Clinical

Tinnitus "ringing in the ears" is a bothersome and potentially debilitating phenomenon. It often accompanies hearing loss and affects over 13% of the population aged over 65 years. Rating scales of different qualities of tinnitus are frequently used alongside questionnaires in the assessment of tinnitus. At face value these are simple assessments that are useful for quantifying tinnitus at a point of time, but what do they really assess?

This study will examine a large data set of rating scales with questionnaire answers to examine convergent and divergent reliability of the scales. This research will assist in the development of more reliable measures of tinnitus and an understanding of the benefits and shortcomings of different existing assessment processes. Secondary data from several past research projects will be examined. The rating scales will be related to hearing assessments, gender, ethnicity, psychological and tinnitus related measures. The research will aid in the development of an understanding of tinnitus as a disorder. The student will learn about the complex nature of tinnitus, how it is assessed and develop some skills in the psychometrics of tinnitus questionnaires and some of the statistics used in assessing questionnaire validity.

Improvements in quality and outcomes of care for pregnant women and their babies requires evidence-based research. This is especially important for women, babies and their whanau living with health inequities. The midwifery model of continuity of care in New Zealand positions midwives to be able to support women to participate in research, to become involved in research themselves, and to evaluate research outcomes. However, there is little known about the research capacity, capability, and culture of midwives and nurses in New Zealand, including in the Counties Manukau Health (CM Health) region, which is a multi-ethnic and lower socioeconomic New Zealand region with a high perinatal mortality rate and high health needs of the population.

We plan to evaluate midwifery and nursing research capacity, capability, and culture within the CM Health region by carrying out an online survey over a six-week period in 2022-2023. The survey is for midwives/midwifery students and nurses within the CM Health region. The survey will be disseminated through midwifery and nursing leadership email databases and through established CM Health networks. The survey will evaluate current research expertise, views of practice-based research, barriers and enablers of research, and priorities for future midwifery and nursing research.

Keratoconus (KC) is a corneal disease which can cause severe visual impairment, and necessitate a corneal transplant. Corneal crosslinking (CXL) is a commonly performed surgical procedure, which prevents disease progression by biomechanically stabilising the thinned cornea. The ADHB KC/CXL service is the largest in NZ, and some patients are referred from other DHBs, as some DHBs do not have a KC/CXL service. This project will involve reviewing the clinical records of cohorts of ADHB and non-ADHB patients in the KC/CXL service, to collate information on and compare a variety of demographic, clinical and health service factors. This will help describe and improve the efficiency and equity of the ADHB KC/CXL service for non-ADHB patients.

Background

Tophi are chronic granulomatous lesions surrounding a core of monosodium urate monohydrate (MSU) crystals, encased by dense connective tissue. These lesions typically occur within subcutaneous tissues and the joints, and develop in the setting of long-standing gout. Tophi are usually non-tender but may lead to cosmetic problems, mechanical obstruction of joint movement, joint damage and musculoskeletal disability.

A number of methods of tophus assessment have been reported using both physical measurement and advanced imaging techniques. Our group has previously led an international initiative to standardize tophus measurement in clinical trials. This work led to a reference paper and pictorial guide in 2012. Here, we propose an updated systemic literature review and reference guide.

Aims

The aim of this studentship is undertake the literature review of tophus regression methods (both physical and imaging), and to formulate a summary paper which includes a reference atlas of methods for tophus assessment. A systematic search strategy for each method will be formulated. The student will be required to undertake the literature review, catalogue the papers identified, review the relevant papers and provide a written summary of the evidence for each method. The student will also assist in obtaining images for the reference atlas.

Skills that will be taught to the student

This project offers a number of learning opportunities:

• General clinical research experience
• Exposure to research in outcomes measurement
• Experience with critical literature review
• Opportunity to work with patients with gout
• Completion of a report for publication
  

Background

Prehabilitation (a holistic suite of interventions to prepare patients for surgery) in the cancer care continuum can encompass exercise, nutrition optimization, smoking cessation, and stress reduction. Internationally, prehabilitation programmes have shown to be feasible in patients with breast cancer.

