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Pacific health future researchers

Meet our postgraduates

Our Pacific health postgraduates are contributing to research discoveries in an array of disciplines that will have a positive impact on the health of our communities. This section provides more about postgraduates research in progress from 2016 to 2019.

For completed theses and symposium abstracts prior to 2017 visit:

Arpana Arthi Devi

Clinical dentistry

Arpana Arthi Devi imageArpana is from Fiji. She is pursuing a Doctor of Clinical Dentistry (DClinDent) supported by a University of Otago Pacific Island Doctoral Scholarship. Arpana graduated with a Bachelor of Dental Surgery from the Fiji School of Medicine. She was a recipient of a Rotary Ambassadorial Scholarship which supported her PGDip in Clinical Dentistry (Endodontics) from the University of Western Australia. Arpana was also a Lecturer at Fiji National University from 2008 to 2013.

Arpana's investigating enhancing the efficacy of antimicrobial peptide BM2 against mono-species biofilms. Her research interest is in endodontics, and she has five publications to date in this specialist field.

Professor Robert Love and Dr Brian Monk were her supervisors.

Arpana was profiled in Pacific Voices 2015 and presented at the Pacific Voices Symposium in 2016.

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Tahzeeb Fatima

PhD candidate in biochemistry on gout and metabolic disease

Tahzeeb Fatima imageTahzeeb is an international student pursuing doctoral studies in Biochemistry. She completed her MPhil in Medical Physiology and Biochemistry in Pakistan. Tahzeeb’s research focuses on integrating scientific and medical understandings of the relationship of gout with metabolic disease.

Tahzeeb's research looks at two variants of the melanocortin 3 and 4 receptor genes (MC3/4R) which have previously been associated with obesity and weight regulation.  Higher adiposity and weight gain are strong risk factors for gout. Her research aims to investigate the association of these variants with gout in New Zealand Pacific, Māori and European people. Tahzeeb presented her work at both the 2015 and 2016 Pacific Voices Symposium.

Professor Tony Merriman supervised Tahzeeb.

Read more in Tahzeeb's abstract in Pacific Voices:

Acelini Hakopa

2016 HRC Pacific Master's scholarship—mental health

Acelini Hakopa imageAcelini's master's is examining Pacific peoples experience of mental disorder and mental health services.

Pacific people are more likely to experience mental disorders compared to the total New Zealand population. There is an increased need for mental health services for Pacific peoples, however this is not reflected in Pacific service utilisation. This research aims to gain insight into what encourages and deters Pacific peoples from accessing mental health services. The results of this study will inform policy makers and health sector planners on how services can be more responsive to Pacific mental health needs.

Dr Rose Richards Hessell and Dr Jesse Kokaua supervised Acelini.

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Amy Henry

2019 HRC Pacific Health Research Masters Scholarship

Amy is exploring palliative care: Staying at home: A qualitative descriptive study on Pacific palliative care

There is limited research available on palliative health for Pacific people. The available research suggests Pacific peoples prefer to die at home and that Pacific persons with a palliative diagnosis experience significant burden from hospital admission. However, according to the Palliative Care Council of New Zealand, approximately 55% of Pacific persons die within a hospital setting. The reasons for the poor uptake of palliative health services by Pacific people are largely unknown.

The aim of the proposed study is to explore Pacific peoples' experiences of home-based palliative care. The underlying objectives are to gain an understanding of what is important to Pacific people when caring for a palliative family member at home, with a view to understanding how home-based palliative nursing services could better serve this community. A qualitative descriptive design will be utilised to undertake the study using a purposive sampling design and qualitative content analysis.

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Melbournemockba Coudetalei Mauiliu

2016 HRC Pacific Health Research Summer Studentship recipient

Mel Mauiliu imageHaving completed her Master of Public Health in 2014 Mel became an undergraduate again—to study medicine. Her HRC Summer Studentship built on her master's study and investigated interpreting reported lived experiences of injured pacific women in New Zealand.

The research carefully interpreted interview outcomes collected from seven injured Pacific women regarding their experiences with the injury insurer—Accident Compensation Corporation (ACC) and the health services. The research interpreted outcomes from a 2014 studentship supported by HRC. Briefly, the findings reported barriers with ACC process and compensation delay as well as barriers with the health services care provision.

The research aimed to carefully analyse the data, given how sensitive it is, and especially how imperative it is in informing recommendations for ACC and health services when dealing with injured Pacific women. The main researcher liaised with an ACC representative and received supervision to interpret and construct recommendations likely to be adopted by ACC. The data will be presented in a manuscript for submission for peer review in an international journal to contribute to existing literature on Pacific and injury.

Sarah Derrett and Faumuina Associate Professor Fa'afetai Sopoaga of the Department of Preventive and Social Medicine, supervised Mel's project.

Read Mel's master's thesis:
Mauiliu, M. (2014). Outcomes for Pacific Peoples after Injury and the Lived Experiences of Injured Pacific Women in New Zealand (Thesis, Master of Public Health). University of Otago. Retrieved from http://hdl.handle.net/10523/5224

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Jaye Moors

PhD candidate studying genetic and environmental causes of metabolic disease in Maori and Pacific populations

Jaye Moors image

Jaye was born in New Zealand and raised in Samoa. She holds a BSc and a PGDipSci in anatomy and structural biology and is a recipient of the Full Circle Theme: Genetics of Māori and Pacific Health Summer Scholarship.

She completed her master's in biochemistry that investigated the genetic, biochemical, and environmental risk factors influencing the metabolic health, particularly obesity and diabetes, of Pacific adolescents.

