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Monday 28 November 2022 2:28pm

From a global health crisis to Aotearoa's health inequity – University of Otago projects awarded Health Research Council funding will benefit those at home and around the world.

Nineteen Otago researchers and students have been granted a total of $3,792,410 in the latest Career Development Awards, which include general, Māori and Pacific awards.

These awards help launch research careers through a wide range of master's and PhD scholarships and help develop research leaders through advanced postdoctoral fellowships. They also support frontline clinicians to undertake research that will improve the health and wellbeing of New Zealanders, while addressing critical gaps in the research workforce.

Dr Simon Jackson, of the Department of Microbiology and Immunology, has been granted almost $600,000 with a Sir Charles Hercus Fellowship to help find a solution to a problem affecting the world – antimicrobial resistance.

“The rapid spread of antimicrobial resistance (AMR) in bacterial pathogens is driving a major global health crisis and we urgently need new treatments for clinical infections,” Dr Jackson explains.

The use of bacterial viruses, called bacteriophages, or phages, as precision antimicrobials to kill bacterial pathogens, is a promising approach to address the AMR crisis, he says.

“Since their discovery over 100 years ago, phages have been explored for their use as therapeutic agents. However, the discovery and pursuit of antibiotics led to a historic side-lining of phage therapy. The rise of AMR is now driving a global renaissance in the phage therapy field.”

A major challenge facing modern phage therapy is in finding the right phages to use against specific pathogen strains. Dr Jackson's research aims to solve this problem using a genomics-led approach to predict which phages should be used to treat particular infections.

“Part of the challenge in finding phages to kill specific bacteria strains is that bacteria possess immune systems to protect themselves from phage infections – similar to how our immune systems protect us from viruses,” Dr Jackson explains.

“Understanding how theses immune systems sense and respond to phage infections is the central theme of this project. A major strength of my research programme is in combining bioinformatics and computational biology approaches with wet-lab experiments,” he says.

“We are also looking at how phages can evolve to evade triggering bacterial immune systems, potentially leading to phages that have more widespread clinical applicability.”

Although the project is primarily research-based, Dr Jackson and his team are keen to support future applications of phage-based treatments for patients in Aotearoa.

“As part of this, the project includes establishing an integrated research and educational outreach programme, where students isolate and characterise new phages that might one day be used to treat patients.”

Thirteen staff and students received funding specifically for Māori or Pacific health research – the majority of which have a purpose of improving the quality of life for those populations and addressing the inequity gap in the health system.

Those projects include one by student Emily Bain, who will focus on the inequity of Aotearoa's Needs Assessment and Co-ordination centre, third year biomedical sciences student Flynn Macredie's project will seek interventions to improve maternal immunisation coverage, and Beatrice Hessell is concentrating on Pacific workplace wellbeing.

However, it is not just those 13 projects focusing on health inequities; Dr Thomas Wilkinson, of Christchurch, has been granted $260,000 for a Clinical Research Training Fellowship to investigate an “artificial pancreas” that combines a glucose monitor and insulin pump with a computer program, to treat diabetes. He is particularly focused on “open source” technology that minimises cost, therefore helping to closing the ethnic and socioeconomic outcome gaps.

Dr Christina Cleghorn, of Wellington, will use her $600,000 Sir Charles Hercus Fellowship to provide evidence to encourage changes in nutrition policy. This has the potential of reducing chronic disease health inequities.

University of Otago Deputy-Vice-Chancellor Research and Enterprise Professor Richard Blaikie congratulates the recipients on their success.

“The range of topics that will be explored by Otago students and staff will have significant health impacts and benefits in Aotearoa and globally,” Professor Blaikie says.

“It is always particularly pleasing to see so many students and emerging researchers recognised by the Health Research Council.”

2022 Career Development Awards

Sir Charles Hercus Fellowship

Dr Cristina Cleghorn, University of Otago, Wellington

Cristina Cleghorn 2022 imageModelling the health and equity impacts of a range of dietary policies in NZ
48 months, $600,000.00

Dr Cleghorn has been modelling the potential health and equity impacts of dietary policy in NZ since 2014. The research outlined in this Fellowship uses the World Cancer Research Fund's NOURISHING framework, alongside NZ-specific criteria, to select a variety of dietary policies to model. It improves modelling methods and estimates the impact these policies could have on chronic disease incidence in NZ. It goes on to pilot how this research can best be disseminated to increase understanding of modelling results and their uptake by policy makers. Providing evidence to encourage changes in nutrition policy has the potential to reduce chronic disease in NZ and health inequities between Māori and non-Māori.

