TogeTher, We are The Kolling

AnnuAl Review 2014

We are the Kolling. We are a community.

We are united by a single mission: Lifelong good health.

We are driven by questions. We are inspired by answers.

We are the patients, the students and the health professionals living and working in the Northern Sydney Local Health District.

Together, we turn discoveries into realities that benefit our local community and beyond.

Together, we are the Kolling.

TogeTherThe Kolling community

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ConTenTsAnnual Review 2014

Where We are

Our locations across the Northern Sydney Local Health District

Kolling sTories

Our research in action

our impaCT

The influence of our work

Join in

Be a part of the Kolling

WhaT We do

Translating research into good health

Who We are

Our team of scientists, clinicians, staff and students

The Kolling

Our vision for the future

The gap

The important task of fundraising for the Kolling

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Our research aims to find tangible solutions to the real world health problems that are impacting our community. We have one core mission: to ensure people enjoy good health throughout their lives, from birth until old age.

For more than 80 years, the Kolling Institute of Medical Research has been turning scientific discoveries into medical realities.

Our research aims to discover, develop, deliver and disseminate new knowledge for the benefit of our patients and the wider community.

With a mix of basic laboratory research, clinical trials, population, epidemiological and health services research, we are making important scientific breakthroughs, identifying new drugs and devices, and developing smarter ways of diagnosing and treating patients.

We have a common vision: to unite health research and education with patient care and community wellbeing. By co-operating together, we can make discoveries that deliver constant innovation across all aspects of healthcare, from birth to death.

our researCh Covers The enTire lifespan:

healThy sTarT To lifeWhat happens to babies before they are born can impact their entire lives. Conditions in the womb, their size at birth and the timing of the birth can predispose babies to conditions such as cancer, diabetes, mental illness and kidney disease – so it’s vital that we ensure everyone gets a healthy start to life.

We bring together basic researchers, healthcare workers, epidemiologists and data analysts to work out how to give women the best pregnancies and birth experiences possible, how to improve services in our hospitals, and how to ensure good health for every baby.

We are helping babies achieve a healthy start to life by:-• Researching prematurity – still a leading global

cause of death and ill health• Studying embryos and the environment in

the womb to understand what causes disease to develop in later life

• Analysing data about pregnant women to improve maternity services

aCuTe and CriTiCal CareIn an emergency, patients need to know that health staff are using the best procedures and processes to treat them quickly and effectively. Our research is providing the evidence necessary to ensure that acute patients receive the best care and outcomes possible.

Our research spans the entire patient journey from Emergency Department to Intensive Care, the wards and through to rehabilitation.

We are helping improve acute and critical care by:-• Researching the best protocols and procedures

to treat people in Emergency and Intensive Care• Researching how doctors and nurses perform

their duties, to provide evidence leading to more efficient services

• Researching rehabilitation, to inform healthcare providers in the wider community

CombaTTing ChroniC diseaseMore than 7 million Australians live with a chronic condition and more are at risk due to obesity and old age. Research is crucial to help them lead healthy, fulfilling lives despite their condition.

Diseases that once spelled a death sentence can now be managed throughout life. Our research into debilitating conditions like heart disease, diabetes, cancer, mental illness and bone and

joint problems will mean people lead better lives. It will also save the health system valuable dollars and will mean people can stay at work and caring for their families for longer, with far reaching implications for the entire community.

We are helping combat chronic diseases by:-• Basic science in the laboratory to work out why

chronic diseases occur and to prevent them• Clinical trials to help us manage diseases with

medication and lifestyle advice• Research into the health system to ensure people

get the best range of care and services possible

healThy ageingWith Australia’s rapidly ageing population, research that ensures a healthy life for people as they get older has never been more important. We take a leading role in research that will improve the way older people are cared for internationally.

Our model ensures a team approach to our research. It brings together everyone involved in aged care research – from GPs to aged care facilities, physiotherapists, pharmacists, policy makers and, most importantly, consumers. This way, we can ensure that the findings of our research projects are quickly translated into real improvements in the community.

