CHARM Invited Speakers

Walter Abhayaratna

Professor Walter Abhayaratna

Clinical Trials Unit Director, Consultant Cardiologist and Clinical Director of Medicine, Canberra Hospital and Health Services, Professor, ANU Medical School

The mystery of heart failure with preserved ejection fraction

Clinical trials have not been able to identify therapeutic options for the management of heart failure with preserved ejection fraction. During this presentation, the lessons learned from these trials will be reviewed, and future therapeutic options for heart failure with preserved ejection fraction will be discussed.

Prof Walter Abhayaratna is a senior staff specialist, consultant cardiologist and Clinical Director of Medicine, Canberra Hospital and Health Services. His PhD at the Australian National University was in the field of cardiovascular epidemiology and echocardiography, and he completed a 3-year fellowship in the Echocardiography Laboratory at Mayo Clinic, Rochester, USA. He holds a number of National Health and Medical Research Council research grants for clinical research into the prevention of cardiovascular disease and is the Director of Clinical Trials at ACT Health. He is Professor of Cardiovascular Medicine at the Australian National University.


Prash Sanders

Professor Prashanthan Sanders

Director of Cardiac Electrophysiology and Pacing, Royal Adelaide Hospital; Director for Heart Rhythm Disorders, University of Adelaide Medical School and Group Leaders for Heart Rhythm Disorders, South Australian Health and Medical Research Institute

Risk factor modification to treat and manage Atrial Fibrillation

Atrial fibrillation (AF) is reaching epidemic proportions affecting over 33 million individuals worldwide. With the rise in obesity recent data has demonstrated a strong correlation between obesity AF, and the related risk factors. Several studies have shown that the significant impact of undertaking dedicated clinics that focus specifically on weight loss, improved exercise and management of associated risk factors. These clinics lead to a marked reduction not only in AF symptoms and recurrence but there is also an overall improvement in ablation outcomes.

Professor Prash Sanders is a clinical and academic electrophysiologist. He undertook his Cardiology training at the Royal Adelaide Hospital, electrophysiology and doctoral training at the Royal Melbourne Hospital, before taking up a postdoctoral training in Bordeaux, France. Professor Sanders was appointed to the Knapman-National Heart Foundation Chair of Cardiology Research at the University of Adelaide and as Clinical Director of Cardiac Electrophysiology at the Royal Adelaide Hospital in 2005. He has since established an internationally recognised electrophysiology laboratory and research group which is at the forefront of strategies for the treatment and management of atrial fibrillation. Professor Sanders is an NHMRC Practitioner Fellow and has published >300 peer-reviewed publications. He has received a variety of accolades including being named the 2010 Australian Medical Researcher of the year under the age of 40, receiving a NHMRC Achievement award for the highest ranked Practitioner Award in 2013, and most recently the RT Hall Prize from the Cardiac Society of Australia and New Zealand in 2015.


Rajeev Pathak

Associate Professor Rajeev Kumar Pathak

Cardiologist and Cardiac Electrophysiologist, Canberra Hospital and Health Services and National Health and Medical Research Council Neil Hamilton Fairley Fellow, The Australian National University

Risk Prediction for Sudden Cardiac Death in Non-Ischaemic Cardiomyopathy

Sudden cardiac death (SCD) accounts for approximately one-third of all deaths among patients with non-ischaemic cardiomyopathy (NICM). Implantable cardioverter-defibrillator (ICD) therapy has been the primary intervention for managing individuals at high risk for SCD. However, individual ICD trials in the NICM population have failed to demonstrate a mortality benefit with prophylactic ICD implantation. Current guidelines recommend ICD implantation in NICM patients with symptomatic heart failure and a left ventricular <_35% and are based on meta-analyses of multiple trials that span almost three decades. A refined approach of risk stratification that selects patients at the highest risk for SCD may lead to a significant improvement in ICD efficacy. This talk highlights some key markers of arrhythmia risk that hold promise in personalizing risk stratification for SCD.

Dr Pathak is a clinical academic who has recently been appointed as the Lead of clinical services for Cardiac Electrophysiology at The Canberra Hospital. He undertook Physician and Cardiology training at The Canberra Hospital. He then completed his sub-specialist training in Cardiac Electrophysiology at the Royal Adelaide Hospital. During this time, he also completed his PhD under the mentorship of Professor Prash Sanders through the University of Adelaide. His PhD comprised of a series of studies entitled “Aggressive Risk Factor Reduction Study for Atrial Fibrillation (ARREST-AF)” that were awarded several accolades including Eric Prystowsky Clinical Research award at Heart Rhythm society (2014), 3 Late breaking trials in international Cardiology scientific meetings, Ralph Reader Award at the Cardiac Society of Australia and New Zealand and Samuel A. Levine Young Investigator Award at American Heart Association. He was honoured with Young author achievement (William W. Parmley Award) at the American College of Cardiology.

