new volume 14 number 4 december 2008 · 2008. 12. 18. · medefacts volume 14 number 4 december...

MeDeFactsvolume 14 number 4 December 2008

EDITIONS OF MEDEFACTS CAN BE VIEWED ONLINE AT WWW. MEDDENT.UWA.EDU.AU

Helping people with mental illness to help themselvesIn a bid to help redress the health inequities for people with mental illness in WA, the HealthRight project, jointly partnered by the

Faculty, has been successfully encouraging this group to visit their GP and tackle lifestyle risk factors.

At an event in September, individuals and organisations which were judged to have made a significant contribution to this endeavour were officially recognised at an awards ceremony.

The HealthRight Project was implemented in response to a UWA report published in 2001, Duty to Care, which highlighted some alarming statistics on the physical health of people with serious long-term mental illness. The study found that this group of people are more likely to die from preventable physical illness, such as heart disease and cancer and that death rates from preventable causes are 2.5 times higher for people with mental illness than the general population.

Three close friends who graduated from medicine at UWA in the late 1970s have gone on to make their mark on medicine locally, nationally and internationally. They are (from left) Terry Nolan, Luigi D’Orsogna and Jim McCluskey. Two of the group, Terry and Jim, undertook a Bachelor of Medical Science degree during their undergraduate years and both credit their ensuing successes largely to the experience gained from the degree.

Full story on pages 12 and 13

Medical students head to and from China on scholarshipsA student exchange program with China is proving popular, with UWA fifth-year medical students choosing to do elective

placements of six weeks at a major hospital in Nanjing after winning scholarships.

And for the first time, a BMed Sci Honours student has elected to go to Zhejiang University in Hangzhou to further her research. Jenifer Meintjes left for China last month.

Derek Horlin (right) from Rockingham Kwinana Mental Health Services receives his Individual Champion award from Faculty Dean Professor Ian Puddey for his outstanding work to improve the physical health of people with mental illness.

continued on page 9

continued on page 10

-By Cathy Saunders

Regenerative medicine is a new buzzword in biomedical research and describes an emerging area of medicine,

according to a leading Faculty investigator.

Professor Minghao Zheng, Director of Research in the School of Surgery’s Centre for Orthopaedic Research, said scientists were now able, by stimulating stem cells or progenitor cells, to regenerate organs and tissues that had deteriorated due to degenerative diseases. These included neurodegenerative disorders, arthritis, tendonopathy and other musculo-skeletal diseases.

His team has used patients’ own chondrocytes, which are considered the progenitor cells of cartilage, to regenerate the cartilage of patients with arthritis of the knee. The technique is known as matrix-induced autologous chondrocyte implantation.

“This technology has been used Australia-wide and world-wide in about 6000 patients,” Professor Zheng said.

The focus has now turned onto tendon regeneration. Tendon injury or tendonopathy is a chronic degenerative condition in which the tendon cells undergo apoptosis and autophagy and die.

Tendon injuries are particularly common in knee joints, shoulders, ankles and elbows, such as in tennis elbow. Almost 15,000 operations are carried out each year in Australia to repair tendon damage in the shoulder and about 8000 operations repair Achilles heel tendons.

“We have now introduced this new technology of taking patients’ own tendon progenitor cells and growing the cells in

Regrowing body parts damaged by disease or injury

a culture,” Professor Zheng said.

After pre-clinical studies in animals over the past five years, the group started the first phase of clinical safety trials in patients with severe, intractable tennis elbow at the Gairdner Hospital in August. There will be up to 30 patients in the trial and some are still being recruited.

Each patient’s cells are harvested by a needle biopsy and then grown in the laboratory by the patented method that expands a significant population of cells. These are then injected into the diseased tendon to restore the pool of the cells depleted by the tendonopathy.

In October, the first two patients received an implantation of tendon cells grown from their own tendon progenitor cells taken from the patella.

The patients will be monitored for up to two years for side effects and evidence of efficacy of the procedure. To date, there have been no side effects caused by harvesting the progenitor cells.

“We still don’t know the final outcome,” Professor Zheng said. “But the procedures are very minimally invasive.

“The reason we have chosen progenitor cells rather than stem cells is that progenitor cells have a more defined differentiation pathway toward tendon regeneration while stem cells have multiple pathways of cell differentiation.”

By using the patients’ own progenitor cells, when the cultured tendons or cartilage are transplanted the potential problem of transmission of viral diseases or rejection of the foreign tissue is avoided.

see related article on page 8

Professor Minghao Zheng

MeDeFacts December 2008 The University of Western Australia2

By Professor Ian Puddey, Dean

The

Dean’s

Desk

Season’s greetings to all our readers. As 2008 draws to an end it is appropriate to reflect on some of the achievements of another demanding year. A record 154

medical students, 43 dental students and 49 health science students have completed their studies and will graduate next year. The medical student numbers in particular continue to grow and approximately 210 students will enter final year in 2009. This has required a major effort throughout 2008 to ensure recruitment of sufficient academic and professional support staff to expand our existing teaching capacity. Forging new partnerships across the health sector has enabled many new staff with a passion for teaching and / or research to join our ranks. The Faculty is particularly grateful to the Department of Health (W.A.) for all its assistance in enabling us to develop new academic units at the Joondalup Health Campus, Armadale-Kelmscott Memorial Hospital, Rockingham-Kwinana District Hospital, Graylands Hospital and Osborne Park Hospital, thereby helping us ensure an ongoing quality teaching and learning experience for our students into the future. As a testimony to that quality it was especially pleasing this year to see Associate Professor Tony Celenza, from the discipline of Emergency Medicine, as the recipient of an Australian Learning and Teaching Council Award for Teaching Excellence. Our Rural Clinical School was also honoured this year as the recipient of one of five Premier’s Award for 2008, in the category of “Creating Jobs and Economic Prosperity for Western Australia”. They were also finalists in the category “Strengthening Capacity in Regional WA”.

