Faculty of Medical and Health Sciences


Externally Funded Projects


We are pleased to advertise the following 2019 - 2020 summer research projects. These projects have already secured funding from external sources.

If you are interested in any of the projects below, please contact the supervisor/contact person by email or phone in the first instance. The project supervisor will assess your suitability to undertake the research project and will select a student based upon their own independent eligibility requirements. Further opportunities will be added as they arise.

Once the proposal is finalised and agreed with the supervisor, please complete the 2019 FMHS external SRS application form and give to your supervisor, along with:

  • A copy of your current CV
  • Your academic transcript and
  • A copy of your bank account details - submit a screen print including bank logo, bank name, your name and bank account details
*
2019 FMHS external Summer Research Project application form
This is the 2019 externally funded scholarships application form (217.2 kB, MSWORD)

**FILLED**Counties Manukau DHB**FILLED**

 

These summer research projects are available through the Counties Manukau District Health Board - CMDHB.  The research projects start from 1 November 2019 and run to 31 March 2020  

Only second to fourth year MBChB students will be considered but you should consider if you can commit to the research without jeopardising your study.  

Please contact the supervisor directly for further information

Closing Date:  20 September 2019

Value of project:  $5,750 paid in two instalments, one in December and the second ($1,000) on submission of abstract and poster                                  

**FILLED**Anticoagulation use for AF stroke prevention in the very elderly patients (Audit of Middlemore hospital)

Supervisors: Catherine Yan, Melisa Birdling                         Department:  AT&R

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**FILLED**Infections in patients with Multiple Myeloma at CMHDB

Supervisor: Dr Hilary Blacklock                         Department:  Haematology

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**FILLED**The feasibility of introducing routine cognitive screening & creating a dementia register

Supervisors: Dr John Hopkins; Dr Sarah Cullum                      Department:  Adult/Old Age _________________________________________________________________________________________________

**FILLED**Obesity: What’s the cost effect in spinal surgery

Supervisor: Brendan Coleman                      Department:  Orthopaedics

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**FILLED**Can complications after total hip joint replacement surgery be predicted by pre-operative serum albumin level or high body mass index (BMI)?

Supervisor: Professor Rocco Pitto                      Department:  Orthopaedic surgery

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**FILLED**The Accuracy of Digital Rectal Examination for Prostate cancer screening in the primary care settings

Supervisor: Kamran Zargar-Shoshtari                      Department:  Urology

 

**FILLED** A+ TRUST **FILLED**

ADHB LOGO colour 200mm

These summer research projects are available through the A+ Trust to the value of $6,000.00 each.  The research projects are run over sixteen weeks from approximately early November to March.   

Fourth and fifth year MBChB students will be considered if they are able to commit to the research without jeopardising their study.  

Value  of each project $6,000.00

Closing Date:  Friday 30 August 2019  (if not awarded prior)

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**FILLED**Dietary normalisation and impact on quality of life following a successful oral food challenge in children with food allergies**FILLED**

Application Number: 8557

Abstract: Food allergy is an important public health concern, affecting 10% of infants1 and 5-6%2 of children worldwide. Current food allergy management strategies minimise harm to patients, but the need for constant vigilance and dietary restriction may have major long-term negative impact on quality of life3. Oral food challenge (OFC), a resource intense and potentially risky procedure, is the widely accepted gold standard test to confirm food tolerance and resolution of allergies4. Successfully passing an OFC enables dietary incorporation of foods in a safe manner. Unexpectedly, recent studies report low rates of continued ingestion after successful OFC procedures5,6. We hypothesise that patient-specific and procedure-specific factors influence outcomes. We will conduct a prospective study evaluating frequency of ingestion and amount ingested of the challenged food at one month or more after a successful OFC performed at Starship Children’s Hospital, ADHB. We will administer a questionnaire adapted from a published food allergen ingestion questionnaire6 and a validated food allergy related quality of life questionnaire (FAQLQ)7 to all eligible participants. We seek to identify patient-specific and procedure-specific factors that predict dietary incorporation of the challenged food at one month or more after a successful food challenge. Findings from this study will inform practice locally and internationally. Results will be disseminated through conference presentations and/or journal publications. Ultimately, we hope this research will lead to augment long-term benefits associated with passing OFC procedures, including dietary normalisation and improvement in quality of life, in food allergic children. 

