1. science
2. medicine
3. medical research

The Auckland District Health Board
2006 Annual Research Report
Auckland District Health Board Annual Plan: 2007-2008 Research
Over the long term we want to:
Develop a deeper understanding of our activities
Build the information/research/analytical base to assist our
work; develop a profile of Auckland city; measure the health
of our community; prioritise local needs and factors linked to
health status; work with other agencies to measure indicators
of health; monitor trends; make sure information collected
is consistent at district, region and national levels; share
information; create one source of knowledge.
o Promote a culture of innovative, appreciative enquiry and
consequential actions
o Build an easy to access information and analytical base to
help with planning and funding decisions
o Update the profile of Auckland city re demographic
characteristics, health status, availability and access of
services, local community needs and factors linked to
health status
Improve cost effectiveness and outcomes of
health services
o Work with other agencies to measure indicators of health and
Make the best use of resources, use the findings from
community consultation/customer feedback/complaints to
inform practice; draw on cultural and gender analysis to
support future planning; analyse risk and develop plans that
prepare us well for future events.
o Draw on social, cultural and gender analysis to support future
Strengthen the relationship with Medical and
Health Sciences
Foster Auckland DHB’s role in medical and community research;
preserve our status as a centre of clinical excellence; recognise
the Medical and Health Sciences faculty’s role as partner for
graduate medical and nursing teaching, and research; critique
health care approaches and investigate new initiatives; further
develop a research governance and management structure.
Objectives 2007 – 2008
Research to improve health care delivery
oU
nderstand the training requirements arising from changes
in clinical practice and service delivery driven by new
technology, research and innovation
o I mprove health care and treatment approaches by
establishing where to support disease prevention, how
to measure success and improve the evidence base
oS
upport staff to test current health care practices and to
investigate new approaches and initiatives
oP
romote a research culture that improves cost effectiveness
oS
upport initiatives that offer short and long term health
outcomes and which make the best use of resources
o E valuate health services and use information to improve
services, mitigate issues and gain further understanding of
effective practise
oS
ecure a high level of quality in health care practice and
delivery across all areas
Research informs future planning
wellbeing, and to monitor trends over time
planning. Support a greater research focus on gender issues
and the inclusion of gendered concerns in the planning stages
of any health initiative
o Continue to analyse risk and develop plans that prepare us
well for future events
o Improve the information systems to create one source
of knowledge
o Increase research workforce capability and capacity
o Increase the application of new knowledge research
o Continue to implement the research management systems
and processes
Maintain strong relationships to build knowledge
o Work with industry, educational facilities, government and
non-government agencies and others to do innovative
research and to improve education and training
o Support the new research governance and management
structure and develop a research strategy to guide and
support the process into the future
o Maintain and advance teaching and university relationships to
build up a highly skilled and responsive workforce
o Investigate the potential use of industry and private services
etc, in conjunction with public provision. Develop partnership
arrangements around priority areas
o Maintain and foster new relationships with research sponsors
in the commercial and public sector
o Strengthen the relationships with the regional and national
ethics committees
o Learn from each other (especially other DHB successes in
diabetes and cardiovascular disease prevention)
Contents
ADHB Annual Plan 2007-2008 Research2
Preface by CEO
4
Comment by CMO
5
Comment by Chair RRC
6
Introduction
7
Partners & Collaborators
11
Snapshots – research from around the organisation 13
Current Research 2006
18
Research Income 2006
47
Preface by CEO
Garry Smith
Chief Executive
I wish to preface our Annual Research
report with my thanks to all the participants
in the more than 500 projects in
progress through 2006.
Thank you to the patients and the volunteers who have participated in the various
research projects, for your interest and forbearance, and thank you to our research
administrators, coordinators, nurses and investigators for the fine aggregate of
research activity. The combined effort produces a scholarly output that contributes to
the incremental advance of science.
2006 for me represented the implementation of much previous development work in
reforming research governance and financing. Special acknowledgement is due for
the excellent work of our Research Office Manager, Gayl Humphrey in streamlining
the research approval processes and setting up a new research governance structure
through the development of a Research Review Committee. I also wish to acknowledge
the considerable efforts of our Finance Department in successfully transferring
research finances into the ADHB Charitable Trust. This move will strengthen our
research investment for years to come.
All of this development has reinforced our view of the fundamental importance of
research to this DHB, as excerpts from our District Annual Plan reproduced in this
report demonstrate. It will be clear that most of our current research is primarily
focused on biomedical and hospital subject matter. My hope is that with the broadening
of our DHB focus in community and primary care, research questions in these areas will
be stimulated.
Reviewing projects for approval can be an arduous task added on at the end of the
day and members of the Research Review Committee under the chairmanship of
Dr Tim Short deserve recognition as they grapple sometimes with difficult decisions.
Finally, to all of our external research partners, I hope this report provides new insight
into the sophistication of our research base and an attraction as a destination for
new projects.
Garry Smith
Chief Executive, ADHB
“The combined effort
produces a scholarly
output that contributes
to the incremental
advance of science”
Comment by Chief Medical Officer
David Sage
Chief Medical Officer
Research in Auckland Hospitals over the last 50 years has been a picture of steady growth
and the source of numerous medical breakthroughs two examples being the treatment of
hyaline membrane disease and congenital heart defects in babies. In the same period the
research community has also been the focus of searching reappraisals of informed consent
(the Cartwright enquiry and the Green Lane Heart Library controversy).
Research at ADHB is alive and well, projects are distributed throughout all clinical
departments, and there is a solid base of research expertise supported by sound
financial and governance structures.
Large amounts of contract research, participation in multicentre Random Controlled
Trials and the trend to increase student demand for formal research to meet postgraduate requirements, have progressively increased our research volume to the levels
described in this report.
The predecessors of the ADHB back to the Auckland Hospital Board have presided
over research efforts initially from hospital clinicians only, and with the founding of
the Auckland Medical School in 1975 increasing number of clinicians with University of
Auckland academic posts. Sir William Liley and Sir Brian Barratt-Boyes illustrate well
the separate vote education and vote health infrastructure support separately funding
their research at that time.
This dual funding of ADHB Research continues. An increasing number of tertiary
institutions have become research partners. In addition our largest partnership with
the University of Auckland has gradually expanded beyond medicine and surgery
into the expanded health sciences and faculties such as bioengineering and psychology.
The DHB financial support for research in addition to bricks and mortar, HR, Legal,
Library, IT Services, and the Research Office, lies largely in its multi-million dollar
physician salary support for research time, and including from 2006 a new sabbatical
programme.
Besides government research support through votes health and education, our third
source of research finance comes from our partners in the pharmaceutical and device
industries, and the variety of trusts, charities and donors acknowledged in this report.
Thank you for your support, without which our research output is unsustainable.
We are justifiably proud of our ADHB contribution to biomedical and health research
in New Zealand and I am confident our high standards will continue to attract new
projects of the highest quality.
David Sage
Chief Medical Officer, ADHB
Clinical Associate Professor Anaesthesiology, University of Auckland
Comment by Chair RRC
Tim Short
Chairman
The need for the newly established Research
Review Committee arose from the need for
improved governance of research undertaken
within the Auckland District Health Board.
It exists to ensure that all projects are ethically and scientifically robust, as well as
legally, contractually and financially sound, and do not act as a drain on resources
which are primarily here to provide publicly funded health care. It is pleasing to see
that there are currently over 500 research projects currently under way in ADHB. This
represents a significant amount of creative thought and drive on the part of our staff
and collaborative partners toward improving medical, health care and service delivery.
The current research income is over six million dollars per annum, which is a significant
industry. Needless to say the Research Office and the committee are very busy.
Research is an essential component of any health care service and for all Specialist
Medical practice. It is only by questioning what we do and dreaming up ways of
improving and then proving it, that progress is made. Research also serves as a strong
link to our International Colleagues and to the best of current practice. I notice it is
at times hard to persuade our administrators of the essential role research plays in
medical and overall health excellence when their primary objectives appear to be
more narrow fiscal and volume based agendas. However anyone can understand that
research is where the proven treatments they want us to deliver more of came from.
Hopefully they will take it on faith that it is also why many of the excellent staff in ADHB
choose to work here and help nurture their professional interests.
The committee has grappled with a number of issues which require some perseverance
from the investigators. We expect all protocols to be capable of proving their hypothesis,
this means that the question worth answering and the project capable of being
completed with the resources and methodology available to the investigator. These
are essentially additional questions to the more narrow scope of the Regional Ethics
Committee. ADHB policy is that research is self-funding within the organisation. We
are currently reviewing the way cost recovery is made to ensure that research costs
are being paid equitably and cost shifting does not occur to the detriment of research
within the ADHB. In time the newly formed Research Trust will also be a significant
financial supporter of research within the organisation.
I am proud to be a part of New Zealand’s largest hospital and the large and diverse
research endeavour based here, and extend my warmest thanks to the citizens of
Auckland and beyond that willingly take part in studies in the hope that everyone’s
health and wellbeing may be improved. We hope in time that the committee will be
seen as a valuable resource that ensures excellence in all aspects of research so
that funders, administrators and patients alike can have complete confidence in the
projects undertaken at Auckland City Hospital.
Tim Short
Chairman, ADHB
“Research is an
essential component
of any health care
service and for all
Specialist Medical
practice”
Introduction
Research Accounts
Income
Background
Research has been an integral part of the Auckland health care environment for
decades. The two areas known to most people are National Women’s Hospital
which has been the site of internationally-acclaimed neonatal research for many
years and conducted the world’s first successful intrauterine (pre-birth) blood
transfusion to counter Rhesus disease. There is also a long history of cutting edge
cardiac research at Greenlane Hospital (now integrated within the Auckland District
Health Board portfolio) and researchers with an international reputation for innovative
research excellence.
Managing Research
Over the years, the depth and breadth of research undertaken within the Auckland
health care setting, both by its own staff and in collaboration with other institutions,
has continued to grow. Up until the late 1990s recording, management and oversight
of research was by the individual health disciplines and services where the
research was being undertaken. In the late 1990s a research office was established
as a means to promote, support and risk manage research that involved patients of
the central Auckland Services (Auckland, Greenlanel, National Women’s and Starship
Children’s Hospitals).
This involved establishing a process for registration of all research with the
Research Office. A central database was developed to record the research details
i.e. title, investigators, funders, legal documents, budgets and ethics approval details.
The purpose of this central system was
1) to monitor the size of research within the organisation,
2)improve the risk management with respect to legal responsibilities and
patient safety,
3)actively engage with service Clinical Directors and General Managers to ensure
they were aware of the research and approved of it being undertaken in their area,
4) monitor ethical and good clinical practice (GCP),
5) initiate a central budget and financial account record,
6)establish a training programme to develop and promote good research and
researchers within the organisation and,
7) actively seek means to support and sustain research.
Reviewing the System
A review of the system began early 2005. The review mandate was to evaluate the
effectiveness of the current research management system to capture all research,
manage research related risk, improve research opportunities, promote and monitor
good research practice, manage legal and finances accountability and consult with
researchers on ways to improve the system, specifically its overall governance and
financial accounting processes.
Based on the findings, it was clear that Governance, financial management, research
monitoring and streamlining the operational systems required further development.
Research informs future planning
New Research Management Structure
Governance
Financial
To improve research Governance,
a Research Review Committee was
established. Its members are researchers
within the organisation and one member
has a university appointment. The
Committee’s mandate involves,
In order to improve and separate out financial management of research from the ADHB’s
core health care delivery activity, various local and international models were reviewed.
This identified the need to introduce project accountancy methods to accurately identify
research costs project by project. It also suggested that a Charitable Trust model would
meet the needs of researchers and the institution.
o an Operational role involving monthly
meetings to review and approve all
research undertaken within ADHB
whether originating internally or via
research partners
o a Promotional and advocacy role
to enhance research within the
organisation and within the wider
research community
The two main gains from a Charitable Trust model were
1) the ability for the Trust to earn interest on its income, hence have a source of income
that can support research, and
2)by having a completely independent accounting system, the ADHB operational
finances and the research finances could be kept clearly separate.
The following [figure 1] illustrates the new governance structure. The dark blue areas
are the new elements established as a consequence of the review.
Figure 1: New Research Governance Model
ADH Board
CEO
MoA
A+ Charitable Trust
Existing
Trust
Accounts
Clinical Board
Research
to improve
health care
delivery
New Research Review
Committee
New Research Fund
General
Accounts
Project
and Directed
Accounts
Reviews & approves
fund usage
o a Governance role involving a review
and development of research policies
and procedures
Shared Membership
Research Office
Research Projects
New Research Grants
Committee
Operational
To operationalise the new system the Research Office roles and responsibilities were
redeveloped and modified. The key outputs are:
1) Direct researcher support
o registration and processing of all research within the ADHB
o reviewing ethics applications and providing advice to researchers on ethical and
related issues
o facilitating legal review
o reviewing and advising on research budgets and costing of research
o record keeping and maintaining database of all research past and present
2) Review and Evaluation
o undertake routine monitoring and GCP auditing of research projects for adherence
to ethical and managerial compliance
o facilitate where necessary external audit of research projects
o ensure all research is operating with current ethical approval
3) Institutional Reporting and Governance – The Research Review Committee
o Prepare agendas for monthly review meetings and all documents for review
o report to the Research Review Committee on research activity within the
ADHB to:
• ensure management approval processes are completed for all Research
• ensure that research complies with GCRP, ethical principles and
ADHB Policies
• bring issues to the attention of the Research Review Committee
4) Trust Grants Committee
o provide conduit to and from the Trust Grants Committee for review
of research financial status
o provide information to Grants Committee on relevant research
o support Trust Grants Committee accountant
5) Research Development and Support
o provide GCRP training opportunities to researchers and other staff
o provide general research development training opportunities
o provide research related information including funding opportunities, new
processes and conferences
o provide regular research updates via the RO website
Maintain strong
relationships to
build knowledge
o provide advice on links with other institutes
ADHB comprises the largest clinical research facility
in New Zealand. Research occurs in almost all
the services within the ADHB environment (Figure
2). Research is conducted by and for a range of
individuals and groups within ADHB, including
clinicians (medical, nursing and allied health staff),
joint academic staff, management, clinical trainees
(registrars, nurses, technicians), and students enrolled
in a variety of international and NZ tertiary institutions.
Figure 2:
ADHB Services
GeneralSurgery
Paediatric Psychiatry
Ophthalmology
Sexual Health
Orthopaedics
Trauma
Cardiothoracic Surgery
Paediatric Haematology
Respiratory
Cardiology
Vascular
Paediatric Otorhinolaryngolgy
General Medicine
Cardiac Intensive Care
Paediatric Intensive Care
Emergency Department
Infectious Disease
A + Links
(Older People’s Health)
Radiation Oncology
Palliative Care
Gastroenterology
Audiology
Rheumatology
Diabetes
Oral Health
Paediatric Cardiology
Obstetrics and Gynaecology
General Paediatrics
edical Specialties
M
(respiratory, renal
immunology, neurology)
Paediatric Surgery
Air Ambulance Services
Adult Haematology
Renal and Liver Transplant
Otorhinolaryngolgy
Te Whetu Tawera - Auckland
City Mental Health Unit, Liaison
Psychiatry
Maternal Mental Health
Mental Health Rehabilitation
Mental
Health Services for
Older People
Eating Disorders
Child Development, Child
and Youth and Child Health
and Disability
The ADHB plays an essential resource and
partnership for researchers from other
organisations. There is the historical and
key relationship with the Faculty of Health
and Medical Sciences at the University of
Auckland, where many of ADHB clinical
researchers have joint positions. In addition
to the University of Auckland, over the
past few years, collaborations with other
10
Critical Care Medicine
Medical Oncology
Fertility
Paediatric Medical Oncology
Paediatric Orthopaedics
Renal medicine
Paediatric Neurosurgery
Urology
Paediatric Palliative Care
Neurosurgery
Pain Services
Lotofale (Pacific Mental
Health Service)
Dermatology
Maori Mental Health
Immunology
Community Neurobehavioural
Service
Endocrinology
Rehabilitation Services
Neonatal Intensive Care
Children’s Emergency
Department
Child & Adolescent Family
Mental Health Service
Specialist Psychotherapy
Service
Neurology
universities and technical institutes in
the disciplines of Nursing, Physiotherapy,
Engineering, Anthropology, Psychology,
Biotechnology and Geography etc. have
dramatically increased, as have those
made with independent research institutes
and not-for-profit organisations. These
relationships have meant that the range of
research has broadened from predominantly
clinical or biomedical research to include
other disciplines such as educational,
epidemiological, social science, health
services, etc.
The ADHB also is a significant resource and
support for a number of students earning
tertiary degrees and diplomas across many
disciplines.
Our Research Partners
Government
• Health Research Council, NZ,
• Accident Compensation Corporation, NZ
• Ministry of Education, NZ
• Ministry of Health, NZ
• National Institute of Health (NIH), US
• National Health and Medical Research Council, Australia
Universities
• University of Auckland, NZ
• University of Otago, NZ
• Auckland University of Technology, NZ
• Victoria University, NZ
• Seattle Institute, US
• Manchester University, England
• Central Manchester Children’s, US
• University of Nottingham, England
• Boston University, US
• New York University, US
• University of Adelaide, Australia
• North Shore Long Island University, US
• University of Sydney, Australia
• University of Michigan, US
• University of Queensland, Australia
• Duke University, US
• Ottawa Heart Institute Research Corporation (OHIRC), Canada
Collaborative Groups
• Australia New Zealand Breast Cancer Trials Group
• Trans-Tasman Radiation Oncology Group
• The Australian and New Zealand
Intensive Care Group
• GIIHPH
• AGIGT
• Australia New Zealand College of Anaesthetists
• Childrens Oncology Group
• Australia and New Zealand Intensive Care Society Clinical
Trials Group
• Australasian Clinical Trials Network
Non-Government Organisations and Sponsors
• The Alcohol Advisory Council of New Zealand
• Physiotherapy Society
• Auckland Medical Research Foundation
• Greenlane Research and Education Fund
• Goodfellow Foundation
• Starship Foundation
• Wishbone Trust
• The Mad Butcher
• Cure Search National Childhood Cancer Foundation
• SPARC
• Cancer Society
• Arthritis New Zealand
• Canterbury Trust
• Neurological Foundation
• National Heart Foundation
• Mental Health Foundation
• Breast Cancer Research Foundation
• Prince Royal Alfred Hospital, Australia
• Genesis Trust
• Royal Melbourne Hospital, Australia
11
Research Partners
cont.