The Kolling is helping to ensure healthy ageing by:-• Studying better ways of managing cognitive

decline, including confusion, dementia and respite care

• Finding better ways to ensure older people receive only the medications they need, avoiding unnecessary frailty and hospitalisation

• Researching rehabilitation services to help people live better

WhaT We doTranslating research into good heath

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Acute And

Critical Care

Healthy Start To

Life

Combatting Chronic Disease

Healthy Ageing

disCover

develop

birTh age

disseminaTe

deliver

Lifespan

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Royal North Shore

Hospital

Macquarie Hospital

Mona Vale Hospital

Northern Beaches Hospital

Community Health Centres

Industry

Community

Early Childhood Health Centres

The University of Sydney

Manly Hospital

Ryde Hospital

Hornsby Ku-ring-gai

Hospital

Kolling Knowledge

Hornsby

Pittwater

Warringah

Ku-ring-gai

Manly

Ryde

Lane Cove

Hunters Hill

North Sydney

Mosman

Willoughby

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The Kolling Institute oversees all research that occurs in the health facilities of the Northern Sydney Local Health District, spanning Sydney Harbour to the Upper North Shore. With researchers and clinicians working closely together, our findings are quickly translated into real improvements for people in the community.

Great hospitals rely on great research facilities and community support. Thanks to the support of the community, we have been able to build a reputation for world class research that is a credit to the high quality care we are delivering across the Northern Sydney Local Health District.

As one of the leading centres of health and medical research in NSW – and the oldest – the Kolling is jointly affiliated with the University of Sydney, through the Northern Clinical School. Many of our researchers operate from a state of the art research facility located at Royal North Shore Hospital in St Leonards.

As a research institute embedded in the Northern Sydney Local Health District, we are uniquely placed to benefit the health and wellbeing

of our community by applying our research findings in the ‘living laboratories’ of our hospitals and clinics.

Just as the research breakthroughs made in our laboratories are quickly translated to the bedside, it’s the questions asked by you – the community – that guide the direction our future research will take.

As a result of overwhelming community support, we are building better hospitals with better research outcomes to help our physicians and treat our patients. Your support is also advancing research in cancer, stem cell and regenerative medicine, and research to improve patient care across Northern Sydney, the Northern Beaches and beyond.

Where We areOur locations across the Northern Sydney Local Health District

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Through working together, continually forging new links between medical research, education, patient care and the community, we are seizing a unique opportunity to share our knowledge and experiences, leading to improved health for all.

At the Kolling, our research teams are inspired by the opportunity to improve healthcare and profoundly motivated to make progress in the fight against devastating illnesses, chronic diseases and improve the health of our community.

This passion fuels our success at the Kolling and is a major reason why we are making important basic scientific discoveries, working to translate those advances into better patient care, and conducting research that is changing how medicine is practiced here in Sydney and across Australia.

Our research is conducted by a mix of basic scientists in the laboratory, medical educators, academics, clinical staff and community health workers all working on the same health priorities.

With more than 350 researchers, including more than 160 students and 30 support staff, experts in many disciplines are able to work together on the same research questions. Doctors talk to scientists, nurses talk to epidemiologists, statisticians talk to health services researchers to

create opportunities for the light bulb moments that will eventually change lives.

Through it all, it’s the patients who provide the most crucial input. Because it’s the health priorities faced by the community that ultimately influence the work we do.

This multidisciplinary approach gives all of our researchers a fresh, exciting perspective. It opens endless possibilities for the future. And it brings us one step closer to finding ways of ensuring good health throughout life for everyone.

It is exciting to see the momentum we have gained in recent years. By working closely with our key partners to provide critical support and leading-edge research facilities, we continue to foster scientific excellence in a unique and truly collaborative environment.

This encourages our scientists and clinicians to join forces in their determination to improve healthcare for Australians and bring you tomorrow’s healthcare today.

Who We areOur team of scientists, clinicians, staff and students

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Community Health

Workers

Medical Educators

Academics

Clinical Staff

Researchers

Support Staff

Nurses

Case Manager

Students

Lecturers

Scientists

Coordinators

Professors

Tutors

Clinicians

Administrators

Doctors

Social Worker

Knowledge

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The Kolling is a place where a community intersects. Where knowledge meets experience.

If you’ve ever had a baby, rushed to the Emergency Department, visited our outpatient clinics or spent time in an aged care facility, you are part of the Kolling community. Our researchers impact the way you are treated whenever you interact with

the Northern Sydney Local Health District. Many of our discoveries are saving lives and changing the way healthcare is delivered for patients all over the world.

He may not realise it, but from the moment he was born, the healthcare Jamie has received has been influenced by the Kolling.

We are all the Kolling. We are a community.

I’m Jamie. I’m part of the Kolling.

