HRC Grants of almost $35 million to Division of Health Sciences researchers

Beta blockers, smoking cessation, stress suppression in motherhood and synthetic cannabinoid signalling are just a few of the areas of University of Otago Division of Health Sciences research to receive a total of almost $35 million in funding this year from the Health Research Council.

In all 26 grants have been made to the Division, with the total across the University hitting more than $40 million. That total includes $5 million to Professor Janet Hoek and her colleagues from the University of Otago, Wellington, for a five-year 'programme' aiming to close smoking disparities, particularly for Māori and Pacific people.

Health Sciences Pro-Vice-Chancellor Professor Paul Brunton says he is delighted to congratulate colleagues who were successful in obtaining HRC funding in the recent grant round.

"I know how much effort goes into these grant applications and trust that you will be pleased with your well deserved success. I strongly believe it demonstrates the strength and quality we have in health research across the division.

"Success in obtaining external grant funding further validates, in my view, the high quality of our research and the esteem in which our researchers are held."

Researchers to receive HRC Programme funding

Professor Janet Hoek, University of Otago
Whakahā o Te Pā Harakeke
60 months, $ 4,949,736.70

The Whakahā o Te Pā Harakeke programme represents a collaboration that will develop and improve evidence designed to close smoking disparities, particularly for Māori and Pasifika, enhance how tobacco control evidence is used in decision making, and accelerate progress towards a Smokefree Aotearoa.

Researchers to receive HRC Project funding

Dr Philip Adamson
University of Otago, Christchurch
Duration of Dual Antiplatelet Therapy in Acute Coronary Syndrome (DUAL-ACS)
48 months, $ 1,549,999.75

Drugs given to 'thin' the blood after a heart attack mean bleeding is more likely, with potentially life-threatening consequences. This nationwide study will help determine how long we should give blood thinning drugs so that heart attacks can be avoided without undue risk of bleeding.

Dr Martin de Bock
University of Otago, Christchurch
Automated Insulin Delivery for Type 1 Diabetes utilizing open source technology
36 months, $ 1,317,623

Automated insulin delivery (or closed loop technology) for type 1 diabetes has heralded a new era of treatment, delivering improved glucose management and quality of life. Cost is a barrier to access with this technology in New Zealand so this research will compare glycaemic control, quality of life and health economics of using open access technology compared to standard insulin pump therapy.

Professor Sarah Derrett
University of Otago, Dunedin
Prospective Outcomes of Injury Study: 10 years on (POIS-10)
36 months, $ 1,193,001

In New Zealand injuries cause 34 per cent of disability. The earlier Prospective Outcomes of Injury Study (POIS) investigated injury outcomes during 24 months post-injury but few studies have investigated outcomes beyond that period. POIS-10 will provide a unique opportunity to do this 10 years on.

Dr Allamanda Faatoese
University of Otago, Christchurch
Environmental Effects on Cardiometabolic Biomarkers in Pacific Peoples
36 months, $ 594,804

Improved screening and management of cardiometabolic conditions have resulted in small health gains for Pacific peoples. Innovative approaches to reduce this burden in the Pacific population are required. This study will focus on epigenetics, the external modification of DNA by environmental exposures controls gene expression, to investigate the interplay between environment and genetic factors and cardiometabolic biomarkers in Pacific peoples.

Professor Michelle Glass
University of Otago, Dunedin
Characterisation of synthetic cannabinoid signalling bias and toxicity
36 months, $ 1,172,581

Synthetic cannabinoid products have effects similar to those of natural cannabis, yet these drugs are more potent and dangerous, and have been associated with serious adverse effects, including over 20 deaths in New Zealand in the past year. This project aims to understand the diverse molecular signalling of these compounds and correlate these with the adverse effects.

Associate Professor Simon Hales
University of Otago, Wellington
Climate change, extreme rainfall events and enteric disease outbreaks
36 months, $ 1,190,579

A major outbreak of campylobacter in Havelock North was linked to contamination of a local water supply following heavy rainfall. Resilience to extreme climate events depends strongly on local factors, but these have not been systematically studied in New Zealand. This study will quantify relationships between extreme rainfall events and water-borne enteric infections and investigate the impact of local factors including land use, source water and type of water supply.

Professor Bob Hancox
University of Otago, Dunedin
A Randomised Controlled Trial of Beta-blockers in COPD
60 months, $ 1,439,384

Many patients with chronic obstructive pulmonary disease (COPD) also have heart disease. Beta-blockers are an important treatment for heart disease that reduce mortality, but are usually avoided in patients with COPD because of concerns they might make their lung disease worse. It is now thought that cardio-selective beta-blockers are probably safe for patients with COPD, so this is randomised, placebo-controlled trial at multiple centres in New Zealand and Australia will evaluate this.

