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Baker Heart and Diabetes Institute

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The Baker Heart and Diabetes Institute, established in 1926, is among Australia’s oldest medical research institutes. The Baker Heart and Diabetes Institute is an independent medical research institute which has historically focussed on cardiovascular disease. In 2008, it became the country’s first medical research institute to target diabetes, heart disease, obesity and their complications at the basic, clinical and population health levels The Institute’s headquarters is in Melbourne, adjacent to The Alfred Hospital. It is located on the Alfred Medical Research and Education Precinct. The Institute also has a national Aboriginal Health program, with a research facility in Alice Springs in the Northern Territory.

Established 1926 Type Non-profit organisation Purpose Prevention, treatment and cure of diabetes, cardiovascular disease and their complications Research agenda Based on the notion of a disease continuum from birth to death, with the aim of treating, managing and preventing progression of disease at any stage Locations Melbourne, Victoria and Alice Springs, Northern Territory, Australia Director Professor Thomas Marwick Staff More than 650 including honorary staff, students and Nucleus Network staff Subsidiaries Nucleus Network (not-for-profit early phase clinical research company) Website www.baker.edu.au

History

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The Baker Medical Research Institute was the brainchild of Dr. John F. Mackeddie, a clinical doctor and researcher, who had the idea of improving the laboratory facilities at The Alfred Hospital to keep up with advances in research. Mackeddie persuaded his friend, the photography industry pioneer and philanthropist Thomas Baker and his wife, Alice and sister-in-law, Eleanor Shaw[1], to assume financial responsibility. They decided the Institute should not only provide a better laboratory service for the hospital but should also have facilities for medical research[2].

Dr. William J. Penfold, who was internationally renowned in bacteriology and preventative medicine and was prominent in establishing the Australian Medical Research Council[3], was the first director of the Baker from 1926 until 1938[4]. He was followed by Dr. Arthur B. Corkill, who first came to the Institute as a biochemist[5]. Corkill described the methods of diagnosis and treatment of diabetes mellitus at The Alfred Hospital in 1927[6]. Twenty years later, in 1947, a young biochemist called Joe Bornstein was introduced to Corkill. Their work together resulted in the discovery of the two forms of diabetes—insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM)[7]. This discovery in 1949 "... literally changed the concepts, research and treatment of diabetes"[8].

From 1949 until 1974, Dr. Thomas E. Lowe was the Institute’s director[9]. With a team of notable investigators, including Paul Fantl (who identified key parts of the clotting cascade)[10], Alf Barnett (a pioneer of the treatment of hypertension and vascular disease[11]), Priscilla Kincaid-Smith (who identified analgesics as a cause of kidney failure[12]), Winifred Nayler (who helped define calcium channel physiology) and Austin Doyle (who had a profound impact on hypertension research and founded the High Blood Pressure Research Council of Australia[13]), Lowe developed the Baker into a major research organisation with world-class facilities[14].

It was during this time that cardiovascular research became the major focus. Research included the further development of cardiovascular surgery; new techniques of ECG and phonocardiography; treatment of congestive cardiac failure and of arterial hypertension. Sir James Officer Brown researched and tested open heart surgery in pre-clinical trials with the support of the Baker Institute, paving the way for Australia’s first successful open heart operation at The Alfred Hospital in 1957[15] which was undertaken by Kenneth Morris[16]. Morris went on to make major contributions to cardiac and thoracic surgery[17], alongside George Stirling[18] (Director of the Cardiothoracic Surgery Unit at The Alfred Hospital from 1971 to 1988), with strong support from the Baker Institute in trialling and developing new cardiothoracic techniques.

Professor Paul Korner AO, a cardiac physiologist noted for his contributions to the understanding of hypertension, took on the role of director in 1975[19] and by this time, the sole focus of the Institute was cardiovascular disease research. Significant advancements during this time included new strategies for hypertension; greater understanding of the role of the autonomic nervous system; insight into the role of cholesterol in atherogenesis and triglycerides as an independent risk factor for coronary atherosclerosis[20]. Notable investigators included Paul Nestel (nutrition, CVD, atherosclerosis and lipid metabolism), Murray Esler[21] (causes and treatment of high blood pressure and heart failure, and effects of stress on the cardiovascular system) and Garry Jennings (causes, prevention and treatment of CVD, and relationship between exercise, blood pressure, sympathetic nervous system activity and glucose metabolism).

Other notable investigators whose work would come to have a significant bearing on the Institute included Paul Zimmet[22], who pioneered Australia's first institute dedicated exclusively to diabetes. His research in Australian, Pacific, and Indian Ocean populations has highlighted the rise of diabetes worldwide, providing new insights into the genetic and environmental determinants of type 2 diabetes.

Professor John Funder AC[23] was appointed Director in 1990 and bought his work on cardiovascular endocrinology, especially aldosterone action to the Institute. Funder has rewritten the pathophysiolology of adrenal steroid action in the cardiovascular system, reshaping what we believe about aldosterone, cortisol and mineralcorticol receptors[24]. He was recognised for his contributions to public policy across primary health issues[25].

