcomes of an YCO.0b013e328345927e. early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. 46. Eapen V. Metabolic monitoring for patients on antipsychotic BMC Pediatr. 2013 Jan 7;13(1):3. doi: 10.1186/1471-2431- medication: are we failing to provide reasonable 13-3. standard of physical healthcare? Evid Based Nurs. 2012 Jul;15(3):97-8. doi: 10.1136/ebnurs-2012-100615. Epub 30. Eapen V, Crncec R, Walter A. Exploring links between 2012 May 6. genotypes, phenotypes, and clinical predictors of response to early intensive behavioral intervention in autism spectrum 47. Eapen V. Obesity and mental health in the young: a two- disorder. Front Hum Neurosci. 2013 Sep 11;7:567. doi: way street? Childhood Obesity: Causes, Management 10.3389/fnhum.2013.00567. and Challenges, edited by Jackson CG. Nova Publishers. 2013:117-28. 31. Eapen V, Crncec R. Strategies and challenges in the management of adolescent depression. Curr 48. Eapen V. What does Neuroscience teach us about Autism? Opin Psychiatry. 2012 Jan;25(1):7-13. doi: 10.1097/ Arquivos de Neuro – Psiquiatria. 2011. YCO.0b013e32834de3bd. 49. Forbes D, Fletcher S, Lockwood E, O’Donnell M, Creamer 32. Eapen V, El-Rufaie O. Mental Health Services. International M, Bryant RA, McFarlane A, Silove D. Requiring both Perspectives on Mental Health edited by Ghodse H. avoidance and emotional numbing in DSM-V PTSD: will RCPsych Publications, London, UK. 2011:245-250. it help? J Affect Disord. 2011 May;130(3):483-6. doi: 10.1016/j.jad.2010.10.032. Epub 2010 Nov 10. 33. Eapen V, Fulton E, Crncec R, Walter A. Early Start Denver Model: an early intervention program for preschool children 50. Forbes D, Fletcher S, Parslow R, Phelps A, O’Donnell M, with autism spectrum disorder (ASD). Aust NZ J Psych. Bryant RA, McFarlane A, Silove D, Creamer M. Trauma at 2013;47(S1)19. the hands of another: longitudinal study of differences in the posttraumatic stress disorder symptom profile following 34. Eapen V, Graham P, Shoba S. Where there is no child interpersonal compared with noninterpersonal trauma. psychiatrist: a mental healthcare manual. RCPsych J Clin Psychiatry. 2012 Mar;73(3):372-6. doi: 10.4088/ Publications. 2012. JCP.10m06640. Epub 2011 Nov 1. 35. Eapen V, John G. Weight gain and metabolic syndrome among young patients on antipsychotic medication: what do we know and where do we go? Australas Psychiatry. 2011 Jun;19(3):232-5. doi: 10.3109/10398562.2010.539609. 82  UNSW in the South West 2011-2013  

51. Forbes D, Lockwood E, Elhai JD, Creamer M, O’Donnell M, 65. Macfarlane S, McKay R, Looi JC. Limited antidepressant Bryant R, McFarlane A, Silove D. An examination of the efficacy in depression in dementia, in the context of limited structure of posttraumatic stress disorder in relation to the evidence. Aust N Z J Psychiatry. 2012 Jul;46(7):595-7. doi: anxiety and depressive disorders. J Affect Disord. 2011 10.1177/0004867412449061. Jul;132(1-2):165-72. doi: 10.1016/j.jad.2011.02.011. Epub 66. Maheshwari R, Steel Z. Mental health and service use in 2011 Apr 14. the Indian community in Australia - an epidemiological 52. Hazell P, Jairam R. Acute treatment of mania in children survey. Aust NZ J Psych. 2011;45:A43. and adolescents. Curr Opin Psychiatry. 2012 Jul;25(4):264- 67. Marnane C, Silove D. DSM-5 allows separation anxiety 70. doi: 10.1097/YCO.0b013e328353d467. disorder to grow up. Aust N Z J Psychiatry. 2013 53. Jairam R, Prabhuswamy M, Dullur P. Do we really know Jan;47(1):12-5. doi: 10.1177/0004867412461285. how to treat a child with bipolar disorder or one with severe 68. Matthey S, Crncec R. Comparison of two strategies to mood dysregulation? Is there a magic bullet? Depress Res improve infant sleep problems, and associated impacts on Treat. 2012;2012:967302. doi: 10.1155/2012/967302. Epub maternal experience, mood and infant emotional health: a 2011 Dec 1. single case replication design study. Early Hum Dev. 2012 54. Kaur M, Battisti RA, Lagopoulos J, Ward PB, Hickie IB, Jun;88(6):437-42. doi: 10.1016/j.earlhumdev.2011.10.010. Hermens DF. Neurophysiological biomarkers support Epub 2011 Nov 23. bipolar-spectrum disorders within psychosis cluster. J 69. McDonald P, Bryant RA, Silove D, Creamer M, O’Donnell Psychiatry Neurosci. 2012 Sep;37(5):313-21. doi: 10.1503/ M, McFarlane AC. The expectancy of threat and jpn.110081. peritraumatic dissociation. Eur J Psychotraumatol. 2013 55. Kaur M, Battisti RA, Ward PB, Ahmed A, Hickie IB, Dec 13;4. doi: 10.3402/ejpt.v4i0.21426. eCollection 2013. Hermens DF. MMN/P3a deficits in first episode psychosis: 70. McErlean RA, Eapen V. Perinatal anxiety and depression: comparing schizophrenia-spectrum and affective-spectrum associations with oxytocin and mother-infant interactions. subgroups. Schizophr Res. 2011 Aug;130(1-3):203-9. doi: Perinatal Depression, edited by Rojas MG. 2012:39-54. 10.1016/j.schres.2011.03.025. Epub 2011 May 6. 71. McKay R, Coombs T. An exploration of the ability of 56. Kaur M, Lagopoulos J, Lee RS, Ward PB, Naismith routine outcome measurement to represent clinically SL, Hickie IB, Hermens DF. Longitudinal associations meaningful information regarding individual consumers. between mismatch negativity and disability in early Australas Psychiatry. 2012 Oct;20(5):433-7. doi: schizophrenia- and affective-spectrum disorders. Prog 10.1177/1039856212458813. Epub 2012 Sep 26. Neuropsychopharmacol Biol Psychiatry. 2013 Oct 1;46:161- 9. doi: 10.1016/j.pnpbp.2013.07.002. Epub 2013 Jul 11. 72. McKay R, McDonald R, Coombs T. Benchmarking older persons mental health organizations. Australas Psychiatry. 57. Kaur M, Lagopoulos J, Ward PB, Watson TL, Naismith SL, 2011 Feb;19(1):45-8. doi: 10.3109/10398562.2010.539222. Hickie IB, Hermens DF. Mismatch negativity/P3a complex in young people with psychiatric disorders: a cluster analysis. 73. McKay R, McDonald R, Lie D, McGowan H. Reclaiming the PLoS One. 2012;7(12):e51871. doi: 10.1371/journal. best of the biopsychosocial model of mental health care pone.0051871. Epub 2012 Dec 14. and ‘recovery’ for older people through a ‘person-centred’ approach. Australas Psychiatry. 2012 Dec;20(6):492-5. doi: 58. Kowitz S, Bryant RA, Creamer M, McFarlane AC, Melvin G, 10.1177/1039856212460286. Epub 2012 Oct 25. O’Donnell M, Silove DM. Pathways to PTSD: support for an avoidant response in adults with a history of childhood 74. McKay R. Mental health community support needs don’t trauma. Eur J Psychotraumatology. 2011;2. stop at 65. Aust N Z J Psychiatry. 2012 Dec;46(12):1202-3. doi: 10.1177/0004867412458459. Epub 2012 Aug 24. 59. Langdon R, Still M, Connors MH, Ward PB, Catts SV. Attributional biases, paranoia, and depression in early 75. McKay R. Mental health promotion in later life: the positive psychosis. Br J Clin Psychol. 2013 Nov;52(4):408-23. doi: living in aged care awards. Aust NZ J Psych. 2012;46:48-9. 10.1111/bjc.12026. Epub 2013 Aug 22. 76. McKay R. Excellence in psychiatry of old age. Aust NZ J 60. Langdon R, Still M, Connors MH, Ward PB, Catts Psych. 2013;47(S1):58. SV. Jumping to delusions in early psychosis. 77. McKay R. Using routine outcome measurement to Cogn Neuropsychiatry. 2014;19(3):241-56. doi: represent clinically significant information. Aust NZ J Psych. 10.1080/13546805.2013.854198. Epub 2013 Nov 11. 2013;47(S1):58. 61. Langdon R, Still M, Connors MH, Ward PB, Catts SV. 78. McKay R. Never too late for recovery. Aust NZ J Psych. Theory of mind in early psychosis. Early Interv Psychiatry. 2013;47(S1):86. 2014 Aug;8(3):286-90. doi: 10.1111/eip.12072. Epub 2013 Jul 10. 79. McKay RG, Draper BM. Is it too late to prevent a decline in mental health care for older Australians? Med J Aust. 2012 62. Lewin TJ, Carr VJ, Conrad AM, Sly KA, Tirupati S, Cohen M, Jul 16;197(2):87-8. Ward PB, Coombs T. Shift climate profiles and correlates in acute psychiatric inpatient units. Soc Psychiatry Psychiatr 80. Mills KL, McFarlane AC, Slade T, Creamer M, Silove Epidemiol. 2012 Sep;47(9):1429-40. doi: 10.1007/s00127- D, Teesson M, Bryant R. Assessing the prevalence 011-0448-7. Epub 2011 Nov 9. of trauma exposure in epidemiological surveys. Aust N Z J Psychiatry. 2011 May;45(5):407-15. doi: 63. Liddell BJ, Chey T, Silove D, Phan TT, Giao NM, Steel 10.3109/00048674.2010.543654. Epub 2010 Dec 28. Z. Patterns of risk for anxiety-depression amongst Vietnamese-immigrants: a comparison with source and 81. Naismith SL, Mowszowski L, Ward PB, Diamond K, host populations. BMC Psychiatry. 2013 Dec 2;13:329. doi: Paradise M, Kaur M, Lewis SJ, Hickie IB, Hermens 10.1186/1471-244X-13-329. DF. Reduced temporal mismatch negativity in late-life depression: an event-related potential index of cognitive 64. Liddell BJ, Silove D, Tay K, Tam N, Nickerson A, Brooks R, deficit and functional disability? J Affect Disord. 2012 Rees S, Zwi AB, Steel Z. Achieving convergence between Apr;138(1-2):71-8. doi: 10.1016/j.jad.2011.12.028. Epub a community-based measure of explosive anger and a 2012 Feb 1. clinical interview for intermittent explosive disorder in Timor- Leste. J Affect Disord. 2013 Sep 25;150(3):1242-6. doi: 82. Newall H, Myles N, Ward PB, Samaras K, Shiers D, 10.1016/j.jad.2013.06.006. Epub 2013 Jul 5. Curtis J. Efficacy of metformin for prevention of weight gain in psychiatric populations: a review. Int Clin Psychopharmacol. 2012 Mar;27(2):69-75. doi: 10.1097/ YIC.0b013e32834d0a5b.   Research in the South West  83

83. Nickerson A, Bryant RA, Brooks R, Steel Z, Silove D, Chen 91. Rees S, Silove D, Chey T, Steel Z, Bauman A, J. The familial influence of loss and trauma on refugee mental Phan T. Physical activity and psychological distress health: a multilevel path analysis. J Trauma Stress. 2011 amongst Vietnamese living in the Mekong Delta. Feb;24(1):25-33. doi: 10.1002/jts.20608. Epub 2011 Jan 25. Aust N Z J Psychiatry. 2012 Oct;46(10):966-71. doi: 10.1177/0004867412459568. Epub 2012 Sep 4. 84. Nickerson A, Bryant RA, Silove D, Steel Z. A critical review of psychological treatments of posttraumatic stress 92. Rees S, Silove D, Verdial T, Tam N, Savio E, Fonseca disorder in refugees. Clin Psychol Rev. 2011 Apr;31(3):399- Z, Thorpe R, Liddell B, Zwi A, Tay K, Brooks R, Steel Z. 417. doi: 10.1016/j.cpr.2010.10.004. Epub 2010 Nov 6. Intermittent explosive disorder amongst women in conflict affected Timor-Leste: associations with human rights 85. Nickerson A, Steel Z, Bryant R, Brooks R, Silove D. trauma, ongoing violence, poverty, and injustice. PLoS Change in visa status amongst Mandaean refugees: ONE. 2013;8(8):e69207. doi:10.1371/journal.pone.0069207. relationship to psychological symptoms and living difficulties. Psychiatry Res. 2011 May 15;187(1-2):267-74. 93. Rees S, Silove D. Sakit Hati: A state of chronic mental doi: 10.1016/j.psychres.2010.12.015. Epub 2011 Feb 5. distress related to resentment and anger amongst West Papuan refugees exposed to persecution. 86. O’Donnell ML, Varker T, Creamer M, Fletcher S, McFarlane Soc Sci Med. 2011 Jul;73(1):103-10. doi: 10.1016/j. AC, Silove D, Bryant RA, Forbes D. Exploration of Delayed- socscimed.2011.05.004. Epub 2011 May 20. Onset Posttraumatic Stress Disorder After Severe Injury. Psychosom Med. 2012 Nov 28. 94. Rees S, Silove DM, Tay K, Kareth M. Human rights trauma and the mental health of West Papuan refugees resettled in 87. O’Donnell ML, Varker T, Holmes AC, Ellen S, Wade Australia. Med J Aust. 2013 Aug 19;199(4):280-3. D, Creamer M, Silove D, McFarlane A, Bryant RA, Forbes D. Disability after injury: the cumulative burden 95. Rees S, Verdial T, Silove D, Thorpe R, Zwi A. Intermittent of physical and mental health. J Clin Psychiatry. 2013 explosive disorder amongst women in conflict affected Feb;74(2):e137-43. doi: 10.4088/JCP.12m08011. Timor-Leste: associations with human rights trauma, ongoing violence, poverty and injustice. Int J Qual Methods. 88. Protopopescu X, Austin M, Reilly N, Barnett BE. Screening 2013;12:738. and psychosocial assessment. Perinatal Mental Health: A clinical guide, edited by Martin CR. 2012:307-22. 96. Rees S. Gender-based violence, mental disorders, disability and suicide. Australian Domestic and Family 89. Rasser PE, Schall U, Todd J, Michie PT, Ward PB, Johnston P, Violence Clearinghouse Newsletter. 2012; 47:12-3. Helmbold K, Case V, Søyland A, Tooney PA, Thompson PM. Gray matter deficits, mismatch negativity, and outcomes in 97. Rees S. Violence against women: the right to protection schizophrenia. Schizophr Bull. 2011 Jan;37(1):131-40. doi: from mental disorders. Human Rights Defender. 10.1093/schbul/sbp060. Epub 2009 Jun 26. 2012;21(3):10-3. 90. Rees S, Silove D, Chey T, Ivancic L, Steel Z, Creamer 98. Rees S. Gender differences among patients with social M, Teesson M, Bryant R, McFarlane AC, Mills KL, Slade T, phobia in Egypt. Aust NZ J Psych.2013;24(1):52-9. Carragher N, O’Donnell M, Forbes D. Lifetime prevalence of 99. Rees SJ, Silove DM. Gender-based violence and the gender-based violence in women and the relationship with threat to women’s mental health. Med J Aust. 2011 Oct mental disorders and psychosocial function. JAMA. 2011 17;195(8):434-5. Aug 3;306(5):513-21. doi: 10.1001/jama.2011.1098.