However little is known about the specific needs of New Zealand patients with breast cancer in the ‘prehabilitation’ period between diagnosis and surgery. There are currently no established prehabilitation programmes for patients diagnosed with breast cancer and waiting for surgery in Aotearoa.

Further, no comparison exists between prehabilitation needs of patients and healthcare providers' understanding of these needs.

Objective

To gain insight into healthcare providers’ understanding of prehabilitation needs of patients with breast cancer. This is one arm of a larger study investigating patients needs and comparing them to healthcare providers understanding of their needs.

Methods

Semi-structured interviews will be undertaken with oncologist, surgeons, anaesthetists, nurse specialists, and physiotherapists.

Research impact

The output will inform development of prehabilitation care pathways and inform future research

Skills learnt

• Teamwork and research coordination skills
• Join the supervisors in undertaking semi-structured interviews
• Qualitative data analysis with Nvivo
• Oral presentation and scientific writing skills
  

The blinq (Rebion Inc) paediatric vision screener is a recently released handheld device that detects bifoveal fixation based on the birefringence properties of the macula. Unlike other handheld photo-screeners which only assess amblyopia risk factors, the blinq screens directly for fixation instabilities associated with amblyopia. However, little is known about how the effect of retinal image blur on the blinq scanning accuracy. Even low, non-amblyogenic levels of uncorrected refractive error can have significant impacts on a child’s education, so a good vision screening program should detect refractive errors as well as amblyopia. If the blinq device is to be used for vision screening in children, then it is important to know how its accuracy is impacted by refractive error. This project aims to use contact lens-induced refractive errors to investigate the accuracy and limitations of the blinq scanning device.

An ideal candidate should have basic clinical skills in measuring vision and eye alignment. Skills learned will include conducting clinical research, vision screening/testing, and statistical analyses.

In 5th and 6th year medicine, students log their learning experiences in the O&G clinical attachment. These experiences range from observing vaginal births, assisting in open surgery, attending clinics, or performing clinical examinations.

While completion of the logbook is required to pass the run, we do not have aggregate information on the number of times students perform/ carry out different skills or observe certain conditions. We also do not know whether there is equitable experience across all sites, or whether students of all genders get equal exposure to different clinical situations.

This summer studentship will involve collecting data from the logbooks, and summarising the number of experiences in different areas that students get across 2 years of O&G training. We will also look to see if students rostered to different teaching sites get a similar number of experiences, and whether those of different genders get a similar number of experiences. This information will be important for shaping clinical teaching in our department.

Magnetic resonance imaging (MRI) is well established for imaging of the abdomen and pelvis. In recent years it has been having an increasingly important role in the evaluation of the pancreas. Although abdominal computed tomography remains valuable, the contemporary emphasis on decreasing patient radiation exposure is driving practice toward non-ionising modalities such as MRI. The inherent dynamic properties of MRI, its superior tissue contrast, and cross-sectional capabilities offer additional advantages.

The aim of this project is to contribute to advancing our knowledge on clinical usefulness of quantitative imaging biomarkers derived from MRI of the pancreas. Depending on the learning goals of the successful candidate, the project may involve a quantitative analysis of the existing images and/or a meta-analysis of published studies. Either way, it is expected that results will be published in an international peer-reviewed journal. The project is part of a larger research theme of the COSMOS (Clinical and epidemiOlogical inveStigations in Metabolism, nutritiOn, and pancreatitic diseaseS) group. The group offers a vibrant research environment, comprehensive research training, and clinical research experience, including involvement in a prospective longitudinal cohort study of MRI in diseases of the exocrine pancreas. For more information, please visit cosmos.auckland.ac.nz

Skills Taught

• Working in a clinical research team environment
• Magnetic resonance image analysis
• Meta-analysis
• Preparation of a manuscript for publication in international peer-reviewed journal
  

Project description

The student will assist with the update of an existing Cochrane systematic review and meta-analysis on the long-term effects of menopausal hormone therapy (MHT). Tasks are anticipated to include article screening, data extraction and risk of bias assessment. The student will be a named author on the review.

