$2.9m HRC funding for Otago

Two Otago researchers have been awarded prestigious Sir Charles Hercus Fellowships in this year's Health Research Council Career Development Awards.

Dr Matthew McNeil

Dr Matthew McNeil, of the Department of Microbiology and Immunology, and Dr Nina Dickerhof, of the Department of Pathology and Biomedical Science, Christchurch, have both received about $600,000 for their projects. Theirs were two of 22 successful Otago grants announced today.

In total, Otago researchers have been awarded almost $2.9 million in the awards which help foster the health research workforce in New Zealand.

Dr McNeil's project, for which he received $582,826, looks at the global issue of drug-resistant Mycobacterium tuberculosis (TBM).

“Antimicrobial resistance is a major international public health crisis. Drug-resistant strains of TB are becoming increasingly difficult to treat, with cure rates as low as two per cent,” he says.

“This project aims to understand the metabolic impacts of drug resistance in TB and using this information develop strategies for drastically improving the rate at which antibiotics are able to kill drug-resistant strains. Ultimately, this work aims to reduce treatment times and increase cure rates.”

While TB is the focus of this project, the result will also be significant for combating other bacterial pathogens for which drug resistance is a problem, Dr McNeil says.

Dr Nina Dickerhof

In Christchurch, Dr Dickerhof's project also focusses on a respiratory illness, both chronic and infections, which are among the top three causes of death worldwide.

To address the urgent need to develop innovative antimicrobial therapies, Dr Dickerhof will use the awarded $599,995 to identify the mechanisms by which bacteria defend themselves against oxidants produced by the immune system.

“This research will provide novel insights into how the immune system fights invading pathogens and may reveal new strategies for treating bacterial infections,” she says.

Dr Dickerhof also intends to find markers of oxidative tissue damage that can help identify the presence of inflammation in the lungs.

“These markers will be of considerable benefit to patients with cystic fibrosis and may also prove useful in respiratory diseases, such as chronic obstructive pulmonary disease, pneumonia and COVID-19.”

Deputy Vice-Chancellor (Research and Enterprise) Professor Richard Blaikie says it is always encouraging to see Otago's projects feature strongly in HRC funding rounds.

“It is testament to the important and quality research produced at Otago which has real-life benefits for not just Aotearoa, but the world,” he says.

General Career Development Awards

Sir Charles Hercus Fellowships

Dr Nina Dickerhof, University of Otago, Christchurch, 48 months, $599,995.00

Immune system-derived oxidants in the treatment and diagnosis of respiratory disease

Respiratory illnesses, caused by chronic inflammation or infections, are among the top three causes of death worldwide. Additionally, antibiotic resistance poses an alarming threat to global health as infections become increasingly difficult to treat. Our immune system produces oxidants to fight invading pathogens. In this project we aim to identify the mechanisms by which bacteria defend themselves against oxidants to reveal novel antimicrobial targets. Immune-derived oxidants, if inappropriately produced, also cause chronic inflammation by damaging host tissue. We intend to find markers of oxidative tissue damage that can be measured in urine to better diagnose the presence of inflammation in the lung. We also have compelling evidence that the recurrent respiratory infections in patients with cystic fibrosis may be caused by impaired oxidant production in their neutrophils – the most abundant immune cells. We will investigate whether oxidant production in their neutrophils can be boosted to restore killing of bacteria.

Dr Matthew McNeil, University of Otago, 48 months, $582,826.00

Dysregulating metabolism to eradicate drug-resistant Mycobacterium tuberculosis

Antimicrobial resistance is a major international public health crisis. Central to this problem are drug-resistant strains of Mycobacterium tuberculosis, the causative agent of tuberculosis. Drug-resistant strains of M. tuberculosis are becoming increasingly difficult to treat, with cure rates as low as 2%. Drug resistance in M. tuberculosis is driven exclusively through chromosomal mutations that typically occur in antibiotic targets or pro-drug activators that play crucial roles in core cellular processes. I hypothesize that mutations in core cellular processes have downstream impacts that ultimately dysregulate cellular metabolism in drug resistant strains of M. tuberculosis. Here, using a combination of microbiological, molecular, metabolomic and next-generation sequencing approaches I will characterize and exploit this metabolic dysregulation to develop and entirely new suite of treatment options that rapidly eliminate and prevent the emergence of drug resistance in M. tuberculosis.