HIGH IMPACT PUBLICATION

Rees S, Silove D, Chey T, Ivancic L, Steel Z, Creamer M, Teesson M, Bryant R, McFarlane AC, Mills KL, Slade T, Carragher N, O’Donnell M, Forbes D. Lifetime prevalence of gender-based violence in women and the relationship with mental disorders and psychosocial function. JAMA. 2011 Aug 3;306(5):513-21. doi: 10.1001/jama.2011.1098.

CONTEXT: Intimate partner physical Organization’s World Mental Health Survey 56.2% (OR, 15.90; 95% CI, 8.32-30.20) violence, rape, sexual assault, and Initiative was used to assess lifetime for PTSD, 89.4% (OR, 11.00; 95% CI, stalking are pervasive and co-occurring prevalence of any mental disorder, anxiety, 5.46-22.17) for any mental disorder, and forms of gender-based violence (GBV). mood disorder, substance use disorder, 34.7% (OR, 14.80; 95% CI, 6.89-31.60) for An association between these forms of and posttraumatic stress disorder suicide attempts. Gender-based violence abuse and lifetime mental disorder and (PTSD). Also included were indices was associated with more severe current psychosocial disability among women of lifetime trauma exposure, including mental disorder (OR, 4.60; 95% CI, 2.93- needs to be examined. GBV, sociodemographic characteristics, 7.22), higher rates of 3 or more lifetime economic status, family history of mental disorders (OR, 7.79; 95% CI, 6.10-9.95), OBJECTIVES: To assess the association disorder, social supports, general mental physical disability (OR, 4.00; 95% CI, of GBV and mental disorder, its severity and physical functioning, quality of life, 1.82-8.82), mental disability (OR, 7.14; and comorbidity, and psychosocial and overall disability. 95% CI, 2.87-17.75), impaired quality functioning among women. of life (OR, 2.96; 95% CI, 1.60-5.47), an RESULTS: A total of 1218 women DESIGN, SETTING, AND PARTICIPANTS: increase in disability days (OR, 3.14; 95% (27.4%) reported experiencing at least A cross-sectional study based on the CI, 2.43-4.05), and overall disability (OR, 1 type of GBV. For women exposed to 3 Australian National Mental Health and 2.73; 95% CI, 1.99-3.75). or 4 types of GBV (n = 139), the rates of Well-being Survey in 2007, of 4451 mental disorders were 77.3% (odds ratio CONCLUSION: Among a nationally women (65% response rate) aged 16 to [OR], 10.06; 95% confidence interval representative sample of Australian 85 years. [CI], 5.85-17.30) for anxiety disorders, women, GBV was significantly associated MAIN OUTCOME MEASURES: The 52.5% (OR, 3.59; 95% CI, 2.31-5.60) for with mental health disorder, dysfunction, Composite International Diagnostic mood disorder, 47.1% (OR, 5.61; 95% CI, and disability. Interview version 3.0 of the World Health 3.46-9.10) for substance use disorder, 84  UNSW in the South West 2011-2013  

100. Rescorla LA, Achenbach TM, Ivanova MY, Harder VS, 112. Silove D, Rees S, Tam N, Liddell B, Zwi A. Staff Otten L, Bilenberg N, Bjarnadottir G, Capron C, De Pauw management and capacity building under conditions of SS, Dias P, Dobrean A, Döpfner M, Duyme M, Eapen V, insecurity: lessons from developing mental health service Erol N, Esmaeili EM, Ezpeleta L, Frigerio A, Fung DS, and research programs in post-conflict Timor-Leste. Gonçalves M, Guðmundsson H, Jeng SF, Jusiené R, Ah Kim Australas Psychiatry. 2011 Jul;19 Suppl 1:S90-4. doi: Y, Kristensen S, Liu J, Lecannelier F, Leung PW, Machado 10.3109/10398562.2011.583076. BC, Montirosso R, Ja Oh K, Ooi YP, Plück J, Pomalima R, 113. Silove D. The ADAPT model. Intervention. 2011;11(3):237-48. Pranvera J, Schmeck K, Shahini M, Silva JR, Simsek Z, Sourander A, Valverde J, van der Ende J, Van Leeuwen KG, 114. Silove D. Do conflict-affected societies need psychiatrists? Wu YT, Yurdusen S, Zubrick SR, Verhulst FC. 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HIGH IMPACT PUBLICATION

Tol WA, Barbui C, Galappatti A, Silove D, Betancourt TS, Souza R, Golaz A, van Ommeren M. Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet. 2011 Oct 29;378(9802):1581-91. doi: 10.1016/S0140-6736(11)61094-5. Epub 2011 Oct 16.

This review links practice, funding, and (21%); and basic counselling for groups (psychotherapy and psychosocial evidence for interventions for mental and families (20%). Most interventions supports) compared with usual care or health and psychosocial wellbeing took place and were funded outside waiting list (standardised mean difference in humanitarian settings. We studied national mental health and protection [SMD] -0·38, 95% CI -0·55 to -0·20). In practice by reviewing reports of mental systems. 32 controlled studies of children, meta-analysis of four RCTs health and psychosocial support interventions were identified, 13 of which failed to show an effect for symptoms of activities (2007-10); funding by analysis were randomised controlled trials (RCTs) PTSD (-0·36, -0·83 to 0·10), but showed of the financial tracking service and the that met the criteria for meta-analysis. a beneficial effect of interventions (group creditor reporting system (2007-09); Two studies showed promising effects psychotherapy, school-based support, and interventions by systematic review for strengthening community and family and other psychosocial support) for and meta-analysis. In 160 reports, the supports. Psychosocial wellbeing was internalising symptoms (six RCTs; SMD five most commonly reported activities not included as an outcome in the meta- -0·24, -0·40 to -0·09). Overall, research were basic counselling for individuals analysis, because its definition varied and evidence focuses on interventions that (39%); facilitation of community support across studies. In adults with symptoms are infrequently implemented, whereas the of vulnerable individuals (23%); provision of post-traumatic stress disorder (PTSD), most commonly used interventions have of child-friendly spaces (21%); support meta-analysis of seven RCTs showed had little rigorous scrutiny. of community-initiated social support beneficial effects for several interventions

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Harris MF, Islam FM, Jalaludin B, Chen J, Bauman AE, Ward JE. Feasibility, acceptability and impact of a Comino EJ. Preventive care in general practice among telephone support service initiated in primary medical healthy older New South Wales residents. BMC Fam Pract. care to help Arabic smokers quit. Aust J Prim Health. 2013 Jun 16;14:83. doi: 10.1186/1471-2296-14-83. 2011;17(3):274-81. doi: 10.1071/PY10066. 183. Harris MF, Lloyd J, Krastev Y, Fanaian M, Davies GP, Zwar 169. Grace R. Development disability in Children, Families N, Liaw ST. Routine use of clinical management guidelines and Communities: Contexts and Consequences, Oxford in Australian general practice. Aust J Prim Health. University Press. 2012:39-57. 2014;20(1):41-6. doi: 10.1071/PY12078. 170. Grace R, Trudgett M. ‘It’s not rocket science’: The 184. Harris MF, Webster V, Jalaludin B, Jackson Pulver LR, perspectives of Indigenous early childhood workers on Comino EJ. Immunisation coverage among a birth cohort supporting the engagement of Indigenous families in early of Aboriginal infants in an urban community. J Paediatr childhood settings. Australian Journal of Early Childhood. Child Health. 2014 Apr;50(4):306-13. doi: 10.1111/ 2012;37(2):10-8. jpc.12482. Epub 2013 Dec 20. 171. Gunning C, Harris P, Mallett J. Assessing the health 185. Harris P, Haigh F, Sainsbury P, Wise M. Influencing land equity impacts of regional land-use plan making: An use planning: making the most of opportunities to work equity focussed health impact assessment of alternative upstream. Aust N Z J Public Health. 2012 Feb;36(1):5-7. patterns of development of the Whitsunday Hinterland and doi: 10.1111/j.1753-6405.2012.00822.x. Mackay Regional Plan, Australia (Short report). Environ 186. Harris P, Spickett J. Health impact assessment in Impact Assess Rev. 2011;31(4):415-9. doi:10.1016/j. Australia: A review and directions for progress. Environ eiar.2010.03.005. Impact Assess Rev. 2011;31(4):425-32. doi:10.1016/j. 172. Haigh F. Health impact assessment for policies, plans eiar.2010.03.002. and projects. New Planner. Planning Institute of Australia. 187. Harris PJ, Haigh F, Harris E. Incorporating health 2012;91:23. considerations in land-use planning and policy 173. Haigh F, Baum F, Dannenberg AL, Harris MF, Harris-Roxas development: a review of activities in Stoke City Council B, Keleher H, Kemp L, Morgan R, Chok HN, Spickett J, in the UK and suggestions for application in NSW. Centre Harris E. The effectiveness of health impact assessment in for Health Equity Training Research and Evaluation, part of influencing decision-making in Australia and New Zealand the Centre for Primary Health Care and Equity, Faculty of 2005-2009. BMC Public Health. 2013 Dec 17;13:1188. doi: Medicine, University of NSW. 2012. 10.1186/1471-2458-13-1188. 188. Harris PJ, Kemp LA, Sainsbury P. The essential elements 174. Haigh F, Harris E, Chok HN, Baum F, Harris-Roxas B, of health impact assessment and healthy public policy: a Kemp L, Spickett J, Keleher H, Morgan R, Harris M, Wendel qualitative study of practitioner perspectives. BMJ Open. AM, Dannenberg AL. Characteristics of health impact 2011;2(6):e001245. doi:10.1136/bmjopen-2012-001245. assessments reported in Australia and New Zealand 2005- 189. Harris PJ, Ritchie JE, Tabi G, Lower T. Addressing 2009. Aust N Z J Public Health. 2013 Dec;37(6):534-46. the social determinants of alcohol use and abuse 175. Harris E, Harris-Roxas BF, Harris PJ, Kemp LA. with adolescents in a Pacific country (Vanuatu). Social Learning by doing’: Building workforce capacity to determinants approaches to public health: from concept to undertake HIA - An Australian case study in Integrating practice. World Health Organization. 2011:175-86. Health Impact Assessment into the Policy Process: 190. Harris-Roxas B, Harris E. Differing forms, differing Lessons and Experiences from around the World, purposes: A typology of health impact assessment. Environ Oxford University Press. 2013:99-108. doi:10.1093/ Impact Assess Rev. 2011;31(4):396-403. doi:10.1016/j. med/9780199639960.001.0001. eiar.2010.03.003. 176. Harris E, Stewart D, Harris N, Ritchie J. Understanding 191. Harris-Roxas B, Harris E. The impact and effectiveness workforce participation as a continuous rather than of health impact assessment: A conceptual framework. dichotomous variable: implications for improving workforce Environ Impact Assess Rev. 2013;42:51-9. doi:10.1016/j. health. Aust N Z J Public Health. 2011 Apr;35(2):190-4. doi: eiar.2012.09.003. 10.1111/j.1753-6405.2010.00646.x. Epub 2010 Dec 9. 192. Harris-Roxas B, Viliani F, Bond A, Cave B, Divall M, 177. Harris MF, Davies PG, Fanaian M, Zwar NA, Liaw Furu P, Harris P, Soeberg M, Wernham A, Winkler M. ST. Access to same day, next day and after-hours Health impact assessment: the state of the art. Impact appointments: the views of Australian general practitioners. Assessment and Project Appraisal. 2012;30(1):43-52. doi:1 Aust Health Rev. 2012 Aug;36(3):325-30. doi: 10.1071/ 0.1080/14615517.2012.666035. AH11080. 193. Harris-Roxas BF. Health Impact assessment in the 178. Harris MF, Dennis S, Pillay M. Multimorbidity: negotiating Asia Pacific (Editorial). Environ Impact Assess Rev. priorities and making progress. Aust Fam Physician. 2013 2011;31(4):393-5. doi:10.1016/j.eiar.2010.10.001. Dec;42(12):850-4. 194. Harris-Roxas BF, Harris PJ, Wise M, Haigh F, Ng Chok 179. Harris MF, Fanaian M, Jayasinghe UW, Passey M, Lyle D, H, Harris E. Health impact assessment in Australia: Where McKenzie S, Davies GP. What predicts patient-reported we’ve been and where we’re going in Health Impact GP management of smoking, nutrition, alcohol, physical Assessment: Past Achievement, Current Understanding activity and weight? Aust J Prim Health. 2012;18(2):123-8. and Future Progress, Oxford University Press. 2012:233-43. doi: 10.1071/PY11024. doi:10.1093/acprof:oso/9780199656011.003.0025. 88  UNSW in the South West 2011-2013  