Research impact

Over 85% of women will experience at least one menopausal symptom. MHT is the most effective treatment for such symptoms. Though MHT use previously raised safety concerns, including increased risk of breast cancer and stroke, more recent research has led to the consensus, that for most women, the benefits of MHT are likely to outweigh its risks. The relevant empirical evidence, however, has not recently been collated and appraised. Cochrane reviews are internationally recognised as the highest standard in evidence-based health and the update of this review will assist policy makers, clinicians and patients to make fully informed decisions regarding MHT use.

Responsiveness to Māori

Māori, who experience menopausal symptoms at the same rate as non-Māori, are less likely to take MHT than non-Māori (24% vs 54%). The inequity may be reduced by increasing overall awareness of the benefits and risks of MHT.

Short-chain enoyl-CoA hydratase (SCEH) deficiency due to biallelic variants in ECHS1 causes fatal Leigh syndrome and increased excretion of S-(2-carboxypropyl)cysteine. It is potentially treatable with a valine-restricted, high-energy diet and emergency regimen.

In 2021 Simon et al described four Pacific-Samoan children harbouring a hypomorphic allele c.489G>A, p.(Pro163=). which is highly prevalent in the Samoan population. Ocular features reported include optic atrophy and nystagmus, but those without obvious ocular abnormalities have not been formally characterized, and there is no information about the progression of optic atrophy and vision .

Loss-of-function mutations in PEX1 or PEX6 causes a spectrum of autosomal-recessive peroxisome-biogenesis disorders (PBDs), including Zellweger syndrome. PBDs include retinopathy, and SNHL. We are now aware the spectrum PBDs may present with a more subtle clinical picture, and seen first with retinal dystrophy, +/- SNHL , often confused with Usher syndrome –This disorder is called Heimler syndrome.

For patients with PEX1, PEX6 and ECHS1 variants, the summer student will review clinical notes to determine age of onset, presenting signs and symptoms, visual acuity, and progression, and also collate imaging (OCT, Optos photos and electrophysiology). This work is unique in that it takes an ophthalmic approach to characterising the disease.

Experiences of inequalities are recognised to be associated with poor health outcomes. Our previous research has demonstrated that Maori and Pacifica peoples carry a greater burden of non-attendance to Ophthalmology Clinics. This carries the risk that important eye conditions are not being treated optimally and may relate to worse visual outcomes.

The purpose of this study is to further explore the utilisation of ophthalmology services in ADHB based on ethnicity by undertaking an Audit to describe ethnic differences in utilisation in different specialty clinics.

The summer student will undertake a clinical audit of patients who have attended the ADHB Ophthalmology Service and explore the range of conditions, severity, to identify ethnic differences in access to ophthalmology care and referral patterns.

Applications from students with an interest in Maori and Pasifika themes are especially welcome. Skills required include communication, initiative, independence and an ability to work well within a team.

In recent decades, women have achieved greater representation in ophthalmology. Globally, women now constitute about 25-30% of ophthalmologists, and 35-45% of trainees. Nevertheless, women remain under-represented in key areas, including positions of professional and academic leadership and ophthalmic surgical subspecialisation. Furthermore, there is evidence that women in ophthalmology encounter more bias and discrimination across multiple domains than men, including a gender-pay gap that is wider than in many other surgical subspecialties. Women ophthalmologists and trainees report sharply differing training experiences from male peers, including fewer opportunities to operate, more bullying and harassment, less access to mentorship, and contrasting expectations around contributions to family life. This appears to continue throughout an ophthalmologists career.

This summer studentship will develop a survey for female and male ophthlmologists to explore burnt out and career progression challenges. It will also involve undertaking a literature review on this topic and collating a database of relevant scientific articles, webinars, podcasts and other material which addresses the issues of gender equality in medicine, research and more specifically surgery.

The summer student will be involved in literature searches, google searches and should be comfortable navigating through social media platforms to find useful resources. It would be helpful if the summer student had experience in website development, but not necessary.

