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PAGANZ 2010 - Adelaide
The annual meeting of the Population Approach Group in Australia and New Zealand (PAGANZ) was held in Adelaide (Australia) on February 8 th – 10 th. The Modelling and Simulation Lab was well represented with a total of eight participants.
PAGANZ is focussed on data analysis in pharmacokinetics and pharmacodynamics (PKPD) by using a population approach, and includes modelling and simulation of biological systems and drug effects.
During the first one and a half days of the meeting, workshops for beginners and intermediate users of NONMEM, the leading computer program in Pharmacometrics, are held. Prof. Steve Duffull was in charge of the beginners’ course, supported by two of his PhD students, Pavan Kumar and Dan Wright, during the hands-on sessions. They gave an excellent introduction on using NONMEM that will be useful for the participants in their future work when using this program.
The conference was then held on the following one and a half days. It provided an opportunity for all attending members of the Modelling and Simulation Lab to present their current work. Indri Rooslamiati presented the work of her recently completed master’s degree: a mathematical model for the effect of malaria on arginine catabolism in endothelial cells. This model was developed to optimise the dosing regime of arginine as an adjunctive treatment in patients with severe malaria. The pharmacodynamics of venlafaxine in overdose was the focus of Pavan Kumar’s presentation, representing the main focus of his PhD thesis which he will submit shortly. Hesham Al-Sallami introduced a newly developed model for estimating lean body weight in children, which is the first model for estimating lean body weight as a function of age and maturation.
In addition to these clinically focussed presentations, members of the Modelling and Simulation Lab were also in the majority during the session on optimal design: Dan Wright presented his work on an optimal design for warfarin INR monitoring, which is just the first step on his recently commenced path as a PhD student. Lee-Kien Foo gave an insight on the use of adaptive optimal design for the planning of the transition between different target groups in clinical trials (e.g. from adult to paediatric patients). The evaluation of an optimal design for melphalan pharmacokinetics was presented by Prof. Steve Duffull, while Julia Korell introduced a design for survival studies of red blood cells. Her work is based on a mathematical model for the survival time of RBCs that Julia developed previously. It aims to facilitate in vivo studies to allow for a better estimation of the survival time of red blood cells in healthy volunteers as well as patients with renal impairment. To the great delight of the whole group, Julia received the student speaker award for her presentation. This is the second award Julia received for an oral presentation during just the first six months of her PhD!
Inspired by this very successful conference, the Modelling and Simulation Lab is starting in an eventful and challenging year 2010, and is looking forward confidently to upcoming conferences in New Zealand and Europe, including the meeting of the Population Approach Group in Europe (PAGE) in Berlin (Germany) in June.
Record number of PhD grads
Seven women graduated with their PhD in Pharmacy last year, the largest number of graduands at the Otago Pharmacy School at any one time.
Kristina Ferderber travelled all the way from Croatia to attend the December graduation in Dunedin, along with Sarah Gordon, Louise Ho, Aarti Patel and Shakila Rizwan. Kirsten Graeser, who is now working in Switzerland, and Bianca Glaessl, working in Germany, graduated in absentia.
No-one was probably prouder than Professor Thomas Rades who was the primary supervisor or co-supervisor of all seven.
The women come from a variety of international backgrounds reflecting the growing international recognition the School’s PhD programme is gaining.
Dr Ferderber’s employer, Pliva Croatia Ltd, has been so impressed with previous employees it has sent to Otago to do the PhD programme, her studies were funded by the company. She is employed as a technical group leader in research and development at Pliva and was delighted to be back in Dunedin, a place she now calls her second home.
“Coming to my graduation after eight months really felt like coming back to my new home and it felt like I’ve never left.”
However, while Dr Graeser was not able to return for the graduation she says she is reminded daily of New Zealand.
“I am reminded every day of my time in New Zealand as the poster you get after submitting your thesis is hanging on my office wall.”
Dr Graeser was able to secure a job even before officially graduating and is now working as a head of laboratory at the pharmaceutical company Hoffmann-La Roche in Basel, Switzerland. For her thesis she looked at the stability prediction of amorphous drugs, particularly the issue of making poorly water soluble drugs more soluble and stabalising them against degradation.