195. Harris-Roxas BF, Maxwell M, Thornell M, Peters S, 204. Kang E, Lee Y, Harris P, Koh K, Kim K. Health impact Harris PJ. From description to action: Using health impact assessment in Korea. Environ Impact Assess Rev. assessment to address the social determinants of health in 2011;31(4):438-40. doi:10.1016/j.eiar.2010.02.005. Determining the Future: A Fair Go & Health for All, Connor 205. Kemp L, Harris E. The challenges of establishing Court Publishing. 2011:119-30. and researching a sustained nurse home visiting 196. Hashimoto-Govindasamy LS, Rose V. An ethnographic programme within the universal child and family process evaluation of a community support program health service system. J Res Nurs. 2012;17(2):127-38. with Sudanese refugee women in western Sydney. Health doi:10.1177/1744987111432228. Promot J Austr. 2011 Aug;22(2):107-12. 206. Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, 197. Hearn S, Nancarrow H, Rose M, Massi L, Wise M, Anderson T, Schmied V, Aslam H, Zapart S. Child and Conigrave K, Barnes I, Bauman A. Evaluating NSW family outcomes of a long-term nurse home visitation SmokeCheck: a culturally specific smoking cessation programme: a randomised controlled trial. Arch Dis Child. training program for health professionals working 2011 Jun;96(6):533-40. doi: 10.1136/adc.2010.196279. in Aboriginal health. Health Promot J Austr. 2011 Epub 2011 Mar 23. Dec;22(3):189-95. 207. Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, 198. Islam FM, Wu J, Jansson J, Wilson DP. Relative risk of Anderson T, Schmied V, Aslam H. Benefits of psychosocial cardiovascular disease among people living with HIV: intervention and continuity of care by child and family a systematic review and meta-analysis. HIV Med. 2012 health nurses in the pre- and postnatal period: process Sep;13(8):453-68. doi: 10.1111/j.1468-1293.2012.00996.x. evaluation. J Adv Nurs. 2013 Aug;69(8):1850-61. doi: Epub 2012 Mar 14. 10.1111/jan.12052. Epub 2012 Nov 30. 199. Islam FM, Wu J, Jansson J, Wilson DP. Relative risk of 208. Kemp LA, Harris E, McMahon C, Matthey S, Vimpani G, renal disease among people living with HIV: a systematic Anderson T, Schmied V, Aslam H. Maternal Early Childhood review and meta-analysis. BMC Public Health. 2012 Mar Sustained Home-visiting (MECSH) Program Manual. Centre 23;12:234. doi: 10.1186/1471-2458-12-234. for Health Equity Training Research and Evaluation, part of the Centre for Primary Health Care and Equity, Faculty of 200. Jalaludin B, Maxwell M, Saddik B, Lobb E, Byun R, Medicine, University of NSW. 2012. Gutierrez R, Paszek J. A pre-and-post study of an urban renewal program in a socially disadvantaged 209. Kirby SE, Dennis SM, Bazeley P, Harris MF. Activating neighbourhood in Sydney, Australia. BMC Public Health. patients with chronic disease for self-management: 2012 Jul 12;12:521. doi: 10.1186/1471-2458-12-521. comparison of self-managing patients with those managing by frequent readmissions to hospital. Aust J Prim Health. 201. Jalaludin BB, Garden FL. Does urban sprawl impact 2013;19(3):198-206. doi: 10.1071/PY12030. on self-rated health and psychological distress? A multilevel study from Sydney, Australia. Ecohealth. 2011 210. Kirby SE, Dennis SM, Bazeley P, Harris MF. What Sep;8(3):268-76. doi: 10.1007/s10393-011-0699-5. Epub distinguishes clinicians who better support patients for 2011 Aug 31. chronic disease self-management? Aust J Prim Health. 2012;18(3):220-7. doi: 10.1071/PY11029. 202. Jeon YH, Sansoni J, Low LF, Chenoweth L, Zapart S, Sansoni E, Marosszeky N. Recommended measures for 211. Kirby SE, Dennis SM, Jayasinghe UW, Harris MF. Frequent the assessment of behavioral disturbances associated with emergency attenders: is there a better way? Aust Health dementia. Am J Geriatr Psychiatry. 2011 May;19(5):403-15. Rev. 2011 Nov;35(4):462-7. doi: 10.1071/AH10964. doi: 10.1097/JGP.0b013e3181ef7a0d. 212. Kirby SE, Dennis SM, Jayasinghe UW, Harris MF. 203. Johnson M, Schmeid V, Lupton SJ, Austin MP, Matthey SM, Unplanned return visits to emergency in a regional hospital. Kemp L, Meade T, Yeo AE. Measuring perinatal mental Aust Health Rev. 2012 Aug;36(3):336-41. doi: 10.1071/ health risk. Arch Womens Ment Health. 2012 Oct;15(5):375- AH11067. 86. doi: 10.1007/s00737-012-0297-8. Epub 2012 Aug 1.

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Li S, Baker PJ, Jalaludin BB, Marks GB, Denison LS, Williams GM. Ambient temperature and lung function in children with asthma in Australia. Eur Respir J. 2014 Apr;43(4):1059-66. doi: 10.1183/09031936.00079313. Epub 2013 Dec 5.

The association between ambient data were obtained daily on ambient PEF, while the effects were stronger in temperature and lung function in children temperature, relative humidity and air females for evening FEV1. Children with with asthma is still uncertain. A panel pollution. Mixed models were used to asthma living in southern cities were more of 270 children (aged 7-12 years) with examine the effects of temperature on sensitive to high temperature than those asthma was recruited from six Australian lung function, controlling for individual in the northernmost city. Higher ambient cities. They performed three successive characteristics and environmental factors. temperature is associated with lower forced expiratory manoeuvres twice daily Ambient temperature was negatively lung function in children with asthma. for 4 weeks. The highest peak expiratory related to both morning and evening PEF Preventive health policies will be required flow rate (PEF) and forced expiratory and FEV1 for 0-3 days lag. In general, to protect children with asthma from volume in 1 s (FEV1) were stored for the effects of temperature were stronger increasingly frequent high temperatures. each session. During the same period, in males than in females for evening   Research in the South West  89

213. Kirby SE, Mutimbe M, Vagholkar S, Bunker J, Dennis 228. Liaw ST, Taggart J, Dennis S, Yeo A. Data quality and SM, Liaw ST. How integrated are services for patients fitness for purpose of routinely collected data--a general with chronic obstructive pulmonary disease? Perceptions practice case study from an electronic practice-based of patients and health care providers. Aust J Prim Health. research network (ePBRN). AMIA Annu Symp Proc. 2014;20(2):158-61. doi: 10.1071/PY12147. 2011;2011:785-94. Epub 2011 Oct 22. 214. Knight A, Lembke T. Appointments 101--how to shape a 229. Liaw ST, Taggart J, Yu H, de Lusignan S. Data extraction more effective appointment system. Aust Fam Physician. from electronic health records - existing tools may be 2013 Mar;42(3):152-6. unreliable and potentially unsafe. Aust Fam Physician. 2013 Nov;42(11):820-3. 215. Knight AW. Patient-centred prescribing. Australian Prescriber. 2013;36(6):199-201. 230. Liaw ST. Decision support systems--a general practice research journey. Aust Fam Physician. 2011 Sep;40(9):711. 216. Knight J, Webster V, Kemp L, Comino E. Sudden infant death syndrome in an urban Aboriginal community. J 231. Liaw ST. HoMER - an opportunity or threat to Paediatr Child Health. 2013 Dec;49(12):1025-31. doi: general practice research? Aust Fam Physician. 2011 10.1111/jpc.12306. Epub 2013 Jun 20. Dec;40(12):1016-7. 217. Lau AY, Dunn A, Mortimer N, Proudfoot J, Andrews A, Liaw 232. Liyanage H, Liaw ST, de Lusignan S. Accelerating the ST, Crimmins J, Arguel A, Coiera E. Consumers’ online development of an information ecosystem in health care, by social network topologies and health behaviours. Stud stimulating the growth of safe intermediate processing of Health Technol Inform. 2013;192:77-81. health information (IPHI). Inform Prim Care. 2012;20(2):81-6. 218. Lau AY, Dunn AG, Mortimer N, Gallagher A, Proudfoot 233. Liyanage H, Liaw ST, de Lusignan S. Reporting of Studies J, Andrews A, Liaw ST, Crimmins J, Arguel A, Coiera E. Conducted using Observational Routinely Collected Data Social and self-reflective use of a Web-based personally (RECORD) statement: call for contributions from the clinical controlled health management system. J Med Internet Res. informatics community. Inform Prim Care. 2012;20(4):221-4. 2013 Sep 23;15(9):e211. doi: 10.2196/jmir.2682. 234. Maneze D, Dennis S, Chen HY, Taggart J, Vagholkar S, 219. Lau AY, Proudfoot J, Andrews A, Liaw ST, Crimmins J, Bunker J, Liaw ST. Multidisciplinary care: experience Arguel A, Coiera E. Which bundles of features in a Web- of patients with complex needs. Aust J Prim Health. based personally controlled health management system 2014;20(1):20-6. doi: 10.1071/PY12072. are associated with consumer help-seeking behaviors for 235. Mayne DJ, Morgan GG, Willmore A, Rose N, Jalaludin B, physical and emotional well-being? J Med Internet Res. Bambrick H, Bauman A. An objective index of walkability 2013 May 6;15(5):e79. doi: 10.2196/jmir.2414. for research and planning in the Sydney metropolitan 220. Li S, Baker PJ, Jalaludin BB, Marks GB, Denison LS, region of New South Wales, Australia: an ecological study. Williams GM. Ambient temperature and lung function Int J Health Geogr. 2013 Dec 24;12:61. doi: 10.1186/1476- in children with asthma in Australia. Eur Respir J. 2014 072X-12-61. Apr;43(4):1059-66. doi: 10.1183/09031936.00079313. Epub 236. McDonald J, Webster V, Knight J, Comino E. The Gudaga 2013 Dec 5. Study: development in 3-year-old urban Aboriginal children. 221. Li S, Williams G, Jalaludin B, Baker P. Panel studies of J Paediatr Child Health. 2014 Feb;50(2):100-6. doi: air pollution on children’s lung function and respiratory 10.1111/jpc.12476. Epub 2013 Dec 27. symptoms: a literature review. J Asthma. 2012 237. McDonald JL, Comino E, Knight J, Webster V. Nov;49(9):895-910. doi: 10.3109/02770903.2012.724129. Developmental progress in urban Aboriginal infants: a cohort Epub 2012 Sep 28. study. J Paediatr Child Health. 2012 Feb;48(2):114-21. doi: 222. Liaw ST. Clinical decision support systems: data quality 10.1111/j.1440-1754.2011.02067.x. Epub 2011 Apr 7. management and governance. Studies in health technology 238. McDonald JL, Milne S, Knight J, Webster V. Developmental and informatics. Health Information Governance in a Digital and behavioural characteristics of children enrolled in a Environment. 2013;193:362-9. doi:10.3233/978-1-61499- child protection pre-school. J Paediatr Child Health. 2013 291-2-362. Feb;49(2):E142-6. doi: 10.1111/jpc.12029. Epub 2012 Dec 2. 223. Liaw ST, Chen H-Y, Maneze D, Taggart J, Dennis SM, 239. McKenzie SH, Jayasinghe UW, Fanaian M, Passey M, Vagholkar S, Bunker JM. The quality of routinely collected Lyle D, Davies GP, Harris MF. Socio-demographic factors, data: using the ‘Principal Diagnosis’ in emergency behaviour and personality: associations with psychological department databases as an example. Electronic Journal distress. Eur J Prev Cardiol. 2012 Apr;19(2):250-7. doi: of Health Informatics. 2012;7(1):e1. 10.1177/1741826711399426. Epub 2011 Feb 21. 224. Liaw ST, Chen HY, Maneze D, Taggart J, Dennis S, 240. Merrifield A, Schindeler S, Jalaludin B, Smith W. Health Vagholkar S, Bunker J. Health reform: is routinely effects of the September 2009 dust storm in Sydney, collected electronic information fit for purpose? Emerg Australia: did emergency department visits and hospital Med Australas. 2012 Feb;24(1):57-63. doi: 10.1111/j.1742- admissions increase? Environ Health. 2013 Apr 16;12:32. 6723.2011.01486.x. Epub 2011 Sep 19. doi: 10.1186/1476-069X-12-32. 225. Liaw ST, Hannan T. Can we trust the PCEHR not to leak? 241. Miller E, Webster V, Knight J, Comino E. The use of a Med J Aust. 2011 Aug 15;195(4):222. standardized language assessment tool to measure the 226. Liaw ST, Lau P, Pyett P, Furler J, Burchill M, Rowley K, language development of urban Aboriginal preschoolers. Kelaher M. Successful chronic disease care for Aboriginal Int J Speech Lang Pathol. 2014 Apr;16(2):109-20. doi: Australians requires cultural competence. Aust N Z J 10.3109/17549507.2013.796000. Epub 2013 Jul 8. Public Health. 2011 Jun;35(3):238-48. doi: 10.1111/j.1753- 242. Milne S, McDonald J, Comino EJ. The use of the 6405.2011.00701.x. Bayley Scales of Infant and Toddler Development III 227. Liaw ST, Rahimi A, Ray P, Taggart J, Dennis S, de with clinical populations: a preliminary exploration. Lusignan S, Jalaludin B, Yeo AE, Talaei-Khoei A. Phys Occup Ther Pediatr. 2012 Feb;32(1):24-33. doi: Towards an ontology for data quality in integrated chronic 10.3109/01942638.2011.592572. Epub 2011 Aug 4. disease management: a realist review of the literature. 243. Milne SL, McDonald JL, Comino EJ. Adaptive function Int J Med Inform. 2013 Jan;82(1):10-24. doi: 10.1016/j. in preschoolers in relation to developmental delay and ijmedinf.2012.10.001. Epub 2012 Nov 2. diagnosis of autism spectrum disorders: insights from a clinical sample. Autism. 2013 Nov;17(6):743-53. doi: 10.1177/1362361312453091. Epub 2012 Sep 17. 90  UNSW in the South West 2011-2013     Research in the South West  91