Jaye has continued to further enrich her knowledge and passion by securing a NZ Health Research Council PhD scholarship that has funded her PhD studies.

Health outcomes for Māori and Pacific are poor compared to Europeans in New Zealand. Dyslipidaemia, a key component of the metabolic syndrome, is commonly observed in gout patients. The presence of gout has consistently been observed with elevated levels of triglyceride, total cholesterol, LDL cholesterol and apolipoprotein B, all well-established risk factors for cardiovascular diseases (CVD). Gout is also associated with lowering of HDL cholesterol and apolipoprotein A-1 levels, both having a protective role in development of CVD, and there seems to be a genetic difference in control between different Polynesian populations.

Jaye’s PhD evaluates the genetic and environmental causes of serum lipid profiles, and by extension, metabolic disease in Polynesians. This research could make a valuable contribution to Pacific health by identifying pathways that could be targeted in treating and preventing metabolic disorders to which Polynesians are more susceptible.

Professor Tony Merriman, Biochemistry, and Dr Mele Taumoepeau, Psychology, supervised Jaye.

Moors, J. (2016). A Metabolic Health Study of Pacific Adolescents: Investigating the metabolic health of Pacific adolescents in New Zealand: Environmental and genetic risk factors. (Thesis, Master of Science). University of Otago. Retrieved from http://hdl.handle.net/10523/6208

Jaye's profile:

Sujita W Narayan

PhD candidate investigating preventive medicines use in older people

Sujita Narayan image Sujita is from Fiji and is a pharmacist by background. She graduated with her Bachelor of Pharmacy from the Fiji School of Medicine, Suva, and her Master of Pharmacy Practice from Monash University in Melbourne, Australia. Sujita is a PhD candidate and is supported by the School of Pharmacy.

Her research interests lie in managing the use of preventive medicines for older people with multiple conditions, including life-limiting illnesses, and adverse reactions. Sujita presented her work at the Pacific Voices Symposium in both 2015 and 2016.

Dr Prasad Nishtala was supervising.

Amara Shaukut

PhD candidate in biochemistry investigating gout

Amara is an international student from Pakistan. She completed an MS degree in medical physiology and biochemistry at Punjab University, Pakistan, graduating with distinction. She is currently studying towards a PhD in biochemistry supported by a University of Otago Doctoral Scholarship. She has also been involved in teaching and research activities at her home university.

Her study is investigating the genetic association of inflammatory gene PPARGC1B with gout in New Zealand polynesian and european groups.

Professor Tony Merriman is supervising.

Amara presented her work as part of the 2016 Pacific Voices Symposium.

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Vanda Symon

PhD candidate researching the portrayal of forensic science

Vanda Symon imageVanda is of Fijian descent and is a PhD candidate in science communication. She has a BPharm(Hons) and PGCert in Pharmacy Research. Her PhD has been supported by a University of Otago Doctoral Scholarship. She is a published crime writer and is examining the communication of science through crime fiction.

Associate Professor Natalie Medlicott, Dr Susan Heydon, and Professor Warwick Duncan supervised Vanda.

Vanda presented her work as part of the 2015 Pacific Voices Symposium, and again in 2016.

'Alapasita Teu

Pacific students transitioning to university

'Alapasita Teu with family at graduation image'Alapasita is of Tongan and Samoan descent. She has completed a Master of Public Health at the University of Otago looking at the the first-year university experiences of Pacific Health Sciences students. She holds a Bachelor of Physical Education (Hons) and Postgraduate Diploma in Public Health, and has commenced studying towards a BSc. Her research interests lie in Pacific health and education, health policy and the first-year / transition to university experience.

Alapasita presented a paper about Pacific students Health Sciences First Year programme experiences at the 2015 Pacific Voices Symposium.

Faumuina Associate Professor Fa'afetai Sopoaga and Dr Jaques van der Meer supervised this project.

Ala subsequently joined the Office of Pacific Development, University of Otago, as Assistant Research Fellow.

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Elizabeth Williams

Doctoral candidate in clinical dentistry

Elizabeth was born and raised in Samoa. She completed her first degree in dentistry at the Fiji School of Medicine and then undertook a postgraduate diploma in clinical dentistry at the University of Otago. She is now studying towards a Doctorate of Clinical Dentistry majoring in oral pathology.

Elizabeth's study is investigating the presence of human papillomavirus in verrucal-papillary lesions of the oral cavity, and comparison of viral detection methods. Her supervisors are:

Elizabeth presented her work at the 2016 Pacific Voices Symposium.

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Meet our undergraduates

Our University of Otago Pacific undergraduates have done exceptionally well in the Health Research Council (HRC) Career Development Awards for Summer Studentships. Recipients between 2015 to 2019 are listed below—we congratulate them on their success!

Ulalei Aiono

2015/16 HRC Pacific Health Research Summer Studentship recipient

Ulalei Aiono imageUlalei is studying pharmacy and explored Pacific people's opinions about prescription charges.

Her research looked at Pacific people's opinions on prescription charges. It is something that affects us all and studies show that Pacific people have poorer health and a lower socio-economic status so it affects them the most.

The aim of this research was to see if Pacific people are aware of how prescription charges work, and if they know that they are entitled to free medicines after paying for 20 items (within a year). Knowing this information can make it a lot easier for them to afford medicines.

Professor Pauline Norris, Department of Pharmacy, supervised this project.

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Toni Anitelea

2016/17 and 2018/19 HRC Pacific Health Research Summer Studentship recipient

2016/17

Toni is studying follow up of hip and knee arthroplasty patients returned to their GP.