This topic is particularly interesting for the pharmacetucial industry where, Dr Graeser says, most of the new drug candidiates show poor water solubility. Because of the relevance for industry, Dr Graeser spent about 18 months of her studies in the UK at GlaxoSmithKline under the supervision of Dr James Patterson, also a School of Pharmacy graduate.
Another of the graduates, Louise Ho, gained the distinction of becoming the first New Zealand student in at least a decade to have won a prestigious American Association of Pharmaceutical Scientists (AAPS) award (Pharmacy Today, December 2009). Dr Ho was presented with the graduate student award for analysis and pharmaceutical quality, in recognition of excellence in graduate research, at the AAPS annual meeting in Los Angles last November.
Her research involved looking at the non-destructive quality monitoring of tablet film coats using terahertz parameters.
A variety of topics were covered in the research from Aarti Patel’s research into medicines in developing countries (see more on this page), to Sarah Gordon’s investigation of chitosan hydrogels containing particulate antigen as vaccine delivery systems.
The Dean of the School of Pharmacy, Professor Ian Tucker says having seven PhD graduands at the December graduation ceremony was an outstanding performance for the School.
“It is a clear indication of the ever-growing research efforts and productivity of the School. These graduates will serve the national and international pharmaceutical science communities.”
Lecturer takes research skills into the ‘real world’
 Lecturer in Social Pharmacy, Aarti Patel, is taking time out from the Otago School of Pharmacy this year to pursue her research interest of access to medicines in developing countries.
Dr Patel has been appointed to the Southern African Regional Programme for Access to Essential Medicines and Diagnostics, a programme funded by the UK Department for International Development.
She will take nine months unpaid leave from her position at Otago and is delighted both the School and Otago University is willing to allow her time off to do what she describes as cementing her research skills in the “real world”.
“ Dunedin may be far away from the rest of the world, but it is great to see a university that understands we are part of a global society and our work needs to extend far beyond our borders.”
Dr Patel says the project will allow her the opportunity to not only utilise some of the skills she gained during her PhD study, but will provide opportunities for increased collaboration among researchers in Dunedin and Southern Africa.
Originally from South Africa, Dr Patel carried out research in public health and medicine for the South African government before immigrating to New Zealand. She has worked at the Otago School of Pharmacy for several years but has continued her links with her homeland, continuing her appointment on the African branch of Health Action International, an organisation promoting increased access to essential medicines.
Dr Patel graduated with a PhD in Pharmacy last year from Otago University. Her thesis explores the issue of quality of medicines in South Africa.
She looked at how the different stakeholders – government, healthcare providers and consumers – understand this concept as well as how their understandings informed procurement and use behaviour. She also assessed actual quality of a few, selected medicines and compared perceptions of quality to the actual quality.
Her findings showed that while medicines in South Africa met pharmacopeial standards, consumers and some healthcare providers perceived the free medicines and generics supplied by the state sector were inferior and there was reluctance to use these. These perceptions were largely influenced by prices, brand names of medicines as well as peoples’ experiences of quality of care.
The rationale for her work arose out of what she describes as the increasing incident of substandard, including counterfeit medicines that are circulating in the health care systems.
“Poor quality medicines is a major concern in terms of their impact on public health. In the developing world this is even more damaging because of limited capacity to actually detect and deal with the problem.”
The Dean, Professor Ian Tucker, says the School is delighted to support Dr Patel taking time away from the university to work in developing improved methods for delivery and use of medicines in Africa. “I am convinced this will open up further international research opportunities for the School which will benefit our undergraduate programme and medicines services in New Zealand.”
Clean sweep for top students
Two students took away the majority of prizes at the Otago Pharmacy School’s top student awards last year.
Tim Vincent and Bronwyn Williams shared the Christina White Prize for the student with the best overall achievement in the BPharm degree course at December's graduation and in doing so took away an armful of other prizes.
Tim was awarded the Pharmaceutical Society of New Zealand prize for being the fourth year student with the highest average as well as the prize for being the top student in two of the Quality Use of Medicines papers. This also resulted in him winning the Pharmacy prize in clinical pharmacy with the best achievement in the three Quality Use of Medicines papers.
