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Wednesday, 4 November 2020

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University of Otago has secured $3.3 million in Health Research Council funding.

Thirty-six University of Otago researchers have received career boosting funding, to the tune of $3.3 million, from the Health Research Council.

Designed to help foster the health research workforce in New Zealand, the funding comes from three career development awards: Career Development Awards (include general, Māori and Pacific categories), Health Delivery Research Career Development Awards, and Health Delivery Research Activation Grants.

Otago recipients are working in areas as wide-ranging as diabetes, oral health, Fetal Alcohol Spectrum Disorder, traumatic brain injury, and physiotherapy.

In total, the University of Otago received $2.3 million for general Career Development Awards, $197,600 for Māori Health Career Development Awards, and $196,980 for Pacific Health Career Development Awards, $297,906 for Health Delivery Research Career Development Awards, and $321,967 for Health Delivery Research Activation Grants.

Three scientists received the prestigious Sir Charles Hercus Health Research Fellowships, worth $1.7 million. Running for four years, the funding will further research into fertility, cancer, and disease-induced protein degradation, respectively.

Deputy Vice-Chancellor (Research and Enterprise) Professor Richard Blaikie says the University is grateful to the Health Research Council for supporting the career development of “bright and ambitious researchers”.

“Not only will the research itself lead to important advances in healthcare and wellbeing, but the projects will allow many of the recipients to advance successfully to the next stage of their careers.”

The HRC's chief executive, Professor Sunny Collings, says this year's award recipients are tackling a broad range of priorities important to their communities and New Zealanders as a whole.

2021 Career Development Awards (General)

Sir Charles Hercus Fellowship

Elodie Desroziers image
Dr Elodie Desroziers

Dr Elodie Desroziers, University of Otago

Unravelling the role of glial cells in fertility regulation

48 months, $506,917

Polycystic Ovary Syndrome (PCOS) is the most common infertility disorders affecting 1 in 10 women of reproductive age in New Zealand and worldwide. PCOS is characterised by the presence of at least two of three diagnostic criteria: elevated androgen hormones, menstrual dysfunction and multiple cyst-like follicles in the ovary. Although commonly considered an ovarian disorder, the brain is now a prime suspect in both the development and maintenance of PCOS. Glial cells outnumber neurons by 10 to 1 in the human brain. Traditionally glial cells have been considered to be passive contributors to brain function resulting in a pronounced neurocentric bias among neuroendocrinologists. To date, no study has investigated a potential role of glial cells in fertility disorders such as PCOS. Therefore, I propose here to unravel the role of glia in physiological regulation of fertility and in the pathological anovulatory disorder Polycystic Ovary Syndrome.

Sunali Mehta image
Dr Sunali Mehta

Dr Sunali Mehta, University of Otago

Adapting to a CINister genome: regulating chromosomal instability and metastasis

48 months, $600,000

Cancer is a major health burden in New Zealand and accounts for one in three deaths. Cancer-related deaths are mainly due to spread of the disease (metastasis) and resistance to treatment. These features are a result of tumour evolution, which is driven by continuous changes in the DNA called chromosomal instability (CIN). Our study aims to understand how CIN contributes to the tumour cell's ability to manipulate the patient's immune response, spread to distant organs and develop resistance to treatment. This study will enable us to identify individuals whose tumours have acquired the ability to evolve and are more likely to have a poor outcome, while providing information on novel ways of targeting pathways that promote CIN in tumours.

Adam Middleton image
Dr Adam Middleton

Dr Adam Middleton, University of Otago

Protein degradation: from understanding to application

48 months, $599,999

Disruptions to protein degradation are an underlying cause or consequence of many diseases, including cancer and neurodegenerative disease. Up to 80% of protein degradation happens through the ubiquitin-proteasome system, yet there are limited treatment options that target this process. A major contribution to the paucity of therapeutics is the complexity of the ubiquitin system. Here, we will focus on the central determinants of the degradative ubiquitin signal, the ubiquitin conjugating enzymes, to understand how they work, and how their activity can be precisely and specifically modulated. Advancing our detailed understanding of how these enzymes contribute to protein degradation will allow the development of more targeted therapeutic approaches.