Clinical Research Training Fellowships

Charlotte Greer, University of Otago, Christchurch, 36 months, $251,000.00

Novel applications of cardiac CT to enhance assessment of coronary disease

Cardiovascular disease is the leading cause of death in New Zealand. It is important to identify those at risk. In those already diagnosed with heart disease, it is essential to make sure they have the right tests and treatments to improve outcomes. In this fellowship, I will use computed tomography (CT) to look at the link between heart disease and traumatic experiences in childhood - unfortunately common in New Zealand. I will look for early plaque in the heart arteries to identify who may be at risk and may benefit from early treatment. I will also look at CT scans of people's heart arteries with suspected heart attacks. I will look for markers of what type of heart attack they have had to identify those who need further tests or treatments. The final study uses CT to see if a new drug reduces inflammation after a heart attack.

Zara Mansoor, University of Otago, Wellington, 30 months, $245,356.00

Evaluating a parenting intervention for adolescents in mental health services

I am a Clinical Psychologist currently working in the community with a specialty in child and adolescent mental health. After several years in Child Adolescent Mental Health Services (CAMHS), I have enrolled in a PhD with the aims of gaining skills to develop a career combining clinical work and research. I have a particular interest in working to intervene with whanāu/families and my current research proposes to evaluate the impact of a parenting program, Tuning into Teens, being run in local CAMHS. This has the potential to be an effective and efficient intervention, however has not been evaluated in this context. A co-design methodology will inform a pilot RCT. The use of co-design in this setting will provide an additional unique contribution that may inform further research with the aim of developing a career promoting excellence in mental health care for young people in Aotearoa, New Zealand.

Dr Peter McLeod, University of Otago, 36 months, $260,000.00

Pressure reduction in Moderate Aortic Stenosis (PUMAS)

Aortic stenosis (AS) is a progressive disease which leads to build up of calcium in the main valve of the heart, reducing the ability of the heart to function. This increased workload can lead to scarring of the heart muscle which is associated with an increased rate of heart failure and death, even after valve replacement (AVR). There are no medical therapies to slow the progression of AS. Currently the only treatment option is an expensive heart valve replacement which carries significant risk for the individual. This study aims to analyse the effect of common, inexpensive medications on slowing the progression of AS and reducing the workload on the heart. By slowing the progression of AS from an early stage we aim to increase the time to AVR and reduce the potential for scarring of the heart muscle benefiting both the patients with AS and the health system.

Dr Katherine Richards, University of Otago, Christchurch, 48 months, $259,230.00

Finding the fit – Haemodialysis vascular access that meets patient priorities

I am a kidney specialist concurrently completing a clinical research fellowship and a Masters in Epidemiology. I aspire to improving the lives of people living in Aotearoa New Zealand by building research capacity and quality clinical evidence as a clinician-researcher in nephrology. This study will explore the challenging experiences of patients requiring vascular access for haemodialysis. These challenges are associated with lower quality of life, higher healthcare utilisation, and an inequitably higher health burden among Māori and Pasifika and those in regional/rural areas. The project aims to describe who is at highest risk of complications of dialysis vascular access, to inform Aotearoa New Zealand-specific priority patient outcomes, and to design a randomised clinical trial informed by epidemiology and the patients' and whānau voices. This will provide empirical evidence to address a high-burden treatment complication, and to design evaluation trials in partnership with patients, whānau and clinicians in Aotearoa New Zealand.

