HEALTHY KIDS, HEALTHY TEETH, HEALTHY HEARTS

On 8 May the Poche Centre for Indigenous Health celebrated the launch of its new three-year strategy: Healthy Kids, Healthy Teeth, Healthy Hearts. The event was hosted by the Dean of the Sydney Medical School, Professor Bruce Robinson with special guests Kay Poche, Reg and Sally Richardson, and new Chancellor of the University of Sydney, Belinda Hutchinson. Presentations by Professor Glenn Salkeld, Professor Sandra Eades, Mr Geoffrey Angeles and Professor Andy Blinkhorn highlighted much of the research currently undertaken by the centre.

Kylie Gwynne, Director of the Poche Centre, said that the event was an important milestone. “It’s exciting that we are able to draw on all the strengths and resources of the university to deliver health services to Aboriginal people and communities,” she said. The centre hopes to make an even greater impact at a local level by establishing a mobile health service and developing long term partnerships with relevant health organisations such as the Centre for Oral Health Strategy, Aboriginal Medical Services and the Far West Medicare Local.

“We have strong foundations as a service centre and provide more than 4000 aboriginal people in remote areas with access to services which are typically only found in the city. Our next aim is to line up evidence with service delivery and strategy to provide services to the community. The five Poche Research Fellows being established across the health-related faculties are key to achieving this. It’s an exciting time and we hope to create capacity, interest and energy about aboriginal health,” she said.

THE BRIDGEISSUE 16 JUNE 2013

SCHOOL OF PUBLIC HEALTH

IN THIS ISSUE

2 WUNDERING ABOUT WHAT TO DO FOR CVD?

3 MY JOURNEY TO SYDNEY AND THE SEIB

4 HELP THE ELDERLY BETTER ADAPT TO CLIMATE CHANGE

6 POCHE CENTRE FOR INDIGENOUS HEALTH

8 AWARDS, GRANTS, PROMOTIONS

9 GRADUATION-MAY2013

10 Q & A WITH MATTHEW SOEBERG

12 GRADUATE NEWS

L-R:KYLIEGWYNNE,BRUCEROBINSON,REGRICHARDSON,SALLYRICHARDSON,KAYPOCHE, BELINDA HUTCHINSON, GLENN SALKELD, JOHN WATSON

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EDITORIAL FROM THE HEAD OF SCHOOL MY JOURNEY TO SYDNEY AND THE SEIB

Prof Glenn Salkeld

BY GRANT HILL CAWTHORNE

The whole is greater than the sum of parts. It’s an ideal that is often used to capture the notion of collective purpose, working towards a common goal and the synergies that flow from working together. It sounds very public health and it is. But drawing the parts together into a whole is no trivial matter – in any organisation. It cannot be

achieved by simple decree of a vision, mission and values statement. Yet having a common vision is a good place to start. So in 2012 the Sydney School of Public Health committed to a common vision based on what we want to achieve for the benefit of others – in particular those people with the greatest need of improved health and wellbeing. It’s handy to have a statement of common purpose close to hand as we consider what we want to achieve over the next five years and how we will do it. The School retreat in January this year was a start – now comes the hard work of strategizing and engaging all staff in shaping of our future. Part of that involves enhancing our leadership team and I’m delighted that Sharon Reid has commenced as our Director of Teaching and Learning (Assessment & Evaluation) to complement Jo Lander Director T&L (Curriculum

and e-Learning) and Joel Negin as our Director of Research. It also involves communication, inclusion and participation of all our staff in the life of the School. Stacy Carter and Becky Freeman are leading our post retreat working group on just that. New ideas and people are part of the plan. In this issue we hear from two new academic staff – Ying Zhang and Grant Hill Cawthorne and their ideas on research in climate change and population health and infectious diseases respectively. The Poche Centre for Indigenous Health has launched its new strategy for ‘Healthy Kids, Healthy Teeth and Healthy Hearts’ and that marks our ongoing commitment to supporting early career researchers who are working towards improving the health of Aboriginal and Torres Strait Islander people. On the whole things are looking very positive in 2013!