Hip and knee joint replacements are relatively expensive to provide, but are one of the most cost-effective and successful interventions provided by the orthopaedic profession. In Otago there has been an ever increasing demand for surgery. This consequently leads to a greater number of patients being returned to their general practitioner (GP). Following return to GP patients may either be re-referred and given certainty for surgery, may choose to go private, or may remain in GP care until they deteriorate.

Initial research suggests that at least 25% of patients are re-referred within 4 months however it is not known how many patients remain in the community without surgery. We wish to track the outcomes of these patients returned to their GP after being wait-listed for hip or knee replacement. We can quantify time spent waiting and deterioration within patient-derived Oxford Hip or Knee scores and WOMAC scores.

2018/19

Toni is examining the immunogenetics of Rheumatic Fever and rheumatic heart disease.

Acute Rheumatic Fever (ARF) can develop after infections with Group A Streptococcal (GAS) bacteria. If untreated this can lead to Rheumatic Heart Disease (RHD). New Zealand children, especially Māori and Pacific Peoples, have a much higher rate of GAS infections and subsequent ARF and RHD than other first-world countries. The current best practice to reduce the risk of ARF and RHD after a confirmed GAS infection is prophylactic BPG delivered once every 4 weeks to maintain a protective level of Penicillin.

This project will engage with Pacific communities and review published studies from around the world to investigate the Immunogenetics of ARF and RHD. A research report on current state of knowledge around the Immunogenetics of ARF and RHD will be prepared highlighting gaps to be investigated and potential areas of focus.

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Adaab Azam

2015/16 HRC Pacific Health Research Summer Studentship recipient

Adaab Azam imageAdaab is studying towards a BBiomedSc, and looked at the relationship between multimorbidity and polypharmacy.

A recent epidemiological study has shown that chronic disease and multimorbidity to be common for people aged 65 years or older. Multimorbidity has extremely poor outcomes such as reduced quality of life and increased mortality. The Māori and Pacific populations have the greatest prevalence of chronic diseases and are thus are highly susceptible to multimorbidity and polypharmacy. Extrapolating from a Scottish study, it is likely that these two populations experience multimorbidity and polypharmacy at an earlier age than New Zealand Europeans.

This study aimed to determine the prevalence of multimorbidity and polypharmacy with respect to age, deprivation, and ethnicity, and to explore the relationship between multimorbidity and polypharmacy.

Tim Stokes in the Department of General Practice (Dunedin School of Medicine) and Fiona Doolan-Noble in Primary Health Care and General Practice, University of Otago, Wellington, supervised this project.

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Sophia Dean

2017/18 HRC Pacific Health Research Summer Studentship

Sophia examined Tongan children's physical activity—native vs New Zealand migrants.

The Pacific is a world leader in non-communicable diseases (NCDs). Reducing premature mortality from NCDs by one third by 2030 is the NCD target for the United Nations Sustainable Development Goals. This is a major challenge for the Pacific region (United Nations, 2017). In 2016, the Kingdom of Tonga hosted the Pacific NCD Summit that explored how to accelerate progress in addressing the NCD challenge.

Tonga has had an NCD Strategy since 2004. Current priorities focus on children and adolescents and include increasing physical activity. This research will report on Kids’Cam Tonga, using innovative methodology to explore the world of Tongan children by analysing the causes of, and interventions to address, Non-Communicable Diseases in Tonga. It will do so through an initial analysis of the physical activity of Tongan children and compare this to Tongan children in New Zealand.

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Damaris Dekker

2015/16 HRC Pacific Health Research Summer Studentship recipient

Damaris Dekker imageDamaris, studying medicine, investigated the extent of preventable illness in Pacific children and infants.

This project examines the incidence of the leading preventable illnesses in New Zealand for children between 0–4 years by ethnicity. This project will utilise the New Zealand Child and Youth Epidemiology Service data, published in the report for the Ministry of Health and the Paediatric Society of New Zealand.

Damaris looked at the health services provided in New Zealand and how well these services are tailored to pacific needs, particularly between each pacific ethnic group, and the result on pacific health outcomes for young children. The area of research is within public health but will not be limited to this field. It is an important question of interest as these are preventable conditions which are effecting Pacific children at higher rates than non-pacific. Investigating the possible causes for these results is key to identifying ways to address the inequalities within Pacific child health statistics.

Rose Richards Hessell and Jean Simpson in the Department of Preventive and Social Medicine, and Jesse Kokaua, Department of Population Health, University of Otago, Christchurch, supervised Damaris's project.

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James Devoe

2015/16 HRC Pacific Health Research Summer Studentship recipient

James Devoe image James is studying medicine and analysed risks affecting vulnerable unborn babies at Counties Manukau Health, Auckland.

Counties Manukau Health has over 6000 deliveries each year. Maternity services, as well as providing clinical care, may identify social and care and protection issues such as family violence, drug and alcohol abuse, maternal incarceration, abuse of older siblings, and/or children removed into the care of Child Youth & Family Services.

The research project constructed a report describing vulnerable at-risk babies referred in the antenatal period at Counties Manukau Health. This involved carrying out a clinical audit of medical records for babies referred during the two year period of 2014–2015 analysing:

  • Demographics
  • Care and protection issues
  • Birth plan management
  • Social service and statutory agency intervention

The results of this research will enable Counties Manukau to better understand the vulnerability and complexity of this high risk group, enabling better service planning and delivery.

Faumuina Associate Professor Fa'afetai Sopoaga, Preventive and Social Medicine, and Teuila Percival, University of Auckland, supervised James' project.