Dr Alice Rogan, University of Otago, Wellington, 36 months, $146,673.00

Biomarkers and their relationship to traumatic brain injuries – The BRAIN Study

Dr Rogan currently works 0.5FTE as an emergency medicine registrar at Wellington Hospital emergency department (ED) and 0.5FTE as a research fellow at the University of Otago, Wellington. She is enrolled on the PhD programme and her thesis aims to investigate the use of blood biomarkers to improve clinical pathways for adult patients who present to ED with traumatic brain injuries (TBI). TBI are a leading cause of death and disability and common (ED) presentation. TBI incorporates mild (concussion) to severe injuries (brain bleeding or swelling). Doctors must decide who is at risk of more severe injuries and warrants a head CT. This can be difficult, particularly in people with severe concussion or intoxication. This project proposes that blood biomarkers could be used as a screening tool to exclude more severe injuries and support doctors' decision making. This could improve care quality, reduce ED workload and lower CT scanning costs.

Māori Health Research Career Development Awards

Māori Health Summer Studentships – 3 months, $5000

Leon Harris, University of Otago

Kaitiaki experiences of adolescence care following sports injury

This summer research internship is aiming to look at the whanau/caregivers of our tamariki (under 18) who have had a major injury while playing sports (had at least 6 weeks off playing sport and went to ED) in the last three years and went back to playing. We will interview five whānau about the impact of injury on their lives. This project seeks to improve our understanding of the way Māori, especially those in rural areas, view and utilise different forms of healthcare. And how the injury can affect multiple peoples and areas of their lives.

Mieka Taylor, University of Otago

Perceptions of caregivers of Māori children attending Māori centred childcare

Māori children have been reported to be more likely than non-Māori children to have experienced unmet needs for primary healthcare and a lack of culturally competent care contributes to health inequities. Physiotherapists play an important role in early childhood paediatric healthcare in a variety of settings and can offer support and education to caregivers for their child's development. This study seeks to identify key cultural values for Māori families in the early childhood service they engage with via qualitative semi-structured interviews. This information may be applied to physiotherapy supported playgroups and/or paediatric healthcare to improve engagement with Māori whanau, improve cultural responsiveness of physiotherapy services and contribute to better support for Māori and Pasifika children and their caregivers.

Tali Wilson-Munday, University of Otago

Implementation of Tikanga Māori into clinical practice by Physiotherapy graduate

The purpose of this research project is to investigate the implementation of Tikanga Māori practices in physiotherapy. Acknowledging the challenges that are being faced and recognising that Mātauranga Māori can be applied in a clinical setting will be the main basis for this research.

Māori Health Masters Scholarships

Elisabeth Dacker, University of Otago, 12 months, $31,600.00

The effects of urinary incontinence on Māori women's health and wellbeing

Urinary incontinence is a global health problem which affects approximately one third of women in their lifetimes. It is an embarrassing condition associated with poor quality of life and other negative health outcomes. One small study in 1994 suggests prevalence is significantly higher in Māori women, affecting nearly half. Despite the gravity of this statistic there has been no further research on urinary incontinence in this demographic. It is well documented that Māori woman additionally have a higher prevalence of other comorbidities, such as obesity and diabetes. Through Kaupapa Māori and grounded theory methodology this qualitative study aims to explore the impact of urinary incontinence on Māori women's health and wellbeing.

Grace Davies, University of Otago, 24 months, $32,400.00

Māori attitudes towards vaccination in Aotearoa New Zealand

Māori immunisation rates are significantly lower than non-Maori immunisation rates throughout Aotearoa in both COVID-19 and childhood immunisation rates. The disparities and rates between Māori and non-Māori are only going to increase. It is clear from these rates that current immunisation programmes and strategies are not beneficial for Māori, and as health workers it is vital that we understand why so we can alter/adapt our immunisation programmes and strategies to work for Māori. In this proposed research project, we will be exploring Māori attitudes across all ages towards vaccinations in Aotearoa, in particular Māori living in a Māori pa community in Porirua, Wellington. A literature review and focus groups will be conducted with residents of the Takapuwahia pa community in Porirua, where the results will be used to make recommendations regarding future immunisation campaigns, services and strategies throughout Aotearoa.