WUNDERING ABOUT WHAT TO DO FOR CVD?BY STEVE LEEDER Starting in Cambridge

I am a new member of the School of Public Health and a bit of a rarity in that I study communicable diseases. I am a doctor by training and did my undergraduate degree in neuroscience and my medical training at the University of Cambridge. I stayed in Cambridge to complete my junior doctor training (which Australians call residency years) and was originally going to specialise in neurology. To that end I have worked in neurology and neurosurgery jobs but I really had my interest in infections piqued when I did a 6-month placement in infectious diseases. I found that the patients that were most prone to “fall between the gaps” were those with neurological infections or where they had a funny MRI scan and no one really knew what was happening. I therefore switched to specialise in medical virology and haven’t looked back since.

Then onto Saudi Arabia

During my virology training a slightly odd opportunity presented itself. A brand new university opened in Saudi Arabia in 2009 called the King Abdullah University of Science and Technology. This was a graduate-only university built with a $10 billion endowment from the King and was to be the first co-educational university in Saudi Arabia (and also the first to take international students). The faculty were similarly international. A malaria genomicist at the www.sanger.ac.uk. Wellcome

Trust Sanger Institute was offered an associate professor position there and asked me if I would like to go out there to set up a lab in pathogen genomics. We were given a blank cheque for $2 million to build a lab and kit it out. We also got free sequencing for the first 2 years. During my time in Saudi I did a PhD in the genomics of tuberculosis – making me the only virologist who specialises in TB.

Research Interests

Infectious diseases and medical microbiology are undergoing the most significant shift since PCR was introduced. By the end of this decade, sequencing will have become the main option when investigating any outbreak or infection. I am interested in the interface between genomics as a pure science and its translation into clinical benefits. In particular I am interested in using sequencing as a diagnostic tool and for prognostication, including assessing drug resistance.

During my neurology years I researched both autism and neuroimmunological diseases. However since my time in Saudi I have been looking at the global genomic diversity of tuberculosis and markers of drug resistance. In Sydney I am continuing to explore the clinical application of sequencing for tuberculosis and the diagnosis of non-tuberculous mycobacteria. In particular I am looking at mutations that increase the transmission of TB, drug resistance mutations present in different TB lineages and the presence of compensatory mutations. I am also keen to marry my interests in neurology and pathogen genomics so am starting exploratory work on neurological infection research.

Sydney Emerging Infections and Biosecurity Institute (SEIB)

I have been appointed jointly between SSPH and SEIB. SEIB is a virtual institute with the aim of facilitating true multidisciplinary interactions – between medicine, vet medicine, science, law, media and social sciences. It aims not only to produce multidisciplinary research but to also establish cross-faculty teaching, policy making, advocacy and laboratory capacity building. To this end we are currently designing a Masters in Health Security where students will be able to pick from units sourced from across the faculties, and are putting in AusAID funding applications to build lab capacity in Indonesia, Mongolia and Bangladesh. By sitting in both SSPH and SEIB I hope to facilitate more cross-disciplinary interactions between SSPH and the Western Clinical School infection researchers.

More about SEIB: sydney.edu.au/seib/

Mark Hanson directs the University of Southampton Academic Unit of Human Development and Health in the Faculty of Medicine. He also holds appointments in Auckland, Singapore, Dublin, Jamaica and Suzhou. A lean, witty and erudite Oxford-trained physiologist in his 60s, his group “is exploring the epigenetic processes which relate to such risks, and which may serve as valuable early life biomarkers in both developed and developing countries in many parts of the world.” He leads the Worldwide Universities’ Network cardiovascular disease (public health aspects thereof) theme and keeps Don Nutbeam, his vice-chancellor who is deeply involved with the theme, happy – which is no mean feat as you may agree.

In introducing this year’s two day conference of the theme, along with other themes concerned with climate change, culture and education, Mark told the 60 attendees from a dozen universities meeting in Washington in May that three things on earth were visible form space – China’s great wall, the Barrier Reef and WUN. I said he was wrong – the Barrier Reef is disappearing.

What differentiates the WUN CVD group from 101 other such worry-groups is that it focuses on the lifecourse, especially early childhood and does not bang on endlessly about reducing salt consumption, flogging

adults to lose weight and change diet, or nuking the food industry. It is concerned especially to explore research collaborations in relation to the effects of the environment on pregnancy, early childhood and then later adolescence on CVD risk and what might be done to reduce that risk. It takes a different fix on the environment and health literacy as vehicles for CVD prevention early on.

