Tech experts on show

September 27, 2022 by Development Team Leave a Comment

Our DevOps and Point of Care Testing tech experts were on show at the Newcastle Tech Futures expo.

We have the jobs of the future right now at NSW Health Pathology.

Madellyn Herd and Tim Eckersley from our award-winning Point of Care Testing and DevOps teams spread the word among students seeking tech opportunities at the recent Newcastle Tech Futures expo at the University of Newcastle.

“It was really great to be able to represent NSW Health Pathology to the students and hopefully we have inspired some to look our way post-graduation,” Madellyn said.

Our teams are working at the cutting-edge, developing solutions to complex challenges to change the way we deliver health services for our communities. The DevOps team is helping deliver tech solutions in digital healthcare technology, genomics, virtual healthcare, health informatics and analytics and more.

Want to work for us?

Check out our vacancies at https://jobs.health.nsw.gov.au/nswhp/

Unlocking the pandemic puzzle to help save lives

September 27, 2022 by Development Team Leave a Comment

Our genomics team has used cutting edge technology and expertise to help keep us safe through COVID-19.

NSW Health Pathology’s Institute of Clinical Pathology and Medical Research (ICPMR) genomics team has worked tirelessly through the COVID-19 pandemic.

The team uses cutting edge technology and expertise to deliver scientific breakthroughs that have provided the cornerstone of disease detection and management to keep us safe.

Their efforts throughout the COVID-19 pandemic have saved thousands of lives, prevented further outbreaks and recently saw the ICPMR team recognised with the NSW Health Secretary’s Award for Integrated Value Based Care.

NSW Health Pathology’s ICPMR team at Westmead Hospital conducts world-class public health and research, working closely with colleagues at the Westmead Institute of Medical Research, the University of Sydney and the Western Sydney Local Health District.

Together, their combined research made it possible to allow tracing of COVID-19 transmission, fast identification of variants of concern and timely detection of drug resistance in new variants as they emerged during the peak of the pandemic.

At its core, this work was about collaboration, taking innovative laboratory work and pulling together different pieces of health data to discover new ways to control the world-changing pandemic as it happened.

ICPMR’s genomic epidemiologist, Dr Alicia Arnott, said “We’ve pulled together as a team and undertaken something that hadn’t been done in NSW before to inform pandemic control and responses”.

NSW Health Pathology’s Director of Public Health Pathology and ICPMR, Professor Dominic Dwyer, said “this has been the biggest emergency in infectious diseases for the last 100 years. We’re talking about millions and millions of infections around the world. This work has been critically important”.

Professor Dwyer describes the award-winning ICPMR genomics team as “the unsung heroes”.

“There are a lot of people doing a lot of work and a lot of hours to benefit the health of people in NSW and keep our community safe.”

Head and neck cancer and the role of the pathologist

September 27, 2022 by Development Team Leave a Comment

The treatment of head and neck cancers can have devastating effects on the way a person eats, speaks, swallows or the way they see and hear. So, what causes them and what role does the pathologist have in the treatment process?

The news that one of Australia’s most beloved performers, John Farnham, had undergone surgery in August 2022 to remove a cancerous tumour in his mouth brought head and neck cancers into the public spotlight like never before.

Professor Ruta Gupta sat down with RCPA President Dr Lawrie Bott to discuss the role of the pathologist in head and neck cancers for an episode of the College’s podcast series, “The Pathologists Cut”.

Prof Gupta holds many positions, including as senior staff specialist at NSW Health Pathology’s Royal Prince Alfred Hospital Laboratory, and as lead pathologist with the Head and Neck Oncology and Thyroid Multidisciplinary team at Chris O’Brien Lifehouse Cancer Centre.

“Because of the area of the body that head and neck cancers affect, they can have very significant effects on the way a person eats or speaks, the way they swallow or the way they see and hear. Head and neck cancers are a very diverse range of cancers caused by a variety of reasons and risk factors, which are all grouped together because of their location on the body,” she said.

“Traditionally, the most frequent cause of head and neck cancer is smoking and drinking alcohol. However, in Australia, the rate of smoking is going down which means that we are seeing a decline in smoking associated head and neck cancers.

“Currently, we are seeing an increase in head and neck cancers caused by viruses such as human papillomavirus (HPV), which causes cancer of the oropharynx, or Epstein Barr Virus (EBV), which causes nasopharyngeal cancer.

“Head and neck cancers associated with smoking or alcohol are generally seen in older people and are much more common in men who have had a lifetime habit with alcohol or smoking.

“On the other hand, head and neck cancers caused by viruses tend to occur in much younger people.

“These patients tend to be in their early 40s to mid 50s and generally do not have lifetime exposure to tobacco. More recently, we are also seeing mouth cancers in young women, the reasons for which we don’t know currently,” said Prof Gupta.

HPV is a common virus that affects both males and females and there are more than 100 strains of HPV.

