NEWSLETTER OF CHILDREN'S HOSPITAL WESTMEAD CLINICAL SCHOOL, AND THE SPECIALTY OF CHILD & ADOLESCENT HEALTH
November 2020
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Welcome
Precision medicine is a reality and happening here and now.
Congratulations are due to a number of our academics and affiliates in today's newsletter. This is the time of year when promotion outcomes are released, and Natalie Lister and Samantha Lain were successful in their application to Level C, Senior Lecturer. Many congratulations to them. More information and other success stories are below.
Today, I wanted to focus on the story about Louise Tofts contributing to a game changing study in achondroplasia, published in the Lancet. Because The Children's Hospital at Westmead contributed the most patients internationally, Louise was granted second authorship. This is an amazing story, and a story about precision medicine. When I was a green paediatrician in training, achondroplasia was a clinical syndrome, with no gene and no treatment other than supportive. Other than short stature, achondroplasia is associated with very significant complications including spinal cord problems and paralysis related to bony issues. In 2020, we now know the genomic cause (growth factor related), and this clinical trial definitely shows a major therapeutic benefit by reducing the overactivity of this gene, resulting in restoration of growth velocity. It will become clear if the drug also reduces the complications of this disorder. This is PRECISION MEDICINE, and only science and research can produce these outcomes. I, for one, am inspired...please read on.
Professor Russell DALE
Head, Children’s Hospital Westmead Clinical School
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Congratulations to Dr Hiba Jebeile
Congratulations to new PhD graduate, Dr Hiba Jebeile, who took part in the virtual graduation at the University of Sydney on 3rd September 2020.
Hiba, who is a dietitian, undertook PhD studies supervised by Prof Louise Baur, A/Prof Sarah Garnett and Drs Natalie Lister and Megan Gow. Her PhD thesis, entitled “Dietary interventions and psychological risk in adolescents with obesity”, addressed the use of novel dietary interventions in the treatment of adolescent obesity, and the association between paediatric obesity treatment and psychological health. Hiba (Dr Jebeile!) published several research papers during the course of her candidature, and also presented at a variety of national and international forums. This included an invited plenary presentation at the US Obesity Week in Las Vegas in November 2019. Hiba’s work falls across the traditional divide of obesity and eating disorders and hence has been especially important in advancing the links between these two areas. Hiba is currently a Post-Doctoral Fellow within the CHW Clinical School, continuing her work in this important area.
Hiba is seen celebrating her PhD graduation at The Children’s Hospital at Westmead with her colleagues Eve House, Sarah Garnett, Natalie Lister, Johanna Hoare and Louise Baur.
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Congratulations to Associate Professor Peter Malouf
Associate Professor Peter Malouf, our Head of Indigenous Health in SMS, and a proud Wakka Wakka and Wuli Wuli man, is a highly recognised public health researcher and experienced health system executive, with experience in applied research and program evaluation focusing on health service, primary care and mental health service delivery in Aboriginal and Torres Strait Islander communities. In recognition of his skills, Peter has been appointed by Robert Skeen, CEO, Aboriginal Health and Medical Research Council NSW (AHMRC NSW) as the Director of Operations to support Aboriginal Community-Controlled Health Sector development across NSW. Peter will spend four days a week in this role for the next 12 months, while continuing to work for the University as Head Indigenous Health role (0.2 FTE). Peter’s experience will strengthen the sector in optimising improved regional health outcomes for Aboriginal and Torres Strait Islander patients across NSW. It will also help SMS achieve our goal of better-established partnership and connection with the Aboriginal Community-Controlled Health Sector. We congratulate Peter for this great honour.
