Staff Profile

Career Summary

Biography

Qualifications

• Doctor of Medicine, University of New South Wales
• Bachelor of Medicine & Surgery, University of Sydney

Research

Research keywords

• Neural Control of Cardiopulmonary Systems

Research expertise

My philosophical goal is to help maintain Global Health, that is to say, the research and practice of sustaining health of human and animal populations as they interact with ecosystems on the planet.

My physiological goal is to identify the integrated mechanisms neural and non-neural responsible for survival in the freely operating, natural state.

A special goal is therefore to wherever possible experiment with conscious man and other awake mammalian species. This approach is justified by our knowledge that acute experimental research models using preparatory anaesthetic agents, surgery plus positive pressure ventilation disrupt in a variety of ways, the natural control systems we seek to identify.

My research therefore involves developing appropriate (new) techniques and a large measure of experimental surgery for pre-implantation in, or application to, the recovered awake experimental model (e.g. the application of thermodilution, electromagnetic, ultrasonic and impedance methods for measuring cardiac function, blood flow and airways dimensions). This enables examination of postulates concerning dynamic physiological control in awake man and animal (in my case rat, rabbit, cat, dog, sheep, pig-tailed monkey, and baboon). A special but not only target is the sensory and central nervous control of the coronary and bronchial circulations by efferent autonomic effectors.

One great advantage with this approach in awake species is the enabling of behavioural studies both at rest and when the species is mobile. We have correlated and analysed behaviour in terms of integrated, moment-to-moment autonomic, hormonal, and local autacoid responses, in both immediate and longer term domains. We have targeted emotion and published on Darwin's hypothesis of emotion, facial expression and linked autonomic responses. The biggest ongoing challenge is to analyse during exercise how the brain normally controls the coronary and bronchial (airways) circulations, and the airways themselves. These studies are relevant to the greatest killers of mammalian species on the planet when the normal, natural control systems are modified by disease, e.g. the cardiopulmonary conditions of coronary artery disease, hypertension (systemic and pulmonary), and the multiplicity of asthma syndromes. I have trained higher degree students in these philosophies since 1970 (see Teaching Expertise below).

An understanding of pathological processes are compromised without an understanding of the normal mechanisms underpinning survival. Special environmental influences requiring analysis are different forms of tissue hypoxia, i.e. ischaemia secondary to heart disease, and the arterial hypoxia (acute and chronic) of pulmonary disease, altitude, and the extremes of mammalian (including sporting) performance, e.g. postural change, diving, and the exercise-induced hypoxia and pulmonary haemorrhage in thoroughbred racehorses.

The review of functional correlates between vertebrate species offers fascinating insights into the evolutionary maintenance of cardiopulmonary survival mechanisms, which has been suggested as defence against tissue hypoxia. This has applied to lung barriers preventing inhaled harmful molecules from penetrating across airways into the systemic circulation, and the reasons for reflex autonomic vasoconstriction in the coronary circulation of the heart when this appears physiologically inappropriate.

I have published 101 fully peer-reviewed papers, Reviews and Book Chapters, and 122 Abstracts since 1970 (as at 22/1/2013)

Fields of Research

Memberships

Body relevant to professional practice.

• Member - Order of Australia
• Elected Fellow/member - Royal Australasian College of Surgeons
• Elected Member - Fellow of Cardiac Society of Australia and NewZealand, 11 August, 2004

Learned Academy.

• Member - Elected President, University of Newcastle Association of Professors (Collegiate Academic Group )
• Elected Member - American Physiological Society
• Elected Member - Australian Physiological Society

Appointments

Awards

Honours.

Recognition.

Research Award.

Invitations

Collaboration

In 1968 my primary collaboration after my higher doctorate in medicine in Australia was with Björn Folkow and Bengt Öberg at the University of Göteborg, Sweden. Here as a medical research fellow I learned a variety of original techniques developed in the Department of Physiology for studies in anaesthetised models of human physiology. We studied rheology and cardiac reflexes. In turn I demonstrated to the Scandinavian Physiological Society the preparation developed by Paul Korner in Australia for analysis of cardiac output control during hypoxia using thermodilution (a new technique not accepted fully at that time).

The next year 1969 I became a cardiology fellow in the novel Seaweed Canyon large animal complex at UC San Diego, La Jolla, California, where a new approach to studies of reflex cardiopulmonary control was used. This was physiological realism. The techniques allowed continuous measurement of dynamic coronary blood flow and cardiac dimension changes under natural behavioural and reflex conditions using frequency shifted ultrasound as originally described by Christian Doppler. The techniques foreshadowed clinical echocardiography and like techniques. I worked with Gene Braunwald, and the inventor of the techniques, Dean Franklin.