Dr Matthias Fellner, University of Otago

Matthias Fellner 2022 imageDevelopment of diagnostic fluorescence and ultrasound probes for S. aureus
72 months, $599,612.00

Staphylococcus aureus is a human pathogen that is a major cause of chronic infections in New Zealand and around the globe. Due to the presence of its unique biomolecular matrix (a biofilm), infections like bacteraemia, pneumonia, or endocarditis are difficult to treat. A specific diagnostic probe for any infected tissue would enable imaging of the location and the extent of active infection. Such a diagnosis would greatly improve the management of the most life-threatening complications of S. aureus internal infections and aid treatments for those infections requiring immediate surgery. This research will enable the development of such imaging agents by targeting biofilm-associated proteins, providing more effective diagnostic options for S. aureus chronic biofilm-based infections. The long-term benefits are significant improvements of health and wellbeing of individuals and populations in New Zealand and world-wide.

Dr Simon Jackson, University of Otago

Simon Jackson 2022 imageA genomics-led approach to bacteriophage therapies for infectious disease
48 months, $596,423.00

With the rise of antimicrobial resistance (AMR) in bacterial pathogens, we urgently need to find alternatives to traditional antibiotics. Using viruses that specifically infect bacteria (known as bacteriophages or phages), is an emerging approach to treat AMR infections, termed phage therapy. A major barrier to the widespread future success of phage therapy is that closely related pathogen isolates typically differ vastly in their phage susceptibility profiles – highlighted by several recent clinical applications of phages that required screening thousands of phage candidates. This research aims to understand the genetic basis for the complex interactions between phages and bacteria, focusing on anti-viral immune systems encoded by bacteria and phage-encoded anti-immunity factors. Combining cutting edge computational and lab-based research with an integrated educational outreach programme, the long-term vision is developing a framework for a genomics-led approach to the future of rapid, cost-effective, and accessible phage therapy in Aotearoa and globally.

Clinical Research Training Fellowship

Dr Florence de Roo, University of Otago

Investigating fibroblast influence on the gastric cancer microenvironment
36 months, $260,000.00

Gastric cancer is more than one disease, having two main subtypes that show markedly different appearances microscopically, yet it is treated as one disease. New Zealand has unique gastric cancer epidemiology, with Māori being one of the few populations that have a higher incidence of the subtype of gastric cancer that shows poorer outcomes and resistance to commonly used treatments. The researchers have identified a protein complex which has known roles in signalling to the immune system that impacts survival from different types of gastric cancer in different ways. Like most solid cancers, gastric cancer is made of more than just “cancer cells”, and includes supportive stromal cells such as fibroblasts and immune cells. This project will investigate whether fibroblasts in the tumour microenvironment are influencing survival from gastric cancer through expression of this protein complex, aiming to identify a new avenue for treatment to improve outcomes from gastric cancer.

Mrs Grace Griffiths, University of Otago, Christchurch

Experiences of people receiving therapy for Complex Regional Pain Syndrome
24 months, $171,990.00

Complex Regional Pain Syndrome is a severe chronic pain condition which most commonly affects the arm and hand. It is a challenge to diagnose and treat. Delays to diagnosis and treatment have serious negative effects on prognosis and quality of life. This research uses a mixed methods approach to explore peoples' lived experiences of the journey to diagnosis and treatment in New Zealand. Mrs Griffiths aims to provide clinicians with recommendations for a management pathway based on these, to improve timely and appropriate care which is centred on the needs and priorities of people receiving healthcare.

Dr Thomas Wilkinson, University of Otago, Christchurch

Assessment of fully automated insulin delivery technology in diabetes
36 months, $260,000.00

Diabetes is a complex chronic condition. Good control prevents complications, however the current need for frequent fingerprick tests and insulin injections (requiring day-to-day planning) significantly impairs quality of life. Diabetes complications are a major driver of ethnic disparity in Aotearoa, with the burden falling predominantly on Māori and Pasifika. This research will investigate an “artificial pancreas” that combines a glucose monitor and insulin pump with a computer program, to treat diabetes. Dr Wilkinson is particularly focused on “open source” technology that minimises cost. This technology has potential to revolutionise diabetes management, improving control and quality of life. Benefits are likely to be greatest in people with suboptimal control, therefore there is a realistic possibility of closing ethnic and socioeconomic outcome gaps.

2022 Māori Health Career Development Awards

Māori Health PhD Scholarship

Miss Emily Bain, University of Otago

The inequities of the NASC system in Aotearoa and the experience of Māori whānau
36 months, $138,800.00

It is well established that there are significant problems in Aotearoa New Zealand's Health and disability system, especially for Māori – largely due to the cultural differences between Māori and the biomedical system the New Zealand health system was modelled on. In Aotearoa, disability funding is determined via the Needs Assessment and Co-ordination (NASC) agencies. These agencies are located around the country and are the agencies which determine the amount of funding a whānau can receive for disability. However, this process is not particularly transparent and is not intuitive to navigate. Therefore, following the completion of a systematic literature review, Miss Bain will be undertaking qualitative interviews with Māori whānau and kaupapa Māori providers, to gain insight to co-design a kaupapa Māori tool to evaluate and assess funding for whaikaha Māori.