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Congratulations to Research Fellow Cristyn Davies
Well Played: Young, Proud and Active wins Positive Media Award at Australian Pride in Sport Awards
On 30th September, the 2020 Australian Pride in Sport Awards, which celebrate LGBTQ inclusion achievements within Australian sports for all National and State level sporting codes including grassroots clubs, were held in Sydney. The awards acknowledge achievement within the Pride in Sport Index (PSI), Australia’s national benchmarking instrument for the inclusion of people with diverse sexualities and genders within Australian Sport, endorsed by Sport Australia and the Australian Human Rights Commission.
Research Fellow, Cristyn Davies, from the Specialty of Child and Adolescent Health and ABC 730 journalist, Mon Schafter, were awarded the Positive Media Award for Well Played: Young Proud and Active. Well Played features five young gender and sexuality diverse people who talk openly about some of the challenges of their personal journeys and the benefits of participating in sports and physical activity including powerlifting, ballet, roller derby, Aussie rules and rugby union. Well Played was specifically designed to counter discrimination on the basis of sexuality and gender diversity, and to reach young people via social media.
Cristyn and Mon designed the inclusion campaign, and wrote and produced a short film for Twenty10 In GLCS NSW, a service providing specialised services for young LGBTIQ+ people aged 12-25 years. The young participants in the film highlight barriers they have faced and also share the impact of positive experiences of inclusion and belonging in sport. Well Played draws attention to the stigma, discrimination, homophobia and transphobia that young people can experience in sporting cultures and environments, while also showcasing the impact of inclusive practices in the context of community sport.
The film calls on sporting organisations to be inclusive of gender and sexuality diverse people, and to implement policies that facilitate best practice. Exclusion from physical activity carries substantial risk to health and wellbeing, with potential mental and physical health implications over a lifetime. Access to physical activity and recreation is upheld as a human right in the United Nation’s Charter on the Rights of the Child.
Well Played was launched by Australian Human Rights Sex Discrimination Commissioner, Kate Jenkins, and the film’s transgender and gender diverse participants’ stories are featured as part of Sport Australia’s Transgender and Gender Diverse Inclusion in Sport resources.
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Congratulations to Samantha Lain
Dr Samantha Lain, a perinatal epidemiologist with the Child Population and Translational Health Research team at CHW Clinical School, has been awarded a promotion to Level C – Senior Lecturer/ Senior Research Fellow. Her research uses linked population-based datasets to examine the short and long-term health and health service utilisation of children with chronic conditions to inform paediatric healthcare, guidelines and policies. She has collaborated with various groups at CHW including NSW Newborn Screening Program to use their data linked with NAPLAN data to show abnormal thyroid-hormone levels at birth was associated with poor reading and numeracy results at school age.
Dr Lain is currently working with Kim Donaghue, Maria Craig and Alison Pryke from the endocrinology team to follow-up children with childhood-onset type 1 diabetes attending CHW clinics since 1990 to explore their risk of diabetes-related complications in adulthood funded by a DART Australia grant. Dr Lain is also collaborating with investigators from across SCHN, including the Heart Centre for Children and VCCRI who were recently awarded a NHMRC Synergy grant to examine long term health and neurodevelopmental outcomes for children diagnosed with congenital heart defects.
Congratulations to Natalie Lister
Dr Natalie Lister was recently awarded a promotion to Level C, Senior Lecturer. Natalie is an NHMRC Peter Doherty Early Career Fellow and research dietitian. Her research is practice-led, investigating dietary interventions that will prevent and manage obesity, diabetes, and cardiovascular risk in children and adolescents. Other research interests include the safety of dietary interventions for adolescents with obesity, and investigating personalised approaches to diet.
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Congratulations to Elizabeth Elliott
Congratulations to Elizabeth Elliott on her below recent successes;
Vernon Collins Medallist
Elizabeth Elliott was awarded the Vernon Collins Medal from the Royal Children’s Hospital Melbourne and delivered the Oration by Zoom in October.