This medical school seeks not only to train a substantial number of its students in rural areas, but also to actively recruit both Indigenous students and students from rural and remote Western Australia, and this year we saw three Indigenous students and 22 of our rural recruits complete the MBBS, our largest number of rural graduates yet, and a number which will double over the next four years. This year also saw the expansion of our Outer Metropolitan High Schools recruitment program from three to 10 schools. In that program, schools are targeted that have never sent a student to study medicine or dentistry at UWA and our staff and medical student volunteers work with the teachers, students and their families to nurture aspirational goals and provide mentoring and support through the otherwise complex entry process into our courses.

On the research front, the Faculty has had another successful year in the National Health and Medical Research Council Project Grants round and, as the many stories in this issue of MeDeFacts (and throughout 2008) attest, this research is making a large difference to the health and wellbeing of our community. It is at an international level in both its reach and quality. In this issue also, the importance of early undergraduate experiences in medical research in shaping the leading medical scientists and educators of tomorrow is once again emphasised through the testimonies of two of our renowned alumni, Professor Terry Nolan and Professor James McCluskey, who relate how sentinel their Bachelor of Medical Science research experience at this Medical School was to their future careers. The donations and pledges to our Foundation Professors B Med Sci scholarship program this year have been generous and now total close to a half a million dollars. I commend this program to you as a way you can make a real difference in shaping the medical researchers of tomorrow. You will also read in this issue about the success of the Students in Health and Medical Research Conference held this year, a tangible demonstration of the increased interest and participation in high quality medical research by our current students which you can further encourage.

To those who are wondering how the above photograph fits in with my reflections on some of the significant achievements for 2008, it is a picture of my first grandchild, Daniel Yu Jin, who arrived on 12 November. His mother, Julia, is Korean and I am advised Daniel resembles at least one of his grandparents. Yu Jin means compassionate and generous and when I tell people he was named after his proud grandfather the retorts have included “Which grandfather?” or “I didn’t know your middle name was Daniel”. Apart from an opportunity to boast, his picture is included as a reminder that when considering all the achievements we are privileged to share in as a Faculty, the most important thing is to keep them in perspective, putting families and relationships first and UWA a close second. I hope this Christmas is a time of rich joy and blessing to you all as you celebrate this special time with your loved ones. Let’s see what we can achieve together in 2009.

Putting families first

Expanding our recruitment

The University of Western Australia MeDeFacts December 2008 3

CAMDH looks to an excellent futureA Centre of Excellence in Indigenous Medical Education is

being mooted for UWA.

Associate Professor Helen Milroy, head of the Centre for Aboriginal Medical and Dental Health (CAMDH), said she had wanted to develop a Centre of Excellence for some time.

It is timely because CAMDH has developed a strong national profile and is one of the national leaders in Indigenous medical education.

“We are the only Medical School in Australia that has published outcomes in Indigenous health (education),” she said. “We have an excellent track record and we meet all the criteria in the Healthy Futures report.”

The “Healthy Futures – Defining best practice in the recruitment and retention of Indigenous medical students” report was put out by the Australian Indigenous Doctors Association in 2005 and suggested various ways to attract and retain Indigenous students.

“We also cover off most of the CDAMS framework, which is the national framework for teaching Indigenous health and medicine,” Associate Professor Milroy said.

“It seems to me that if we were able to expand some of the resource materials and other things, we could actually assist other Medical Schools in developing their Indigenous health curricula.”

To develop a Centre of Excellence, CAMDH would require Federal funding to expand its work, establish a Chair in Indigenous medical education, and obtain research assistants to increase the research component.

“Although people want us to train medical students and they want us to educate medical students in general about Indigenous health, there has been no external financial support for an Indigenous academic workforce,” Associate Professor Milroy said.

At present, CAMDH depends fully on the Faculty for its support, even though it meets many national policy directives for health.

Its staff have also won a series of national awards, scholarships and positions. Associate Professor Milroy was presented with a National LIFE (Living Is For Everyone) award in the Indigenous category by Suicide Prevention Australia in Brisbane in September.

The citation said the award recognised her ongoing commitment to mental health and suicide prevention among Indigenous people.

“This commitment is reflected in her position as chair of the Aboriginal and Torres Strait Islander Mental Health Committee of the Royal Australian and New Zealand College of Psychiatrists, and her recent appointment to the National Advisory Council Advising the Minister for Health and Ageing on mental health,” it said.

Associate Professor Milroy said her emphasis was on the mental health of Indigenous children.

“It is often neglected and we often only look at the pointy end of the spectrum, which is severe end adult mental health,” she said.

“There has got to be more emphasis on supporting families and making sure children get off to the right start. That may require looking after the mental health of their mothers but also providing good early childhood intervention services.”

In other achievements by CAMDH staff, Senior Research Fellow Dr Tamara Mackean has won the inaugural Indigenous scholarship with the Royal Australasian College of Physicians. And she has been appointed to the National Indigenous Health Equality Council.

In addition, Adele Cox, a Lecturer with CAMDH and the Rural Clinical School, has been appointed to the Australian Suicide Prevention Advisory Council.

“Not bad for a little centre at UWA,” Associate Professor Milroy said. “Perhaps we can collectively make a difference in Canberra.”

(from left) Associate Professor Helen Milroy and Ms Adele Cox


From sandfly bites to sore ears – it’s all in a day’s workA recently established genetics division at the Telethon Institute

for Child Health Research is on the hunt for bright research students keen to undertake studies into problems ranging from ear infections to exotic tropical diseases.

Professor Jenefer Blackwell, a PhD graduate from UWA in 1974, returned from Cambridge University last year to set up the Division of Genetics and Health.

She was the founding director of the Cambridge Institute for Medical Research, where she had a large program of tropical medical research, using genetics to understand susceptibility to infectious diseases.

“Genetics is a major tool now in any epidemiological study of any disease,” Professor Blackwell said. “We can add genetics in now because we can measure variations across the whole genome.”

The division is seeking students who may wish to do an Honours, Masters or Bachelor of Medical Science degree next year. They are also targeting potential PhD students for the following year.

