$3.8 million to Otago researchers in Career Development Awards

The Health Research Council has awarded 23 University of Otago researchers $3.8 million in Career Development Awards.

Three scientists carrying out research aiming to find new ways of treating cancer have received the prestigious Sir Charles Hercus Health Research Fellowships worth almost $1.8 million. While a number of Māori and Pacific Health Development Awards have been shared among both staff and students.

The awards help foster the health research workforce in New Zealand, in keeping with the Health Research Council's commitment to building capacity and capability within the research community.

In total, the University of Otago receives $2.95 million for Career Development Awards, $604,153 for Pacific and $239,927 for Māori Health Career Development Awards. Nationally, the Health Research Council distributed $9.7 million for Career Development Awards, $2.9 million for Pacific and $837,000 for Māori.

Deputy Vice-Chancellor (Research and Enterprise) Professor Richard Blaikie says the University is delighted to receive this support from the Health Research Council.

“It helps the next generation of outstanding researchers and research leaders develop their careers with us.”

2020 Career Development Awards (General)

Sir Charles Hercus Health Research Fellowship

Dr Nicholas Fleming

Dr Nicholas Fleming, University of Otago
Rational extension of immunotherapy in colorectal cancer.
48 months, $600,000

A new class of cancer drugs called the immune checkpoint inhibitors (ICIs) (eg, Keytruda) are making a transformative impact on the treatment of cancers, including bowel cancer. However, evidence suggests they will only work for a subset of patients unless better predictive biomarkers and cooperating drugs are identified. In a recent research programme, Dr Fleming has identified two robust and accessible markers for bowel cancer that correlate with disease progression, and which are expected to predict response to ICIs. Moreover, the markers identify a further potential drug class that may increase the effectiveness of ICI therapy. He aims to clarify the mechanism of the biomarkers, test the proposed combination therapy using disease models, and drive their potential translation to the clinic. The aim is to expand the utility of ICIs to a larger number of bowel cancer patients.

Christoph Goebl

Dr Christoph Goebl, University of Otago, Christchurch
Understanding the role of the aryl hydrocarbon receptor in cancer
48 months, $587,351.00

Cancer is the largest cause of death in New Zealand and is very often treated by chemotherapy. Unfortunately, this treatment method kills cells throughout the entire body, often has a low success rate and a large number of severe side-effects, such as sterility. Therefore, more cancer-specific therapies are needed; a better understanding of the underlying tumour biology is essential for development for these so-called targeted therapies. Dr Goebl's team recently discovered that the protein AhR is a major contributor to tumour formation, however, the underlying mechanism is totally unclear. In this project, they will elucidate the contribution of AhR to tumour growth by investigating the molecular mechanism of action. The understanding of this pathway can be used to increase the efficiency of targeted tumour therapies.

Dr Rachel Purcell

Dr Rachel Purcell, University of Otago, Christchurch
Molecular mechanisms and the gut microbiome in CRC
48 months, $598,972

New Zealand has one of the highest rates of colorectal cancer in the world, with poorer outcomes in Māori and Pacific peoples. This study will investigate the link between the microorganisms living in our gut (the microbiome) and the vital host mechanisms involved in colorectal cancer development. It will use a combination of nucleic acid sequencing of patient tissue cohorts and in vitro mechanistic studies to investigate the microbiome and host molecular interactions that contribute to the development of this cancer, and response to therapy in the treatment. The outcomes of this study will lead to the development of more sensitive early detection of colorectal cancer, and microbiome-based predictive tests that will improve stratification of patients for treatment. This research programme will ultimately lead to a decrease in incidence and improved survival for patients in New Zealand, reducing inequity for Māori and Pacific people.

Clinical Research Training Fellowship

Ms Louise Fangupo, University of Otago
Does a sleep intervention reduce weight gain in infancy? A novel approach
36 months, $320,000

Ms Fangupo is a New Zealand Registered Dietitian in a rural hospital where she regularly receives referrals for overweight children. Improving sleep in infants has been shown to substantially reduce the risk of child obesity, but in predominantly European populations. Māori and Pasifika expertise on sleep and wellbeing will be woven with scientific knowledge and a novel research technique to develop a sleep toolkit that Well Child providers and other health professionals can use to improve sleep, reduce excessive weight gain, support communication and connectedness, and improve the wellbeing of tamariki and whānau.