Primary supervisor: Kuang-Chih Hsaio

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**FILLED**The experiences of Maori in management roles in New Zealand District Health Boards**FILLED**

Application: 8540

Abstract Auckland DHB has a strategic plan to achieve proportional representation of Maori in the DHB workforce. The plan has a specific aim to achieve equity for roles at management level. Despite the strong rationale for a representative health workforce  found in the Treaty, from indigenous studies and from the perspective of health service quality, information about the motivation, aspirations, experiences and personas of Maori in health services is not readily available. In this project we will draw upon the network of the Maori Health Workforce Development team to identify and recruit current or former managers of Auckland DHBs for key informant interviews. In this qualitative project a summer research student with be supported to 1) perform a literature review, 2) develop an interview schedule (open ended with prompts), 3) assist with obtaining informed consent and schedule interviews, 4) assist/conduct recorded interviews, 5) transcribe interviews and learn how to extract themes from transcripts using a grounded theory perspective and the nVIVO tool. It is predicted that saturation of themes may be obtained from 8-12 interviews. This work will enable the team to describe barriers and enablers to attracting and retaining Maori managers and inform the identification of unique or diverse Maori personas within DHB management. Though informed by earlier scholarly projects we believe this project to be completely novel. The outputs will be of value to the Maori Workforce and HR teams for designing a recruitment and career development environment that will meet Maori needs and achieve DHB goals.

Primary supervisor: Vanessa Duthie

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**FILLED**Informed consent prior to prostate cancer screening: Does it actually happen?**FILLED**

Application Number: 8559

Abstract: Population-based screening for Prostate cancer (Pea) with Prostate specific antigen (PSA), has been a controversial topic for decades. This is largely attributed to the lack of sufficient evidence that the benefits of screening, heavily outweigh the potential harms of overdiagnosis and treatment of non-clinically significant cancers. Accordingly, most international guidelines, including in New Zealand (NZ), recommend an individualised approach to the screening process. This must include providing culturally appropriate counselling prior to instigating screening with PSA testing. Essentially, in additions to the benefits, each man needs to understand the potential harms and risks attributed to PSA testing such as unnecessary prostate biopsies.
Previous international reports have shown that the counselling process is fa·r from perfect in the real-life clinical settings. Our observation, being on the receiving end of many referrals from the primary health care sector, is that many men arrive to our clinics not even knowing that they had a PSA test performed in the first place.
This study aims to prospectively survey all men referred to urology clinics, with abnormal Pea screening related results, to quantify and qualify their level of knowledge about the screening process.
This survey is first in NZ to examine the adequacy of counselling that men receive, prior to undergoing PSA testing. This is an important step to assure that, adequate healthcare quality is provided to our men in the community.
It is well documented that better knowledge of healthcare, is associated with improved health. Consequently, we would like to assess whether Maori men receive less information about Pea screening, when compared to none Maori, to help partially explain the previously documented disparities in Pea outcomes.
Last!y, the results of this survey will be used in the future to develop "tailored information sheet" that can be given to men prior to undergoing PSA testing in the community.

Primary supervisor: Kamran Zargar-Shoshtari

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** FILLED **Modelling maximal ventilation based on vector interpolated interpretation of flow-volume curve in COPD and normal subjects** FILLED **