Commercial
• Amgen Inc
• Abbott Laboratories
• Medpace, Inc
• Medtronic, Inc USA
• Cameron Health, Inc
• Pharmacia
• AstraZeneca
• Novartis NZ Ltd
• Sanofi-Synthelabo Australia Pty Ltd
• Celltech R & D Ltd
• Wyeth Australia Pty Ltd ICON
• Interventional Systems
• Centocor
12
• Allergan Australia Pty Ltd
• Biorest Ltd / Gerling
• Schering Ltd
• Global Pharmaceutical Company
• UCB Pharma, Inc
• Janssen-Cilag
• Conor Medsystems Inc
• VentraCor
• Protemix Corp, Ltd
• TAK Pharmaceuticals
• Sunshine Heart Company
• Chiron Corporation
• Hort Research
• Savacor, Inc
• Fuisawa GmbH
• Takeda
• Hoffmann-LaRoche Ltd
• AFT Pharmaceuticals
• Astellas Pharma
• Biogen Idec Australia Pty Ltd
• Eli Lilly
• Wyeth
• Cameron Health, Inc
• Guidant
• Corus Pharma
• Fournier Pharma
• EBR Systems
• DEVAX
• Avantec Vascular Corporation
• CSL Ltd
• Cierra
• Novo Nordisk
• Keryx Biopharmaceutical
• Proacta Inc
• Novatech
• Fournier Pharma
• UCB Pharma, Inc
• Lumen Biomedical
• Pharmaxis
• Bayside Health
• Elixer Medical
• Bayer
• ALLG
• Otsuka Maryland Research Inc
• Biogen Idec Inc
• Merck Sharp and Dohme
• Procare Health Limited
• Antipodean Pharmaceutacals
• Sanofi Winthrop Pty Ltd
• Roche Products
• Aventis Pharma Ltd
• Johnson and Johnson
• Boehringer Ingleheim Alcon Research Ltd
• Novartis
• Medtronic Australia
• Boston Scientific Corp USA
• The Medicines Co
• Schwarz Biosciences GMBH
• Fisher & Paykel Healthcare
• GlaxoSmithKline NZ Ltd
• Eisai Ltd, UK
• Cephalon
• Quintiles
• Schwarz Biosciences GMBH
• Diagnostic MedLab
Snapshots
The following brief snapshots described here are examples of research aimed
at translating ideas and new knowledge into new or improved clinical practice
and patient outcomes – a major goal of clinical research. Some are in the early
stages of knowledge seeking (see Liver Transplant snapshot) while others are
attempting to directly impact on patient wellbeing (see Oncology snapshot).
Snapshots
Oncology
Humidification Minimising Toxicity for Head
and Neck Cancer
Lead Investigator: Andrew McCann
A new strategy to assist with the management
of mucositis is the therapeutic use of humidification with radiotherapy. Preventing the
desiccation of wounds can reduce the extent
of tissue injury and enhance the healing
process. It can also minimise the adverse
effect associated with significant pain,
impaired oral intake, hospitalisation and
potential interruption of the radiotherapy
treatment schedule. Humidification to
moisturise mucosa is in accord with the
general principle of moist wound care in
wound management.
A randomised phase III trial, was developed
to evaluate prospectively the benefits of
humidification. With Fisher & Paykel support
using their MR880 humidifier, patients
receiving radiotherapy/chemoradiation for
head and neck cancer will use specially
designed nasal prongs to deliver water vapour
at a rate of 25 to 35 litres per minute.
Pilot experience with humidification at
Auckland City Hospital has shown this to
be well tolerated and as such it has grown
into a collaborative trial working with the
Trans-Tasman Radiation Oncology Group
and Fisher and Paykel Healthcare to extend
the trial to ten hospitals from Australia and
New Zealand.
If effective not only will it help the treatment
process for patients but it may have an
impact on the patient’s experience of acute
treatment toxicities and the effect of
humidification on long term swallowing
function in patients and reduce hospitalisation rates and hospital bed occupancy.
Strengthen the relationship
with Medical and Health Sciences
Liver Transplant Unit
Scientist: Bill Abbott
In addition to the array of patient-centered research undertaken by the team in
the Liver Transplant group, the group has also established a research laboratory,
thanks to the Lloyd Morgan Lions Clubs Charitable Trust New Zealand.
This laboratory has substantially increased
the group’s capabilities. Currently the
laboratory is collaborating with Polynesian
communities in Auckland to develop a
‘therapeutic’ vaccine for patients who have
chronic liver inflammation caused by the
hepatitis B virus. If untreated, this liver
inflammation can lead to liver cirrhosis and
liver cancer. These diseases place a significant
demand on scarce liver transplantation
resources in New Zealand, and kill over
500,000 people per year worldwide.
“Our approach is to
try and ‘trick’ the
immune system”
Currently, people with active liver
inflammation caused by the hepatitis B virus
receive life-long treatment with drugs such
as Lamivudine and Adefovir. The lifetime
cost of taking these drugs runs from tens
to hundreds of thousands of dollars, and
is beyond the means of most people in the
world who need therapy. Thus a ‘therapeutic’
vaccine that could stimulate a successful
immune response to the virus at a cost of a
few thousand dollars would be commercially
viable, and would substantially increase the
number of people in the world who could
afford treatment.
Our approach is to try and ‘trick’ the immune
system into thinking that the hepatitis B virus
is part of another bug, and generate an immune
response that clears both simultaneously.
We have recently identified a microorganism that may be useful. The purpose of
identifying hepatitis B susceptibility genes
is to understand the mechanisms by which
the virus is able to avoid the immune system.
Vaccine adjuvants may need to be designed
on the basis of this information to compensate
for genetically determined deficiencies in
immune function in some people. We have
found that Polynesian people with chronic
hepatitis B commonly have a form of this
gene that produces lower amounts of the
virus-suppressing protein than the form of
the gene that is present in the majority of
Polynesian people who have suppressed the
virus. We will need to conduct laboratory
studies to ensure that this low interferongamma-producing gene does not limit the
effectiveness of any therapeutic vaccine
that is developed. This finding highlights the
value of understanding genetic influences
on disease processes, and the unique role
that studies of Polynesian DNA may have in
understanding other genetic diseases such
as diabetes and asthma.
13
Snapshots
Anaesthesia
Fuzzy Logic
Research Team: Michael Harrison,
Frank Johnson, Andrew Lowe,
Phil Guise, Nigel Robertson,
Michal Kluger, Brian Mace,
Guy Warman, Brian Pollard,
Ron Jones, Tom Healy, Alan Merry,
Doug Campbell, Richard Jones,
David Kabel and Jim Hunter
“More evidence is the
key to overcoming
uncertainty”
No anaesthetist can guarantee an uneventful
anaesthetic. Intra-operative diagnoses may
be uncertain – clinical signs may be common
to many disorders; there may be an incomplete set of data, and too much emphasis
on one parameter. When uncertainty exists
it is difficult to know when to intervene, and
possibly how to intervene. More evidence
is the key to overcoming uncertainty. The
researchers have teamed up with computer
specialists, engineers, mathematicians and
programmers to see how using computers
can assist with decision making during
anaesthesia.
Humans are preferentially pattern recognisers
but use knowledge-based thinking when
pattern recognition does not work.
Reasoning implies conscious thought – “if
this has occurred then ‘such-and-such’ is
likely”. These IF-THEN rules are seldom
voiced but are the mainstay of computer
algorithms. Most of the contents of our work
on diagnosis and decision-making depends
on the careful use of IF-THEN statements
– deductions from data, from assumptions,
from knowledge of pathophysiology and
pharmacology. Uncertainty will still exist; it
is ubiquitous. The goal is to tame it.
Current work has shown that using modern
computing power, mathematical techniques
for pattern recognition (neural networks,
fuzzy logic and statistical probabilities) and
insightful knowledge of how physiology is
modified by anaesthesia and surgery, it is
possible to create a decision support system
that acts as another source of information
and barrier to error. The goal is to use these
systems to help detect early problems and
abnormal physiological for example, which
then should result in a reduction in associated
morbidity.
Topics of investigation have been; Physiological data display during anaesthesia;
computer enhanced diagnosis of malignant
hyperpyrexia; the relationship between
change in blood pressure, blood pressure
and time; assessment of heart function using
fuzzy trend templates and evidence based
reasoning to process data during anaesthesia
and probabilistic alarms from sequential
physiological measurements (the Whistley
algorithm). Current research is examining
orthogonal search-based rule extraction for
modelling the decision to transfuse and a
pre-operative assessment of cardiac output
reserve and likelihood of transfusion among
anaesthetists. The potential is endless.
However, the anaesthetist still has to make
the final judgment as to the validity of the
diagnosis but the enhancement of intraoperative diagnostics and decision-making,
using computational methods, is possible and
is a new tool to enhance patient safety.
Develop a deeper understanding of our activities
Developing a feasible,
reliable and valid workplace
assessment for specialist
trainees in anaesthesia.
Research Team: J. Weller,
A. Jones, A. Merry, K. Smith,
K. Pedersen and M. Misur
The goal of training in anaesthesia is to
produce specialists whose practice is sound,
safe and ethical.
Written assessments and vivas may assess
knowledge and problem solving skills but do
not assess competence or workplace
performance. Effective workplace assessment can provide valuable feedback to
trainees at all stages of training, identify
strengths and deficiencies, and facilitating
remediation. However, workplace assessment
can be unreliable, especially when supervisor
reports are based on memory, infrequent
contact or impressions gained from tea room
conversations.
For a reliable assessment of a trainee, multiple
observations are required, over a range of
different cases of varying complexity, and
using a number of supervisors. The mini-
14
Clinical Evaluation Exercise (mini-CEX) system
enables assessments based on daily work
practices, and with immediate feedback built
in to the process, can have a positive effect
on learning for trainees, and on supervisors’
skills in delivering constructive feedback.
The current research work of the team aims
to link the mini-Clinical Evaluation exercise
with previous work using high fidelity
patient simulators to observe and record
errors during simulated anaesthetics. In
these simulations, objective measures of
performance have been developed, i.e. the
number of errors observed in a complex
standardised, simulated anaesthetic.
The ultimate goal of this body of work is
to help train highly skilled anaesthetists
and consequently improve health outcomes
for patients.
Urology
Investigator: Jonathan Masters
Sexual Health
Research Team: Sunita Azariah,
Nicky Perkins and Jackie Hilton
Research areas abound in sexual
health with major sexual health issues
currently facing Aucklanders and
New Zealand, such as:
oA
n epidemic of infectious syphilis
o Rising rates of HIV
o Rising rates of chlamydia and
gonorrhoea infections
o Rapidly increasing levels of
ciprofloxacin resistance in the
treatment of gonorrhoea
The team have been undertaking a
range of epidemiological studies. These
clinical epidemiological data, relevant to
the New Zealand context are important,
not only in order to contribute to the
local, national and global picture of
sexually transmitted illness, but also so
that accurate information can be given
to patients when counselling them about
a diagnosis.
A very generous benefaction from the Mad Butcher has helped build the
research team in the urology department and as such has enabled the
department to look at a programme of research on SNP polymorphisms in
Selenoproteins in men with and without biopsy proven prostate cancer.
With Professor Lynn Ferguson and Nishi
Karungasinghe (Department of Nutrition,
University of Auckland) we hypothesize that
the need for Selenium to make these DNA
protecting enzymes function maximally will
depend on the isoenzyme and that this will
lead to an increase in development of prostate
cancer in certain groups of men that may be
prevented with Selenium supplementation.
Early results are very promising. We have
already begun to design the follow on study,
which uses the findings. That is by identifying
men from a blood test who are regarded
as being at high risk because of the form
of selenoprotein isoenzyme they have and
see if we can reduce the risk of prostate
cancer development by targeting Selenium
supplementation at this particular group. Ultimately, the whole aim of these studies
is to prevent the development of prostate
cancer in men at high risk. Enhanced Syphilis Surveillance
demonstrated a considerable increase in
genetic diversity over a 2 year time period,
confirming that these strains are now endemic
within the Auckland population. This data has
important implications regarding the control
of this epidemic and has led to increased
monitoring and routine audits of gohorrhoea
cases.
Syphilis is not a notifiable disease but we do
need accurate epidemiological data in order
to make a case for extra funding to control
the current epidemic. The research team have
therefore started a pilot study of enhanced
syphilis surveillance in the Auckland region.
Sixty cases collected to date - far in excess of
the numbers we envisaged. These findings will
assist in planning prevention programmes.
HIV anonymous unlinked seroprevalence
survey
A multicentre study coordinated by the
AIDS Epidemiology Unit (University of
Otago) and funded by the Ministry of Health
commenced in April 2005 and aimed to recruit
approximately 5000 subjects over a 12 month
period. The findings will help ascertain
prevalence figures for parts of the New
Zealand population. The findings will help the
Ministry and sexual health providers plan and
prepare for potential future costs regarding
HIV and AIDS patients.
Clinical Audit of Gonorrhoea Cases
The rising prevalence of gonococcal infections
in Auckland coupled with very high rates of
ciprofloxacin resistance which now stands
at 19% of diagnosed cases is a concern to
sexual health services. A research audit
found the main risk factors for acquisition of
gonorrhoea were age and ethnicity. Typing of
gonococcal isolates resistant to ciprofloxacin
Another study has the team collaborating with
academic colleagues and funds from the
Canterbury Urology Research Trust is aimed
at optimising the time of semen preservation
in men undergoing surgery for testicular
cancer. The team are also collaborating on
research looking at prostate cancer decisionmaking projects.
Genital Herpes
A study was developed to describe the
epidemiology of first episode genital herpes
in New Zealand by correlation of clinical,
culture and serological findings in 100
patients presenting to the service. The
results confirmed what has been documented
internationally, that Herpes Simplex Virus
Type 1 is playing an increasingly important
role in first episode genital herpes, accounting
for 40% of the first episodes in this study.
Non-gonococcal Urethritis (NGU)
A case-control study of men with NGU to
determine the prevalence of this organism is
currently in place. This entails sending urine
specimens to The Royal Women’s Hospital
in Melbourne for testing. Data on sexual
behaviour is collected to investigate possible
risk factors for infection. Results from this
study will improve knowledge of the aetiology
and epidemiology of NGU in men presenting
to the service. This research may also have
important implications for women’s health as
this organism has been implicated in pelvic
inflammatory disease in overseas research.
15
Snapshots
Women’s Health
Metformin in Gestational
Diabetes and the Offspring
Follow Up
Principal Investigator:
Janet Rowan
“The MiG trial is a
prospective randomised
multicentre trial that
completed recruitment
of 750 women at the
end of October 2006”
There is a well-recognised explosion of
obesity and type 2 diabetes in New Zealand
and the rest of the world. Research is
focused on identifying modifiable risk factors
and testing interventions that may reduce
this epidemic. Within this field, women with
pregnancy diabetes (gestational diabetes
(GDM)) are an important group to look at,
as the women and their offspring are at
increased risk of later type 2 diabetes. The
aims of the MiG and MiG:TOFU studies are
to compare two different treatments during
pregnancy and look at how these impact on
pregnancy and long term health outcomes.
The MiG trial is a prospective randomised
multicentre trial that completed recruitment
of 750 women at the end of October 2006.
In this trial, eligible women with GDM have
been randomised to insulin or metformin
treatment aiming to show that metformin
tablets are an effective alternative to insulin
injections. The primary outcome measure is
a composite of neonatal morbidity. Insulin
has been used during pregnancy because it
does not cross the placenta and is effective
in helping reduce elevated maternal glucose
levels. However, it can be associated with
hypoglycaemia in the woman and extra
weight gain. Metformin works by reducing
insulin resistance; it is not associated with
hypoglycaemia or weight gain and has the
potential to reduce the risk of subsequent
type 2 diabetes in the mother. Metformin has
been used safely during pregnancy for over
30 years in some countries. It does cross
the placenta to the fetus, which may lead to
additional direct effects on insulin sensitivity
in the child. Trial outcomes will be reported
during 2007.
The MiG:TOFU study is following the growth
and development of the children born to the
women randomised into the MiG trial. It is
not known whether a specific treatment
or achieving particular maternal glucose
targets during pregnancy decreases risks of
obesity and associated health problems in
the offspring. We are able to address these
questions with this unique cohort of children.
We have collected detailed pregnancy
information as part of MiG, including four
maternal glucose measurements each day,
fetal growth scans, pregnancy complications, delivery details, postnatal morbidity
and feeding practice. We have also collected
cord blood to measure insulin and relevant
adipocytokines. Background information,
including paternal details has also been
recorded. As part of MiG:TOFU we are
collecting information about postnatal diet
and activity, assessing body composition
of the children and mothers and performing
neurodevelopment assessments. Currently,
the children are being assessed at 2 years
of age.