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Adam Faatoese

2018/19 HRC Pacific Health Research Summer Studentship

Adam is investigating the applicability of ctDNA as a tool for early cancer detection.

The burden of cancer among Pacific peoples living in New Zealand and in the Pacific remains a public health concern. Given the health inequalities that exist for Pacific peoples and the global burden of cancer, it remains a priority to consider the medical situation for cancer patients not only in New Zealand but also in the Pacific.

It is acknowledged that within this resource-constrained environment, the diagnosis, treatment and management of cancer patients is fraught with challenges and difficulties where routine tests and equipment may be unavailable and even vary from hospital to hospital. Overall this project seeks to explore the literature base to support the utilisation of a cancer detection method known as circulating tumour DNA (ctDNA) to improve the diagnosis, care and health outcomes of cancer patients with a focus on exploring its use as an early cancer detection method.

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Jonathan Feki

2015/16 HRC Pacific Health Research Summer Studentship recipient

Jonathan Feki image Jonathan, who is studying medicine, examined patients' perspectives of spiritual care and treatment for kidney disease in New Zealand.

Kidney disease is an ever growing issue in New Zealand, particularly for Pacific and Māori populations. Kidney disease in most cases requires long-term management. Thus it requires treatment beyond that of a biopsychosocial approach but one also inclusive of 'spirituality'. This research proposed a closer look into the provision of spiritual care in a renal-based clinical setting. It looked to uncover the perspectives of renal patients on this provision of care and their understanding of spirituality.

Richard Egan, Department of Preventive and Social Medicine, supervised this project.

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Theresa Fitzpatrick

2015/16 and 2017/18 HRC Pacific Health Research Summer Studentship recipient

Theresa Fitzpatrick image 2015/16

In 2015/16 Theresa, studying towards a BBiomedSc, investigated the suitability of a low-carb, high-fat diet among Pasifika peoples.

Low carbohydrate diets are currently receiving huge publicity and coverage in both social media and in the academic literature. Thus the wider community are currently bombarded with claims that low carbohydrate (often promoted as high fat) diets are the healthiest option for both the general population and those with diabetes or at high risk of developing diabetes, such as Māori and Pasifika people.

However, little is known about the acceptability of these diets among Māori and Pasifika people, who traditionally consume diets high in carbohydrates. There is also a risk that such advice could be misinterpreted as giving a green light to eating unlimited quantities of high fat foods that are not compatible with good health.

We aimed to investigate how low carbohydrate diets are perceived by members of the local Pasifika communities and the barriers and facilitators to following this type of diet.

Lisa Te Morenga, Human Nutrition, and Moana Theodore, Psychology, supervised this project.

2017/18

In 2017/18 Theresa investigated Heart samples collected by Heart Otago—the link to Pacific populations.

From 2006 to 2007, 10 per cent of Pacific peoples aged over 15 years were diagnosed with diabetes – approximately three times the diagnosis rate for the total New Zealand population (Statistics New Zealand and Ministry of Pacific Island Affairs, 2011). Diabetes and heart disease are becoming increasingly common among Māori and Pacific populations in New Zealand, and this project will aim to explore the feasibility to link human functional cardiovascular and clinical data to diabetes and heart disease in pacific populations.

Using heart tissue collected by HeartOtago, the goal of the current project is to compare the functional outcomes of the diabetic and non-diabetic human heart studies to patient characteristics such as ethnicity. This could provide a perspective on the current status of diabetic heart disease specific to a Pacific population.

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Kaylarina Fuata'i

2015/16 HRC Pacific Health Research Summer Studentship recipient

Kaylarina Fuata'i imageKaylarina, studying medicine, investigated rheumatic fever injection compliance rates in Samoa.

Rates of rheumatic fever and rheumatic heart disease are both diseases of developing nations. They are also particularly prevalent among pacific island nations. Being a developed country, New Zealand has astounding rates of rheumatic fever especially among the pacific population.

"In this study, I looked at the compliance rates of patients with acute rheumatic fever to their antibiotic injections. These injections are supposed to prevent the recurrence of future episodes of rheumatic fever. Multiple episodes can in fact fast track the progression onto rheumatic heart disease which has dire outcomes. Many factors affect rates of compliance such as age, gender and location. I  analysed patient data on compliance and tried to look at which variables are associated with good and bad compliance rates."

Philip Hill, Centre for International Health, Preventive and Social Medicine, supervised Kaylarina's project.

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Ryder Fuimaono

2015/16 HRC Pacific Health Research Summer Studentship recipient

Ryder Fuimaono imageRyder, studying medicine, conducted a paired case study to investigate Samoan patients' pathways to renal services.

Chronic kidney disease (CKD), and the need for health care services to manage CKD, are increasing internationally. The Global Burden of Disease 2010 study identified chronic kidney failure as one of the three causes of death with the greatest increase from 1990 to 2010. In New Zealand, the incidence of new patients entering the renal replacement programme is increasing by 10–12% per annum.

Sarah Derrett and Faumuina Associate Professor Fa'afetai Sopoaga of the Department of Preventive and Social Medicine, and Rob Walker, Department of Medicine (Dunedin School of Medicine) supervised Ryder's project.

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Hilla Fukofuka

2015/16 HRC Pacific Health Research Summer Studentship recipient

Hilla Fukofuka imageHilla, studying medicine, investigated associations between mental wellbeing and diabetes biomarkers in Pasifika youth.