244. Möller H, Haigh F, Harwood C, Kinsella T, Pope D. Rising 259. Rose VK, Harris MF. ‘Training’ friends and family to provide unemployment and increasing spatial health inequalities positive social support in diabetes self-management: in England: further extension of the North-South divide. J experience of ethnically diverse patients. Diabet Med. 2013 Public Health (Oxf). 2013 Jun;35(2):313-21. doi: 10.1093/ Mar;30(3):372-3. doi: 10.1111/dme.12015. pubmed/fds085. Epub 2013 Jan 4. 260. Rose VK, Morrow M, Harris E. Walk the Talk: Surviving 245. Parker JD, Rich DQ, Glinianaia SV, Leem JH, Wartenberg D, unemployment, staying healthy and getting a job [Kit]. Bell ML, Bonzini M, Brauer M, Darrow L, Gehring U, Gouveia UNSW. 2012. N, Grillo P, Ha E, van den Hooven EH, Jalaludin B, Jesdale 261. Rose VK, Perz J, Harris E. Vocationally oriented cognitive BM, Lepeule J, Morello-Frosch R, Morgan GG, Slama R, Pierik behavioural training for the very long-term unemployed. FH, Pesatori AC, Sathyanarayana S, Seo J, Strickland M, Occup Med (Lond). 2012 Jun;62(4):298-300. doi: 10.1093/ Tamburic L, Woodruff TJ. The International Collaboration on occmed/kqs038. Epub 2012 May 8. Air Pollution and Pregnancy Outcomes: initial results. Environ Health Perspect. 2011 Jul;119(7):1023-8. doi: 10.1289/ 262. Rose VK, Thompson LM. Space, place and people: ehp.1002725. Epub 2011 Feb 9. a community development approach to mental health promotion in a disadvantaged community. Community 246. Passey ME, Laws RA, Jayasinghe UW, Fanaian M, Development Journal. 2012;47(4):604-11. doi:10.1093/cdj/ McKenzie S, Powell-Davies G, Lyle D, Harris MF. bss024. Predictors of primary care referrals to a vascular disease prevention lifestyle program among participants in a 263. Saan H, Wise M. Enable, mediate, advocate. Health Promot cluster randomised trial. BMC Health Serv Res. 2012 Aug Int. 2011 Dec;26 Suppl 2:ii187-93. doi: 10.1093/heapro/ 3;12:234. doi: 10.1186/1472-6963-12-234. dar069. 247. Poulos RG, Chong SS, Olivier J, Jalaludin B. Geospatial 264. Sainsbury P, Harris E, Wise M. The built environment as analyses to prioritize public health interventions: a case a social determinant of health in Determining the Future: study of pedestrian and pedal cycle injuries in New South A Fair Go & Health for All, Connor Court Publishing. Wales, Australia. Int J Public Health. 2012 Jun;57(3):467-75. 2011:177-85. doi: 10.1007/s00038-012-0331-7. Epub 2012 Jan 24. 265. Schmied V, Donovan J, Kruske S, Kemp L, Homer C, Fowler 248. Povall SL, Haigh FA, Abrahams D, Scott-Samuel A. Health C. Commonalities and challenges: a review of Australian equity impact assessment. Health Promot Int. 2013 Feb 28. state and territory maternity and child health policies. Contemp Nurse. 2011 Dec;40(1):106-17. doi: 10.5172/ 249. Qummouh R, Rose V, Hall P. Specific issues, exact conu.2011.40.1.106. locations: case study of a community mapping project to improve safety in a disadvantaged community. Health 266. Schmied V, Johnson M, Naidoo N, Austin MP, Matthey S, Promot J Austr. 2012 Dec;23(3):231-3. Kemp L, Mills A, Meade T, Yeo A. Maternal mental health in Australia and New Zealand: a review of longitudinal 250. Rhee JJ, Zwar NA, Kemp LA. Advance care planning and studies. Women Birth. 2013 Sep;26(3):167-78. doi: interpersonal relationships: a two-way street. Fam Pract. 10.1016/j.wombi.2013.02.006. Epub 2013 Apr 12. 2013 Apr;30(2):219-26. doi: 10.1093/fampra/cms063. Epub 2012 Oct 1. 267. Shortus T, Kemp L, McKenzie S, Harris M. ‘Managing patient involvement’: provider perspectives on diabetes 251. Rhee JJ, Zwar NA, Kemp LA. Uptake and implementation decision-making. Health Expect. 2013 Jun;16(2):189-98. of Advance Care Planning in Australia: findings of key doi: 10.1111/j.1369-7625.2011.00700.x. Epub 2011 Jun 7. informant interviews. Aust Health Rev. 2012 Feb;36(1):98- 104. doi: 10.1071/AH11019. 268. Silk J, Harris E, Rose VK. Real World Stories: Reflections on working in locationally disadvantaged communities 252. Rhee JJ, Zwar NA, Kemp LA. Why are advance care [Booklet]. UNSW. 2012. planning decisions not implemented? Insights from interviews with Australian general practitioners. J 269. Spickett J, Katscherian D, Harris P. The role of Health Palliat Med. 2013 Oct;16(10):1197-204. doi: 10.1089/ Impact Assessment in the setting of air quality standards: jpm.2013.0156. Epub 2013 Aug 21. An Australian perspective. Environ Impact Assess Rev. 2011;43:97-103. doi:10.1016/j.eiar.2013.06.001. 253. Robinson P, Comino E, Forbes A, Webster V, Knight J. Timeliness of antenatal care for mothers of Aboriginal 270. Taggart J, Liaw ST, Dennis S, Yu H, Rahimi A, Jalaludin B, and non-Aboriginal infants in an urban setting. Aust J Prim Harris M. The University of NSW electronic practice based Health. 2012;18(1):56-61. doi: 10.1071/PY10073. research network: disease registers, data quality and utility. Stud Health Technol Inform. 2012;178:219-27. 254. Rollans M, Meade T, Schmied V, Kemp L. Capturing clinician-client interaction: development of the 4D&4R 271. Taggart J, Williams A, Dennis S, Newall A, Shortus T, Zwar observational tool. Nurse Res. 2013 May;20(5):11-9. N, Denney-Wilson E, Harris MF. A systematic review of interventions in primary care to improve health literacy for 255. Rollans M, Schmied V, Kemp L, Meade T. ‘We just ask chronic disease behavioral risk factors. BMC Fam Pract. some questions…’ the process of antenatal psychosocial 2012 Jun 1;13:49. assessment by midwives. Midwifery. 2013 Aug;29(8):935- 42. doi: 10.1016/j.midw.2012.11.013. Epub 2013 Feb 15. 272. Tamburrini A-L, Gilhuly K, Harris-Roxas B. Enhancing benefits in health impact assessment through 256. Rollans M, Schmied V, Kemp L, Meade T. Digging over stakeholder consultation. Impact Assessment and Project that old ground: an Australian perspective of women’s Appraisal. 2011;29(3):195-204. doi:10.3152/14615511 experience of psychosocial assessment and depression 1X12959673796281. screening in pregnancy and following birth. BMC Womens Health. 2013 Apr 9;13:18. doi: 10.1186/1472-6874-13-18. 273. Thompson SM, Kent J, Jalaludin BB. Supporting human health: focusing effective built environment interventions. 257. Rollans M, Schmied V, Kemp L, Meade T. Negotiating Australian Sustainabile Cities and Regions Network policy in practice: child and family health nurses’ approach (ASCRN). 2011:1-12. to the process of postnatal psychosocial assessment. BMC Health Serv Res. 2013 Apr 8;13:133. doi: 10.1186/1472- 274. Vagholkar S, Zwar N, Jayasinghe UW, Denney- 6963-13-133. Wilson E, Patel A, Campbell T, Harris MF. Influence of cardiovascular absolute risk assessment on prescribing 258. Rose VK, Harris E, Comino E, Anderson T, Harris MF. of antihypertensive and lipid-lowering medications: a GP and community nurse co-location in a disadvantaged cluster randomized controlled trial. Am Heart J. 2014 community. Aust J Prim Health. 2011;17(4):300-1. doi: Jan;167(1):28-35. doi: 10.1016/j.ahj.2013.10.002. Epub 10.1071/PY11054. 2013 Oct 17. 92  UNSW in the South West 2011-2013  

HIGH IMPACT PUBLICATION

Vagholkar S, Zwar N, Jayasinghe UW, Denney-Wilson E, Patel A, Campbell T, Harris MF. Influence of cardiovascular absolute risk assessment on prescribing of antihypertensive and lipid-lowering medications: a cluster randomized controlled trial. Am Heart J. 2014 Jan;167(1):28-35. doi: 10.1016/j. ahj.2013.10.002. Epub 2013 Oct 17.

BACKGROUND: Guidelines for CVAR, provided with an electronic CVAR groups in proportion of patients on management of hypertension and lipids calculator, and assessed their patients’ antihypertensives (31.2% vs 34.3%, P = recommend using cardiovascular absolute absolute risk in a dedicated consultation. .31), but control group patients were more risk (CVAR) to manage patients. This Control practice patients received a likely to be on lipid-lowering medications randomized controlled trial investigated general health check. Primary outcome (30.2% vs 22.7%, P = .01). After the impact of CVAR assessment in analyzed was the proportion of patients multilevel analysis, this difference was not family practice on management of in each group on antihypertensive present. Intensification or reduction of cardiovascular risk, including prescription and/or lipid-lowering medication at 12 pharmacologic therapy was associated of antihypertensive and lipid-lowering months. Multilevel logistic regression was with meeting treatment targets for blood medication. performed to explore variables influencing pressure and lipids but not with the CVAR changes in pharmacologic therapy. or intervention group. METHODS: A cluster randomized controlled trial was conducted from RESULTS: The study recruited 36 FPs CONCLUSIONS: Single-risk factor 2008 to 2010 in Sydney, Australia. from 34 practices and 1,074 patients, management remains a strong influence Family practices were randomized, of which 906 (84.4%) completed on FP prescribing practices. Shifting to and patients aged 45 to 69 years were 12-month follow-up. At 12 months, an approach based on CVAR will require invited to participate. Intervention family there was no significant difference more intensive intervention. physicians (FP) were trained in use of between the intervention and control

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HIGH IMPACT PUBLICATION

Biankin AV, Waddell N, Kassahn KS, Gingras MC, Muthuswamy LB, Johns AL, Miller DK, Wilson PJ, Patch AM, Wu J, Chang DK, Cowley MJ, Gardiner BB, Song S, Harliwong I, Idrisoglu S, Nourse C, Nourbakhsh E, Manning S, Wani S, Gongora M, Pajic M, Scarlett CJ, Gill AJ, Pinho AV, Rooman I, Anderson M, Holmes O, Leonard C, Taylor D, Wood S, Xu Q, Nones K, Fink JL, Christ A, Bruxner T, Cloonan N, Kolle G, Newell F, Pinese M, Mead RS, Humphris JL, Kaplan W, Jones MD, Colvin EK, Nagrial AM, Humphrey ES, Chou A, Chin VT, Chantrill LA, Mawson A, Samra JS, Kench JG, Lovell JA, Daly RJ, Merrett ND, Toon C, Epari K, Nguyen NQ, Barbour A, Zeps N; Australian Pancreatic Cancer Genome Initiative, Kakkar N, Zhao F, Wu YQ, Wang M, Muzny DM, Fisher WE, Brunicardi FC, Hodges SE, Reid JG, Drummond J, Chang K, Han Y, Lewis LR, Dinh H, Buhay CJ, Beck T, Timms L, Sam M, Begley K, Brown A, Pai D, Panchal A, Buchner N, De Borja R, Denroche RE, Yung CK, Serra S, Onetto N, Mukhopadhyay D, Tsao MS, Shaw PA, Petersen GM, Gallinger S, Hruban RH, Maitra A, Iacobuzio-Donahue CA, Schulick RD, Wolfgang CL, Morgan RA, Lawlor RT, Capelli P, Corbo V, Scardoni M, Tortora G, Tempero MA, Mann KM, Jenkins NA, Perez-Mancera PA, Adams DJ, Largaespada DA, Wessels LF, Rust AG, Stein LD, Tuveson DA, Copeland NG, Musgrove EA, Scarpa A, Eshleman JR, Hudson TJ, Sutherland RL, Wheeler DA, Pearson JV, McPherson JD, Gibbs RA, Grimmond SM. Pancreatic cancer genomes reveal aberrations in axon guidance pathway genes. Nature. 2012 Nov 15;491(7424):399-405. doi: 10.1038/nature11547. Epub 2012 Oct 24.

