Conjoint Associate Professor Gary Baker

Professor Amanda Baker is a National Health and Medical Research Council Senior Research Fellow at the University of Newcastle. An award winning innovator, she specializes in the treatment of co-existing mental health and substance use problems.

Early in her career as a clinical psychologist, Professor Baker identified a lack of integration between mental health supports, and drug and alcohol treatments as a major barrier to behaviour change.

Rather than treating co-occurring problems in a consolidated manner, patients were often refused treatment from one targeted service, if they also needed treatment from the other.

"What drives me are the dualities in the system between mental health and drug and alcohol," Amanda explains.

Over one hundred and fifty publications later - including five national amphetamine treatment clinician guidelines and eight treatment manuals for comorbidity - Amanda and her team have made significant progress toward the recognition of the need to integrate the treatment of co-existing issues.

INTEGRATION AND COMMUNITY

By the time Amanda graduated in the early 1980s, the push to de-institutionalise mental health in Australia had begun in earnest. Research and practice from around the world showed that mental health patients, who had previously been institutionalised, had better health outcomes when transitioned back into the community.

A stint practicing in community health in Manchester, the United Kingdom, gave Amanda a new perspective on how psychologists could successfully aid this transition. During this time, Amanda experienced first-hand the positive outcomes of a system where practice and research were highly integrated, and was eager to facilitate a change in this direction back home.

Returning to Australia three years later, Amanda took up a position at the National Drug and Alcohol Research Centre, where she completed her PhD on reducing HIV risk in injecting drug users, before working in the drug and alcohol facility at Westmead Hospital, Sydney.

In 1995 Amanda was appointed to head up a graduate course in Drug and Alcohol Studies for clinicians at the University of Newcastle. Armed with experience in the clinical and research spheres of both mental health, and drugs and alcohol, Amanda's input into the Faculty of Health and Medicine has been invaluable. Her attention shifted from teaching and research to research in 2003, where has been continuously funded by NHRMC fellowships ever since. Known as a generous mentor and supporter of early career researchers, Amanda was appointed Deputy Head of the School of Medicine and Public Health (Research) in 2010 for a three year term.

METHAMPHETAMINE TREATMENT OPTIONS

A consistent area of focus in Amanda's research has been the use of methamphetamines by people with mental health problems. Leading a Commonwealth funded trial in the early 2000s, Amanda found counselling to have favourable outcomes for methamphetamine users. The treatment framework was disseminated nationally, but unfortunately, the model was not sustained.

Amanda points to several factors including poly-drug use, presenting behaviours such as paranoia or violence, and sector worker turnover as barriers to methamphetamine users accessing drug and alcohol services.

"Methamphetamine is the drug that makes you confront that overlap between mental health and substance use," she says.

"It really draws out the psychotic symptomatology and edginess in people."

"Users can be angry or violent, and workers need training to be confident on how to proceed from there."

As immediate past president of the Australasian Professional Society for Alcohol and other Drugs (APSAD) Amanda represented this peak body in consultations with the Federal Government's National Ice Taskforce. Called upon to help inform the community response to ice use as a major public health issue in Australia, she presented at the National Methamphetamine Symposium in early May 2015.

WHERE THERE'S SMOKE

More recently, another drug has almost completely captured Amanda's attention.

"In the last ten years or so I have become very interested in tobacco, the drug that everyone forgets."

"Because it is legal, people don't understand that it can create so much harm," she adds.

Amanda has been an advisor during the transition of forensic hospitals to smoke-free facilities, and is currently working on a phone delivered smoking cessation program for people with mental health problems in partnership with Quitline Victoria.

"I'm very passionate about trying to help people with mental health problems give up smoking," she declares.

"They die 20 years earlier than people in the general community from tobacco related causes."

Amanda is also currently involved in an NHMRC trial, testing the efficacy of iPad delivered smoking cessation programs targeting hospital patients who have suffered orthopaedic trauma.

The trial, led by Associate Professor Billie Bonevski, is attempting to decrease the healing time and amputation risk of participants by helping them quit smoking.

WHERE TO FROM HERE

When asked about her future, Amanda conveys her enthusiasm for the Quitline telephone delivered smoking cessation program. She sees this as her direct future, evaluating phone interventions in real life delivery.

"I think telephone interventions are where I can make an impact," she avows.

"It's always assumed that people with severe mental illness need intensive individual intervention with face-to-face treatment."

"But we have proved that phone intervention, which everyone loved, was simpler, briefer and just as effective."

Amanda also speaks eagerly about a related project she is undertaking with Doctor Peter Kelly from the University of Wollongong.  This project trains peer workers to deliver healthy living interventions with a focus on diet and activity, to people with mental health problems, again via telephone.