Clinical Research Training Fellowship

Dr Mercedes Burnside, University of Otago, Christchurch

CREATE Trial; Community deRivEd AutomaTEd insulin delivery

24 months, $180,000

Commercialised automated insulin delivery (AID) systems have demonstrated improved outcomes in type 1 diabetes (T1D); however, they can be prohibitively expensive if an individual is without access to health insurance or health funding subsidy. Freely available open-source algorithms, paired with commercial insulin pumps, and continuous glucose monitoring make up the so-called “DIY” AID system. Limited data on the DIY approach have shown promising results, but data from a large randomised control trial are lacking. As a paediatric endocrine trainee with a passion for diabetes, I am undertaking a fulltime PhD on the CREATE Trial, the first randomised, multi-site trial comparing DIY AID to standard insulin pump therapy. 100 participants with T1D aged 7 – 70 years, will be recruited from four sites in New Zealand. Establishing the effectiveness and safety of the open-source algorithm will address the inequity of care for people with T1D in New Zealand and worldwide.

Ms Sarah Goldsbury, University of Otago, Christchurch

Māori whānau experiences of neuropsychological assessment for FASD

36 months, $260,000

I am a Clinical Neuropsychologist of Ngāti Porou and Te-Aitanga-a-Hauiti whakapapa. I undertake the neuropsychological component of Fetal Alcohol Spectrum Disorder (FASD) assessments. I work alongside children and youth in temporary and permanent care, and through Youth Court referrals. I am one of few Māori clinicians in this field of clinical practice and research. To date, this is an emerging field of research in Aotearoa, and the impacts of institutional racism within this process and protocol have not been identified. The purpose of this research is to explore and document Māori whānau experiences of the neuropsychological processes in FASD assessment. I will utilise a Kaupapa Māori methodological approach for this qualitative study, using semi-structured interviews, and inductive thematic analysis. The findings of this study will utilise participant voices as experts to formulate how neuropsychological assessment for a diagnosis of FASD can be more responsive and acceptable to Māori whānau.

Dr Ngaire Keenan, University of Otago, Wellington

Defining Māori epilepsy burden and developing an approach for future research

24 months, $173,333

Epilepsy, the most common serious neurological disorder in childhood, affects ~4000 New Zealand children. Although children with epilepsy may live normal lives, 30% have uncontrolled seizures and poor outcomes. Epilepsy is 40% more common in Māori children than other ethnicities. International reports suggest that higher rates of epilepsy result from preventable causes which can be reduced with successful public health initiatives. Dr Ngaire Keenan is a Māori Paediatric Neurology trainee who plans to become a New Zealand clinician scientist. Her PhD aims to describe the syndromes, aetiologies, comorbidities and management of epilepsy in Māori children compared to non-Māori children. If the increased rate of epilepsy in Māori children is due to preventable causes, then culturally appropriate health strategies can be implemented to promote positive change. She will also develop strategies to identify epilepsy cohorts for future research which will ultimately aid her long-term career goal of improving childhood epilepsy outcomes.

2021 Māori Health Career Development Awards

Māori Health PhD Scholarship

Ms Jordon Lima, University of Otago

Equitable Application of Circulating Tumour DNA to the New Zealand Population

36 months, $141,000

Circulating tumour DNA (ctDNA) is DNA released by a tumour into the bloodstream and represents a novel class of blood marker for cancer detection. ctDNA can potentially change how cancer is diagnosed and how patients are monitored during and after treatment. Before ctDNA can be integrated into the New Zealand healthcare system, we must test the technology's clinical utility and determine its best application for reducing health inequities, particularly amongst Māori and rural communities. In this proposed PhD research, I will analyse ctDNA testing for surveillance of stage 2-3 colorectal cancer patients on the West Coast of the South Island. Māori health providers will co-design this study, which will add personalised ctDNA testing to patients post-treatment surveillance plan for approximately 1-2 years. Māori co-design and integration in this project will ensure ethical issues are identified, benefits to Māori are optimised, and tikanga is retained in future ctDNA use.