Pancreatic cancer is a highly lethal SMAD4, MLL3, TGFBR2, ARID1A and ductal adenocarcinoma, and identified malignancy with few effective therapies. SF3B1), and uncover novel mutated genes new mutated genes in each pathway. We performed exome sequencing and including additional genes involved in We also identified frequent and diverse copy number analysis to define genomic chromatin modification (EPC1 and ARID2), somatic aberrations in genes described aberrations in a prospectively accrued DNA damage repair (ATM) and other traditionally as embryonic regulators of clinical cohort (n = 142) of early (stage mechanisms (ZIM2, MAP2K4, NALCN, axon guidance, particularly SLIT/ROBO I and II) sporadic pancreatic ductal SLC16A4 and MAGEA6). Integrative signalling, which was also evident in adenocarcinoma. Detailed analysis analysis with in vitro functional data and murine Sleeping Beauty transposon- of 99 informative tumours identified animal models provided supportive mediated somatic mutagenesis models substantial heterogeneity with 2,016 evidence for potential roles for these of pancreatic cancer, providing further non-silent mutations and 1,628 copy- genetic aberrations in carcinogenesis. supportive evidence for the potential number variations. We define 16 Pathway-based analysis of recurrently involvement of axon guidance genes in significantly mutated genes, reaffirming mutated genes recapitulated clustering pancreatic carcinogenesis. known mutations (KRAS, TP53, CDKN2A, in core signalling pathways in pancreatic 98  UNSW in the South West 2011-2013  

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720. Ghose S, Dowling J, Holloway L, Lim K, Veera J, Vinod 732. Girgis A, Stojanovski E, Boyes A, King M, Lecathelinais C. SK, Chan P, Liney G, Greer PB. A survey of cervix The next generation of the supportive care needs survey: segmentation methods in magnetic resonance images. a brief screening tool for administration in the clinical Lecture Notes in Computer Science (including subseries oncology setting. Psychooncology. 2011 Apr 12. doi: Lecture Notes in Artificial Intelligence and Lecture Notes in 10.1002/pon.1973. [Epub ahead of print] Bioinformatics). 2013;8198LNCS:290-8. 733. Girgis A, Webber K, Bennetts BH, Bonaventura A, Boyle 721. Ghougassian DF, Beran RG, O’Brien TJ. 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Feasibility study of an oncology nurse practitioner model of care in a rural cancer setting. Asia Pac J Clin Oncol. 2013;9:122-3. 727. Girgis A, Lambert S, Johnson C, Currow DC. Applying an evidence-based approach to development and evaluation HIGH IMPACT PUBLICATION of resources for families facing advanced cancer: Lessons learned from the ‘Consumer Toolkit’. Asia Pac J Clin Oncol. Goldblatt F, O’Neill SG. Clinical aspects of 2012;8(S3):232. autoimmune rheumatic diseases. Lancet. 728. Girgis A, Lambert S, Johnson C, Waller A, Currow D. 2013 Aug 31;382(9894):797-808. doi: Physical, psychosocial, relationship, and economic burden 10.1016/S0140-6736(13)61499-3. of caring for people with cancer: a review. J Oncol Pract. 2013 Jul;9(4):197-202. doi: 10.1200/JOP.2012.000690. Epub 2012 Dec 4. 729. Girgis A, Lambert S, Lecathelinais C. The supportive Multisystem autoimmune rheumatic diseases are care needs survey for partners and caregivers of cancer heterogeneous rare disorders associated with substantial survivors: development and psychometric evaluation. morbidity and mortality. Efforts to create international Psychooncology. 2011 Apr;20(4):387-93. doi: 10.1002/ consensus within the past decade have resulted in the pon.1740. Epub 2010 Apr 5. publication of new classification or nomenclature criteria for several autoimmune rheumatic diseases, specifically 730. Girgis A, Lambert SD, McElduff P, Bonevski B, for systemic lupus erythematosus, Sjögren’s syndrome, Lecathelinais C, Boyes A, Stacey F. Some things change, and the systemic vasculitides. Substantial progress has some things stay the same: a longitudinal analysis been made in the formulation of new criteria in systemic of cancer caregivers’ unmet supportive care needs. sclerosis and idiopathic inflammatory myositis. Although Psychooncology. 2013 Jul;22(7):1557-64. doi: 10.1002/ the autoimmune rheumatic diseases share many common pon.3166. Epub 2012 Sep 3. features and clinical presentations, differentiation 731. Girgis A, Stacey F, Lee T, Black D, Kilbreath S. Priorities between the diseases is crucial because of important for women with lymphoedema after treatment for breast distinctions in clinical course, appropriate drugs, and cancer: population based cohort study. BMJ. 2011 Jun prognoses. We review some of the dilemmas in the 21;342:d3442. doi: 10.1136/bmj.d3442. diagnosis of these autoimmune rheumatic diseases, and focus on the importance of new classification criteria, clinical assessment, and interpretation of autoimmune serology. In this era of improvement of mortality rates for patients with autoimmune rheumatic diseases, we pay particular attention to the effect of leading complications, specifically cardiovascular manifestations and cancer, and we update epidemiology and prognosis.   Research in the South West  111

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BACKGROUND: Non-fatal health a systematic analysis of prevalence, models, back-calculation models (models outcomes from diseases and injuries are a incidence, remission, duration, and calculating incidence from population crucial consideration in the promotion and excess mortality. Sources included mortality rates and case fatality), or monitoring of individual and population published studies, case notification, registration completeness models (models health. The Global Burden of Disease population-based cancer registries, adjusting for incomplete registration (GBD) studies done in 1990 and 2000 other disease registries, antenatal clinic with health-system access and other have been the only studies to quantify serosurveillance, hospital discharge data, covariates). Disability weights for 220 non-fatal health outcomes across an ambulatory care data, household surveys, unique health states were used to capture exhaustive set of disorders at the global other surveys, and cohort studies. For the severity of health loss. YLDs by cause and regional level. Neither effort quantified most sequelae, we used a Bayesian at age, sex, country, and year levels were uncertainty in prevalence or years lived meta-regression method, DisMod-MR, adjusted for comorbidity with simulation with disability (YLDs). designed to address key limitations methods. We included uncertainty in descriptive epidemiological data, estimates at all stages of the analysis. METHODS: Of the 291 diseases and including missing data, inconsistency, and injuries in the GBD cause list, 289 cause FINDINGS: Global prevalence for all large methodological variation between disability. For 1160 sequelae of the 289 ages combined in 2010 across the 1160 data sources. For some disorders, we diseases and injuries, we undertook sequelae ranged from fewer than one used natural history models, geospatial   Research in the South West  143

case per 1 million people to 350,000 falls. Age-specific prevalence of YLDs over the past two decades. Prevalences cases per 1 million people. Prevalence increased with age in all regions and has of the most common causes of YLDs, and severity of health loss were weakly decreased slightly from 1990 to 2010. such as mental and behavioural disorders correlated (correlation coefficient -0·37). Regional patterns of the leading causes and musculoskeletal disorders, have not In 2010, there were 777 million YLDs from of YLDs were more similar compared decreased. Health systems will need to all causes, up from 583 million in 1990. with years of life lost due to premature address the needs of the rising numbers The main contributors to global YLDs mortality. Neglected tropical diseases, of individuals with a range of disorders were mental and behavioural disorders, HIV/AIDS, tuberculosis, malaria, and that largely cause disability but not musculoskeletal disorders, and diabetes anaemia were important causes of YLDs mortality. Quantification of the burden of or endocrine diseases. The leading in sub-Saharan Africa. non-fatal health outcomes will be crucial specific causes of YLDs were much the to understand how well health systems are INTERPRETATION: Rates of YLDs per same in 2010 as they were in 1990: low responding to these challenges. Effective 100,000 people have remained largely back pain, major depressive disorder, and affordable strategies to deal with this constant over time but rise steadily with iron-deficiency anaemia, neck pain, rising burden are an urgent priority for age. Population growth and ageing have chronic obstructive pulmonary disease, health systems in most parts of the world. increased YLD numbers and crude rates anxiety disorders, migraine, diabetes, and

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J Gastroenterol Hepatol. 2012;27:28-9. air- and bone-conducted sound stimulation in superior 1533. Yau Y, Shin SC, Bustamante S, Pickford R, Leong canal dehiscence. Exp Brain Res. 2012 Nov;223(1):51-64. R, Wasinger V. Tryptophan metabolome signature doi: 10.1007/s00221-012-3240-3. Epub 2012 Sep 2. differences in inflammatory bowel diseases. 1546. Zhang AS, Govender S, Colebatch JG. Tuning of Gastroenterology. 2011;S840. the ocular vestibular evoked myogenic potential to bone-conducted sound stimulation. J Appl Physiol (1985). 2012 Apr;112(8):1279-90. doi: 10.1152/ japplphysiol.01024.2011. Epub 2012 Feb 2. 146  UNSW in the South West 2011-2013  

