Clinical School newsletter

2013 - Issue 4

CHW Clinical School news

Congratulations to A/Prof Ben Marais: NHMRC excellence award winner

ben

Congratulations to Associate Professor Ben Marais, who has won a prestigious NHMRC Excellence Award. This year the National Health and Medical Research Council has presented 20 Excellence Awards to the highest ranking applicants in their funding schemes; award winners represent the top 20 of the 5,236 applications peer reviewed for funding in 2012. Ben was the top ranked Career Development Fellowship (CDF) – Category 1 applicant with the project, ‘Tuberculosis - transmission, drug resistance and strain emergence’.

The project is based on the premise that Australia has one of the lowest rates of tuberculosis (TB) in the world and the potential to eliminate transmission within its borders. This has particular importance because of the rapid emergence of drug resistant TB in the Asia-Pacific region, which is the source of most imported TB cases. We need to better understand how transmission occurs and the factors that facilitate transmission, and develop the capacity to track transmission.

The project will focus on the genomic variables that influence transmissibility by comparing major Mycobacterium tuberculosis (MTB) lineages. The project will: provide a highly discriminatory typing system for early detection and tracking of transmission events; improve our understanding of differences in transmissibility between strains and provide insight into the evolution of successful lineages; and provide scientifically valid estimates of TB transmission rates in Australia. As next-generation sequencing becomes accepted practice, combined genomic/epidemiologic approaches used in this project will be a critical step towards TB elimination in Australia and understanding of factors sustaining the global epidemic.

Clinical teacher profile: Dr Arany Nerminathan

arany

Dr Arany Nerminathan has had a longstanding interest in teaching and takes every opportunity to teach, be it at the bedside as informal teaching or presenting to larger audiences. Teaching is an integral part of her day-to-day work. She believes enthusiasm and giving students confidence is important to get the most out of them.

Arany enjoys interacting with medical students and watching their progression and improvement through the Child and Adolescent Health specialty block to become competent in dealing with children and recognising important aspects of paediatric practice. Arany has had the pleasure of following previous students from her tutorial groups through to becoming basic trainees in paediatrics. She believes there is no higher accolade than knowing you have influenced a student to pursue a career path in paediatrics.

Arany attended university in London and commenced her paediatric training there before moving to Sydney in 2009. Since then she has been affiliated with The Children’s Hospital at Westmead. Following on from her passion for teaching and advocacy, she is taking on the role as Chief Resident at CHW currently and into next year. She has thoroughly enjoyed the increased exposure to teaching through her role as the Discipline of Paediatrics and Child Health Academic Fellow, working with the Clinical School to develop teaching and learning materials, and run the end of block examinations. Arany wishes to continue to have a role in education in her long term career as a paediatrician.

Postcard from Paris: Dr Meg Phelps

Paris

"Let me say, first of all, that I know I’m very lucky to be spending a sabbatical here in Paris. It’s a wonderful opportunity to renew and strengthen links and friendships from when I worked here 25 years ago, and create new ones. Our first Sydney Medical School student is completing the Child and Adolescent Health (paediatric) term here; more about that in the future.

Université Descartes, Faculté de la Médecine, and their Dean, Professeur Patrick Berche, are proud of their increasing links with other countries. On 20 November I attended a meeting of the Commission de Rélations Internationales, chaired by Professeur Olivier Goulet, a paediatric gastroenterologist at Necker Children’s Hospital. I heard reports on their involvement in Europe’s Erasmus program (90 students hosted each year) and their summer Elective terms as well as other international projects. I am assisting at the moment with the selection process for English-speaking Elective terms, including for two students to come to The Children’s Hospital at Westmead in our winter 2014. Having for a long time resisted English-language encroachment, the French are now looking for opportunities to interact and improve their English.

There are many things that are so familiar about the French medical education system (strategic learners, timetabling challenges) and some that are very different (absence of clinical exams, three month terms, the focus on the national ranking exam). I look forward to more ‘cartes postales’ from Paris over the next nine months."