Her team at TICHR is conducting several international research projects that span Brazil, Sudan, USA, Vietnam, Europe, Hong Kong and India.

The team includes Senior Research Fellow Dr Christopher Peacock, Research Fellow Dr Sarra Jamieson and Bioinformatician Richard Francis, all of whom were recruited with her from Cambridge.

They are continuing their tropical disease research, which includes studies into leishmaniasis, a major parasitic disease that is transmitted by the bite of the sandfly and kills a large number of people annually in the tropics.

They have a large project with the Cambridge Institute for Medical Research and the Wellcome Trust Case Control Consortium, in which 5000 DNA samples from patients with the disease, and controls, in India, Sudan and Brazil are being studied using the latest SNP (single nucleotide polymorphism) chip technology.

“We look at about 600,000 polymorphisms (genetic changes or variations) across your genome on one chip so we will be getting all the data from that,” Professor Blackwell said.

“Different people respond differently to parasitic infections or auto-immune diseases. So if you can map the genes that vary between people in terms of making some more resistant to those diseases and some people more susceptible, then you can understand the mechanism.”

The information potentially will help with intervention – the development of new therapies or lifestyle changes such as diet.

Professor Blackwell retains a position at the Cambridge Institute as Honorary Senior Scientist and Affiliated Principal Investigator and apart from continuing with the UK collaborative studies, she has set up new studies at TICHR.

“One we are collecting a large number of samples for at the moment is a family study of otitis media in WA children,” she said. The study is cross-cultural and includes Indigenous and non-Indigenous family-based sampling.

“Again, we are using genetics as an approach to try to determine why some children are more susceptible to ear infections and get worse cases... than other children. It is another disease which is quite highly heritable.”

Those found to be at higher risk for the condition because of their genes could be counselled to avoid known risk factors or have drugs targeted more specifically to their needs.

Another of the team’s studies is into toxoplasmosis, a parasitic infection that can cause stillbirth or miscarriage in pregnant women and eye or brain disease in congenitally infected babies. They have discovered a gene that appears to be responsible for the fact that some people are more prone than others to the disease.

The team is also pursuing research into hypospadias, or malformation of the penis.

“It seems to be very much determined by the mother’s exposure to phyto-oestrogens in the environment,” Professor Blackwell said.

In the study, Dr Jamieson is looking for gene by environment interactions that determine the rising rates of hypospadias in WA.

(from left) Professor Jenefer Blackwell, Dr Christopher Peacock and Dr Sarra Jamieson in the genetics laboratory

-By Cathy Saunders


Andrew Webster chats with some of the Indigenous children at Ranku on Bathurst Island in the NT

Generous pledges for another named scholarshipProfessor Paul McMenamin, the current Professor of

Anatomy at UWA, recently paid a visit to the auld country and caught up with the Foundation Professor of Anatomy, Professor David Sinclair, in Aberdeen.

Professor Sinclair has agreed that a Bachelor of Medical Science scholarship set up to remember him should be named the Robert A. Milne Bachelor of Medical Science scholarship in honour of Professor David Sinclair, in recognition of a bequest of $52,000 by Robert Allan Milne to the University.

Little is known about Robert Milne, who also bequeathed his body to the School of Anatomy, other than that he was an active service man for more than 40 years and was interested in anatomy and research.

The scholarship will be named after him for five years, after which time it will be called the Bachelor of Medical Science scholarship in honour of Professor David Sinclair.

Professor Sinclair has pledged a substantial amount of money for the scholarship and also indicated that he will leave 20,000 pounds in his will. His daughter, Anne Hillman, is another donor.

The scholarship is part of the Foundation Professors Bachelor of Medical Science scholarship program, which has attracted generous donations in order that the 11 Foundation Professors of the Medical School can be remembered.

Other named scholarships to date are the John Harriott

Professor David Sinclair (left) with Professor Paul McMenamin in Aberdeen

Rural research calls to country-born studentThe winner of a rural award for medical students will head to

the UK next year to examine why rural cancer patients have poorer survival rates than their urban counterparts.

Fourth-year student Andrew Webster won the Rural Medical Student of the Year award at the Rural Doctors’ Association of Australia and Australian College of Rural and Remote Medicine annual conference last month.

He shared the Westpac-sponsored award with Flinders University student Jeremy Wells and won $2000 to help fund his research during next year.

“This money makes a huge difference and hopefully it will ...allow me to do my research full time next year and not have to work ... to support myself,” Mr Webster said.

As part of a UWA research program, he will travel to England in April for a six-month stint at Cambridge University to conduct research into the lower survival rates of cancer patients in country areas.

“I hope that I’ll learn a lot about research, particularly in the area of primary care, from some of the world leaders in the field,” he said.

Born in Narrogin, Mr Webster’s interest in rural health began as a Bunbury school boy when he joined the Rural High School Visit (RSHV) program and last year he was appointed RHSV coordinator on the SPINRPHEX Rural Health Club executive.

He is currently on a John Flynn scholarship placement in Nhulunbuy in the Northern Territory, where he will be returning for several weeks each year for the next three years.

When working in health clinics at Bathurst Island in the NT and other remote townships last year, Mr Webster realised that no two areas are the same and that each community has highly variable health care needs.

The greatest challenges facing rural health practitioners are immense stress and inadequate support, he said.

“Health workforce and health infrastructure in rural and remote areas is inadequate and often as a result patient outcomes suffer,” he said.

-By Amanda Saunders

Bachelor of Medical Science scholarship in honour of Professor Mary Lockett and the John and Rosemary Pearman Bachelor of Medical Science scholarship in honour of Professor Neville Stanley.

The aim of the scholarships is to encourage medical students to undertake scientific medical research and the recipients spend a year studying an aspect of one of the 11 medical founding disciplines or related disciplines.


Unlikely pairing - engineers team up with surgical oncologistsAn unusual partnership between a group of surgeons and engineers at UWA is showing promising results that could change the

way cancer is detected.