1547. Zhang M, Boughton P, Rose B, Lee CS, Hong AM. The 1560. Eastwood JG, Jalaludin BB, Kemp LA, Phung HN, use of porous scaffold as a tumor model. Int J Biomater. Barnett BE. Relationship of postnatal depressive 2013;2013:396056. doi: 10.1155/2013/396056. Epub symptoms to infant temperament, maternal expectations, 2013 Sep 11. social support and other potential risk factors: findings from a large Australian cross-sectional study. BMC 1548. Zhang X, Ye N, Pan M, Lim CED. Preventive treatment Pregnancy Childbirth. 2012 Dec 12;12:148. doi: for diseases: A practice model. A challenge for hospital 10.1186/1471-2393-12-148. management in the field of integrative medicine. J Aust Tradit Med Soc. 2012;18(4):221-3. 1561. Eastwood J, Jalaludin B, Kemp L, Phung H, Barnett B, Tobin J. Social exclusion, infant behavior, social 1549. Zhu X, Lim CED, Nagels HE. Acupuncture for isolation, and maternal expectations independently female subfertility. Cochrane Database of Systematic predict maternal depressive symptoms. Brain Behav. Reviews 2013, Issue 3. Art. No.: CD010462. doi: 2013 Jan;3(1):14-23. doi: 10.1002/brb3.107. Epub 2012 10.1002/14651858.CD010462. Nov 29. 1550. Zilliacus E, Meiser B, Taouk M, Watts K, Kissane D, 1562. Eastwood JG, Kemp LA, Jalaludin BB, Phung HN. Girgis A, Butow P, Hale S, Perry A, Aranda S, Goldstein Neighborhood adversity, ethnic diversity, and weak D. Working with patients from culturally and linguistically social cohesion and social networks predict high rates diverse backgrounds: perspectives of oncology health of maternal depressive symptoms: a critical realist professionals. Asia Pac J Clin Oncol. 2013;9:130. ecological study in South Western Sydney, Australia. Int J 1551. Zucca A, Boyes A, Newling G, Hall A, Girgis A. Health Serv. 2013;43(2):241-66. Travelling all over the countryside: travel-related 1563. Eastwood JG, Phung H, Barnett B. Postnatal burden and financial difficulties reported by cancer depression and socio-demographic risk: factors patients in New South Wales and Victoria. Aust J Rural associated with Edinburgh Depression Scale scores Health. 2011 Dec;19(6):298-305. doi: 10.1111/j.1440- in a metropolitan area of New South Wales, Australia. 1584.2011.01232.x. Aust N Z J Psychiatry. 2011 Dec;45(12):1040-6. doi: 1552. Zucca A, Lambert SD, Boyes AW, Pallant JF. Rasch 10.3109/00048674.2011.619160. Epub 2011 Oct 22. analysis of the Mini-Mental Adjustment to Cancer Scale 1564. Emder PJ, Jack MM. Iodine-induced neonatal (mini-MAC) among a heterogeneous sample of long-term hypothyroidism secondary to maternal seaweed cancer survivors: a cross-sectional study. Health Qual consumption: a common practice in some Asian Life Outcomes. 2012 May 20;10:55. doi: 10.1186/1477- cultures to promote breast milk supply. J Paediatr Child 7525-10-55. Health. 2011 Oct;47(10):750-2. doi: 10.1111/j.1440- 1553. Zucca AC, Boyes AW, Linden W, Girgis A. All’s well that 1754.2010.01972.x. Epub 2011 Jan 31. ends well? Quality of life and physical symptom clusters 1565. Ferrara AM, Onigata K, Ercan O, Woodhead H, Weiss in long-term cancer survivors across cancer types. J Pain RE, Refetoff S. Homozygous thyroid hormone receptor Symptom Manage. 2012 Apr;43(4):720-31. doi: 10.1016/j. β-gene mutations in resistance to thyroid hormone: three jpainsymman.2011.04.023. Epub 2012 Jan 24. new cases and review of the literature. J Clin Endocrinol 1554. Zwar NA, Hermiz O, Comino E, Middleton S, Vagholkar Metab. 2012 Apr;97(4):1328-36. doi: 10.1210/jc.2011- S, Xuan W, Wilson SF, Marks GB. Care of patients with 2642. Epub 2012 Feb 8. a diagnosis of chronic obstructive pulmonary disease: a 1566. Fisher KE, Guaran R, Stack J, Simpson S, Krause W, cluster randomised controlled trial. Med J Aust. 2012 Oct For KD, Ryan E, Conaty S, Hope K, Isaacs D, Chay 1;197(7):394-8. P, Eastwood J, Marks GB. Nosocomial pulmonary 1555. Zwar NA, Marks GB, Hermiz O, Middleton S, Comino EJ, tuberculosis contact investigation in a neonatal Hasan I, Vagholkar S, Wilson SF. Predictors of accuracy intensive care unit. Infect Control Hosp Epidemiol. 2013 of diagnosis of chronic obstructive pulmonary disease in Jul;34(7):754-6. doi: 10.1086/670995. Epub 2013 May 22. general practice. Med J Aust. 2011 Aug 15;195(4):168-71. 1567. Garnett SP, Gow M, Ho M, Baur LA, Noakes M, Woodhead HJ, Broderick CR, Burrell S, Chisholm K, W omen’s and Children’s Health Halim J, De S, Steinbeck K, Srinivasan S, Ambler GR, Kohn MR, Cowell CT. Optimal macronutrient content of the diet for adolescents with prediabetes; RESIST a 1556. Argent E, Emder P, Monagle P, Mowat D, Petterson randomised control trial. J Clin Endocrinol Metab. 2013 T, Russell S, Sachdev R, Stone C, Ziegler DS. May;98(5):2116-25. doi: 10.1210/jc.2012-4251. Epub Australian Paediatric Surveillance Unit study of 2013 Mar 26. haemoglobinopathies in Australian children. J Paediatr Child Health. 2012 Apr;48(4):356-60. doi: 10.1111/j.1440- 1568. Hameed S, Ellard S, Woodhead HJ, Neville KA, 1754.2011.02236.x. Epub 2011 Dec 13. Walker JL, Craig ME, Armstrong T, Yu L, Eisenbarth GS, Hattersley AT, Verge CF. Persistently autoantibody 1557. Arora A, Bedros D, Bhole S, Eastwood J, Moody negative (PAN) type 1 diabetes mellitus in children. G. A qualitative evaluation of the views of Child and Pediatr Diabetes. 2011 May;12(3 Pt 1):142-9. doi: Family Health Nurses on the early childhood oral health 10.1111/j.1399-5448.2010.00681.x. Epub 2010 Sep 6. education materials in New South Wales, Australia. Health Promot J Austr. 2012 Aug;23(2):112-6. 1569. Hameed S, Mendoza-Cruz AC, Neville KA, Woodhead HJ, Walker JL, Verge CF. Home blood sodium monitoring, 1558. Eastwood JG, Jalaludin BB, Kemp LA, Phung sliding-scale fluid prescription and subcutaneous HN, Adusumilli SK. Clusters of maternal depressive DDAVP for infantile diabetes insipidus with impaired symptoms in South Western Sydney, Australia. Spat thirst mechanism. Int J Pediatr Endocrinol. 2012 Jun Spatiotemporal Epidemiol. 2013 Mar;4:25-31. doi: 9;2012(1):18. doi: 10.1186/1687-9856-2012-18. 10.1016/j.sste.2012.11.001. Epub 2012 Dec 20. 1570. Hameed S, Morton JR, Field PI, Belessis Y, Yoong T, Katz 1559. Eastwood JG, Jalaludin BB, Kemp LA, Phung HN, T, Woodhead HJ, Walker JL, Neville KA, Campbell TA, Barnett BE. Immigrant maternal depression and social Jaffé A, Verge CF. Once daily insulin detemir in cystic networks. A multilevel Bayesian spatial logistic regression fibrosis with insulin deficiency. Arch Dis Child. 2012 in South Western Sydney, Australia. Spat Spatiotemporal May;97(5):464-7. doi: 10.1136/adc.2010.204636. 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1571. Hosking KA, Leung H, Andrews I, Sachdev R. 1584. Wong, WSF, A safe optically guided entry technique Ataxia telangiectasia in a three-year-old-girl. Pediatr using Endopath Xcel Trocars in laparoscopic surgery: Neurol. 2014 Mar;50(3):279-80. doi: 10.1016/j. A personal series of 821 patients. Gynecol Min Invasive pediatrneurol.2013.11.011. Epub 2013 Nov 21. Surg. 2013 Feb;2(1):30-3. 1572. Hurwitz R, Blackmore R, Hazell P, Williams K, 1585. Woolfenden S, Goldfeld S, Raman S, Eapen V, Kemp Woolfenden S. Tricyclic antidepressants for autism L, Williams K. Inequity in child health: the importance of spectrum disorders (ASD) in children and adolescents. early childhood development. J Paediatr Child Health. Cochrane Database Syst Rev. 2012 Mar 14;3:CD008372. 2013 Sep;49(9):E365-9. doi: 10.1111/jpc.12171. Epub doi: 10.1002/14651858.CD008372.pub2. 2013 Mar 29. 1573. Jefferson AL, Woodhead HJ, Fyfe S, Briody J, 1586. Woolfenden S, Sarkozy V, Ridley G, Coory M, Williams Bebbington A, Strauss BJ, Jacoby P, Leonard H. Bone K. A systematic review of two outcomes in autism mineral content and density in Rett syndrome and their spectrum disorder - epilepsy and mortality. Dev Med contributing factors. Pediatr Res. 2011 Apr;69(4):293-8. Child Neurol. 2012 Apr;54(4):306-12. doi: 10.1111/j.1469- doi: 10.1203/PDR.0b013e31820b937d. 8749.2012.04223.x. Epub 2012 Feb 21. 1574. Joshua PR, Smith MM, Koh AS, Woodland LA, Zwi 1587. Woolfenden S, Sarkozy V, Ridley G, Williams K. K. Australian population cohort study of newly arrived A systematic review of the diagnostic stability of refugee children: how effective is predeparture measles Autism Spectrum Disorder. Res Autism Spectr Disord. and rubella vaccination? Pediatr Infect Dis J. 2013 2012;6:345-54. Feb;32(2):104-9. doi: 10.1097/INF.0b013e31827075c2. 1588. Yeoh B, Woolfenden S, Lanphear B, Ridley GF, 1575. Knight O, Bebbington A, Siafarikas A, Woodhead H, Livingstone N. Household interventions for preventing Girdler S, Leonard H. Pubertal trajectory in females with domestic lead exposure in children. Cochrane Rett syndrome: a population-based study. Brain Dev. 2013 Database Syst Rev. 2012 Apr 18;4:CD006047. doi: Nov;35(10):912-20. doi: 10.1016/j.braindev.2012.11.007. 10.1002/14651858.CD006047.pub3. Epub 2012 Dec 25. 1589. Zhu L, Hai N, Lang JH, Yu SY, Li B, Wong F. Value of the 1576. Kuehn R, Fong J, Taylor R, Gyaneshwar R, Carter K. pudendal nerves terminal motor latency measurements in Cervical cancer incidence and mortality in Fiji 2003-2009. the diagnosis of occult stress urinary incontinence. Chin Aust N Z J Obstet Gynaecol. 2012 Aug;52(4):380-6. doi: Med J (Engl). 2011 Dec;124(23):4046-9. 10.1111/j.1479-828X.2012.01461.x. 1577. Levin AD, Wadhera V, Leach ST, Woodhead HJ, Lemberg DA, Mendoza-Cruz AC, Day AS. Vitamin D deficiency in children with inflammatory bowel disease. Dig Dis Sci. 2011 Mar;56(3):830-6. doi: 10.1007/s10620-010-1544-3. Epub 2011 Jan 11. 1578. Parab CS, Cooper C, Woolfenden S, Piper SM. Specialist home-based nursing services for children with acute and chronic illnesses. Cochrane Database Syst Rev. 2013 Jun 15;6:CD004383. doi: 10.1002/14651858. CD004383.pub3. 1579. Rana M, Munns CF, Selvadurai HC, Simonds S, Cooper PJ, Woodhead HJ, Hameed S, Verge CF, Lafferty AR, Crock PA, Craig ME. Increased detection of cystic- fibrosis-related diabetes in Australia. Arch Dis Child. 2011 Sep;96(9):823-6. doi: 10.1136/adc.2010.208652. Epub 2011 Jun 8. 1580. Samtani A, Sterling-Levis K, Scholten RJPM, Woolfenden S, Hooft L, Williams K. Diagnostic tests for Autism Spectrum Disorders (ASD) in preschool children (Protocol). Cochrane Database Syst Rev. 2011, Issue 3. Art. No.: CD009044. doi:10.1002/14651858.CD009044. 1581. Scheffer IE, Grinton BE, Heron SE, Kivity S, Afawi Z, Iona X, Goldberg-Stern H, Kinali M, Andrews I, Guerrini R, Marini C, Sadleir LG, Berkovic SF, Dibbens LM. PRRT2 phenotypic spectrum includes sporadic and fever-related infantile seizures. Neurology. 2012 Nov 20;79(21):2104-8. doi: 10.1212/WNL.0b013e3182752c6c. Epub 2012 Oct 17. 1582. Sidrak S, Yoong T, Woolfenden S. Iron deficiency in children with global developmental delay and autism spectrum disorder. J Paediatr Child Health. 2014 May;50(5):356-61. doi: 10.1111/jpc.12483. Epub 2013 Dec 23. 1583. Steinbeck KS, Harvey V, Shrewsbury VA, Donaghue K, Woodhead H. Outcomes for adolescents with type 1 diabetes mellitus participating in a comprehensive program to aid transition from pediatric to adult care: a pilot randomized controlled trial. J Adolesc Health. 2012 Feb;50(2):S77. 148  UNSW in the South West 2011-2013  

Papers of the Year

Each year the South Western Sydney Clinical School awards Paper of the Year prizes in two categories.

Biomedical / Clinical Research

2011 before the eighth decade is likely to represent a pathological change. Changes in phasic atrial volumes develop earlier consequent to age-related alteration in LV diastolic relaxation. JACC: Cardiovascular Imaging. 2011 Mar; 4:234-42. Atrial dilation and altered function are mediated by 2012 (Joint Recipients) age and diastolic function but do not occur before the eighth decade. Boyd AC, Schiller NB, Leung DY, Ross DL, Am Heart J. 2012 Apr;163(4):649-56.e1. doi: Thomas L. 10.1016/j.ahj.2012.01.014 Safety and efficacy of rescue angioplasty for ST- elevation myocardial infarction with high utilization OBJECTIVES: This study investigated changes in rates of glycoprotein IIb/IIIa inhibitors. left atrial (LA) volumes and phasic atrial function, by deciles, with normal aging. Shugman IM, Hsieh V, Cheng S, Parikh D, Tobing D, Wouters N, van der Vijver R, Lo Q, Rajaratnam BACKGROUND: LA volume increase is a sensitive R, Hopkins AP, Lo S, Leung D, Juergens CP, independent marker for cardiovascular disease French JK. and adverse outcomes. To use this variable more effectively as a marker of pathology and a gauge of outcome, physiological changes due to aging BACKGROUND: Fibrinolytic therapies remain alone need to be quantitated. widely used for ST-elevation myocardial infarction, and for “failed reperfusion,” rescue percutaneous METHODS: A detailed transthoracic coronary intervention (PCI) is guideline echocardiogram was performed in 220 normal recommended to improve outcomes. However, subjects; 89 (41%) were male and their age these recommendations are based on data from ranged from 20 to 80 years (mean 45 ± 17 years). an earlier era of pharmacotherapy and procedural Maximum (end-ventricular systole), minimum techniques. (end-ventricular diastole), and pre-a-wave volumes were measured using the biplane method of disks. METHODS AND RESULTS: To determine LA filling, passive emptying, conduit and active factors affecting prognosis after rescue PCI, emptying volumes, and fractions were calculated. we studied 241 consecutive patients (median Transmitral inflow, pulmonary vein flow, and age 55 years, interquartile range [IQR] 48-65) pulsed-wave Doppler tissue imaging parameters undergoing procedures between 2001 and 2009 were measured as expressions of left ventricular (53% anterior ST-elevation myocardial infarction diastolic function. For purposes of analysis, and 78% transferred). The median treatment- subjects were divided by age deciles. related times were 1.2 hours (IQR 0.8-2.2) from symptom onset to door, 2 hours (IQR 1.3-3.2) from RESULTS: LA indexed maximum (0.05 ml/m(2) per symptom onset to fibrinolysis (93% tenecteplase), year) and minimum (0.06 ml/m(2) per year) volume and 3.9 hours (IQR 3.1-5.2) from fibrinolysis to increased with age but only became significant in balloon. Procedural characteristics were stent the eighth decade (26.0 ± 6.3 ml/m(2), p = 0.02, and deployment in 95% (11.6% drug eluting) and 78% 13.5 ± 3.9 ml/m(2), respectively; p < 0.001). Impaired glycoprotein IIb/IIIa inhibitor use, and Thrombolysis left ventricular diastolic relaxation was apparent in In Myocardial Infarction (TIMI) 3 flow rates pre-PCI decade 6 and was associated with a shift in phasic and post-PCI were 41% and 91%, respectively (P LA volumes so that LA expansion index and passive < .001). At 30 days, TIMI major bleeding occurred emptying decreased with increasing age, whereas in 16 (6.6%) patients, and 23 (9.5%) patients active emptying volume increased. received transfusions; nonfatal stroke occurred in 4 (1.7%) patients (2 hemorrhagic). Predictors of TIMI CONCLUSIONS: In normal healthy subjects, LA major bleeding were female gender (odds ratio indexed volumes remain nearly stable until the 3.194, 95% CI 1.063-9.597; P = .039) and pre-PCI eighth decade when they increase significantly. Therefore, an increase in LA size that occurs   Research in the South West  149