Preventing Prematurity: a great challenge of our timeBeing born healthy and at the right time can impact people’s entire lives. Being born too early can have far reaching health consequences, but, despite incredible advances in medical science, the rate of preterm birth is increasing. Preventing prematurity and resulting disability is now one of our most important health challenges. Our research at the Kolling ensures these tiny babies get the best start in life possible.

We’re doing that in a variety of ways, such as in large trials to see if treating thrush infections in mothers can prevent spontaneous premature birth, and by studying embryos and the environment in the womb to understand what causes disease to develop in later life. We’re also involved in a large international collaboration to trial a simple intervention that could save thousands of lives, particularly in the third world. It involves delaying cutting the umbilical cord so that blood from the placenta drains back into the body for a full minute, preventing inflammation, serious infection, anaemia and other complications that can lead to disability.

One of the babies who took part in this trial was Thea, born 11 weeks early in 2013, weighing just 576g. Thankfully she had no complications and just needed to grow before she was allowed home 12 weeks later. Now a bouncing toddler, there’s no looking back for Thea. “She came out eyes wide open and crying and she has been pretty feisty ever since!” says her mother, Clare.

World research

Premature babies have never had such good chance of survival – but there’s so much more to be done to give them the best start in life.

a healthy start to life

asKing mothers What they really WantThe experience of having a baby is different for every woman. Maternity services in NSW strive to recognise the unique needs of patients – but in reality it’s not always clear what those needs are.

We collaborated with NSW Kids and Families to ask more than 900 women about their experiences of prenatal care, childbirth and postnatal care to help policy makers understand what hospitals were doing well – and what they could do better.

While the majority of women said they were very happy with the quality of care they received, 15 to 25 per cent commented that they would like to see improvements. As with other countries and other parts of Australia, there was most dissatisfaction during the period after the baby was born.

“Sometimes women were feeling very anxious, they couldn’t find a nurse or midwife because everyone was so busy,” says Associate Professor Angela Todd, who led the study.

“Some of the women in the survey described wanting a longer stay in hospital, and others wanted to leave hospital sooner than they did. These results suggest one area where we could possibly do things a bit differently.”

The study was conducted among women who had their babies in seven public hospitals in the Northern Sydney and Central Coast Local Health Districts: Central Coast, Gosford, Wyong, Royal North Shore, Manly, Hornsby, Ryde and Mona Vale.

“My antenatal care by the midwives was very thorough. I was treated in a very kind manner which made me look forward to each of my visits.”

the long lasting effects of mothers’ smoKingA mother’s habits can have far reaching effects on her babies – even if she has stopped them long before she falls pregnant. Professor Carol Pollock’s research shows that maternal smoking and obesity both cause ‘epigenetic’ changes in babies – that is, certain genes are switched on or off, potentially causing diseases like kidney disease.

“If you smoke, you modify the proteins in your body and that abnormality is transmitted to your offspring. By looking at the kidney cells of prior or current smokers, we can see how their metabolism is completely different,” says Carol. “Everyone knows they shouldn’t smoke – but they don’t realise the damage they may be doing to future babies. It’s something people need to know.”

Carol and her team are collecting samples of the placenta and amniotic fluid of past and current mothers to see how their smoking has affected the foetal tissue. They are planning to study whether using antioxidants may reverse some of the damage. They are also studying maternal obesity to see if problems like raised levels of fatty acids in the blood are transferred to the foetus, raising its risk of kidney disease in later life.

having a baby

We look at pregnancy from every angle – from the environment of the womb to women’s experiences of giving birth.

Patients participating.

Would like to see care improvements.

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ensuring the best treatment for trauma PatientsIf you have a serious accident, the speed with which you are treated can make all the difference to the rest of your life.

That’s particularly true for people experiencing a traumatic spinal cord injury. Delays can lead to the injury becoming more serious, which is vital in injuries which usually cause lifelong disability and significant cost.

Postdoctoral fellow Lisa Sharwood, a former trauma nurse who has now devoted herself to medical research, is interviewing hundreds of people with spinal cord injuries to assess how the early care they received in the ambulance and hospital affected their long term outcomes.

If the research finds gaps in how the health system deals with these serious injuries, it will inform changes to policies and procedures to ensure people’s disabilities are managed in the best way possible and that they can return to healthy, productive lives.