The investigators aim to continue follow up
of the growth trajectories, insulin sensitivity
and other metabolic and neurocognitive
features of these children, as this will
contribute to our knowledge about treatment
of women with GDM and how we may
reduce adverse effects, such as obesity in
the offspring. If metformin is shown to be a
useful alternative treatment to insulin it will
have an important role in future management
of GDM and long term effects also need to
be known. At present GDM complicates
5-10% of pregnancies and is increasing in
association with the epidemic of obesity.
The results of these studies will have huge
ramifications for the health of pregnant
women and subsequent generations.
“As part of MiG:TOFU we are collecting
information about postnatal diet and
activity, assessing body composition of
the children and mothers and performing
neurodevelopment assessments”
16
Children’s
Haematology
and Oncology
Research
“We currently have
27 open studies and
14 closed studies
in which we are
continuing to follow
patients”
Since 1999, this service has been an active
participant of the Children’s Cancer Group
which became the Children’s Oncology Group
shortly after this. The Children’s Oncology
Group provides Phase II and III therapeutic
studies for most childhood malignancies
and there has been ample evidence that
participation in such trials has improved the
outlook for children with cancer. Indeed,
every children’s oncology service throughout
the western world is a participating and
practising member of a large collaborative
group with the three paediatric oncology
centres in New Zealand, seven in Australia
and those in Canada and the US being
members of the Children’s Oncology Group.
We currently have 27 open studies and 14
closed studies in which we are continuing
to follow patients. In addition, there are 7
studies awaiting either ethics or management
approval. It is anticipated that we will continue
to open around 20-25 new studies per year in
order that the majority of newly diagnosed
children with oncological conditions have
access to Phase II and III clinical studies
through the Children’s Oncology Group.
A minority of other non-pharmaceutical
international collaborative groups also exist
in which we are also participating, namely
the Medical Research Council, Acute Myeloid
Leukaemia trials and the International Society
of Paediatric Oncology (SIOP) trials for liver
tumours and occasional brain tumours.
This department currently has only one
pharmaceutical company sponsored research
study in infectious disease and as yet we have
no patients enrolled on any pharmaceutical
company sponsored study. In total, the
Paediatric Oncology Service deals with
approximately 80-120 new patients per year
and in the most common disease category,
acute lymphoblastic leukaemia, there are
now a classification and biology study, a Very
High Risk Study, a High Risk Study, a Standard
Risk Study, a T-Cell Study, and shortly to be,
an Infant Leukaemia Study. In any one year
therefore, it is unlikely that any single study
will accrue more than ten patients even in the
most common disease category. It is because
of the moderately good outcomes for some of
these diseases that large scale international
collaboration is required to answer questions
with any statistical validity. Furthermore, for
some of the less common diseases which
may not have favourable outcomes, the same
rationale applies. Tissue banking for purposes
of timely research by appropriately approved
researchers is integral to the success of
international collaboration particularly for
these less common disorders.
Improve cost
effectiveness
and outcomes
of health
services
17
Current Research
In 2006, 183 new projects were submitted, approved
and started. However, there are over 500 projects
currently running within the ADHB. ADHB researchers
lead some of the research and researchers from other
organisations are the lead in others. There are also
pieces of research that are primarily undertaken by
researchers outside of the ADHB. In these cases the
ADHB researchers often offer minor support i.e. patient
referrals or advice and support the researchers to
understand the processes and procedures of the ADHB.
ADHB researchers also were successful 41 times
with main grant and funding applications in 2006 with
three being with the Health Research Council, a
highly contested fund. There were also a number of
other successful funding grants and research support
achievements with for example, AMRF, Goodfellow
Research, the Wishbone Trust, Cancer Society,
National Heart Foundation, Canterbury Urological
Genesis, and the Australasian Physiotherapy Society.
The following research projects are currently in progress in ADHB
Allied Health, Older Persons and Ambulatory
Allied Health, Older Persons
and Ambulatory services
are a collection of services
encompassing social
work, community links,
interpreters and disability
support. Some are new
to undertaking formal
research programmes. Much of the work these
services undertake has
been primarily health
service reviews.
Ian Scott o
Robyn Duffy
o
Clare Mccann o
A
Phonation Therapy Approach for Mandarin
English Bilingual Clients with Dysarthria – Will
it improve speech intelligiblity in Mandarin
more than English?
Amy Lineham o
A
ssessing Safety Culture by Means of the
Safety Climate Survey
Peter Huggard
ilot study: the residual effectiveness of
P
chlorhexidine gluconate 0.5% on public
health nurses hand flora during student
mass vaccination programmes
Julie Park o
P
olitical Ecology of Tuberculosis in
New Zealand – Past & Present
Trish Fraser
o
E valuation of the Effectiveness of the
Smokestop Internet Smoking Cessation
Programme
o A
Measure of the Quality of Professional Life
and its’ Relationship to Individual and
Organisational Resilience
Beryl Fabian Jagpal Benipal Leigh Hale o
18
A
n Alcohol Intervention Programme for
Auckland Hospital
P
hase I: Is the Number of Acute Adult Medical
Admissions Rising in Auckland?
o
o
T he Experience of and Response to Diagnosis
in Alzheimer’s Disease
E xploring the Process of Physiotherapy
in Home-based Stroke Rehabilitation in
New Zealand
o
Audiology
Mridula Sharma
Ophthalmology
Jennifer Craig
The Department of
Ophthalmology works
closely with the Faculty
of Medical and Health
Sciences at the University
of Auckland and collectively
they undertake a comprehensive and innovative
research programme.
The department of
Ophthalmology also works
closely with students and
research fellows, to support
and provide an excellent
opportunity for training in
both clinical Ophthalmology
and biomedical vision
research. o
o
I mproving Diagnosis and Comparing
Interventions for Children with Auditory
Processing Difficulties
M
orphological and Cellular Changes in the
Human Cornea with Orthokeratology
Silvia Fennell
o
Helen Danesh-Meyer
o
Mark Donaldson
o
o
o
o
o
A
n Eval. of Efficacy & Safety of Posterior
Juxtascleral Injections of Anecortave Acetate
15mg (0.5ml of 30mg/ml Anecortave acetate
sterile suspension) vs Vehicle in Pts with
Subfoveal (CNV) Due to Exudative
S
tudy of Transpupillary Thermotherapy for the
treatment of Diabetic Maculopathy
A
n Eval. of Efficacy & Safety of Posterior
Juxtascleral Admin of Anecortave Acetate for
Depot Suspension (15/30mg) vs Sham Admin
in Pts (Enrolled in Study “A” or Study “B”) at
Risk for Developing Sight-Threatening
Choroidal Neovascularisation
o
o
Q
uantitative Analysis of Vigabatrin Induced
Visual Loss with Optical Coherence
Tomography of the Retinal Nerve Fibre Layer
and Correlation with Visual Field Defects
Dipika Patel
o
C
orneal Nerve Density Analysed by in Vivo
Confocal Microscopy in the Normal Cornea
and Following Herpetic Corneal Disease
Andrea Vincent
o
L inkage Analysis, Mutational Analysis and
Characterisation of Genes Causing Disease
in the Glaucomatous Optic Neuropathies
Thomas Stumpf
o
P
rospective Randomised Controlled Trial of
Intracameral Perfluoropropapane (C3F8) Gas
for Acute Hydrops in Keratoconus
A
6M PIII MC Masked, Rand, Sham-controlled
Trial to Assess the Safety & Efficacy of 700µg
& 350µg Dexamethasone Posterior Segment
Drug Delivery System in the Treatment of
Pts w/Macular Edema Foll. C.Retinal Vein
Occlusion/Branch Retinal Vein Occlusion
Charles NJ McGhee
A
3Y P3 MC, Masked, Rand., Sham Controlled
Trial to Assess the Safety & Efficacy of 700µg
& 350µg Dexamethasone Posterior Segment
Drug Delivery System (DEX PS DDS)
Applicator System in the Treatment of Ps with
Diabetic Macular Edema
o
Helen Danesh-Meyer
o
L istening, Seeing and Doing: The Relationship
of Cochlear Implant Recipient’s Listening to,
Making Meaning of and Identifying Music
C
orrelation Between Optic Disc Structure
Obtained by the Heidelberg Retina Tomograph
(HRT), Optical Coherence Tomography (OCT),
and Optic Nerve Function in Optic Neuropathy
C
orrelation Between Optic Disc Structure
Obtained by the Heidelberg Retina Tomograph
(HRT) and Optic Nerve Function (Visual Acuity,
Colour Vision, Visual Field) in Pseudotumour
o
Q
ualitative and Quantitative Analysis of
Cellular and Sub-cellular Structural Changes
in Keratoconus by in Vivo and in Vitro Analysis
in the Human Cornea
Diane Sharpe
A
Rand. DM MC PII Study Assessing the
Safety & Efficacy of Two Concentrations of
Ranibizumab (Intravitreal Injections)
Compared with Non-Treatment Control for the
Treatment of Diabetic Macular Oedema with
Centre Involvement
Austin McCormick
o
A
Randomised Controlled Trial: Should Aspirin
be stopped prior to dacryocystorhinostomy?
o
D
imensions of the Nasolacrimal Duct by
Computed Tomography in European and
Polynesian Peoples
C
orrelation Between Accumap Objective
Perimetry and Humphrey’s Automated
Perimetry in Patients with Optic Neuropathies
19
CURRENT RESEARCH
Sexual Health
Pharmacy
The Pharmacy department
at ADHB is involved in
a variety of research.
The focus of most of
the research is around
medicines management
and medication safety.
The benefit to the hospital
is always considered
when we assess the initial
research proposal.
Rehab Plus
With a range of specialists,
Rehab Plus offers intensive
and comprehensive
rehabilitation following
moderate to severe
injury or illness.
Laboratory
Involved in all clinical trials
requiring specimen analysis,
LabPlus is accredited and
therefore able to analyse
specimens for research
studies. LabPlus scientists
and technicians are
continually looking for new
methods to advance
diagnostic methodologies.
20
Sunita Azariah
o
A
Case-Control Study of the Prevalence of
Mycoplasma Genitalium (MG) in Men with
Non-Gonococcal Urethritis (NGU) at Auckland
Sexual Health Service (ASHS)
The research is co-ordinated by the
Pharmacy Practice Research Group
consisting of 5 ADHB pharmacists and one
staff member from Auckland University
School of Pharmacy.
Sunita Azariah
o
A
Pilot Study for Enhanced Surveillance of
Infectious Syphilis in the Auckland Region
Alison Forbes
o
O
xycodone use at ADHB
Adele Print
o
The department has an active programme
working with students and undertaking
audits and reviews of practise primarily
within the medication safety sphere;
W
arfarin: The Deadly Lifesaver - Examination
of a Structured Patient Education Initiative
to Improve Warfarin Safety
• Help training staff
• Improving health outcomes by identifying
and putting in place medication safety
processes
• Auditing medication use
• Investigating cost effectiveness
It is a service emerging into the research
arena with increasing partnerships
developing with researchers from AUT
and Massey University.
Suzanne Ackerley
o
Kathryn McPherson
o
G
oal Setting in Rehabilitation: Two New
Approaches in Traumatic Brain Injury
In general most of its core review is
primarily around quality assurance, in
recent times, and in collaboration with
other academic institutes, there has
been an increase in research looking
at new techniques and methodologies
for sample analyses.
Q
uality of Life (as Measured by the WHOQOLBREF) and Participation in Life Roles (As
Approximated by the London Handicap Scale)
in a Population Over a Time of Outpatient
Rehabilitation
Varsha Patel
o
E valuation of a New Syphilis Assay
(KODE-SYP)
Anthony Roberton
o
N
ovel Method for Identification of Bacteria
Catherine Marson
o
D
evelopment of a Flow Cytometry Method
for the Measurement of Zap-70 in B Chronic
Lymphocytic Leukaemia
Infectious Diseases
The Infectious Disease team
work closely with all areas
of the organisation and with
the Regional Public Health
Service. Although only a
small research programme
is operating, they are very
active in infection control
and surveillance. Andrew Grey
o
A community and hospital
based service, the Mental
Health Service team have
a core role in working
with tertiary students from
a variety of disciplines
to provide training and
supervision opportunities.
Much of the research
programme centres on
this responsibility. o
o
o
M
ental Health Crisis Services: What do
Service Users, and their Primary Support
People, need when in Crisis? Given that
Feedback, what is the response to a proposal
for an alternative to acute hospital care?
Julie Wharewera-Mika
o
o
T he Auckland Outpatient Antipsychotic Audit
Josephine Stanton
o
E xploration of Multiple Role Relationships
Experienced when Doctors are in the Role of
Patient of a Psychiatrist
A
n Observational Study of the Impact of LongActing Risperidone Microspheres in Maori
and Pacific People with Schizophrenia and
Related Psychotic Disorders
o
L ike Minds Like Mine Mental Health Services
Research
Duncan Milne
o
A
n Observational Study of the Effect of
Knowing the CYP450 Metaboliser Status on
Clinician Prescribing Behaviour When
Treating Psychosis with Risperidone
Deborah Antcliff
o
Allan Wyllie
o
A
Phenomenological Investigation pf
Disturbances in Self-Experience Prior to
Psychosis Among Clients of Auckland Mental
Health Services Receiving Treatment for a
First Episode of Psychosis
Wayne Miles
Gail Robinson
o
M
ental Health Inpatient Services: Improving
our understanding of the needs for Maori
when acutely unwell
Angus Maxwell
Amanda Wheeler
o
T he Perceptions and Beliefs of Healthcare
Workers (HCW’s) about Tuberculosis (TB)
I nvestigations into the Potential Role of
Streptococcal Superantigens in Severe
Invasive GAS Disease
Kirsty Agar
o
A
Study to Determine the Pharmacokinetics of
Intravenously Administered Flucloxacillin in
Cerebrospinal Fluid of Patients Treated for
Presumptive or Proven Meningitis
Jill Miller
Thomas Proft
Mental Health
A
Two Year Double Blind, Randomised,
Controlled Trial to Evaluate the Efficacy of
Zoledronic Acid in the Prevention of Bone
Loss in Patients Infected with Human
Immunodeficiency Virus Taking Highly Active
Antiretroviral Therapy
Mark Thomas
A
Process and Outcome Evaluation of the
Development of the Acute Home Based
Service at Auckland District Health Board
Mental Health Services
A
n Investigation into the Relationship
Between Competence to Consent to Mental
Health Treatment and Civil Commitment on a
Community Treatment Order Under S.29 of the
NZ Mental Health (Compulsory Assessment
And Treatment) Act 1992
21
CURRENT RESEARCH
Diabetes
The Diabetes Centre has an
active research programme
with studies across the
bench, treatment and
community spectrum in
both Type 1 and 2 diabetes.
Uwe G Kersting
o
B
iomechanical and Morphological Evaluation
of Diabetic Feet - Effects of Different
Offloading Modalities for Diabetic Feet
Raina Elley
o
T he Diabetes Cohort Study
Paul Drury
o
A
MC, Rand., DB, Placebo-Controlled Study
to Determine the Efficacy and Safety of
SYR110322 (SYR-322) Compared with Placebo
in Subjects with Type 2 Diabetes
o
A
MC, Rand., DB, Placebo-Controlled Study
to Determine the Efficacy and Safety of
SYR110322 (SYR-322) when used in
Combination with Metformin in Subjects
with Type 2 Diabetes
o
A
Long-Term, Open-label Extension Study to
Investigate the Long-Term Safety of SYR110322
(SYR-322) in Subjects with Type 2 Diabetes
o
L iraglutide Effect and Action in Diabetes:
Effect on Glycaemic Control After Once Daily
Administration of Liraglutide in Combination
with Metformin vs Metformin Monotherapy vs
Metformin & Glimepiride Combination Therapy
in Subjects with Type 2 Diabetes
Paul Drury
o
S
H-AHM-0045/EC556 (Component of
DIRECT Programme)
o
T rialNet Natural History Study of the
Development of Type I Diabetes
o
T he Collaborative Study Group Trial:
The Effect of Sulodexide in overt Type 2
Diabetic Nephropathy
o
T he Collaborative Study Group Trial: The Effect
of Sulodexide in Patients with Type 2 Diabetes
and Microalbuminuria.
o
A
MC, Rand., DB, Placebo-Controlled. Study
to Determine the Efficacy and Safety of
SYR110322 (SYR-322) when used in
Combination with Insulin in Subjects
with Type 2 Diabetes
Melanie Lindsay
o
M
indfulness-Based Cognitive Behavioural
Therapy and Type 2 Diabetes Mellitus: A Pilot
Program for Developing Self-Efficacy and
Self-Compassion
Nursing Research
Andrew Jull
o
H
oney as Adjuvant Therapy for Leg Ulcers
(HALT): A Randomised Controlled Trial
Elizabeth Blake-Palmer
o
B
eing an Orthopaedic Nurse: A Hermeneutic
Inquiry
Jagpal Benipal
o
C
hanges in the Burden of Medical
Admissions/Discharges in Auckland: Phase II
Lyn Dyson
o
A
ssessment of Learning Needs of Registered
Nurses in Clinical Practice
Jane Stewart
o
22
A
ddressing Obstacles to Success:
Improving Student Completion, Retention
and Achievement in Science Modules in
Applied Health Programmes, with Particular
Attention to Mäori
Barbara Daly
o
E mpowering Primary Health Care Nurses in
the Community Management of Diabetes
Helen McGrinder
o
H
eart Failure Services: Developing the Role
of the Heart Failure Nurse to Improve
Service Provision
Rheumatology
The Department of
Rheumatology has an active
research team. The main
current research activities
undertaken are those
focusing on gout and
arthritis. In particular, there
is an interest in magnetic
resonance imaging (MRI)
in arthritis and its role in
prognostication and
mechanisms of bone
erosion in gout. Nicola Dalbeth
o
R
andomised DB Multicentre Study to Evaluate
the Tolerability and Effectiveness of Etoricoxib
in Patients with Rheumatoid Arthritis (‘EDGE’)
o
M
echanisms of Bone Erosion in Chronic
Tophaceous Gout
o
P
redictors of Hand Function in Patients with
Gout: A Three-Dimensional CT Study
o
T he Genetic Causes of Gout in New Zealand
o
A
Multicentre, Randomized, Double-blind,
Placebo-controlled Trial of Golimumab, a Fully
Human Anti-TNFa Monoclonal Antibody,
Administered Subcutaneously, in Subjects
with Active Rheumatoid Arthritis Despite
Methotrexate Therapy
Nicola Dalbeth
o
T he Effects of Knee Joint Aspiration and
Corticosteroid Injection on Quadriceps Muscle
Performance and Lower Limb Function in
Patients with Chronic Arthritis
o
A
Longitudinal Observational Study of Clinical
Outcomes in Gout
Fiona McQueen
o
M
RI to Monitor the Effect of Zoledronic Acid
Therapy in Aggressive Erosive Psoriatic
Arthritis (Arthritis Mutilans)
o
B
one Oedema and Rheumatoid Arthritis:
Correlating MRI with Histopathology
Paul Carver
o
A
Brief Acceptance Intervention for
Rheumatoid Arthritis
Pain Services
Diane Henare
o
P
articipating in Pain Management
Programmes
Catherine Howie
o
Coralee Jane Marshall
o
General Surgery
I s distraction too much of an effort? An
Experimental Investigation into the Impact of
Attentional Demands of Distraction on Pain
Intensity and Exercise Tolerance in Chronic
Low Back Pain Patients
Wayne Jones
o
M
enstrual Cycle and Surgical Treatment of
Breast Cancer
Jonathan Koea
o
Richard Harman
o
S
entinel Node Biopsy Versus Axillary
Clearance in Operable Breast Cancer
Ian Bissett
o
O
utcome of Interventions from a Pelvic Floor
Clinic for Defecatory Disorders: The Auckland
experience
o
D
etection and Identification of Bacterial
Substances that Activate Adaptive Immune
responses in Pouchitis
I s neuropsychological function modified by
acute and chronic pain, and if so, is this
dependent on pain intensity, duration or
emotional status?