shock (odds ratio 3.619, 95% CI,1.073-12.207; P = pressure of brain tissue oxygen (24.9±6.6 mm .038). Mortality at 30 days was 6.2%, and 3.2% in Hg versus 21.8±6.3 mm Hg, P=0.048), and patients without pre-PCI shock. One-year mortality Fisher grade (P=0.03). In a multivariate analysis, was 8.2% (5.3% in patients without pre-PCI ORx (P<0.001) and age (P=0.003) retained an cardiogenic shock), 5.2% had reinfarction, and the independent predictive value for outcome. ORx target vessel revascularization rate was 6.4% (2.6% correlated with Glasgow Outcome Scale (r=-0.70, in arteries ≥ 3.5 mm in diameter). Pre-PCI shock, P<0.001). female gender, and post-PCI TIMI flow grades ≤ 2 were significant predictors of 1-year mortality on CONCLUSIONS: The status of cerebrovascular multivariable regression modeling, but TIMI major autoregulation might be an important bleeding was not. pathophysiological factor in the disease process after subarachnoid hemorrhage, because impaired CONCLUSIONS: Rescue PCI with contemporary autoregulation was independently associated with treatments can achieve mortality rates similar to an unfavorable outcome. rates for contemporary primary PCI in patients without pre-PCI shock. Whether rates of bleeding can be reduced by different pharmacotherapies 2013 (Joint Recipients) and interventional techniques needs clarification in future studies. J Immunol. 2013 Aug 1;191(3):1404-12. doi: 10.4049/jimmunol.1300856. Epub 2013 Jun 24. Stroke. 2012 Aug;43(8):2097-101. doi: 10.1161/ Mast cell-restricted, tetramer-forming tryptases STROKEAHA.112.659888. Epub 2012 May 22. induce aggrecanolysis in articular cartilage by activating matrix metalloproteinase-3 and -13 Clinical significance of impaired cerebrovascular zymogens. autoregulation after severe aneurysmal subarachnoid hemorrhage. Magarinos NJ, Bryant KJ, Fosang AJ, Adachi R, Stevens RL, McNeil HP. Jaeger M, Soehle M, Schuhmann MU, Meixensberger J. ABSTRACT: Mouse mast cell protease (mMCP)-6- null C57BL/6 mice lost less aggrecan proteoglycan BACKGROUND AND PURPOSE: The purpose from the extracellular matrix of their articular of this study was to investigate the relationship cartilage during inflammatory arthritis than wild- between cerebrovascular autoregulation and type (WT) C57BL/6 mice, suggesting that this mast outcome after aneurysmal subarachnoid cell (MC)-specific mouse tryptase plays prominent hemorrhage. roles in articular cartilage catabolism. We used ex METHODS: In a prospective observational study, vivo mouse femoral head explants to determine 80 patients after severe subarachnoid hemorrhage how mMCP-6 and its human ortholog hTryptase-β were continuously monitored for cerebral perfusion mediate aggrecanolysis. Exposure of the explants pressure and partial pressure of brain tissue to recombinant hTryptase-β, recombinant mMCP- oxygen for an average of 7.9 days (range, 1.9-14.9 6, or lysates harvested from WT mouse peritoneal days). Autoregulation was assessed using the MCs (PMCs) significantly increased the levels of index of brain tissue oxygen pressure reactivity enzymatically active matrix metalloproteinases (ORx), a moving correlation coefficient between (MMP) in cartilage and significantly induced cerebral perfusion pressure and partial pressure aggrecan loss into the conditioned media, relative of brain tissue oxygen. High ORx indicates to replicate explants exposed to medium alone impaired autoregulation; low ORx signifies intact or lysates collected from mMCP-6-null PMCs. autoregulation. Outcome was determined at 6 Treatment of cartilage explants with tetramer- months and dichotomized into favorable (Glasgow forming tryptases generated aggrecan fragments Outcome Scale 4-5) and unfavorable outcome that contained C-terminal DIPEN and N-terminal (Glasgow Outcome Scale 1-3). FFGVG neoepitopes, consistent with MMP- dependent aggrecanolysis. In support of these data, RESULTS: Twenty-four patients had a favorable hTryptase-β was unable to induce aggrecan release and 56 an unfavorable outcome. In a univariate from the femoral head explants obtained from Chloe analysis, there were significant differences in mice that resist MMP cleavage at the DIPEN↓FFGVG autoregulation (ORx 0.19±0.10 versus 0.37±0.11, site in the interglobular domain of aggrecan. In P<0.001, for favorable versus unfavorable outcome, addition, the abilities of mMCP-6-containing lysates respectively), age (44.1±11.0 years versus from WT PMCs to induce aggrecanolysis were 54.2±12.1 years, P=0.001), occurrence of delayed prevented by inhibitors of MMP-3 and MMP-13. cerebral infarction (8% versus 46%, P<0.001), Finally, recombinant hTryptase-β was able to activate use of coiling (25% versus 54%, P=0.02), partial latent pro-MMP-3 and pro-MMP-13 in vitro. The 150  UNSW in the South West 2011-2013  

accumulated data suggest that human and mouse respectively which were evaluated at baseline tetramer-forming tryptases are MMP convertases and at 1-year follow-up. Patients were grouped by that mediate cartilage damage and the proteolytic age into <55(n=33), 55-65(n=75), 66-75(n=75) loss of aggrecan proteoglycans in arthritis, in part, and >75(n=44). Target levels were defined as by activating the zymogen forms of MMP-3 and HbA1c<7% and TC<4.0 mmol/L. Patients <55 MMP-13, which are constitutively present in articular years had the highest HbA1c at 9.1[7.6-11.2]% cartilage. with the lowest proportion of patients (n=3; 11.1%) within target at baseline, while 66-75 years had the best HbA1c at 7.1[6.4-7.8]% with the highest proportion (n=28, 45.2%) reaching target Int J Cardiol. 2013 Aug 20;167(4):1276-81. doi: (p<0.0001). At 1-year, the poorest HbA1c control 10.1016/j.ijcard.2012.03.162. Epub 2012 May 4. was again observed in the age <55 with fewer Risk factor modification in diabetic patients following patients achieving target compared to the 66-75 angiographic identification of multi-vessel disease. age group (HbA1c: 8.5% vs 6.9%; % of patients at target: 20.7% vs 54.5%; p<0.0001). Furthermore, Hee L, Thomas L, Ang X, Yang L, Lo S, Juergens the group <55 years demonstrated the worst CP, Mussap CJ, Dignan R, French JK. TC control at 1-year with a significant increase compared to the baseline TC (p=0.01). Patients with a lower body mass index (BMI) were likely to ABSTRACT: There is little information on whether have an improvement in HbA1c and reach target identification of multi-vessel disease (MVD) in (p=0.01). Paradoxically, patients who were current patients with diabetic mellitus (DM) affects risk smokers demonstrated a beneficial effect on factor management. From 1125 consecutively optimal TC control (29.2% vs 15.4%, p=0.027). In screened patients between June 2006 and March younger diabetic patients, risk factor modification 2010, we examined 227 diabetic patients with at 1-year was poor despite identification of MVD. MVD on coronary angiography. Diabetic control Developing an effective education and monitoring and cholesterol levels were assessed by glycated programme to improve glycaemic control in this haemoglobin (HbA1c) and total cholesterol (TC) high risk group should be a priority.

Epidemiological / Health Services Research

2011 RESULTS: In total, there were 988 patients, including 504 patients who were presented at MDT meetings and 484 who were not presented at MDT meetings. The median patient age was 69 Cancer 2011:117:5112-20. years and 73 years in the MDT group and the non- Do multidisciplinary teams make a difference in the MDT group, respectively (P < .01). There was no management of lung cancer? pathologic diagnosis for 13% of non-MDT patients Boxer MM, Vinod SK, Shafiq J and Duggan KJ. compared with 4% of MDT patients (P < .01). Treatment receipt for MDT patients versus non- MDT patients was 12% versus 13%, respectively, BACKGROUND: There is limited evidence for surgery (P value nonsignificant); 66% versus regarding the effectiveness of multidisciplinary 33%, respectively, for radiotherapy (P < .001); team (MDT) meetings in lung cancer. The objective 46% versus 29%, respectively, for chemotherapy of this study was to compare the patterns of care (P < .001); and 66% versus 53%, respectively, for patients with newly diagnosed lung cancer who for palliative care (P < .001). In patients with were presented at a lung cancer MDT meeting good performance status, the MDT group had with the patterns of care for patients who were not significantly better receipt of radiotherapy presented. among patients with stage I through IV nonsmall cell lung cancer (NSCLC) and had significantly METHODS: All patients who had lung cancer better receipt of chemotherapy among patients newly diagnosed in South West Sydney (SWS) with stage IV NSCLC. MDT discussion was an between December 1, 2005, and December independent predictor of receiving radiotherapy, 31, 2008, were identified from the local Clinical chemotherapy, and referral to palliative care but Cancer Registry. Patient and tumor characteristics did not influence survival. and treatment receipt were compared between patients who were and were not presented at CONCLUSIONS: MDT discussion was associated MDT meetings. A logistic regression model was with better treatment receipt, which potentially may constructed to determine predictors for receiving improve quality of life for patients with lung cancer. treatment and survival. However, it did not improve survival.   Research in the South West  151

2012 2013

Ann Behav Med. 2012 Oct;44(2):225-35. doi: Psychooncology. 2013 Jul;22(7):1557-64. doi: 10.1007/s12160-012-9385-2. 10.1002/pon.3166. Epub 2012 Sep 3. Distressed partners and caregivers do not recover Some things change, some things stay the same: a easily: adjustment trajectories among partners and longitudinal analysis of cancer caregivers’ unmet caregivers of cancer survivors. supportive care needs. Lambert SD, Jones BL, Girgis A, Lecathelinais C. Girgis A, Lambert SD, McElduff P, Bonevski B, Lecathelinais C, Boyes A, Stacey F.

BACKGROUND: Although a number of cross-sectional studies document the distress OBJECTIVE: The objective of this study was experienced by partners and caregivers of cancer to identify caregivers’ unmet needs and the survivors, few have considered their potential psychosocial variables associated with unmet differential patterns of adjustment over time. need count within the first 24 months post-survivor diagnosis. PURPOSE: Identify distinct trajectories of anxiety and depression among partners and caregivers METHODS: Caregivers completed a of cancer survivors and predictors of these comprehensive survey measuring the primary trajectories. outcome, psychosocial variables, and demographics of interest at 6 (n=547), 12 (n=519), METHODS: Participants completed a survey to and 24 (n=443) months post-survivor diagnosis. examine the impact of caring for, or living with, a cancer survivor at 6, 12, and 24 months post-survivor RESULTS: Although prevalence of unmet needs diagnosis. Anxiety and depression were measured significantly decreased over time, almost a third using the Hospital Anxiety and Depression Scale of caregivers still reported unmet needs at 24 (N(anxiety) = 510; N(depression) = 511). months. Unmet needs were more prevalent among caregivers of lung cancer survivors, at 6 RESULTS: Anxiety trajectories included: no anxiety and 24 months. Top ranking unmet needs across (15.1% scored <3; 37.8% scored 3-5); chronic, time included ‘managing concerns about cancer borderline anxiety (33.2%); and chronic, clinical coming back’, ‘reducing stress in the person with anxiety (13.9%). The depression trajectories were: cancer’s life’, ‘understanding the experience of no depression (38.9% scored <2; 31.5% scored the person with cancer’, and ‘accessible hospital around 3); a sustained score of 7 (25.5%); and parking’. At 24 months, some of the top ranking chronic, clinical depression (4.1%). Variables unmet needs were related to caregivers’ well- associated with the trajectories included most of being and relationships. Increased interference in the psychosocial variables. activities due to caregiving, anxiety, depression, avoidant and active coping, and out-of-pocket CONCLUSIONS: Findings highlight that most expenses was associated with reporting more caregivers maintained their baseline level of distress, unmet needs. Less involvement in caregiving roles which is particularly concerning for participants and increased physical well-being and social reporting chronic anxiety or depression. support were associated with reporting less unmet needs. For some variables (e.g. anxiety and depression), association with unmet needs strengthened over time.