On return to Australia in 1970, I joined foundation science staff at the University of Sydney Cardiology Department, then known as the Hallstrom Institute. Collaboration was commenced between clinicians and basic scientists, and with the Veterinary School, and Pharmacology, through new higher degree students.

In 1976 I accepted the Foundation Chair of Human Physiology at the new medical school, University of Newcastle. Collaborative research commenced with the Depts of Anaesthetics, and of Surgery, at the established Royal Newcastle Hospital. We evaluated Impedance Cardiography for measurement of cardiac function in man. We also commenced novel community collaborative studies, on the menstrual cycle of the female athlete in Hunter Ballet Schools, and on G-force adaptation of blood pressure control in RAAF fighter-pilots. I founded the Hunter Academy of Sport in 1989, as a community based, service, education and (university) research company, limited by guarantee. In 1991, I was invited by Respiratory Medicine, University of California, Davis, to commence long term collaboration on asthma, namely, on reflex control of airways and bronchial circulation during rest, behaviour (including sleep), and exercise. In 1999, I developed in conjunction with bioengineer Koullis Pitsillides at UC Davis the airways internal diameter assessment (AIDA) ultrasound technique for online tracking of airway dimensions and blood flow. This international University collaboration foreshadowed new University of Newcastle collaborative policy. It was timely, as the Faculty of Medicine was restructured into a Faculty of Health, and the Hunter Medical Research Institute came on line at the new John Hunter Hospital.

Administrative

Administrative expertise

I was a full-time researcher until I went in 1974 to the new Medical School at Flinders University for my brief tenure of 18 months, where I became Foundation Chairman of the Library Committee. On taking up the Foundation Chair at Newcastle Medical School in May 1976, I repeated this tenure, and also became Foundation Chair of the Research Committee. I also became Chairman of Phase I in the new curriculum responsible for planning and implementing the problem-based course when the students arrived in 1978. During the next 22 years I served on many committees of the medical faculty and the University, and became the elected President of the Association of Professors of the University of Newcastle. Externally I served on the National Heart Foundation Scientific Advisory Committee for some 10 yr, and as mentioned elsewhere, on the Australian Postgraduate Federation of Medicine, and on the (Part 1) Board of Examiners, of the Royal Australasian College of Surgeons.

Teaching

Teaching keywords

• Medical Education

Teaching expertise

I have worked in 4 new medical schools during the evolution of their clinical and basic science curricula, namely, UNSW (1962-67), UC San Diego (1969), Flinders University of South Australia (1974-76), and as a Foundation Professor at the University of Newcastle, NSW (1976- ). Therefore, I have an evolutionary view of the change in medical school approaches to medical education internationally, and of the evolution within each school. Early in my career, I was a junior teacher, and simply followed the policy laid down by committees. Later I became a committee member and took part in developing policy as well as teaching. At Newcastle, I was responsible for initiating (e.g. Chairman of the initial Phase 1 of the new medical curriculum, ) and establishing policy and participating in new courses using problem-based learning (PBL), e.g. in both medicine and biomedical science courses we linked Group PBL tutorials to Interactive whole year learning sessions). We viewed Problem Based Learning in undergraduate curricula as analogous to the learning process in research

My focus was also on the undergraduate, graduate, and postgraduate domains for research education and process. As a physiologist I trained higher degree students by initially working closely with them in the laboratory and while writing, a process where the variable capacity of students to become potentially independent researchers is efficiently revealed. At the University of Sydney and at the University of Newcastle I have trained 1 higher Doctorate in Medicine by thesis (MD), 9 PhD (6 medical, 1 veterinary, 2 science grads), 4 B Med Sci, and 5 Sci Hons students. I am currently mentoring in 'retirement' PhD and Honours students by invitation in Professor AW Quail's laboratory in the Medical Sciences Building at the University of Newcastle.

I was also a Foundation member (Treasurer) of the Hunter PostGraduate Medical Institute, and represented the Institute on the Australian PostGraduate Federation of Medicine where I recommended policy changes in medical postgraduate learning. I also sat on the Part 1 Board for Basic Surgical Training, Royal Australasian College of Surgeons, and was intimately involved in the change of the College from an Examining Institution alone, to an Educational and Examining Institution. I have not published this experience widely, but encouraged others to do so, mainly because my publishing time was devoted to physiological research writing.