In 2001, cardiologist-researcher Professor Garry Jennings AO became the Institute’s sixth Director. Under Jennings’ leadership, the Institute grew substantially and by 2002, the Institute had its own purpose-built facilities adjacent to The Alfred Hospital. By 2007, a national Aboriginal Health research program was established[26] to help address the profound health disadvantage experienced by Aboriginal Australians and Torres Strait Islanders. Jennings also oversaw one of the most significant changes in the Institute’s history, the merger in 2008 of the Baker Heart Research Institute[27] with the International Diabetes Institute, which was founded and led by Zimmet. This created Australia’s first multidisciplinary medical research institute dedicated to the prevention and treatment of cardiovascular disease, diabetes, obesity and their complications, such as kidney disease.

References

  1. ^ Lowe, Thomas (December 1974). The Thomas Baker, Alice Baker and Eleanor Shaw Medical Research Institute – The First Fifty Years (First ed.). Melbourne, Australia: The Trustees of the Institute. pp. 3–7. ISBN 0 5956982 0 5. {{cite book}}: |access-date= requires |url= (help); Check |isbn= value: checksum (help); Check date values in: |accessdate= (help)
  2. ^ Lowe, Thomas (December 1974). The Thomas Baker, Alice Baker and Eleanor Shaw Medical Research Institute – The First Fifty Years (First ed.). Melbourne, Australia: The Trustees of the Institute. pp. 3–7. ISBN 0 5956982 0 5. {{cite book}}: |access-date= requires |url= (help); Check |isbn= value: checksum (help); Check date values in: |accessdate= (help)
  3. ^ "Penfold, William James (1875–1941)". Australian Dictionary of Biography. Australian National University. Retrieved 14 September 2015.
  4. ^ Lowe, Thomas (December 1974). The Thomas Baker, Alice Baker and Eleanor Shaw Medical Research Institute – The First Fifty Years (First ed.). Melbourne, Australia: The Trustees of the Institute. pp. 15–20. ISBN 0 5956982 0 5. {{cite book}}: |access-date= requires |url= (help); Check |isbn= value: checksum (help); Check date values in: |accessdate= (help)
  5. ^ Lowe, Thomas (December 1974). The Thomas Baker, Alice Baker and Eleanor Shaw Medical Research Institute – The First Fifty Years (First ed.). Melbourne, Australia: The Trustees of the Institute. pp. 20–22. ISBN 0 5956982 0 5. {{cite book}}: |access-date= requires |url= (help); Check |isbn= value: checksum (help); Check date values in: |accessdate= (help)
  6. ^ Corkill, A (1927). "A review of the diabetes question". Medical Journal of Australia. 1: 46–52. {{cite journal}}: |access-date= requires |url= (help)
  7. ^ Bornstein, J; Lawrence, R D (1951). "Two types of diabetes mellitus with and without available plasma insulin". British Medical Journal. 1: 732.
  8. ^ Martin (1998), A history of diabetes in Australia, p. 37 {{citation}}: Unknown parameter |First1= ignored (|first1= suggested) (help)
  9. ^ Lowe, Thomas (December 1974). The Thomas Baker, Alice Baker and Eleanor Shaw Medical Research Institute – The First Fifty Years (First ed.). Melbourne, Australia: The Trustees of the Institute. pp. 23–30. ISBN 0 5956982 0 5. {{cite book}}: |access-date= requires |url= (help); Check |isbn= value: checksum (help); Check date values in: |accessdate= (help)
  10. ^ "Fantl, Paul (1900–1972)".
  11. ^ https://members.racp.edu.au/page/library/college-roll/college-roll-detail&id=611. {{cite web}}: Missing or empty |title= (help)
  12. ^ https://www.science.org.au/node/335824. {{cite web}}: Missing or empty |title= (help)
  13. ^ http://www.hbprca.com.au/about/history/. {{cite web}}: Missing or empty |title= (help)
  14. ^ http://adb.anu.edu.au/biography/lowe-thomas-edward-14386. {{cite web}}: Missing or empty |title= (help)
  15. ^ The Alfred Health Care Group Heritage Committee (1996). Alfred Hospital Faces and Places. The Alfred Health Care Group. pp. 81–82. ISBN 0 9596503 1 8.
  16. ^ The Alfred Health Care Group Heritage Committee (1996). Alfred Hospital Faces and Places. The Alfred Health Care Group. pp. 82–83. ISBN 0 9596503 1 8.
  17. ^ The Alfred Health Care Group Heritage Committee (1996). Alfred Hospital Faces and Places. The Alfred Health Care Group. p. 101. ISBN 0 9596503 1 8.
  18. ^ The Alfred Health Care Group Heritage Committee (1996). Alfred Hospital Faces and Places. The Alfred Health Care Group. pp. 119–126. ISBN 0 9596503 1 8.
  19. ^ The Alfred Health Care Group Heritage Committee (1996). Alfred Hospital Faces and Places. The Alfred Health Care Group. p. 86. ISBN 0 9596503 1 8.
  20. ^ Andrew, Rod; Barnett, Alf. [1 875657 02 9 In Their Day: Memoirs of Alumni, The Baker Medical Research Institute]. pp. 151–157. {{cite book}}: Check |url= value (help)
  21. ^ https://en.wikipedia.org/wiki/Murray_Esler. {{cite web}}: Missing or empty |title= (help)
  22. ^ http://www.obesityaustralia.org/about-oa-the-board/professor-paul-zimmet-ao. {{cite web}}: Missing or empty |title= (help)
  23. ^ https://en.wikipedia.org/wiki/John_Funder. {{cite web}}: Missing or empty |title= (help)
  24. ^ The Endocrine Society Oral History Collection , PhD, Interview conducted by Michael Chappelle. 4 June 2011.
  25. ^ https://en.wikipedia.org/wiki/John_Funder. {{cite web}}: Missing or empty |title= (help)
  26. ^ "Baker IDI Central Australia".
  27. ^ "National Library of Australia".