Paris3

Above: Some of the members of the Commission des Relations Internationales who met on 20 November 2013:
From left, Tamara Milosevic (Universite Descartes), Prof Bernard Chollet (Anaesthetics , Hôpital Européen Georges Pompidou), Charlotte Girard (Student representative), Prof Bertrand Devaux (Neurochiururgie, Hopital Sainte-Anne), Tiffen Jego (International Office Admin. Officer), Meg Phelps and on the far right, Alice Demarez (Universite Descartes).

paris2

Team CHW vs Kids on the Move – The Global Corporate Challenge

From 23 May to 11 September this year, two teams from the Children’s Hospital at Westmead Clinical School competed in the Global Corporate Challenge (GCC). More than 80 teams of University staff took part, capitalising on the strong links between health and wellbeing and physical activity. Over the 16 weeks, teams kept a record of their daily activity and charted their progress online. As well as competing against each other, the University teams were also competing collectively against other participating organisations across the world. The University was awarded the 3rd most active organisation in Australia in the Education and Training sector.

challenge

Team CHW

Our two teams were: ‘Team CHW (Children’s Healthy Walkers)’ and ‘Kids on the Move’. Right from the start there was great rivalry and competition between the teams, with Team CHW taking the lead from the start. Kids on the Move tried to catch up but they just didn’t have the stepping power to catch up to or overtake Team CHW.

 

Team CHW

Kids on the Move

Daily step average

11,095

9,480

Total steps over 16 weeks

8,687,755

7,110,033


Research news

Lancet profile on Prof Cheryl Jones

lancet

A profile on Professor Cheryl Jones was featured in the Lancet in September 2013, in an article titled Cheryl Jones: cracking mysteries in paediatric infection. The lancet profile traces Cheryl’s education, medical and research training and career achievements, before outlining the range of research projects in which Cheryl is currently involved. The profile finishes with glowing praise from Professor Kathryn North.

Hearing ear health and language services for Aboriginal children

HEALS

Dr Hasantha Gunasekera, Senior Lecturer in the Discipline of Paediatrics and Child Health, managed an exciting new initiative from NSW Health called HEALS (Hearing ear health and language services for Aboriginal children). The funding originated from the research project SEARCH (Study of Environment on Aboriginal Resilience and Child Health).

HEALS required collaboration with five Aboriginal Community Controlled Health Organisations throughout NSW: Aboriginal Medical Service Western Sydney in Mt Druitt, Tharawal Aboriginal Corporation in Campbelltown, Awabakal in Newcastle, Riverina Medical and Dental in Wagga Wagga and Illawarra Aboriginal Medical Service in Wollongong. HEALS was managed through the Sydney Children’s Hospitals Network (Westmead) with the assistance of the SAX institute.

Within a very tight timeframe of 17 weeks, HEALS managed to provide up to 28 sessions of speech therapy for 260 Aboriginal children. Many also received audiology assessments. Ninety-two ear nose and throat operations were undertaken through HEALS funding, including pre-operative and post-operative assessments.

All NSW Health targets were either achieved or, more commonly, exceeded and the feedback from the participating sites, families and schools was glowing. Hasantha is now working with the Rural Doctors' Network to ensure this one-off funding becomes recurrent in 2014 and beyond.

Debilitating childhood illness traced to antibody

The ground breaking research of Associate Professor Russell Dale and Dr Fabienne Brilot-Turville was featured on ABC TV’s 7.30 NSW on Friday 13 September 2013.

The item focused on Russell and Fabienne’s discovery of a D2R antibody that is causing a debilitating encephalitis-type illness in young children. The breakthrough poses hope for better treatments for a range of neurological and movement disorders.

Researcher profile: Prof Peter van Asperen

PVA

Professor Peter van Asperen has had an ongoing research interest and productivity since undertaking studies on ‘The development of atopy in infancy and childhood’, for which he was awarded an MD in 1987. His current research interest still lies in the development and management of asthma and the related diagnosis, assessment and management of cough in children. He has been a co-investigator on two recent NHMRC project grants in the area of cough: ‘Multicentre evaluation of a clinical pathway for the evaluation of chronic cough in children – can its use improve clinical outcomes?’ (2008-2010); and ‘Multicentre randomised controlled trial to improve the management of exacerbations in children with bronchiectasis’ (2012-2014).