The two days of colloquium took unexpected turns. Reflecting the nationality of the attendees and the interests of several culture people who invaded our group, migration caught people’s attention. Given that between 140,000,000 and 200,000,000 Chinese people are migrating to the cities each year, leaving their children in the care of grandparents, and that WUN is by definition is meant to have global reach, what might we do/say about the health of those people? These are heavy questions indeed. Add to these folk the millions that will migrate from Bangladesh when the tides rise due to global warming.

Three CVD theme working groups will continue to meet by phone and email – on migration, adolescent health and health literacy? Interested? Let me know by email and I will get you involved.

Next year WUN meets in Cape Town. Now there’s another challenge for you!

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Current development patterns and human activities are bringing a range of new challenges to public health. Climate change is the clearest example. The global average temperature is increasing faster than we expected, and the Intergovernmental Panel on Climate Change (IPCC) 2007 Assessment Report already looks conservative. Although climate change is called “the biggest global health treat of the 21st century”, more research is needed to reduce the uncertainties and to support decision-making to reduce health risks from climate change.

HELP THE ELDERLY BETTER ADAPT TO CLIMATE CHANGEBY YING ZHANG

I have been conducting research on climate change and population health for almost ten years. My PhD study in environmental epidemiology at the Discipline of Public Health, University of Adelaide, was focused on the impact of climate variations on infectious diseases. Advanced time-series analyses were applied to quantify the association between meteorological variables and some vector-borne and food-borne diseases, e.g. Ross River virus infection and salmonella infection in Australia, and malaria and bacillary dysentery in China. Results from the research have been adopted by local Department of Health/Centres

for Disease Prevention and Control to improve the effectiveness of their early warning systems.

While I continued my research on climate change and health after my PhD, my following postdoctoral research on quality use of medicines for the elderly with multiple conditions shaped my research focuses by adding experience in pharmacoepidemiology and in ageing health. Two large cohort databases were analysed, including the pharmaceutical database from the Department of Veterans Affairs and the Australian Longitudinal Study of Ageing. I have discovered a significant gap in current

Australian clinical guidelines related to co-morbidity in older patients, and made a number of recommendations regarding the use of antidepressants and the relationship between co-morbidity and utilisation of health care by Australian veterans with diabetes.

Another fact of the 21st century is that populations are ageing, and it is the aged who are most vulnerable during bouts of hot weather. When I realised that there is an obvious gap between ageing health and climate change research, I took the opportunity to successfully apply for a NHMRC Training Fellowship (2010-2014) to conduct research

YING WITH HER ‘OLD’ FRIEND IN ADELAIDE

A NURSING HOME IN JINAN, SHANDONG, CHINA

to “help the elderly better adapt to climate change and extremes”. Thanks to the opportunities provided by the NHMRC Fellowship, I have been successful in applying for other grants as chief investigator to support my research on climate change and ageing health, e.g. an ARC linkage project with SA Health as an industrial partner (LP110200820), a National Climate Change Research Facility (NCCARF) project, and an Australia-China Science and Research Fund Group Mission project (ACSRF01060). Epidemiological studies are underway in Adelaide to identify a range of risk factors for direct heat-related illnesses, including their living conditions, social support, health status and the potential risk from the use of certain medications commonly used to treat conditions associated with ageing, e.g. mental disorders and cardiovascular disease.

Link with the community

In addition to my research and teaching commitments, I am constantly engaged in community activities. For example, I have been a volunteer for an aged care organisation in Australia since I came to Australia in 2004. Due to my passion to pass on knowledge to the community and the next generation, I have been a volunteer scientist for the CSIRO Scientists in Schools program for more than 5 years and working with primary school students on science projects on climate change and health.

Link with China

I was a lecturer in epidemiology at Shandong University China before I came to Australia and have been able to keep a long-term working relationship in public health research and teaching with my colleagues in China. As a result of my ongoing collaborative work with China, the Shandong University Centre for Climate Change and Health was established in September 2010, the first such centre in China. Together with my Chinese colleagues, we have also been successful in applying for teaching and research funding from Shandong Provincial Government and the National Nature Science Foundation of China. It was my work related to China that has led to the movement towards the new position in Sydney.