“As a trauma nurse I was over wrapping up bodies of trauma victims – I wanted to do something on a bigger scale that would either prevent the problem, or help our healthcare service provide the best care possible to optimise patient outcomes,” she says.

emergency

“ Here at the Kolling that’s what the research is trying to do – to help people on a larger scale.”

rehabilitation

getting the best out of life after serious injuryWhen you pay for your green slip, a small percentage of the fee goes towards supporting people who have been severely injured on the roads. Our research is ensuring that money is well spent.

Rehabilitation physician Professor Ian Cameron is working with the NSW Government’s Lifetime Care and Support Scheme and Motor Accidents Authority to understand the best ways of helping people recover and lead better lives.

His research is leading to new guidelines which will help more people to recover effectively. He’s also evaluating the effectiveness of NSW Government support so that the Lifetime Care and Support Scheme can be adapted to help people in ways they really need.

This research will also help the new National Disability Insurance Scheme to tailor support for people with very serious injuries.

Our research helps people live more independently and participate more in society after an injury.

giving smoKers a WaKe-uP callStonemason Rene Hojland thinks he must have smoked close to 22,000 packets of cigarettes during his life. Sometimes he could get through 70 cigarettes in one night alone – until a heart attack at the age of 45 gave him the wake-up call he needed to stop.

“I woke up in a room full of old men on heart machines. I said to myself ‘If I live through this I’m never smoking again’ – and I never did. That was five years ago,” he says.

Doctors call having a heart attack a “teachable moment” – a shock so great that more than half of patients are able to give up smoking on the spot. A team led by cardiologist Professor Geoffrey Tofler has produced a video which uses pictures of a smoker and his or her family to recreate the shock of a heart attack.

Unlike a quit smoking advertisement on the back of a bus, the video delivers a very personalised message demonstrating what it would be like if the viewer had a heart attack. It’s proving highly effective in helping people stop before their first signs of heart trouble.

“There’s a huge advantage to helping people stop smoking, and this patented technique could also help with other behaviour modifications,” Geoffrey says.

heart attacK

Recreating the shock of a heart attack can give smokers the incentive they need to quit.

our research helPs PeoPle coPe better With their conditions

helPing Patients With osteoarthritis manage betterFor the more than 3 million Australians who suffer from osteoarthritis, a joint replacement is often the only solution. About 70,000 people have the operation every year.

But for many, there could be a better way. We’re helping people manage this painful condition by using physiotherapy exercises and dieting. As a result, we’ve shown that patients’ pain is reduced and they’re much less likely to need surgery.

As a result of this work, done by Professor David Hunter as part of the Agency for Clinical Innovation, we’ve developed a website to help people manage their condition better.

www.myjointpain.com.au – developed by the Kolling, Arthritis Australia and Bupa – uses the evidence we’ve gathered to enable people to assess if they are at high risk of osteoarthritis. Then they receive expert, tailored advice, and create an action plan to help them self-manage their condition.

develoPing a safe, effective treatment for Painful tendons Tendinopathy – or the painful degeneration of tendons – is a growing medical problem.

It’s hard to treat because we still don’t fully understand what’s going on at a molecular level in humans.

The veterinary community, on the other hand, is already using treatments that target the cellular causes of tendinopathy in animals. These drugs are being used in humans at an alarming rate, despite lack of scientific evidence.

Our researchers are studying tendinopathy in sheep and have found that injecting a certain type of stem cells can improve the condition.

We’re now trying to figure out the best time to use this therapy, to understand how it works, and to track its effectiveness.

Results from this study will change the way tendinopathy is treated, meaning for the first time doctors will have a safe, effective treatment for painful tendons.

mind PoWer: retraining the brain to reduce PainTwo people may experience pain completely differently: even though x-rays show they have the same problem, one may be in excruciating pain while the other is not.

The key to our experience of pain may be in the sensitisation of the central nervous system, says Professor Philip Siddall of the Greenwich Hospital Pain Clinic. His team has trialled a highly successful program in which patients are trained in various strategies that help to literally desensitise the nervous system and reduce pain.

The study used various techniques including physical activity, relaxation and meditation to retrain the neural pathways in the brain. Patients are educated about central nervous system sensitisation and then taught techniques to control their pain using the brain’s own natural chemicals and pathways.

In just 18 hours over six weeks, many patients have reported life-changing improvements in their pain, reduction in their pain medications, improvements in physical function and improvements in their overall quality of life.