Bronwyn also did extremely well and, together with Judy Ngu, gained top place in the Professional Pharmacy Practice paper. The pair (Bronwyn and Judy) was also awarded the prize in Pharmacy Practice, donated by Douglas Pharmaceuticals, with the best achievement in the Professional Pharmacy Practice paper.
But despite the close competition, Tim and Bronwyn, says there was no real rivalry between them. Tim explained while they “dominated on the day” there were a number of talented students who could have easily taken the prizes. “There was really only friendly competition; there are so many talented people in the Pharmacy School.”
The Dean of the School, Professor Ian Tucker, says it is a delight having two such outstanding students as Bronwyn and Timothy vie for the top student prize. “In the end we could not separate them and we are delighted that they shared the Christina White Prize.”
The pair both began their pharmacy training straight out of high school and haven’t looked back, although they are keen to pursue different routes in their chosen careers.
Tim, who is currently undertaking his internship at the UniChem Bishopdale Pharmacy in Christchurch enjoys community pharmacy while Bronwyn, who is working at Taranaki Base Hospital, wants to continue working in hospitals.
Bronwyn and Tim thoroughly enjoyed their time at Otago and Bronwyn says she is now reveling in the opportunity to put into practice what she has learnt. The friendships that were made over three years, together with the support of School staff who Tim says genuinely cared about students, will be his everlasting impressions of his time at Otago.
The pair was among a group of five students who received project prizes for the most publication-worthy projects in the elective paper. Other winners were: Robynne Matthews, Hannah O’Malley and Archana Padmakumar.
The other prize winners for 2009 were: Thomson Reuters prize in pharmacy for the student with the highest overall mark in pharmacy law across all years of the BPharm programme, Judy Ngu; Pharmacy Defence Association prize for the student with the highest standard in the law and ethics component of the BPharm programme, Isabella Chan.
Prestigious US Research Award won by Otago Pharmacy PhD Student
Pharmacy School PhD graduate Louise Ho was awarded an American Association of Pharmaceutical Scientists (AAPS) graduate student award in Analysis and Pharmaceutical Quality at the AAPS conference in Los Angeles last month. Dr. Ho, who graduated on 5 December, is the first AAPS graduate student award winner from New Zealand this decade.
Dr. Ho began her PhD research at the University of Otago, and also spent two and half years at the Cavendish Laboratory, University of Cambridge, UK and with TeraView Ltd ( Cambridge, UK). Her thesis examined using a terahertz pulsed imaging technique to determine the quality of slow-release film coatings regularly used on tablets. It has been formally recognised by the Division of Health Sciences as being a thesis of exceptional quality.
The Future is in Our Hands
Final-year student Kasey Brown is taking the theme for this year’s Pasifika Medical Conference – “Kaveinga Ora – The Future is in our Hands” – to heart.
The 23-year-old who recently attended the conference in Rarotonga is enthusiastic about ensuring Pacific young people consider pharmacy as a career option.
The health of Pacific people will only improve when there are more Pacific health professionals working in the sector, she told conference delegates.
Kasey, whose mother is Samoan born and raised, was herself brought up in Wellington. She is currently the only Pacific student at the Pharmacy School and believes she is one of only a few Pacific students to graduate from the school.
She attended the conference as the pharmacy representative on the Pacific Islands Health Professionals Students Association (PIHPSA) and presented her views about the lack of Pacific students entering health courses at Otago University.
She is concerned most of her peers with an interest in health only consider medicine as a career option, but fail to consider – possibly because they are not aware of -other options like pharmacy, dentistry and physiotherapy.
“We need to be increasing the intake of Pacific Islanders into pharmacy because we need experts in this field to be able to educate and provide services for others working in health and more importantly the patients,” Kasey told delegates.
“Our patients will open up more to health professionals of the same or similar ethnicity because they are able to relate better and open up more. I feel this will contribute immensely to better communication, compliance and understanding of their medications and conditions which ultimately should increase the health status nationwide.”
At Otago University’s open day this year, Kasey spoke about pharmacy to a group of secondary school Pacific students from all around New Zealand. She believes systems, schemes and programmes need to be put in place so that secondary school students and university entrants have a better understanding of what health professional courses are available.