Optic neuritis is an autoimmune inflammatory disorder of the optic nerve. It is most commonly associated with demyelination related to multiple sclerosis. However, over the past decade other antibodies have been identified that are associated with distinct conditions such as neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein (MOG) associated disease. These are a heterogeneous group of conditions. We are still discovering new information regarding the phenotypic presentations. This research will involve the optic neuritis registry and clinical analysis of patients and database.

Objectives

1. To work on an established data of patients with optic neuritis and enter further clinical information.

2. To undertake analysis of the different phenotypes of optic neuritis to develop guidelines for investigation and treatment.

What we are looking for in a successful applicant

A background biomedical science, medicine, or health related fields is helpful.We are looking for student who has a good grasp of Excel and medical statistics.

This student project is preparatory to research aimed at developing an instrument for examining nurses' perspectives on missed care in New Zealand acute care settings. Missed care is also termed care left undone, unfinished care, and implicitly rationed care. (1,2)

Project Aim: To identify survey instruments used to measure missed care.

Objective: To review instruments currently used to measure missed care and collate the reliability, validity and applicability for each.

Method: Integrative literature review

Skills learned will include:

• Systematic searches of electronic databases
• Creating an EndNote library of the search results
• Systematic data extraction
• Narrative and tabular synthesis
• Academic writing
• Preparing a draft manuscript for publication as co-author
  

Reference

1. Jones TL, Hamilton P, Murry N. Unfinished nursing care, missed care, and implicitly rationed care: state of the science review. Int J Nurs Stud. 2015;52:1121- 1137.
2. Ball J, Griffiths P, Target S. Missed nursing care: a key measure for patient safety. Agency for Healthcare Research and Quality, PSNet. 2018 Mar 6.

Endophthalmitis is a severe infection of the eye which may occur following ocular surgery. It occurs in approximately 1 in 1200 cataract surgeries and 1 in 2000 intravitreal injections. Patients developing this severe infection will often require multiple eye procedures and there is a high risk of vision loss. This project involves updating the current endophthalmitis registry and analysing risk factors for retinal detachment following infection.

Skills taught

• introductory ophthalmology
• infection control and the role of audit in identifying clusters of infections
• data collection
• statistical analysis
• literature review
• preparation of a manuscript for submission to an international journal
  

Keratoconus is a cause of vision loss among young, often otherwise healthy patients. This condition is more common among individuals of Maori and Pasifika backgrounds, and many individuals are not diagnosed until advanced stages of disease when there has already been some loss of vision. This project will involve using a screening tool for keratoconus detection among adolescents. The student’s role will include performing screenings, collection of data, and analysis of data.

In order to regain function and improve chances of a successful discharge home, many patients admitted with an acute illness require a period of inpatient rehabilitation prior to discharge. Health institutions are interested in measuring ‘successful rehabilitation’ in order to determine if the service is effective and to assist in identifying patients that will benefit from inpatient rehabilitation, doing so with a variety of professional-identified outcomes such as discharge destination. However, it is not clear locally or internationally what patients themselves, caregivers or whanau consider markers of rehab success.

We will explore this with a mixed methods study, including qualitative interviews with inpatients, caregivers and/or whanau and collect/analyse relevant inpatient data. By understanding what patients/whanau consider as markers of rehab success clinicians will be able to have a greater understanding of how our service aligns with patient/whanau expectations of success, and how best to measure it.

Skills gained

• Quantitative and qualitative research methods including semi-structured interviews, data coding/analysis
• Literature review/critical appraisal
• Academic writing/manuscript preparation

This would suit those with:

• Excellent communication skills
• The ability to undertake some self-directed work
  

ABCA4 retinopathy presents in childhood with vision loss but with variable severity. It is one of the most common causes of childhood onset macular dystrophy. Understanding the mutations involved and the clinical characteristics benefits patients in helping to predict prognosis and to enlist them in potential treatment trials.

At least 100 patients in Aotearoa have ABCA4 related retinal dystrophy including Maori patients who have not been previously published. This project aims to build on previous work and expand the phenotypic and molecular characterisation in a detailed database. The student will need to have a good understanding of ophthalmic terms and will be taught how to interpret genetic results and retinal imaging. The project will involve reviewing patient notes and electronic records to collect detailed phenotypic data including age of onset, vision, symptoms, retinal imaging and electrophysiology.