Following this, Dr Pathak was awarded Neil Hamilton Fairley Fellowship by National Health and Medical Research Council and Bushells Fellowship by Royal Australasian College of Physician (RACP) to join highly prestigious Electrophysiology Fellowship program at the Hospital of University of Pennsylvania, USA under the mentorship of Professor Francis Marchlinski. Dr Pathak developed a significant expertise in devices and complex catheter ablation techniques for a variety of atrial and ventricular arrhythmias. During his fellowship, he published avidly in this clinical area and has been recognized as an emerging leader by all major cardiovascular societies such as American College of Cardiology, American Heart Association, Heart Rhythm Society and Cardiac Society of Australia and New Zealand.

Dr Pathak has returned to Canberra in 2017 to build the Electrophysiology services at the Canberra Hospital. He has brought the expert knowledge, skills and ongoing collaborations acquired during his fellowship that he is committed to use towards strengthening Australian cardiovascular research. His interests are in all aspects of clinical Cardiology with a particular focus on complex atrial and ventricular arrhythmias along with other comorbidities such as structural, functional and congenital heart diseases. He undertakes pacemaker, cardiac defibrillator implantation, cardiac resynchronization, electrophysiology studies and ablation of complex atrial and ventricular arrhythmias.


Professor Ross Hannan

Professor Ross Hannan

Executive Director of Research, ACT Health, Centenary Chair in Cancer Research, JCSMR, The Australian National University

​Novel approaches to treat cancer and bone marrow failure syndromes based on the targeting the ribosome

Professor Hannan will discuss his latest research findings on how the nucleolus the site of ribosome biogenesis, is providing new therapeutic approaches to treat cancer and bone marrow failure syndromes.

Professor Hannan is a NHMRC Senior Principal Research Fellow, ANU Foundation Centenary Chair in Cancer Research, Head of the Department of Cancer Biology and Therapeutics at John Curtin School of Medical Research, ANU, Canberra, a group leader at the Peter MacCallum Cancer Centre, Melbourne and Executive Director -  Research, ACT Health. Professor Hannan’s research career spans over 20 years of internationally competitive research in Australia and the USA working on the genetic and epigenetic regulation of cancer. Most recently he brought together multi-disciplinary teams of laboratory and clinician researchers and forged industry collaborations to devise ‘first in class’ cancer therapies that are now in clinical trials for a range of human cancers.

Professor Hannan’s achievements have been recognised by his election to the Fellowship of the Australian Academy of Health and Medical Sciences (2017).

In 2017 he was appointed as a Director of the National Breast Cancer Foundation (NBCF) and Chair of the NBCF Scientific Advisory Board.

As Executive Director of Research, ACT Health, Professor Hannan is focused on effective translation of research from fundamental science to the clinical practice; improving patient outcomes by strengthening health services, clinical research, and clinical trials; growing and unlocking health opportunities with data science; and improving investment opportunities for ACT Health Innovations.

 


Mark Daniel

Professor Mark Daniel

Professor of Epidemiology, Health Research Institute, University of Canberra; Professorial Fellow, Department of Medicine, St Vincent’s Hospital, The University of Melbourne; Senior Principal Research Fellow at the South Australian Health and Medical Research Institute

Geospatial analysis for cardiovascular disease prevention in a population context

Geographic information systems (GIS) can aid the identification of environmental factors that shape population risks, morbidity and mortality. Geospatial analysis is the sine qua non for seeing lifestyles as the intersection of environments and behaviour. GIS remains, however, underused in prevention science and policy decisions. This presentation will (i) cover the application of GIS to cardiovascular disease (CVD), (ii) distinguish environmental risk conditions for CVD from individual CVD risk factors, (iii) illustrate research on built and social environmental associations with CVD, and (iv) showcase new and novel aetiological research on ecological mechanisms of environmental effects. Current advances in the development of a national Australian GIS infrastructure will be covered, drawing a prototype originally developed and integrated into the public health service in Montreal, Canada.

Mark Daniel is Professor of Epidemiology in the Health Research Institute, University of Canberra where he leads the Spatial Epidemiology Group. He is concurrently appointed Professorial Fellow in the Department of Medicine, St. Vincent’s Hospital, the University of Melbourne, and Senior Principal Research Fellow at the South Australian Health and Medical Research Institute.