Kasey is grateful to the Pharmacy School and PIHPSA for providing some financial assistance for her to attend the conference. The conference was not only educational but also provided opportunities for networking, she says.
“For me it made me realise there is more to pharmacy than what I thought. The knowledge that I gained can be used to challenge the ideas and ways things are currently done, but most importantly I want to use this information to share with others to help make a change in the future of pharmacy and the Pacific peoples.”
Ultimately, Kasey would like to return to the Cook Islands to work as a hospital pharmacist.
 Congratulations to
Amanda Wheeler
The School of Pharmacy says congratulations to Amanda Wheeler on gaining her PhD. Amanda graduated in with her BPharm from this School in 1989 and is now well know pharmacist in psychiatric pharmacy. Amanda recently completed her PhD under the supervision of Professor Peter Joyce at the University of Otago (Christchurch). Peter joined Amanda at the celebration of her PhD graduation ceremony on the 22 August 2009. Natalie Medlicott, Associate Dean for Undergraduate Programmes & Admissions, was also present.
 Medicines and the elderly
When Michael Bagge graduated from Otago University with a Masters in History, he never for a moment envisaged carrying out his PhD at the School of Pharmacy.
But fast forward a couple of years and that is exactly what he is doing after enjoying working as a research assistant on one of the country’s first studies into the medicine-taking practices of New Zealanders aged over 75.
Mr Bagge so enjoyed his time interviewing more than 300 of Dunedin’s elderly for the project and working with Senior Lecturer June Tordoff, he is now set to begin his own research with a similar theme: “Medicines in the context of older people’s lives”.
He aims to examine the experiences and attitudes of people aged over 75 towards medicines and how taking them fits into the wider context of their lives.
Last month Dr Tordoff presented findings from their earlier research at the New Zealand Association of Gerontology’s annual conference. Overall, the researchers found people aged over 75 who live in the community manage their medicines well.
However, some challenges exist with the research highlighting a need to improve medication labeling and leaflets as well as tailoring dosage forms for individuals.
Further, the researchers highlighted a need to improve the information and education elderly patients receive about medicines particularly when they are discharged from hospital.
While previous research has considered medicines in people aged over 65, Dr Tordoff decided to hone in on the older age group after Otago University’s Professor of Geriatric Medicine, John Campbell, suggested there were often more difficulties in the medicine-taking practices of people aged over 75.
The research found on average these people were using a median of seven prescription medicines (with a range of one to 19) and one non-prescription medicine (range nil to 14).
The majority (58 per cent) believe medicines are effective and had systems or routines (92 per cent) in place to help remember to take the medication. Men were more likely to report “trouble remembering” then women.
Common problems were reading and understanding labels and leaflets and difficulty swallowing solid dose forms. Some wanted to know more about their medicines and several mentioned they were confused about their medicines following hospital discharge.
Mr Bagge says this was an interesting finding given no specific question was asked about hospital discharge. This is an aspect he is planning to further investigate.
Generally, the findings seem to fit with similar international research, Dr Tordoff says. However, she believes the results should not be interpreted as a reflection on the medicine-taking practices of all over 75 year olds in New Zealand. The Dunedin study considered only those living in the community, had a small Maori representation (2 per cent) and involved participants who volunteered and who were able to respond independently.
 Anthropologist joins team
Social anthropologist Dr Kirsten Lovelock has joined the Otago School of Pharmacy team as a research fellow.
She is working on the Health Research Council funded “Equity in Prescription Medicines Use” project led by Chair in Social Pharmacy, Pauline Norris, and Research Fellow, Dr Simon Horsburgh.
Almost $1 million was awarded for the project two years ago to enable researchers to take a close look into the use of medicines among New Zealanders, using Gisborne as the community of interest.
Currently, the research team is in the process of generating results from the study which focuses on prescriptions for medication in the community over a year-long period.
Dr Lovelock is currently conducting a review of research which identifies patterns of prescription use in order to understand what social factors shape prescribing and the use of medicines by various groups. Findings from the Gisborne project will then be compared to findings internationally.
Most recently a research fellow and project manager in the Injury Prevention Research Unit at Otago University exploring occupational health in agriculture, Dr Lovelock is enjoying bringing her social science skills to the Pharmacy School.