Māori Health Masters Scholarship

Mr Witana Petley, University of Otago

Experiences of Stroke Rehabilitation for Māori Stroke Survivors and their whanau

24 months, $31,600

Stroke is the second leading cause of death and disability in New Zealand with notable ethnic and socioeconomic disparities. Māori are more likely to have a stroke event compared to non-Maori and are also experiencing strokes at a younger age. Stroke survivors and their caregivers' collective experiences of stroke rehabilitation have been explored and have found positive benefits when caregivers have had active input during physical rehabilitation. However, this research has not been explored for Māori stroke survivors and their whanau members. This research will aim to identify what the current experience of stroke rehabilitation is for our Māori Stroke Survivors and their whanau members. The intention of this study is to identify what type of support will be best-suited to our Māori stroke survivors and their whanau members during their rehabilitation journey.

Māori Health Summer Studentship

Miss Brooke Bridges, University of Otago, Wellington

Understanding how the supportive care needs of Māori with cancer are assessed

3 months, $5,000

Culturally appropriate supportive cancer care for patients is an essential part of the care pathway and vital to improving cancer outcomes for Māori yet little is known about how these needs are assessed. Māori have higher rates of most cancers, comorbid conditions and poorer survival rates compared to non-Māori. Previous research in Aotearoa/NZ identified issues with the supportive care experienced by Māori whānau including unaddressed cultural, spiritual accommodation and financial needs along with displacement from family and community during treatment. Recent work has identified that a supportive care needs assessment tool can be modified successfully to accurately measure the support care needs of Indigenous Australians. This research project aims to use qualitative methods to identify how the supportive care needs of Māori patients and whānau experiencing cancer are currently assessed in Aotearoa/NZ.

Ms Raiha Cook, University of Otago, Wellington

An inquiry into Raukura integration into Euro-centric Otago University

4 months, $5,000

Raukura (students who Māori-medium school graduates, such as Kura Kaupapa Māori, Kura-a-iwi, Kura Māori) will have had an undeniably different schooling experience than those who graduated through mainstream high schools. Once graduated from high school, the next step of education for the majority of these graduates is to attend University. The University of Otago, known as New Zealand's oldest University, has gained a reputation for quality research skills, and teaching staff. This inquiry will look into Raukura integration to a more Euro-centric style of teaching, which is predominantly the style of teaching at the University of Otago. The inquiry will provide a te ao Māori perspective of Raukura experiences through the lens of a current Raukura student attending the University of Otago.

Miss Sade Gilbert-Perenise, University of Otago, Wellington

Utilisation of Wai for the Holistic Wellbeing of Māori

3 months, $5,000

This project aims to understand how wai (water) utilisation is significant to the holistic wellbeing of Māori. Te Whare Tapa Wha model will be used (tinana, wairua, hinengaro and whānau) to explore how wai might be used to enhance Māori health and wellbeing. The summer studentship will include a literature review and interviews with 3-4 participants with expertise in matauranga Māori and Tikanga Māori associated with the use of wai.

Ms Jordon Lima, University of Otago

Investigating Genetic Links Between Height and Gout in Māori and Pacific people

3 months, $5,000

Gout, an inflammatory form of arthritis disproportionately affects Māori and Pacific people. Recently in a cohort of Māori and Pacific people with gout, a genetic variant unique to these populations has been identified that reduces risk of gout for those that are carriers. Surprisingly the variant also reduces height, by ~4 cm if an individual carries the variant. It is important that these findings are replicated in a second independent cohort so that research can then be carried out to understand the biology that underlies this variation. The aim of this summer studentship is to carry out the replication work.

Ms Saskia van der Wilt, University of Otago

Physiotherapists use of green-space for life long health conditions

2 months, $5,000

The intervention of a green space is seen to positively influence the 'being' of hauora outcomes in prevention and rehabilitation. The purpose of the study is to gain insight into how physiotherapists' knowledge of the typical prescription and management of green spaces in a clinical practice has a positive impact on Māori with life-long conditions specific to hauora.