Mark earned a doctorate in Health Care & Epidemiology at the University of British Columbia and was exposed to Australia as an MRC Canada Postdoctoral Fellow in Epidemiology and Preventive Medicine at Monash University. He has since held faculty appointments at the University of North Carolina at Chapel Hill and Université de Montréal (Canada Research Chair in Population Health). He returned to Australia in 2008, joining the University of South Australia as Research S.A. Chair: Social Epidemiology and then the University of Canberra in 2017. He has authored 180 refereed articles and 21 book chapters. He has been a chief investigator on 91 grants in excess of $67.5 M, from the Centers for Disease Control, National Institutes of Health, Canadian Institutes of Health Research, Canada Foundation for Innovation, National Health and Medical Research Council of Australia and Australian Research Council. He has led 30 grant-funded projects.

Mark’s research aims to identify the drivers and multi-sectoral levers for policy and practice-level intervention to reduce risk factors and slow rising rates of chronic diseases. For 18 years, he has utilised geographic information systems in spatial analyses of social and built environmental conditions, lifestyle risks, biochemical markers and cardiometabolic diseases, mental health disorders, adverse birth outcomes, HIV/AIDS, hepatitis C and mortality. Most of this work aims at knowledge translation for improved disease prevention via partnerships with stakeholders including community leaders, health professionals, and policy makers.


Matthew Cook

Professor Matthew Cook

Director of Immunology ACT Health, Professor of Medicine, The Australian National University Medical School, and Director of the Centre for Personalised Immunology, John Curtin School of Medical Research, The Australian National University

The future of personalised medicine in chronic conditions management

Personalisation of medical diagnosis and treatment has been made feasible by tremendous progress in next generation sequencing, matched by advances in bioinformatics analysis of the substantial datasets of genome variants that result from whole exome and whole genome sequencing (WES and WGS). We now have numerous proof-of-principle cases where elucidation of a single novel variant reveals mechanism of disease, and in some cases, identifies a precision therapy. This represents substantial progress towards personalised medicine. The majority of human morbidity and mortality is not accounted for by single gene defects, however, and the transition to personalised medicine will not be universal. I will provide a theoretical framework for the nature of phenotypic variation, and build on this with examples from disease of immunity to outline how we might start to apply the principles of personalised medicine to common disease.

Matthew Cook is Professor of Medicine at the Australian National University (ANU), Director of Immunology at Canberra Hospital and Director of the Centre for Personalised Immunology, a National Health and Medical Research Council Centre of Research Excellence. He is also founder Canberra Clinical Genomics, a joint venture between ACT Health and ANU. He is a clinician-scientist with more than 20 years’ experience investigating the pathogenesis of human immunological disease, and more recently, has investigated genome variation as a discovery platform for understanding human immune disease.


Nigel Lovell

Scientia Prof Nigel Lovell

Graduate School on Biomedical Engineering, UNSW Sydney

The future of chronic disease management – the role of wearables, implantables and data analytics

As a response to the increasing burden of chronic disease and the ageing population on health care expenditure, considerable focus has been placed on appropriate technologies for promoting self-care and for supporting ageing-in-place.

A number of medical device technologies aimed at relieving the burden of disease and improving quality of life will be explored. These devices, developed at the Graduate School of Biomedical Engineering, UNSW over the past two decades include telehealth monitoring and decision support systems for chronic disease management; and wearable ambulatory technologies based around triaxial accelerometry for estimating risks of falling and for automatically detecting falls.

A vision of how an existing telehealth framework would support data monitoring from wearable devices as well as other telecare sensors is presented. Looking further to the future, we also propose a model of how this architecture would integrate control and measurements to and from fully implantable bionic devices in order to provide ubiquitous personalised care.

Nigel Lovell received the B.E. (Hons) and Ph.D. degrees from the University of New South Wales (UNSW), Sydney, Australia. He is currently Head of the Graduate School of Biomedical Engineering UNSW Sydney where he holds a position of Scientia Professor and Head of School. He has authored 250+ journal papers and been awarded over $80 million in R&D and infrastructure funding. He is a Fellow of seven learned academies throughout the world.

His research work has covered areas of expertise ranging from cardiac and retinal modelling, telehealth technologies, biological signal processing, and visual prosthesis design. Through a spin-out company from UNSW, TeleMedCare Pty. Ltd., he has commercialised a range of telehealth technologies for managing chronic disease and falls in the older population. He is also one of the key researchers leading an R&D program to develop in Australia a retinal neuroprosthesis or ‘bionic eye’.

