MQ Health - Macquarie University

Clinical sciences

Given the strong link between research and clinical care within MQ Health, much diverse research occurs within clinical sciences. Our main research activities in this area are outlined below.

Bacterial biofilms and hospital-acquired infections

As part of research to prevent surgical infection, MQ Health researchers have demonstrated the prevalence of bacterial biofilms on surfaces and their role in causing surgical and other hospital-acquired infections.

Biofilms are extended colonies of bacteria that develop on surfaces. The colonies are protected by a self-generated layer of biological molecules, the ‘biofilm’, and so are difficult to remove or kill with disinfectant. Moreover, the bacteria can survive within the biofilm for extended periods and consequently can remain an ongoing source of possible infection.

Research within MQ Health is exploring ways to remove biofilms and minimise their (re-)development. Studies of the biology and chemistry of biofilms, and the bacteria that live within them, are helping identify and test better ways to sterilise surfaces.

Other research is examining the effects of bacterial biofilms in wounds, breast implants, cystic fibrosis, orthopaedic plates and the dental environment. This work has already allowed development of new strategies to minimise the risk of biofilm-associated capsular contraction in breast implants. These strategies are used as standard practice by MQ Health’s Plastic and Reconstructive Surgery Clinic.

Biomechanics

Biomechanics is the study of how the human body moves, and is a growing area of clinical research activity for MQ Health. Studies usually combine experimental measurements with computational simulations to bring new insights into normal function of joints such as the knees, hips and shoulders, but also into joint problems and the best use of orthopaedic implants when joint replacement is needed.

For example, some of our biomechanics researchers are developing new evidence-based approaches, often drawing on the rich data streams available through ‘wearable technologies’, to improve military training and sports training. These projects are identifying improved ways to build fitness, strength and technique of members of the armed forces, elite athletes and amateur sportspeople alike, while reducing injury.

Other research is examining how to ensure that older Australian’s with joint pain and mobility problems – for example, in their knees – receive evidence-based rehabilitation and care in order to avoid unnecessary surgical joint replacement (or arthroplasty), or to at least prolong the time until surgery is required.

And, when arthroplasty is required, our researchers are exploring better approaches to precisely measure how individuals’ joints move in order to reduce the incidence of implant problems or failure down the track. To achieve this goal, they are developing improved methods to tailor selection of implants for each patient, as well as to allow more precise surgical pre-planning and therefore optimal positioning of the implants during surgery. These studies take advantage of the experimental capabilities of our Surgical Skills Centreand Macquarie University’s Simulation Hub, and combine the resulting data with biomechanical simulations of joints and motion and load distributions.

Pain mechanisms and management

An episode of lower back pain occurs for the vast majority of Australians at some point during their lives, but when it recurs it can become a chronic and debilitating condition. Indeed, currently over 10% of Australians live with chronic back pain, and yet little is understood about the various causes that can underlie or contribute to this complex condition.

To help address this public health issue, MQ Health has a substantial research effort to better understand the causes, diagnosis, treatment and prevention of recurrent back pain. For example, our researchers are leading, or contributing to, a number of studies and trials to assess risk factors for lower back pain, and which types of existing and new management approaches can reduce back pain and minimise the risk of recurrence.

They are also undertaking studies to understand whether medical imaging can be of any use to diagnose causes of back pain, or to determine the likely prognosis of patients and the best treatment approach. This remains an under-explored research space in modern medicine, despite the value of medical imaging for other conditions and diseases.

Further pain-related research within MQ Health is working towards a better understanding of, and new treatment options for, other forms of chronic pain, such as that caused by knee osteoarthritis, sciatica, neck injuries and other types of trauma.

Recovery from stroke and brain injury

This research focusses on improving recovery of patients after stroke or other acquired brain injury, by maximising appropriate physical activity in patients on a long-term basis. Sustainable physical activity is proven to deliver the greatest recovery and to reduce the risk of other complications or health issues arising from reduced exercise and activity.

Projects in this area involve developing and validating evidence-based programs to facilitate patients’ self-management of their physical activity, and to reduce risk of other problems such as patients’ falling due to impaired balance and coordination.

Surgical innovation

Beyond the biomechanics-related research to improve the approaches for orthopaedic surgery, or new approaches for cancer surgeries or neurosurgery, MQ Health does other research to advance surgical techniques.

One such area is in cardiothoracic surgery and development of evidence-based surgical approaches to improve patient experience and outcomes after major heart surgery, such as aortic arch surgery. Other efforts are seeking to test and develop a solid evidence base for minimally invasive techniques for cardiac, lung and gastrointestinal surgeries. Often the end goal of this work is the development of national or global surgical databases and protocols for best-practice, evidence-based treatment.

Other innovations are occurring in the development of new devices, instruments and technologies that can support more precise and safer surgical approaches.

To underpin all of this activity, collaborative research with the Department of Philosophy is developing a practical framework to better manage the ethical and regulatory issues associate with surgical innovation in the healthcare system.