Matai Medical Research Institute in Gisborne/Tairawhiti is partnering with Hauora Tairawhiti to introduce a new pathway for prostate cancer diagnosis involving pre-biopsy MRI exams and image guided biopsies. We believe that, like in Europe and the UK, this pathway will improve clinical outcomes for patients suspected of having prostate cancer. To prove this we will compare clinical metrics before and after the pathway was introduced. This sub-project will begin a clinical audit of medical records of patients suspected of having prostate cancer evaluated through the Urology Clinic at. Hauora Tairawhiti over the past 7 years. Audited metrics to include: time from referral to MRI and/or biopsy; stage and grade of disease on presentation; treatment provided including watchful waiting, active surveillance, androgen therapy, chemotherapy, surgery, and radiation; number of curative treatments; and treatment morbidity.

Skills: Ability to design a clinical review, organize data, analyse and present data.

Herpes zoster occurs as a late complication of the chickenpox virus and is characterised by a blistering rash in a dermatomal distribution. In 10-20% of patients this occurs in the V1 distribution (herpes zoster ophthalmicus) with the potential for inflammation involving the eye which may be chronic or recurrent in nature. This study aims to examine quality of life in patients with herpes zoster ophthalmicus and compare to other inflammatory eye conditions and normal controls.

Skills taught

• introduction to ophthalmology, herpes zoster ophthalmicus and uveitis
• history taking
• administering surveys
• informed consent
• data analysis
• presentation of final data at seminars and local conferences (e.g. summer studentship symposium)
• manuscript preparation for submission to an international journal
  

Optic neuropathies have a myriad of causes including compression, inflammation, demyelination, trauma, ischaemia, hereditary disease, and nutritional/toxic disease. The hereditary optic neuropathies comprise a group of disorders in which the cause of optic nerve dysfunction appears to be hereditable, based on familial expression or genetic analysis. In some hereditary optic neuropathies, optic nerve dysfunction is typically the only manifestation of the disease. In others, various neurologic and systemic abnormalities are regularly observed. Inherited disorders of the optic nerve significantly impact vision in children and adults. Knowledge of the genetics of optic neuropathy makes it possible to test for mutations in disease-causing genes allowing for pre-symptomatic testing and risk assessment, and recent advances have revealed important disease mechanisms that may suggest potential therapeutic targets.

The aim of this project is to create a comprehensive database of patients with optic neuropathies including hereditary optic neuropathies within the neuro-ophthalmology service to better understand its prevalence and characteristics within Aotearoa. This will then direct further research in to phenotypically similar subgroups. The student will need to understand ophthalmic terms and be able to create a comprehensive and accurate phenotypic database that includes optic nerve imaging and neuroimaging.

Asthma is one of the most common lung conditions in New Zealand with associated high morbidity and mortality. Asthma attacks are the leading cause of lost days from school and work and loss of quality of life. Unfortunately at present asthma attacks cannot be predicted, however there is increasing evidence that early changes in physiological measures, such as respiratory rate, which can be measured by digital technology may be helpful in identifying individuals at risk of asthma attacks. This summer studentship aims to review the literature systematically to identify what physiological changes may be associated with an increase in asthma attack risk, that may be able to be measured using digital technology such as smart watches or smart phones.

The student will be able to learn skills such as:

• writing skills
• communication skills
• systematic review skills
• critical appraisal
• data interpretation and data extraction
• time and project management

The successful student will also have an opportunity to present these results at a national or international forum, depending on funding available.

Recent analysis has suggested that early decrease in albumin levels from baseline = 10% at week 6 (pre cycle III) of immunotherapy monotherapy is significantly associated with lower response rates, time on treatment and shorter overall survival in NSCLC. Is this potential biomarker valid in other cancer types?

Aim

The aim of this project is to conduct a clinical audit of patients receiving immunotherapy +/- chemotherapy in all cancer types. Data will be collected from public ADHB medical records and private oncology centres. Analysis will be sub-divided into immunotherapy monotherapy and immunotherapy + chemotherapy.