Professor Janet Hoek
University of Otago, Wellington
Developing optimal strategies to support smoking cessation among RYO users
36 months, $ 1,195,934

New Zealand has among the highest rates of roll your own (RYO) tobacco use internationally. RYO causes particular harm to Māori, young adults and people experiencing lower prosperity. Conducted in partnership with Hāpai te Hauora, this research will develop and test RYO-specific high-affect warnings, and provide the first evidence of how tailored warnings and efficacy messages influence cessation-related beliefs and behaviours among groups most affected by RYO use.

Associate Professor Julia Horsfield
University of Otago, Dunedin
A novel genetic mechanism in Acute Myeloid Leukaemia
36 months, $ 1,177,919

Acute myeloid leukaemia (AML) is an aggressive cancer of the bone marrow with an overall survival of about 30 per cent. Treatment for AML has not changed substantially in more than 30 years. This research will identify a new genetic combination as a molecular cause for AML and uncover novel options for therapy.

Associate Professor Stephanie Hughes
University of Otago, Dunedin
Dissecting the role of glial lysosome function in neurodegeneration
36 months, $ 1,199,417

The lysosome is the final destination of cellular waste and its dysfunction is a common feature of many neurological diseases including Alzheimer's and Parkinson's disease. However there are other important cells in the brain that have received little attention and this research aims to determine the role of these support cells in the development of neurodegenerative disease and how defects in the lysosomal system in these cells impacts on normal function of neurons.

Dr Karl Iremonger
University of Otago, Dunedin
A neural circuit to suppress stress in motherhood
36 months, $ 1,167,222

Prolactin is a hormone which drives many neural adaptations during pregnancy and lactation, including the suppression of behavioural and endocrine stress responses. This project will determine how a particular group of prolactin sensitive neurons control stress responses during pregnancy and lactation. This will give important insight into a form of neural plasticity essential for safeguarding the health of mother and child during the perinatal period.

Mrs Bernadette Jones
University of Otago, Wellington
Te Ao Mārama: Disability perspectives of tāngata whaikaha Māori
36 months, $ 1,186,338

When adjusted for age, the rate of Māori disability is 32 per cent. Currently, there is a gap in Māori disability research and no accurate measure regarding the impact of disability on Māori. By using a Kaupapa Māori methodology to understand the perspectives of Tāngata Whaikaha (Māori with a disability) this project aims to develop culturally appropriate approaches to measuring disability. It will accurately quantify the prevalence of 'disability' among Māori and its impacts on health, well-being, social inclusion, and costs for Tāngata Whaikaha.

Professor Kurt Krause
University of Otago, Dunedin
New Drugs for the Post-Antibiotic Era by Targeting Glutamate Racemase
36 months, $ 1,199,914

There is an urgent need to develop new antimicrobials as the world-wide spread of drug-resistant bacteria threatens to create a post-antibiotic era in which diseases like tuberculosis and even routine bacterial infection cannot be effectively treated. Glutamate racemase is an essential enzyme in bacteria and is an excellent target for structure based drug discovery. This research will use its structure as a scaffold for drug development in a multi-disciplinary approach that includes medicinal chemistry, structural biology, and microbial genetics.

Dr Alex Macmillian
University of Otago, Dunedin
Health and equity impacts of Te Ara Mua Future Streets
30 months, $ 1,185,793

Shifting short trips by car to walking and cycling would bring large benefits for health and fairness in cities, including building physical exercise back into our daily lives, improving air quality, reducing car crash injuries, improving neighbourhood social connection and saving families money. This research is about how we retrofit suburbs which have been designed for cars use, to make them safer, more attractive, and more convenient for walking and cycling, with a focus on what works for Māori and Pacific communities.

Professor Tony Merriman
University of Otago, Dunedin
Addressing clinical questions in gout using genetic data
36 months, $ 1,198,120

In Aoteoroa, 6 per cent of Māori, 8 per cent of Pacific and 3 per cent of European people have the arthritis gout and there is co-morbidity with other serious diseases, such as diabetes, heart and kidney disease. This research will use the research group's existing large genome-wide genotyped datasets, and various genetic epidemiological approaches, to address several clinically-relevant questions to help provide more specific lifestyle advice and drug prescribing for people with gout.

Associate Professor Brian Monk
University of Otago, Dunedin
Readying next-generation antifungals for drug development
36 months, $ 1,199,967

Opportunistic invasive fungal infections (IFIs) carry high morbidity and mortality (approximately 50%) for those with co-morbidities, especially the immunocompromised, such as transplant and AIDS patients. This project will address an urgent need for new, potent and inexpensive fungicides due to innate and acquired resistance to antifungal agents.

Dr Garry Nixon
University of Otago, Dunedin
A rural-urban classification for NZ health research and policy
30 months, $ 943,443

Recent evidence suggests that around 40 per cent of the people who actually access rural health services are currently classified as 'urban', and 20 per cent of those defined as 'rural' actually receive urban health care. The extent of this mismatch masks any inequality in healthcare access or outcomes that may exist and hampers all current and future research. We propose to develop and validate a “fit for purpose” rurality classification and to use this to analyse current health data to better understand rural health in New Zealand.