Dr Amanda Landers, University of Otago, Christchurch
Evaluating a model of care for patients with COPD in their last year of life
36 months, $319,850

Only 2–9 per cent of patients with chronic obstructive pulmonary disease (COPD) ever receive the benefit of specialist palliative care. In previous research, people with severe COPD identified six milestones that occur in a cumulative way as they get closer to death. These are loss of recreation, changes to the home environment, episodic acute care, long-term oxygen treatment, panic attacks, and difficulties with self-care. These milestones may represent opportunities to change the focus of care and plan future management. This research will evaluate the perspectives and preferences of patients, carers and members of the healthcare team involved in the care of people with advanced COPD using the six milestones. The aim is to develop a detailed, integrated and resource efficient model of care which enables positive experiences for all people with COPD in their last year of life.

Dr Matt Richardson, University of Otago
Nocebo Hypothesis Cognitive Behavioural Therapy (NH-CBT): an RCT
36 months, $320,000

NH-CBT is a treatment protocol for functional neurological symptoms. It involves transparently sharing with the patient the hypothesis that functional neurological symptoms are the result of a nocebo effect. Typically, the person then undertakes behavioural experiments that varies their attention to their symptoms, with immediate video feedback given. This usually allows the person to witness themselves functioning better, undermining their belief that they are (neurologically) damaged, thus reducing the nocebo effect and reducing symptoms. This treatment saw 93 per cent of patients achieve full symptom remission in a consecutive case series published in 2018. It is hoped that a randomised controlled trial will show similar treatment success. If achieved, this would be very likely to surpass the current "best evidence" treatment, in terms of its effectiveness.

Mrs Sarah Walker, University of Otago
Supporting Allied Health Professionals in Rural Areas
36 months, $204,586

Rural healthcare is recognised as having unique complexities and challenges. In New Zealand, residents of rural towns have overall higher levels of socio-economic deprivation, higher avoidable and amenable mortality rates, and poorer access to health services. Māori are more likely than non-Māori to live in rural areas. Allied health professionals provide efficient and cost-effective health services to communities, resulting in improved health outcomes. A better understanding of their scope of practice, the challenges they face and the attributes and skills needed to reach the full potential of their roles in the rural context, will inform rural healthcare delivery, health professional training and, and government policy. There may be significant opportunity to improve recruitment and retention in rural areas by developing rural training pathways. This project will help ensure that New Zealand rural communities benefit from the right mix of skilled health professionals to best meet their health care needs.

2020 Māori Health Career Development Awards

Māori Health Research PhD Scholarship

Miss Lisa Kremer, University of Otago
Microdrop administration of phenylephrine and cyclopentolate in neonates
36 months, $74,927

Very premature babies are at high-risk for many health issues including permanent blindness associated with retinopathy of prematurity. Because of the risk of blindness, routine eye tests are performed to determine the presence and severity of this condition. Screening requires the use of pupil dilating medications which are associated with a host of side-effects including increased blood pressure and apnoea. This study could answer important questions as to the effectiveness and safety of low dose and very low dose microdrop regimens when screening premature babies. This research has the potential to inform guidelines both here and internationally, which would represent a significant impact on health outcomes for vulnerable babies.

Miss Georgia McCarty, University of Otago
Hauora Rangatahi Māori: Appropriateness and acceptability of health measures
36 months, $135,000

An early career Māori health researcher in the Ngāi Tahu Māori Health Research Unit, University of Otago. This study will utilise qualitative methods underpinned by kaupapa Māori principles to conduct a scoping review of the advantages and disadvantages of existing youth HRQoL measures for rangatahi Māori. Acceptability and feasibility of existing youth HRQoL measures will be investigated through wānanga and think aloud sessions with Māori rangatahi and their whānau. Findings will be analysed, synthesised and interpreted. The valuation of health states is of public health significance in NZ. Adapting or creating a health measure specifically for Māori rangatahi and understanding the HRQoL preferences of Māori, will contribute to knowledge and improve the efficiency of health funding decision-making, and help to reduce health disparities for Māori.

Maori Health Research Development Grant

Ms Carmen Timu-Parata, University of Otago, Wellington
Breastfeeding support for whānau Māori: The Northland experience
12 months, $10,000

Breastfeeding plays a crucial role in strengthening immunity, physical and psychological development of the infant. National exclusive breastfeeding rates are decreasing and there is an urgent need for effective Māori-specific interventions to address lower rates in Māori that are contributing to health inequities. Māori in the Northland area have maintained high exclusive breastfeeding rates since 2012, an impressive outcome that contrasts with the national trend. The nurse researcher applicant has an interest in Māori communities and breastfeeding and proposes to use a qualitative kaupapa Māori approach. The key objective of the research project is to explore the client/whānau journey through breastfeeding support from Lead Maternity Carers, maternity, Well Child Tamariki Ora to whānau/family support. This project represents an exciting opportunity to co-design a “whānau ora” approach for breastfeeding with Northland iwi and to learn what they have to share about this experience.