Skills

The student will gain skills in the clinical audit process, developing an audit tool, through to analysis and scientific report writing.

Currently in New Zealand cancer patients can receive their treatment within the public sector via local DHBs or use their health insurance and/or opt to self fund to receive their treatment within private oncology centers.

Are survival data the same in public vs private for metastatic pancreatic patients and metastatic non-small cell lung cancer patients?

Data will be collected on regimens offered, number of treatments (cycles) given and overall survival at patients attending public ADHB Medical Oncology and private oncology centers.

The student will gain skills in the clinical audit process, developing an audit tool, through to analysis and scientific report writing

You will help us analyse epidemiologic data on acute leukaemia (lymphoblastic, ALL and myeloid, AML) in New Zealand children, and prepare it for publication. Acute leukaemia is an aggressive blood malignancy that remains poorly understood and treatments remain suboptimal. Epidemiological studies are important to help identify risk factors and for guiding clinical research.

We have already analysed demographic data collected by the New Zealand Cancer Registry for children diagnosed with ALL or AML between 2000-2019. Some interesting findings emerged that we would now like to verify. The focus is on demographic factors such as patient age, gender, ethnicity, and the NZ deprivation index and if there is any association between these factors and patient outcomes. The overriding aim is to better understand the scope of childhood acute leukaemia in New Zealand and define any ethnic disparities between European and Maori children.

We will teach you relevant statistical methods if required. We are looking for a person with strong analytical skills, an avid reader and a good writer willing to help us disseminate these findings. The style of work will be similar to our previous publications (https://doi.org/10.1080/16078454.2021.1882146 and https://doi.org/10.3390/curroncol28020146).

You will help us analyse epidemiologic data on acute leukaemia (lymphoblastic, ALL and myeloid, AML) in New Zealand adults (ie patients >19 years of age), and prepare it for publication. Acute leukaemia is an aggressive blood malignancy that remains poorly understood and treatments remain suboptimal. Epidemiological studies are important to help identify risk factors and for guiding clinical research.

We have already analysed demographic data collected by the New Zealand Cancer Registry for adult patients diagnosed with ALL or AML between 2000-2019. Some interesting findings emerged that we would now like to verify. The focus is on demographic factors such as patient age, gender, ethnicity, and the NZ deprivation index and if there is any association between these factors and patient outcomes. The overriding aim is to better understand the scope of adult acute leukaemia in New Zealand and define any ethnic disparities between European, Maori and Pacific Island patients.

We will teach you relevant statistical methods if required. We are looking for a person with strong analytical skills, an avid reader and a good writer willing to help us disseminate these findings. The style of work will be similar to our previous publications (https://doi.org/10.1080/16078454.2021.1882146 and https://doi.org/10.3390/curroncol28020146).

This is a pilot study to understand the functional anatomy of the left LVJ using MR in living individuals. The research team wish to measure the lymphatic flow at left LVJ and understand its clinical and surgical application.

Projects includes:

1 - Literature Review
2 - Learning cross sectional anatomy

Dry eye disease, due predominantly to dysfunction of the eyelid meibomian glands (blepharitis), is becoming increasingly common. Symptoms of ocular surface discomfort are exacerbated by the lifestyles we lead where increasing periods of time are spent on digital devices and in challenging environments. There has been a move away from prescribed antibiotics and anti-inflammatories to manage eyelid inflammation and microbial overcolonisation, towards more natural therapies.

This clinical project extends the work of the research group in ocular surface disease management and natural therapeutics and will evaluate the safety and efficacy of topical application of a castor oil-based formulation in reducing the signs and symptoms of blepharitis.

Skills gained: participant interaction; clinical evaluation of the ocular surface, including slit lamp examination, non-invasive tear film assessment, lipid layer interferometry and infrared meibography; dry eye diagnosis and sub typing; clinical trial methodology; quantitative data analysis; research report-writing.

Cerebral palsy (CP) is a childhood disorder but leads to life-long physical disability with the great majority of adults with cerebral palsy having a normal lifespan. Little is known about adults with CP, but older overseas literature suggests premature aging and increased risk of conditions such as cardiovascular disease, hypertension, and insulin resistance.