T he Oncological Consequences of Hepatic
Mobilization: Detection of Tumour Cells in
Blood in Patients Undergoing Hepatic
Resection for Colorectal Cancer Metastases
Paul Brown
o
U
se of Private and Public Sectors for Surgical
Procedures
23
CURRENT RESEARCH
Anaesthesia
Alan Merry
o
S
afer Drug Administration in Anaesthesia
o
With close links to the
University of Auckland,
the anaesthetic department
are interested in areas
across the clinical spectrum,
from fuzzy logic decision
making systems to
physiology of coagulation
in cardiac surgery.
o
B
rain Protection During Cardiac Surgery by
Reduction of Exposure to Arterial Emboli and
Administration of Lignocaine
Grant Hounsell
A
Prospective, Parallel Group, DB Comparison
of the Analgesic Effect of a Combination of
Paracetamol and Ibuprofen, Paracetamol
Alone or Ibuprofen Alone in Patients with
Post-Operative Pain
Francesca Storr
o
D
eterminants of Coagulation after
Cardiopulmonary Bypass (CPB)
The department is also
actively involved in
understanding pain and
delivering services for
acute and chronic pain. o
A
natomical Relationship Between Sensory
Pathways Recruited in Spinal Cord
Stimulation and Paresthesia for the
Treatment of Chronic Refractory Angina
Pectoris and Chronic Pain
o
o
A
Randomised, Double-Blind, Placebocontrolled Study of Glypromate in Patients
Undergoing Coronary Artery Bypass
Graft Surgery
Timothy Short
o
C
ognitive Function After Aneurysm Surgery
Trial (CFAAST)
o
F actor VIIa/NovaSeven Haemostasis Registry
o
A
R.C. Trial of Bispectral Index Monitoring to
Prevent Awareness During Anaesthesia - to
compare the long term mortality and morbidity
of pts enrolled in the B-Aware Trial who were
randomised to Bispectral Index (BIS)
monitoring or routine care
Yatin Young
o
T he PeriOperative Ischemic Evaluation Study
(POISE) McMaster University
o
A
MC Rand. DB Parallel Group, Placebo
Controlled Trial to Evaluate the Efficacy &
Safety of Activated Recombinant Factor VII
in Severely Injured Trauma Patients with
Bleeding Refractory to Standard Treatment
Novo Nordisk
Robert Fry
o
H
as Education and Awareness Reduced
the Incidence of Substance Abuse in
Anaesthetists in Australasia?
Cornelius Kruger
o
24
S
uperficial Cervical Plexus Block for the
Treatment and Prevention of Ipsilateral
Shoulder Pain Post - Thoracotomy
James Cheeseman
o
o
C
hronopharmacology of the Neuromuscular
Blocker Rocuronium
A
Prospective Randomized Clinical Trial
Comparing the Henderson and Macintosh
Laryngoscopes
A
Randomised Double Blind Placebo
Controlled Trial of Site-Specific Clonidine
Patches in Treatment of Neuropathic Wound
Pain Following Caesarean Section
Neil MacLennan
o
U
ltrasound Guided Regional Anaesthesia - an
Audit of Practice
Guy Warman
o
Investigation of the Relationship Between Core
Body Temperature and Peripheral Arterial
Blood Temperature in Patients Undergoing
Cardiopulmonary Bypass
o
C
ircadian Disruption after Anaesthesia and
Surgery in Patients Undergoing Cardiac Surgery
Michael Harrison
o
D
evelopment and Validation of an Interactive
Anaesthesia Warning System for Monitoring
the Adverse Effects that Might Arise During
Anaesthesia Administration
Jennifer Weller
o
F easibility, Reliability, Validity and Acceptability of the Mini-CEX Assessment Process
During the Anaesthesia Training Programme
Barry Slon
o
A
ccuracy, Precision and Reliability of the
I-STAT Point-Of-Care Device in Assessment of
Haematocrit in Patients Undergoing Massive
Blood Loss and Transfusion and with Consequent Instability of Plasma Albumin Levels
James Lai
o
U
ltrasound Measurement of the Internal
Jugular Vein as an Indication of Central
Venous Pressure
Doug Campbell
o
T he Use of Response Surface Modelling to
Define the Interaction Between Sevoflurane
and Remifentanil
Jack Hill
o
A
n In Vitro Assessment of Amniotic Fluid
on Platelet Function in Pregnancy Using a
PFA-100 Analyser
Cardiology
An active research
department with
research currently across
transplant, interventional,
electrophysiological and
medical areas. Many of
the researchers are active
participants and leaders in
the international arena and
are part of teams developing
and designing innovative
research across the
cardiology discipline. Chris Ellis
o
C
an a Cardiac Rehabilitation Nurse Improve
the Uptake of Secondary Prevention (The
CRISP Study)
o
T he New Zealand Registry of Acute Coronary
Syndromes
Sue Crengle
o
Daniel Devcich
o
Chris Occleshaw
o
T he Assessment of Magnetic Resonance
Imaging in Detecting Cardiac Transplant
Vasculopathy
C
linical Priority Assessment Criteria (CPAC)
Evaluation Project: Coronary Artery Bypass
Graft (CABG) Surgery Priority Assessment
Tool: Economic Substudy
John French
o
C
ardiac Inherited Disease Registries
o
O
ngoing Telmisartan Alone and in combination
with Ramipril Global Endpoint Trial
o
A
Rand., DB, Placebo-controlled, Pilot Study of
the Efficacy and Safety of GC811007 in
Patients with Type 2 Diabetes Mellitus and
Heart Failure
o
o
C
hronic Heart Failure Angiotensin Blockade
With Irbesartan Study
F ollow-Up Serial Infusions of Natrecor
(nesiritide) for the Management of Patients
with Heart Failure (FUSION II)
o
N
ew Zealand Heart Failure Registry
o
H
emodynamically Guided Home Self-Therapy
in Severe Heart Failure Patients
(HOMEOSTASIS 1)
Rod Jackson
o
I nternational Multicentre Study of Promotion
of Early Response to Acute Myocardial
Infarction Symptoms
Cheryl Campbell
o
A
n Intervention for Changing Symptom
Perceptions of European and Maori Women
with Angina or a Heart Attack
Julie Reeve
o
Robert Doughty
o
H
ow do patients’ perceptions of the
angiography procedure affect reassurance?
Heather Baker
Jacqueline Cumming
o
P
reventing Further Heart Disease in General
Practice: Secondary Preventative Care
Following Admission to Hospital
D
o Physiotherapy Interventions Reduce the
Incidence of Postoperative Complications in
Patients Following Pulmonary Resection Via
Thoracotomy? A Randomised Controlled Trial
Lisa Reynolds
o
A
re Drawings Associated with Level of
Disability and Adherence to Treatment in
Heart Failure and Myocardial Infarction
Patients?
Rachael Palmer
o
EC
G Electrode Placement Study
Mark Cannell
o
S
tructure and Function in Failing Heart
Peter Black
o
W
hat is the Prevalence of Airflow Obstruction
in Congestive Heart Failure?
Vernon Harvey
o
C
ardiac Marker Substudy
C
linical Priority Assessment Criteria (CPAC)
Evaluation Project: Validity of the Coronary
Artery Bypass Graft (CABG) Surgery Priority
Assessment Tool
Sally Greaves
o
C
ardioplegia and Perioperative Myocardial
Protection
Sanjeevan Pasupati
o
E ffects of Coronary Angioplasty on the Plasma
Natriuretic Peptides (NP) and Surfactant
Protein-B (SP-B) Concentrations During
Exercise
25
Heart Transplant Research
Cara Wasywich
o
A
Rand. O-L Study to Compare the Safety and
Efficacy of Conversion from a Calcineurin
Inhibitor to Sirolimus V. Continued use of a
Calcineurin Inhibitor in Cardiac Transplant
Recipients with Mild to Mod. Renal
Insufficiency.
Peter Ruygrok
o
S
afety and Performance of the External Driver
C-Pulse Device, a New Device Intended for
Providing Relief and/or Recovery from
Moderate to Severe Heart Failure
o
C
omparison of Augmentation Index Derived
from the Ascending Aorta and Suprasystolic
Brachial Artery Recordings
o
A
24MM MC Rand. OL Non-Inferiority Study of
Efficacy & Safety Comparing 2 Exposures of
Concentration-Controlled Certican with
Reduced Neoral Versus 3.0g MMF with
Standard Dose Neoral in De Novo Heart
Transplant Recipients
Peter Ruygrok
o
E valuation of the VentrAssist(TM) Left
Ventricular Assist System as Destination
Therapy in End Stage Cardiac Failure
Cardiac Intensive Care Research
Shay McGuinness
o
Cardio-thoracic
A
Pilot Study to Validate the Use of High
Flow Humidified Nasal Oxygen Therapy,
in a Cardiothoracic and Vascular Intensive
Care Unit
Shay McGuinness
o
M
ulticentre, Unblinded, Randomised
Controlled Trial to assess the effect of
Augmented vs. Normal Continuous Renal
Replacement Therapy (CRRT) on 90-day allcause mortality of Intensive Care Unit
Patients with Severe Acute Renal Failure
Paget Milsom
o
C
ardioplegia and Perioperative Myocardial
Protection
Interventional Cardiology Research
The interventional cardiology
group has an active research
programme with a focus on
new coronary interventional
devices. Studies with new
coronary drug-eluting
stents include phase 2 firstin-man (FIM) evaluations
and phase 3 pivotal
randomised comparisons.
26
The unit undertook the first implantation
of a fully bioabsorbable drug-eluting stent.
Other areas of interest include dedicated
devices for coronary bifurcation lesions,
new techniques for closure of patent
foramen ovale, a randomised comparison
of carotid stenting versus surgical
endarterectomy, proximal and distal
vascular protection devices, point-of-care
testing of antiplatelet pharmacokinetics
and pharmacodynamics, and assessment
of trans-coronary biomarker release during
percutaneous coronary intervention.
Jim Stewart
o
ICSS
International Carotid Stenting Study
John Ormiston
o
T AXUS II. A Randomized, DB, Controlled,
Study of the Safety and Performance of the
NIRxTM Paclitaxel-coated Conformer
Coronary Stent
o
T he Clinical Evaluation of the Medtronic AVE
ABT-578 Coated DRIVER Coronary Stent in De
Novo Native Coronary Artery Lesions
o
A
n Australian and New Zealand PostMarketing e-Registry of the Use of Cypher™
Sirolimus-Eluting Stents in Public Patients
Interventional
Cardiology
Research cont.
John Ormiston
o
E ndeavor II Study: A Randomised Controlled
Trial to Evaluate the Safety & Efficacy of the
Medtronic AVE ABT-578 Eluting Driver
Coronary Stent in De Novo Native Coronary
Artery Lesions
o
T he ‘Crush’ Technique for Coronary
Bifurcations Using Drug-eluting Stents:
Clinical and Angiographic Follow-up
o
RESOLUTE
Clinical Trial. The Clinical
Response Evaluation of the Medtronic
Endeavor CR ABT-578 Eluting Coronary
Stent System in De Novo Native Coronary
Artery Lesions
o
B
ioabsorbable Vascular Solutions Everolimus
Eluting Coronary Stent System 1st in Man
Clinical Investigation: A Clinical Evaluation of
the BVS Everolimus Eluting Coronary Stent
System in the Treatment of Pts w/Single De
Novo Native Coronary Artery Lesions
o
o
o
A
Rand. Controlled Trial to Evaluate the Safety
& Efficacy of the Zomax Drug Eluting Coronary
Stent System as Compared to the TAXUS
Paclitaxel-eluting Stent in De Novo Coronary
Artery Lesions
A
Non-Rand., Consecutive Enrolment
Evaluation of the Avantec PimecrolimusEluting Duraflex Stent in the Treatment of
Patients with De Novo Native Coronary
Artery Lesions
D
rug Eluting Stent Intervention for Treating
Side Branches Effectively
Mark Webster
o
A
MC Single-arm Study of the Taxus Liberte™
SR Stent for the Treatment
of Patients with De Novo Coronary
Artery Lesions
o
A
ngioplasty Balloon-Associated Coronary
Debris and the Boston Scientific EZ
Filter Wire System
o
T AXUS ATLAS SMALL VESSEL: A MC,
Single-arm Study of the TAXUS Liberte™
-SR stent for the Treatment of Patients with
De Novo Coronary Artery Lesions in Small
Vessels
Mark Webster
o
T AXUS ATLAS DIRECT STENT STUDY: A MC
Single-arm Study of the TAXUS Liberte™ - SR
Stent for the Direct Stenting Treatment of Pts
with De Novo Coronary Artery Lesions
o
T AXUS ATLAS LONG LESION: A MC Singlearm Study of the TAXUS Liberte™ - SR Stent
for the Treatment of Pts with De Novo
Coronary Artery Lesions
o
COST
AR II - Prospective MC SB 2-arm
Rand Controlled Trial of the Conor Costar
Paclitaxel-Eluting Coronary Stent System vs
the Taxus Drug-eluting coronary Stent
System in Pts w/ De Novo Lesions of the
Native Coronary Arteries
o
P
hysician Preference/ Performance
Evaluation of F.A.S.T. - LVG for the Temporary
Occlusion of Blood Flow in Patients During
Interventional Procedures in Saphenous Vein
Grafts and Coronary Arteries
o
D
o Non-steroidal Anti-inflammatory Drugs
Interfere with the antiplatelet effects of
Aspirin (NADIA).
o
T he Xtract™ Aspiration Catheter
Registry Study
o
T he PreCiSE Trial: CoStar™ Paclitaxel-Eluting
Coronary Stent. Catheter System Evaluation
Patrick Gladding
o
P
lavix Response in Coronary Intervention
(PRINC)
Peter Ruygrok
o
A
Clinical Evaluation of the XIENCE™ V
Everolimus Eluting Coronary Stent System in
the Treatment of Patients with De Novo Native
Coronary Artery Lesions
o
S
tudy of the PFx Closure System in Subjects
with Cryptogenic Stroke, Transient Ischaemic
Attack, Migraine or Decompression Illness.
The Paradigm 11ca
o
S
PIRIT II Clinical Study: A Clinical Evaluation
of the XIENCE™ V Everolimus Eluting Coronary
Stent System in the Treatment of Patients with
de novo Native Coronary
Artery Lesions
27
Cardiovascular Research Unit
The CVRU undertakes
clinical research aimed at
improving treatments for
acute coronary syndromes,
heart valve disease, atrial
fibrillation, obesity and
cardiovascular risk. Members
of the CVRU include Harvey
White, Ralph Stewart and
Jocelyn Benatar. Our
research is sponsored by
industry, and public good
funders including the
National Institutes of Health,
the Health Research Council
of NZ and the National Heart
Foundation. Examples of
studies currently in progress
include the IMPROVE-IT
trial which is evaluating a
promising new cholesterol
lowering treatment currently
approved for use in New
Zealand; the STITCH trial
which is evaluating the
role of cardiac surgery in
patients with severe cardiac
impairment; the NZ Heart
Valve studies which aim to
improve identification of
early LV dysfunction in
patients with heart valve
disease; and studies of new
anti-coagulant treatments
which have the potential to
improve outcomes and
reduce complications for
patients now treated with
warfarin.
