Research

The School of Medicine comprises the disciplines of Anaesthesia & Intensive Care,
Medicine, Orthopaedics & Trauma, Psychiatry and Surgery. This page will, from time to time, focus in more detail on selected staff members and research in the School, providing snapshots of current research in progress.

• Psychiatry
  Research
  Two PhD highlights
  Some staff highlights
• Surgery
  Research
  
• Orthopaedics and Trauma
  Current Research
  Publications
  Current Postgraduate Students
• Medicine
  Wayne Tilley Group
  Dorothy Keefe Mucositis Research Group
  

Psychiatry

In 2006 the Discipline of Psychiatry research programme covered a number of areas.  Whilst the Discipline is characterized by individuals working on their own areas of interest and expertise, we are unified by most of our research activities being congruent with national research priorities, especially "Promoting and maintaining good health" , and with the 2007 SA Strategic Plan targets 2.6 “Chronic disease”, and 2.7 “Psychological well-being”.

Anthropological studies continued, examining schizophrenia and investigating the manifestations of this disorder in different cultures.  Foci included societal responses to psychotic illness in a small-scale society in Malaysia, a genetic study of schizophrenia in this population, and cultural determinants of recovery from acute psychosis in Indonesia.  In Adelaide qualitative and quantitative studies into schizophrenia focused on first episode psychosis. 

Anthropological research was conducted into the hospital’s community psychiatric emergency service, its organizational culture and function, and two papers on this were published.  A further project investigated the homeless mentally ill in the city of Adelaide. 

Several projects commenced in 2005, applying linguistic approaches, and these continued in 2006; first to the study of auditory hallucinations, second the study of thought disorder, and third to the study of therapeutic interaction in cognitive behavioural therapy.

A body of research in the field of medical education is ongoing in the Discipline.  Quantitative and qualitative studies continue, in the areas of the role of English language proficiency in academic and clinical performance, aspects of best practice postgraduate supervision in psychiatry, and interdisciplinary approaches to teaching and learning in undergraduate and postgraduate training.  A project examining the selection procedures for Clinical Nursing applicants commenced.

Investigations have been carried out into the management of high prevalence psychological disorders in general practice settings, examining the role of clinical psychologists in primary health care.  In the field of Health Psychology, a major strand of research involves an examination of the relationship between companion animal ownership and physical and psychological health.  Work is being undertaken on occupational stress in service professionals, its effects on their psychological well-being, health and work performance, as well as its management and prevention.  Finally, there have been a series of studies into psychosocial supports needed by people suffering serious and/or chronic illness, and their family members; these include the role of coaching in the treatment of people with diabetes, and the internet as a source of information and support for cancer patients.
An NHMRC funded study into the identification and management of depression in patients with heart failure and angina in general practice was commenced.  This study involves a cluster randomized control study of 600 patients in 24 practices of an intervention based on  work previously conducted as part of the Identifying Depression as a Comorbid Condition (IDACC) project.  A study on the prevalence of depression in the community, with a specific focus on the association between depression and chronic lung disease was undertaken.  Phase 2 of the North West Adelaide Health study was completed in 2006.

An NHMRC grant was won in 2006, the team of which included some members of the Discipline, to investigate “Childhood cognitive antecedents of adult psychopathology: follow up of the Port Pirie lead cohort into adulthood.”

Two PhD highlights:

Tumby Bay General Practitioner, Dr Graham Fleming, submitted his MD thesis on suicide prevention in a rural community, through an initiative coordinating the medical and educational resources and the parents and young people of the community (Supervisor Professor Goldney).

Malaysian Psychiatrist, Dr Muhsin Ahmad Zaharia, with the support of Professor Rob Barrett won an Endeavour International Postgraduate Research Scholarship, to pursue PhD research in Forensic Psychiatry, investigating the reasons for women's lower rates of incarceration (Supervisors Associate Professor Cherrie Galletly and Dr Ken O’Brien).

Some staff highlights in Psychiatry

• Associate Professor Anna Churhansen
• Associate Professor Cherrie Galletly
• Professor Robert Goldney
• Professor Johan Schioldann
• Dr. Helen R. Winefield
  

Surgery at the University of Adelaide

Surgery deals with the impact of diseases and trauma, the techniques and technology to repair or alleviate, and treatment outcomes experienced by patients

The University of Adelaide Discipline of Surgery has a presence within the Royal Adelaide Hospital and The Queen Elizabeth Hospital, both major teaching hospitals of the University of Adelaide. In addition, it has representation in a number of rural centres including Mount Gambier, Whyalla, Port Lincoln, Port Augusta and Port Pirie.

