2013 Annual Research Report, Princess Alexandra Hospital T1

188 Pages·2015·7.79 MB·English

Metro South Health
Centres for
Health Research
2013 ANNUAL RESEARCH REPORT
'translating science into better health'
Great state. Great opportunity.
Translating science
into better health
T1 – Translation to first in humans
Findings from basic research are tested for clinical effect
and/or applicability. T1 research yields knowledge about
human physiology and the potential for intervention.
T2 – Translation to patients
(refer page 17)
T3 – Translation to clinical practice
(refer page 24)
T4 – Translation to population health
(refer page 142)
© State of Queensland (Queensland Health) 2014
http://creativecommons.org/licenses/by/3.0/au/deed.en
ISSN 1833-6574
Contents
Introduction Group Reports Mental Health Services 92
Nutrition and Dietetics 94
Message from the 2 Acquired Brain Injury 25
Department
Chief Executive Outreach Service
Metro South Health Occupational Therapy 100
Alcohol and Drug 27
Department
Message from the Chair 4 Assessment Unit
Princess Alexandra Hospital Older Adult Mental Health 103
Anaesthetic Department 29
Service
Features Australian Prostate 30
Orthopaedic Unit 104
Cancer Research Centre –
Queensland Melanoma 6 Queensland Otolaryngology – Head and 106
Project 1963 – 2013 Neck Surgery
Brain Injury Rehabilitation 35
Aged Care and Telehealth 8 Unit / Hypertonicity Service Pathology Queensland – 109
Research Group PAH
Queensland University of 10
Technology Breast and Endocrine 36 Pharmacy Department 110
Surgery Unit
The University 12 Physiotherapy Department 112
of Queensland Cancer Nursing Research 37
Queensland Melanoma 117
Group
Postgraduate Research 14 Project
Cardiology Department 40
Clinical Research 16 Queensland Spinal Cord 120
Fellowships 1999-2013 Cardiovascular Imaging 42 Injuries Service

Research Group
Radiation Oncology 123
Committee Reports
Centre for Functioning and 43 Department
Health Research
Human Research Ethics 18 Radiation Oncology – Mater 125
Committee Centre for Kidney 49 Centre
Disease Research
Research Committee 20 Radiology Department 128
Centre for Liver Disease 60
Princess Alexandra 21 Respiratory and Sleep 131
Research
Research Foundation Medicine Department
Centre for 62
Health Practitioner Research 22 Speech Pathology 132
Online Health
Collaborative Department
Centre for Research 65
Therapeutics Research 135
in Geriatric Medicine
Centre
Clinical Pharmacology 68
Trauma Service 137
Department
Upper Gastro-intestinal 138
Dermatology Research 69
and Soft Tissue Unit
Centre
Urology Department 141
Diabetes and Endocrinology 72
Department
Publications,
Diamantina Institute 76
Major Grants & People
Emergency Department 77
Summary Table 143
Endocrine Hypertension 79
Journal Articles 144
Research Centre
Books & Book Chapters 168
Gastroenterology & 81
Hepatology Department Reports 170
Haematology Department 82 Major Grants 171
Infection Management 84 Research Staff 176
Services
Postgraduate Students 182
Intensive Care Unit 85
Internal Medicine and 89
Clinical Epidemiology
Lung & Allergy Research 91
Centre
Centres for Health Research 2013 Annual Research Report
Message from the Chief Executive
Metro South Health
Dr Richard Ashby AM Dr Jennifer King
Chief Executive Executive Director
Welcome to the 2013 Princess Alexandra Hospital (PAH) Centres for Health

Research Annual Research Report, highlighting another year of achievement
and significant progress in our mission to translate advances in research into
real benefits for patients locally and around the world.