During the last year the CVRU contributed
to more than 20 publications in leading
international medical journals. The Director of
the CVRU is also on the steering committee
for a number of international clinical trials.
o
A
Rand. DB Placebo Controlled Trial to
Investigate the Effects of Long-term Treatment
w/Aldosterone Receptor Antagonist
Eplerenone on the L Ventricular Mass &
Volume w/Magnetic Resonance Imaging in
Pts w/Asymptomatic Moderate to
Severe Stenosis
o
N
ew Zealand Heart Valve Study - third arm Natriuretic Proteins for Assessment of Severe
Aortic Regurgitation
o
E fficacy of Beta-blockers in Mitral
Regurgitation
o
C
ardiac Neurohormonal Activation and the
Effect of Intracoronary Beta-blockers During
Percutaneous Coronary Intervention in Acute
Coronary Syndromes: Mechanistic Study
o
C
oronary Artery Disease Biomarkers Study
o
A
Clinical Trial Comparing Cangrelor to
Clopidogrel in Subjects who Require
Percutaneous Coronary Intervention
o
N
atriuretic Peptides and Exercise Capacity in
Mixed Valvular Heart Disease
o
A
Multicentre, Double-Blind, Randomised
Study to Establish the Clinical Benefit and
Safety of Vytorin (Ezetimibe/ Simvastatin
Tablet) vs Simvastatin Monotherapy in HighRisk Subjects Presenting with Acute Coronary
Syndrome
Brett Cowan
o
o
T he Cardiac MRI Substudy in the Ongoing
Telmisartan Alone and in Combination with
ramipril Global Endpoint Trial
E ffect of Pulmonary Valve Replacement in
Teralogy of Fallot
Christopher Raffel
o
T he Role of Brain Natriuretic Peptide (BNP) in
the Assessment of Valvular Heart Disease
Jocelyn Benetar
o
o
A
Multicenter Randomised, Double Blind
Study to Evaluate the Safety and Efficacy of
MK-0431 Monotherapy in Patients with Type 2
Diabetes Mellitus who have Inadequate
Glycemic Control
A
MC, DB, Rand. Study to Evaluate the Safety
& Efficacy of the Addition of MK-0431
Compared with Sulfonylurea Therapy in
patients with Type 2 Diabetes with Inadequate
Glycemic Control on Metformin Monotherapy.
o
A
Multicenter, Randomised, Double-Blind
Factorial Study of the Co-administration of
MK-0431 and Metformin in Patients with Type
2 Diabetes Mellitus who have Inadequate
Glycemic Control
o
A
Multicentre, Randomised, Double Blind
Study to Evaluate the Safety, Efficacy and
Tolerability of L-000 899055 Monotherapy in
Obese Patients
o
A
Multicenter Randomised, Double Blind,
Placebo Controlled Study to Evaluate the
Safety and Efficacy of MK-0736 and Mk-0916
in Hypertensive patients
o
A
MC Rand, DB Placebo & Active Controlled,
Rand Study to Evaluate the Safety & Efficacy
of the Addition of Sitagliptin 100mg OD in Pts
W/Type 2 Diabetes W/Inadequate Glycaemic
Control on Metformin Monotherapy
o
28
Ralph Stewart
A
phase IIb/III Randomised, Placebocontrolled Clinical; Trial to Study the Safety
and Efficacy of MK-0364 in Obese Patients
and in Overweight Patients with Obesityrelated Co-morbidities
Harvey White
o
A
Random Placebo-controlled Factorial Trial
of Low Molecular Weight Heparin, of
Simvastatin and of Benzafibrate, on
Restenosis and Coronary Artery Disease
Progression in Patients Following Coronary
Angioplasty
o
O
ccluded Artery Trial (OAT) (USA)
o
O
ngoing Telmisartan Alone and in Combination
with Ramipril Global Endpoint Trial
o
E xTRACT-TIMI25. Enoxaparin & Thrombolysis
reperfusion for Acute Myocardial Infarction
Treatment. A Rand. DB, DD, Par Group MN
Clinical Study to Eval Efficacy & Safety of
Enoxaparin vs Unfractionated Heparin in Pts
w/Acute ST-segment Elevation Myocardial
Cardiovascular
Research Unit cont.
Harvey White
o
F ifteen Year Review of the Medtronic Intact
Tissue Valve at Green Lane Hospital
o
T ype 2 Diabetes Database Study
o
STIC
H - The Surgical Treatment for Ischaemic
Heart Failure
o
T he ACUITY Trial: A Randomised Comparison
of Angiomax (bivalirudin) vs Lovenox / Clexane
(enoxaparin) in Patients Undergoing Early
Invasive Management for Acute Coronary
Syndromes Without ST-Segment Elevation
o
o
o
o
Harvey White
o
A
Study to Evaluate the Pharmacodynamic
and Pharmacokinetic Response and Safety
and Tolerability of SB424323 in Men and
Women with Non Valvular Atrial Fibrillation at
a Low or Intermediate Risk for Stroke
o
A
MC, Rand., DB, Parallel-group, Placebocontrolled Study of Pexelizumab in Patients
with Acute Myocardial Infarction Undergoing
Primary Percutaneous Coronary Intervention
A
MC DB Rand Study to Compare the Efficacy
& Safety of the Comb of 145mg Fenofibrate
and 40mg Simvastatin w/40mg Simvastatin
Nonotherapy in Pts w/Mixed Dyslipidaemia
At Risk of Cardiovascular Disease not
Adequately Controlled by 40mg
Simvastatin Alone
o
A
MC, Rand. DB Study of MK-0431 In Patients
with Type 2 Diabetes Mellitus who have
Inadequate Glycemic Control (Protocol
MK-0431-023)
A
mendment 11. Unstable Angina/Non-STSegment Elevation Myocardial Infarction
Subjects Treated with Aspirin and a
Glycoprotein IIb/IIIa Antagnonist
o
A
Comparison of Prasugrel (CS-747) and
Clopidogrel in Acute Coronary Syndrome
Subjects who are to Undergo Percutaneious
Coronary Intervention/TIMI-38
o
A
Clinical Trial Comparing Treatment with
Cangrelor (in combination with usual care) to
Usual Care, in Subjects who Require
Percutaneous Coronary Intervention INTE
GRILIN (eptifibatide) Injection Early
Glycoprotein Iib/IIIa Inhibition in Non-STsegment Elevation Acute Coronary Syndrome:
A Rand. Placebo-Controlled Trial Evaluating
the Clinical Benefits of Early Front-loaded
Eptifibatide in the Treatment of Pts w/
A
Comparison of CS-747 and Clopidogrel in
Acute Coronary Syndrome Subjects who are to
Undergo Percutaneous Coronary Intervention
Electrophysiology Research
The electrophysiology service
has extensive clinical
experience, especially with
pacing and defibrillation.
Current research is centred
on clinical defibrillation and,
via the Departments of
Engineering and Physiology
of Auckland University .
Active studies include randomized
international trials of internal (ICD) and
external (AED) defibrillation, development
of a new defibrillator with a private
company, a morphological study of the
right ventricle, computer modelling of VF.
Warren Smith
o
A
lternative Defibrillation and Sensing
Methods for the Prevention of Cardiac
Arrest and Innovative Treatment
o
H
ome Automatic External Defibrillator
Trial - H.A.T.
o
P
atient’s and Family’s Psychological
Response to H.A.T.
Margaret Hood
o
T emporary Pacing in Patients using the EBR
Device EBR systems
o
E valuation of the Subcutaneous Implantable
Defibrillator (S-ICD) System Cameron
Health, Inc.
o
R
esynchronization/Defibrillation for Advanced
Heart Failure Trial
29
Critical Care Medicine
The Department of Critical
Care Medicine has had an
active research programme
for 12 years, and is a
significant participant in the
Australia and New Zealand
Intensive Care Society’s
Clinical Trials Group. The
department has successfully
gained Health Research
Council funding of over
$1M over the last 6 years
to support New Zealand’s
participation in international
multicentre studies of
resuscitation fluids, glucose
control in the critically ill and
renal replacement therapy for
acute renal failure.
Other current investigator-initiated studies
include early decompressive craniectomy
in traumatic brain injury, and observational
studies of feeding of the critically ill, use of
resuscitation fluids and DVT prophylaxis.
Pharmaceutical company sponsored
studies currently include coagulationmodifying treatments in pneumonia and
severe trauma. Two other studies in
severe sepsis are in development.
Endocrinology
Ian Reid
o
A
Prospective, Rand., DB, Placebo Controlled,
Dose Ranging, Multicenter Study of the
Safety and Efficacy of Three Days Continuous
Intravenous Infusion of GR270773 in the
Treatment of Suspected or Confirmed Gramnegative Severe Sepsis in Adults
o
A
Randomised Controlled Trial of
Normoglycaemia versus Conventional
Glycaemic Control in Intensive Care Unit
Patients
o
A
Pivotal, Multicenter, Multinational,
Randomized, Double-Blind, PlaceboControlled PII Study to Evaluate the
Efficacy and Safety of Tak-242 in Adults
with Severe Sepsis
Colin McArthur
o
o
o
o
M
ulticentre Prospective Randomised Trial of
Early Decompressive Craniectomy in Patients
with Severe Traumatic Brain Injury (the
DECRA study)
A
PIII MC, Rand., Placebo-controlled, DB, 3Arm Study to Evaluate the Safety & Efficacy of
Tifacogin (Recombinant Tissue Factor
Pathway Inhibitor) Administration in Subjects
with Severe Community-Acquired Pneumonia
o
o
o
R
andomised, DB, Safety & Efficacy Trial with
Intravenous Zoledronic Acid for the Treatment
of Paget’s Disease of Bone Using Risedronate
as a Comparator
o
E pidemiology of Acromegaly in the Auckland
Region and Factors Predicting the Outcome
of Treatment
E ffect of Two Years Treatment with
Norditropin® Simplexx™ on Bone Mineral
Density in Young Adults with Childhood-Onset
Growth Hormone Deficiency
Mark Bolland
o
Tim Cundy
A
nti-fracture Efficacy of Calcium
Supplementation in Normal Post
Menopausal Women
Ian Holdaway
30
Colin McArthur
D
iscovery of Paget’s Disease in People
Inheriting Sequestosome I Gene Mutations
The Role of Insulin-Like Growth Factor 2
(IGF2) in Growth and Diabetes Study
Andrew Grey
A
Three Month Randomised, Double-Blind,
Placebo-Controlled Trial to Determine
the Effect of Rosiglitazone on Bone and
Calcium Metabolism in Normal Post
Menopausal Women
Malcolm Tingle
o
T he Role of Enzyme Expression in the
Metabolism of Novel Drugs by Human
Liver Cells
Catherine Bacon
o
T ime-Course of Parathyroid Hormone Change
Following Vitamin D Supplementation in
Vitamin D Deficient Elderly: A Pilot Study
ORL
Rebecca Baskett
o
D
evelopment of Patient Care Diaries for Head
and Neck Cancer Patients Undergoing
Radiotherapy at Auckland City Hospital
Suzanne Purdy
o
A
n Investigation into the Patient’s Perspective
of the Nature and Impact of Swallowing
Problems Resulting from Total Laryngectomy
Orthopaedics
Susan Stott
o
A
Pilot Study Comparing the Results of three
Dimensional Gait Analysis with Function in the
Community in Children and Young Adults with
Cerebral Palsy
Mark Wright
o
Trauma
O
utcome of Cemented vs Uncemented
Hemiarthroplasty. A Randomised Clinical Trial
Bruce Twaddle
o
C
orrelation Between Clinical, Radiological
and Functional Outcome for Distal Radius
Fractures Treated with Closed Reduction
and Percutaneous Wire
Brendan Coleman
o
P
eri-Acetabular Osteotomy for the
Treatment of Developmental Dysplasia
of the Hip in Adults
Grant Christey
o
S
tudy of Deep Vein Thrombosis Following
Major Trauma: Experience at Auckland
City Hospital
Shanthi Ameratunga
o
A
Case-Control Study of Falls Occurring in the
Home Environs in the Auckland Region
in People Aged 25 to 60 Years Resulting in
Hospitalisation
o
P
ost-injury alcohol intervention research
(PAIR): acceptability survey and chart review
Adult Emergency Department
Peter Jones
o
S
urvival from In-hospital Cardiac Arrest in
Auckland City Hospital During 2004
31
Gastroenterology
The Department of
Gastroenterology,
Hepatology and Liver
Transplant have an
integrated research
programme. They
undertake an extensive
array of research including
laboratory based work
examining genetic
linkages and undertake
Phase I research. The
Liver Transplant group
is also the NZ centre for
liver transplants. Susan Parry
o
Mark Lane
A
ustralian Colerectal Cancer Family Study
o
A
PIII MC Rand., DB Par-Arm, 52W Dose
Comparison Study of the Efficacy & Safety
of 25mg QD And 50mg QD of OPC-6535 Oral
Tablets and 800mg BID of Asacol ® in the
Maintenance of Remission in Subjects with
Ulcerative Colitis
o
P
rotocol T-EE04-085 - A PIII Study to Evaluate
the Efficacy & Safety of TAK-390MR (60mg
QD and 90mg QD) and an Active Comparator,
Lansoprazole (30mg QD) on Healing of Erosive
Esophagitis
o
P
rotocol T-EE04-087 - A PIII Study to Evaluate
the Efficacy & Safety of TAK-390MR (60mg
QD and 90mg QD) Compared to Placebo in
Maintenance of Healing in Subjects with
Healed Erosive Esophagitis
Geoffrey Krissansen
o
G
enetic Susceptibility to Crohn’s Disease
Mark Lane
o
A
PIII, Multi-Nat., MC OL, 52Wk Study to
Assess the Safety of Re-Exposure with the
Humanised Anti-TNF PEG, CDP870 400mg Sc,
in the Treatment of Pts with Active Crohn’s
Disease Who’ve Withdrawn From CDP870-031
or CDP-032
o
A
Long-Term Follow up Study to Determine
the Safety of CDP870 in Patients with
Active Crohn’s
o
A
Multicenter International Study of the
Long-term Safety of Infliximab (REMICADE®)
in Ulcerative Colitis
o
O
pen-label Trial of LEUKINE (Sargramostim),
a Recombinant Human GranulocyteMacrophage Colony Stimulating Factor
(GM-CSF), in Active Crohn’s Disease
o
o
A
PIII, MC, 52wk, OL, Extn Study of the Safety
of Efficacy of 25mg or 50mg or OPC-6535 Oral
Tablets in the Treatment of Subjects with
Ulcerative Colitis
Graeme Dickson
®
Lynnette R Ferguson
o
G
enes Causing Disease in Inflammatory
Bowel Disease in New Zealand, and
Development of a Diet to Ameliorate
the Disease
P
ilot Study to Investigate a Possible
Association Between Long QT Syndrome
Type1 , Achlorhydria, Hypergastrinaemia
and Gastric Carcinoid Tumours
Hepatology and Liver Transplant
Lindsay Plank
o
E ffect of Pre- and Post-operative
Immunonutrition on Clinical Outcome in
Patients with End-stage Liver Disease
Undergoing Liver Transplantation - a
Randomised DB Controlled Trial
William Abbott
o
32
A
Search for Genes that Influence the
Probability of Lamivudine-induced
Seroconversion in Patients with HbEaGPositive, Chronic Hepatitis B Virus Infection
William Abbott
o
S
earch for Genes that Influence Susceptibility
to Chronic HBV Infection
o
T he Influence of Heterologous Immunity on
HBeAg Seroconversion
o
T he Influence of the Human Immune System
on the Evolution of Mutations in the Hepatitis
B Virus Genome
Hepatology and
Liver Transplant cont.
Edward Gane
o
T he Clinical Pattern of Hepatitis on HBeAgNegative Chronic Hepatitis B in Tongans
o
A
Rand. Controlled, MC Study on the Safety
& Efficacy Lamivudine (LAM) & Adefovir
dipivoxil (ADV) vs Standard Antiviral
Prophylaxis (Lamivudine+HepB
Immunoglobulin (HBIG) for the Prevention
of Recurrent HepB in HBsAg Pos Liver
Transplantation Candidates
o
o
A
PIV Rand., MC, Efficacy & Safety Study
Examining the Efficacy of the Combination
of Peginterferon Alfa-2a Ribavirin vs
Peginterferon Alfa-2a Monotherapy in Liver
Transplant Recipients w/Recurrent HepC
Virus Infection
A
Rand., OL, Comparative Evaluation of
Conversion from Calcineurin Inhibitor
Treatment to Sirolimus Treatment Vs.
Continued Calcineurin Inhibitor Treatment
in Liver Allograft Recipients Undergoing
Maintenance Therapy
Edward Gane
o
A
DB Rand. Placebo Controlled MC PII Parellel
Dose Ranging Study to Assess the Antifibrotic
Activity of GI262570 in Chronic Hepatitis C
Subjects with Hepatitic Fibrosis who have
Failed Prior Antiviral Therapy
o
T o Evaluate the Usefulness of Serum Markers
of Hepatic Fibrosis (Hyaluronic Acid, 2
Macroglobulin, GGT and Bilirubin) in
Determining the Amount of Hepatic Fibrosis In
Patients with all Forms of Liver Disease
o
A
Phase IV, Randomized, Multicentre, Efficacy
and Safety Study Examining the Effect of
Induction Dosing with the Combination of
Peginterferon Alfa-2a and Ribavirin In Patients
with Chronic Hepatitis C Infected with
Hepatitis C Genotype 1
o
S
earch for Immunological and Human
Genetic Variables that Influence the Rate
of Progression of Chronic Hepatitis B in
Polynesian People
Stephen Munn
o
A
Randomised Study to Assess the Safety and
Efficacy of Adefovir Dipivoxil Substitution for
Hbig in Liver Transplantation Patients
Receiving Long-Term Low Dose IM Hbig and
Lamivudine Prophylaxis
o
A
Long-Term Follow up Study to Evaluate the
Safety and Efficacy in Transplant Recipients
Treated with Modified Release Tacrolimus
FK506E (MR4), Based Immunosuppression
Regimen
o
A
Phase III Randomised, Placebo-Controlled
Study of Sorafenib in Patients with Advanced
Hepatocellular Carcinoma
o
o
P
hase IV study of tailored therapy with Peg
Interferon alfa 2b and Ribavirin for patients
with Genotype 3 and High Viral Load.