Professor Suetonia Palmer
University of Otago, Christchurch
Teaching to improve health outcomes for peritoneal dialysis: The TEACH-PD trial
60 months, $ 1,439,326

Peritoneal dialysis provides a way for patients to do dialysis at home that can be easily learned and is lower cost than hospital-based dialysis. About 40 per cent of people starting therapy choose peritoneal dialysis, but serious complications cause patients to switch to haemodialysis meaning only 16 per cent of patients who start peritoneal dialysis are using the treatment at five years. TEACH-PD is a randomised trial of dialysis training modules for nurse trainers and patients to identify whether a standardised curriculum helps maintain patient independence and survival better than usual care.

Professor Suetonia Palmer
University of Otago, Christchurch
Serum phosphate to improve outcomes for dialysis patients: The PHOSPHATE trial
60 months, $ 1,266,603

Over 4,500 New Zealanders live with kidney failure requiring treatment with dialysis or a kidney transplant. Although dialysis is life-sustaining, the death rate is unacceptably high at 13 per 100-person-years and disproportionately affects Maori and Pacific patients. Kidney failure leads to accumulation of phosphate in blood vessels and body tissues and increases risks of death. The PHOSPHATE trial is a pragmatic, multi-national randomised trial evaluating whether intensive reduction of serum phosphate levels improves cardiovascular outcomes and mortality for dialysis patients.

Dr Anna Pilbrow
University of Otago, Christchurch
A precision medicine approach to improving heart disease outcomes
36 months, $ 1,193,680

Mortality rates for coronary heart disease have fallen over the last 50 years. Patients now live longer with many surviving to incur later adverse sequelae, especially heart failure. However, disease progression varies considerably between patients and is difficult to predict. This research aims to discover what information an individual's DNA may contribute to predicting disease progression and establish a genetic risk score to improve on current methods of predicting progression from heart attacks to ischaemic heart failure.

Professor John Reynolds
University of Otago, Dunedin
Manipulating rewards to treat maladaptive brain disorders: focus on tinnitus
36 months, $ 1,192,994

Tinnitus, chronic pain, depression, obesity and addiction are common neurological and neuropsychiatric conditions that impose significant negative impact on individuals and society and lack effective treatments. These conditions appear to share similar abnormalities in parts of the brain network associated with reward. Brain networks can be modulated in certain conditions such as Parkinson's disease using deep brain stimulation (DBS) and this project will set out to develop a novel DBS approach to reverse the abnormalities in the reward network with a focus on tinnitus.

Professor Rachael Taylor
University of Otago, Dunedin
Does a brief sleep intervention in infancy have long-term health benefits?
36 months, $ 1,190,308

Given that one in three New Zealand children are overweight or obese, research aiming to address the global obesity pandemic has increasingly focused on opportunities for prevention in early life, particularly in the 'first 1000 days' (from conception to 24 months of age). A recent trial demonstrated that children who received a brief sleep intervention in infancy had only half the risk of obesity at two years of age and, more importantly, these benefits remained at five years of age without further intervention. This follow-up, involving 700 children, will determine the long-term sustainability of this brief intervention.

Dr James Ussher
University of Otago, Dunedin
The role of microbial viability in regulating MAIT cell activation
36 months, $ 1,191,634

Mucosal surfaces are a critical interface with the external environment. The mucosal immune system must be tightly regulated to fight infection while avoiding disease-causing inflammation. Mucosal associated invariant T (MAIT) cells are pro-inflammatory, antibacterial T cells that are abundant at mucosal surfaces. This study will add to the understanding of MAIT cell function and inform the future development of MAIT cell-directed therapies.

Associate Professor Logan Walker
University of Otago, Christchurch
Impact of germline copy number variation on endometrial cancer risk
36 months, $ 1,145,197

Endometrial cancer is the most common gynaecological tumour in developed countries, and the incidence of this disease is increasing. The disease is associated with significant morbidity due to surgical and radiation treatment options, increased mortality for Māori, and increased incidence for Pacific women. This research aims to exploit a large international collaboration to identify and functionally characterise genetic changes associated with endometrial cancer. Discoveries will provide candidate risk factors for future diagnostic and treatment protocols, and provide new insights into tumour development.

Dr Emma Wyeth
University of Otago, Dunedin
POIS-10 Māori: Outcomes and experiences in the decade following injury
36 months, $ 1,191,067

Māori experience injury and disability inequities. The Prospective Outcomes of Injury Study (POIS) investigated a range of Māori post-injury outcomes to two years post-injury. POIS-10 Māori aims to understand and improve long-term (12 years post-injury) outcomes and experiences (positive and negative) for injured Māori and their whānau. POIS-10 Māori will provide vital insights about the complex injury and rehabilitation pathway to improve long-term outcomes and experiences, and identify intervention opportunities.