Service Profile Education and Research
The PAH sits within Metro South Health, the major Metro South Health is committed to strong
provider of public health services in the Brisbane south undergraduate and postgraduate teaching programs in
side, Logan, Redland and Scenic Rim regions. It is one medicine, nursing and allied health with linkages to The
of 16 hospital and health services in Queensland and University of Queensland (UQ), Queensland University
serves an estimated population of 1 million people, 23 of Technology (QUT), and Griffith University, as well as
per cent of Queensland’s population. It employs more several other Queensland universities.
than 13,000 staff and has an annual operating budget
The Princess Alexandra Hospital and the Queensland
of $1.8 billion. Metro South Health is overseen by the
University of Technology have formed the Australian
Metro South Hospital and Health Board, Chaired by Mr
Prostate Cancer Research Centre (Queensland). Their
Terry White AO, with responsibility for setting strategic
work has created a consolidated multidisciplinary clinic
direction, establishing goals and objectives for executive
and clinical trials unit for prostate cancer and other
management, monitoring the organisation in line with
urogenital malignancies, in collaboration with Australian
current government health policies and directives, and
and Canadian Prostate Cancer Research Alliance.
ensuring that adequate and appropriate community
consultation is undertaken. Work has continued with the Queensland Head and
Neck Cancer Centre (QHNCC) which was established
In 2013, the following services transitioned to in 2012. The Centre is a collaborative arrangement
PAH from the Department of Health: between the PAH, Translational Research Institute
• Public Health (Metro South) – 1 March 2013 (TRI), UQ, Queensland Institute of Medical Research
and the Australian Institute for Bioengineering and
• Organ and Tissue Services – Reporting from March
Nanotechnology. The QHNCC to deliver novel diagnostic
2013, financial from 1 July 2013
and treatment modalities, and provide advanced
• Tuberculosis Services – 1 July 2013.
education programs for head and neck cancer. To further
this important work, a $5 million Positron Emission
Research - key to health
Tomography (PET) Magnetic Resonance Imaging Awards
(MRI) unit was purchased for the hospital’s Molecular
Imaging Department. This project was funded from Of special mention are staff from across the Health
PAH Private Practice Trust Fund in conjunction with Service who were acknowledged through awards in
Atlantic Philanthropies and the Department of Science, 2013:
Information Technology, Innovation and the Arts.
• Dr Peter Woodruff was awarded a Queen’s Birthday
Honour – Member (AM) in the General Division for
significant service to medicine, particularly in the field
Translational Research Institute
of vascular surgery and through contributions to
health care standards
Metro South Health is internationally recognised as
a leader in biomedical and clinical research. In 2012, • Sue Golding and her cancer support team were
PAH campus became home to the new Translational awarded the prestigious title of Look Good Feel
Research Institute (TRI), which was officially opened on Better National Venue of the Year, out of 180 venues.
10 October 2013 by the Governor-General, Her Excellency LGBF workshops provide free information and
the Honourable Quentin Bryce AC CVO. TRI combines workshops for women, men and teens to help
the expertise of four leading research institutes (PAH, manage the appearance-related side-effects caused by
UQ, QUT and Mater Research) and is co-located with a cancer treatment.
biopharmaceutical manufacturer, Patheon. The research The Centres for Health Research is a vital part of the
conducted at TRI enables new therapies and vaccines, commitment of the hospital to strengthen and facilitate
for common and serious diseases, to be developed and the integration of research and teaching with clinical
tested within shorter timeframes. care.
The TRI Clinical Research Facility (CRF) is a controlled

and safe environment to conduct research on human
subjects. Located on Levels 4 and 5 of PAH R-Wing,
with ready access to hospital facilities and emergency
response teams, the CRF is operated by the Princess
Alexandra Hospital under the Directorship of Professor Dr Jennifer King
Ken Ho, Chair PAH Centres for Health Research. The CRF Executive Director, PAH-QEII Health Network
is expected to open for research in 2014. MBBS, MBA, FRACMA, FAICD
Diamantina Health Partners
Diamantina Health Partners (DHP), launched in July 2011
as Queensland’s first academic health science centre
Dr Richard Ashby AM
unites eight of the state’s leading hospitals research
Chief Executive, Metro South Health
institutes and universities to improve care for patients.