Type 2 diabetes is a rising epidemic in New Zealand, with Pacific adolescents being a particular high-risk group, who also have the highest rates of mental illness. However, emerging research both nationally and internationally is showing positive associations between mental wellbeing and good physical health—several studies have been using diabetes risk factors as the variables for biological markers of health.

This research project will analyse the data of a local Dunedin study with Pacific adolescents, which has also found similar correlations so as to assess the nature of the associations found. Combined with a literature review on this particular field, such knowledge has the potential to help us fight these two issues of diabetes and poor mental health by allowing us to tailor new potential interventions to this high-risk group of Pacific adolescents.

Mele Taumoepeau, Department of Psychology, supervised this project.

Hilla presented her work at the 2016 Pacific Voices Symposium.

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Tumanu Futi

2016/17  and 2018/19 HRC Pacific Health Research Summer Studentship recipient

2016/17

Tumanu is studying the effects of uric acid on beta cell function.

The purpose of this project is to investigate the effects of hyperuricemia on pancreatic beta cell function. Hyperuricemia has been linked to major diseases such as cardiovascular diseases as well as diabetes mellitus and gout. Sadly, these diseases have also become an increasing health threat to the Pacific population.

Studies have identified that Pacific populations may already be predisposed to these diseases due to our genetics. Therefore, this project aims to extend our understanding of how decreasing uric acid in the blood will benefit the health of Pacific Island population by looking specifically at the urate transporter GLUT9.

Dr Marie Inder co-supervised Tumanu's project.

2018/19

Tumanu is researching if elevated cardiac fibrosis in Pacific patients is associated with reduced klotho.

Diabetes is known risk factor for development of heart disease and Pacific people are more likely to develop diabetes (11.1%) compared to Māori (7.6%) and NZ European (4.9%). Māori and Pacific patients are also carrying the heaviest burden of cardiovascular disease requiring surgical intervention at a younger age.

The question is why does this earlier manifestation of cardiovascular disease occur? We know that ageing and fibrosis are important players in detrimental changes in heart function, with the ability of the heart to contract and work effectively reduced in older individuals and with increased fibrosis.

Klotho is an anti-ageing protein, and when this protein is low it induces a variety of disorders including increased fibrosis. Perhaps the answer is that the level of klotho is low in Pacific and Māori which could lead to an increased level of cardiac fibrosis and could explain the early diagnosis of heart dysfunction in these cohorts.

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Louise Jansen

2017/18 HRC Pacific Health Research Summer Studentship

Louise investigated acceptability of the treadmill six-minute walk test in Pacific peoples.

The traditional hall-way six-minute walk test has been used successfully as a measure of cardiorespiratory fitness in Māori and Pacific peoples with multi-morbidity. However, exercise interventions are more commonly run in community settings where long hallways do not exist, which suggests the need for an alternative outcome measure. Previously, the treadmill six-minute walk test have been trialed and validated in people with other health impairments, such as following cardiothoracic surgery. While this may be a useful measurement tool in a community setting, the acceptability and the validity of the treadmill six-minute walk test in Māori and Pacific peoples is not yet known.

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Mary Jane Kivalu

2016/17 HRC Pacific Health Research Summer Studentship recipient

Mary Jane Kivalu imageMary Jane is reviewing New Zealand district health boards' policies about translation services.

This is a project reviewing New Zealand District Health Board policies about translation services, with a focus on Pacific. The aim of this project is to examine the availability of interpretation services for Pacific peoples accessing healthcare in New Zealand. To achieve this aim, this study will submit an Official Information Request to the 20 District Health Boards in New Zealand, and use the data to analyse translation services within each District Health Board and the process / guidelines to providing this service.

The study will also heavily focus on its service for Pacific peoples, identifying which languages are covered by the services and whether there are enough Pacific interpreters relative to the amount of Pacific people living in the region. This will provide information about necessary improvements needed in the healthcare service for Pacific peoples who deserve high quality service, and also an opportunity for further research with Pacific patients.

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Bridie Laing

2018/19 HRC Pacific Health Research Scholarship

Bridie is investigating: What are the reformulation preferences of children and young people receiving regular BPG injections?

Acute Rheumatic Fever (ARF) is an autoimmune condition caused by untreated Group A Streptococcal (GAS) infection of the throat and possibly skin. Multiple or severe attacks of ARF can cause permanent heart damage known as Rheumatic Heart Disease (RHD). Painful monthly injections of Benzathine Penicillin G (BPG) are given intramuscularly for 10 years or more to prevent GAS infections.

This project seeks to explore the perspectives and preferences of children and young people who received regular BPG injections to prevent ARF/RHD for a new reformulated version of BPG. These findings will directly inform global research efforts to reformulate BPG to produce a more appropriate form of Penicillin for those with ARF/RHD.

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Zebulun Laqekoro

2015/16 HRC Pacific Health Research Summer Studentship recipient

Zebulun Laqekoro imageZeb, studying dentistry, examined Pacific young people's perspective of oral health and oral health care.

Poor oral health is an important public health issue. Untreated dental caries in permanent teeth are the most prevalent condition worldwide, affecting 2.4 billion people, and untreated caries in primary teeth are the 10th-most prevalent condition, affecting 621 million children worldwide.

Adolescents represent a challenging group in terms of oral health as they have their permanent teeth erupting and it is a time when they are establishing their independence. New Zealand research has indicated that regular dental visiting is associated with better oral health outcomes.

Previous New Zealand studies that have explored issues relating to Pacific young people’s oral health have confirmed that Pacific young peoples’ attendance at dental or dental therapy appointments is very low and below the attendance of other, same-age peers. This research project explored Pacific young peoples’ attitudes and beliefs towards oral health and oral health care.