Professor Christobel Saunders, a cancer surgeon from the School of Surgery, and Dr Peter Robbins from PathWest have joined forces with a team of researchers working in the UWA Optical and Biomedical Engineering Laboratory (OBEL). The team consists of Professor David Sampson, Dr Robert McLaughlin and PhD candidate Loretta Scolaro.

The multidisciplinary team, lead by Dr McLaughlin, has been investigating the use of optical coherence tomography (OCT) to differentiate between cancerous and non-cancerous tissues, in particular lymph nodes, removed during surgical treatment for breast cancer.

In the same way that ultrasound uses sound waves to differentiate structures in the human body, OCT uses light to generate high resolution, three dimensional images. The research group particularly focuses on the use of OCT for identification of cancerous tissue.

Cancer is known to spread through the lymphatic system and so it is common for breast surgery to involve the removal of some or all of the lymph nodes in the axilla (armpit).However, this can lead to often severe complications for patients.

There is no in vivo method available to identify lymph node involvement of cancer. This means that during procedures such as an axillary clearance, healthy, non-cancerous lymph nodes may be unnecessarily removed.

Exciting results of the OCT study have demonstrated that this type of optical imaging can differentiate between tissue types and show some microstructures in human lymph nodes. The next stage of the study will involve developing an OCT needle probe for in vivo assessment of lymph nodes and cancer in other sites of the body.

The investigators have recently been awarded a Novel Concept Award from the National Breast Cancer Foundation which will fund expansion of the study over the next two years.

- By Aimee Nichevich, Research Officer, School of Surgery

Loretta Scolaro with colleague Blake Klyen from the Optical and Biomedical Engineering Laboratory


Collagen sponge (centre) is identical to human trabecular bone (left). Current commercial scaffold (right) for bone regeneration lacks a structure which mimics normal human bone.

In search of the perfect scaffold See related article on page 2

As with any structure, the scaffold holds the key in the successful building of tissue for tendon or cartilage repair.

According to Professor Zheng, the reason the scaffold is so important is that it is the matrix that determines the shape and function of an organ or tissue.

So in therapies using stem cells or progenitor cells to grow new tendon or cartilage that may be damaged in patients with tennis elbow or arthritis, for example, the ideal scaffold is the holy grail.

“You can not just whack these stem cells or progenitor cells in, you have to ensure they will do what you want them to do, which is maintain the function of the tissue or the organ,” he said.

One way of achieving this is to integrate the cells with a scaffold to stimulate regeneration.

“Our aim is to manufacture a scaffold that can mimic the process of organogenesis,” Professor Zheng said.

And it happens that Professor Zheng serendipitously hit upon the latest scaffold for the regeneration of bone and the meniscus, or cartilage that provides protection to the knee joint.

He was walking along the beach three years ago at Margaret River after convening a biotherapeutics forum and, his mind still racing with medical images, he noticed a sea sponge that looked remarkably like trabecular or internal human bone.

“Normally I would see just a sea sponge that is smelly and put it to one side,” he says. “But suddenly what I saw was not a sea sponge but a piece of the human body. It was the result of the stimulation of the meeting.”

He then picked up another sponge, which reminded him of the structure of the meniscus.

Back in the laboratory, the sea sponge turned out to be an ideal scaffold because it is made of collagen, which is the substance of human bone.

“Now we are using the sea sponge scaffold because its structure very much mimics the tissue texture of the meniscus and bone tissue,” Professor Zheng said.

WA has the largest collection of sea sponges in the world. “And the good thing about sea sponges is we can farm them,” Professor Zheng said. “We can control the production of sea sponges under a controlled environment so we can make it safe for use in humans.”

For a tendon scaffold, the team uses a collagen-based scaffold derived from pigs, chemically modified in the laboratory to reduce the cellular density, enhance the bio-compatibility and increase the mechanical strength of the tendon.

Visiting Raine fellow Dr Zhang Xiagling, from the Shanghai Jaiotong Medical School, worked with Professor Zheng for three months this year on the scaffold research.

The collaboration between the two medical schools will continue into the future. -By Cathy Saunders


Faculty Dean Professor Ian Puddey with Margaret Cook, who received a special commendation in the HealthRight awards for her on-going involvement in the project and her tireless work to improve the health of people with mental illness

Faculty Dean Professor Ian Puddey presents the HealthRight Organisation Award to Subiaco Rehabilitation Service representatives Claire Cochrane and Michelle Baillie.

The service has introduced a series of health-promoting groups for its clients, such as sports, weight management, gym and a quit smoking group.

Teaching on the Run takes off and picks up more health professions

The project is run by the UWA School of Psychiatry and Clinical Neurosciences, Community, Culture and Mental Health Unit and funded by the Mental Health Division in the Department of Health.

It has included a peer support program assisting people to access GPs and healthy lifestyle activities, and a health promotion campaign.

The awards were the culmination of a one-year Healthy Lifestyles program, funded by Healthway. Special guests at the event included Faculty Dean Professor Ian Puddey, Professor Sasha Janca, Head of the School of Psychiatry and Clinical Neurosciences, and Tim Rolfe, Clinical Consultant from the Office of the Chief Psychiatrist.

HealthRight Project Officer Mrs Ann Bates said the HealthRight awards were an important way to acknowledge those who had made a commitment to supporting people with mental illness to look after their physical health.

“People with mental illness are often marginalised in the community and they can be affected by low confidence and motivation and reduced capacity for self care,” she said. “That’s why support and encouragement from others are vital for improved physical health and the recovery process.”

The awards were:

Individual Champion: Derek Horlin, Organisation Award: Subiaco Rehabilitation Service, and Special Commendation: Margaret Cook.

continued from page 1

A staff development program for clinical teachers in medicine has been so popular that it has been expanded and rolled out to other health professionals.

Teaching on the Run, which was developed in 2001 by Professor of Medicine Fiona Lake, Dr Gerard Ryan, a respiratory physician at Sir Charles Gairdner Hospital, and others, has been acclaimed locally and nationally.