Pain

Ground breaking research at the Kolling is making a genuine difference to the lives of thousands of Australians.

Australians suffer from osteoarthritis.

Australians have joint replacements every year.

To life changing pain management.

3 mil70,0006 weeks

cancer

fighting cancer from bench to bedside

lung cancer: finding effective neW treatmentsAs smoking rates drop, it’s often gene mutations that cause younger people to develop lung cancer. And even though lung cancer is still one of the world’s biggest killers, for some forms of the disease there are still few treatments that can prolong life beyond a few months.

The good news is that these mutations provide new targets for drug therapies. PhD student Cilla Hasovits and her colleagues at the Bill Walsh Laboratory are researching new therapies which target these gene defects, and working out why some people develop resistance to them.

a vaccine against cancerUsing the body’s own immune system to fight cancer could soon become a reality. Dr Chris Weir has developed a personalised cancer vaccine which reintroduces tumour proteins into the body, provoking the immune system to fight cancer cells but leaving other cells unharmed.

A trial in dogs has proven highly successful, with 84 per cent of the animals which received the vaccine living longer than expected with no side effects. He and the team are now ready to trial a vaccine against brain tumours in humans.

If successful, any tumour that is surgically removed or biopsied could be used to develop a personalised vaccine, offering a potent new weapon in the arsenal against this lethal and hard to treat cancer.

helPing Patients through their cancer journeySydney Vital brings together clinicians, researchers and patients across the Northern Sydney Local Health District to ensure scientific findings are quickly translated into better care for patients. Through this collaboration, clinicians and researchers work together, each informing the other, to boost research while at the same time improving the cancer journey for patients.

Dry July is a not-for-profit organisation that challenges people to abstain from drinking alcohol for the month of July to support adults living with cancer. For the 2014 campaign, Dry July raised over $250,000 for Royal North Shore Hospital to provide both health and wellness services to patients during their cancer journey.

We conduct a wide range of cancer research, spanning from understanding the disease at a molecular level through to ensuring a better journey for patients. Our researchers are transforming the world’s understanding of many different sorts of cancer, including breast, brain, thyroid, gynaecological, pancreatic and mesothelioma.

cancer

World-first research offers hoPe to Women liKe jane“Having breast cancer can be a very solitary experience,” says Jane Healy, 52, a refugee advocate and single mother to a 24 year old daughter. “One of the most difficult things is the effect it has on the people who love you. It’s heart breaking to watch their suffering.”

Jane is recovering from triple negative breast cancer, an aggressive form of the disease for which common breast cancer therapies like Tamoxifen and Herceptin don’t work.

In an exciting breakthrough after many years of research, the Kolling Institute has developed a powerful combination of drugs that is proving highly effective in the laboratory against triple-negative breast cancer.

“These drugs, doxorubicin and gefitinib, hit two pathways in combination to stop tumour growth and in our studies are proving to be extremely effective when used together,” says Professor Robert Baxter.

Preclinical work is currently underway into the new treatment and Robert is confident that human trials could start relatively quickly.

In an exciting breakthrough after many years of research, the Kolling Institute is about to trial a powerful combination of drugs to treat an aggressive form of breast cancer.

Kolling breaKthrough eases diagnosis odysseyIt was 2009 and Julie Egan was at work typing when she realised the fingers of her right hand had stopped working. “I was petrified,” she says. “No-one could work out what was wrong with me and I went into a very dark place.”

During her life Julie has undergone multiple operations, lives with muscle weakness and fatigue, and has problems with her digestion. She is confined to a wheelchair and is largely dependent on her husband, Graham, and her friends.

But it was not until she came to see Professor Carolyn Sue that she finally discovered the cause of her symptoms: mitochondrial disease, a problem with the cells’ ability to generate energy.

Existing tests can only detect about 10-20 per cent of cases, even after expensive genome sequencing. But a new test introduced by Carolyn and her team has raised the diagnosis rate to 70 per cent by measuring blood levels of a substance called “serum fibroblast growth factor 21”.

Forty five times more accurate than any test, it means patients can get early detection and diagnosis of their condition and receive treatment to prevent life

threatening complications of mitochondrial disease including heart problems, stroke, diabetes, seizures and blindness.

“There is dignity in a diagnosis. Patients find validation that they have a real disease that has a name, it helps them deal with the reality of it. And then we can help change their lives,” says Carolyn.