Mr Jonathan Martin, University of Otago

Mamaku: ethnobiology and use as a novel intraoral medicament – an in vitro study
30 months, $190,133.00

This pilot project combines an understanding of ethnobiology, the traditional knowledge of indigenous populations about the natural world, including using plants as medicaments (rongoā rākau), with established laboratory-based technologies to develop evidence supporting the use of Mamaku (Black tree fern) to treat oral disease. Māori tradition suggests that Mamaku has therapeutic potential for treating intraoral inflammatory disease. Previous research has shown that a gel developed from the mucilage of Mamaku has promising flow properties and may possess the ability to adhere to soft tissues despite saliva flow. The researchers hypothesise that Mamaku formulations will show antibacterial properties, encourage the growth of oral cells, and demonstrate adherence and persistence in a simulated mouth environment. From the current pilot study, they anticipate that future development will follow their established protocols. Further formulation, characterisation, safety and efficacy testing will follow in appropriate animal models, culminating in a pilot human clinical trial.

Mr Mana Mitchell, University of Otago

Utilising Mātauranga to Guide Biomedical Research
36 months, $138,800.00

Rapid developments in the fields of intergenerational trauma and indigenous health literature worldwide have posed novel ethical challenges and philosophical threats to indigenous communities. This, alongside an existing need to further support and protect Māori researchers, participants and academics, means that a more comprehensive understanding of Kaupapa Māori methodologies and ethical strategies has become increasingly necessary. By analysing a number of Māori primary sources such as mōteatea (poetic songs, often laments), whakataukī (aphorisms), whakatauākī (proverbialised quotations) and pūrākau (Māori legends or tales), Mr Mitchell hopes to identify a number of central tenets that underlie Māori philosophies. This will be further developed by interviews with tohunga (experts in the Māori world), kaiako (teachers) and kairangahau Māori (Māori researchers), to provide a depth of knowledge to the analysis. Finally, Mr Mitchell will compare and contrast to existing ethical theories, in the hope of guiding future investigations in intergenerational trauma and leading indigenous health research.

Māori Health Summer Studentship

Miss Emily Bain, University of Otago

Māori experiences of the InterRAI interviews
3 months, $ 7,500.00

The InterRAI is a tool used to assess the needs of the elderly and to determine what level of support is needed for them. Miss Bain will be looking at Māori whānau experiences with the InterRAI system. This is part of a larger research project, and I will go with the research team to interviews with whānau and assessors. I will ask my own set of questions about their experiences and whether the InterRAI assessment process meets the needs of Māori whānau.

Ms Kendall Coker, University of Otago

An Exploratory Qualitative Study with Māori Whānau Experiences with ROPEE
5 months, $7,500.00

Preterm infants born less than 31 weeks gestational age, or 1,250 gram birthweight require regular eye examinations to screen for retinopathy of prematurity. Retinopathy of prematurity is an eye condition that in some cases, if left untreated, can cause permanent blindness. The risk of permanent vision loss is the reason why eligible preterm infants have regular eye examinations for early identification and treatment. Currently whānau are encouraged by staff to leave their preterm infant while the Ophthalmologist and nursing staff preform the eye examination. Whānau are encouraged to leave because the eye examination can cause significant distress in the infant, which can in turn, cause distress to the whānau. The purpose of this research is to explore the lived experiences of Māori whānau during the retinopathy of prematurity eye examinations in Neonatal Intensive Care Unit.

Mr Ihaia Kendrew, University of Otago

Pathways to health for Maori meat workers and their whanau
3 months, $7,500.00

Māori make up 38 per cent of the meat processing workforce. There is some evidence that Māori experience less access to care for musculoskeletal conditions, including in the meat industry. The aim of this research is to explore the experiences of Māori working in the meat works and their whānau in accessing care for musculoskeletal and cardiovascular conditions.

Mr Flynn Macredie, University of Otago

Interventions to improve maternal immunisation coverage in Aotearoa
3 months, $7,500.00

This summer project will explore interventions that support maternal immunisation against influenza, pertussis and COVID‑19 through interviews with the four Regional Immunisation Coordinators. These regional coordinators are a source of expertise and leadership in training vaccination staff and advising vaccine education in clinic, as a result they are likely to have insights into such interventions. Maternal immunisation is essential in the prevention of adverse health effects during pregnancy and during pēpē's first 3 months of life. This project is likely to illuminate potential interventions to improve the health of māmā and pēpē.