Peter has supervised research in a variety of other respiratory related areas, including cystic fibrosis, chronic neonatal lung disease, exercise and novel lung function testing, which has formed part of five PhD theses. His clinical and research interests have resulted in over 170 publications and two books for parents on asthma in children.

Peter’s expertise in the area of asthma and cough in children has been recognised by invitations to be involved in national and international organisations dealing with asthma, allergic disease and cough. These have included the Thoracic Society of Australia and New Zealand, Australian Lung Foundation, NSW and Australian Asthma Foundations, National Asthma Council, ACI Respiratory Network, the International Paediatric Allergy and Immunology Society, and the Asia Pacific Association of Paediatric Allergy, Respirology and Immunology.

As Head of the Department of Respiratory Medicine at the Children’s Hospital at Westmead, he fostered the importance of research at all levels. The Children’s Chest Research Centre (now Respiratory Medicine Research) was established in 1998 with the appointment of a full time research coordinator, Dr Karen McKay, which resulted in significant improvement in research co-ordination and productivity in the Department, as well as involvement in multi-centre clinical trials and other collaborative research projects.

The Department’s research productivity was further enhanced with the appointment in 2003 of Associate Professor Hiran Selvadurai (the current Department Head) with a 50% research commitment. He has established important collaborative local and international research links related to his work in exercise physiology and exercise training programs in children with chronic diseases. The Department’s research productivity will be further enhanced by the recent appointment of Dr Paul Robinson, who has an interest in novel lung function testing techniques.

Early Career Researcher profile: Dr Kate Quinlan

"I am a research scientist and team leader within the Children’s Hospital at Westmead Clinical School (the University of Sydney). My lab is based within the Institute for Neuroscience and Muscle Research (INMR) at the Children’s Hospital at Westmead. I first joined the INMR in 2006, as a post-doctoral scientist fresh from my PhD at the University of Sydney. Thanks to an NHMRC CJ Martin Fellowship I spent two years at the University of Cambridge from 2008-2010 before returning to the INMR in 2010 to work with Professor Kathryn North. I started my own research team in 2013.

My major research interest is the ACTN3 gene, which encodes a skeletal muscle protein α-actinin-3. A common genetic change in the ACTN3 gene means that over 1.5 billion people worldwide do not express any α-actinin-3 protein. We have shown that ACTN3 genotype influences human elite athletic performance with α-actinin-3 deficiency being detrimental to sprint performance but beneficial to endurance performance. ACTN3 genotype is also associated with differences in muscle function in the general population. We have shown that α-actinin-3 deficiency has been positively selected in human evolution, suggesting that it was advantageous to not express this protein. Over the last few years we have addressed a number of fascinating questions, such as: Why is α-actinin-3 deficiency so common and what was the evolutionary advantage of not having this protein? What properties of muscle are different when there is no α-actinin-3 and what is the mechanism behind this? Is ACTN3 a genetic modifier of genetic muscle disease, muscle loss with age or muscle loss following inactivity?

A particular interest of mine has been the changes in muscle metabolism that occur in the absence of α-actinin-3 and we are now extending these studies to look at the effects of altered muscle metabolism on whole body metabolic processes such as weight gain and glucose metabolism.

I feel very lucky to work within a fantastic team of scientists and with a number of wonderful collaborators and to be able to satisfy my thirst for knowledge through my research."

Kate

Kate (far right) with colleagues

Medical education research update

Medical Education Research meetings are held on the first Tuesday of every second month from 12 to 1pm in the CHW Clinical School seminar room. The final meeting for 2013 will be held on Tuesday 3 December.

Meetings in 2014 will be held on:

  • 4 March
  • 6 May
  • 1 July
  • 2 September
  • 4 November

Please contact or if you would like more information.