2021 Pacific Health Career Development Awards

Pacific Health Knowledge Translation Grant

Dr Losa Moata'ane, University of Otago

Reducing Health Inequalities. Pacific Experiences in DHB System

4 months, $5,000

The principal purpose of my research was to analyse the Pacific health sector experience during the health reforms that began in the year 2000, which established District Health Boards (DHBs) and required, for the first time, an explicit focus on reducing health inequalities. It is a qualitative piece of research undertaken by an 'insider', which aims to capture the stories and experiences, voices and viewpoints of those trying to paddle the popao (canoe) to reduce Pacific health inequalities during this period of intensive reform. This funding will be used to further disseminate my results to the wider Pacific Communities particularly with Churches, Women's groups, Elderly people's groups and Youth. These groups are less likely to engage in policy discussions and/or policy development.

Miss Jaye Moors, University of Otago

Metabolic disease in Polynesian adults and adolescents in New Zealand

4 months, $5,000

Metabolic disease is twice as likely to affect Māori and Pacific peoples in New Zealand compared to the general population. It affects these populations at an earlier age resulting in greater morbidity, disability, and lower life expectancy. This project aimed to 1) evaluate the current physical health status of young Pasifika living in NZ, and 2) identify Polynesian-specific genetic variants to metabolic disease in people of Māori and Pasifika descent in New Zealand. The dissemination of the research findings from this project is crucial as these findings will lead to improved understanding and medical approaches for Māori and Pasifika people in NZ, as everyone deserves biologically informed healthcare.

Mr Troy Ruhe, University of Otago

The 'Niu Movement' - The effectiveness of Circuit Based Exercise in Communities

4 months, $5,000

The effectiveness of circuit based exercise utilising Cook Islands dance has proven to be effective in a small cohort of Pacific peoples in Dunedin, NZ. Furthermore, it was shown to be acceptable and popular in Cook Islands residents in Rarotonga. Fono will now be held for the communities to present the research back to the communities to inform future decisions for the programme implementation.

Pacific Health PhD Scholarship

Mr Jordan Taylor, University of Otago

Decoding the genome of Mycobacterium tuberculosis strains endemic to the Pacific

36 months, $129,550

Tuberculosis is no longer a significant issue for New Zealand. However, with Pacific peoples experiencing rates 21-fold higher than their European counterparts, tuberculosis remains a significant Pacific health issue that disproportionately affects Pacific peoples. Within the Pacific community, the Mycobacterium tuberculosis strain, which to date has not been identified in non-Pacific, has accounted for 69% of all Pacific cases within the last five years. With this strain having little dedicated research, and significantly affecting Pacific health, improving our understanding of the origins and genomic structural variants of this strain could provide an insight into the biological interplay that predisposes Pacific. Establishing the landscape of this disease will be critical in informing public health initiatives in reducing health inequalities in Pacific.

Pacific Health Masters Scholarship

Mr Oka Sanerivi, University of Otago

Culturally responsive Physiotherapy approaches for working with Pacific children

24 months, $32,430

The aim of this research is to explore culturally responsive physiotherapy approaches to improve the health and wellbeing of Pacific children. Pacific families and physiotherapists will be interviewed utilising a Pacific quantitative research methodology (Talanoa) to explore their cultural knowledge with respect to health, with the view of evaluating the data to construct a model of care and/or clinical practice guidelines for physiotherapists working with children in Aotearoa New Zealand. These are to be disseminated to Physiotherapy New Zealand, the physiotherapy schools in Aotearoa New Zealand and to the Physiotherapy Board of New Zealand.

Pacific Health Summer Studentship

Mr Duncan Drysdale, University of Otago

Developing a supported playgroup for children of Pacific families

2 months, $5,000

This project aims to promote development and maximise beneficial childhood experiences/support for the Pacific community by identifying key components of the playgroup experience that are culturally important to Pacific peoples through qualitative interviews with family members of the Pacific Trust Otago playgroup.

Miss Paige Enoka, University of Otago

Physical activity participation for Pacific people

2 months, $5,000

Increasing physical activity is one proven way of preventing and managing a long-term condition. It is known that health interventions are more effective when they are tailored to meet the cultural needs of people and their communities. The aim of this research project is to find out what enables Pacific people to engage in physical activity and what tends to prevent Pacific people from being physically active.

Ms Ileana Lameta, University of Otago

Self-management of Long-Term Conditions for Pacific people

2 months, $5,000

Self-management is a time-consuming, continuous challenge, with little research specific to Pacific people. This project will explore the key cultural elements that assist Pacific people in managing long-term health conditions.