2022 Pacific Health Career Development Awards

Pacific Health Clinical Training Fellowship

Miss Leinasei Isno, University of Otago

Improving management, diagnosis and prevention of scrub typhus among Ni‑Vanuatu
36 months, $260,000.00

Scrub typhus is a severe tropical infectious disease caused by a germ that usually lives in rodents but can be transmitted to people by insects called mites that feed on both rodents and people in scrublands. Scrub typhus causes a fever illness, sometimes with a rash, that is fatal in 6 per cent of those infected. It is difficult to diagnose and requires specific antibiotics to prevent death. In Vanuatu, scrub typhus was a major cause of illness in troops during World War II and research in the 1970s showed it was common among Ni‑Vanuatu. To improve treatment and outcomes for patients with scrub typhus in Vanuatu, the researchers will describe how common it is in patients with fever; characterise local strains to improve locally-appropriate diagnostic tests; and identify risk factors for infection to inform prevention messages. They will work with Ni‑Vanuatu seasonal workers in New Zealand to disseminate public health messages.

Pacific Health PhD Scholarship

Miss Bwenaua Biiri, University of Otago

Investigating metabolic disease in I‑Kiribati
24 months, $94,050.00

Metabolic disease is a problem faced by many Pacific communities, both those living in New Zealand and those living on their home islands. This study aims to look at the burden of metabolic disease amongst I‑Kiribati living in New Zealand and to look at some of the genetic variants that may underlie these conditions. Previous studies of Pacific cohorts have identified shared genetic variants unique to the Pacific that appear to contribute to the susceptibility to metabolic disease. I‑Kiribati communities have not yet been involved in such studies, therefore this is important research as it will provide an understanding of metabolic disease and the factors that contribute to disease within the I‑Kiribati population.

Pacific Health Postdoctoral Fellowship

Dr Troy Ruhe, University of Otago

Measuring research impact in Pacific Health Research
48 months, $430,102.00

Evidencing research impact has been alluded to as a “wicked problem” with multiple moving parts to consider, which is more unknown in Pacific health research. This project combines qualitative data and quantitative analysis to develop a culturally relevant tool that captures research impact in Pacific health research. This will be achieved through a multiphased approach of reviews of literature, workshops with community members and Pacific health researchers to understand 1) what is Research impact and 2) how can it be measured. Using the integrated data infrastructure, a model that measures research impact in Pacific health research will be developed and implemented into Cook Islands community research.

Pacific Health Summer Studentship

Ms Beatrice Hessell, University of Otago

Pacific workplace wellbeing – perspectives from Pacific managers
3 months, $7,500.00

We spend a significant portion of our time in the workplace. Workplace values and norms play a significant part in our wellbeing. This project looks at workplace wellbeing using a Pacific lens. The aim of the project is to explore how the Pacific managers support the workplace wellbeing of Pacific staff using the Fonofale model of health. A group of 5–10 Pacific managers will be interviewed to discuss their role as a Pacific manager, how they think about workplace wellbeing and what organisations can do to support this for Pacific staff. Themes will be developed from these interviews and it is hoped that the findings can be used to help organisations support Pacific staff to achieve their aspirations.

Mr Miguel Veilofia, University of Otago

Pathways to health for Pacific meat workers and their whānau
3 months, $7,500.00

This proposal is based on a research project regarding Pacific meat workers in Oamaru, Otago. During this project, we will be asking about the effect that this occupation has on their health and wellbeing and their access to healthcare. This research is important as not a lot is known about this area of Pacific health. The data for this research will be gathered through talanoa styled interviews with Pacific meat workers in this community. Key themes within these findings will then be used to inform future research questions and next steps for this programme of work with the Oamaru community.

Mr Cameron Young, University of Otago

Splice mutations in the TP53 gene and its drive in aggressive tumours
4 months, $7,500.00

Māori and Pacific cancer patients have poorer outcomes and more aggressive forms of tumours compared with their Pākehā counterparts. Discovering effective clinical biomarkers may aid in addressing these disparities and uncover genetic predispositions to these diseases. One such biomarker may be found in the TP53 gene which encodes the tumour-suppressing p53 protein. TP53 mutants have been associated with aggressive forms of tumours as they encode non- or dysfunctional proteins. Our lab recently identified a TP53 splice mutation, called X126, whose role is yet to be determined. The aim of this project is to characterise the X126 splice mutation in gene-edited cells and determine its association with aggressive tumours. We will use common cancer research methods including CRISPR-Cas9 gene-editing technology, RNA sequencing, molecular and cell biology assays, and bioinformatic analyses. This work contributes to ongoing efforts to understand tumour biology and develop prognostic and predictive biomarkers for use in clinical settings.

For further information, contact:

Jessica Wilson
Adviser Media Engagement
University of Otago
Mob +64 21 279 5016

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