Most types of HPV are harmless, do not cause any symptoms, and go away on their own.

A small proportion of people, both men and women, will not clear HPV from their systems – these people are at higher risk of developing cancers, either of the head and neck, or in the case of women, cancer of the cervix.

“Because head and neck cancers that arise from HPV are generally hidden in the fold of the tonsils or right at the back of the throat, they can be very difficult to see. Surgeons will use an endoscope to look and take biopsies from the tonsils or the back of the tongue. These biopsies are then sent to the pathologist who will look under the microscope and make a cancer diagnosis. If cancer is present, there are certain tests we can do to see if it is related to HPV,” said Prof Gupta.

“Once a diagnosis of cancer is made, the patient then undergoes surgery. For head and neck cancer this is not just the removal of tissue with cancer. It is not just taking out the tongue, the jaw, or the tonsils, we also need to take out lymph glands from the patient’s neck.

“These are big surgical procedures and can require ICU care and long hospital admissions whilst the patient recovers. The diagnosis of head and neck cancer is a critical step to start the patient’s cancer journey.

“The pathologists examine the tissues removed during surgery to determine whether all of the cancer was removed or whether microscopic amounts is left behind or whether the cancer has invaded blood vessels and nerves. If this has happened additional treatment with radiotherapy or chemotherapy may be needed. Thus, it is the pathologist that informs every step of a patient’s cancer management,” said Prof Gupta.

You can listen to Prof Gupta’s podcast episode here: https://www.rcpa.edu.au/Library/Publications/The-Pathologists-Cut-Podcast

Genetic detectives on the case

September 27, 2022 by Development Team Leave a Comment

NSW Health Pathology is a national leader in genome sequencing and its expertise came to the fore during the COVID-19 pandemic. Within two weeks our Westmead laboratory had developed an in-house whole genome sequencing process for the COVID-19 virus.

When the coronavirus SARS-CoV‑2 first landed on Australian shores in January 2020, it carried with it a genetic passport.

Each case of the virus had its own passport with a genetic stamp showing how the nucleotides inside it were ordered.

As with many viruses, as SARS-CoV‑2 spread it evolved and mutated, changing the type and ordering of these nucleotides ever so slightly.

This may sound sinister, but it is in fact a very useful development.

Understanding how the virus was spreading was going to be key to its containment. Professor Vitali Sintchenko, lead pathologist for the Microbial Genomics Laboratory at NSW Health Pathology’s ICPMR-Westmead, describes nucleotides within an RNA genome as the building blocks of a virus.

“In order to understand transmission pathways of the pathogen, you must first understand the order of these building blocks. You can then identify any presence or absence of changes in the building blocks,” Prof Sintchenko said.

“With whole genome sequencing we capture the sequence of these building blocks very accurately and we employ complex instruments to do it quickly and in high volumes.

“Rapid sequencing techniques allow us to gain a whole genome wide view of the pathogen very quickly and predict or understand behaviours of the virus.

“When we look at nucleotides, we can identify with high accuracy any variance within the virus genetic sequence.

“We compare viruses from patients at different stages of the disease or with a different history of disease and look for potential relationships between cases.

“From this we can infer, from genomic data, potential transmission patterns or pathways that can help track how it has spread through a community and beyond,” Prof Sintchenko said.

Through whole genome sequencing, experts can match new cases to clusters, or identify the origin of, and relationships between COVID-19 cases, providing a deeper understanding of the spread of the disease.

Whole genome sequencing offers another line of evidence to support contact tracing by filling in gaps where people have not or cannot provide all necessary details to help trace the source.

Within two weeks NSW Heath Pathology’s Westmead laboratory had developed an in-house whole genome sequencing process for the COVID-19 virus, in collaboration with academics from the University of Sydney, soon followed by NSW Health Pathology’s laboratories at Randwick.

In eight months, the team at Westmead successfully sequenced more than 1,000 cases and discovered 51 genomic clusters.

Sequences are also uploaded to an international virus sequence database to assist epidemiologists and researchers around the world.

Prof Sintchenko says the application of whole genome sequencing to the investigation of COVID-19 has been transformational and the number of genomes uploaded to the international database has been unprecedented.

“NSW Health Pathology is a national leader in genome sequencing, and we have made a significant contribution to data sharing to international research teams,” Prof Sintchenko said.

“We have very well-developed translational research collaboration between clinicians, scientists and researchers that has enabled us to achieve what we have in a very short timeframe.”

NSW Health Pathology continues to work closely with Health Protection NSW, providing whole genome sequencing data and reporting to support their centralised contact tracing and epidemiology teams.

This work is critical to identify people at risk of COVID-19 and minimise further spread of the virus in the community and among the most vulnerable.

“The evolution and spread of the virus around the globe and in Australia is fascinating but complex,” Prof Sintchenko said.

“It is like detective work, and we are part of the NSW Health COVID-19 response team.”