He has been conference or scientific chair of half a dozen international conferences including the triennial World Congress of Medical Physics and Biomedical Engineering in Sydney in 2003. For 2017 and 2018 he is the President of the world’s largest biomedical engineering society – the IEEE Engineering in Medicine and Biology Society.


Gordon Waddington

Professor Gordon Waddington

Professor of Physiotherapy, University of Canberra; Research Professor of Sports Medicine, Australian Institute of Sport

Lower Limb Somatosensory Assessment: Measuring tactile and proprioceptive ability using an active movement extent discrimination approach. What is the link to walking on Mars?

This presentation will examine human Somatosensation from the basis of our group’s research and why the AMEDA (Active Movement Extent Discrimination Assessment) approach is potentially the most valid mechanism of assessing dynamic proprioception? Aspects of talent identification, performance enhancement/injury prevention will be examined and the current application for human undertaking long periods of microgravity exposure such as on a Mars space flight will be discussed.

Gordon Waddington holds the conjoint appointments of Research Professor of Sports Medicine at the Australian Institute of Sport and Professor of Physiotherapy at the University of Canberra. Professor Waddington has established a reputation as an international expert in the field of human somatosensory performance incorporating proprioceptive and tactile function. This work has led to more than a dozen invited lectures and keynote presentations in this area in the last five years. His group has published more than 60 publications during this time in the top ranked journals in the field, such as the British Journal of Sports Medicine, The Scandinavian Journal of Science and Medicine in Sport and the Journal of Science and Medicine in Sport. The multidisciplinary research team Professor Waddington currently leads comprises researchers from human performance sciences, a biostatistician and an epidemiologist and supports 11 PhDs and two Masters’ students and is currently undertaking ongoing research collaborations with a number of international and national partners. Within Australia, the team partners with the ANU, the Australian Institute of Sport, the Queensland Academy of Sport and the NSW Institute of Sport examining the development of proprioceptive ability during growth and development and its contribution to injury risk in athletic populations. Internationally the centre has projects with the European Space Agency, the Wingate Institute in Israel, the University of Nottingham and NASA, to determine mechanisms to reduce the loss of somatosensory function with exposure to microgravity.


Josephine Forbes

Professor Josephine Forbes

Professor of Medicine, University of Queensland, Principal Research Fellow, Department of Medicine, University of Melbourne

How advances glycation of food by modern processing techniques and storage may be contributing to our diabetes epidemic

Advanced glycation end products (AGEs) are sugar modifications to proteins formed in the body. AGEs can also be absorbed from dietary sources, in particular from westernised diets as a result of modern food processing, storage and choice of cooking method. AGEs are arguably best studied in diabetes complications where increased burden of AGEs in the body, measured at sites such as the skin and in the blood, can predict the later onset of diabetic complications. Recently, however, there has been a paradigm shift which suggests that AGEs, including those from dietary sources may be direct modulators of insulin secretion and peripheral insulin sensitivity and as such, may play a crucial role in the development of both major forms of diabetes per se.

Prof Forbes completed her PhD in Paediatric Nephrology in 2000 at the University of Melbourne and Royal Children’s Hospital in Melbourne, Australia. She then continued her training as a post-doctoral fellow in diabetes and kidney disease at both Austin Health and Baker IDI Heart and Diabetes Institute in Melbourne, Australia. Currently she is a Professorial Research Fellow at Mater Research Institute-UQ in Brisbane, Australia where she also leads the Chronic Disease Biology and Care Program. She holds/has received research grants from National Health and Medical Research Council of Australia, Kidney Health Australia, National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases and the Juvenile Diabetes Research Foundation. She is board member of the Australian Diabetes Society the outgoing co-chair of the Diabetes Australia Research Program and an elected fellow of the Queensland Academy of Arts and Science.

Her work to date has resulted in more than 150 publications in highly ranked journals which have been cited more than 9000 times. Her primary research focuses on the pathological mechanisms that contribute to diabetes and its complications including advanced glycation and mitochondrial energy production. This is with a view to designing and translating therapies to combat these diseases. She has received numerous awards for her research including the Commonwealth Health Minister’s Award for Excellence in Medical Research in Australia and a Young Researcher Award from the International Diabetes Federation.