New platform in Sydney

On 14 January 2013, I joined the University of Sydney on a joint appointment between the School of Public Health and the China Studies Centre. There is no doubt that the outstanding research environment, resources and support available at the University of Sydney will enhance my capability as an independent researcher. It indeed provides a perfect platform for my career development by helping me continue my commitment to improve the health status of the most vulnerable elderly in a changing environment. In particular, by feeling the huge gap in the quality of life between developed and developing countries, I am looking forward to conducting more field research in developing countries to help the elderly better adapt to the changing environment.

In addition to increase the research strength on climate change and health in the School, my research focuses fit nicely within established school strengths, e.g. epidemiology, ageing health, global health and health policy. By working with the team for the International Public Health and the China Studies Centre, more opportunities will be identified in promoting cross-disciplinary research and teaching in public health, with existing and new international collaborators in China and other countries. Given the population ageing, increasing global health burden from non-communicable diseases with more medication use, and continuing environment degradations, I expect that more contributions will be

made at Sydney to inform public health practitioners and policy-makers in both developed and developing countries.

More information from the old media news click here

China Studies Centre sydney.edu.au/china_studies_centre

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1. Kay Poche 2. Sally Tracy 3. Sandra Eades 4. Charles Chicka Madden 5. Michael Otim

6. GeoffreyAngeles7.KimSzerdahelyi8.KylieGwynne9.L-R:BarbaraLucas,Michael Otim, Tanya Martin10. RegRichardson

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Congratulations to

AWARDS AND GRANTS

PROMOTIONS AND APPOINTMENTS

JulieLeask,AlexandraMartiniukandAngelaWebsterhavebeenpromotedtoAssociateProfessor.

JoelNeginisournewDirectorofResearch.

SharonReidhasbeenappointedasDirector,Teaching&Learning(AssessmentandEvaluation).ThiscomplementsJoLander’scurrentappointmentasDirector,Teaching&Learning(CurriculumandE-learning)

ProfessorStephenLeederhasbeenappointedEditor-in-ChiefoftheMedical Journal of Australia.

CONGRATULATIONS TO OUR RECENT GRADUATESGRADUATION CEREMONY MAY 2013

1. INDIGENOUS HEALTH PROMOTION GRADUATES WITH SUZANNE PLATER AND SHANE HOUSTON 2. BIOSTATISTICSGRADUATESWITHJUDYSIMPSON3.MASTEROFINDIGENOUSHEALTH(SUBSTANCEUSE)GRADUATE JIMMY PERRY WITH KATE CONIGRAVE AND KYLIE LEE 4. QUALITATIVE HEALTH RESEARCH GRADUATESWITHJULIEMOONEY-SOMERS5.INTERNATIONALPUBLICHEALTHGRADUATESWITHBOBCUMMING

Professor Sandra Eades and colleagues for being awarded the MJA/MDA National Research Award for the best research article published in the MJA in 2012: “An intensive smoking intervention for pregnant Aboriginal and Torres Strait Islander women: a randomised controlled trial” by Sandra J Eades, Rob W Sanson-Fisher, Mark Wenitong, Katie Panaretto, Catherine D’Este, Conor Gilligan and Jessica Stewart. More information click here. Nehmat Houssami who was awarded a National Breast Cancer Foundation Practitioner Fellowship to support her from 2013 to 2016.

Josephine Chau for her successful application to the Early Career Researcher Grant Scheme through the Sydney Medical School. Project Title: Opt to Stand: A sitting reduction pilot study in Optus call centre staff. Amount: $25,000

Michelle Irving for her successful application to the Early Career Researcher Grant Scheme through the Sydney Medical School. Project title: Exploration of attitudes to organ donation in Australia’s ethnic communities (ENDORSE project): pilot study. Amount: $20,000.

Rachel Morton for her successful application to the Early Career Researcher Grant Scheme through the Sydney Medical School. Project title: ICECAP-O: A novel approach for assessment of wellbeing in older patients with end-stage kidney disease and their carers. Amount: $25,000.