Culturally safe and sensitive care when life’s journey ends

September 27, 2022 by Development Team Leave a Comment

First Nations people are over-represented in the coronial system and NSW Health Pathology’s Forensic Medicine Service is working in partnership with the Aboriginal community to ensure all deceased persons are given the respect, dignity and care they deserve.

The Forensic Medicine service is committed to providing culturally safe and sensitive support for Aboriginal and Torres Strait Islander families whose loved ones have been referred to the Coroner following an unexpected or unexplained death.

Recently, the service welcomed Aboriginal Liaison Officers from Local Health Districts across NSW to its Newcastle facility for an afternoon of listening and sharing.

Senior Forensic Medicine Social Worker Danny Nugus said it was an opportunity to show how the service operates and its commitment to supporting the Indigenous community.

“The Forensic Medicine service is acutely aware of the overrepresentation of First Nations people in the coronial system as a result of the impacts of colonisation and intergenerational grief, loss and trauma,” said Mr Nugus.

“Distressingly, many of these families encounter the coronial process and our service multiple times.

“Much is misunderstood about the coronial referral and post-mortem process, particularly in regional areas.

“Working in partnership with community and partner agencies can help demystify the work of the Forensic Medicine Service and the organisation welcomes opportunities to talk about how respect, dignity and care for deceased persons, and their families, is central to everything that they do at Forensic Medicine.

“Culturally competent practice and building relationships is at the heart of reconciliation and that there can never be a ‘one-size fits all’ approach.

“By asking people what their needs are – individually, culturally, spiritually, as a family, and as a community – we can do their best to be responsive.

“For example, we will support a family’s request for a viewing, memory collation such as hand prints, a smoking ceremony, or other cultural rituals including painting,” he said.

The service also supports the leaving of artefacts such as photographs, animal skins, clap sticks or gum leaves with a deceased person who is in the care of Forensic Medicine.

During the recent visit, staff were humbled to hear one of the Aboriginal Liaison Officer colleagues say, ‘I’m going to tell my families they don’t need to be afraid. Everyone here is kind and will take good care of your loved ones’.

‘Path in Boots’ clinic delivering care to remote communities

September 27, 2022 by Development Team Leave a Comment

An award-winning project in northern NSW is delivering truly connected care and helping to close the gap for remote Indigenous communities. The mobile diabetes clinic, known as ‘Path in Boots’, takes pathology staff, GPs, Aboriginal health workers, dietitians and other allied health workers directly into the communities they are serving.

A multidisciplinary diabetes clinic for Aboriginal people has been on the road and delivering care direct to patients in northern NSW since 2005.

Scientific staff from NSW Health Pathology’s Lismore Laboratory, Karen Kennedy, Steve Alvarez and Trish Law, are part of the Goorie Diabetes Complication Assessment Clinics, targeting Aboriginal clients aged 15 and over who have Type 2 Diabetes.

Rather than get patients from distant Aboriginal communities to come to Lismore, a team of health professionals travel to them.

They pack a ‘mobile lab’ of equipment into the boot of a car, referred to as ‘Path in Boots’.

The team returns to the same Aboriginal communities regularly to build rapport and trust.

“The main thing with this service is the clients get everything all in one day,” said team member and senior hospital scientist, Karen Kennedy.

“There are pathology staff, a physician, general practitioner, diabetic educator, dietitian, pharmacist, podiatrist, renal nurse, exercise physiologist as well as Aboriginal health workers.

“We’re pretty committed. We go on the road every month, although we have missed a few trips due to COVID and bushfires in recent years.”

The mobile lab is just the first stop for patients attending the clinics.

They give a urine sample and have their bloods collected and within 20 minutes, get their results which they take with them in a folder to see the other health workers who provide lifestyle, diet and medication advice.

When the clinics finish, our staff join the other health workers in case conferences ensuring patients receive the highest level of individual attention and care.

The team won the 2020 NSW Health Pathology Staff Award for Delivering Truly Connected Care.

The initiative is a past winner of the NSW Health Aboriginal Health Awards for Excellence in Service Delivery as a team.

Tech experts on show

Our DevOps and Point of Care Testing tech experts were on show at the Newcastle Tech Futures expo.

Our genomics team has used cutting edge technology and expertise to help keep us safe through COVID-19.

The treatment of head and neck cancers can have devastating effects on the way a person eats, speaks, swallows or the way they see and hear. So, what causes them and what role does the pathologist have in the treatment process?

NSW Health Pathology is a national leader in genome sequencing and its expertise came to the fore during the COVID-19 pandemic. Within two weeks our Westmead laboratory had developed an in-house whole genome sequencing process for the COVID-19 virus.

First Nations people are over-represented in the coronial system and NSW Health Pathology’s Forensic Medicine Service is working in partnership with the Aboriginal community to ensure all deceased persons are given the respect, dignity and care they deserve.

Connect with us