Jeffrey Braithwaite

Professor Jeffrey Braithwaite

Professor of Health Systems research, Founding Director, Australian Institute of Health Innovation, Director, Centre for Healthcare resilience and Implementation Science, Macquarie University

Health services conceptualised as complex adaptive systems

People have tried to improve the care given to patients suffering from chronic conditions by many methods, including promoting health and healthy behaviours; improving the availability of community and GP services; making assistive devices available; and providing community resources. Implementation of these and other strategies has often taken a linear approach—issue more policy, institute a new service, trial and then prescribe another drug, for example. But linear approaches do not work well on complex problems, for people with complex conditions, or in complex contexts. This means we have to understand how health services are not amenable to linear, step-wise solutions but are better conceptualised as complex adaptive systems. This talk uses recent ideas about complexity science to appreciate this point and argues for a better approach to managing chronic conditions and illness.

References

Braithwaite J, Churruca K, Long JC, Ellis LA, Herkes J. When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Medicine. 2018; 16(63).

Braithwaite J. Changing how we think about healthcare improvement. The BMJ. 2018; 361.

Professor Jeffrey Braithwaite, BA, MIR (Hons), MBA, DipLR, PhD, FAIM, FCHSM, FFPHRCP (UK), FAcSS (UK), Hon FRACMA, FAHMS is Foundation Director of the Australian Institute of Health Innovation, Director of the Centre for Healthcare Resilience and Implementation Science and Professor of Health Systems Research, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. He has appointments at six other universities internationally, and he is a board member and President Elect of the International Society for Quality in Health Care and consultant to the World Health Organisation.

His research examines the changing nature of health systems, which has attracted funding of more than AUD $110 million. He is particularly interested in health care as a complex adaptive system and applying complexity science to health care problems.

Professor Braithwaite has contributed over 900 total publications and presented at international and national conferences on more than 900 occasions, including 90 keynote addresses. His research appears in journals such as The BMJ, The Lancet, Social Science & Medicine, BMJ Quality and Safety, and the International Journal for Quality in Health Care. He has received 39 different national and international awards for his teaching and research.


Walter Abhayaratna

Professor Walter Abhayaratna

Clinical Trials Unit Director, Consultant Cardiologist and Clinical Director of Medicine, Canberra Hospital and Health Services, Professor, ANU Medical School

Clinical Trials – emerging methods

Randomised clinical trials, designed to enhance the internal validity of clinical experimentation, have been the mainstay of evidence based medicine over the past seven decades. Innovations in clinical trials methodology and contemporary challenges to clinical trials investigators are reviewed.

Prof Walter Abhayaratna is a senior staff specialist, consultant cardiologist and Clinical Director of Medicine, Canberra Hospital and Health Services. His PhD at the Australian National University was in the field of cardiovascular epidemiology and echocardiography, and he completed a 3-year fellowship in the Echocardiography Laboratory at Mayo Clinic, Rochester, USA. He holds a number of National Health and Medical Research Council research grants for clinical research into the prevention of cardiovascular disease and is the Director of Clinical Trials at ACT Health. He is Professor of Cardiovascular Medicine at the Australian National University.


Bruce Shadbolt

Associate Professor Bruce Shadbolt

Director of Research, ACT Health; Associate Professor, The Australian National University Medical School and School of Finance, Actuarial Studies and Statistics

Enabling research in Health Care: Adding value to diverse data sets

One of our most immediate challenges in healthcare is to develop new approaches to research that better use data to support clinical practice. The complexity of care and an increasing societal problem of an aging population provides an ideal platform upon which to advance unique multidisciplinary research approaches. Current patient and research data limits most of the human-machine solutions to activity and behaviours. We need to go further by introducing concepts of wellbeing, personal values and judgements into algorithmic research translations that span philosophy, linguistics, psychology, demography, epidemiology, sociology, economics, and data science.

We are developing a model that incorporates qualitative, quantitative, experimentation and data science methods with technology to create “real-world” learning algorithms that address societal concepts and practical issues to provide views of probable scenarios, choices and outcomes in health care systems – the ultimate in research translation. These futuristic human-research-machine principles and taxonomy structures will achieve real-time research translation. A new technological process for predictive modelling of tacit and explicit knowledge classifications will significantly change the landscape of how research and personal data are used in person-centred care.

Dr Shadbolt has combined a career in healthcare services with research to lead the epidemiological direction of ACT Health in the Australian Capital Territory. With university qualifications in science, psychology, mathematics and epidemiology, Dr Shadbolt has a broad understanding of research and its role in healthcare delivery. His PhD in women’s health and social roles using a life course design paved the way for the Australian Women’s Longitudinal Study and changes to family and work legislation to support better family-work balance. His research with the Australian National University and ACT Health has primarily focused on using evaluation, research and data science skills to improve clinical practice. As part of this, evidence-based medicine and translating new evidence into clinical care have been paramount to Dr Shadbolt’s endeavours.