CONCLUSIONS: This is the first longitudinal analysis of caregivers’ unmet needs as they enter early and extended survivorship. Findings provide valuable insights into caregiver’s unmet needs over time and identified a sub-group of caregivers at risk of experiencing unmet needs, extending previous research and informing the timing and content of psychosocial services. 152  UNSW in the South West 2011-2013  

Staff

UNSW appointees in south western Sydney in 2013

Academics Associate Lecturer Iain Gosbell Adam Bryant Professor Janelle Levesque Anna Holdgate Peter Buchanan Minoti Apte Tim Luckett Matthias Jaeger Tram Bui Michael Barton Emeritus Professor Craig Juergens Cecilia Cappelen- Valsa Eapen Ian Webster Grigori Kaplan Smith Afaf Girgis Conjoints/ Norbert Kienzle David Chang Ken Hillman Adjuncts Jens Kilian Nicholas Cheng Bruce Hall Professor Murray Killingsworth Shanley Chong Ian Harris Bryanne Barnett Friedbert Kohler Raymond Clarke Siaw-Teng Liaw Christophe Berney Miriam Levy Peter Collett Patrick McNeil Andrew Biankin Gary Liney Alison Colley Guy Marks Daniel Chan Andrew McDonald David Conforti Shan Rajendra David Davies Neil Merrett Susan Connor Derrick Silove Paul De Souza Matthew Morgan Elspeth Correy Jeremy Wilson Geoffrey Delaney Justine Naylor Rudi Crncec Associate Professor Hugh Dickson Bin Ong Scott D’Amours Jack Chen John French Michael Parr Linda Dann Elizabeth Comino Annemarie Christopher Pokorny Jayker Dave Hennessey Elizabeth Harris John Quin Jennifer Davidson Bin Jalaludin Lynn Kemp David Richards Hugh Dixson Cheok Soon Lee Phillip Ward Leonardo Santos Claudia Dobler Rupert Leong Senior Lecturer Mark Sheridan Lindsay Dunlop Dominic Leung Katherine Bryant Mitchell Smith Ardalan Ebrahimi Peter McCluskey Christine Cowie Michael Suranyi Phillip Emder Tuan Van Nguyen Roberto Forero James van Gelder Louise Evans Jim Parker Frances Garden Shalini Vinod Ian Ferguson John Smoleniec Melina Gattellari Phillip Ward Frank Formby Liza Thomas Suzanne Hodgkinson Robert Wilson Dion Forstner Felix Wong Jude Ng Vincent Wong Anthony Frankel Associate Professor Sean O’Neill John Worthington Stephen Fulham Meera Agar Susan Rees Senior Lecturer Gary Goozee Anders Aneman Patsy Soon Alan Adno Monisha Gupta Roy Beran Tim Spicer Ahmad Alrubaie Ibrahim Hanna Geoffrey Cains Bin Wang Ian Andrews Zinta Harrington Jonathan Clark Lecturer Christos Apostolou Michael Harvey Dennis Cordato Elizabeth Armstrong Ray Asghari Geraldine Hassett Rebecca Dignan Hassan Assareh Melissa Baraket Garry Helprin John Eastwood Pooria Sarrami Therese Maria Becker Christabelle Hill Antonio Fernandes Foroushani Roger Blackmore Natalie Hitchens Jeffrey Flack Stephanie Hollis Paull Botterill Ivan Ho Shon Kathryn Gibson Geoffrey McDonnell Miriam Boxer Quang-Phu Ho Lixin Ou   Staff  153

Lois Holloway Douglas Samuel Felix Chan Claire Jones Craig Hore Glen Schlaphoff Ramony Chan Mariam Joseph Jim Iliopoulos Christopher Shanley James Chau-Vo Marry Jyothi Seyed Imam Mark Sidhom Louise Chiam Frank Keh Susannah Jacob Seu Som Raymond Chin George Kirsh Rajeev Jairam Jing Song Wei Chua Zoe Knights Slade Jensen Michael Tam Alwin Chuan James Kokkinos Charlotte Johnstone Timothy Tan Carolyn Cooper Chee Khoo Anthony Kaplan Ben Taylor Peter Cosman Alaric Koh Andrew Knight Hui Tie Richard Cracknell Ken Koo Anita Ko Svetlana Trmcic Bolsom Darwish Daniel Kozman Eng-Siew Koh Sanjyot Vaholkar Scott Davison Mahesh Kulkarni Namson Lau Alla Waldman Stephen Della- Mukesh Kumar Kien Seng Lee Tai-Tak Wan Fiorentina Gregory Leslie Mark Lee Daniel Wardman Joseph Descallar Melissa Leung Peter Lin Janindra Eric Diu Casmir Liber Silvia Ling Warusavitarne Claire Dobson Karen Lim Christine Loo Penelope Weir Pravin Dullur Michael Lin Angela Makris Jonathan Williamson Jyotsna Dwivedi Ka Mei Lo Ian McCrossin Desmond Wilson Sharif Elgafi Ruchika Luhach Alan McDougall Richard Wittal Alar Enno Adeeb Majid Laurence McCleary Helen Woodhead Bjorn Espedido Pascal Mancuso Roderick McKay Ying-Hua Xu Sanj Fernando Lakshmeesh Markuli Susheel Wei Xuan Gary Flynn David Massasso Manambrakkat Terence Yoong Lai Heng Foong Sunil Mathew Dan Milder Lis Young David Freiberg Thomas Mathews Kelly Mok Lecturer Steven Frost Sharon May Penelope Motum Mahmood Alam Ashish Gargya Ahmed Mayat Christian Mussap Evan Alexandrou Alan Giles Anthony McGuiness Weng Ng Sayed Ali Naeshka Govender Ian Meakin Huong Van Nguyen Olataga Alofivae- Neil Griffith Gregory Melbourne Doorbinnia Phong Nguyen Christopher Michael Mina Craig Andrews Groombridge Navindran Niles Susan Mulligan Mona Asghari-Fard Robert Guaran Karin Obrecht Blair Munford Yasmin Ashraff Andrew Haig William O’Regan Sophie Najjarin Seymour Atlas Tushar Halder Fintan O’Rourke Anas Natfaji Amjed Aziz Leia Hee James Otton Vincent Ngian Darren Pavey Felicity Bagnall Christohper Henderson Robert Nguyen Ann Poynten Luke Baker Sonia Herrera Marwan Obaid Astrid Przezdziecki Satyadeepak Bhonagiri Andrew Hopkins Aiden O’Loughlin Kanaka Rachakonda David Blomberg Kelvin Hsu Kevin Ooi Farhad Rahimpanah Kathleen Brennan Romy Hurwitz Isidor Papapetros Rohan Rajaratnam Chuong Bui Jackson Huynh Edmond Park Shanti Raman Triet Bui Thang Du Huynh Harry Patapanian Merelyn Rae Brian Burns Susan Ieraci Susan Piper Kent Robinson Ross Calcroft Joe Jardiolin Graham Radford David Rosenfeld Ian Callander Helene Johansen Helen Redmond Hamish Russell Christine Chan Kevin Johnstone Roger Renton 154  UNSW in the South West 2011-2013  

Napoleon Reppas Associate Lecturer Sherly Halim Domonic Manassa Sharon Rutledge Cuneyt Ada Ricardo Hamilton Manimegalai Jeffrey Sacks Sam Adie Por Shee Han Manoharan Ramesh Sanghavi Abhinav Aggarwal Katherine Hanks Ryan McConnell Payal Saxena Sam Al-Sohaily Mahbub Hasan Myo Min Jesmin Shafiq Mustafa Alttahir Mohammed Hasan Tun Lin Myat Albert Shafransky Chandra Annabattula Zubair Hasan Hajir Nabi Aashit Shah Dilshan Ariyarathna Rebekah Hoffman Fazlur Nadri Qing Shen Jarrett Barker-Whittle Charith Horadagoda Adnan Nagrial Milan Simic Michael Barkley Allan Hsu Tamer Badie Brendon Smith Milan Bassan Danny Hsu Tyagarajalu Naidu Matthew Smith Daniel Bui Tom Huang Mohammadreza Namazi Timothy Spencer Ken Cai Siong-Hou Hui Hareeshan Jacqueline Stack Zeljka Calic Mohammad Hussain Nandakoban Deborah Stephens Joy Chakraborty Paul Joshua Arnold Ng Antony Stewart Varun Chandra Krishna Kadappu Gareth Ng Rebecca Strutt Andy Chen Ahmed Shahir Teng Ng Nimali Sumanaweera Lily Chen Mohammed Kakkat TuanNguyen Sultana Syeda Samantha Chen Narainraj Kamalaraj Vi Nguyen Patricia Symons Lisa Cheng Gihan Kamalasena Benjamin Nham Victor Tam Jason Cheung Barry Kane Ferdinand Ong Richard Thode Kok Ho Choong Muhammad Nadeem Alexander Owen Matthew Thomas Penelope De Rajinderdeep Kaur Riona Pais Lacavalerie Steven Thou Sarah Kleinman Swapnil S Pawar Ankur Dhar Jill Timbs John Kok Trang Pham Delfino Di Mascio Rodney Tobiansky Peey Sei Kok Justin Phan Pei Ni Ding Denise Tong Sireesha Koneru Carlos Pilasi Ashraf Dower Kim Tran Lynette Kuwahata Sugendran Pillay Chris Dwyer John Trantalis Raymond Kwok Gandhi Ponniah Carlos El-Haddad Fleur Trezise Trevor Kwok Ariyanto Pramana Yehia ElHgar Sankar Vadali Angela Kwong Davin Prasetyo Mahmoud Elsayed Rameswaran Daniel Lai David Prince Vannitamby Amir Faour Jessica Lai Saissan Rajendran Hima Vedam Yvonne Feng Ngee-Soon Lau Maya Raj Tatiana Velitchko Andrew Fong Minmin Li Christopher Reitz Alexander Voukelatos Jamie Foo Danforn Lim AndreSafvat Kristina Wainwright Peter Fox Ranah Lim James Salinas Stuart Watkins John Frew Stephanie Lim Li Na Sam Anne-Marie Watson Darshan Ghia Min Ling Sartaj Sandhu Bruce Wilson Katherine Gibson Seo Lung Ling Conceicao Santos Jennifer Wiltshire Jerome Goldstein Ken Liu Kiran Sarathy Karen Wong Praveen Gounder Shinuo Liu Katharine Scrivener Lisa Worgan Astrid-Jane Greenup Sumit Lumba Mohsen Shafiei Peter Wyllie Caroline Guirgis Patricia Ly Rihan Shahab Shu Ching Yang Rohan Gupta Arvind Madras Shamus Shepherd Mei Ling Yap Saurabh Gupta Sara Maher Ganeshwaran Simon Yarrow Roger Haddad Ram Malhotra Shivapathasundram Brendan Paul Hale Phillip Malouf Parveen Sidhu   Staff  155

Nicholas Smith Professional Subash Srikantha and Technical Nagendraprasad Jane Anderson BECOMING A CONJOINT Sungala Fiona Byrne Conjoint appointees are Himali Claudia Calero Suwandaranthne individuals who generally hold Hayley Candler a relevant position external to Arnold Suzuki Lorinda Carter UNSW who have contributed Krishna Tallapragada Felix Chan to the research and/or teaching effort of UNSW Medicine. Sanjeev Taneja Lily Chen Conjoint appointments are unpaid Vivek Thakkar Margaret Crowley positions. Sanchai Thientosapol Vincent D’Cruz James Toh There are a number of benefits of Sarah Dennis obtaining a conjoint appointment Winnie Tong Catherine Dillon including: Catherine Toong Kylie French Chau Tran yy public recognition of academic Emma Friesen standing through use of a Fiona Tran Gabriel Gabriel conjoint title; Michael Tran Chris Goumas yy access to over 2.7 million items Peter Tran Rebekah Grace through the UNSW library; Minh Truong Fiona Haigh yy access to Search First - the Ted Tsai Patrick Harris electronic gateway to the UNSW e-journal collection of 23000 Nicolas Urriola Iqbal Hasan titles; Benoj Varghese Oshana Hermiz yy provision of zMail as a separate Jacqueline Veera Andrea Herring @unsw.edu.au email address; Priya Virdi Robyn Hittmann yy access to the UNSW Uniwide Patel Vishal Marry Jyothi network when on campus, in the Suhirdan Catherine Kaplun south western Sydney hospital Vivekanandarajah education facilities and on other Jennifer Knight Anastasia Volovets university campuses through Mary Knopp EduRoam; Vedran Vulovic Carla LeCordier Kejia Wang yy eligibility for academic pricing Brydan Lenne on a range of products Nan Wang Yafeng Ma including computer software Lambros Wassef and hardware purchased for Fakhra Maan Timothy West non-commercial purposes; Harrison Ng Chok Dulip Wettasinghe yy discounts on a range of Stephanie O’Regan Kate Wilkinson other products and services Isidor Papapetros using UNSW negotiated rates Apsara Windsor Jim Parker including restuarants, airline April Wong lounge programs, gift vouchers Farhad Rahimpanah May Wong and travel; and Catherine Robinson Chu Wu yy access to research Charmaine Rodricks James Wykes workshops through the Grants Vanessa Rose Management Office and to James Xu Shalini Saverimuttu research clinics provided by Liang Xu Outreach Library services. David Saxton Takako Yabe For more information on becoming Sheryl Sharkie Clarence Yeong a conjoint, contact the South Joan Silk David Youssef Western Sydney Clinical School on Carole Tactacan +61 2 8738 3844 or download an Lili Yuen Jane Taggart application form from: Alexander Zhang med.unsw.edu.au/information- Giang Tran Executive conjoint-staff Zhihong Xu Craig Smith Siggi Zapart

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