Miss Urata Sofai, University of Otago

Mental Health and Wellbeing of the Pacific Non-Regulated Health Workforce

3 months, $5,000

This is a qualitative study on the Mental Health and Well-being of the Pacific Non-Regulated Health Workforce. This refers to health workers who are not regulated by a governing body or organisation. There is limited research available on the Pacific non-regulated workforce and so we aim to provide some initial information on them as well as inquire into their health and well-being and the services or lack thereof that are accessible to them.

2020 Health Delivery Research Career Development Award

Dr Hemakumar Devan, University of Otago, Wellington

Partnering with whānau to address inequities to pain management

12 months, $91,689

Chronic or persistent non-cancer pain affects one in five New Zealanders. Persistent pain disproportionately affects Māori and their whānau. Māori face significant inequities in accessing specialist pain services and experience stigma and stoicism in expressing and managing pain. Community programmes co-developed with Māori empower whānau and hapū fostering healthy behaviours. Our previous community engagement has identified the need for a kaupapa Māori (by Māori, for Māori) pain support programme that prioritises kanohi-ki-te-kanohi group-based interactions. Hosted in Capital and Coast DHB Pain Management Service, this placement will allow me to develop and deepen my own clinical skills needed to provide pain services and to lead a collaborative project with Tu Kotahi Māori Asthma and Research Trust as a clinician-researcher. The dual aims of this fellowship are to gain clinical skills in pain management and to support the co-design of a Māori pain support programme for whānau with persistent pain.

Shekhar Sehgal, University of Otago

Wearing your Continuous Glucose Monitor on your sleeve

12 months, $154,523

Continuous Glucose Monitoring (CGM) has revolutionised diabetes care and improves both clinical and patient centred psychosocial outcomes. There are multiple financial, technological and practitioner related barriers to its widespread use. Flash glucose monitoring (FGM) is an alternative to CGM which provides many of the functional benefits of CGM at a lower cost. The Miao Miao add on can convert a standard FGM to CGM, known as do it yourself continuous glucose monitoring (DIY- CGM). Our study, a randomised cross-over study of 55 adults with Type 1 diabetes randomised initially to DIY-CGM or FGM. We hypothesise adults using DIY CGM will experience a reduction in the fear of hypoglycemia, reduced diabetes related distress and increased device satisfaction compared to CGM as well as improved clinical outcomes. A successful study will make CGM technology available to more diabetes patients, leading to improved diabetes care and quality of life.

Ms Amber Young, University of Otago

Reducing immunisation inequities during pregnancy

12 months, $51,694

Influenza and pertussis (whooping cough) vaccinations are recommended for pregnant women in New Zealand because Influenza infection during pregnancy is associated with severe disease in the mother and poorer outcomes in babies (e.g. premature birth). Immunising pregnant women creates antibodies against infection that are passed to the fetus and protects the baby against disease in the first few months of life. However, Māori and Pacific women have lower rates of immunisation during pregnancy, especially in areas of high deprivation. The aim of this research is to understand what information Māori and Pacific women need to know to encourage vaccination during pregnancy, and how this information should be delivered.

2020 Health Delivery Research Activation Grant 2

Dr Mudassir Anwar, University of Otago

Exploring refugee access to primary healthcare services in Aotearoa

3 months, $30,000

Refugees represent a diverse group of displaced individuals with unique health issues and disease risks. New Zealand has long been accepting refugees from countries such as Afghanistan, Bhutan, Somalia, Ethiopia, Sudan, Iraq, Myanmar, and Syria. Since 2016 more people who have had to flee conflict in Syria, Palestine and Iraq have arrived. Although New Zealand has a well-designed resettlement program for refugees that includes initial health screening and later access to funded health care, data on the experience of refugees with the New Zealand health care system is scarce. Therefore, this research activation project aims to develop relationships with the recent refugee communities/community from the Arabian countries, who have made their home in Wellington and Dunedin. We are keen to work with these communities to establish their primary health care needs, how these are currently being fulfilled, and what barriers they have experienced in accessing health care.