She runs the largest tertiary referral clinic for patients with mitochondrial disease in the southern hemisphere at Royal North Shore Hospital. She is working collaboratively with other centres towards creating a national network for mitochondrial disease to coordinate services, conduct research, train health professionals and educate patients.

Many patients with mitochondrial disease never find out the cause of their debilitating symptoms. Our ground-breaking research now means a simple blood test can start their journey toward management of their condition.

mitochondrial disease

maPPing the teenage brain for clues of dePressionBy identifying brain changes in teenage girls, we may be able to stave off mental health problems in later life. Like the early explorers who first mapped distant continents, Professor Gin Malhi and his team are mapping the brains of teenage girls to find clues that will predict who will develop depression and anxiety.

By scanning the brains of 15 year old girls from a local school and comparing the findings to clinical assessments, which determine their emotional vulnerability, he’s recently shown that it’s possible to identify physical changes which signal they may be more at risk of developing anxiety or depression.The team found subtle but clear differences in the functioning of the brains of emotionally vulnerable girls. There was less activity in their hippocampus, and the connections between the hippocampus and other key emotion-related areas of their brains were weaker.

The girls were still healthy – but their brains were already processing emotions differently. That means it will be possible to treat them before fully fledged symptoms occur. “Our ultimate aim is to find out how depression and anxiety arise, what circuits are involved – and if we can do that with confidence, we can work out what to put in place to prevent it happening,” he says.

“If we can stave off problems in even a small percentage of people, you can imagine how huge the downstream impact would be. We would change the trajectory of their lives.”

Gin has now followed the girls as they turn 18, comparing their brain maps to other factors that might influence their emotions, such as their parents, schooling and social interactions. The findings are remarkably similar – those who were displaying early signs are generally still experiencing problems.

Now he is planning to study the brains of younger adolescents, at 12 or 13, to work out when the brain changes first start. If he can do that, it will be clearer when preventive treatment should begin.

“If we can with confidence find factors that predict anxiety and depression, we can prevent later problems with strategies such as physical exercise, mental problem-solving, relaxation, and help dealing with emotional problems.”

mental health

reducing older PeoPle’s meds can lead to a healthier old ageAs a young geriatrician completing her PhD in geriatric pharmacology, Sarah Hilmer saw firsthand how medication can affect elderly people when her grandmother, Margaret, became very confused after she started taking over the counter antihistamine tablets for a rash.

“She stopped the antihistamine and she was so happy that she could think clearly again,” says Sarah, now an Associate Professor whose work is optimising prescribing for older people internationally.

Even if you’ve been taking certain medications since middle age, as you get older your body metabolises and responds to them differently. Sometimes you’re taking medications in combinations that have never been tested. The result can be serious side effects leading to falls, frailty and hospitalisation.

“We don’t test drugs in frail older people so we don’t know whether they work. The evidence about their efficacy is weak – but the evidence about their risk is quite strong.”

Sarah developed the Drug Burden Index, which is now being used all over the world to help doctors and researchers calculate and reduce older people’s exposure to specific classes of medications that reduce their functional independence.

She is also working on a project through the Kolling’s NHMRC Partnership Centre on Cognitive Decline to understand the attitudes of older people and their carers about stopping drugs, known as deprescribing, and is studying when and how to help older people safely come off some of their medications that may be causing more harm than good.

the drug burdenThe Drug Burden Index is now being used all over the world to help healthcare practitioners reduce people’s potentially harmful medication and lower their risk of falls, frailty and hospitalisation.

PhD student Lisa Kouladjian has now developed an online calculator for pharmacists to make the process even easier. When pharmacists are referred by a GP to do a medication review, they simply key the patient’s medications into the website, which will then calculate how high the drug burden is.

The online calculator is now being trialled amongst GPs and pharmacists in Sydney. If they like it – and it’s shown to help take people off potentially harmful medication, a larger randomised study will be conducted before it’s rolled out to the rest of Australia.

World first

Pharmacologist Sarah Hilmer is helping reduce the burden of over-medication in older people worldwide.

healthy ageing

With images of thousands of physiotherapy exercises available to physiotherapists at the click of a button, our new website www.physiotherapyexercises.com is helping patients all over Sydney get their exercises right.

The team of physios at the John Walsh Centre of Rehabilitation Research Centre print out the exercises to give to their elderly patients, like Helga Farkas, ensuring they can follow precise movements and carry on living independent lives.

ensuring the best for elderly Patients

“there should be no research about us Without us”When our researchers asked people living with dementia what they wanted us to study, we were surprised at the results.