Joel Negin, Bob Cumming and Leanne Howie (Graduate School of Government) who have been awarded an AusAID Development Research Awards Scheme grant. The Award focuses on evaluating outcomes of AusAID scholarships to Africans to study in Australia (ie. how do they do on return, are they able to implement what they learned, etc).  The grant is worth $457,408 over two years and focuses on Mozambique, Uganda and Kenya.

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Q & A WITH MATTHEW SOEBERG

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“..itisnolongersufficienttobe‘justgood’atsomething.Wemuststrivetobeoutstandingtosucceed. To me, theUniversityofSydneyprovidesanoutstandingresearchenvironment.”

YoubeganworkingatSPHlastyear.Tellusalittleaboutyourrolehereatthe School.

I have a really interesting research fellow role in the Cancer Epidemiology and Services Research Group. Half of my role is funded through a translational programme grant awarded to Professor Nico van Zandwijk and colleagues at the Asbestos Disease Research Institute. My focus is on accurately describing the malignant mesothelioma epidemic in Australia using cancer registry and other sources of data. Asbestos-related disease is a big challenge for Australia as well as for developing countries where asbestos bans are not in place. Nico and I are visiting Vietnam shortly to assist their health ministry with ways to monitor asbestos exposures and related disease. The other part of my role involves working with Professor Jane Young and colleagues on cancer epidemiological research using data held at the Cancer Institute NSW.

What enticed you to this role?

I went to a talk given by Thomas Friedman, a US journalist and

commentator, a couple of years ago where one of his key messages was that it is no longer sufficient to be ‘just good’ at something. We must strive to be outstanding to succeed. To me, the University of Sydney provides an outstanding research environment. A core philosophy for me in this role is to add value and make a tangible difference so that there are opportunities to achieve breakthrough results – as a researcher working in a collaborative environment – and to make changes so that new systems, thinking and environments are in place for new generations of researchers to succeed.

YouhavepublishedpapersanalysinginequalityandcancersurvivalinNewZealand.Whataresomeofyourmajorfindings?

I was the lead author of a report on trends and inequalities in cancer survival in New Zealand. In this report, I demonstrated profound improvements in cancer survival in New Zealand for some cancers (e.g. breast, thyroid, leukaemia) but not others (e.g. lung, pancreas). I also found a persistently 29% higher excess mortality among Maori over time. I am interested in the different interpretations that can be made about trends and inequalities in cancer survival when absolute and relative differences are considered on the risk and rate scales.

DoyoubelievethefindingsfromthesestudiesinNewZealandarerelevanttothe Australian context?

Absolutely. Through my role with Cancer Institute NSW, I am part of the CONCORD-2 global cancer surveillance research programme that includes data on 10 major cancers from 240 cancer registries in 60 countries over a 10-year period. That is a rich data source! At the moment, 5 of the 8 Australian states and territories have signed up to be part of this study and I hoping to apply my skills and expertise to analyse Australasian cancer survival patterns and trends.

You worked at the WHO in the area ofenvironmentalhealth.Tellusaboutsome of your work at the WHO.

My most recent role involved helping WHO to put in place due diligence systems and training for assessing the environmental impacts of healthcare activities delivered by or through WHO resources. For example, what happens to used syringes from mass vaccination programmes or used bed nets to prevent malaria? Part of the role involved developing and delivering some training to WHO staff in the African region on the environmental due diligence systems. The training was held in Kinshasa in the Democratic Republic of the Congo. It was an amazing experience. We visited a local maternity clinic and the major urban hospital to see how they were

managing healthcare waste and pharmaceutical distribution. The key outcome of the site visits and other case studies was that just because great environmental health policies are in place at the national and local level, limited resources means that these policies often fall over in the implementation phase.

Youhavebeeninvolvedinanumberofroleswhichinvolvehealthimpactassessment.Whatishealthimpactassessment and what role does it haveinpublichealth?

Health impact assessment is part of the growing health in all policies movement. Health in All Policies is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve population health and health equity. To me, this is what public health is all about, particularly the research and policy interface. I would love to see the University of Sydney’s School of Public Health take up a focus on

health in all policies in its work with policy makers and the community.