Dr Carol Atmore, University of Otago

Laying the foundations for a NZ primary care research and surveillance network

12 months, $30,000

Primary care centred clinical research is required to explore effects of new service delivery models and disease treatments on patient access and outcomes in community settings, and whether there are different outcomes for Māori, for Pacific and rural patient groups. New Zealand also lacks primary care surveillance infrastructure to monitor the impact over time of health service delivery change in community settings, and whether the impacts are experienced equitably. This application is to explore establishing a nationally representative primary care research and surveillance network. We will build relationships with key stakeholders, review literature regarding research networks, establish contact with successful networks internationally and explore why previous local attempts were unsuccessful. We will produce a roadmap outlining the infrastructure and processes required to establish a successful and sustainable research network. Once established, the network will provide ongoing future primary care research opportunities based in community settings.

Dr Angela Campbell, University of Otago, Wellington

Māori sleep health across the life span

9 months, $29,594

Māori sleep health across the life span - how to improve sleep health from a population and clinical perspective. A review of the literature by an expert advisory panel made up of Māori health researchers and health professionals will be used to inform future health research directions for sleep health. A focus of future research will also be consideration of current sleep services pathways from a Māori patient and health professional view. Health literacy around' healthy sleep' will also be a focus of future research.

Dr Cathy Chapple, University of Otago

Adaptation and implementation of stratified care (STarT Back) in New Zealand

6 months, $29,619

Low back pain (LBP) is common and often debilitating for the patient, as well as costly for society. There is good evidence to support different physical treatment approaches such as exercise and manipulation. However, the presence of psychosocial factors increases the risk of developing on-going (chronic) recurrent/episodic LBP. Extensive research has shown clinical and economic benefit of stratifying patients with LBP using the STarT Back screening tool and matched care, based on identification of psychosocial factors. The STarT Back programme, developed in the United Kingdom, requires adaptation to the New Zealand (NZ) health system. The purpose of this activation grant would be to engage with a wide range of stakeholders to co-create a modified version of Start Back suitable for the NZ context, and preferred strategies for implementing the new approach. Findings would inform future grant applications to test feasibility and implementation of the modified STarT Back model.

Associate Professor Kirsten Coppell, University of Otago

Delivering optimal weight gain advice to pregnant women (DOT) study

6 months, $29,582

Excess gestational weight gain (GWG) increases the risk of adverse outcomes for mother and baby, e.g. gestational diabetes, postpartum weight retention, and large for gestational age babies. An estimated 75-80% of women who birth in NZ have sub-optimal GWG. We assessed the feasibility of our midwife-delivered intervention designed to guide individualised dietary advice for pregnant women to facilitate optimal GWG. Eight midwives recruited 27 pregnant women, and delivered the intervention as part of antenatal care. Fourteen of these women (51.9%; 95%CI: 33.0%, 70.7%) achieved their recommended GWG. An independent qualitative evaluation reported participating midwives spoke positively about the intervention. We plan to undertake a multicentre pragmatic trial to examine the effectiveness of our midwife-delivered weight management tool on GWG. Our next step is to further develop relationships with the high risk communities where the study will be undertaken, update our literature review, and refine the study design and data collection.

Dr Sarah Gordon, University of Otago, Wellington

Mental Health: Enabling the application of supported decision making in practice

6 months, $29,501

The national mental health inquiry identified that New Zealand is not compliant with international obligations, particularly in terms of the continued practice of substitute decision making as opposed to supported decision-making (SDM) (where individuals are supported to make their own decisions based on their will and preferences). However, there is little known about what and how interventions can support SDM being facilitated in practice. We will: (i) bring together key stakeholders from the numerous organisations that have pledged support for the activity proposed; and (ii) facilitate them to identify and then prioritise interventions in support of SDM that are considered as having the potential to lead to the greatest improvements in the lives of New Zealanders. Multi-disciplinary teams and plans to undertake the co-produced development and piloting of the identified and prioritised SDM interventions across various mental health care delivery settings will then be established as proposed health delivery research.