Nearly half of the research projects initially proposed by the $25 million NHMRC Partnership Centre on Cognitive Decline were discarded because they wouldn’t be of use to the people who really mattered – the consumers themselves.

“Researchers are good at selecting excellent research, yet consumers are good at selecting relevant research.

Working together, we can find research that is both excellent and relevant,” says Christine Bryden, one of the people living with dementia who is helping us tailor our research programs.

Consumers are involved in all of the 17 activities being conducted by the Centre – they shape the projects from development to conclusion.

The Centre is working hard with local GPs, aged care facilities, service providers and even the police to ensure its findings are translated into improvements in the real world.

a Project to get older PeoPle the vitamin d they needHaving enough Vitamin D is extremely important for people in aged care facilities. Studies worldwide have shown that it helps to prevent falls and has other health benefits.

But when people live in aged care facilities, it’s often too hard for them to get out into the sun. The best way is to give residents supplements – but although the benefits of Vitamin D supplementation are proven, it hardly ever happens.

“Often it’s because staff or GPs aren’t on board, and sometimes it’s because families don’t agree because it’s too expensive or their loved one is

already taking too many medications,” explains Professor Ian Cameron.

He has launched a project with aged care providers in Northern Sydney and other states to firstly work out the extent of Vitamin D use. Then, working with the aged care facilities, GPs, staff, residents and their families, he will implement a program to try to widen its use.

If it’s successful, this program will be rolled out across other aged care facilities in the Northern Sydney Local Health District.

For the young and the old, for people who have a health emergency or those with chronic disease, the work we do changes lives. No matter how young or how old, where you live or your situation in life, medical research matters.

Together, we are the Kolling.

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Health and medical research is about making what is currently not possible, possible. It’s about finding answers to the problems that we doctors see every day in our patients. It’s about experimenting so we can make progress and change lives.

professor JonaThan morris

direCTor, Kolling insTiTuTe for mediCal researCh I am very privileged to work as an obstetrician at Royal North Shore Hospital. Like the other hospitals in the Northern Sydney Local Health District, facilities are being transformed with new buildings and equipment. The campus here is barely recognisable from that when I started work here in 1998.

But though health facilities are wonderful, ultimately they can only deliver what is known. It is for that reason that we need research.

If we want to care for babies that are born as early as 24 weeks and weighing as little as 500g, we need neonatal intensive care units. But if we want to prevent preterm birth, we need research.

If we want to the best care for people with cancer, then we need first class buildings and clinicians. But if we want to know what causes cancer, we need research.

If we want to restore mobility to people whose arthritis means that they can no longer walk freely, then we need state of the art artificial joint prostheses. If we want to reverse degeneration of joints, we need research.

If we want to care for people who develop dementia, we need support services that communicate effectively for them and their families. If we want to ensure that brain function does not deteriorate early, we need research.

For so many of the conditions we doctors see every day, the answers to unsolved questions will be found in the laboratory and not the library. It is clinical trials, not clinical care, that will ultimately help us achieve better health. It will be through experimentation, not expert opinion, that we will make progress.

Research is not as tangible as other activities. It is about investment in people and bold ideas, not places and big buildings. It recognises that it is a search for answers. A search requires something worth searching for – and health research does that. It recognises that sometimes the search may not discover what one seeks. It acknowledges that the search takes time.

At the Kolling Institute, our research aims to find tangible solutions to the real world health problems that impact our community.

We oversee, in partnership with The University of Sydney through the Northern Clinical School, all research that occurs in the health facilities of the Northern Sydney Local Health District. We bring together scientists, academics, clinical staff, community health workers and educators, all working towards a common goal of achieving good health for everyone in the community, at every stage of life.

Ultimately, the answers we find will benefit people all over the world. And they will one day benefit you. Your support for this research will ensure our discoveries can become realities.