The program, which trains doctors to teach and supervise while working on the run, is used by many hospitals, community organisations and specialist colleges across Australia and has been delivered to more than 1000 clinicians and medical educators.

Following this success, Professor Lake was awarded an Australian Learning and Teaching Council Fellowship in 2006 to refine and implement the program for other health professions in specific disciplines and multidisciplinary groups. She worked on the expanded program with Dr Margaret Potter, Education Consultant in the School of Medicine and Pharmacology.

Because many professional groups face similar issues when trying to teach in a clinical work setting, the program was easily adapted to meet individual needs.

It has since been successfully delivered to groups of physiotherapists at Sir Charles Gairdner and Royal Perth Hospitals and staff from the Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service at The Royal Brisbane and Women’s Hospital. It has also been taken up by nurses in collaboration with staff development at Fremantle Hospital and multidisciplinary groups from Curtin University of Technology and the University of British Columbia.

Dr Potter said the exciting innovation was to run workshops for multidisciplinary groups.

“It is challenging because the groups have varying knowledge of their colleagues and each group has different needs,” she said. “In addition to providing participants with teaching skills, it encourages learning about, from and with colleagues, a central feature of multidisciplinary education.”

Professor Lake said it was a great opportunity to work with and learn from clinical teachers across the health professions and the widespread positive responses to the program were an indication of the strength of the content and delivery of Teaching on the Run.

The program was initially set up for hospital-based clinicians supervising junior doctors but now covers clinicians teaching students and specialist trainees and also embraces specialty areas such as dermatology and obstetrics and gynaecology, dental teachers, academic tutors and students as teachers.

If you are interested in more information about Teaching on the Run for health professionals, please contact Dr Margaret Potter at [email protected].


?

In the Nanjing exchange, Jonathan Chiew will do a rotation in Orthopaedic Surgery and Ben Allanson and Yu Min Ong will focus on Obstetrics and Gynaecology during their term at the at Drum Tower Hospital, which is affiliated with the Nanjing University Medical School.

The hospital, respected for its neurology, stroke, gene and stem cell research, has 21 special research sections or laboratories, 32 clinical departments and treats 37,000 inpatients and 1.5 million outpatients and emergency cases each year.

The students were the recipients of a P. F. Sobotka undergraduate scholarship, provided by the Faculty, which pays for their airfare. The Nanjing Medical School provides their accommodation.

In return, three medical students from the Nanjing Medical School arrived in Perth in October to undertake three four-week electives at Royal Perth Hospital.

Meijuang Zhang, Ling Lin and Dongyan Shi, were selected by Professor Minghao Zheng, Director of Orthopaedic Research in the Faculty’s School of Surgery and Pathology, on a recent visit to China.

They won scholarships awarded by the Faculty to help with the cost of accommodation and living expenses while their airfares were paid by the Nanjing Medical School.

In another initiative to foster the partnership between the Faculty and Zhejiang University, Professor George Yeoh and his team at the WA Institute for Medical Research (WAIMR) will join forces with visiting Associate Professor Aibin Zhang of Zhejiang University to carry out research into new treatments for liver disease.

The joint program will seek ways to improve on current dialysis techniques.

Professor Yeoh said about 10 per cent of the population in China had hepatitis B and many would end up on a transplant waiting list, being treated with a bioreactor dialysis system that was labour and cost intensive.

A bioreactor replaces the function of the diseased liver and gives it the chance to regenerate naturally but the machine must be constantly topped up with artificially created liver cells.

Professor Yeoh’s team has had success with liver progenitor cells which produce important liver cells and it is hoped that if a way can be found to keep the cells functioning in a bioreactor, they may sustain the machine for months or longer, compared with just days as happens at present.

t h e c h i n e s e c o n n e c t i o n

(From left) Meijuang Zhang and Ling Lin, two Nanjing students at UWA for their elective studies, Jenifer Meintjes, the first UWA BMed Sci Honours student to go to Zhejiang University, and Yu Min Ong and Jonathan Chiew, two of three UWA medical students going to Nanjing University, with Faculty Dean Professor Ian Puddey.

Ben Allanson, absent from the photograph, is the third UWA medical student travelling to Nanjing for the Year 6 elective placement.

continued from page 1


t h e c h i n e s e c o n n e c t i o n

Sino-Australian cancer research links stronger

A Faculty team has added to its success in establishing a multi-faceted international research program with China on the anti-cancer properties of green tea by winning a prestigious national award.

Dr Min Zhang, Senior Research Fellow in the School of Population Health (SPH), last month received the Federal Government’s 2009 Endeavour Research Fellowship to conduct a pilot trial in China, gaining her team a much-needed funding boost.

With travel and living expenses covered by the Fellowship, Dr Min Zhang will spend at least half of next year in China, carrying out a pilot randomised controlled trial on a group of 200 healthy Chinese women in an attempt to consolidate the link between breast cancer control and green tea consumption.

Twice a day for six months, half the participants will be given two green tea capsules that have the same amount of green tea extract found in nine standard cups, while the other half of the women will be given placebos.

Each woman will undergo a mammography to assess any difference in mammographic density and gauge green tea’s ability to modify circulating levels of the hormones oestrogen and progesterone, which are linked to breast cancer.

“The most difficult challenge for me has been data collection during my trips to China because interviewing patients in the community is very difficult and talking to them on the phone is very expensive,” said Dr Zhang, who is also Director of the Lu Cha (green tea) Sino-Australian Research Collaboration established three years ago.

When presenting the fellowship, Deputy Prime Minister Julia Gillard said it was designed to support research collaboration in areas of common interest between Australia and the region – namely Asia and the Middle East.

Professor of Public Health D’Arcy Holman has led the UWA green tea intervention research and said the Fellowship was a welcome reward for the hard slog put in by Dr Zhang and her colleagues, including Research Fellows Dr Max Bulsara and Dr Frank Sanfilippo from the SPH, Professor Michael Millward, of the School of Medicine and Pharmacology, and Professor Christobel Saunders, of the School of Surgery.