Maori Health Research Summer Studentship

Ms Julia Law, University of Otago
Student health professionals' understanding of tāngata whaikaha Māori concepts
2 months, $5,000

In Aotearoa 24 per cent of the general population and 26 per cent of Māori self reported as disabled in 2013. When adjusted for age, the rate of Māori disability is 32 per cent with many experiencing inequities in accessing funding for equipment and care. Initiatives to address the under-representation of Māori health professionals and purposeful inclusion of Māori framework content within health professional curriculums has occurred in tertiary institutions. However, research identifying knowledge of Māori disability concepts in student health professionals is lacking. The results may provide useful recommendations for health professional education and complimentary findings to the HRC project: Te Ao Mārama: Disability perspectives of tāngata whaikaha Māori.

Miss Denver Ruwhiu, University of Otago, Wellington
Conflicts of professionalism in medical curricula with Māori tīkanga and values
3 months, $5,000

All healthcare providers are held to a high standard and expectation of how they are to treat patients and conduct themselves. For doctors, this is called the 'Code of professional conduct'. In medical school, students training to become doctors are taught what this looks like in the workforce. In the same curriculum, students are expected to treat patients with cultural sensitivity and competence. This research project explores the ideas of Māori medical students studying at the University of Otago, when this idea of 'professional conduct' comes into conflict with Māori beliefs, traditions and values. Some examples of this conflict include doctors having tāmoko (traditional tattoos), strict time constraints for treating patients, dress codes, and regulations regarding gift giving and the treatment of closely-related family members.

Ms Rian Sanerive, University of Otago
Use of online technology for effective wellness and exercise programme delivery
2 months, $5,000

An examination of all the potential media devices that could be used to deliver exercise and wellness programmes. Literature published after 2005 that have a focus on physiotherapy, Māori Health and computer science will be researched. The main objective is to determine the technology that is most effective at providing exercise and wellness programmes for the Māori population. Given the current status of the overall Māori health, it is a significant and urgent matter to be addressed.

Mr Ben Shine, University of Otago
Positive youth development in Māori youth through an adventure education programme
3 months, $5,000

The focus of the current study are the youth that take part in the seven-day youth development voyages run on the R. Tucker Thompson, a traditional gaff-rigged schooner based in the Bay of Islands. The voyages draw youth exclusively from Northland, an area characterised by a large Māori population and a number of low socio-economic indicators. Previously, it has been shown that youth who take part in these voyages display increases in a number of positive youth development outcomes, including resilience and self-esteem. The aim of the current study is to move beyond these quantitative approaches and conduct a qualitative study.

2020 Pacific Health Career Development Awards

Sir Thomas Davis Te Patu Kite Rangi Ariki Health Research Fellowship

Dr Jesse Kokaua, University of Otago, Wellington
Lighted paths: Education and pathways to better health for Pacific families
24 months, $256,775

Leveraging off the work previously funded in an HRC-funded Pacific post-doctoral study which was able to investigate associations between years of parental education at one point in time and comparatively high-level health conditions. This proposed piece of work will seek to use the longitudinal nature of the Integrated Data Infrastructure (IDI) to investigate further the associations between education on the health burden of Pacific families. Also the pathway for a Pacific family to progress from one state at one point in time to another state ten years later. Thus for example how did Pacific families with generally good health outcomes today look ten years ago. In particular what contributed to families considered to have fewer opportunities to continue to comparatively successful health outcomes over time and did education play a part in that progression.

Pacific Health Research PhD Scholarship

Mrs Amy Henry, University of Otago, Christchurch
Health and the Ta'unga: Cook Island palliative health knowledge in New Zealand
36 months, $134,921

The aim of the proposed study is to explore the beliefs and understanding of palliative care of Cook Island peoples in New Zealand from an indigenous Cook Island perspective. The Cook Island people hold knowledge passed down from the tupuna which supports community-based practices to support the family and community during palliative and end of life care. Indigenous knowledge of health and wellbeing is at risk of universal models of health and globalisation and at risk of being lost. As the majority of Cook Islanders live outside of the Islands this knowledge is important for generations of Cook Islanders born outside of the Cook Islands or outside of traditional Cook Island communities. The underlying objectives are to explore traditional models of palliative health to understand what is important to Cook Island people in New Zealand when receiving palliative services or when caring for a family member.

Miss Albany Lucas, University of Otago, Wellington
Sleep, health, communication, and wellbeing for Pacific children and families
36 months, $132,661

The aims of this research is to design potential sleep toolkit components in partnership with Pacific families, communities and stakeholders that incorporate relevant Pacific cultural values and traditions and to use the multiphase optimisation strategy – a novel experimental design – to determine which potential intervention components are effective for Pacific families. Other team members will develop similar conceptual models for Māori and non-Māori/non-Pacific populations that might have different components mediators and outcomes. They will then work together to determine whether the models are able to be integrated or whether some differentiation is required. Potentially suitable components for an intervention toolkit that aim to change the sleep behaviours of children in New Zealand will be selected.

