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Monday 18 June 2018 1:21pm

As part of its annual funding round, the Health Research Council has just awarded $55.56 million to 49 projects with the potential to vastly improve the health of New Zealanders. The Dunedin School of Medicine warmly congratulates the following researchers who were awarded almost $4.4 million in grants.

Professor Haxby AbbottDepartment of Surgical Sciences, Dunedin School of Medicine
Project: The primary care management and impact of osteoarthritis: learning from big data

36 months, $1,199,993
Osteoarthritis (OA) is a very common chronic condition, causing a significant health and social burden. Every year more than 5 per cent of the total adult population ≥55 years will consult their general practitioner about OA. Overseas, it is known that management of OA is well short of best practice. In New Zealand, little is known about how GPs actually manage people with OA across the long-term course of the disease. Further, we have poor information about the economic and social costs (such as employment, productivity, income and welfare effects), due to lack of knowledge of the early clinical course and management of OA. This study will investigate the primary care management of OA, the health and social economic costs of OA across the whole course of the disease, and the potential gains from improving the delivery of care for OA. This will inform GP practice and national health policy.

Professor Michael Eccles Department of Pathology, Dunedin School of Medicine
Epigenomic profiling to predict patient response to melanoma immunotherapy

36 months, $1,198,714
The recent developments of cancer immunotherapies that target immune checkpoint proteins are demonstrating durable clinical success for melanoma patients. However, a large proportion (60-70 per cent) of patients do not respond to this treatment and therefore it is crucial to develop predictive biomarkers for the success of this therapy. Recent data from pre-clinical models and our own work suggest that distinct DNA methylation profiles of patients could potentially serve as a predictive biomarker.
Based on epigenomic and immune gene-related profiles of responder and non-responder patients, we will develop a DNA methylation marker panel that predicts the likelihood of melanoma patients responding to immune checkpoint treatment. We will then perform functional assays and molecular editing of key loci to understand how exclusive DNA methylation changes in cells regulate immune checkpoint signalling. This work will contribute to selecting the best treatment option for patients, and also for developing new targets for epigenetic therapies.

Dr Rebecca BrooklandDepartment of Preventive and Social Medicine, Dunedin School of Medicine
Predictors and impact of driving cessation on older adults and whanau/families

48 months, $1,199,989
This research focuses on balancing the need for independent mobility among older drivers with their safety and that of other road users. Stopping driving can have serious consequences for older people: depression, poorer health, and social isolation. The transition to driving cessation can be distressing for drivers and families. This 4 year longitudinal study of drivers over 65 years and family members will investigate how older adults modify their driving, meet their transport needs and adapt to driving cessation, and the role families play. Study participants, 15 per cent Māori, have been recruited and interviewed once. Two further interviews (2 and 4 years later) will be undertaken to identify individual and family factors associated with driving self-regulation and cessation, and assess the impact of these changes on social, psychological, health and mobility outcomes. The findings will contribute to better policy, a need identified by NZ Road Safety and Positive Ageing Strategies.

Professor Timothy Stokes, Department of General Practice and Rural Health, Dunedin School of Medicine
Do regional DHB groupings improve service integration and health outcomes?

24 months, $799,562
This research aims to improve health care for New Zealanders through studying the four regional District Health Board (DHB) groupings which together cover all of New Zealand (NZ). The four regional DHB groupings are fundamental to delivering better integration of health care as they plan, fund and deliver health services in their defined geographical regions, with the aim of reducing fragmentation, duplication and service vulnerability. We do not know if these four regional DHB groupings have delivered improved health outcomes for New Zealanders and whether, if they have achieved this, what organisational features explain this success. This research will use a combination of interviews with key stakeholders and analysis of routine collected health system measures to answer these questions. It seeks to explore if regional DHB groupings can improve health outcomes and, if so, to understand what is it about the way they operate that may explain their success.

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