Following the completion of the pilot RCT in China, the team hopes to put the anti-cancer properties of green tea to the test on home soil in a trial involving West Australian women with high-risk stage 1, stage 2 and stage 3a breast cancer.

In another coup for the Green Tea research team, the NHMRC will fund a million-dollar multi-centre green tea research program in Zhejiang and Laoning provinces that is due to begin next year. A five-year partnership with researchers at UWA’s sister school Zhejiang University has broadened research avenues and the latest trial involves 5,000 participants with colon cancer, leukemia and breast cancer.

-By Amanda Saunders

(from left) Dr Min Zhang and her local research team, Dr Huang, Ms Zhang and Dr Ding, at the Breast Clinic of Zhejiang University Women’s Hospital in China, following completion of fieldwork into green tea and breast cancer risk


Professor Terry Nolan

Intense exposure to research cements life-long career plansProfessor Terry Nolan, Foundation Head of the University of

Melbourne School of Population Health, says the Bachelor of Medicine Science degree was profoundly life-changing.

He had already had his interest in research fuelled by the Mary Raine Vocational Research Scholarship which he won at the end of second year medicine and again at the end of third year, which prompted him to undertake the BMedSc in his fourth year.

He and close friend Jim McCluskey, now Professor and Head of Microbiology and Immunology at the University of Melbourne (see page 13), were the only two students to undertake the degree in 1973.

“It confirmed my interest in research,” Professor Nolan says. “I was offered a place to do a PhD at Cambridge at the end of my year but I decided instead to finish medicine first and to make a decision then about whether I would go into a full-time research career or not.”

During his BMedSc year he worked with Dr Gareth Jones, who later became Professor of Anatomy and Structural Biology and Deputy Vice-Chancellor (Academic and International) at the University of Otago and who was a world leader in the description of nerve synapses.

“Our findings were novel and important in defining the ultrastructure (of nerve synapses),” he says, adding that they were published in several international journals.

“At the time, we were using cutting-edge electron microscope technology. We were looking at how nerves transmitted their messages from one nerve cell to another. The structure and how those electrical signals were generated were still being understood.”

In the same year, he used funds from a Sobotka scholarship to head for the University of Otago in New Zealand to work for three months in the pathology department where they were using a brand-new technique for examining the structure of cell membranes.

On his return to Perth, he taught the new technique to researchers at UWA.

“At the end of the year I was exhausted but I felt enthused and committed to continuing working in research in medicine,” he says.

Having completed his BMedSc, Professor Nolan was awarded yet another vocational research scholarship at the end of his fourth year and then, once he had graduated in medicine from UWA, he went interstate and overseas to undertake further studies and complete his training in paediatrics.

“But it (the BMedSc degree) was such an important year to give me the intense exposure to research at an early stage,” says the Professor, who is also Associate Dean of the Faculty of Medicine, Dentistry and Health Sciences in the University of Melbourne. “It allowed me to confirm my interest by having some firm scientific training and a level of contact with other people working in medical research.

“It had a huge influence on my later life.”

Professor Nolan’s research career led him in the opposite direction to where he was heading during his BMedSc year.

“I have ended up pursuing research in humans and in public health which is quite the opposite end of the spectrum to laboratory research,” he says.

But his experience in the laboratory has been invaluable and made him appreciative of the importance of such research.

“The convergence of molecular information with epidemiologic and public health information is where things are going now,” he says. The work of virologists and molecular scientists who are “virus detectives” discovering new viruses is married with the findings of epidemiologic studies that provide the samples and with environmental information about the way in which epidemics spread.

His research centres on the epidemiology of respiratory viruses and other vaccine-preventable diseases. He is also involved at a high level in the evaluation of vaccines, such as the candidate vaccines being considered by CSL for protection against the bird flu in humans.

He is Director of the National Health and Medical Research Centre for Clinical Research Excellence in Immunisation and is Chair of the Australian Technical Advisory Group on Immunisation, among many other high-level positions.

-By Cathy Saunders


Influencing clinical practice – medical research is the keyAn international expert on immunology and transplant matching

is a believer in getting an early taste of medical research before the demands of work and family make it trickier.

Professor James McCluskey, Head of Microbiology and Immunology at the University of Melbourne, is a fan of the Bachelor of Medical Science degree which he undertook at UWA and which he says has been enormously helpful and a very powerful influence on his career.

“I run a large research department at the University of Melbourne…and I think that is directly attributable to the opportunity during the medical course to have the research exposure without risking losing your position in medicine,” he says.

“It is very important that you take time out and then go back. If you are no good at research or you don’t like it or it doesn’t suit you, then you can go off and be a terrific doctor.”

Professor McCluskey, who is also Associate Dean (Research) in the Faculty of Medicine, Dentistry and Health Sciences in the University of Melbourne, says later on in a medical career, either as an intern or during specialist training, it can be difficult to find time to try out research.

“By that stage you are usually married and thinking of having a family and buying a house and you are thoroughly embedded in reality,” he says.

The BMedSci degree sharpens critical thinking, develops communication skills, and hones writing skills and the ability to present complex data, according to the Professor.

“They are very broad skills that benefit clinical practice and evidence-based decision-making about patient management,” he says. “And you tend to be very critical about what you read after the BMed Sci experience.”

But there is one dimension the degree added to his studies that he considers the most important.

“It made me see you can probably do much more in medicine by learning new things that influence clinical practice than beavering away at the coalface, seeing one patient at a time,” he says. “Research is really what it is about.”

The thrust of much of his work has been immunology issues relating to transplantation matching and the genes that control immunity.

“I think I have had a much broader influence nationally and internationally in the way we select organ donors than I could ever have had as a practising clinician in a transplant unit,” he says.

He adds that the degree gives the student the opportunity to work with some outstanding researchers who are role models and makes it clear it is possible to mix a clinical career with a research career.