Pacific Health Research Masters Scholarship

Ms Tutangi Amataiti, University of Otago, Wellington
Improving adherence to a reduced carb diet for women with gestational diabetes
12 months, $30,951

Gestational diabetes imposes an inequitable disease burden for Māori and Pacific Island women and their newborns. The higher rates of overweight and obesity in this population increases the risk of developing gestational diabetes and this increases the risk of developing type 2 diabetes for women post-partum and in their offspring. Limiting excessive weight gain during gestational diabetes is likely to improve these health outcomes and could be achieved by following a reduced carbohydrate diet. Social determinants can impact health outcomes and need to be considered with adherence to nutrition interventions. Reduced carbohydrate diets can be more costly and this could impact adherence to the diet. This study aims to investigate if providing fruit and vegetables to the participant at no cost would increase adherence to follow a reduced carbohydrate diet in gestational diabetes and whether the micronutrient intake is maintained when following a reduced carbohydrate diet.

Miss Tilda Leleai, University of Otago
Pacific and Māori populations undergoing cardiac surgery in the SDHB region.
12 months, $28,845

Cardiovascular disease is a leading cause of death in New Zealand with the burden falling heavily on New Zealand Pacific. HeartOtago collects heart tissue samples from Southern District Health Board (SDHB) resident patients undergoing cardiac surgery at the Dunedin Hospital. Upon retrospective analysis of the HeartOtago study it was found that Pacific patients were underrepresented compared to the percentage of Pacific people in the SDHB catchment area from the New Zealand census data. The project aims to determine how Pacific patients differ from other ethnic groups in terms of cardiovascular disease.

Pacific Health Research Knowledge Translation Grant

Dr Dianne Sika-Paotonu, University of Otago, Wellington
Towards a new penicillin for rheumatic fever prevention
6 months, $5,000

Acute Rheumatic Fever is an autoimmune condition caused by untreated group A streptococcal infection of the throat and possibly skin. Multiple or severe attacks can cause permanent heart damage known as Rheumatic Heart Disease. This remains a major cause of morbidity and mortality worldwide. It is recognised that Māori and Pacific children and youth remain disproportionately affected by both. The purpose of this work is to host two Knowledge Translation events focused on connecting and engaging with Pacific communities to support, disseminate and share research work and findings of direct relevance and importance to Pacific people in this field.

Pacific Health Research Summer Studentship

Miss Fuatino Heath, University of Otago, Wellington
Global Health Classroom as a tool for global child health learning
3 months, $5,000

The Global Health Classroom is a tool for global health learning where medical students in different countries can collaboratively learn about each other's health systems cultures and determinants of health via videoconference. Since 2017, there have been regular sessions between medical students at the National University of Samoa and the University of Otago. In 2018 data was collected to explore the learning outcomes particularly regarding global child health and experiences of Samoan and New Zealand medical students involved. This project aims to analyse this data to determine its effectiveness for global child health learning.

Ms Leilani Pereira, University of Otago, Wellington
Exploring appropriate ways to recruit Pacific people into research
3 months, $5,000

This summer studentship involves reviewing literature on how to ensure that Pacific people are recruited into research studies and work alongside the team carrying out a randomised controlled trial of prescription charges. Many Pacific people struggle to afford their medicines and so it is important that their experience is reflected in the trial. Based on the literature review, Ms Pereira will work with a designer to develop culturally appropriate advertising material and with the support of supervisors explore ways to ensure Pacific people are included.

Miss Ruby Tukia, University of Otago, Wellington
Oral health of elderly Pacific people among New Zealand nursing home residents
3 months, $5,000

In New Zealand, recent studies have shown poorer oral health outcomes for elderly Pacific Island people aged 65 and over compared to the wider population. Oral health issues may include higher levels of untreated decay and missing teeth more dental treatments and poorer self-reported overall oral health. Poorer oral health outcomes may also influence co-morbidities including cardiovascular disease and obesity. While the majority of older Pacific people in New Zealand live in their own homes they are also entering into aged residential care in greater numbers than ever before. It may continue to burden the health budget if the New Zealand health system is not prepared to meet their oral health needs. Thus this project aims to collate the existing research about the oral health status of elderly Pacific people aged 65 years and over in New Zealand nursing home residents.

For further information, contact:

Liane Topham-Kindley
Senior Communications Adviser
Tel +64 3 479 9065
Mob +64 21 279 9065
Email liane.topham-kindley@otago.ac.nz