Genotype 3 Extended Treatment for HCV
A
MC 1:1 Rand., DB, 2-arm Parallel Group
Study to Evaluate and Compare the Efficacy
and Safety of Modified Release Tacrolimus
FK506E(MR4) versus Tacrolimus FK506 in
Combination with Steroids in Patients
Undergoing Primary Liver Transplantation
o
A
Phase 1b, Observer-Blind, Randomised,
Placebo-Controlled Study to Evaluate the
Safety, Tolerability, Immunogenicity and
Antiviral Effect of HCV Core ISCOMATRIX
Vaccine in Patients with Chronic
Hepatitis C Infection
o
E xpanded Access Programme of PEGASYS
(Peg interferon alpha-2a 40KD) in patients
with HBeAg positive and HBeAg negative
Chronic Hepatitis B
o
R
andomised Evaluation of Fibrosis due to
Hepatitis C after De Novo Liver Transplant
Rita Yassi
o
C
onstructing a Three-dimensional
Anatomically Based Mathematical Model to
Investigate the Effect of Microstructure on the
Function of the Gastro-oesophageal Junction
33
Haematology and Thrombolysis
The haematology research
group is a collaboration
between the Clinical and
Laboratory Haematology
Services and the University
of Auckland. A vast array
of research across the
spectrum is undertaken
including a focus on new
strategies for purifying
haematopoietic stem cells
for clinical use. It also
aims to foster the ongoing
research programmes in
Haematology, including
studies on the genetics
of haemophilia and
prothrombotic disorders,
mutation analysis in familial
cancer syndromes, and
assessment of minimal
residual disease in patients
with leukaemia and other
cancers.
Timothy Hawkins
Paul Ockelford
o
R
andomised Study of Rituximab (Mabthera)
in Patients with Relapsed Follicular Lymphoma
prior to High Dose Therapy as in vivo Purging
and to Maintain Remission Following High
Dose Therapy
o
A
MC, Rand., DB, Placebo-Controlled Clinical
Trial Examining the Efficacy & Safety of
Low-dose Aspirin After Initial Oral
Anticoagulation to Prevent Recurrent
Venous Thromboembolism
o
A
n OL. MC Rand. Comparative PIII Study to
Eval. the Efficacy & Safety of Mabthera +
Fludarabine & Cyclophosphamide (FCR) vs
Fludarabine & Cyclophsphamide Alone (FC) in
Prev Treated Pts w/CD20 Pos B-cell Chronic
Lymphocytic Leukemia
o
T he Van Gogh PE-Study (P64714), A MC, Int’l,
Rand, OL, Assessor-Blind, Non-Inferiority
Study Comparing the Efficacy & Safety of 1x/
W Subcutaneous Sanorg34006 W/The
Combination of (LMW)Heparin & Vitamin K
Antagonist
o
A
PIII Rand. DB Par-group Study of the
Efficacy & Safety of Oral Dabigatran Etexilate
(150mg bid) Compared to Warfarin (INR 2.03.0) for 6m Treatment of Acute Symptomatic
Venous Thromboembolosm
o
I nt’l MC Rand. Par-group, DB study in pts w/
Acute Symptomatic DVT of the Lower Limbs,
Demonstrating the Bioequipotency at Steady
State of Equimolar Doses of SSR12651E(3.0mg)
OD & SR34006(2.5mg)/wk, Documenting the
Safety & Efficacy of Both Compounds
Peter Browett
o
A
PIII Study of ST1571 vs Interferon-alpha
(IFN-alpha) combined w/Cytarabine (Ara-C) in
the Treatment of Pts w/newly Diagnosed
Previously Untreated Philadelphia
Chromosome Positive (Ph+) Chronic
Myelogenous Leukemia in Chronic Phase
o
A
PII Study of a Modified “Hyper-CVAD”
Frontline Therapy for Patients with Poor
Prognosis Diffuse Large B-cell and Peripheral
T-cell Non-Hodgkin’s Lymphoma
o
P
rimary Thrombocythaemia Trial 1: Aspirin vs
Hydroxyurea/Aspirin in Intermediate Risk
Primary Thrombocythaemia & Hydroxyurea/
Aspirin vs Anagrelide/Aspirin in High Risk
Primary Thrombocythaemia
o
A
n Open Label Multicentre Study to Assess
the Efficacy and Safety of B-Domain Deleted
Recombinant Factor VIII in Patients with
Haemophilia Undergoing Elective Major
Surgery
o
L eukaemia in Adults and Children Acute
Myeloid Leukaemia Trial 15
o
o
R
andomized study of ICE plus rituximab (RICE) versus DHAP plus rituximab (R-DHAP) in
previously treated patients with CD 20 positive
diffuse large B-cell lymphoma, eligible for
transplantation followed by randomized
maintenance treatment with Rituximab
A
n Int’l, MC Rand. DB DD Par-Group Study of 3
Mths/6 Mths Treatment W/SSR126517E (3.0
Mg S.C. Once Weekly) Vs Oral INR- Adjusted
Warfarin in the Treatment of Pts W/
Symptomatic Pulmonary Embolism, with or
without Symptomatic Deep Venous
Thrombosis
o
A
PIA/II MC Dose-Escalation Study of Oral
AMN107 on a Continuous Daily Dosing
Schedule in Adult Pts W/Glivec™ (Imatinib)Resistant/Intolerant CML in Chronic or
Accelerated Phase or Blast Crisis, Relapsed/
Refractory Ph+ ALL
Maggie Kalev
o
Andrew Grey
o
34
S
creening of Human Sera Derived from
Patients with Malignant and Benign
Hypergammaglobulinaemias for the Presence
of Glutamate Receptor Modulating Antibodies
plus substudy
T he Effect of Imatinib Mesylate (Glivec™)
on Bone Metabolism in Chronic Myeloid
Leukemia
Haematology and
Thrombolysis cont.
Julie Park
o
N
ew Technologies and Haemophilia:
Individual and Social Implications
Paul Harper
o
T he incidence of protein Z dependent
protease inhibitor (ZPI) mutations in
thrombosis patients and possible synergism
between factor V Leiden and ZPI mutations
causing thrombophilia
o
RECORD
2 Study: Regulation of Coagulation
in Orthopaedic Surgery to Prevent DVT and
PE, Controlled, DB, Rand. Study Of BAY 597939 in the Extended Prevention of VTE in Pts
Undergoing Elective Total Hip Replacement
Leanne Berkahn
o
o
A
PIII Trial of Combined Immunochemotherapy
w/Fludarabine, Cyclephosphamide &
Rituximab (FC-R) vs Chemotherapy w/
Fludarabine & Cyclephosphamide (FC) Alone,
in Pts with Previously untreated Chronic
Lymphocytic Leukaemia
E valuating the Benefit of Maintenance
Therapy with Rituximab (Mabthera®) after
Induction of Response with Chemotherapy
Plus Rituximab in Comparison with no
Maintenance Therapy
Paul Harper
Urology
o
T he Evaluation of an Internet-based
Computerised Anticoagulant Monitoring
System
o
E valuation of Refacto AF® and Advate® in
patients with Haemophilia A
John Tuckey
o
A
Randomised, Db, Placebo-Controlled,
Parallel Group Study of the Efficacy and
Safety of Dutasteride
Karen Edgecombe
o
Sanjeev Chunilal
o
R
ole Of SNP’s in Genes Coding for Antioxident
Enzymes Glutathione Peroxidase and
Manganese Superoxide Dismutase in
Modulating Prostate Cancer Risk
Jonathan Masters
o
A
PIII Rand. MC DB Par-group, Active
Controlled Study to Evaluate Efficacy & Safety
of Oral Dabigatran Etexilate Compared to
Warfarin (INR 2.0-3.00) for the Secondary
Prevention of Venous Thromboembolism Ian Mundy
o
Jonathan Masters
o
W
hat is it Like for New Zealand Men to Live
with Severe Haemophilia? A Pilot Study
A
Randomized, Double-Blind, Placebo
Controlled, Multicenter Phase 3 Study of
Denosumab on Prolonging Bone MetastasisFree Survival in Men with Hormone-Refractory
Prostate Cancer
Lynnette R Ferguson
o
O
ptimising selenium intake for cancer
prevention – a pilot study on Caucasian men
in Auckland
O
ptimal Timing of Cryopreservation in Men
with Testic Cancer
Tony Beaven
o
A
Phase III, Parallel Group, Randomized,
Open-Label, Multicenter Clinical Trial of
Zometa in Males Receiving Androgen
Deprivation Therapy for Advanced
Prostate Cancer
35
Neurology
The Neurology Dept is the
only neurology department
for the Auckland and
Northland regions and,
as such, has extensive
clinical experience. There
are active clinical and
pharmaceutical company
sponsored research studies
in neurological disorders,
particularly cerebrovascular
diseases, brain imaging,
movement disorders,
epilepsy, multiple sclerosis
and neurogenetics. Current
research projects include
national and international
phase II and III studies
examining therapeutic
agents/strategies in
human subjects.
Lynette Tippett
o
N
europsychological and Clinical
Investigations of Huntington’s Disease
Barry Snow
o
A
n Open-Label, Multicenter, Multinational
Phase III Follow-up Study to Investigate the
Long-Term Safety and Efficacy of Sarizotan
Hcl 1mg B.I.D. in Patients with Parkinson’s
Disease Suffering from Treatment-Associated
Dyskinesia
o
P
II, A Double-Blind, Prospective, Randomized
Comparison of 2 Doses of MitoQ and Placebo
for the Treatment of Patients with Parkinson’s
Disease
o
A
MC Rand. DB Placebo-controlled,
Par-Group Study of the Efficacy, Safety &
Tolerability of E2007 in levodopa Treated
Parkinson’s Disease Pts with Motor
fluctuations
Jenni Ogden
o
S
tudies of Hemineglect
o
S
ingle Case Neuropsychological Research
Neil Anderson
o
o
V
ITATOPS: A MC, Randomised, Double-blind,
Placebo Controlled Trial examining the
Efficacy and Safety of Multi-vitamin Therapy
in Secondary Stroke Victims
A
Prospective, Int’l, MC, Rand.. Par-Group,
Blinded, Controlled, Collaborative, Factorial
Trial to Investigate the Safety & Efficacy of
Treatment w/Transdermal Glyceryl Trinitrate,
a Nitric Oxide Donor
Alan Barber
o
E cho Planar Imaging Thrombolysis Evaluation
Trial (EPITHET)
Mark Rees
o
Kirsten van Kessel
A
Randomised Controlled Trial of Cognitive
Behavioural Therapy for Fatigue in Patients
with Multiple Sclerosis
o
A
Study of the Effectiveness of Strategies to
Improve Stroke Recovery for Maori, Pacific
Peoples and their Whanau/Families
o
o
A
SP-II (Ancrod in Stroke Program-II) A Rand.
DB Placebo-controlled Study of Anrod
(ViprinexTM) in Subjects Beginning
Treatment Wihtin 6 Hrs of the Onset of
Acute, Ischemic Stroke
Ernest Willoughby
o
P
RECISE GA/9010. A Multinational, MC, Rand.,
DB, Placebo Controlled, Parallel Group Study
to Evaluate the Effect of Early Glatiramer
Acetate Treatment in Delaying the Conversion
to Clinically Definite Multiple Sclerosis
o
A
MC, OL Study to Investigate the Recovery
of Interferon-B Efficacy in Relapsing-remitting
Multiple Sclerosis patients with neutralising
INF-B Antibodies and Reduced Bioavailability
A
MC, M-Nat., PIII, Rand, DB, D-dummy,
3-arm Parallel Group, Placebo- and
Ropinirole-controlled, Trial of Efficacy
and Safety of the Rotigotine CDS Patch in
Subjects with Early Stage Idiopathic
Parkinson’s Disease
o
A
n OL, MC, Ext. Study to Evaluate the Safety
and Tolerability of Natalizumab Following Reinitiation of Dosing in MS Subjects who have
Completed the Study C-1801 or C-1802 and a
Dosing Suspension Safety Evaluation
A
MC MN PIII OL Extn Trial to Assess the Long
Term Treatment of Ritigotine Patch in Subjects
with Advanced Stage Idiopathic Parkinson’s
Disease who are not well Controlled on
Levodopa
o
Craig Anderson
o
A
uckland Regional Community Stroke (ARCOS
III) study. Determinants of Stroke Impact on
Individuals, Families and the Community
Barry Snow
o
o
36
A
nalysis of Candidate Genes in Temporal
Lobe and Reflex Epilepsy
Elizabeth Walker
A
n OL MC FU Study to Evaluate the Safety &
Efficacy of Levetiracetam (LEV)
Neurology cont.
Winston D Byblow
Natasha Moloczij
H
elp Seeking at the Time of Stroke: Patients
Perspectives on their Decisions
o
A
Novel Rehabilitation Protocol to Enhance
Motor Recovery Following Stroke
o
o
R
ecovery of Hand Function Following Stroke
Grace O’Sullivan
Aileen Victoria Alegado
o
T he Relationship Between Disorders of Reality
Monitoring and Anosognosia
of Hemiplegia Following Right
Hemispheric Stroke
Richard Roxburgh
o
G
enetic Linkage Study in Parkinson’s Disease
o
H
untington’s Disease Study Group
o
A
Double-Blind, Prospective, Randomized
Comparison of MitoQ Tablets and Placebo
Tablets for the Treatment of Patients with
Friedreich Ataxia
o
A
ssisting People who live with Dementia in
the Community to Engage in Daily Activities
Nicola Kayes
o
I dentifying Facilitators and Barriers to
Physical Activity in People with Multiple
Sclerosis (MS)
Suzie Mudge
o
R
elationship of the Stepwatch™ Activity
Monitor Output to Clinical Measures of
Walking
Deborah Payne
o
M
anaging Multiple Sclerosis and Motherhood:
An Interpretive Descriptive Study
Fertility Research
Larry Chamley
o
S
PRASA, a Novel Sperm Protein: Is it
important in fertility?
Neil Johnson
o
A
Pilot Randomised Trial of Endometrial
Effects of Lipiodol Endometrial Bathing
Through Microarray and Immunochemistry
Analysis
Claire McLintock
o
T he Scottish Pregnancy Intervention Study:
The Effect of Low Molecular Weight Heparin
and Aspirin on Recurrent Pregnancy Loss
Megan Ogilvie
o
I s polycystic ovarian syndrome associated
with depressive disorder in adolescents
Katrina Humphrey
o
P
sychoneuroimmunology of Fertility: A
Theoretical Model Explaining how what we
Think and Feel can Affect our Reproduction
Sonya Jessup
o
A
Rand. Controlled Trial to Look at Whether
Fallopian Sperm Perfusion Gives Better
Pregnancy and Live Birth Rates than Standard
Intrauterine Insemination for Patient Having
Artificial Insemination With or Without
Gonadotrophin or Clomiphene Stimulation
37
Medical and Radiation Oncology
The Department of Medical
and Radiation Oncology
actively participates in
both local investigator
initiated studies as well as
large multicentre studies.
There is a particularly
strong relationship with the
Collaborative Groups like
the Australian New Zealand
Breast Trials Group and the
Trans-Tasman Radiation
Oncology Group (TROG).
These studies involve
patients with prostate
cancer, cervix cancer,
bladder cancer, lung
cancer, breast cancer,
follicular non hodgkins
lymphoma, melanoma,
and skin cancer.