“In an ordinary medical course, there is very little of that kind of exposure. You wouldn’t have a clue what research your teacher is doing.”

By working in a laboratory alongside researchers, you learn how the research world works, from obtaining grants and selecting respected journals to understanding that ingredients of successful research are a combination of hard work, and critical thinking and good luck, Professor McCluskey says.

However, he does not think that more than 5-10 per cent of medical students are cut out for research, which he finds surprising.

“You would think intuitively that these very talented, bright people would be very enriched for inquisitiveness and curiosity and a desire to experiment more and push the boundaries,” he says.

“But oddly enough they are not particularly enriched for that at all, despite their passion for life-long learning. The lure of clinical practice provides more instant positive feedback and daily rewards than is realistically possible in research. So one of my pet views about the BMedSc is that it is not for everybody, it is for a special group of people who have all those gifts and are naturally inquisitive… and have a desire to do research and test themselves over the long haul.

“The less research oriented medical students are more likely to become clinical practitioners and many of these will make outstanding contributions to medicine and surgery.”

However, he believes the 5-10 per cent who do a BMedSc are more likely to go on to be research academics and educational leaders, leaders in the professional colleges, policy setters and trendsetters.

“They have shown from an early point this natural inclination to test new ideas,” he says.

Professor James McCluskey

Professor McCluskey conducted research into the genetics and evolution of wild rabbits for his BMedSc degree and gained the great achievement of having his first paper published in the prestigious journal Nature.

He went on to become a renowned rheumatologist and immunologist who has looked at the genetic influences on rheumatic diseases. His research has also focused strongly on the immune system, looking at auto-immunity, allergy and why the body rejects transplants.

He has developed diagnostic tests and been hugely influential in how transplants are managed.

Apart from numerous other positions, he is Medical Consultant to the Victorian Transplantation and Immunogenetics Service.

-By Cathy Saunders


The West Australian:

Professor Peter LeSouef, Head of the School of Paediatrics and Child Health, is QAS parents should not smoke around children when in cars or at home, even with the windows and doors open. “The adverse effects of second-hand smoke on children have been extensively documented over the past 30 years and I see these effects every day in my work,” he said. Every second child admitted to hospital in the first year of life with a respiratory disorder had parents who smoked, he said. He was speaking before the launch of a new hard-hitting WA campaign, Making Smoking History, that warns about the dangers of passive smoking.


Professor Osvaldo Almeida, Professor of Old Age Psychiatry in the School of Psychiatry and Clinical Neurosciences, is QAS that if the plasma concentration of the amino acid homocysteine could be reduced by one-fifth, the number of elderly Australians affected by depression could be reduced by the same amount. He was commenting on a study by his team at the WA Institute for Medical Research’s Centre for Health and Ageing of 3700 men which found that high levels of homocysteine increased the risk of depression in people over 70 by interfering with serotonin and noradrenaline, which act to lighten mood.

the word is out - faculty in the newsQ u o t e d A s S a y i n g


Professor Hugh Barrett, of the School of Medicine and Pharmacology, is QAS the ageing process of arteries, hastened by eating a lot of animal and saturated fats, smoking and having diabetes, begins in the late teens. “Studies have showed atherosclerosis starts to develop in even young people,” he said. “In fact, the current generation of teenagers is going to be at potentially even greater risk.” He was commenting on a study which found fatty diets are ageing the arteries of 40-year-olds by as much as 20 years.

Australian Doctor:Professor George Jelinek, Professor of Emergency Medicine, is QAS that frequent attenders form a small part of emergency department caseload, do not contribute much in terms of costs and genuinely require hospital care and could not be managed in other settings. He was commenting after the release of findings of a study by his research team which showed most “frequent-flyer” patients had serious or urgent conditions.

WITS ABOUT YOUOur medical quiz is kindly supplied by Emeritus Professor Bernard Catchpole, the second Professor of Surgery appointed to the Faculty.

Questions:

1. A Frenchman’s name is on every milk carton. Who was he and what was his profession?

2. What is the frequency of gastric muscle contractions?

3. In the early antiseptic days of surgery, a chemical was sprayed into operating theatres. What was it?

4. Is atropine useful in the relief of renal colic? Explain your answer.

5. Why were rubber gloves first used in surgery and by whom?

Answers page 15

b

bc

c

aa b

bc

c

a

Hone facial trauma management skills Health professionals will have the chance to brush up on the emergency management of dental and facial trauma in the sporting

arena at a congress in Perth next year.

A half day lecture series on the subject, which is expected to be popular with those involved in looking after the welfare of athletes on the field, will be part of the program of the Australian Dental Congress.

The Australian Dental Association, which is organising the congress, is taking the unusual step of opening the lectures to interested health professionals. Registration will be on the day.

“We anticipate this event to be a great opportunity for all members of the sporting fraternities to get together to not only hear the lectures but also to discuss the huge issue of trauma in sport in all of its facets,” Dr Jenny Ball, a congress organiser, said.

A large number of the speakers will be lecturers associated with the Faculty’s undergraduate Bachelor of Dental Science degree.

The congress, which will be held at the Perth Convention Exhibition Centre from 12-15 March next year, will have a second unusual feature. This is the addition of a specialised program targeted at the Allied Members of the dental team.

Details of the program are at www.ada2009.


Answers to Quiz on page 14

1. Louis Pasteur 1822-95. This famous microbiologist devised, inter alia, a method of destroying bacteria in liquids by heating them.

2. About four per minute.

3. Phenol (carbolic acid).

4. No. The motor drive of ureteric muscle is via adrenergic receptors.

5. The scrub nurse of William S. Halsted, an American surgeon, found that the phenol solution she had to dip her hands and arms in was irritating. Halsted provided rubber gloves for her which were later taken up by the whole team. The scrub nurse became Halsted’s wife.

Made to mentor

A sixth-year medical student who won an award for his outstanding efforts as a volunteer mentor to other medical students hopes to

continue to support students during his years as a hospital doctor.