Māori Health PhD Scholarships

Callum August, University of Otago, 36 months, $131,850.00

Combatting Mate Kohi (Tuberculosis) on the home front

Mate Kohi (Tuberculosis/TB) is a significant disease worldwide, which has been almost eliminated from New Zealand. Here in Aotearoa, TB infects Māori at a rate 6 times higher than Europeans. My research is focused on decreasing these inequalities in Aotearoa. To ensure equitable health outcomes, what causes the increased burden of TB in Maori communities must be understood. My proposed research will investigate bacterial genetic factors in the Mycobacterium tuberculosis (Mtb) Rangipo strain to identify if this strain is more virulent than other strains. I will refine the origins and common ancestors of this endemic strain to understand how this strain was dispersed and is maintained among Maori communities, to improve strategies for TB control. I will also engage with Maori communities to identify socio-cultural factors that result in TB transmission. This research will link the laboratory with the community to improve health outcomes in our communities.

Maori Health Clinical Training Fellowships

Cara Meredith, University of Otago, Christchurch, 36 months, $263,405.00

Kaupapa Māori approaches to maternal mental health

In Aotearoa, mental health statistics for Māori wāhine highlight disparities in both engagement and outcomes. Māori wāhine experience higher rates of depression, anxiety, substance abuse and maternal suicide. Urgent recommendations from the He Ara Oranga report, the Perinatal and Maternal Mortality Committee and working group for maternal mental health include improvement of services to ensure they are culturally appropriate and responsive to wāhine Māori, the development of culturally appropriate maternal mental health screening tools and treatment, and that health investment prioritise populations that would benefit most such as ngā māmā Māori. This research will investigate the experiences of Māori whānau of maternal mental health distress and explore how kaupapa Māori approaches and practices can improve maternal mental health outcomes for Māori māmā. A secondary aim of this research will be to develop an Indigenous screening and assessment tool specific to Māori maternal mental health.

Pacific Health Research Career Development Awards

Pacific Health Summer Studentship – 3 months, $5,000

Caitlin Bland, University of Otago, Christchurch

Audit of implementation of single-dose rifampicin chemoprophylaxis for leprosy

Control and elimination of leprosy is a major goal identified in the Strategic Plan published by the Kiribati Ministry of Health (MoH). A chemoprophylaxis programme was established in 2018 by the Pacific Leprosy Foundation with the MoH in response to the increasing incidence between 2013 and 2017. Single-Dose Rifampicin (SDR) prophylaxis for household members of those suffering from leprosy was introduced in 2018. This research will analyse the difference between leprosy in Kiribati before and after SDR prophylaxis was introduced. The aim of this project is to evaluate its coverage and acceptability before the ambitious second phase of mass chemoprophylaxis. A report will be provided to the MoH in Kiribati and may identify gaps in implementation that may need to be addressed to achieve health targets. The ability to publish this data will also help guide future public health research initiatives.

Peyton Fields, University of Otago

Natural products of Samoan medicinal plants

The overall objective of this summer project is to use a range of analytical techniques to chemically profile selected Samoan medicinal plants, and then to isolate bioactive compounds. This work is important not only in discovering new bioactive agents for treating diseases, but also in improving awareness of the efficacy and, more importantly, the safety of Samoan medicinal plants. The studies involved in this project have the potential to contribute to Samoa's economy through the generation of value-added products, such as plant-based health products, environmentally friendly pesticides, or growth regulators. A range of techniques are employed to get the best possible representation of the chemical composition of an extract before targeting compounds for isolation.

Fetuoleaniva Hunkin, University of Otago

Mai Mana – A Pacific Resilience Project

A study assessing those resilience factors that enabled our Pasifika communities to flourish in the face of adversity during and post-COVID 19 lockdown periods.