Vernon Collins (1909-1978), was a prominent paediatrician who was appointed as the first Medical Director of the Royal Children’s Hospital in Melbourne in 1946 and the first Stevenson Chair of Child Health (later Paediatrics) at the University of Melbourne in 1959. He is remembered as an administrator, who advocated for senior, salaried staff in place of the system of honorary medical officers; liberalised parent visiting; and introduced play rooms and family accommodation at the hospital; and as a mentor and teacher.
Recent previous Orators include Dame Quentin Bryce, Justice Jennifer Coate, Professor Dinah Reddihough, Professor Sandra Eades, and John Daley CEO of the Grattan Institute.
Election to the Council of the Australia Academy of Health and Medical Science (AAHMS)
Elizabeth Elliott has been elected a member of the Council of the AAHMS. “The Australian Academy of Health and Medical Sciences is the impartial, authoritative, cross-sector voice of health and medical science in Australia. It is an independent, interdisciplinary body of 426 Fellows – elected by their peers for their outstanding achievements and exceptional contributions to health and medical science in Australia. Collectively, they are a representative and independent voice, through which we engage with the community, industry and governments.” The current President is Professor Ingrid Scheffer AO and the Past President Professor Ian Frazer AC. Read more at https://aahms.org/.
Appointment as Co-Chair to the Australian Government’s National Fetal Alcohol spectrum Disorder Advisory Group
Elizabeth Elliott has been appointed Co-chair of the National FASD Advisory Group (the FASD Advisory Group) whose role is to advise the Australian Department of Health on national strategy and to monitor the implementation of the National FASD Strategic Action Plan 2018-28.
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SMS 'Specialities" to replace 'Disciplines'
The establishment of the Faculty of Medicine and Health (FMH), and the conversion of SMS into a school of FMH which oversees clinical schools and the Education Office, meant we could no longer incorporate “Disciplines” into the formal organisational structure of SMS. The Disciplines however play a vital role in linking our medical specialty (or subspecialty) craft groups with the activities of the Medial School and University. Many of its functions are not served by the geographic organizational structure of clinical schools. SMS Executive therefore sought Faculty approval to create ‘Specialties’ within SMS as informal networks. We have defined a “Specialty” in Sydney Medical School as an intellectual community of medical practitioners and other interested academics or affiliates grouped by an AMC accredited specialty who provide expert advice to the School on matters including curriculum development, research endeavour and affiliate recommendations. The details of the objectives, duties, appointment of Heads, and creation of new specialities will shortly be available online. The Heads of Specialties will meet quarterly with myself and the SMS Exec portfolio leads as the “SMS Specialty Advisory Group”. Through this, we hope better to better connect SMS and FMH/ the University with our affiliates and partners.
I have discussed the transition with the former Heads of Disciplines who were all offered a new term as Heads of Specialties until end December 2021. The process for appointments of Specialty Heads thereafter will be through a process of EOI and interview as per our guidelines. I would like to give my thanks to Professor Kirsten Black (Co-Head. Obstetrics and Gynaecology), Professor Paul Bannon (Surgery), and Associate Professor John Loadsman (Anaesthetics) who have taken the opportunity to hand over the banner to their successors. I thank them for their service to the School as Heads of Discipline over the last several years. I thank those who have agreed to serve in their stead in this transition period: Professor Dharmintra Parsupathy (Co-Head O&G with Dr Sean Seeho), Professor Henry Pleass (Surgery) and Professor Robert Sanders (Anaesthetics). I also congratulate Professor Anthony Gill who has been appointed Head of the newly created Specialty of Clinical Pathology after a submission made by our pathologists was approved. I also congratulate (and thank) all our other new Heads of Specialities. The full list of Heads is shown below:.
MEMBER ROLE NAME
Head of Specialty, Medicine Professor Jenny Gunton
Head of Specialty, Surgery Professor Henry Pleass
Head of Specialty, Addiction Medicine Professor Paul Haber
Head of Specialty, Anaesthesia Professor Robert Sanders
Head of Specialty Child and Adolescent Health Professor Russell Dale
Head of Specialty, Clinical Ophthalmology and Eye Health Professor John Grigg
Head(s) of Specialty, Dermatology Professor Diona Damian/Professor Pablo Fernandez Penas
Head of Specialty, Ear, Nose and Throat Clinical Associate Professor Ray Sacks
Head of Specialty, Emergency Medicine Clinical Professor Gary Browne
Head(s) of Specialty, General Practice Professor Tim Usherwood/Dr Fiona Robinson
Head of Specialty, Genomic Medicine Professor Robyn Jamieson
Head of Specialty, Intensive Care Medicine Clinical Professor Anthony McLean - Interim
Head of Specialty, Medical Imaging Clinical Associate Professor Noel Young
Head(s) of Specialty, Obstetrics and Gynaecology Professor Dharmintra Pasupathy/ Dr Sean Seeho
Head of Specialty, Pain Medicine Professor Paul Glare
Head of Specialty, Psychiatry Professor Anthony Harris
Head of Specialty, Sleep Medicine Professor Peter Cistulli
Head of Specialty Clinical Pathology Professor Anthony Gill
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Successful trial shows that new drug modifies disease in children with achondroplasia
A phase 3 multicentre clinical trial conducted in seven countries including CHW and RCH Melbourne (alongside Germany, Japan, Spain, Turkey, USA and UK) has successfully shown that a new drug, Vosoritide, restores typical growth velocity in 5-15 year olds with Achondroplasia.
The study has been recently published in The Lancet and can be accessed through this link
Dr Louise Tofts, Paediatric Rehabilitation Physician at Kids Rehab, Children’s Hospital at Westmead and the Clinical Research Centre team at Kids Research were the joint top recruiting site internationally and so were granted second author on the publication.
The experimental drug, Vosoritide, manufactured by BioMarin Pharmaceutical tested in this trial blocks the over-activity of FGFR3 created by the gene mutation in Achondroplasia. A total of 121 children aged 5 to 17 were enrolled in this trial - the 60 children who recieved daily subcutaneous injections of Vosoritide grew an average of 1.57 cm per year more than the children who received placebo, which brought them almost in line with their typically developing peers. This demonstrates efficacy in modifying the disease, and further information is awaited on the drugs ability to modify the most serious complications which relate to abnormal growth in the base of skull (foramen magnum stenosis, recurrent ear infections, sleep apnoea, SUDI) and spine (spinal stenosis with spinal cord compression). Reported side effects were either commonly seen in Achondroplasia and evenly distributed across the active and placebo group, or minor (injection site redness).
The results from this study shows promise for an effective, precision therapy for Achondroplasia. We will continue further follow up studies to test the effects of this drug in the longer term in our 5-15 year olds and a hybrid phase 2/3 trial is underway in a younger age group. The CHW -wide team (including CRC, Kids Rehab, Sleep Medicine, Anaesthetics and Radiology) were one of only 12 sites in the world considered to be experienced and skilled enough to be invited to participate in the infant trials.
We are hopeful that this will be a treatment option that will minimise the medical complications and physical disability this group experience as a result of their condition, and could fundamentally change the way we care for children with Achondroplasia.
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Learning about research and how to conduct a research project is an important part of every clinician’s professional development. Successful completion of a research project is a mandatory requirement for The Royal Australian College of Paediatrics trainees.
From May to August this year, Patrina Caldwell (Senior Staff Specialist and Academic) and Trish Bennett (librarian) with the help of Nounu Sarukkali Patabendige (Academic Fellow) conducted a 10-week online research workshop series to teach JMOs how to conduct a systematic review. The systematic review was chosen because the generic skills are helpful for clinical practice and it is a type of research that can be completed in a relatively short duration without ethics approval, so it is an ideal research type for a college project. The workshops were well received, with 86 JMOs registering, of whom 30-40 attended each week. A few senior medical staff who were interested in supervising JMOs with research projects also joined. The workshops included an overview of systematic reviews, how to define a research question, how to develop and register a protocol, how to plan and select databases, how to perform a search, data extraction, how to appraise, analyse and interpret the data, and to write for publication. The workshops were recorded, and the recordings were available for participants on request to watch at their leisure.