DPCH staff have recently published the following journal article in medical education research:

Scott KM, Charles AR & Holland AJA. (2013) Clinical embryology teaching: Is it relevant anymore? ANZ Journal of Surgery 83, 709–712.

The following journal articles in medical education research have been accepted for publication:

Barrett J & Scott KM. (in press) Pedagogical and professional compromises by medical teachers in hospitals. Accepted by The Clinical Teacher.

McGarvey K, Scott KM & O’Leary F. (in press) ‘Round the table teaching’: A novel approach to resuscitation education. Accepted by The Clinical Teacher.

The following symposium and poster are being presented at conferences in November and December:

Lewis MJ, Scott KM & Calwell P (2013) Designer-writer-scholar: emerging frontiers for collaborative elearning scholarship? Symposium at Australian Society for Computers in Learning in Tertiary Education (ascilite) conference, 1 - 4 December, Sydney, Australia.

O’Leary F, McGarvey K, Scott KM & Lockie F (2013) ‘Round the table teaching’: A novel method for small group teaching using a simulated learning environment. Australasian College for Emergency Medicine 30th Annual Scientific Meeting, 24 – 29 November 2013, Adelaide.


Student news

Medical student profile: Victor Wu

Victor Wu is a final year medical student at the University of Sydney. He has recently completed his pre-internship in general paediatrics at the Children’s Hospital at Westmead. Earlier this year he undertook his clinical electives in paediatric emergency medicine at the Hospital for Sick Children, Toronto, Canada, and paediatric haematology/oncology at BC Children’s Hospital, Canada.

In addition to training in paediatrics, Victor is extensively involved in clinical research. He is currently a research assistant at the Australian Paediatric Surveillance Unit, which monitors rare childhood diseases at a national level. He is involved in international research and leads projects that highlight the burden of surgically correctable disabilities in Kenya and among Somali refugees. The latter has taken him to the Dadaab Refugee Camp to assist with work alongside the UNHCR. Prior to coming to Australia four years ago, Victor received his MSc in Health Research Methodology at McMaster University, Canada, where he engaged in research in intimate partner violence and the methodology of randomized surgical trials.

Wu

Victor and his wife, Ada, explore the sights of Sydney

When asked about how he arrived at this stage in his career, Victor notes that his life is a product of being vigilant in embarking on things that interest him: “I worked for free in many projects and in some of them I dialogued with individual donors to get them on board. Ease or personal gain was never a prerequisite, but if I believed something was worthwhile, I would just start running and see what happened. The results will often surprise you.”

Victor hopes to pursue a career in paediatrics or family medicine. He would welcome a career that allows him to be involved with clinical practice, research and teaching. His wife is a huge source of motivation for his work as she shares a desire to help others at an international level and keeps him interested in things outside of academia. They are regular moviegoers and she enjoys it when he cooks for her.

Congratulations Dr Emily Oates: Winner of the Dean's Publication Prize

Dr Emily Oates has been announced as this year's winner of the Dean's Publication Prize. This award follows on from other success for Emily, who has recently received the University of Sydney Medal for "Best overall presentation at the Australian Society for Medical Research New South Wales Scientific Meeting", as well as a prestigious Churchill Travelling Fellowship to fund travel to the USA and UK related to her research.

Emily

The Dean's Publication Prize is awarded to the Sydney Medical School student who published the best research paper in a peer-reviewed journal in the previous year. The award is up to $500 cash, plus $500 towards meeting registration or travel expenses to enable the student to present their research at a scientific meeting.

The purpose of these prizes is to encourage students to publish their research and to assist and encourage them to participate in scientific meetings early in their research careers. The title and abstract of the paper for which Emily received her award are: Oates, Emily. (2013), Mutations in BICD2 Cause Dominant Congenital Spinal Muscular Atrophy and Hereditary Spastic Paraplegia. The American Journal of Human Genetics, 92,1-9