Zeb is a local Dunedin student with a Fijian background. He is studying towards a Bachelor of Dental Surgery (BDS).

"I am enjoying my time at University and meeting exciting new people. Dentistry is a difficult course but it challenges me and I enjoy that aspect about it. Five years ago I would not have thought I would be in such a privileged position and it is all thanks to the Pacific Foundation Programme!"

Lyndie Foster Page, Oral Sciences, and Vivienne Anderson, Higher Education Development Centre (HEDC) supervised this project.

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Nina Maifea

2015/16 HRC Pacific Health Research Summer Studentship recipient

Nina MaifeaNina's project was called Rethink: factors influencing student's life-work balance decision. She is studying towards a Bachelor of Oral Health (BOH).

The decisions students make at the beginning of their career will affect the rest of their lives. Pacific students planning to enter the health professions have the potential to improve the health of New Zealand's Pacific population.

This study looked to investigate and understand some of the underlying influences, thoughts and pre-existing ideas of Pacific health sciences students when deciding on a career path. By understanding factors influencing their decision making, we can help support services, students, and Pacific people.

Bryndl Hohmann-Marriott, Department of Sociology, Gender and Social Work, supervised this project.

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Brogan Maoate

2015/16 HRC Pacific Health Research Summer Studentship recipient

Brogan Maote image Brogan examined patterns of nutritional behaviour among a Pacific Christchurch cohort. She is studying medicine.

The study documents cardiovascular and metabolic profiles for Pacific in the South Island, by recruiting and screening 200 Pacific adults living in Christchurch aged 20–64 years. It involved a nutrition questionnaire with face-to-face interviews and novel lipoprotein profiles (circulating and genetic) will also be investigated to provide normal range data for lipoproteins and assess their use for calculating risk among a Pacific cohort.

The significant decline of heart disease mortality over the past 50 years for the New Zealand population has been slower for New Zealand’s Pacific population. Previous Pacific cardiovascular risk data are over a decade old and originate from the Auckland region, therefore a more recent study is well overdue.

Allamanda Fa'atoese, University of Otago, Christchurch, supervised Brogan's project.

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Brooke Marsters

2016/17 HRC Pacific Health Research Summer Studentship recipient

Brooke is investigating antibiotic prophylaxis and the progression of acute rheumatic fever to rheumatic heart disease.

The effectiveness of interventions aiming to control acute rheumatic fever (ARF) and prevent its dangerous sequela rheumatic heart disease (RHD) is limited by a lack of knowledge of the ARF causal pathway. In this study we will determine the proportion of ARF cases that progress to RHD, and what proportion of ARF cases that did and did not progress were receiving regular antibiotic prophylaxis.

The ultimate goal of this research is to inform ARF control and prevention interventions in order to improve their effectiveness.

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Melbournemockba Coudetalei Mauiliu

2015/16 HRC Pacific Health Research Summer Studentship recipient

Mel Mauiliu imageHaving completed her Master of Public Health in 2014 Mel became an undergraduate again—to study medicine. Her HRC Summer Studentship built on her master's study and investigated interpreting reported lived experiences of injured pacific women in New Zealand.

The research carefully interpreted interview outcomes collected from seven injured Pacific women regarding their experiences with the injury insurer—Accident Compensation Corporation (ACC) and the health services. The research interpreted outcomes from a 2014 studentship supported by HRC. Briefly, the findings reported barriers with ACC process and compensation delay as well as barriers with the health services care provision.

The research aimed to carefully analyse the data, given how sensitive it is, and especially how imperative it is in informing recommendations for ACC and health services when dealing with injured Pacific women. The main researcher liaised with an ACC representative and received supervision to interpret and construct recommendations likely to be adopted by ACC. The data will be presented in a manuscript for submission for peer review in an international journal to contribute to existing literature on Pacific and injury.

Sarah Derrett and Faumuina Associate Professor Fa'afetai Sopoaga of the Department of Preventive and Social Medicine, supervised Mel's project.

Mel's master's thesis:
Mauiliu, M. (2014). Outcomes for Pacific Peoples after Injury and the Lived Experiences of Injured Pacific Women in New Zealand (Thesis, Master of Public Health). University of Otago. Retrieved from http://hdl.handle.net/10523/5224

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David Nair

2015/16  and 2017/18 HRC Pacific Health Research Summer Studentship recipient

David Nair graduating image2015/16

David's 2015/16 project looked at alcohol consumption and behaviours of pacific youth. He is studying medicine.

With all ethnicities in New Zealand, alcohol is a burden for the health of Pacific people. It has been estimated that more than five per cent of premature deaths in New Zealand are attributable to alcohol and, based on information from the Ministry of Health, 79 per cent of people aged over 15 drink alcohol. However, there is limited research focused on Pacific people and even less on Pacific youth.

Pacific high school students have been shown to be less likely to be drinkers compared to non-Pacific, but drink more when they do drink, and experience a disproportionate burden of alcohol related harm. This project summarised current knowledge about Pacific youth drinking from previous research, and expanded knowledge by analysing survey data that had already been collected. We need to know more about the patterns of drinking amongst Pacific people to identify opportunities for health promotion, and specific issues for research.

Jennie Connor, Preventive and Social Medicine, supervised this project.

2017/18

In 2017/18 David explored development of a 3D printed thoracoscopic oesophageal atresia simulator.