At the end of the workshop series, we conducted an evaluation survey to explore participants’ readiness to do a systematic review. To our knowledge, 8 participants started to conduct a systematic review during the workshop series, and many more are considering starting a systematic review.
From our survey, we learnt that many participants preferred online teaching to face to face teaching due to the convenience of attending. The trainees also appreciated having the workshops recorded so they could catch up on sessions they missed.
At the end of this successful systematic review workshop series, there was a demand for continuing weekly research focused meetings. So far, we have conducted sessions on how to conduct audits, questionnaires, randomised controlled trials, qualitative research, how to use Endnote, statistics, ethics and conducting research in general.
We have managed to create a culture of research interest with junior medical staff who are keen to develop and share their research skills. The research workshop is held (online) every Tuesday at 2-3 pm. Our classroom does not have walls and is open to everyone!! If you are interested in research (either as someone who would like to share your experience or as someone who would like to be involved in research) – please come and join us.
Please email Patrina Caldwell (patrina.caldwell@health.nsw.gov.au) or Nounu Sarukkali (nounu.sarukkalipatabendig@health.nsw.gov.au) if you would like to join this group and get our weekly emails.
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Selection of Recent Publications from Dr Ben MaraisRecent publications from Dr Ben Marais were recently highlighted at the Sydney Global Child Health Network Steering Committee meeting.
Antibiotic use in Children Hospitalised with Pneumonia in Central Vietnam - Read Here
Predictors of Unlikely Bacterial Pneumonia and Adverse Pneumonia Outcome in Children Admitted to a Hospital in Central Vietnam - Read Here
Tuberculosis in Migrants – Screening, Surveillance and Ethics - Read Here
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Graduation Celebration Online Event 2020
The face to face large scale graduation ceremonies in the Great Hall cannot proceed due to COVID-19 restrictions. The University has arranged online formal ceremonies and photograph opportunities for students in their academic gowns and mortarboards. In addition, SMS Executive and Clinical School Managers have arranged an on-line event on the evening of Thursday November 19 to have some form of COVID-safe celebration to congratulate the Graduating MD Class of 2020. Professor Maree Teesson from the Matilda Centre and Aspasia Manos (final year student/former SUMS President) will give short addresses. If you would like to register to attend the online event with the students and their families, please register your interest here.
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The Academy of Child and Adolescent Health Webinars
The Academy of Child and Adolescent Health is a new organisation bringing together health professionals, trainees and students interested in child and adolescent health. It spans disciplines and has representation from across Australia and internationally. The our face to face conference has been delayed until Oct 14th to 16th 2021 (Doltone House Hyde Park, Sydney), however, we are happy to announce the first in a series of free open-access Webinars as follows:
Save the dates for the following:
Webinar 3; Thu 12th Nov, 6-7pm (zoom)
Prof Gillian Triggs, Assistant Secretary General, Assistant High Commissioner for Protection, United Nations “Refugee child health rights” (Chaired by Professor Elizabeth Elliott AM)
Webinar 4; (Likely to be Fri 11th Dec, 1pm)
Prof Zulfi Bhutta, former President International Paediatric Association and Prof Sue Sawyer, Chair Adolescent Health, University of Melbourne “Global child and adolescent health”
Registration is best made through a Chrome browser.
ACAH Webinars are free and open access (membership of the Academy of Child and Adolescent Health is not required). However, pls visit www.acah.org.au to join (NB: students join for free) and support the ACAH community.
Please contact Has Gunasekera if you have any questions or suggestions for speakers and/or topics for future Webinars: hasantha.gunasekera@health.nsw.gov.au
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