The KollingOur vision for the future

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Our research has addressed some of the most pressing health questions facing people today:-

• Early birth: Almost one in three women now have their baby before the optimal time

• Cancer: Now Australia’s biggest killer. 12% of all patients in NSW are seen on our campus

• Bone and joint: 3 million Australians suffer painful osteoarthritis

• Pain: 3.2 million Australians will experience chronic pain during their life

• Kidney disease: 1 in 7 hospitalisations are for dialysis. High rates of diabetes will lead to even more chronic kidney disease in future

• Mental health: Depression, anxiety and bipolar disorder are significant and increasing problems

• Dementia: The number of people living with dementia will increase by a third to 400,000 in 10 years

• The health system: With rising costs due to ageing and chronic disease, it’s never been more important to deliver healthcare more efficiently and sustainably

The Kolling not only conducts the research to answer some of these important questions – but it translates those findings to where they’re needed most, out there in the community.

To do this effectively, we

our impaCTThe influence of our work

We strive to deliver constant innovation across all aspects of healthcare, from birth to death.

This year, our work has made a real difference to not just our local community, but the state, the nation and the world.

Mechanisms, diagnostics and therapeutics = Smart science.

Optimal clinical care = Clinical research.

Safe and effective health services and community information = Population health and health services research.

Key research findings through educational programs = Education for behavioural change.

Discover

Develop

Deliver

Disseminate

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Impact

1,000

6

62

140+

500+

120

178

350+

Active Research Projects

Health Forums

New Clinical Trials

Students

Publications Published

Clinical Drug Trials

Grants Received

Researchers

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universiTy CollaboraTions

organisaTion funding

privaTe foundaTions

federal governmenT

funding

nsW governmenT

fundingCommunity

Support

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As part of the Kolling family, your help is vital if we are to tackle the most important health challenges of our time.

Medical research is funded by the Government and other organisations. But for every dollar they give us, we need match at least the same amount to enable our researchers to do their job.

Doing research is about much more than funding researchers. We desperately need money for everything else that goes with it, things like support staff and lab equipment, software and chemicals – even the electricity bills and cleaners need to be paid.

We have exciting plans for the future. We want to continue our discovery programs to find new cures and treatments. We want to run more high quality, relevant clinical trials to provide answers to priority health questions. We want to do more population health and health service research to make sure the services we provide are both appropriate and efficient. And we want to find out how to educate both patients and healthcare workers to turn our research into real life changes.

But none of this is possible without your help. It is only with your support that we can continue to translate today’s research into improving the healthcare you receive tomorrow.

The gapWhy we need your help

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CommuniTy supporT

donaTePledge your support as a regular giving partner, providing the Kolling with the financial stability that allows us to plan for the future.

dediCaTeDedicate your next event, birthday or anniversary celebration to fundraise for the Kolling and involve your family, friends and community in supporting the Kolling.

sponsorSponsor a long-term research program, donate vital equipment or sponsor a fellowship or scholarship to make a long term impact to the work of the Kolling.

bequesTBecome a Kolling Foundation Partner for Life, by leaving a bequest for the Kolling to make a lasting difference to the health of the future generations within our community.

be a parT of a Consumer group or CliniCal TrialBe an important part of our research by participating in consumer group research or a clinical trial and be at the front line of Kolling research and development.

Join inAttend a free Kolling Knowledge session and be an integral part of sharing knowledge amongst our community. Sign up on our website to receive notification of upcoming events.

volunTeerVolunteers are an important asset at the Kolling. They help us keep our costs to a minimum enabling us to channel funds to where it is needed most. We need your help to answer phones at reception, or work at the Kolling Foundation office with our support team.

gifTMake a gift in memory of a loved one or celebrate special occasions by requesting donations to the Kolling in lieu of gifts.

ConTaCTFor more information contact kolling.com.au or call 1300 KOLLING.

Join inBe a part of the Kolling

Support from our community comes in many forms and is vital in funding research now and well into the future.

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Community Support

volunTeerdediCaTe

Consumer group

sponsor

CliniCal Trial

gifT

bequesT

donaTe

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To our professionals who provide their expertise, passion and vision;

To our community which fuels our mission towards lifelong good heath;

To our supporters who provide the funding without which we could not continue our important work.

Thank you.

Together, we are the Kolling.

CrediTsThe Kolling Annual Review 2014 has been created with the assistance of:

editorCraig Tobler Kolling Foundation

CopyWrite Media writemedia.com.au

photographyMichael Amendolia michaelamendolia.photoshelter.com

Concept and designSunnySideUp sunnysideup.com.au

printing J.A. Wales Printers jawales.com.au

paperBJ Ball bjball.com.au

This report is printed on Mohawk Superfine Smooth Ultra White: an environmentally responsible, carbon neutral paper, certified for FSC standards.

ThanK youFrom the Kolling

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