Abstract: Dominant congenital spinal muscular atrophy (DCSMA) is a disorder of developing anterior horn cells and shows lower-limb predominance and clinical overlap with hereditary spastic paraplegia (HSP), a lower-limb-predominant disorder of corticospinal motor neurons. We have identified four mutations in bicaudal D homolog 2 (Drosophila) (BICD2) in six kindreds affected by DCSMA, DCSMA with upper motor neuron features, or HSP. BICD2 encodes BICD2, a key adaptor protein that interacts with the dynein-dynactin motor complex, which facilitates trafficking of cellular cargos that are critical to motor neuron development and maintenance. We demonstrate that mutations resulting in amino acid substitutions in two binding regions of BICD2 increase its binding affinity for the cytoplasmic dynein-dynactin complex, which might result in the perturbation of BICD2-dynein-dynactin-mediated trafficking, and impair neurite outgrowth. These findings provide insight into the mechanism underlying both the static and the slowly progressive clinical features and the motor neuron pathology that characterize BICD2-associated diseases, and underscore the importance of the dynein-dynactin transport pathway in the development and survival of both lower and upper motor neurons.

DPCH PhD students on ABC TV’s 7.30

Dr James Fitzpatrick, Professor Elizabeth Elliott’s PhD student and former DPCH academic fellow, was interviewed on ABC TV’s 7.30 on 12 September. James described the work he is doing on Marulu – the Lililwan Project on Fetal Alcohol Spectrum Disorder (FASD) with colleagues from the University of Sydney and George Institute, and Fitzroy Valley leaders, communities and families. They are working to identify the extent of FASD and educate families on how to prevent it. They are also advocating to have FASD officially recognised as a disability so families can receive financial support.

Also appearing in the report was Barbara Lucas, specialist paediatric physiotherapist, and Emily Fitzgerald, paediatrician, both involved in Marulu – the Lililwan Project, and PhD students of Elizabeth Elliott.

The 7.30 item and transcript are available on the ABC website.

On 15 October Elizabeth was interviewed on SBS TV’s Insight. The Insight item ‘Drinking when pregnant’, and transcript are available on the SBS website.

This program built on Elizabeth’s work on FASD, including the Lililwan Project and sensitively highlighted the challenges of children and families living with FASD.

fitzroyvalley

Grants, Achievements, Promotions and Titles

2014 NHMRC Grant announcement

Congratulations to Discipline of Paediatrics and Child Health staff who have received NHMRC grants this year.

Project Grants – CIA from SCHN:
Chief Investigators: Prof Adam Jaffe, Dr Thomas Snelling, Prof Gwendolyn Gilbert, A/Prof Stephen Lambert, Dr Melanie Wong
Project Title: Evaluation of the effectiveness of the 13-valent pneumococcal conjugate vaccine on pneumococcal serotypes causing pneumonia in children
Total Awarded: $1,091,024

Chief Investigators: Prof Ian Alexander, Prof Adrian Thrasher
Project Title: Reconstitution of B-cell ontogeny in Btk-deficient patient-derived CD34+ cells in a humanised mouse model: The foundations for an Australian XLA gene therapy trial
Total Awarded: $656,226

Chief Investigators: Prof Ian Alexander, Prof Andras Nagy, A/Prof Kevin Carpenter
Project Title: Development of a novel hybrid rAAV/transposon gene delivery system for life-long correction of metabolic liver disease in infants and children
Total Awarded: $489,169

Project Grants – CIA from external organisations:
Chief Investigators: Dr Rosemary Sutton, Dr Luciano Dalla-Pozza, A/Prof Tamas Revesz
Project Title: Improving risk evaluation and outcomes in paediatric acute lymphoblastic leukaemia
Total Awarded: $771,596

Chief Investigators: A/Prof Yves d'Udekem d'Acoz, A/Prof David Winlaw, Prof Paul Monagle, Dr Nadine Kasparian, A/Prof Michael Cheung,
A/Prof Robert Weintraub, Prof Igor Konstantinov, Dr Julian Ayer, Dr Mark Mackay
Project Title: Improving functional outcomes after Fontan surgery by a cross-sectional study of the outcomes following variation in practice in Australia and New Zealand: focus on anticoagulation and cardiac shunting by the fenestration
Total Awarded: $743,660