Jason Joon Qing Tan was a co-recipient of the UWA 2008 UniMentor of the Year award along with Balsam Abdul Jabar of Engineering, Computing and Mathematics.

Mr Joon Qing Tan said he helped his mentees by encouraging them to discuss any problems they had, helping them find their way around the campus, advising them about their choices of units, providing them with past examination papers and suggesting ways of relieving stress. “I guess really my ambition was to help them have a great transition to university,” he said.

In his first year as a mentor, he had one mentee but by this year he had five. “I really learnt to organise myself,” he said. His aim was to be friendly, approachable and non-judgmental.

Mr Joon Qing Tan said in his work next year at Sir Charles Gairdner Hospital, he would keep a look-out for his former mentees and would be happy to take them on his rounds or give them tutorials.

He said he was grateful to the Faculty for the excellent clinical training, which had contributed greatly to his professional development, leadership skills and success at UWA.

Every year the UniMentor program hosts a mentor appreciation ceremony where volunteer mentors are publicly recognised for their contribution to the UWA community and outstanding mentors receive special recognition awards.

The UniMentor of the Year Award is the ultimate award and given to the student who has been recognised by the staff of UniMentor and their mentees as an outstanding and committed mentor who has consistently supported students in their transition and has provided support to staff of UniMentor.

Jayne Brown, UniMentor co-ordinator, said Mr Joon Qing Tan had a long association with the program, participating as a Host Day Leader in 2004 and then as a mentor from 2005 until 2008 for the Faculty of Medicine, Dentistry and Health Sciences. “Jason is an extremely conscientious mentor who gives a lot of his time to support his

mentees,” she said. “He has maintained contact with many of his mentees beyond their first year.

“He seeks feedback from staff about his mentoring and has a very planned approach to managing his relationships with mentees. Jason is an outstanding role model for mentors and an excellent ambassador for UWA.”Jason Joon Qing Tan receives his award as UWA 2008 UniMentor of the Year from UWA Vice Chancellor Professor Alan Robson

A broken surf board highlights injuries seen in general practiceThe notion of the general practice rooms being a

research laboratory is beginning to be recognised, especially in the Eastern States.

This theme emerged during a a primary health care conference held last month in Perth. according to Professor Jon Emery, Head of the School of Primary, Aboriginal and Rural Health Care and Professor of General Practice.

He said the Primary Health Care Research, Evaluation and Development (PHCRED) conference was an extremely positive day with a good range of presentations from early career primary care researchers from all over WA.

“I particularly enjoyed the presentation by Dr Allan Walley, GP from Margaret River, who came along with his broken surf board and presented a study exploring the epidemiology of surfing injuries in Margaret River,” Professor Emery said. “This was his first toe in the water of research and had been helped through the process by the PHCRED funded team at UWA.”

The State PHCRED Conference was held in conjunction with Royal Australian College of General Practitioners (RACGP).

Delegates, who travelled from as far as Albany and Margaret River in the South, to Geraldton and Broome in the North, included GPs, registrars, nurses, medical students, allied health professionals, consumer group representatives, physiotherapists and other health professionals.

PHCRED Statewide Coordinator Lyn Brun said delegates were encouraged by the amount of evidence-based research being undertaken in WA and the conference provided a great opportunity for researchers from across the state to share the learning gained from the PHCRED program.

PHCRED provides fellowships and bursaries resulting from funding of research into key areas for Primary Health Care with an additional focus on rural and indigenous health.

“The research findings will go a long way to assisting doctors and health professionals across the state in providing a better level of service and more targeted programs,” she said.


MeDeFacts

Students shine in health researchA conference initiated by UWA medical students to showcase undergraduate health research has proven so successful in its second year

that it could become a national event.

The Students in Health and Medical Research Conference (SHMRC) is the first conference designed exclusively to raise the profile of research by students within the Faculty of Medicine, Dentistry and Health Sciences. Co-conveners Sarah O’Neill, a fourth-year medical student, and Patrick Wong, a sixth-year medical student, said the conference also aimed to provide inspiration for other students.

“The Faculty tries to promote research but… people are doing international calibre research that no one knows about,” Ms O’Neill said. “They have the chance to present it at international conferences in Australia and overseas but they rarely have the chance to present it to their colleagues and to members of the Faculty.”

The quality of competition at SHMRC was amazing, with nine students selected to speak from a field of 32 entrants, she said.

Fifth-year medical student Mike Kamara won best young investigator while Sally Banfield, also a fifth-year medical student, won best verbal presentation. They each took home $500.

About 100 people attended the conference held in October, which was an increase on the debut conference last year. “We’d like to make it bigger, perhaps get (even broader) involvement from the Faculty, and ultimately we want it to go Australia wide,” Ms O’Neill said.

“We have the Australian Students’ Medical Conference in July every year and we were hoping to have a day conference either side of that so that it includes students from all the unis around Australia.”

The conference was supported strongly by the WA Institute for Medical Research and the School of Medicine and Pharmacology.

- By Amanda Saunders

FACULTY OF MEDICINE, DENTISTRY AND HEALTH SCIENCESThe University of Western Australia, 35 Stirling Highway, Crawley, WA 6009

Ph: (08) 9346 7323 Fax: (08) 9346 2369 Web site: http://meddent.uwa.edu.au/Dean - Professor Ian Puddey - Deputy Dean - Professor John Newnham

Faculty Manager/Assistant Editor - Susan Henshall (08) 9346 2680 - email: [email protected]/Writer - Cathy Saunders (08) 9349 8190 or 0403 813 830 - email: [email protected]

CONTRIBUTIONS: We aim to make the newsletter relevant to as many members of the Faculty as possible, and to achieve this we welcome contributions of articles, photographs, letters, feedback, story ideas and humorous medical or dental anecdotes.

Please email your contributions to the editor at: [email protected]

Presenters at the Students in Health and Medical Research Conference held in Perth.


new volume 14 number 4 december 2008 · 2008. 12. 18. · medefacts volume 14 number 4 december...

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