MBBS (Qld), BHA (NSW), FRACGP,
DHP aims to position itself to take advantage of future
FRACMA, FACEM, FIFEM
funding opportunities through the demonstration
of innovative thinking and productive collaborative
arrangements which deliver on the tripartite mission of
excellence in patient care, training and research. DHP’s
vision is to be recognised internationally as a premier
academic health science centre achieving innovative
healthcare through academic leadership.
Centres for Health Research 2013 Annual Research Report
Message from the Chair
Centres for Health Research
CHR 5th Anniversary Celebration Professor Ian Frazer, Professor Ken Ho, Assoc Professor Carmel Hawley, Professor
Devinder Gill, Ms Areti Gavrilidis, Professor Don Cameron, Ms Joy Vickerstaff, Professor David Theile AO

1998-2013: 15 years of research at Wing), new office space for the Therapeutic Research
the Princess Alexandra Hospital Group, and Professor Ian Frazer’s success in obtaining a
grant of $1 million from the Australian Cancer Research
Patients have always been at the centre of research at Foundation to fit out space in the new research building
Princess Alexandra Hospital, making the outcomes of which led to additional funds from the Department of
research milestones more relevant at the bedside. In State Development and The University of Queensland.
the late 1990’s this philosophy was recognised by key
From its infancy, the CHR has grown amazingly in
clinicians and academics at PAH with the establishment
response to the needs and inspiration from clinical
of the Centres for Health Research (CHR), and the start
researchers. Research areas which have gained strength
of a journey that would see health and medical research
and have established a national or international
collaborations blossom between hospital clinicians, local
reputation include cardiovascular, metabolic, renal,
and national universities, industry, and other research
therapeutics, aged care, telehealth and health services.
institutes, and would place PAH on the international
Among the many prestigious research initiatives on the
map as one of Australia’s leading academic and research
PAH campus over the past 15 years are the Australian
health centres.
Prostate Cancer Research Centre-Queensland, the Cancer
The CHR 15th Anniversary was celebrated with a Nursing Research Group, the Centre for Functioning
luncheon to mark the opening of the 2013 PAH Health and Health Research, Diamantina Health Partners,
Symposium, organised by the CHR and themed Making the Lung & Allergy Research Centre, the Queensland
advances matter: research, education and treatment Melanoma Project, the Translational Research Institute,
in partnership. Special guest was Professor Donald refurbishment of two floors of R Wing into a Clinical
Cameron, former Director of the PAH Department of Research Facility, and the Queensland Head and Neck
Diabetes and Endocrinology, President of the Royal Cancer Centre.
Australian College of Physicians, and Member of the
Professor David Theile AO, former PAH surgeon, retired
NHMRC Council, who was appointed in 1998 to lead
CEO of Metro South Health and Chairman of the
the CHR.
Diamantina Health Partners, says the CHR has played a
With more than 25 years as clinician and clinician- key role in the development of PAH as a true academic
scientist Professor Cameron was a key figure in driving tertiary hospital, and the decision in 1998 to establish
the momentum of clinical and research integration. and support the CHR was one of foresight and initiative.
In 2000, the year the CHR Annual Report was first At the 15th Anniversary celebration Professor Theile said,
published, Professor Cameron wrote about the ‘the Centres for Health Research, under the leadership
completion of the new PAH research building (now R of Professor Ken Ho, looks forward to another 15 years
Research - key to health
of mentoring researchers, fostering collaborations and
undertaking important research that contributes to
government policy which makes a difference to patients’.
PAH research achievements 2013
This sixteenth Annual Research Report of the Centres
for Health Research captures the highlights of the many
outstanding achievements of the staff and students
who participated in research activities across the PAH
campus in 2013. In addition to the hundreds of research
projects in progress on the campus, as described in this
report, other significant research achievements in 2013
included:
Ms Areti Gavrilidis and Professor Ken Ho
• $41.5 million of competitive peer-reviewed grant
funding received
• 800 peer-reviewed journal articles and books chapters
published activities, CHR responsibilities grew in 2013 to include
• 225 postgraduate students supervised the establishment and directorship of the new Clinical
Research Facility on Levels 4 and 5 of PAH R Wing which
• 185 linkages with other institutions and departments,
was refurbished by the TRI in 2013.
providing evidence of integration between clinical
5
services, research and education.