This project will develop a model paediatric surgeons can practice and acquire the skills for a difficult and challenging key-hole (thoracoscopic) operation in babies (neonates). The simulated operation is the repair of an oesophagus which has developed abnormally. This abnormality consists of a blind ending upper oesophageal pouch and the lower oesophagus abnormally attached to the main airway.

The operation requires separation of the lower oesophagus from the airway and joining it to the upper oesophagus pouch within the small space of a baby’s chest by the keyhole method (thoracoscopic oesophageal atresia and tracheo-oesophageal fistula repair). This project is of importance to Pacific health as Pacific babies have higher rates of congenital anomalies than the general New Zealand population. Therefore developing effective treatment options are of particular importance for Pacific health and the broader New Zealand population.

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Johanna Nee-Nee

2016/17 HRC Pacific Health Research Summer Scholarship recipient

Johanna is investigating the impact of media coverage of cancer issues in New Zealand. She asks if media are raising awareness or creating confusion.

Cancer is an important issue for Pacific health, with some evidence that Pacific peoples in New Zealand experience higher incidence and mortality of some forms of cancer. It is a government goal that, by 2018, more people will be aware of cancer risks and doing something about them. The news media plays an important role in shaping awareness and understanding of health risk behaviours.

This study involves a content analysis of news reporting related to cancer over a five month period. Patterns in media presentation of information about cancer control will be contrasted with the findings of a national study of public perceptions of cancer and used to discuss alignment and misalignment with evidence-based recommendations about health behaviour.

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Oprah Pupi

2018/19 HRC Pacific Health Research Summer Scholoarship

Oprah is exploring the anti-cancer properties of traditional remedies.

This feasibility study will explore the anti-cancer properties of a combination of turmeric and papaya (esi) leaves. It will also explore the options of best research protocols to follow in order to balance the desire of growing knowledge in this area with the protection of indigenous knowledge and sharing of benefits between the research partners. This research will set the foundation necessary for the larger project led by Professor Rhonda Rosengren and Dr Marie Inder.

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Ashleigh Raikuna

2016/17 HRC Pacific Health Research Summer Scholarship recipient

Ashleigh Raikuna imageAshleigh is studying the effects of severe early childhood caries on Pacific Island families, she is a final year dentistry student in 2017.

Although oral health is improving on a national scale, substantial disparities remain between Pacific and non-Pacific people, in both oral health and access to oral health care services. Dental caries during childhood can affect development, school performance and behaviour, as well as affecting the wellbeing of the child’s family unit. Despite being largely preventable, early childhood caries (ECC) continues to be one of the most prevalent diseases to affect young children.

ECC is difficult to manage in the general dental setting, and subsequently extensive decay often requires children to undergo dental treatment under general anaesthesia. This is associated with a significant burden to the public health sector (approximately NZD$2400 per case). Around 6000 children per year in New Zealand require their dental treatment to be carried out under a dental general anaesthesia (DGA). Pacific children are significantly overrepresented among those with higher rates of hospital admission due to dental decay, and poorer access to oral health care services.

This project aims to investigate the characteristics of Pacific Island children in the last five years who have had a DGA in Auckland:

  • To explore the parents’ experiences of the impact that severe ECC has on their child and family
  • To understand what Pacific Island parents face in seeking dental care for their children
  • To understand their cultural attitudes, understandings and beliefs surrounding oral health.

Her supervisor was Associate Professor Lyndie Foster Page, along with co-supervisors Professor Murray Thomson (Oral Sciences) and Dr Marie Inder (formerly Division of Sciences).

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Troy Ruhe

2015/16 and 2017/18 HRC Pacific Health Research Summer Studentship recipient

Troy Ruhe imageTroy is a Physical Education student who conducted his summer research through the School of Physiotherapy.

2015/16

Troy's 2015/16 project focused on falls risk, incidence and prevention, for Pacific peoples

Elders falling has major consequences for health and quality of life. With the School of Physiotherapy, he did a scoping literature review of the current exercise practice for elder falls in Pacific communities. He then investigated the falls risk, and attitudes towards exercise as falls prevention, within a Dunedin Pacific community.

The questionnaires (Ask, assist, act, and Attitudes towards Falls Intervention Scale) were administered to Pacific elders in a diabetes exercise group and a community exercise group run by Pacific Trust Otago, Dunedin.

This research could help to decrease the amount of elder falls within Pacific communities by knowing what forms of exercise would be of most value to the Pacific community, and how to best deliver that information in accordance to community preference.

Rose Richards Hessell, Preventive and Social Medicine, and Associate Professor Debra Waters supervised Troy. Debra Waters is a research expert in the area of falls, and is Director of Gerontology (School of Medicine / School of Physiotherapy). She is also Director of the Collaboration of Ageing Research Excellence (CARE). Troy also worked with School of Physiotherapy Professional Practice Fellow, Chris Higgs. Chris brings his experience of working with community exercise classes for Pacific Peoples in Dunedin. The entire research team was well supported and guided throughout the process with consultation from Pacific Trust Otago.

For Troy this research experience has highlighted “an understanding of the need for cultural sensitivity within practice, as well as the motivation to contribute, where I can, to better health in Pacific communities”.

2017/18

In his 2017/18 project Troy examined the effectiveness of circuit-based exercise in Cook Islands communities.

The proposed research is a physical activity intervention that will take place in Cook Island communities of both New Zealand and within the Cook Islands. The development of a physical activity programme which comprises movements of traditional Cook Islands daily activities of food gathering and preparation has been piloted to test the feasibility and acceptability of such imagery.