Research

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The Baker Institute’s research agenda is based on the notion of a disease continuum from birth to death, with the aim of treating, managing and preventing the progression of disease at any stage. The Institute’s work ranges from cellular and molecular biology research in the laboratory to clinical-based research through to lifestyle and behavioural research that aims to inform prevention strategies.


The Institute’s science strategy and organisation structure contains programs to encourage broad-based, multidisciplinary research to focus on peaks of scientific excellence, and domains to accommodate funding and line management.

The present five programs focus on specific questions that form the basis for the Institute’s work. The Baker Institute’s teams comprising medical specialists, scientists and public health experts are focussed on bringing their knowledge and expertise to bear on these areas:
Metabolism and Inflammation
What is the role of inflammation in the initiation and progression of heart disease, diabetes, chronic kidney disease and heart failure?

Atherothrombosis and Vascular
How can vulnerable plaque be identified and treated?

Diabetes Complications
How can we prevent the progression of diabetes to complications affecting arteries, the heart, the kidneys and the eyes?

Behavioural and Generational Change
What physical activity, diet and other behavioural patterns are optimal at different life stages in preventing diabetes and cardiovascular disease, and how can behavioural and generational change best be addressed?

Hypertension and Cardiac Disease
How can we reverse chronic heart disease, and prevent and repair structural damage to the heart from hypertension, heart disease and associated rhythm disturbances?

The Institute’s domains are based around seven themes.

  • The Prevention domain seeks to slow ageing and prevent progression of these conditions by research informing primary prevention through physical activity, more accurate risk assessment and early-intervention strategies to limit/reverse disease progression.
  • The Cardiometabolic Risk domain aim is to understand diabetes and obesity at the clinical and population levels, and to build the evidence to support specific policy or practice approaches.
  • Aboriginal Health is a national program of research to improve the health of Aboriginal and Torres Strait Islander peoples, with a particular focus on the residents of Central Australia. This domain leads research projects in close collaboration with community stakeholders across remote, regional and urban settings.
  • The Clinical Research domain provides a focal point for the Institute’s interests in human research and clinical-service provision, including governance and planning of clinical trials, clinical-service delivery through the Baker Specialist Clinics, and an increasing interest in diagnostic imaging – including MRI, cardiac echo and ultrasound.
  • The Diabetes domain incorporates basic, translational and clinical research in the field of diabetes, with a particular interest in diabetic complications. The focus is on developing and retesting novel pharmacological approaches to reduce the disease burden.
  • The Vascular Disease domain encompasses teams focused on understanding vascular disease pathologies from pre-symptomatic through to overt disease.
  • The Heart Disease and Neuroscience domain encompasses disorders including heart failure, coronary-artery disease, myocardial infarctions and arrhythmias.

Collaborative partners

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The Institute was a founding partner of the Alfred Medical Research and Education Precinct[1] in 2002, which also includes Alfred Health, Monash University, Burnet Institute, La Trobe University and Deakin University.

The Baker Heart and Diabetes Institute is also a partner of Monash Partners Academic Health Science Centre[2], an Australian health industry, research and educational collaboration. In March 2015, Monash Partners was recognised by the National Health and Medical Research Council as one of four Advanced Health Research and Translation Centres in Australia[3].

The Baker Institute’s longest partnership has been with The Alfred Hospital, which dates back to the Institute’s inception in 1926 on the hospital site. One of the significant developments of this partnership has been the Alfred Baker Medical Unit, which was established in 1949[4] and is the hub of joint research and clinical activity between the two institutions.

References

  1. ^ "Alfred Medical Research and Education Precinct".
  2. ^ "Monash Partners Academic Health Science Centre".
  3. ^ http://www.nhmrc.gov.au/research/nhmrc-advanced-health-research-and-translation-centres. {{cite web}}: Missing or empty |title= (help)
  4. ^ Baker Heart Research Institute Annual Report 2005. State Library of Victoria. p. 17.
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Nucleus Network Alfred Medical Research and Education Precinct Alfred Health Monash Partners Academic Health Science Centre DamienCoup (talk) 04:22, 26 November 2015 (UTC)[reply]

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