I take this opportunity to acknowledge all the staff of the
CHR 2013, who are displayed on the inside back cover. I
Facilitating research would like to thank Kathy Harvey, CHR Research Manager,
for her production of this annual report, and Maria
The PA Research Support Scheme, jointly funded by the Wojciechowski for her assistance.
Princess Alexandra Research Foundation (PARF) and
I would also like to acknowledge Areti Gavrilidis who,
the PAH Private Practice Trust Fund (PPTF), awarded
since joining the CHR in 2002, has worked tirelessly to
over $1.88 million in 2013 to 37 successful applicants in
support, facilitate and strengthen health and medical
support of three categories of research: People Support
research at Princess Alexandra Hospital. Areti was
($885,000), Project Support ($640,000) and Research
seconded in 2013 to the position of Executive Consultant
Excellence ($361,000). We express our gratitude to
for Diamantina Health Partners, while maintaining an
the PARF and PPTF, and congratulate all the successful
invaluable consultancy role to the CHR.
applicants and wish them every success with their
research. In this 15th anniversary edition we looked On behalf of the CHR, it gives me great pleasure to
back at the 39 Clinical Research Fellowships supported present this sixteenth Annual Research Report, which is a
through PARF and PPTF funding, to some pleasing summary of achievements through a wealth of research
results. partnerships and collaborations. We look forward to
continuing to work with our academic, research and
health care partners.
A dynamic year for the CHR
2013 was a truly dynamic year for the CHR, the first in
its new home in the Translational Research Institute. The
Human Research Ethics Committee (HREC) reviewed 306
applications, an increase of 7% over 2012. Through the
efforts of the Research Committee much appreciated
Professor Ken Ho
PPTF funding was secured to establish both a research
Chair
grants administration officer position and a biostatistics
Princess Alexandra Hospital
support service for PAH. A number of PAH Health
Centres for Health Research
Symposium sessions were organised to be held in the
FRACP, FRCP (UK), MD
new TRI in recognition of its close association with the
hospital. In addition to these and other longstanding
Centres for Health Research 2013 Annual Research Report
Queensland Melanoma Project 1963 – 2013
The Queensland Melanoma Project (QMP), Princess Alexandra Hospital’s first
major clinical research project, celebrates 50 years of outcomes.
In 1962, the newly established Queensland Cancer Fund
British Journal of Surgery and the Medical Journal of
(now Cancer Council Queensland) announced it would
Australia.
offer grants in support of local, Queensland-based
research. Neville Davis, visiting surgeon at the Princess In addition, the Queensland Melanoma Project
Alexandra Hospital, decided to apply for a grant to study developed an educational program to help doctors
melanoma, a particularly Queensland cancer. diagnose and treat melanoma at an early stage. While
Queensland was found to have the highest incidence of
In 1963, the Queensland Cancer Fund awarded Dr Davis
melanoma in the world, it also had the best treatment
and his team a two-year grant and the Queensland
results. The Queensland Cancer Fund supported the
Melanoma Project (QMP) was born.
QMP for more than 20 years, and continues to be the
major non-government funder of cancer research in
A small team of dedicated researchers, including
Queensland. The work of the QMP continues today at
surgeons, pathologists, dermatologists, research
the Princess Alexandra Hospital under the leadership
fellows and hospital administration staff embarked on
of Professor B Mark Smithers, collaborating with many
an initiative that was soon recognised internationally.
organisations and institutions, with a particular focus
The project was ambitious – its aim was to record
on clinical trials to improve the treatment of melanoma.
and analyse the clinical features and outcomes of all

Since 1963, the QMP has published more than 100
melanomas diagnosed, not just at the Princess Alexandra
scholarly papers and has made a significant and lasting
Hospital, but in the whole of Queensland. The scope
contribution to melanoma control efforts in Queensland.
and quality of the information that resulted was unique
in the world at that time, and resulted in publications in
such esteemed journals as the Lancet, Cancer, Pathology,
1999 Neville Davis interview
Diamantina Health Care Museum
Association Inc. Oral History Project
‘…in 1962 the Queensland Cancer Fund had a public appeal and
they raised quite a lot of money and they said that they were
going to support research locally and I spoke to my Senior,
who was Evan Thomson, and I said, “There is a bit of money
for research and so we ought to do something”.