Chief Investigators: Dr Paul Baldock, Prof David Little, Dr Aaron Schindeler, Prof Peter Croucher
Project Title: Sclerostin and Dickkopf-1 in regulation of bone mass
Total Awarded: $617,562

Chief Investigators: Dr Steven Tong, Prof Stephen Locarnini, Dr Joshua Davis, A/Prof Gail Garvey, A/Prof John Condon, Dr Margaret Littlejohn, Dr Nicholas Wood, Dr Nadia Warner, Dr Renae Walsh
Project Title: A novel Hepatitis B virus genotype in Indigenous Australians: impact on vaccine efficacy and clinical outcomes
Total Awarded: $1,065,763

Chief Investigators: Prof Kathryn North, Prof David Bishop, Dr Stewart Head, Dr Kate Quinlan
Project Title: The effects of actinin-3 on muscle metabolism, human health and disease
Total Awarded: $621,894

Chief Investigators: Dr Helen Liley, A/Prof Rod Hunt, A/Prof Susan Jacobs, Prof Nadia Badawi, A/Prof Iona Novak, A/Prof Lisa Askie, A/Prof Malcolm Battin, Dr Rachel O'Connell
Project Title: Preventing Adverse Outcomes of Neonatal Hypoxic Ischaemic Encephalopathy with Erythropoietin: A Randomised Controlled Multicentre Australian Trial
Total Awarded: $2,010,583

Chief Investigators: Prof Rebecca Ivers, Prof Andrew Holland, Prof Roy Kimble, Prof Kathleen Clapham, Doctor Serigne Lo,
Dr John Daniels Redfern, Ms Delia Hendrie
Project Title: Understanding burn injuries in Aboriginal and Torres Strait Islander children: treatment, access to services and outcomes.
Total Awarded: $872,801

Partnership Grant:
Chief Investigators: Prof Jeffrey Braithwaite, Prof Adam Jaffe, Prof Les White, Prof Chris Cowell, Prof Mark Harris
Project Title: The appropriateness of healthcare delivered to Australian children: CareTrack Kids
Total Awarded: $1,263,318

Practitioner Fellowships:
Chief Investigator: A/Prof Russell Dale
Total Awarded: $387,432

Career Development Fellowships:
Chief Investigator: Dr Nicholas Wood
Total Awarded: $283,419

New titles

Manasee Bidarkar - Clinical associate lecturer
Elizabeth Ellis – Clinical associate lecturer (dual appt with Disc Genetic Medicine)
Kasia Koslowska – Clinical associate professor
Sarath Narayanan – Clinical associate lecturer
Ruth Lollgen – Clinical lecturer


Conferences

Upcoming conferences and meetings


2013

DECEMBER
Commonwealth Association of Paediatric Gastroenterology and Nutrition 2013
Further information. Submit your best research to present at the unique event via email to

2014

JANUARY
4th Annual Winter Symposium in Intensive Care & Emergency Medicine: Colorado - 5-10/01/2014
Contact: or visit the website

MARCH
‘Revalidation’ Conjoint Medical Education Seminar: Melbourne - 14/03/2014
The Royal Australasian College of Physicians (RACP), the Royal Australasian College of Surgeons (RACS) and the Royal College of Physicians and Surgeons of Canada (RCPSC) are holding a one day seminar on Friday, 14 March 2014 at the Hilton on the Park, Melbourne to explore the concept of ‘Revalidation’. The registration link for this conference will be posted on the RACP website in due course, but at this time please save the date.

APRIL
INTASE Educational Leadership Summit: Singapore - 16-17/04/2014
Register before February 2014 and receive $140 off your seat. For more information please visit the INTASE website.

JUNE
5th International Conference on the Development of Bioengineering in Vietnam: HO Chi Minh City – 16-18/6/2014
The Conference will bring together researchers and scientists from advanced and emerging countries to discuss problems and solutions, identify challenges and shape future research directions.
More information

OCTOBER
International Conference on Residency Education: Canada - 23-25/10/2014
For more information visit the Royal College of Physicians and Surgeons of Canada website or .