Application Number: 8567

Abstract:  This study will retrospectively apply a new method for predicting maximal ventilation (VEMaxl and assessment breathing reserve (BR) during cardiopulmonary exercise testing (CPET). BR is a measure used to determine if ventilatory limitation exists at peak exercise, and to determine if ventilation is a limiting factor of peak exercise. BR is estimated by comparing the measured peak ventilation (VEPeak) to predicted VEMax, theoretically the measured  VEPeak should not exceed the predicted. Current techniques to predict VEMax are poor, particularly in patients with obstructive airways disease. This often leads to an underestimation of BR and consequently an over diagnosis of ventilatory limitation, which may have detrimental consequences to treatment options for such individuals.
This study aims to employ a new technique to predict VEMax and compare this new measure to the currently used method. The summer student will firstly assess the validity of the new method by applying it to healthy normal subjects. They will then apply the new method to a cohort of patients with chronic obstructive pulmonary disease (COPD).
We expect the predicted VEMax values estimated by our novel technique will be significantly higher for patients with COPD and this will provide a better estimation of their true VE Max· Using our technique, we do not expect BR measures to be negative for COPD patients. We believe our new technique will provide a more accurate estimate of a patient's upper limit of ventilation during exercise. This has the potential to improve our ability to estimate BR and provide a more accurate and appropriate determination of physiologucal limitation at peak exercise which will improve both diagnostic and treatment outcomes derived from the CPET.

Primary supervisor: Kevin Ellyett

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** FILLED **Does growth and nutritional status in infancy affect the outcome of biliary atresia in New Zealand children?** FILLED **

Application Number: 8569

Abstract: Biliary atresia (BA) is a rare liver disease affecting newborn babies. The cause is unknown. Untreated, it leads to liver failure and death within 6-18 months. It is the commonest reason for liver transplantation (LT) in children. There is an operation called the Kasai portoenterostomy that can be done in the first weeks of life which can improve outcomes in some children. We are not able to predict the outcome of the operation when babies are first diagnosed with BA.  
I have published that BA is more common in NZ than other countries, because it is three times more common in Māori than European children. Despite coming to medical attention later than European babies, Māori children have better outcomes and are less likely to need LT in infancy.  
One factor known to influence the rate at which liver disease progresses in children is growth and nutritional status. We have not looked at whether this may be a factor in why Māori babies with BA have better outcomes. This study aims to look at that. If we find that Māori children have better nutritional status before and after Kasai, then we may be able to more aggressively treat all babies with BA to improve outcomes. The study is a straightforward analysis of the growth data we have collected for clinical purposes on babies with BA born in NZ since 2002. No new information will be collected.

Primary supervisor: Helen Evans
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**FILLED**Patch testing for topical corticosteroid allergy**FILLED**

Application Number:8570

Abstract: Allergic contact dermatitis (ACD) is an important cause of eczema caused by allergy to substances in contact with the skin and is diagnosed with patch testing. Various sets of allergens can be tested (known as 'series'), including preservatives, metals, rubber chemicals and prescribed topical treatments such as antiseptics, antibiotics and corticosteroids. These are selected based on the clinical presentation of each case.
Corticosteroid creams and ointments are amongst the most commonly prescribed preparations in dermatology. Topical corticosteroid allergy is rare and difficult to diagnose as the anti-inflammatory effect of the steroid can mask the allergic response. In New Zealand a variety of topical corticosteroids are fully funded by PHARMAC which may lead to greater exposure and therefore risk of sensitisation in our population. Because of this, it has been our practice to test a wide range of corticosteroids (the 'steroids series') as routine in all patients having patch testing in our department. Additionally, markers of steroid allergy (chemicals structurally related to multiple different corticosteroids) are also tested routinely.
We plan to review case notes of patients patch-tested at Greenlane Clinical Centre (servicing Auckland, Waitemata, Counties Manukau and Northland DHBs for patch testing) over a five-year period to investigate the rate of corticosteroid allergy and additional benefit of testing the steroid series over the steroid allergy markers. This study has the potential for cost savings if we demonstrate that testing the steroid series as routine is not advantageous.