Now in 1962 and 1963 the hospital was under great
pressure in relation to the X Ray Department in doing
any particular investigative work and he said, “Well,
what can we investigate?”, and I said, “Well, what about
melanoma? It’s common here and we don’t need an X
Ray to diagnose it – you can use your eyes – we can get
the pathology done and we could do a study. So it was
decided that we would apply for a grant and we obtained
a grant from the Queensland Cancer Fund and that initiated
the Queensland Melanoma Project.’
Research - key to health
QMP Co-Ordinators 9-0
Dr. Neville C. Davis Prof Mark Smithers Dr. G. Roderick McLeod
Visiting Surgeon Princess Alexandra Hospital Research Fellow
(1966 – 1968)
Princess Alexandra Hospital Visiting Surgeon (1987 –
Chairman Supervisory Current) Senior Research Fellow
(1968 – 1979)
Committee (1963 – 1983) Chairman (2003 – Current)
Chairman (1982 – 2002)
Project Co-ordinator
(1963 – 1981)

Centres for Health Research 2013 Annual Research Report
Aged Care and Telehealth
10 years of research in geriatric medicine at the PAH
CRGM Team
 The life expectancy of Australians is now among the state-of-the-art video-consulting suite, co-locates all
highest in the world. While this is a proud achievement staff for the first time in the seven year history of the
for our nation, with it comes the attendant risks of very group
old age: frailty, dementia, disability and dependence • Research income continues to escalate, derived from
on others in the last few years of life. The future of the four NHMRC grants, philanthropic research support
health system will increasingly be shaped by growing and contract work; for the first time, income exceeds
numbers of older people seeking diagnostic advice, $1 million
supervision of their medical care, and assistance with
• Several multi-site studies are coordinated,
daily tasks.
encompassing 15 Australian and 14 international sites
• The Centre’s first two PhD students successfully
From Academic Unit to Centre conclude their studies.
for Research in Geriatric Medicine 2009 also saw the CRGM commence an exciting program
of work to take specialist care into the residential aged
(CRGM)
care setting through telehealth. A demonstration project
The Academic Unit in Geriatric Medicine was established in a local nursing home used video-conferencing to
following the appointment of the Chair in Geriatric introduce a range of hitherto inaccessible specialties to
Medicine for The University of Queensland, Professor the bedside. CRGM developed quality indicators for care
Len Gray, in mid-2002. The Unit set out to build on the of older people in hospital and in post-acute home care,
excellent clinical and biological research already in place and demonstrated that assessments of people conducted
within the Geriatric and Rehabilitation Unit (GARU) of using a web-based assessment without any interaction
Princess Alexandra Hospital under the Directorship of Dr with the patient can be as precise as the more time
Paul Varghese. consuming in-person specialist consultations.
2009 was a landmark year for research in geriatric A five year NHMRC Program Grant conducted in
medicine at the Princess Alexandra Hospital: partnership with the University of Sydney and Flinders
University was concluded in 2012. It explored the
• The Unit is awarded School of Medicine ‘Centre’ status
effectiveness of Australia’s national home care program
by The University of Queensland: the Centre for
for older people discharged from hospital with complex
Research in Geriatric Medicine’s (CRGM)
needs – the Transition Care Program. The Centre is
• CRGM is officially launched by the Parliamentary a member of the first NHMRC Partnership Centre (in
Secretary, Murray Watt Dementia Care) which has a 5 year budget of $25 million.
• A move into purpose built facilities, incorporating a
Research - key to health