Vernon Harvey
I nt. Breast Cancer Study IX: Adjuvant Therapy
Post Menopausal Patients with Node
Negative Operative Breast Cancer
A
Phase III Study to Evaluate Letrozole as
Adjuvant Endocrine Therapy for Post
Menopausal Women with Receptor (ER and/or
PgR) Positive Tumours
o
A
djuvent Therapy for Post/Peri Menopausal
Women with Node Positive Breast Cancer Who
Are Not Suitable for Endocrine Therapy Alone
A
PIII Trial to Evaluate Oral Chemotherapy
with Capecitabine vs Standard Chemotherapy
with CMF for Advanced Breast Cancer
o
A
MC PIII Rand. Trial Comparing Docetaxel in
Comb.w/Doxorubicin & Cyclophosphamide
(TAC) vs Doxorubicin & Cyclophosphamide
Followed by Docetaxel (AC - T) As Adjuvant
Treatment of Operable Breast Cancer
Her2neu/neg w/pos Axillary Lymph Nodes
o
M
C PIII Rand Trial Comparing Doxorubicin
& Cyclophosphamide Followed by Docetaxel
(AC-T) w/Doxorubin & Cyclophosphamide
Followed by Docetaxel & Trastuzumab
(AC-TH) & w/Docetaxel, Platinum Salt &
Trastuzumab (TCH) in the Adjuvant Treatment
of Node Positive
o
A
Rand 3-arm MC Comparison of 1Y & 2Ys of
Herceptin vs No Herceptin in Women with
HER2-positive Primary Breast Cancer who
have Completed Adjuvant Chemotherapy
o
A
MC PIII Rand Trial Comparing
Docetaxel(Taxotere) & Trastuzumab
(Herceptin) w/Docetaxel(Taxotere),
Platimum salt(Ciplatin or Carboplatin) &
Transtuzumab(Herceptin) as First Line
Chemotherapy for Pts W/advanced
Breast Cancer
o
A
Randomised Trial of 2 CT Scans Versus 5 CT
Scans in the Surveillance of Patients with
Stage I Teratoma of the Testis
o
A
n OL, Non-comparative, 2Arm, PII trial of
ZD1839 (IRESSA) in Pts w/Hormoneinsensitive (ER & PgR neg) or Hormone
Resistant (ER & PgR pos) Metastatic or
Inoperable Locally Advanced Breast Cancer
o
A
Rand. PII Study Comparing Capecitabine
w/Capecitabine & Oral Cyclophosphamide
in Patients with Advanced Breast Cancer
I nt. Breast Cancer Study VIII: Adjuvant
Therapy in Pre and Post Menopausal Patients
with Node Negative Breast Cancer
o
o
A
djuvent Therapy for Premenopausal Women
with Node Positive Breast Cancer Who Are
Suitable for Endocrine Therapy Alone
o
A
djuvent Therapy for Premenopausal Women
with Node Positive Breast Cancer Who Are
Not Suitable for Endocrine Therapy Alone
o
R
andomised Phase III Trial for Good Prognosis
Germ Cell Tumours Comparing Two Different
Regimes of Cisplatin, Etoposide and Bleomycin
o
A
TLAS Adjuvent Tamoxifen - Longer Against
Shorter. Reliable Assessment of the Efficacy
and Safety of Prolonging the Use of Adjuvent
Tamoxifen: A Large Simple Randomised Study
o
o
o
o
38
o
o
o
Vernon Harvey
A
Phase II Study of Trans-Urethral Resection
Followed by Synchronous Chemo-Radiation in
the Definitive Management of Localised
Invasive TCC of the Urinary Bladder
A
n Intergroup PIII Trial to Evaluate the Activity
of Docetoxel, given either sequentially or in
comb. w/Doxorubicin Followed by CMF in
compar. to Doxirubicin alone or in comb. w/
Cyclophosphamide, followed by CFM in the
Adjuvant Treatment of Node Positive
R
andomised DB Trial in Postmenopausal
Women with Primary Breast Cancer Who
Have Received Adjuvant Tamoxifen for 2-3 yrs,
Comparing Subsequent Adjuvant Exemestone
Treatment with Further Tamoxifen
A
uckland Breast Cancer Study Group Breast Cancer Registry 2000 for the Auckland
Regional Area to document Incidence,
Treatment Patterns and Outcomes for
Women with Breast Cancer
Medical and Radiation
Oncology cont.
Vernon Harvey
o
o
o
A
Rand., OL, Phase III Study of RPR109881 IV
Every 3 Weeks Versus Capecitabine (Xeloda)
Tablets Twice Daily for 2 Weeks in 3-week
Cycles in Pts with Metastatic Breast Cancer
Progressing After Taxanes and
Anthracycline Therapy
A
PIII Trial Evaluating the Role of
Chemotherapy as Adjuvant Therapy for
Premenopausal Women with Endocrine
Response Breast Cancer who Receive
Endocrine Therapy.
A
Phase III Trial Evaluating the Role of Ovarian
Function Suppression and the Role of
Exemestane as Adjuvant Therapies for
Premenopausal Women with Endocrine
Responsive Breast Cancer
o
P
atient Perceptions of Adjuvant
Chemotherapy in Early Breast Cancer:
What Makes it Worthwhile?’
o
C
ognitive Function Substudy
Chakiath Jose
o
P
rospective, Randomised, Double-blind,
Placebo controlled Study of Oral Sodium
Clondronate in Patients with Locally Advanced
Adenocarcinoma
o
A
Randomised Comparison of Single Agent
Carboplatin with Radiotherapy in the Adjuvant
Treatment of Stage I Seminoma of the Testes,
Following Orchidectomy
o
o
A
Randomised Trial of High Dose Radiotherapy
in Localised Cancer of the Prostate using
Conformal Radiotherapy Techniques
A
Randomised Trial of Hormone Therapy
plus Radical Radiotherapy versus Hormone
Therapy Alone in Non-metastic
Prostate Cancer
Andrew Macann
o
P
III Rand. Trial of Concomitant Radiation,
Cisplatin, andTirapazamine (SR259075) vs
Concomitant Radiation and Cisplatin in Pts
with Advanced Head & Neck Cancer
o
P
ost-Operative Concurrent ChemoRadiotherapy Versus Post-Operative
Radiotherapy in High-Risk Cutaneous
Squamous Cell Carcinoma of the Head and
Neck
David Porter
o
A
Prospective, Non-Randomised Study of
Chemotherapy and Radiotherapy for
Osteolymphoma
o
A
Phase 2 Study of Idarubicin-based
Combined Modality Therapy in Primary Central
Nervous System Lymphoma
o
R
andomised Trial Comparing 2 Years Of
Imatinib Vs No Treatment Following
Successfully Resected Gastrointestinal
Stromal Tumour
John Matthews
o
A
Randomised Trial Investigating the
Effectiveness of Different Durations of
Maximal Androgen Deprivation prior to and
during Definitive Radiation Therapy for Locally
Advanced Carcinoma of the Prostate
o
A
Prospective Single Arm Non Randomised
Study of Concurrent Radiation and
Chemotherapy for the Organ Conserving
Treatment of Early Anal Canal Cancer
o
A
Phase I/II Study of Trans-urethral Resection
Followed by Modified Synchronous Chemoradiation in the Definitive Management of
Localised Invasive TCC of the Urinary Bladder
o
A
Rand. PIII Trial of Radical Chemo/
Radiotherapy vs Radiotherapy Alone in the
Definitive Management of Localised Muscle
Invasive TCC of the Urinary Bladder.
o
A
Rand. Trial Investigating the Effect on
Biochemical (PSA) Control and Survival of
Different Durations of Adjuvant Androgen
Deprivation in Association with Definitive
Radiation Treatment for Localised Carcinoma
of the Prostate
Andrew Macann
o
o
R
andomised Phase II Study of Two Different
Strategies for Chemoradiotherapy of
Advanced Squamous Cell Carcinoma of the
Head and Neck
A
Randomised Multicentre Phase III Trial of
Involved Field Radiotherapy versus Involved
Field Radiotherapy Plus Chemotherapy for
Stage I-II Low Grade Follicular Lymphoma
39
Medical and Radiation
Oncology cont.
Paul Thompson
o
A
Randomised Trial of Preoperative
Radiotherapy for Stage T3 Adenocarcinoma
of Rectum
o
A
Rand. DB Placebo Controlled, PIII Study
of Oxaliplatin/5FL/LV with PTK787/ZK222584 or
Placebo in Pts with Previously Treated
Metastic Adenocarcinoma of the Colon
or Rectum
o
R
andomised Double Blind Trial of Megestrol
Acetate Versus Placebo for the Treatment
of Inoperable Hepatocellular Carcinoma
o
A
n OL Rand. PIII Study if Internmittence
Oral Capecitabine In Comb. W/Intravenous
Oxaliplatin (Q3W)(“XELOX” vs Fluorouracil/
Leucovorin as Adjuvant Therapy for Pts
Who’ve Undergone Surgery for Colon
Carcinoma AJCC/UICC Stage III
(Dukes’ Stage C)
o
o
A
Rand. 3Arm MN PIII Study to Investigate
Bevacizumab (q3w or q2w) in Combi W/Either
Intermittent Capecitabine+Oxaliplatin
(XELOX)(q3w) or Fluorouracil/Leucovorin W/
Oxaliplatin (FOLFOX-4) vs regimen alone as
Adjuvant Chemotherapy in Colon Carcinoma
A
Multicentre Study Using the Chemotherapy
Combination of Bi-Monthly Capecitabine and
Oxaliplatin, with the Addition of Avastin, in
Patients with Advanced Colorectal Cancer
Hedley Krawitz
o
o
T umour Volume as an Independent Prognostic
Factor in Patients with Non-small Cell Lung
Cancer: a Protocol for a Prospective Database
A
Randomised Clinical Trial of Surgery vs
Surgery Plus Adjuvant Radiotherapy for
Regional Control in Patients with Completely
Resected Macroscopic Nodal Metastatic
Melanoma Protocol
Gillian Campbell
o
Kate Gardner
o
40
A
Study of the Time-course of Acute
Peripheral Nerve Hyperexcitability in Cancer
Patients Receiving Standard Chemotherapy
o
A
n OL, Rand, PI/II Study of DMXAA in
Combination with Carboplatin and Paclitaxel
in Patients with Locally Advanced and
Metastatic Non Small Cell Lung Cancer
o
A
n Exploratory Pharmacokinetic Study of
Plasma Concentrations of Unchanged
Platinum Based Drugs Requring Blood
Collection from Cancer Patients Having
Standard Chemotherapy
A
Study Investigating the Feasibility of Using
the Measurement of Serum 5-HIAA as a
Surrogate Clinical Marker for the Antivascular
Activity of Non-Steroidal Anti-Inflammatory
Agents and Anticancer Therapies
Michelle Vaughan
o
A
n OL, Rand, PII Study of DMXAA in
Combination with Carboplatin and Paclitaxel
in Patients with Platinum-sensitive Recurrent
Ovarian Epithelial Cancer
o
A
Prospective, Multicentre, Randomised Trial
of Carboplatin Flat Dosing Vs Intrapatient
Dose Escalation in First Line Chemotherapy
of Ovarian, Fallopian Tube and Primary
Peritoneal Cancers
o
A
Multinational Randomised Phase II GCIG
Intergroup Study Comparing Pegylated
Liposomal Dororubicin Vs Paclitaxel and
Carboplatin in Patients with Epithelial Ovarian
Cancer in Late Relapse (> 6 Months)
Leanne Berkahn
o
I ntergroup Study BEACOPP vs ABVD in Stage
III & IV Hodgkin’s Lymphoma (HD4)
Nicole McCarthy
o
T he Pharmacogenetic and Pathological
Assessment of CYP2C19 Activity in Patients
with Advanced Cancer
Richard Sullivan
o
A
multicentre, double-blind randomised,
phase III study to evaluate the efficacy
of Tarceva
o
A
MC OL Rand PIII to evaluate the efficacy of
Tarceva or comparator Alimta (pemetrexed) or
Taxotere (docetaxel) in pts with histologically
documented, advanced/recurrent/metastatic
(Stage IV) non-small cell lung cancer
Mark McKeage
o
A
Prospective Study of Cosmetic Outcomes
for Patients Treated with Breast Conservation
and Radiation Therapy Using Shorter
Fractionation Schedules
Medical and Radiation
Oncology cont.
Simon Coulter
o
A
Survey of tthe Attitudes and Beliefs of
Patients Regarding Cancer Associated Weight
Loss and Weight Assessment
Sarah Hill
o
Gillian Campbell
o
Maria Pearse
o
P
rospective study to determine the
relationships between survival and FIGO
stage, tumour volume and corpus invasion in
cervical cancer
Renal
The department of Renal
Medicine and the Auckland
Renal Transplant group
are busy clinical services.
There are active clinical and
pharmaceutical company
sponsored research studies
in a number of areas.
These include multicentre
international clinical trials
in renal transplantation,
dialysis treatment and
initiation and management
of renovascular disease
and lipids. Additionally
we have active research
in pharmacogenetics
in the treatment of SLE
and omeprazole induced
interstitial nephritis,
Aldosterone blockade,
Sexual Function in renal
failure, Chronic Allograft
Nephropathy, Diabetic
Nephropathy and
cardiac disease in renal
transplant recipients.
o
A
Retrospective Study of Appendicular
Neoplasm
A
ssessment of the Influence of Timing of PostLumpectomy Radiation Therapy (RT) on Local
Recurrence in Early Breast Cancer
We are currently also contributing to
a number of registries, including the
Peritoneal Dialysis Registry and an
international transplant registry. Our
department includes a number of research
co-ordinators and nurses, a statistician
and a transplant research fellow. We look
forward to our ongoing contribution to many
collaborations in international research in
addition to locally-initiated projects.
Laurie Williams
o
o
I nitiation of Dialysis Early and Late
o
D
ialysis Outcomes and Practice Patterns Study
o
D
elaying the Progression of Kidney Disease in
Maori and Pacific Patients with Diabetic
Kidney Disease
Helen Pilmore
D
evelopment of Chronic Allograft
Nephropathy. Histopathological Correlates
Predict Decline in Renal Allograft Function
S
tudy of Heart and Renal Protection (SHARP).
Does lowering cholesterol prevent major
vascular events in patients with chronic
kidney disease?
Ian Dittmer
o
O
pen Randomised Study to Evaluate Efficacy
and Safety of Oral Valganciclovir Versus
Ganciclovir for the Treatment of CMV Disease
in Solid Organ Transplant Recipients
o
A
Randomized, Double Blind, Placebo
Controlled Multicentre Study of the Efficacy
and Safety of 100 days vs 200 days of
Valganciclovir for the Prevention of
Cytomegalovirus Disease in High-Risk Kidney
Allograft Recipients
John Collins
o
A
Retrospective Review of Prognostic Factors,
Including Tumour Cytogenetics, in Low Grade
Oligodendroglimos in New Zealand
Kai Chau
Graham Stevens
o
D
ifferential Colon Cancer Survival by Ethnicity
Lyn Lloyd
o
N
orthern American SGA Validation Project
Paul Manley
o
A
ssessment of Everolimus in addition to
Calcineurin Inhibitors Reduction in
Maintenance Renal Transplant Recipients
o
o
A
24M MC Rand.OL Noninferiority Study of
Efficacy & Safety Comparing ConcentrationControlled Certican® in 2 Doses (1.5 & 3.0 mg/
Day Starting Doses) w/Reduced Neoral® vs
1.44 G Myfortic® w/Standard Dose Neoral in
De Novo Renal Transplant Recipients
Frederic Doss
A
Randomised Open-Label Study to Compare
the Rate of New Non-Melanoma Skin Cancer
in Maintenance Renal Allograft Recipients
Converted to a Sirolimus Based Regimen
Versus Continuation of a Calcineurin InhibitorBased Regimen
o
o
o
A
ssessment of Predictors for the Development
of Diabetes Mellitus Following Renal
Transplantation
A
ssessing Sexual Function and its Associated
Factors in Renal Patients Undergoing Dialysis
at Auckland Using the Modified ASEX Scale
Janak de Zoysa
F ailure of Cyclophosphamide Therapy in Lupus
Nephritis Patients: The Role of Bioactivation
Phenotype and Genotype
41
Respiratory
Respiratory Services, based
at Auckland City Hospital and
Greenlane Clinical Centre
continues its considerable
involvement in Clinical
Research. Members of the
Department have been
involved in Pharmaceutical
Company sponsored
research (Phase II and
Phase III trials) in the clinical
areas of Cystic Fibrosis,
Bronchiectasis, COPD
and Idiopathic Pulmonary
Fibrosis. Members of the
Department are also in
receipt of funding from
Health Research Council,
Greenlane Research and
Education Fund, Auckland
Medical Research Fund,
Asthma and Respiratory
Foundation of New Zealand
and SPARC for research
projects in Asthma,
COPD, Bronchiectasis,
Sarcoidosis and Rheumatoid
Lung Disease.
Collaborations have been established
with the University of Auckland, University
of Otago, Massey University and with
Colleagues in other Respiratory Medicine
Departments in Australia and New Zealand.
Tam Eaton
Ian Town
Mark O’Carroll
o
N
ew Zealand Alpha-1 Antitrypsin Deficiency
Registry
Louisa Voight
o
A
Prospective Study of Airway and Interstitial
Lung Disease in Early Rheumatoid Arthritis
Using High Resolution Computerised
Tomography and Pulmonary Function Testing
o
o
o
A
Phase III Multicenter, Randomised, Parallel,
Placebo-Controlled, Double-Blind Study to
Investigate the Safety and Efficacy of
Treatment with Bronchitol (Dry Powder
Mannitol) in the Symptomatic Treatment of
Bronchiectasis
o
A
PIII DB MC MN, Rand., Placebo-Controlled
Trial Evaluating Aztreonam Lysinate for
Inhalation in Cystic Fibrosis Patients with
Pulmonary P. aeruginosa
o
C
linical Utility of Expired Nitric Oxide in the
Diagnosis of Asthma in Elite Athletes
T he Prevalence and Predictors of Airway
Hyperresponsiveness in Sarcoidosis
Juliet Ireland
o
E xperience of Having Sarcoidosis Psychological Distress, Perception of Illness
and Beliefs About Medications
Jessica Hayward
o
I nvestigation of Methods to Detect
Respiratory Irregularities in OSA
Robert Young
o
G
enetics of Smoking-Induced Pulmonary
Emphysema/COPD
Peter Black
o
Margaret Wilsher
o
V
alidation of the Six -Minute Walk Test in
Patients with Scleroderma Lung Disease
o
A
MC Rand.Placebo-Controlled, DB 4-Arm
Par-Group, 2wk Study to Evaluate the
Safety, Tolerability, Pharmacodynamics &
Pharmacokinetics of GW642444H Compared
with Salmeterol & Placebo in Subjects
with COPD.