Go to Discipline of Surgery Webpage

Orthopaedics and Trauma

Current Research in Orthopaedics and Trauma

The research in this discipline comprises clinical and basic investigation of diseases that affect the skeleton.
The clinical research program includes projects at each of the campuses of the RAH, Modbury, QEH and the WCH. The work encompasses studies in joint replacement, trauma and fracture repair, spinal surgery and hand and upper limb surgery. An example of projects pursued in 2006 was the further development of a three-dimensional imaging technique, using conventional scanned CT data. This novel technology, developed by Mr Michael Sandow, provides a platform accessible to the surgeon to better understand the normal and abnormal pathology, perform virtual surgery and template arthroplasty or corrective bony procedures. A second project was the development of an exciting method of objectively measuring fracture repair, using radiostereometric analysis (RSA). With chief investigators Dr Mellick Chehade, Dr Bogdan Solomon and Mr Tony Pohl, this work is enabling a better understanding of fracture repair and the factors that influence it, as well as providing the surgeon, for the first time, with a means to differentiate healed and non-united fractures. A third clinical project, led by Prof Howie and Margaret McGee, involves the use of new generation CT to image around metal joint implants, in order to measure bone loss (or osteolysis) around these protheses. This information is enabling much better monitoring of joint replacement patients and also providing much needed information on the natural history of this type of bone loss and the factors responsible for it.
The basic research program takes place in the Orthopaedic Bone Cell Biology Laboratory in the Hanson Institute/IMVS, with Prof David Findlay as Head. The work focuses on identifying the cells and molecules that are responsible for bone diseases including osteoporosis, osteoarthritis, bone cancer and bone loss around artificial joints. The aim of their work is to understand the basis of these disorders, in order to identify more effective treatments. The research involves collaboration with orthopaedists, haematologists, metabolic bone researchers, pathologists, bioengineers, on campus and elsewhere, as well as biotechnology companies. A group led by Dr Gerald Atkins has focused on several related molecules with different actions in bone. One is an osteoclast growth factor, RANKL, which is central to the process of bone turnover and repair required for healthy bone. The work has revealed that increased bone production of RANKL occurs in those disease processes, which are directly related to bone loss. In addition, the role in bone remodelling of a molecule called TWEAK, is being studied.

This information is currently being applied to understanding mechanisms for reducing bone loss. Healthy bone is maintained by two types of cells, those that control bone formation (osteoblasts) and those responsible for bone breakdown (osteoclasts). The ability to study these processes in human bone cells has been impaired by a lack of a suitable model, in which human osteoblasts could promote the formation of human osteoclasts. The group has moved closer to solving this problem by identifying conditions under which human osteoclasts can be produced. This finding will enable treatments that have the ability to either reduce bone loss or enhance bone formation to be tested and allow determination of the mechanism of their action. This is being applied to studies on the mechanisms by which vitamin D and a range of other skeletally active agents, act on these bone cells, and studies of the way human osteoblasts interact with new orthopaedic biomaterials such as porous tantalum. In addition, it is being used to examine the way, in which tumour cells interact with, and change the behaviour of, normal bone cells.

A group led by Dr Andreas Evdokiou is studying another molecule, TRAIL, which has a remarkable ability to kill tumour cells but not normal cells. TRAIL is one of several members of a cytokine superfamily that induce programmed cell death. This work is motivated by the current problem that cancers are particularly difficult to treat once they become resident in bone. The laboratory has shown in animal model studies that TRAIL in partnership with other non-toxic drugs is very effective in killing bone cancer cells as well as cancer cells from breast and prostate which migrate to and colonise bone. These studies are most promising and bring the dual advantages of a more effective treatment and reduced toxicity for the patient. Extensive studies are also being performed examining the potential usefulness of a number of other drugs to inhibit the growth of tumours in bone and their effect on the degradation of the bone.

Here is a snapshot of publications and post-graduate students in the Discipline of Orthopaedics and Trauma

Medicine

The Mucositis Research Group, headed by Prof Dorothy Keefe is researching mucositis, a common, costly and unpleasant side effect of anti-cancer treatment that has previously been under-researched. The Mucositis Research Group investigates patho-biology and possible treatments for alimentary (oral and gastrointestinal) mucositis. Her group has developed animal models of both chemotherapy- and radiotherapy-induced mucositis, and use these to investigate the changes over time post-treatment both along the alimentary canal and through its depth. This allows investigation of new agents as potential anti-mucotoxic treatments. The group has an international reputation in this area, with Professor Keefe acting as a consultant to many of the Pharmaceutical companies that have drugs in development for mucositis, as well as collaborating to investigate new agents in our animal model. The Triad Burden of Illness studies are prospectively investigating the clinical and quality of life implications, as well as health-care costs associated with mucositis from multi-cycle chemotherapy and chemo-radiotherapy.

Professor Wayne Tilley's group in the Dame Roma Mitchell Cancer Research Laboratories is undertaking research into breast and prostate cancer with a particular focus on sex hormone receptors.