“As a social anthropologist I am particularly interested in how socio-economic status, ethnicity, gender, age and cultural understandings shape access to medicines, the use of medicines and ultimately health outcomes for people, locally and globally”.
 Sir Ed’s seal of approval
Sue Heydon is delighted she had Sir Edmund Hillary’s seal of approval for her recently-published book, a case study on one of his aid projects, Khunde Hospital, in Nepal.
The lecturer in social pharmacy worked alongside doctor husband, John, at the hospital for two years in the late 1990s. This experience forms the basis of the book “Modern Medicine and International Aid: Khunde Hospital, Nepal, 1966-1998”.
And, it’s a story which Sir Edmund, while still alive, was delighted would be told not because it is about him but instead the aid work that was carried out, Dr Heydon says.
An historical case study, the book is based on her PhD thesis, and is of interest because despite the wealth of information about Sir Ed, little has ever been written about the aid work he carried out.
“It’s really a study about introducing modern medicine into the Mt Everest region in Nepal and implementing an aid project, because despite the billions of dollars spent on international aid, we know remarkably little about implementing aid, especially over a period of time,” Dr Heydon says.
The importance of long-term relationships and the way people work together in these projects were lessons that could be learnt, Dr Heydon concludes, together with the importance of giving projects time.
“One of the key things about Sir Ed’s work was not what he did, but the way he went about it. The key thing was he worked with people, he didn’t tell them what to do – the importance of trust, respect and relationships were all there long before they came into international thinking on aid policy and practice.”
Published by Orient Blackswan in India with financial support from the Wellcome Trust Centre for the History of Medicine, University College, London, the book is part of an international series called “New Perspectives in South Asian History”.
NZ Meeting of ASCEPT 2009, Dunedin
From the 3 - 5 September 3rd the Annual New Zealand Scientific Meeting of the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) was held at the Otago Museum here in Dunedin. The Modelling and Simulation Lab were well represented with all students, as well as Steve Duffull, Carolyn Coulter, and Hesham Al-Sallami, giving oral presentations.
One very notable presentation was that given by Julia Korell. Julia joined the Modelling and Simulation Lab in February 2009, coming from the Black Forest in Germany. Julia had just completed here Post Graduate Certificate (PGCert) in Pharmacy and embarked on her PhD – for which she was awarded a University of Otago Prestigious Scholarship. Julia very succinctly presented her complex and detailed statistical model for the survival of red blood cells (RBCs), the work that her PGCert thesis comprised of. Julia had developed this complex model from existing simplistic models for the purpose of enabling all possible processes of RBC destruction to be correlated to different pathological states. The results Julia obtained from this theoretical approach were in accordance with the existing data on RBC survival. Julia also outlined how her model will interface with current in vivo studies looking at RBC survival. Specifically the difference between RBC survival in healthy individuals, which is purported to be 120 days despite reliable evidence for this, and pathological states such as severe renal impairment.
Julia’s presentation was excellent, sparking a long and vivid discussion on many aspects of both RBC survival and how to accurately model this. Julia was awarded second prize in the Fred Fastier Student Oral Presentation competition, where Fred – the founder of Pharmacy at the University of Otago – was on hand to present her with her certificate. This was a remarkable achievement given it was Julia’s first oral presentation at a scientific meeting.
As ASCEPT NZ is a smaller conference than many international meetings it allowed both the academics and students to present their work and engage in scientific debate. Additionally, it strengthened relationships between the various pharmacology and toxicology research groups in New Zealand, forming the basis for future collaborations. Overall, this was a very successful conference and the Modelling and Simulation Lab look forward to participating each year!
11th Conference another success
The 11th Conference on Formulation and Delivery of Bioactives was held over two days on 18 & 19 February 2009 at the Hutton Theatre, Otago Museum. Speakers included Prof. Werner Weitschies from the University of Greifswald, Germany; Assist. Prof. Stefania Baldursdottir from the University of Copenhagen, Denmark; Dr Ian Larson from Monash University, Melbourne and Associate Professor Roger Lentle from Massey University.
Pictured above: Dr Natalie Medlicott, Dr Ian Larson and Ms Louise Ho enjoying a break during the Conference proceedings
Pictured above: Prof. Werner Weitschies and Dr Olaf Bork
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