The main aim of the study is to determine effective strategies to increase physical activity adherence within Cook Islands communities. This aim will be achieved through developing a validated strength-based model for Cook Islands health through the medium of physical activity incorporating Cook Islands values, belief systems and principles within a Cook Islands framework.

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Fuakava Tanginoa

2015/16 and 2018/19 HRC Pacific Health Research Summer Studentship recipient

Fuakava Tanginoa image2015/16

Fuakava is studying towards a BSc in Physiology. Her project examined ethical issues in sexuality education with an exploration of Pacific approaches.

This studentship helps to start the conversation about sexual health in Pacific communities. The sensitive subject of sexual education in a Pacific community is hard to understand, as is why there is a taboo about it. What we can do is look into sexual education with an ethical approach by starting with a literature review to help build a better understanding of this.

The lens that will be used to reflect on this area is the ethical concept of autonomy; where the individual can be able to make their choices based on their own knowledge of sexual education. This is an important concept as you would expect to make decisions based on fully informed decisions. In relation to Pacific people cultural beliefs, values and tradition contributes and plays an important role in autonomous decision making.

Grant Gillett, Bioethics Centre, supervised Fuakava.

2018/19

Kids'Cam

This study investigates the infectious disease risk factors present in NZ Pacific children's everyday environments. The study uses image data from Kids'Cam to determine from the Pacific participants' perspectives the features of their day-to-day lives that increase their risk to infectious diseases. The findings will better inform interventions to reduce the risk factors present in Pacific children’s lives and contribute to improvements in their health.

The findings of the current study will also be used to compare and contrast the risk factors present in the lives of children living in Tonga using previous findings from Kids’Cam Tonga.

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Eirenei Tauai

2015/16 HRC Pacific Health Research Summer Studentship recipient

Eirenei Tauai imageEirenei, studying towards a BSc in neuroscience, investigated if language has a positive impact of the prevalence of mental health.

This research project aimed to explore language, place of birth, mental health illness, addiction and service use in in the Te Rau Hinengaro: New Zealand Mental health survey. She employed a quantitative approach in order to explore if language has a positive impact on the prevalence on mental health.

The project will provide evidence about if having a Pacific language is a protective factor for mental disorder, or for accessing mental health services.

Jesse Kokaua, Department of Population Health, University of Otago Christchurch, and Rose Richards, Preventive and Social Medicine, were supervisors.

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Jordan Taylor

2018/19 HRC Pacific Health Research Summer  Studentship  recipient

New Zealand has some of the highest cases of eczema and skin infections in the developed world. The microbiome plays a critical role in the development of eczema in early childhood. Escherichia coli has been associated with an increased risk of developing infant atopic dermatitis and it is its strain variation that drives this clinical difference. E. coli is associated with health outcomes that disproportionately affect Pacific children.

Analysing the sequencing data from a well-phenotyped cohort, I will quantify the number of unique strains of E. coli within individuals and identify if there is an atopic dermatitis-associated phenotype. This could potentially be used as a therapeutic target. Furthermore, I will be investigating if there is a difference in the unique strains between the Pacific Infant microbiomes and the microbiome of Māori and Caucasians.

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'Eseta Vaipuna

2017/18 HRC Pacific Health Research Summer Studentship recipient

'Eseta studied the home environment of Tongan children, identifying and analysing the risk factors present in the homes of children in Ha'apai, Tonga, and addressing them to reduce the spread of infectious disease across the Pacific, particularly to New Zealand.

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Tevita Vaipuna

2016/17 and 2017/18 HRC Pacific Health Research Summer Studentship recipient

2016/17

Tevita explored if sleep differs according to ethnicity in children.

Tevita is conducting an analysis of accelerometer data from over 1000 children gathered over a period of seven night's sleep. He will then determine whether there is any variation in sleep duration, timing, and/or variability, between ethnicities of children in New Zealand.

2017/18

In this study he examined Tongan children's nutrition—native vs New Zealand migrants.

An investigation into the similarities and differences between the diets of Tongan children in Tonga, and Tongan children in New Zealand. By doing this, we hope to see how the traditional Tongan diet can be used to improve the diets of Pacific children in New Zealand.

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Tapuaki (Langi) Vehikite

2015/16 HRC Pacific Health Research Summer Studentship recipient

Langi Vehikite imageLangi's summer research project studied the antifibrotic effect of remote ischemic preconditioning on the diabetic heart.

Langi is Tongan and was born and raised in Christchurch. She came to the University of Otago through the Dux Scholarship and completed her Bachelor of Science, majoring in Physiology, in 2014. In 2015 she was working towards her BSc(Hons) in Physiology with a focus on the cardiovascular system.

Diabetes leads to progressive loss of cardiovascular cells which are replaced by fibrotic scar tissue, making the heart stiff, leading to the development of contractile dysfunction of the heart. This research determined whether remote ischemic preconditioning (rIPC), a process that activates endogenous survival cascade, is able to prevent the loss of cardiac cells and hence development of fibrosis in diabetic heart.

This was determined by histological analysis for cardiac fibrosis in heart tissues, collected from diabetic and non-diabetic mice that underwent rIPC, and correlating the level of fibrosis to contractile parameters in diabetic hearts.

This was the first study to examine the effects of rIPC in protecting the diabetic heart against fibrosis, and hence therefore potential heart failure. This research is particularly important in improving health in Pacific people because the incidence of mortality rate from diabetes-related heart diseases is five times greater in Pacific people.

Dr Rajesh Katare, Department of Physiology, supervised this project.

Langi also presented this work as part of the Pacific Voices Postgraduate Symposium in 2015:

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