The NZ Cerebral Palsy Register (NZCPR) holds health information, collected with consent, from people with cerebral palsy across Aotearoa NZ. The register has information on about 1500 children and adults with CP, with 28% being Maori. This project uses data from NZCPR to look at how our cohort are ageing and their strategies for healthy ageing, using a combination of established linkages with other databases and surveys.

A second part will be to inform future research directions and data collection, through interviewing families / stakeholders with CP in a co-design process. This part of the project will also involve whanaungatanga / relationship building with Tamaki Makaurau / Auckland wide mana whenua / iwi. The project will also further define the mutual potential outcomes for Maori and for the NZCPR, to determine how high-quality data for Maori with whaikaha / disability can assist future advocacy in this space.

In 2021 around 130 people had a major lower limb amputation, with many of them being elderly. Following this, patients face major physical and psychological challenges. Many amputees are not able to walk with a prosthesic limb. The BLARt is used in the UK to predict preoperatively which patients will be able to walk with a prosthesis following amputation. This allows better management of the expectations of the patients and whanua.

This project will look at the BLARt in the New Zealand context to see if it is a tool that would be useful in our clinical setting.

The summer student will gain skills in working in a multi-disciplinary team, data collection & analysis and scientific report writing

The Auckland Orthopaedic Society funds a rotating research studentship each year.

The studentship aims to identify and develop students with an interest in surgery to the field of orthopaedics and research. Past student projects have been highly successful with a high rate of publications The 2022/3 studentship will be based at Middlemore Hospital.

Please contact directly for project details.

Resting-state fMRI is a relatively new MRI technique that can measure spontaneous neural connectivity across different brain regions. These patterns are known to change in disease states including acute and chronic stress. This project would involve researching the literature, and preparing a review of the current use of resting-state fMRI in stress and post traumatic stress disorder. They may also become involved in imaging. The successful student is someone who is interested in MR imaging and its use in diagnosis in medical and psychiatric disease. The student would likely earn authorship on a paper.

Skill to have or learn: How to perform a formal literature review.

Slipped Upper Femoral Epiphysis (SUFE) is the commonest cause of hip pain in the adolescent population. SUFE is associated with obesity during childhood and with the increasing rate of childhood obesity in the South Auckland population, SUFE is becoming a major cause of hip morbidity. There is a high prevalence in adolescent Maori and Pacific population and issues with early access to healthcare have seen an increasing degree of severity in these populations.

The aim of this study is to identify factors associated with improved outcomes in high grade SUFE surgery and factors that may be associated with failure leading to total hip replacement. The hypothesis is that osteotomy has improved outcomes from the traditional treatment of screw fixation in-situ.

The patient population is patients undergoing surgical treatment for high grade SUFE at Middlemore Hospital and Starship Children’s Hospital between the 1st January 2000 and 31st December 2021. This timeframe has been selected to investigate technical advances that may affect outcome. It also enables a suitable timeframe for the development of osteoarthritis necessitating conversion to total hip replacement.

A clinical note review will be undertaken to identify areas of investigation including BMI, slip degree, surgery type, length of stay, delay to surgery, duration of symptoms, complications, additional surgery. The clinical note review will include follow up clinic notes to identify late complications, Patients will be categorized by BMI and slip angle as well as surgery type. A secondary outcome is conversion to total hip replacement. Functional assessments of patients may be undertaken.

This study is important as increasing obesity in the Counties Manukau is impacting on health resource utilization. Obesity is associated with SUFE and is more prevalent in the Maori and Pacific population. Advancing techniques of surgical treatment in high grade SUFEs has led to improved outcomes. The inequity of access to healthcare in lower socioeconomic groups and Maori leads to delayed presentation and increasing severity of slip. Identifying factors that improve outcomes may lead to increased functional outcome and lessenthe need for hip arthroplasty in the future.

Skills that will be taught to the student:
Clinical note review
Study design and protocol development
Data collection
Statistical analysis
Manuscript preparation