Although it may seem incongruous for Amanda to be focusing on diet and activity she points out that changing dietary intake (like levels of fruit and vegetables) and reducing TV watching may impact positively on the other behaviours that affect cardio-vascular health – smoking, alcohol, and snacking on high fat foods.

"They are all addictive behaviours," she explains.  

"In today's society, you can buy so much food, so much packaged food. Forty years ago it wasn't available. Food really is the new tobacco."

Dr Mark Baker has picked up the pace of sperm cell research by harnessing the power of proteomics.

There is a competitive side to Dr Mark Baker, who likes to keep fit and, at 37, still enjoys the challenge of matching strides with younger opponents on the soccer field. But the race Baker is most keen to win is the one to develop a male version of the contraceptive pill – and the proteomics expert believes his research team at the University of Newcastle has a real chance of achieving that goal.

"We are the world leaders in sperm proteomics," points out Baker, who was the first researcher to create a complete inventory of the proteins in sperm and has established a state-of-the-art proteomics laboratory at the University. "The work we do is part of a worldwide effort but we are recognised as pioneers and the most progressive group in our field."

Baker joined the University's influential Reproductive Science Group, led by Laureate Professor John Aitken, after being awarded a PhD from Monash University in 2002. Aitken, who specialises in sperm cell biology, recognised the potential in combining their areas of expertise towards the common goal of solving the mysteries of male fertility. 

Whilst Baker's ultimate goal is to develop a male contraceptive, his research has equal potential to assist men who are infertile, as it is necessary to understand the mechanisms of infertility in order to mimic the condition with a male contraceptive. In identifying and publishing the sperm proteome, Baker advanced the number of known proteins from less than 40 to more than 1200. He and the research team have subsequently narrowed down that list of proteins to a handful that can potentially be targeted by fertility drugs.

"One of the important criteria is that the protein is found only in the testes, because if you are designing a drug that inhibits a protein you don't want it to affect other parts of the body," Baker explains.  "So, we have identified a number of proteins that we know are both unique to the testes and are vital for fertility. We are now moving into the next phase of the research, which is designing a drug to target them."

Baker's work has attracted the attention of Bayer (formerly Bayer Schering Pharma), one of the first companies to market the contraceptive pill back in the 1960s. He has also established collaborations with leading international research groups in the field.

"The implications of our research are widespread when you consider that about half of all pregnancies in Australia are unwanted or unplanned and that there are about 250 abortions for every 1000 live births," Baker asserts. "There are also thousands of women who suffer side effects from contraception and there is an inextricable link between poverty and high birth rates in developing counties. As you can imagine, there is a real global imperative to improve options by developing a male contraceptive. At the same time, up to 10 per cent of the male population is infertile, so we want to be able to help them as well."

Baker has contributed his expertise in identifying the protein structure of cells to other interesting collaborations with leading University health researchers. He is currently working with Professor Hubert Hondermark on a project to detect metastatic potential in breast cancer cells and with Conjoint Professor Jim Denham to determine new biomarkers for prostate cancer. He is also working with members of the translational stroke research team on a project investigating indicators of stroke in cerebral spinal fluid.

Baker holds a National Health and Medical Research Council (NHMRC) Career Development Fellowship to research sperm motility and is an investigator on several projects supported by the NHMRC. Late last year he received the 2011 Early Career Researcher Award sponsored by the Hunter Medical Research Institute (HMRI) fundraising group PULSE.

Baker's research in sperm-egg recognition and proteomic analysis of sperm cells is internationally recognised and has been cited more than 950 times. The proteomics laboratory he was instrumental  in establishing, with its world-class mass spectrometry equipment, has made a broad contribution to research at the University of Newcastle,  supporting work across the disciplines of life science, science, medicine and engineering as well as research from HMRI and international and national collaborations.

Two minds are better than one

The powerful combination of Laureate Professor John Aitken's vast knowledge of sperm cell biology and Dr Mark Baker's proteomics prowess makes the University of Newcastle's Reproductive Science Group a formidable force in the research field of sperm function and male fertility.

"John and I decided seven years ago that we needed to investigate the proteins in sperm cells to understand the mechanisms of fertility," Baker advises. "We saw the potential in it and went after it, and the University has backed us all the way. We quickly got into the field and we have raised the bar."

Baker believes he has benefited greatly from working with Aitken, one of the world's most esteemed reproductive scientists. "He has been my primary mentor, but it is a relationship built on mutual respect," Baker emphasises. "There is a willingness to work together but also a willingness to listen to each other's points of view – and that is critical to successful research: to be able to agree but also disagree."

Aitken describes Baker as"an ideal example of how postdoctoral researchers can blossom into fully-fledged professional scientists when the University supports their careers."Now, Mark is generating research income in his own right that will more than repay the investment the University has made in developing his research portfolio."

Visit the Centre for Reproductive Science website

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