Dr Ewan Kennedy, University of Otago

Improving health services for people with musculoskeletal chest pain

12 months, $28,283

We propose activities to improve health services for people with musculoskeletal chest pain. Chest pain is a common reason to see a doctor and is not always a heart attack. Musculoskeletal causes are recognised as the second most common cause of chest pain, yet there is a surprising lack of international research on this condition. For example, no clinical trials to guide management. Observational research and the experience of our team indicates that physiotherapy is likely to be effective. The research activation activity we propose is to build the foundation of prevalence data, relationships and processes required to perform a clinical trial comparing medical and physiotherapy care of musculoskeletal chest pain. This will involve a retrospective case notes review of the prevalence of musculoskeletal chest pain in key clinics, then engaging further with these clinics to scope a pathway for the physiotherapy management of musculoskeletal chest pain.

Dr Moira Smith, University of Otago, Wellington

Assessing the oral health sector's organisational commitment to equity

12 months, $29,879

Equity is a key priority of NZ's health system, and for Māori, a constitutional right. Yet, severe, unacceptable and avoidable disparities in oral health persist. Achieving health equity requires a coordinated and collaborative effort across all levels of the health system, and a shared understanding and strategic prioritisation of equity. Little is known about how and to what extent oral health professionals' organisations and associations prioritise and embed equity within their structures, processes, policies and practices. This project will develop a means of assessing and then identify gaps in oral health organisations' prioritisation of and commitment to equity. It will also identify opportunities for future intervention and collaboration with key stakeholders within those organisations. The study findings will inform the design of further research to establish an evidence-based equity accreditation programme to assist oral health organisations to 'advocate, navigate and support' equity in oral health care delivery and sector leadership.

Associate Professor Deborah Snell, University of Otago, Christchurch

Capturing traumatic brain injury when this co-occurs with spinal cord injury

12 months, $29,980

Traumatic brain injury (TBI) is common among those sustaining a traumatic spinal cord injury (tSCI) although rates vary associated with difficulties robustly identifying TBI. When a person with tSCI is admitted acutely the usual TBI indicators can be invalidated by the interacting effects of the tSCI resulting in missed cases. Co-occurring TBI has been associated with increased length and cost of tSCI rehabilitation, smaller gains from admission to discharge and added difficulties with psychosocial functioning, adjustment and return to productivity. The real impacts are difficult to quantify because TBI is often missed and rates in New Zealand are unknown. Our objectives are to i) engage with and build relationships in proposed localities for a follow-on health delivery study and ii) develop a TBI diagnostic algorithm so that this can be used in this follow-on study to consistently capture TBI and understand impacts on outcomes for New Zealanders who sustain tSCI.

Associate Professor Michael Tatley, University of Otago

Developing KIWIvax – an automated SMS-system to monitor vaccine adverse events

12 months, $30,000

There is an urgent need for NZ to broaden its approach to vaccine safety monitoring, to maintain community current confidence in current national schedule vaccines and importantly, to ensure a platform is ready for a COVID-19 vaccine. The aim is to develop and validate the use of a Smartphone-based SMS tool, via primary care with active followup of vaccinees post receiving vaccination This activation grant will be used to determine if an automated real time SMSSmartphone based vaccine-associated adverse event reporting system tool, already effectively used in Australia (SmartVax, AusVax), can be modified, enhanced and imported into the New Zealand system to produce KIWIvax. This will provide a community-used method to support the needs of New Zealand vaccine safety surveillance and can be modified to accommodate monitoring new vaccines and related clinical occurrences of interest.

Associate Professor Stephanie Woodley, University of Otago

Digital technology for women's pelvic health – Creative marketing or good science?

12 months, $25,529

Urinary incontinence significantly impacts on physical and mental health and is common with one-in-three women suffering at some stage during their lifetime. Pelvic floor muscle training is recommended as first line treatment, but is often unsuccessful due to poor adherence and/or inability to access relevant health services. Digital technologies provide a rapidly growing market with hundreds of pelvic floor training apps now available, which are attractive to many women. However, little is known about how well these applications cater for women at various life stages, and if the solutions offered are evidence-based or appropriate from a cultural perspective. We aim to identify what technologies women are using for their pelvic floor health via a scoping literature review and to determine whether these are evidence-based and effective for managing incontinence. The findings will help inform future development of digital technologies, which meet specific cultural and population needs for New Zealand women.

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