T he Effect of Rofecoxib on Matrix
Metalloproteinases in the Sputum of
Patients with COPD
Rona Moss-Morris
o
D
iagnosis of Cystic Fibrosis Related Diabetes:
The role of Continuous Glucose monitoring
John Kolbe
Lisa Young
o
E arly Inpatient-Outpatient Hospital-Based
Pulmonary Rehabilitation Following
Hospitalisation for Acute Exacerbations of
COPD: A Randomised Controlled Study
A
dolescents with a Chronic Condition :
Parental and Self-Expectations and Their
Relationship to Adjustment
Children and Young People Respiratory
Cass Byrnes
o
A
Multicentre Randomised Controlled Trial of
Bronchoalveolar Lavage Therapy in Young
Children with Cystic Fibrosis
Jacob Twiss
o
A
Randomised Controlled Trial of Inhaled
Antibiotics in Young People with
Bronchiectasis
Cameron Grant
o
42
R
isk Factors for Pneumonia and
Hospitalisation for Pneumonia in Children
David McNamara
o
Humidification for Children with Tracheostomies:
a Cross-Over Trial Comparing a Heated
Humidifier to a Heat and Moisture Exchanger
David McNamara
o
S
tudy of Overnight Humidification for Children
with Tracheostomies
Peter Black
o
C
an the use of electronic reminder alarms in
metered dose inhalers lead to better control
of asthma?
Women’s Health and Maternity
Women’s Health and
Maternity Research team
is dedicated to improving
women’s health, and
participate in various
controlled clinical trials that
determine the safety and
effectiveness of emerging
new medications. Studies
are on osteoporosis,
endometriosis, uterine
fibroids, and modifying
pregnancy risks, just to
cite a few examples. Other
research trials have included
cardiovascular diseases,
Alzheimer’s disease, and
urinary incontinence.
The team are actively
involved in women’s health
promotion and disease
prevention and treatment
that covers the entire age
spectrum: from puberty to
the elderly.
Andrew Shelling
o
F amilial Premature Ovarian Failure
Peter Stone
o
Larry Chamley
o
T he Effect of Hypoxia on Placental Factors
Involved in Implantation, with a Focus on
Abnormalities in Hypoxic Regulation in
Recurrent Miscarriage
Jenny McDougall
o
o
Larry Chamley
o
B
lood Sampling in Recurrent Miscarriage to
Allow Development of Tests for Recurrent
Miscarriage and Development of a Minimally
Invasive Test for Fetal Karyotype Analysis
o
T he Life Cycle of Placental Trophoblasts in
Health and Diseases of Pregnancy
T wins: Timing of Birth at Term. Timing of Birth
for Women with a Twin Pregnancy at Term - a
Randomised Controlled Trial
Tomasina Stacey
D
eterminants of Late Fetal Death in Auckland
2006-9: The Exploration of Modifiable Risk
Factors for Late Fetal Death
Robyn North
o
Lesley McCowan
o
o
S
creening for Pregnancy Endpoints
(SCOPE Study)
A
ustralian Collaborative Trial of Repeat Doses
of Steroids for the Prevention of Neonatal
Respiratory Disease
Susan Morton
o
F ield Test for Development Phase of
Longitudinal Study of New Zealand Children
and Families
Hilary Liddell
o
A
udit of the Recurrent Miscarriage Clinic at
National Women’s Hospital and Research into
the Maternal and Neonatal Outcomes of
Women Who Suffered Recurrent Miscarriage,
from 1991-2000
P
lacental Proteomic and Gene Transcriptional
Analysis in Normal Pregnancy and in
Pregnancy Complications
Jeffrey Keelan
o
B
iomarkers of Placental Growth and
Development in Maternal Plasma
o
P
lacental Growth and Inflammatory Factors
in Pregnancy Disorders
Emma Parry
o
A
nxiety Levels in Women Undergoing Fetal
Fibronectin Testing for Threatened Preterm
Labour
T he Placental Bed in Women with Recurrent
Miscarriage and Phospholipid Antibodies
Lesa Freeman
o
D
ecision Making in Midwifery Practice for the
Management of Women in Labour
Janet Rowan
o
G
estational Diabetes: Treatment with
Metformin Compared with Insulin and Initial
Offspring Follow-up [MiG] plus MIG Tofu
o
G
estional Diabetes: Treatment with Metformin
Compared with Insulin - the offspring Followup Study
Murray D Mitchell
o
C
annabinoids in Human Pregnancy
43
Children and Young People Oncology
The primary objective of the
Haematology / Oncology
Division at Starship Hospital
is to improve the lives and
potentially provide a cure
for children and adolescents
with cancer, blood and
immune disorders. This
mission is achieved by
offering compassionate,
state-of-the-art clinical
care to patients and their
families, advancing our
understanding of these
diseases through basic
and translational research
and educating future
health care providers and
leaders in the field. David Mauger
C
hildren’s Cancer Group P9641 - Primary
Surgical Therapy for Biologically Defined LowRisk Neuroblastoma
o
C
ytokine Gene Polymorphisim in Paediatric
Patients Receiving Tacrolimus or Cyclosporin
for Graft-Versus-Host Disease Prophylaxis
o
T rial of Chemotherapy Intensification Through
Internal Compression in Ewings Sarcoma and
Related Tumours
o
o
C
hildren’s Oncology Group: AEWS02b1: A
Groupwide Biology and Banking Study for
Ewing Sarcoma
A
Children’s Oncology Group Pilot Study for
the Treatment of Very High Risk Acute
Lymphoblastic Leukemia in Children and
Adolescents
o
A
n International, Randomised, Controlled
Trial of Immune-Tolerance Induction
o
A
Children’s Oncology Group Protocol for
Collecting and Banking Paediatric Research
Specimens Including Rare Paediatric Tumours
o
A
MC OL Noncomparative Study to Evaluate
the Safety, Tolerability, and Efficacy of
Caspofungin Acetate in Children with
Documented Candida or Aspergillus
Infections
o
C
lassification of Acute Lymphoblastic
Leukemia
o
A
ALL0232 High Risk B - Precursor Acute
Lymphoblastic Leukaemia
o
T reatment Protocol of the Third International
Study of Langerhans Cell Histiocytosis
o
S
tandard Risk B-precursor Acute
Lumphoblastic Leukemia. A PIII groupwide Study
o
T reatment of Late Isolated Extramedullary
Relapse from Acute Lymphoblastic Leukemia
Jane Skeen
o
I rinotecan Single-drug Treatment for Children
With Refractory or Recurrent Hepatoblastoma.
A Phase II Trial of the Childhood Liver Tumours
Strategy Group of SIOP
o
SIO
PEL 4: Intensified pre-operative
chemotherapy and radical surgery for High
Risk Hepatoblastoma
o
I nternational Childhood Liver Tumours
Strategy Group SIOPEL 5 (HCC-1) trial on the
Hepatocellular Carcinoma family of Tumours
in Children / Adolescents and Young Adults
Lochie Teague
44
Lochie Teague
o
o
P
rotocol for Collection of Biology Specimens
for Research Studies
o
C
hemotherapy for Progressive Low Grade
Astrocytoma in Children Less Than Ten
Years Old
o
N
ational Wilms Tumour Study V-Therapeutic
Trial and Biology Study
o
T reatment of Children with Down
Sydrome and Acute Myeloid Leukaemia,
Myelodysplastic Syndrome and Transparent
Myeloproliferative Disorder
o
M
edical Resesarch Council Working Party on
Leukaemia in childhood. Acute Myeloid
Leukaemia Trial 12
o
E scalating Dose Intravenous Methotrexate
Without Leukovorin Rescue vs Oral
Methotrexate and Single vs Double Delayed
Intensification for Children with Standard
Risk Acute Lymphoblastic Leukaemia
Ruellyn Cockcroft
o
CO
G: A Phase III Study of Reduced Therapy
in the Treatment of Children with Low and
Intermediate Risk Extracranial Germ
Cell Tumors
o
CO
G: A Pilot Phase II Study for Children with
Infantile Fibrosarcoma
o
A
Study of Unilateral Retinoblastoma with and
without Histopathologic High-Risk Features
and the Role of Adjuvant Chemotherapy
Children and Young
People Oncology cont.
Scott Macfarlane
A
cute Lymphoblastic Leukaemia Study VII
Protocol. A Phase III Group Wide Study
Wayne Nicholls
o
o
o
E VA/ABV for Patients with Stage I & II
Disease without Massive Mediastinal Disease
MOPP/ABV for Patients with Stage III - IV
Disease and with Massive Mediastinal
Disease
P
II Window Eval. of the Farnesyl Transferase
Inhibitor Followed by 13-Cis Retinoic Acid,
Cytosine Arabinoside & Fludarabine plus
Hematopoietic Stem Cell Transplantation in
Children w/Juvenile Myelomonocytic
Leukemia
o
o
A
Study Evaluating Limited Target Volume
Boost Irradiation and Reduced Dose
Craniospinal Radiotherapy & Chemotherapy
in Children with Newly Diagnosed Standard
Risk Medulloblastoma: A PIII Double
Rand. Trial
A
Phase II Trial of Conformal Radiation
Therapy for Paediatric Patients with Localized
Ependymoma, Chemotherapy Prior to Second
Surgery for Incompletely Resected Ependymoma
and Observation for Completely Resected,
Differentiated, Supratentorial Ependymoma
o
o
A
Phase II Study of Oxaliplatin in Children
with Recurrent Solid Tumours
A
Children Oncology Group Protocol for
Collecting and Banking Pediatric Brain
Tumour Research Specimens
o
A
Phase II Study of Sulindac and Tamoxifen
in Patients with Desmoid Tumors that are
Recurrent or Not Amenable to Standard
Therapy
Wayne Nicholls
o
A
PII Study of Concurrent Radiation and
Temozolomide Followed by Temozolomide and
Lomustine (CCNU) in the Treatment of Children
with High Grade Glioma
S
ystemic Chemotherapy, Second Look
Surgery and Conformal Radiation Therapy
Limited to the Posterior Fossa and Primary
Site for Children > 8mths and < 3yrs with Nonmetastatic Medulloblastoma: A Children’s
Oncology Group Phase III Study
o
A
PII Study to Assess the Ability of
Neoadjuvant Chemotherapy +/- Second
Look Surgery to Eliminate all Measurable
Disease Prior to Radiotherapy for NGGCT
o
P
erinatal Neuroblastoma: Expectant
Observation a COG Pilot Study
I nternational Society for Pediatric Oncology
Treatment of Tumours of the Choroid
Plexus Epithelium
Sally Davis
Wayne Nicholls
o
o
o
T he Long-Term Cognitive and Adaptive
Outcomes of Childhood Medulloblastoma:
Impact of Radiotherapy
Children and Young People Surgical
Brian Anderson
Susan Stott
o
o
P
harmacokinetics and Pharmacodynamics of
Alpha2-Adrenoceptor Agonists in Children
Undergoing Cardiac Surgery
Haemish Crawford
o
R
andomised Prospective Controlled Trial:
A Comparison of Two Management Strategies
of Congenital Idiopathic Clubfoot
Katja Oberhofer
o
Michael Shepherd
o
P
aracetamol versus Ibuprofen: A Trial of
Outpatient Analgesia Efficacy for Paediatric
Acute Limb Fractures
Stuart Walsh
o
T he Evaluation of Outcome Following
Conservative and / or Surgical Treatment for
Children who are Idiopathic Toe Walkers
M
RI-based Patient-specific Musculoskeletal
Modelling for Computation of Lower Limb
Muscle Lengths During Walking in Children
with Cerebral Palsy
Anna Mackey
o
I mproving Arm Function in Young People with
Hemiplegia - Insights from Neuroscience
O
steochondral Fractures of the Lateral
Femoral Condyle in the Adolescent Knee.
Outcome of Bio-Absorbable Pin Fixation
45
Children and Young People Medical and Emergency
Medical: The Starship
Medical Research Team are
committed to excellence in
family-centred paediatric
patient care, life-enhancing
research and professional
education. They have extensive interests in rheumatic
fever, genetic and neurological research areas.
Emergency: The Children’s
emergency department
sees more than 30,000
children each year with
a wide range of medical,
surgical and orthopaedic
emergencies. CED has a
half-time research fellow
and is actively involved
in research. Last year a
large pharmacodynamic
study on ketamine resulted
in 4 publications. There
is a nursing quality group
who are actively involved
with audit and quality
improvement. In addition
the department is running
three randomised controlled
trials. Starship CED is also
a member of the Paediatric
Research in Emergency
Departments Collaborative,
a group of 11 Australasian
children’s emergency
departments.
46
Ranee Gedye
o
T he Relationship Between Coping Behaviour,
Hope and Level of Adjustment in Families of
Children with Brain Tumours. An Investigation
of Change Over a Two-year Period from the
Time of Diagnosis
Ed Mitchell
o
S
erum Anticardiac Antibodies in Children with
Rheumatic Fever
o
T he Treatment of Non-Synostotic
Plagiocephaly and Brachycephaly in Infancy
Sandra Murphy
o
Wayne Cutfield
o
K
idz First and Middlemore Hospital-based
Post Marketing Safety Surveillance of the
New Zealand Strain Specific Group B
Meningococcal Vaccine (MeNZB)
Wayne Cutfield
o
G
rowth Hormone Resistance in Premature
Children
o
E valuation of SERUM IGF-II in Children and
Adolescents Born Prematurely
o
E arly Prediction of Brain Damage after Heart
Surgery in Infants
o
A
Pilot Study Investigating Hypothermia in
Traumatic Brain Injury in Children
o
H
ypothermia for Cardiac Arrest in Paediatrics
(HypCAP) - Pilot Study
David Herd
o
N
on-accidental Infantile Subdural
Haemorrhage in Auckland 1988 to 1998. The
Outcome of Referral to Statutory Authorities
B
aby, Infant and Toddler Transillumination
Study (BITTS)
Craig Jefferies
o
Patrick Kelly
o
E valuation of Insulin Sensitivity in Prepubertal
Children with Constitutional Delay of Growth
and Development
John Beca
Anne McNicholas
o
T hrough Mothers’ Eyes: The Lived Experience
of 4-6 Children One Year After Liver
Transplantation Using an In-depth Interview of
the Mothers
T rialNet Natural History Study of the
Development of Type I Diabetes
Kevin Plumpton
o
T hyroid Hormone Levels and Cortisol Levels
Post Congenital Heart Surgery in Infants Less
Than 3 Months of Age. Delineation of
Acceptable Range and Investigation of
Association with Outcome
Andrew Thompson
o
I ncreasing our Understanding of Whanau/
Family Meetings and the Whanau/Family’s
Perception of the Quality of those Meetings in
the Paediatric Intensive Care Unit at Starship
Children’s Hospital
Katharine Huggard
o
S
creening for Psychological Well-being and
Difficulties in Adolescents with Type 1
Diabetes
New Born Research
Newborn Services has an
active interest in clinical and
basic science research. The
key areas of interest within
the department are perinatal
and neonatal nutrition,
ventilation, chronic lung
disease, haemodynamics
(in particular, the impact
of the patent ductus
arteriosus), and neonatal
neurology. Presently,
several randomised trials
are being undertaken,
including international
multicentre studies (the
INIS trial, the LessMAS
trial, and the BOOST-NZ
trial). In addition, the
service is running one local
randomised clinical pilot trial
evaluating the treatment of
hyperglycaemia, which it
is hoped will expand to a
multicentre trial. Jane Harding
o
E ffects of Repeated Courses of Antenatal
Corticosteroids on the Neonate
o
N
asal CPAP or Ventilation for Very
Preterm Infants at Birth. A Randomised
Controlled Trial
Malcolm Battin
o
P
rediction of Neonatal White Matter Injury
by EEG
o
I nternational Neonatal Immunotherapy Study
(INIS): A RCT of Intravenous Immunoglobulin
o
C
ontrolled Trial of Therapeutic Lung Lavage
in Meconium Aspiration Syndrome
Shirley Tonkin
o
P
ilot Investigation of Infant Upper Airway Size
and Respiratory Function in Standard Car
Seats and the Effect of Modifying the Car
Seats to Maintain a Physiological Position
Peter Black
o
A
Randomised Controlled Trial of the Effects of
Probiotics on the Development of Atrophy and
Allergic Disease in Early Childhood
Ed Mitchell
o
T he Prevalence of SIDS Risk Factors in the
Auckland Region
Trecia Wouldes
o
T he Development of Infants Exposed
Prenatally to Methamphetamines
Gabrielle L McCarthy
o
A
Qualitative Descriptive, Exploratory
Study Examining the Information Needs of
Four Key Stakeholder Groups in Regard to
Parental Information Needs When a Child
is Born Intersex
Jane Alsweiler
o
R
andomised Controlled Trial of Tight
Glycaemic Control with Insulin in
Hyperglycaemic Preterm Neonates
Carl Kuschel
o
B
OOST-NZ Study: What Oxygen Saturation
Level Should we Target in Very Preterm
Infants? - A Randomised Controlled Trial
Paul Hofman
o
T he Determination of Factors that Affect
Metabolic Programming in Preterm Children
Research
Income
2006
Neurosurgery Research
7,037
DCCM Research
167,981
Gen Surgery Research
124,256
ORL Research
Urology - Research
56,427
Orthopaedics Research
62,107
NICE Study
45,039
Neurology Research Unit
310,710
General Medicine Research
64
Liver Transplant Research
443,762
Gastroenterology Research
30,796
Infectious Disease Research
Renal Research
10,601
Renal Research 2
141,794
Renal-Ideal Research
58,359
Sharp Research
10,938
Haematology Research
266,732
Oncology Research
533,368
Cardiac Research
3,086,644
Respiratory Research
217
CVICU Research
149,496
Respiratory Research ADHB
366,320
Anaesthesia Research
113,232
Gestational Diabetes
240,689
PICU Research
116,014
CED Research
25,740
Paediatric Cardiac Research
1,750
Diabetes Research
124,018
Endocrinology Research
13
Rheumatology Research
66,563
Diabetes Field Study Research
5,258
Sexual Health Research 35,896
Immunology Research
6
Ophthalmology Research 36,203
Research Office
68,403
Total Research Income 2006
6,692,360
47
www.adhb.govt.nz