Primary Supervisor: Harriet Cheng

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** FILLED ** A retrospective audit of enteral feeding practices in the Paediatric Intensive Care Unit (PICU) at Starship Hospital since the revision of the enteral feeding algorithm in 2014  **  FILLED **

Application Number: 8571

Abstract:  It is well documented that poor nutrition delivery in critically ill children is associated with adverse clinical outcomes. Therefore, optimising nutrition in the paediatric intensive care unit (PICU) is essential. Implementing, and regularly revising, algorithms or protocols for feeding in PICUs helps to ensure these critically ill children are receiving appropriate nutrition, therefore reducing their risk for these adverse clinical outcomes.
In 201 4, a new enteral feeding algorithm in the PICU at Starship Hospital was implemented. The objective of this study is to audit enteral feeding practices in Starship PICU to compare current practice with the enteral feeding algorithm and with recommended best practice (1 ,2).
Online records since 2014 will be accessed to investigate current feeding practices in patients who had a PICU stay >72hrs; e.g. time to initiation of enteral feeding, time to reach nutritional requirements, average daily enteral nutrition intake, interruptions to enteral feeding, enteral feeding route used; and relevant clinical outcomes; e.g. admission and discharge weights, time on mechanical ventilation, length of PICU stay, mortality. The timeframe for completion of this study is estimated to be early 2020.
The results of this study will be analysed and used to make recommendations to the Starship PICU on what changes need to be made to the current feeding algorithm to improve enteral feeding practices and therefore patient outcomes.

Primary supervisor: Barbara Cormack

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** FILLED **Is Therapeutic Tranexamic Acid Toxic to Bone Osteoblasts and Osteoclasts when Administered Topically?** FILLED **

Application Number: 8558

Abstract:

Context
Controlling peri-operative blood loss is a major consideration for orthopedic joint arthroplasty. Tranexamic acid (TXA) is an anti-fibrinolytic drug that is commonly used to prevent peri-operative blood loss by inhibiting coagulation proteases.  The use of topical TXA in high local concentrations has been expanding in orthopedic surgery in the past decade. There have been some reports of TXA having detrimental effects on bone healing, however this still requires further investigation. 

Objective
Our aim is to investigate whether TXA has any detrimental effects on osteoblasts, and osteoclasts and establish a safe does for use in clinical practice.

Method
Murine osteoblast and osteoclast cells will be cultured in vitro with varying TXA concentrations. Effect will be determined by cellular viability and genetic analysis of differentiation markers. Bone formation will be quantified in osteoblasts by bone matrix mineralization.

Benefits
Given TXA is increasingly used topically in orthopaedic surgeries, understanding if high local concentrations have any detrimental effects on bone cells is an important first step towards determining safe dosage in a clinical setting. 

Primary supervisor: Jacob Munro

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**FILLED**Council of Medical Colleges - Choosing Wisely**FILLED**

Banner-High-Res_ Choose EDM-02

 

 

 

 

 

**FILLED**A qualitative study on clinicians’ rationale for requesting urine cultures at Middlemore Hospital

Choosing Wisely NZ guidelines recommend that urine culture (UC) should only be requested in patients who have specific localising symptoms that are suggestive of urinary tract infection.  Despite this, unnecessary UC testing remains common and commonly leads to reflexive prescription of unnecessary antibiotics. 

 

Local data at Middlemore Hospital showed that the majority of UC requests were not clinically indicated, and that this practise occurred across all departments, patient groups and staff groups.  The reasons could not be clearly elicited due to the study design. 

Current literature on this subject has only explored knowledge gap, with no published qualitative studies exploring this further.

 

Methodology 

The project will be a qualitative study using structured interviews and focus groups among a representative selection of front-line doctors and nurses at Middlemore Hospital.  This will aim to explore knowledge of clinical indications for UC, interpretation of UC results, and socio-cultural influences on testing behaviour.  Thematic analysis will be used to identify behavioural themes. 

The aim of this project is to inform an interventional project to improve UC testing behaviour via clinical decision support tools at the point of UC request.  The output will also be unique in this field.

 

Support

The prospective student will receive training and support in thematic analysis from Ko Awatea at Middlemore Hospital.  There will be clinical/research supervision from an Infectious Diseases Physician with an active interest in this area, as well as supervision from a public health physician. 

 

Please note that MDChB medical students are eligible to apply IF they are still able to commit to 8 - 10 weeks of research from November to January and does not affect this research project commitment or their Year 4 or 5 lectures or placements in early 2019.

Value: $6000.00  Primary Supervisors: Graeme Lindsay (g.lindsay@auckland.ac.nz) phone 021 054 3319 and Chris Hopkins, CMDHB

Closing Date: 30 August 2019