What initially drew you to a career in publichealth?

Like a lot of good scientific discoveries, it was an accident. Over 15 years ago, I was working at the New Zealand Ministry of Health and helped out on a piece of work looking at what public health officers should do when an individual with HIV/AIDS poses a risk to public health, particularly as the public health legal framework was written a long time before HIV/AIDS was identified. I spent three years at the New Zealand AIDS Foundation where I was asked to lead some work on the integration of health protection and health promotion services in the Auckland region. I then worked for the Auckland Regional Public Health Service – involved in everything from regional land transport planning to prostitution reform. Along the way, I developed a strong passion for international and environmental health and health impact assessment. After some time oversees with WHO, I returned to Wellington to do a PhD in cancer survival epidemiology.

Andnowfortheelephantintheroom….justhowdifferentislivinginAustraliacomparedwithNewZealand?

I am passionate about my home town of Wellington. It is the coolest little capital in the world and would recommend it as a “must see” when you are heading to New Zealand. My partner, Paul, and I are currently living in Pyrmont and there is nothing better than walking along the harbour and seeing all the amazing sites that Sydney has to offer. We are still getting used to a few things. Our house in Pyrmont still has an “out house” so nothing like experiencing nature when nature calls! We also get tripped up on having to say “skinny” (with an Australian accent) instead of “trim” when ordering our coffees. So after reading this article and you want to meet up for coffee to share research ideas, I might just have to order a coffee with normal milk instead!

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FOR MORE INFORMATION CONTACT

T +61 2 9351 4366F +61 2 9036 6247E sph.enquiries@sydney.edu.au sydney.edu.au/medicine/public-health

PRODUCED by the School of Public Health of the University of Sydney, June 2013.PLEASE send your stories and events for the next issue of The Bridge to sph.comms@sydney.edu.au. Deadline: 31 August, 2013

CRICOS ProviderNo.00026A

SCHOOL OF PUBLIC HEALTH

Congratulations to Dr Yousif Al Hosani, a Doctor of Public Health graduate, who was recently awarded the Abu Dhabi Medical Distinction Award-Public Health and Health Promotion category. Since 1998 Dr Al Hosani has been the Head of Public Health and Infectious Diseases Dept, Medical Services Corps at the UAE Armed Forces. In this position Dr Al Hosani has set up several public health programs and initiatives to enhance the role of public health within the military including initiatives such as cardiovascular diseases prevention programs, Ramadan Initiative, Health Education and Health Promotion Campaign, Health, Safety and

Environment Initiative.

“I was really so happy when I received an email from Health Authority-Abu Dhabi (HAAD) that I was among the top six people who were shortlisted in Public Health and Health Promotion Category. I then went for an official interview with a panel of local public health specialists, and was then invited, along with three other candidates, to a meeting to discuss the ceremony protocol and was told that the two winners were to be announced during the ceremony. During the ceremony, we were left to the end of the list as this was a new category; only added this year. I was there with my wife and two sons, and we were so happy

when my name was called to receive the award from His Highness Sheikh Hazaa Bin Zayed Al Nahyan,” said Dr Al Hosani.

Dr Al Hosani graduated from the Royal College of Surgeons in Ireland in 1995. He earned his MPH from the University College Dublin (UCD) – Ireland in June 2001, and in 2009 he was awarded the Doctor of Public Health (DrPH) from the University of Sydney-Australia. He is currently enrolled in the Executive MBA (Health Service Management), University of Plymouth, UK and expects to complete the degree in January 2014.

FRONTROWL-R:SHAIKHHAZZABINZAYEDALNAHYAN,NATIONALSECURITYADVISOR,ANDDEPUTYCHAIRMAN OF ABU DHABI EXECUTIVE COUNCIL; MOHAMMAD SULTAN AL HAMELI, CHAIRMAN OF THE BOARD

OFDIRECTORSOFHEALTHAUTHORITYABUDHABI,DRYOUSIFALHOSANI; DRMAHATAYSIRBARAKAT,DIRECTORGENERALOFTHEHEALTHAUTHORITY-ABUDHABI.

DOCTOR OF PUBLIC HEALTH GRADUATE WINS ABU DHABI MEDICAL DISTINCTION AWARD