Julia Kayes, University of Otago, Christchurch

The breath of a mother: A review of Te Hā Waitaha smokefree pregnancy incentive

This involves evaluating the performance of a pregnancy incentive programme conducted by the Canterbury District Health Board via the Smokefree provider Te Ha Waitaha. It focuses on the long-term effect of this programme on smoking cessation, which has been offered since 2017. The programme has previously succeeded in engaging Māori and Pacific Islander smokers. This research would focus on the success in the long term. The participants involved in the programme are offered motivational support and vouchers to the total value of $280 throughout their pregnancy. This study would use a telephone survey of participants who were Smokefree at birth, to gather data on self-reporting Smokefree status at one year and up to five years after the programme/birth. I will also be asking participants if they are willing to participate in focus groups for future studies to explore other ways to improve the support available in this area.

Aislinn Reid, University of Otago

Medicine storage

I will be looking at medication storage within seven Pacific families located in Dunedin and Porirua. This will be part of a larger project called 'Access to medicines: Exploring lived experience to inform policies and programmes', led by Professor Pauline Norris at Va'a o Tautai, University of Otago. I will look into the understanding that these families have of how to keep their medication, what information they are told by their health professionals, and what information that may be lacking.

Pacific Health Masters Scholarship

Dr Letava Tafuna'i, University of Otago, 24 months, $31,800

Knowledge, attitudes and practices of Samoans towards the COVID-19 vaccine

With the current coronavirus disease 2019 pandemic claiming over 4 million deaths worldwide, devastating every aspect of society, to date there is still no definitive therapy. Vaccines are one of our most important health measures and critical in achieving stability and a new normality. Pacific people in New Zealand are at high risk of severe adverse outcomes due not only to socioeconomic factors and high chronic disease burden, but structural inequities in our health system, to name a few. With the recent measles epidemic in Samoa, which claimed 83 (documented) lives mostly due to a low vaccination rate for the measles vaccine, this research aims to explore the current knowledge, attitudes and practices of Samoans and Samoan health workers in New Zealand and in Samoa to aid in effective vaccine efficacy, and serve as a precursor to good pharmacovigilance support to this community.

Pacific Health PhD Scholarship

Joanna Minster, University of Otago, Wellington, 36 months, $133,088

Mental wellbeing, identity, and sense of belonging in Pacific peoples

This project will investigate the relationship between mental wellbeing, identity, and sense of belonging in Pacific peoples through a public health and psychological medicine lens. A mixed-methods approach will be used to explore mental wellbeing and sense of belonging in two overlapping groups: (1) Pacific peoples born in New Zealand ('NZ-born Pacific'), and (2) Pacific peoples identifying with more than one ethnic group ('multi-ethnic Pacific'). National data from the New Zealand Health Survey and the New Zealand General Social Survey will be analysed. Interviews with New Zealand-born and multi-ethnic Cook Islands Māori participants will then explore their sense of belonging in Pacific spaces, and how they believe this influences their mental wellbeing. The interview research processes will use a community-based participatory research methodology. The project will be supported by a panel of Cook Islands community representatives and will generate knowledge that contributes towards improving Pacific mental health outcomes in New Zealand.

Pacific Health Clinical Training Fellowship

Oka Sanerivi, University of Otago, 28 months, $202,900

Culturally responsive physiotherapy approaches to working with Pacific families

This study explores the cultural knowledge, specifically pertaining to health, of Samoan families and physiotherapists living across Aotearoa New Zealand and Samoa. This knowledge will be gleaned through Talanoa interviews with participants in person or via web-conferencing platforms (Zoom app). The themes from the interviews will be analysed using the Kakala methodology and synthesised to construct a clinical practice guideline or model of care. This guideline will then be presented to the key physiotherapy professional bodies in Aotearoa for feedback via focus groups. Information from the participant interviews and the focus groups will be integrated to finalise the guideline that will then be widely disseminated through the key professional organisations. A specific focus of the dissemination of the findings will be to inform the position of the Physiotherapy Board of New Zealand on physiotherapy service provision for Pacific peoples in Aotearoa.

For further information, please contact: