Clinical

Investigating paediatric cardiac using CT scan

Supervisor

Ali Mirjalili

Discipline

Clinical

Project code: MHS001

This study of the paediatric heart is based mainly on 3D reconstruction using CT scans. Several features of the associated cardiovascular system will be investigated. Despite considerable differences between the cardiac form in the children, the orientation of the heart in children is said to be similar. The aim of this study is to 3D segment the heart and neighbouring organs to revisit the anatomy of the heart in children.
This project involves:

  1. Literature review
  2. Learning cross sectional anatomy of the heart
  3. Learning 3D slicer programme
  4. 3D segmenting paediatric heart

3D investigation of the thymus in children

Supervisor

Ali Mirjalili

Discipline

Clinical

Project code: MHS002

The thymus is a paediatric organ that sits in the anterior medistinum. It shrinks by age and disappears in adults. The aim of this study is to 3D reconstruct the thymus in children and revisit its anatomy in relation to neighbouring organs.
This project involves:

  1. Literature review
  2. Learning cross section anatomy
  3. Learning 3D slicer programme
  4. 3D segmenting the thymus

Antidepressants for children and young people: parents, young people and clinician views of efficacy

Supervisor

Sarah Hetrick (021 173 3878)

Discipline

Clinical

Project code: MHS005

We are undertaking a large and complex systematic review and network meta-analysis (NMA) to investigate the efficacy of newer generation antidepressants for children and young people with depression. The key indicators are depression symptoms and suicide-related behaviour. However, depression symptoms can be measured in a number of ways. Typically, in trials of antidepressants the clinician-rated measure of depression symptoms is the primary outcome. We are interested to explore to the extent to which parent and child/youth measures are also used, and whether the treatment effect varies according to who is rating the symptoms. The impact of this review will be significant, for example, previous versions have been included in International Clinical Practice Guidelines. We need a student who has good attention to detail, can undertake systematic data extraction and has excellent written communication skills.

Novel oral anticoagulants (NOACs) in end stage liver disease

Supervisors

Amy Chan (ext 85524)
Jay Gong
Kebede Beyene

Discipline

Clinical

Project code: MHS009

Novel oral anticoagulants (NOACs) are increasingly being used to prevent and treat thrombotic events such as deep or portal vein thrombosis, however the safety of these new agents (e.g. dabigatran, rivaroxaban) relative to traditional agents (e.g. warfarin, heparin) in patients with end stage liver disease (cirrhosis) is not yet known. This project examines the risk of bleed in patients with end-stage liver disease treated with NOACs versus patients treated with traditional standard of care anticoagulants (e.g. warfarin, low molecular weight heparin (LMWH) and heparin). The aim of this project is to determine the rates of bleeding with NOACs versus non-NOAC anticoagulants in patients with end-stage liver disease, and identify patient characteristics which increase or decrease this bleed risk, such as age and ethnicity. Our study will also assess whether there are any outcome differences between Maori and non- Maori patients.
The study will involve a review of clinical notes and laboratory data from Auckland DHB for patients with end-stage liver disease, and relevant data extraction to inform a statistical model of bleed risk. The summer student will receive a clinical orientation to Auckland DHB and be supported by a pharmacoepidemiologist for the statistical modelling of the data.
The student will gain skills in literature review and critical appraisal, quantitative research, data extraction, clinical understanding of liver disease and the role of anticoagulants in thrombosis management, anad writing skills. There will be an opportunity for the student to be involved in a peer-reviewed publication of their work.
Skill required:

  • Basic understanding in lab results / biochemical interpretation
  • Able to work in a systematic and methodological manner

Consumer involvement in musculoskeletal clinical trials

Supervisors

Prof Nicola Dalbeth (ext 82568)
Dr Sarah Stewart

Discipline

Clinical

Project code: MHS015

Involvement of consumers in the design, conduct and dissemination of clinical trials is widely recommended to ensure quality, relevance, and uptake of the research. For musculoskeletal clinical trials, patient research partners have been pivotal to the development of outcome measures through the OMERACT (Outcome Measures in Rheumatology Trials) process. However, it is unknown whether this approach extends to the design and conduct of individual musculoskeletal clinical trials.
In this study, we will analyse musculoskeletal clinical trials published in the last ten years to determine the involvement of consumers throughout the research project. The National Institute for Health Research INVOLVE framework will be used to assess reported involvement of consumers at each stage of the research cycle. We will determine the impact of funding sources, geographical region, type of intervention, and disease area on consumer involvement.
This project will utilize an existing database of rheumatology research articles, and provide the student with experience in assessment of clinical trials conduct, literature review and synthesis, data extraction and management, statistical analysis, and preparation of a manuscript for publication.
Our research team has a great track record of supporting summer students to gain experience in clinical research, complete their projects, and publish the results.

Understanding the genetics of metabolic function in Maori and Pacific peoples

Supervisor

Troy Merry

Discipline

Clinical

Project code: MHS016

You will assist with a clinical trial aimed at understanding how genetic variants unique to people of Māori and Pacific effect metabolic function. You will assist with recruitment, sample collection and running the trial as well as analysis of collected samples and data.

Artificial Intelligence in optometry and ophthalmology

Supervisors

Ehsan Vaghefi (021 102 7705)
David Squirrell

Discipline

Clinical

Project code: MHS024

During past few years, many research projects have implemented Artificial Intelligence (AI) with high levels of success in ophthalmic diagnostics tasks. Meanwhile, there has been few attempts at application of AI in ophthalmic prognostics (i.e. predicting a state of a disease at a future date). These models have often focused on predicting the advancement of macular degeneration or diabetic retinopathy, using longitudinal community screening data.
In this research, the candidate will be reviewing the literature and perform a hyperparameter space search for relevant prognostics models, in order to establish an optimum criteria for AI development.
The ideal candidate should have a passion for learning and understanding novel technologies in optometry and ophthalmology. Having a background in computer programming is not essential, but could be advantageous.

A post-natal observational study of 'Contraception Planning' for women birthing at Auckland DHB facilities

Supervisors

Lynn Sadler (021 535 187)
Helen Roberts

Discipline

Clinical

Project code: MHS025

This study aims to provide baseline data around post-natal contraception use, to assess if women are well-informed and are able to access contraception by asking women during their hospital or birthing unit post-natal stay to complete a short survey. We want to identify rates of unintended pregnancy, to identify whether women are receiving what they believe is adequate information, and whether there is equitable access to contraception.

This project has ethical and locality (ADHB) approval.

The involvement for a student(s) would include setting up the web-based format of the survey, administering the survey at Auckland Hospital and Birthcare (approximately 4 weeks, but longer as needed to ensure equal explanatory power for all ethnic groupings), undertaking an appropriate literature search, followed by analysis as time allows.

An audit of the initial care of adults presenting with a potential diagnosis of meningitis at Auckland City Hospital during 2019 and 2020

Supervisors

Associate Professor Mark Thomas (021 412 727)
Dr Anabelle Donaldson
Dr Nic Young

Discipline

Clinical

Project code: MHS028

Bacterial meningitis is a rapidly progressing potentially fatal disease. Effective management depends on safely obtaining microbiologic evidence of the infecting organism and of its susceptibility to antimicrobial agents, without delay. New guidelines have recently been developed for the management of patients who present to Auckland City Hospital (ACH) Emergency Department (ED) with features suggestive of meningitis. These guidelines provide recommendations with regard to selection of patients for CT scanning, collection of CSF and blood cultures, initiation of empiric antimicrobial therapy within one hour of presentation, and other relevant matters.

We wish to audit the management of patients presenting with possible meningitis to the ED at ACH. In particular we wish to determine: (i) the strengths and weaknesses of care prior to the introduction of the new guidelines in May 2020, and (ii) the impact of the introduction of the guidelines on the management of patients.

The student performing this project will be based in the Infectious Diseases Department at ACH working alongside the three supervisors.

Exploring medication use in the last year of life for people living in residential aged care

Supervisors

Michal Boyd (09 923 3722)
Jo Hikaka
Katherine Bloomfield
Jackie Robinson
Zhiqiang Wu
Aileen Collier
Rosemary Frey
Deborah Balmer

Discipline

Clinical

Project code: MHS042

Almost 40% of all deaths occur in residential aged care (RAC) facilities in New Zealand (NZ). Old age palliative care is complicated by multi-morbidity and advanced frailty, however, little is known about medication use for those who die in RAC. The ELDER study conducted post-mortem surveys in RACs in NZ, and this data will be used to explore end of life medication use. Ministry of Health deidentified pharmacy data has been obtained for all 286 deaths in the ELDER sample.

The summer student will answer these research questions in collaboration with researchers: 1) what medications are used in the last months of life for people dying in RAC, 2) how does medication use correlate with observed end of life symptoms, 3) how does NZ RAC data compare to similar European data. Our previous summer students published their work in high ranking journals, and this study will also be submitted for publication.

Skills developed include:

  • Pharmacy and clinical dataset management
  • Descriptive and correlation/regression statistics
  • Literature review and academic writing leading to publication

Those that would suit those with an: 

  • interest in quantitative analysis of existing databases
  • interest in honing academic writing skills
  • ability to work independently

A randomised controlled trial in retirement villages: Exploring older adults' experiences

Supervisors

Katherine Bloomfield (021 159 1580)
Jo Hikaka (021 130 4917)
Michal Boyd

Discipline

Clinical

Project code: MHS053

Our research group is studying the health, social and functional needs of residents living in retirement villages (RVs). Part of this project included a randomised controlled trial (RCT, n=412) investigating the effect of a multi-disciplinary team (MDT) intervention on healthcare utilisation.

Understanding participant experiences of an intervention is an important step in the development of health services/research design. This current study is a qualitative study conducted in a subgroup who participated in the intervention arm. The aim is to understand resident experiences of the MDT intervention which will help inform further health service/research development. Non-European participation rate in the RCT was low (<4%). Therefore, ALL non-European RCT participants will be invited into this study, with additional European RCT participants chosen randomly.

The student will conduct semi-structured interviews (in residents’ homes/over the telephone), transcribe the interviews, code the transcripts, participate in the data analysis and collaborate with researchers to draft an academic paper for journal publication.

Skills developed include:

  • Literature review/critical appraisal
  • Qualitative research methods including semi-structured interviews, data coding/analysis
  • Academic writing 
  • Working as part of a collaborative, multi-disciplinary research group

This would suit those with:

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

MRI-determined ectopic fat depositions in a multi-ethnic cohort

Supervisor

Associate Professor Max Petrov

Discipline

Clinical

Project code: MHS059

Excess adiposity has reached global epidemic levels with increasing impact on public health, given its association with metabolic syndrome, diabetes, and cardiovascular disorders. Individuals with similar general adiposity can vary significantly in their fat distribution. The clinical importance of body fat distribution over total body fat content has become increasingly evident in recent years. In particular, central or abdominal adiposity measures predict increased risk of metabolic complications better than general adiposity. Modern magnetic resonance (MR) imaging enables accurate quantification of not only abdominal adiposity, but also ectopic fat phenotypes [1,2].

The aim of this project is to investigate ectopic fat deposition using MR images from a large multi-ethnic cohort. The project is part of a larger research theme of the COSMOS group. The group offers a vibrant research environment, comprehensive research training, and clinical research experience.

Further reading:

  • Cervantes A, Singh RG, Kim JU, DeSouza SV, Petrov MS. Relationship of anthropometric indices to abdominal body composition: a multi-ethnic New Zealand magnetic resonance imaging study. J Clin Med Res 2019;11:435-446.
  • Singh RG, Nguyen NN, DeSouza SV, Pendharkar SA, Petrov MS. Comprehensive analysis of body composition and insulin traits associated with intra-pancreatic fat deposition in healthy individuals and people with new-onset prediabetes/diabetes after acute pancreatitis. Diabetes Obes Metab 2019;21:417-423.

Skills developed include:

  • Working in a clinical research team environment
  • Management of a cross-sectional clinical study
  • MR image analysis
  • Preparation of a manuscript for publication in an international peer-reviewed journal

Pancreas volume and metabolic outcomes

Supervisor

Associate Professor Max Petrov

Discipline

Clinical

Project code: MHS060

The prevalence of obesity is increasing each decade. The current prevalence of obesity world-wide is 25% and it is associated with several serious diseases - metabolic syndrome, cardiovascular disease, and cancer - which makes obesity a major public health issue. Moreover, obesity is associated with altered volume of parenchymatous organs, such as the pancreas. The aim of this project is to summarize the available literature on the topic by conducting a systematic review of clinical studies. 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 case-control study of MRI after diseases of the exocrine pancreas.

Skills developed include:

  • Working in a clinical research team environment
  • Management of a case-control clinical study
  • Systematic literature review
  • Preparation of a manuscript for publication in an international peer-reviewed journal

Development of care scenarios for virtual patient simulators

Supervisors

Nataly Martini (021 133 7367)
Craig Webster

Discipline

Clinical

Project code: MHS061

We have previously created and evaluated a virtual patient simulator using an intuitive point and click interface. The key element of the teaching potential of such simulations is the use of credible and well developed patient care scenarios around which the audio-visuals can be assembled. In this summer student project the participant will be involved in developing further clinically sound patient care scenarios which can be used for further virtual patient simulations. This will involve drawing on their own clinical knowledge, interviewing relevant clinicians within the Faculty, creating a timeline or story board of scenario events, and piloting the scenario with fellow students. Scenarios will be developed with the aim of converting them into a virtual patient simulation, and including teaching elements relevant to the Faculty’s healthcare curriculum.

Skills developed include:

  • Abstract and logical thinking about what learning opportunities could exist in a patient care episode
  • Consideration of scenario elements to challenge and engage participants within the simulation
  • Identification of the kinds of data that could be collected to demonstrate that learning using the scenario has occurred

Glaucoma Agreement in NZ (GAINZ)

Supervisors

Robert Ng
Dr Geraint Phillips
Dr Hussain Patel

Discipline

Clinical

Project code: MHS062

Since the introduction of the Medicines Amendment Act in 2014, optometrists have been allowed to prescribe and manage glaucoma. This study will investigate the trends and interpretation in the diagnosis and management of glaucoma by clinicians (optometrists and ophthalmologists).

Skills developed include:

  • Literature review/critical appraisal 
  • Qualitative research methods and analysis
  • Academic writing 
  • Working as part of a collaborative, multi-disciplinary team

Natural history of retinal degeneration associated with a founder mutation in the PDE6B gene

Supervisors

Associate Professor Andrea Vincent (027 444 3937)
Dr Monica Acosta
Dr Sarah Hull

Discipline

Clinical

Project code: MHS089

Inherited retinal dystrophies affect 1 in 2500 people, and are the leading cause of visual impairment in adults of working age, causing progressive night blindness, and peripheral vision loss leading to tunnel vision, and ultimately blindness. A number of gene-targeted therapies are in clinical trial, including gene replacement therapy for autosomal recessive rod cone retinal dystrophy associated with mutations in the Phosphodiesterase 6B (PDE6B) gene. A pre-requisite for clinical intervention and trial is understanding the natural history and rate of progression in these diseases.

In New Zealand, we have identified a founder mutation present in patients of Māori and Polynesian ancestry with rod cone dystrophy, and this is the cause for disease in 20 patients.

This studentship will retrospectively review clinical notes, and imaging including fundus autofluorescence and ocular coherence tomography (OCT) scan to record and extrapolate change and rate of progression in visual acuity, preservation of the photoreceptors, and hyperautofluorescence ring size. These are established parameters in determining disease progression, but has not been undertaken in this gene and mutation specific cohort.

Skills developed include:

  • Literature review
  • Review and collection of clinical data
  • OCT imaging analysis
  • Fundus hypoautofluorescence analysis
  • Data analysis
  • Phenotype-genotype correlation
  • Report writing and presentation skills

How many hours per night are enough? A systematic integrative review to identify optimal hours of CPAP therapy use for sleep apnoea

Supervisor

Kim Ward

Discipline

Clinical

Project code: MHS097

Obstructive sleep apnoea (OSA) is a global health issue and continuous positive airway pressure (CPAP), delivered overnight via face-mask is the go to treatment worldwide. However, concern exists that patients under-utilise this therapy, despite a lack of consensus about what is good therapy use. An array of studies are available regarding the hours per night and nights per week required for CPAP use, but which differ in opinion about what is optimal.
 
This systematic review aims to identify from the current literature what constitutes optimal CPAP use for OSA. 

Skills developed include:
  • Literature search and review
  • Basic research skills including data collection methods and data quality appraisal
  • Data interpretation and presentation
  • Professional scientific writing and the publication process

The student will be based at the School of Nursing, University of Auckland.

Synthesising evidence on predictive factors for CPAP use and non-use for sleep apnoea using systematic integrative review

Supervisor

Kim Ward

Discipline

Clinical

Project code: MHS099

Obstructive sleep apnoea (OSA) is a global health issue and continuous positive airway pressure (CPAP), delivered overnight via face-mask is the go-to treatment worldwide. However, concern exists that patients under-utilise this therapy, despite a lack of consensus about what is good therapy use. An array of studies are available regarding interventions to support CPAP use, but which factors leverage CPAP use the best?
This systematic review aims to identify from the current literature what key predictive factors support CPAP use and which predict non-use for OSA.

Skills developed include:

  • Literature search and review
  • Basic research skills including data collection methods and data quality appraisal
  • Data interpretation and presentation
  • Professional scientific writing and the publication process

The student will be based at the School of Nursing, University of Auckland.

Medical Students and Graduates’ Career Intention in Psychiatry

Supervisors

Dr Yan Chen (09 923 1471)
Antonia Verstappen

Discipline

Clinical

Project code: MHS100

The Ministry of Health has projected a workforce shortage in the mental health service for the next decade, compounded by high levels of work-related stress and burnout experienced by the workforce. It is vital that we understand how to select, train, and sustain a specialist medical workforce to meet the rising demand in mental health services. In this project, we will use the Medical Schools Outcomes Database and Longitudinal Tracking Project’s (MSOD) surveys to track medical students’ and graduates’ preference for psychiatry as a specialist discipline. The project aims to 1) examine the trends in students’ and early postgraduate doctors’ preference for practicing psychiatry and 2) explore the characteristics and reasons associated with respondents’ career preference.

Survey data have been collected and are available for further analysis. Successful candidate is expected to review and synthesize relevant literature in the first few weeks of the studentship, and spend the remaining studentship linking survey data and conducting statistical analysis.

This project aims to:

  • Review NZ and overseas literature
  • Use an existing database to identify medical school experiences that might influence students interest in a career in Psychiatry post-graduation
  • Conduct interviews with medical students and graduates

Skills developed include:

  • Literature review and critical appraisal
  • Statistical analysis
  • Oral and written presentation skills

The importance of flare attributes to the burden of flares over time for patients with gout

Supervisors

Dr Sarah Stewart (ext 81747)
Professor Nicola Dalbeth

Discipline

Clinical

Project code: MHS102

Gout flares cause severe pain and disability and are a central concern to patients with gout. There is a wide variation in patterns of gout flares over time in long-term gout studies. It is not known which attributes of flares (i.e. frequency, duration, pain, impact on function) are more meaningful to patients and should be measured and reported in longitudinal studies. This study will aim to determine which attributes of gout flares are most important to the long-term burden of flares for patients with gout.

Patients with gout will participate in an online survey to determine which flare attributes are ranked as most important to them in contributing to the long-term burden of a flare. Qualtrics software will be used to collect data using best-worst scaling. Data will be analysed to compare relative rankings for each attribute.

This project will be conducted from the Bone and Joint Research Group, Clinical Research Center. This study will provide the following skills: literature review and synthesis, recruitment of research participants, data collection and data entry, and data management and analysis. A manuscript describing the findings will be completed for submission.

The Fertility and IVF and IUI in uneXplained infertility – the FIIX study

Supervisors

Prof Cindy Farquhar (021 995 414)
Dr Lynn Sadler
Dr Richard Edlin

Discipline

Clinical

Project code: MHS103

Unexplained infertility is diagnosed when there is no obvious reason for not being able to get pregnant, after all the normal tests have been done. People with unexplained infertility may be offered fertility treatments such as intrauterine insemination (IUI) or in vitro fertilisation (IVF). IUI is a less invasive and cheaper treatment option per cycle compared to IVF, however people may need to undergo more IUI cycles to achieve the same chance of getting pregnant.

The aims of the FIIX study are:

  • Are four cycles of IUI-OS associated with a lower cost per live birth compared to one completed cycle of IVF?
  • Will four cycles of IUI-OS followed by one complete cycle of IVF result in as many live births at lower cost per live birth, than two complete cycles of IVF? 
  • Will four cycles of IUI-OS followed by two complete cycles of IVF result in more live births at lower cost per live birth, than two complete cycles of IVF alone?

This summer studentship project will compare payments for fertility treatments in the Northern Regional Fertility Service and the true cost of fertility treatments in the FIIX study. This will be helpful for the final cost analyses. We will consider these costs for 30 IUI cycles and 30 IVF cycles.

The student will gain experience working as part of a clinical trial and gain insight into cost analyses and clinical trial design.

A systematic or Integrative review "Health promotion strategies for women with Irritable Bowel Syndrome"

Supervisors

Bobbi Laing (09 923 8418)
Rajshri Roy

Discipline

Clinical

Project code: MHS105

Choose the methodology of a systematic or Integrative review. Use a clear and precise search and selection criterion, which is described clearly so that another researcher can duplicate the searches and the study selection. From this review (a) Analyse and compare articles, identify themes and determine gaps in the current research, and draw conclusions. (b) Where applicable identify evidence based practice and describe how this can be incorporated into clinical practice.

The outcomes of patients presenting to a large Emergency Department with fever and hypothermia

Supervisors

Dr Stephen Ritchie (021 493 361)
Dr Nick Gow

Discipline

Clinical

Project code: MHS109

Are patients with sepsis recognised and managed appropriately? Are patients prescribed antibiotics in accordance with antibiotic guidelines? Are patients with infectious diseases receiving optimal management? How often do patients with fever receive anti-pyretic therapy?

Fever is a common symptom provoking people to seek medical help. When associated with bacterial infection fever can be a harbinger of serious illness. Very little is known about the causes of fever, or the outcomes for patients with fever in our community.

We aim to examine a cohort of patients presenting to the Emergency Department at Waitemata DHB with fever or hypothermia to learn about their illnesses, management, antibiotic treatment and outcomes. We will publish the findings in an infectious disease journal.

Preparing Pharmacy for the future: Factors in graduate pharmacist career choice

Supervisors

Dr Rhys Ponton
Antonia Verstappen

Discipline

Clinical

Project code: MHS112

The Health Careers Pathways Project is a Faculty project that collects information from students at their entry and exit to a number of health programmes. Data for pharmacy students has been collected for 15 years and is available for analysis. This project will look at the career preferences of the students on entry and graduation, and assess how these fit with the needs of the profession, the New Zealand healthcare system and the NZ population.

This project aims to:

  • Systematically review the NZ and overseas literature
  • Use an existing database to identify the career preferences of Bachelor of Pharmacy students over 15 years
  • Link existing large datasets

Skills developed include:

  • Literature review
  • Quantitative analysis of data
  • Data interpretation and presentation
  • Academic writing and the publication process

The project will be supported with input from both the School of Pharmacy and the Health Careers Pathways Project.

Broadening the state of play – the second national survey of consultation-liaison psychiatry services in New Zealand

Supervisors

Dr Frederick Sundram (09 923 7521)
Dr John Hopkins

Discipline

Clinical

Project code: MHS114

Consultation-liaison psychiatry (CLP) is the psychiatric specialty that focusses on the care of people presenting with both mental and physical health needs regardless of presumed cause typically within general hospitals. The first national survey of CLP services in New Zealand (CLPSNZ-1) was conducted in April 2018 using a multiple-choice online survey and results of this survey have already been published. This is the second iteration of the survey with a planned launch in the second half of 2020 and aims to sample all services available in the 36 public hospitals in New Zealand with 24/7 Emergency Departments, for people presenting with comorbid mental and physical health needs.

Skills developed include:

  • Reviewing the literature relating to consultation-liaison psychiatry
  • Developing, involvement in and administering a national survey
  • Summarising findings from various DHBs in a database
  • Working towards publication of findings together with the research team


Ideal applicants:

  • Students with prior research skills
  • Students with interest in mental health
  • Students keen to work towards future publication

The prevalence of student nurses' use of alcohol: A systematic review and meta-analysis of the literature

Supervisors

Marea Topp (027 497 4405)
Cynthia Wensley

Discipline

Clinical

Project code: MHS115

Young people have been identified as a population that engage in higher risk behaviours which includes the misuse of alcohol (1, 3, 4, 6). For student nurses', alcohol misuse may impact on their ability to deliver safe patient care, academic performance, relationships, and health and wellbeing (1, 2, 5). Understanding student nurses' use of alcohol has implications for curricula and a focus on health promotion activities that foster student nurses health and wellbeing.

Project aim: to systematically review all literature reporting the prevalence of student nurses' use of alcohol.

Method
Using the research protocol the student will
1. Update the current search to include 2020 publications
2. Select 2020 studies
3. Appraise selected studies
4. Complete data extraction and management
5. Analyse and interpret results

Prepare the first draft of a manuscript for publication

Skills developed include:
• Systematic searches of electronic databases
• The use of Covidence online software
• Meta-analysis and narrative literature synthesis
• Academic writing skills

1. Baldwin, J. N., Bartek, J. K., Scott, D. M., Davis-Hall, R. E., & Desimone Ii, E. M. (2009). Survey of alcohol and other drug use attitudes and behaviors in nursing students. Substance Abuse, 30(3), 230-238. https://doi.org/10.1080/08897070903040964

2. Oliveira Gomes, V. L. D., Amarijo, C. L., Baumgarten, L. Z., Arejano, C. B., da Fonseca, A. D., & Tomaschewski-Barlem, J. G. (2013). Vulnerability of nursing and medicine students by ingestion of alcoholic drinks. Journal of Nursing UFPE/Revista de Enfermagem UFPE, 7(1).https://doi:10.5205/reuol.3049-24704-1-LE.0701201318

3. Tavolacci, M. P., Delay, J., Grigioni, S., Déchelotte, P., & Ladner, J. (2018). Changes and specificities in health behaviors among healthcare students over an 8-year period. PloS one, 13(3), e0194188. https://doi.org/10.1371/journal.pone.0194188

4. Blake, H., & Harrison, C. (2013). Health behaviours and attitudes towards being role models. British Journal of Nursing, 22(2), 86-94. https://doi.org/10.12968/bjon.2013.22.2.86

5. Bergamaschi, A., Zanetti, F., Stampi, S., & De Luca, G. (1995). Consumption, behaviour and knowledge with respect to alcoholic drinks in student nurses in the province of Bologna, Italy. European Journal of Epidemiology, 11(2), 185-191.

6. Barrientos-Trigo, S., Gil-García, E., & Porcel-Gálvez, A. M. (2014). Gender differences in risk behaviors of nursing students at the University of Seville. Journal of Addictions Nursing, 25(3), 148-156. https://doi:10.1097/JAN.0000000000000039

The effect of topical calcium channel blockers in anal fissures: A systematic review and meta-analysis

Supervisors

Dr James Jin (021 0235 1160)
Professor Andrew Hill

Discipline

Clinical

Project code: MHS117

Topical calcium channel blockers (CCBs) are routinely prescribed to patients with anal fissures. It is proposed that CCBs reduce anal sphincter tone by inducing smooth muscle relaxation, thereby reducing pain and promoting healing of anal fissures. However, despite the routine use of CCBs in anal fissures, there is a lack of clear evidence that topical calcium channel blockers are superior to placebo in reducing pain or promoting healing.

We aim to conduct:

  1. A systematic review and meta-analysis of Randomised Controlled Trials (RCTs) to compare the effect of topical CCBs against placebo in both pain scores and rates of healing
  2. Asystematic review and meta-analysis of RCTs comparing the effect of topical CCBs vs other treatments of anal fissures on pain scores and rates of healing. The results of this review may provide evidence that directly impact on our clinical practice.

The Economic Impact of Tendon Injuries in Aotearoa/New Zealand

Supervisors

Scott Bolam (021 0253 8391)
David Musson

Discipline

Clinical

Project code: MHS122

Health and economic costs burdens of tendon injuries are rising in New Zealand. We want to better understand the cost of specific tendon injuries (rotator cuff, Achilles tendon and ACL tears), including the operative and non-operative (physiotherapy, rehabilitation and employment) costs. Accident Compensation Corporation (ACC) provides a unique way of capturing the cost of these injuries because it encompasses all of New Zealand’s population.

Using the Accident Compensation Corporation (ACC) database, data specific to tendon injuries will be analysed to look at the cost of these claims with respect to anatomical site and type of injury. The Summer studentship will involve helping to analyse this data and report on its outcomes, with the aim of a publication in an orthopaedic/musculoskeletal journal. You will learn population data analysis, statistical analysis and oral and written presentation skills.

We are looking for someone who is hard-working and with an interest in developing research skills.

You will be working with an experienced senior research fellow and an orthopaedic registrar on this project. We have successfully supervised six previous Summer studentships and published with every student. There may also opportunity for some clinical operating theatre exposure at Auckland City Hospital, if that is of interest.

An integrative review: Nurse practitioners' work with vulnerable populations in primary health care settings

Supervisors

Dr Sue Adams (021 388 8449)
Dr Michal Boyd

Discipline

Clinical

Project code: MHS123

Using integrative review methodology explore how nurse practitioners (in Aotearoa New Zealand and internationally) work with vulnerable populations to improve access and health outcomes. Use a clear and precise search strategy with selection criteria that is described clearly so that another researcher can duplicate the searches and the study selection. From the search results, analyse and compare articles; identify themes and determine gaps in the current research; and draw conclusions for the development of NPs in primary health care settings.

Maximising comfort – how do we measure the care that matters? A state-of-the-art review of the literature

Supervisor

Dr Cynthia Wensley (09 923 4257)

Discipline

Clinical

Project code: MHS124

This student project is preparatory to research aimed at developing clinically relevant metrics for (1) patient comfort and (2) monitoring comfort-related care.

Project Aim: To conduct a state-of-the-art review of the literature to identify how patient comfort (the outcome) and comfort-related care (processes of care) are currently measured in healthcare settings.
Objectives:

  1. To review instruments currently used to measure patient comfort, evaluating the conceptual underpinnings and validity for each
  2. To examine how patient experience indicators currently monitor the provision of care that patients have identified as important for maximising comfort and minimising distress

Review Methods

The review methods (search strategy, data extraction and data analysis) will be guided by a comprehensive conceptual framework - the Comfort ALways Matters (CALM) Framework1. The framework incorporates (1) a definition of patients’ perspectives on comfort and (2) factors influencing patient comfort. As defined by patients, comfort is multidimensional, incorporating more than the absence of pain.

Skills developed include:

  • Systematic searches of electronic databases
  • Systematic data extraction
  • Narrative and tabular synthesis 
  • Academic writing
  • Preparing a manuscript for publication


References

1. Wensley C, Botti M, McKillop A, et al. Maximising comfort: how do patients describe the care that matters? A two-stage qualitative descriptive study to develop a quality improvement framework for comfort-related care in inpatient settings. BMJ Open 2020;10(5):e033336. doi: 10.1136/bmjopen-2019-033336

Clinical observations, vignettes, insights and dying: The hospice perspective on COVID-19 lockdown

Supervisors

Dr Di Winstanley (027 499 6684)
Assoc Prof M Henning
Dr Yan Chen
Dr Dean Fourie
Dr Marie Rose

Discipline

Clinical

Project code: MHS136

COVID-19 has had a significant bearing on how palliative care services operate, impacting on the entire multidisciplinary team (medical, nursing, social work, counselling, IT, etc) both in the inpatient unit and in the community, as well as on patients and their families.

During the lockdown period, traditional delivery of palliative care services was challenged, and new, and often innovative, ways of providing care were required. This was reportedly most significant for how care towards the end of life was managed.

This study explores the impact of COVID-19 on the staff of a single hospice (Mercy Hospice) and what insights were gained. Staff from all areas of the multidisciplinary team will be interviewed regarding their experiences during the COVID-19 lockdown, with a focus on the challenges faced, confronting cases, and insights into their own practice and wider palliative care provision in a resource-limited situation. Data will be qualitatively analysed using a thematic analysis approach.

Mental wellbeing in healthcare workers – what factors contribute to higher team performance?

Supervisors

Karen Day (09 923 3870)
Elizabeth Berryman

Discipline

Clinical

Project code: MHS140

Research aim: To determine statistical measurements of mental wellbeing in healthcare workers and detect correlations with team performance outcomes.

The COVID-19 pandemic has shattered the daily routines, business, schools, lifestyles and economies around the globe. Most of the current COVID-19 research focused on physical health, but research data on mental health during the COVID-19 pandemic is lacking. Due to COVID-19, healthcare workers on the frontline are being exposed to previously unknown and unsurpassed levels of psychological risks including high levels of stress and anxiety from workplace pressures, which may affect work performance and productivity.

Chnnl is an app that collects daily data about mood from people who have downloaded the app onto their mobile phones.

This project seeks to optimise workplace mental performance through developing new evidenced-based ways of monitoring and measuring the mental wellbeing of healthcare workers.

We are seeking a student who has big data analytics skills to help develop a customisable, scalable platform for measuring mental wellbeing and team performance by applying statistical methods to analyse and model the data.

Skills developed include:

  • Literature review
  • Statistical analysis
  • Manuscript preparation for publication

Ethnic differences in PSA reduction following transurethral resection of the prostate

Supervisors

Dr Bashar Matti
Assoc Prof Kamran Zargar

Discipline

Clinical

Project code: MHS141

Prostate Specific Antigen (PSA) is a widely utilized serum marker in the assessment of the Benign and malignant conditions of the prostate. In most men, PSA levels increase with age largely due to Benign Prostatic Hypertrophy (BPH). Our recent work on PSA testing in New Zealand, has demonstrated that ethnic differences in PSA levels exist among men without Prostate cancer.

Trans Urethral Resection of The Prostate (TURP) is a surgical procedure for treating bladder outlet obstruction related symptoms, due to prostatic enlargement. It involves resecting the transitional zone of the prostate. Since this is the site where BPH tend to occur. it is well established the PSA levels drop following TURP. This area, however, has never been investigated in New Zealand.

This study aims to assess the presence of any differences in the levels of PSA reduction following the resection of the transitional zone in a cohort of New Zealand men, and investigate the presence of ethnic differences in this aspect.

This project will provide an opportunity for the student to get involved with clinical research and data collection and analysis. Experience in data management is not necessary but welcomed.

Women Wellness Programme after Stroke project

Supervisors

Julia Slark (09 923 8471)
Bobbi Laing

Discipline

Clinical

Project code: MHS150

Women Wellness Programme after Stroke project administration and transcribing duties, data collection and entry, cleaning and coding data; preliminary data analysis under supervision of team members

Tubo ovarian abscess study (TOAST) predictors of failed medical management

Supervisor

Charlotte Oyston (027 668 7560)

Discipline

Clinical

Project code: MHS157

Tubo-ovarian abscesses (TOA) occur where a pelvic inflammatory mass develops to involve the fallopian tube and / or ovary. They are associated with high rates of morbidity, and increased mortality. TOA is an important health complication for women living in the Counties Manukau, with high rates of women admitted with TOA at Middlemore Hospital.

Historically, antibiotic therapy has been the mainstay of treatment for TOA. Alternatives or adjuncts to medical management include surgical or radiological guided drainage. The decision as to which procedure to perform, and the optimal time to perform it is clinician dependent. Interventions are often undertaken when medical therapy has been unsuccessful, thereby exposing a deteriorating patient to additional anaesthetic and surgical morbidity. If a group of factors could be identified that predict which women will need surgery prior to clinical deterioration, early operative or radiologic intervention may be associated with less morbidity.

The objectives of this retrospective cohort study are to describe the demographics, management, outcomes, and microbiology associated with TOA, and use regression analysis to identify factors predictive of unsuccessful medical management. This study will result in a manuscript for publication, and the findings be used locally to counsel patients, ensure antibiotic guidelines are appropriate, and guide future research into best management of TOA.

The studentship will involve a brief literature review, data collection, statistical analysis (with support) and preparation of a manuscript for publication.

An integrative review: Engaging with local communities to develop nurse practitioner services in rural communities

Supervisors

Dr Sue Adams (021 388 449)
Dr Michal Boyd

Discipline

Clinical

Project code: MHS158

Nurse practitioners are proposed as a solution to the reducing numbers of general practitioners working rurally. To meet local health needs and promote health and wellbeing, health services should be developed in collaboration with the local community. Using integrative review methodology, identify literature exploring how nurse practitioners engage with local rural communities (in Aotearoa New Zealand and internationally) to plan and implement meaningful and comprehensive primary health care services. Use a clear and precise search strategy, with selection criteria that is described clearly so that another researcher can duplicate the searches and the study selection. From the search results, analyse and compare articles; identify themes and determine gaps in the current research; and draw conclusions to inform nurse practitioner approaches to community engagement.

Quantification of pharmaceutical waste: the extent of the problem and its environmental impact

Supervisors

Andrew MacCormick (021 189 9953)
Sara Hanning

Discipline

Clinical

Project code: MHS161

Pharmaceutical waste is generated through disposal of unwanted medicines and has a potentially significant environmental impact. In New Zealand, individuals are encouraged to return unwanted medicines to pharmacies. The medicines are then taken by contractors, autoclaved and then disposed at landfill sites. This can lead to potential contamination of soil and water. To address this, collaborators at the Faculty of Engineering and Middlemore Hospital are investigating a treatment process that can destroy this substances without contaminating the environment.

This summer studentship aims to identify current waste handling practices and quantify pharmaceutical waste in hospital and retail pharmacies in the Auckland region. The findings can then be used to validate destruction technologies.

Skills developed include:

  • Interdisciplinary collaboration
  • Research design
  • Data collection and analysis
  • Academic writing and presentation

Environmental impact of disposable equipment in the operating theatre

Supervisors

Andrew MacCormick (021 189 9953)
Rob Burrell

Discipline

Clinical

Project code: MHS162

There are a number of items used in the operating theatre that are disposed of after a single use. These include sequential calf compression devices (SCD) and patient transfer mattresses. There is collaborative work around a SCD reprocessing program and also newly developed technology to reprocess the patient transfer mattresses.

We need to collect initial data on the volume and the environmental impact of these devices going straight to landfill. This data would then be used to conduct a life cycle analysis (LCA). LCA's allow us to better understand the comparative carbon emissions of original suppliers compared to products that are reprocessed. This would be in collaboration with the Faculty of Engineering and industry partners.

We would use the data to justify a reprocessing programme at Counties Manukau Health.

Skills developed include:

  • Interdisciplinary collaboration
  • Research design
  • Data collection and analysis
  • Academic writing and presentation

Long-term risk of advanced lesions and colorectal cancer in patients with serrated polyposis syndrome undergoing colonoscopy surveillance

Supervisor

Dr Maggie Ow (021 424 956)

Discipline

Clinical

Project code: MHS163

Serrated polyposis syndrome (SPS) is a condition characterised by development of multiple serrated or hyperplastic polyps in the colon, and carries a high risk of colorectal cancer (CRC). Consequently, intensive 1-2 yearly colonoscopy surveillance is recommended to detect lesions when they are early and amenable to removal. The phenotype of SPS is highly variable, however, with some individuals at lower risk of developing CRC and advanced lesions than others, but, to date, there is uncertainty as to what patient/disease factors may determine who can have relatively more relaxed surveillance. There is also a lack of long-term data on this group of individuals, as to whether surveillance can be relaxed over time.

This project involves collating data from a multi-centre database of patients with SPS, to examine factors such as demographics, time to diagnosis, polyp burden at diagnosis and over time,and frequency of advanced lesions and CRC. Once there is a successful applicant, ethics approval will be organised by the supervisor. The bulk of the data will be collected and analysed during the studentship and presentation of results will occur in the first half of 2021.

Essential skills/characteristics required: Microsoft Excel, good organisational and record keeping skills, enthusiasm, ability to take initiative

Skills developed include:
  • Design of database, Statistics 
  • There is the opportunity for the student to present findings at a conference or pursue publication, although this will occur beyond the time allocated for the studentship

To what extent are nurses in New Zealand valued by themselves, other health professionals, and society?

Supervisors

Stephen Jacobs (021 242 1385)
Kim Ward

Discipline

Clinical

Project code: MHS164

COVID-19 has raised discussion internationally about the extent to which nurses and other health workers are valued. This project will focus on reviewing academic and grey literature to identify the ways in which in the New Zealand setting nurses are valued by themselves, their health colleagues, and society.

The project's aim is to review all literature in New Zealand – both peer reviewed and grey literature – that explores the place of nursing in the New Zealand context.

The School of Nursing operates a Valuing Nurses and Nursing Research programme. This project will asist us to determine more about the NZ setting, including what is know about the valuing of Māori and Pacific nurses. Successful applicants will need to be good writers and enjoy reading. They will learn academic search techniques, but will also become skilled in the assessment of grey literature. Presentations of findings to acadamic and professionial nurses is an expeceted outcome, as is a published article.

What do nurses’ value about their nursing careers? An integrative review exploring empowerment in nursing

Supervisors

Stephen Jacobs (021 242 1385)
Kim Ward

Discipline

Clinical

Project code: MHS165

Retention of nurses in the profession in the New Zealand setting is vital for the healthy future of the health services. Strike action by nurses last year is one indicator of ongoing dissatisfaction. Research using empowerment models is producing results telling us that nurses feel moderately, personally and structurally empowered. However, the meaning of this remains unclear. To design effective training programmes for nurses that enable them to grow into nurses who can thrive both personally and professionally, we need to know more about the existing values and experiences of nurses. This project will identify existing research and opinions in New Zealand.

The project's aim is to review all literature in New Zealand – both peer reviewed and grey literature – that explores nurses’views about nursing in the New Zealand context.

Skills developed include:

  • Literature search and review
  • Basic research skills including data collection methods and data quality appraisal
  • Data interpretation and presentation
  • Professional scientific writing and the publication process

The student will be based at the School of Nursing, University of Auckland.

What does nursing leadership look like in New Zealand and to what extent is it valued?

Supervisors

Stephen Jacobs (021 242 1385)
Susan Waterworth

Discipline

Clinical

Project code: MHS166

We know that good nursing leadership in clinical settings has a positive impact on patient outcomes. However, during the COVID-19 pandemic there have also been questions raised about nursing leadership at all levels, including national policy. This project will involve searching academic and grey literature to identify how nursing leadership is understood in the New Zealand context.

The project's aim is to review all literature in New Zealand – both peer reviewed and grey literature – that has discussed or researched nursing leadership in the New Zealand context. There will be no date restrictions to how far back this research explores so there will be an historical overview element to this project, as well as a need to present the current context. Leadership at all levels - policy, management, frontline - will be explored.

Skills developed include:

  • Literature search and review (Finding grey literature will require talking to people to find out reports, etc that may be in the sector but not formally published.)
  • Basic research skills, including data collection and data quality appraisal
  • Data interpretation and presentation
  • Professional scientific writing and publication

The student will be based at the School of Nursing, University of Auckland.

Remote testing of vision in children

Supervisors

Steven Dakin (027 836 5800)
Tina Gao

Discipline

Clinical

Project code: MHS168

Effective diagnosis and management of vision problems in children relies on accurate measurement of how well they can see. The gold standard for measuring eyesight is visual acuity which is measured using a symbol-chart. However such an assessment procedure requires that optometrist and patient be in physical proximity for an extended period and the COVID-19 pandemic has led to an urgent, unmet need for a vision test that can be administered remotely (in the child’s home). This is particularly relevant to children a significant percentage of whom are receiving treatment for amblyopia ("lazy eye") which requires assessment of their vision over many months.

Electronic acuity tests (eg, on smartphones) are available but all have limitations making them unsuitable for widespread use by clinicians. We are developing a home vision-testing system that is (a) universal (free, works with any device), (b) clinically relevant, and (c) fast and easy to use. This summer project sets out to validate our test by comparing it to clinical gold standard measures of acuity available for children. The project would suit a B Optom student with an interest in paediatric optometry. No specific technical skills are necessary but a basic knowledge of Matlab would be helpful.

Understanding patient and whānau experiences of the clot retrieval procedure after stroke

Supervisors

Dr Marie-Claire Smith (021 0232 3351)
Professor Cathy Stinear

Discipline

Clinical

Project code: MHS175

Clot retrieval is a new development in acute stroke care which involves removing the clot in an emergency procedure within a few hours of stroke. This procedure results in significant improvements in physical outcomes. This project will identify whether patients continue to have issues with cognition, mood or fatigue, how these are affecting their return to their usual activities, and whether these needs are being met by the current health service. Patients and whanau will be interviewed to find out about their experience of the procedure and their stroke recovery. The results will be used to develop a clinical pathway for patients who have clot retrieval.

You will be involved in transcribing and coding interview transcripts from patients and whanau after stroke. You will have the opportunity to attend home visit assessments with a research physiotherapist to observe the clinical assessment and interviews. There will also be opportunity to be involved in other aspects of the teams’ work at Auckland City Hospital, which will provide you with a broad experience of clinical neuroscience carried out in the hospital environment and in the community setting.

Skills developed include:

  • Interview transcription and coding
  • data processing and analysis
  • professional research interactions with patients

How hard do patients work during physiotherapy for walking after stroke?

Supervisors

Dr Marie-Claire Smith (021 0232 3351)
Professor Cathy Stinear

Discipline

Clinical

Project code: MHS177

High intensity training improves walking outcomes after stroke, however most studies have been conducted more than 6 months post-stroke when patients are quite stable. It isn’t clear what current practice is early after stroke, or whether patients and their physiotherapists would be willing to increase training intensity. It is important to understand any potential barriers before designing a large trial of high intensity training after stroke.

This pilot study is based at Auckland Hospital, and will use heart rate monitors and Fitbit step-counters to analyse how hard patients are working. Patients and physiotherapists will also be asked to estimate how hard they worked and will complete a questionnaire to identify any factors that would prevent them from working harder.

This study is an opportunity to participate in clinical research in an experienced stroke research team. This will include assisting in data collection, processing, and analysis. There will also be opportunity to be involved in other aspects of the teams’ work. This includes various projects about the recovery of movement after stroke, which will provide you with a broad experience of clinical neuroscience carried out in the hospital environment.

Skills developed include:

  • Data collection
  • Pand analysis
  • Professional research interactions with patients

An iPad-based assessment of reading performance

Supervisors

Prof S Dakin (027 836 5800)
Geraint Phillips
Joanna Black

Discipline

Clinical

Project code: MHS181

The COVID-19 pandemic has highlighted the need for effective home-based monitoring of patients’ vision. This includes older adults who need to be monitored for changes in their vision that might signal a deterioration in long-term conditions such as age-related macular degeneration (AMD).

Although patients complain about problems reading, there is currently no means of their measuring their own reading performance on a regular basis. To address this we have developed an eReader application, that runs on Apple iOS devices, and leverages these devices’ imaging capabilities to measure where the patient is looking during reading. This allows us to make detailed, daily, automated assessment of patients reading while they enjoy their preferred reading material.

In this project we will validate this approach by comparing the measures made using the iPad to (a) results from an infra-red eyetracker and (b) gold-standard measures of reading speed made in the clinic. We will do this for people with normal vision and a variety of simulated visual problems (e.g. AMD).

The project would suit a student with a background in optometry, psychology and/or programming (e.g. Matlab, Swift).

Seasonal variation in BMI in children and adolescents

Supervisors

Dr Yvonne Anderson
Cervantée Wild
Dr José Derraik
Prof Paul Hofman

Discipline

Clinical

Project code: MHS185

Whanau Pakari is a child and adolescent obesity assessment and intervention programme that has been running in Taranaki since 2012, which had an RCT embedded within the service to assess participant outcome. There is evidence that paediatric BMI is influenced by seasonal variation, thought to reflect influences related to energy imbalance and an obesogenic environment over school holidays. The aim of this project is to determine if BMI SDS change varies according to season among Whanau Pakari participants.

The student would be supervised by Dr Yvonne Anderson, who has supervised many students in varying stages of their careers. Ideally the student would be based in Taranaki for at least a portion of their studentship. They would be assisted by the Tamariki Pakari research team (www.tamarikipakari.org) and have the opportunity to observe the Whanau Pakari multi-disciplinary team meetings. The wider collaborative team on this project would include Cervantée Wild (FMHS), Dr José Derraik (FMHS), and Professor Paul Hofman (paediatric endocrinologist, Starship Children’s Hospital and Liggins Institute). It is expected the student would have a manuscript drafted with support at the completion of this project.

This project would suit a candidate who:

  • is interested in clinical research/evidence-based practice and/or Paediatrics
  • is self-motivated, independent, with a willingness to learn
  • has basic excel skills and is proficient at writing in English

Understanding health inequity: which patients are considered “difficult” and why?

Supervisors

Prof Nathan Consedine (09 923 5976)
Alina Pavlova (PhD Candidate)

Discipline

Clinical

Project code: MHS186

Despite efforts to remain impartial, evidence suggests that (like most of us) clinicians are not immune to bias in our attitudes, diagnoses, and treatment decisions. Ongoing studies show that treatment inequalities stem from (implicit) physician judgements of patient characteristics, the “usual suspects” being race/ethnicity, gender, or the stigmatization of certain issues (e.g., one’s weight, personality disorder, or substance disorder). However, while we know that such patients are seen as difficult, little is known about why.

Put another way, the empirical regularities or underlying factors that lead to a person being labelled “difficult” are unclear. To reduce the effects of judgement and the related healthcare inequities, there is a need to better understand what a “difficult patient” means to physicians. This studentship will focus on the development of a taxonomy of the difficult patient by (1) conducting a critical literature review and, (2) developing and implementing a survey to explore the underlying dimensions of the “difficult patient” as it is understood by the doctors. An anticipated output of this research will be an academic journal article of which a student will be co-author. This research will also lead to future scientific work trying to understand how to use our understanding of “difficult patient” to create interventions to reduce judgment and bias.

Aim:
To create an empirically-based taxonomy of “difficult patient” concept.

Required tasks:
  • Carry out a critical literature review 
  • Develop and implement a new survey
  • Conduct factor analysis (SPSS or R)
  • Prepare a manuscript for publication in collaboration with the research team
  • Contribute to positive change in healthcare equality

External validation of international Pre-Radical Prostatectomy risk models in a cohort of New Zealand men

Supervisors

Bashar Matti
Kamran Zargar-Shoshtari

Discipline

Clinical

Project code: MHS187

Prostate cancer is a common cause of morbidity and mortality for New Zealand men. Men with intermediate to high risk cancers, who presents relatively early in the course of the diseases, have the highest chances of benefiting from curative surgery (Radical Prostatectomy). Considering the significance of the decision making, it is crucial to accurately identify these men prior to proceeding to surgery.

A widely used objective approach is predictive modeling. However, there currently no models that has been developed or validated specifically for New Zealand men. Therefore, this project aims to assess the applicability of one of the most utilized international models, the Memorial Sloan Kettering Cancer center (MSKCC) developed by Kattan et al, in a cohort of NZ men. This risk calculator uses few pre-surgery variables to predict cancer recurrence at 2, 5 and 10 years intervals. These variables are: Adjutant treatment, Age, Prostate Specific Antigen (PSA) and Prostate Biopsy information such as Gleason score and number of positive cores. The student will help collecting data on NZ men who had Radical Prostatectomy between 2008 to 2017. These will be applied to the model. The accuracy will be assessed statistically to investigate its applicability in these settings.

This project will provide an opportunity for the student to get involved with clinical research and data collection and analysis. Experience in data management is not necessary but welcomed.

Childhood Leukaemia: How many children are at risk of neurocognitive problems following treatment?

Supervisor

Dr Rebecca Slykerman (09 923 1132)

Discipline

Clinical

Project code: MHS194

This project aims to identify how many children diagnosed with leukaemia and treated at Starship Children's Hospital are at risk of neurocognitive problems that may affect their learning and development. A secondary aim is to determine how many at-risk children have historically had a specialised neuropsychological assessment of these difficulties.

Using data from the New Zealand Child Cancer Registry the project involves looking at treatment information in patient records to identify children who have had chemotherapy treatment known to carry an increased risk of cognitive problems. This project is an excellent opportunity to learn about research that answers a clinical question and leads to improvement of processes for patients. It will offer the opportunity to get experience in data collection and anlysis.

Skills required: attention to detail and some basic familiarity with Excel would be helpful.

Geographic variations in access to inpatient hospices and place of death: a population based analysis

Supervisors

Dr Jackie Robinson (021 938 020)
Dr Jinfeng Zhao

Discipline

Clinical

Project code: MHS206

Evidence has shown variation in hospice use with respect to geographic factors such as area-based deprivation, location of patient’s residence and proximity to services location. For example, a UK study has shown wide differences in geographic access to inpatient hospices across regions and an indication that people who lived further away from hospice locations (= 10 minutes) were less likely to die in a hospice. However, little is known about variations in access to hospice inpatient care in New Zealand. The aim of this project is to identify associations between area deprivation, geographical access to hospices (or health care services), and place of death by undertaking a secondary analysis of deaths in the Auckland Region over a 5 year period. Trough this project, the student will assist with geo-coding, develop skills in data processing, analysis, mapping/visualisation, interpretation and writing reports.

A new method for measuring visual acuity at home

Supervisors

Joanna Black
Jason Turuwhenua
Mohammad Norouzifard

Discipline

Clinical

Project code: MHS210

The COVID-19 pandemic has highlighted the need for new ways of assessing eye-sight in remote/home environments. In this project we will test a new state-of-the-art method for measuring visual acuity that works using only a home computer and webcam with internet connection. The idea will be to compare standard visual acuity measurements made in adults under normal clinical conditions with measurements made in home environments.

Skills developed include:

  • In the use of state of the art technology 
  • Literature searching 
  • Basic research skills including data collection methods
  • Data interpretation and developing presentation

The student will work between the School of Optometry and Vision Science and the Auckland Bioengineering Institute, University of Auckland.

Does the ABO blood group A afford immunoprotection to cardiac valvular bioprostheses?

Supervisors

Professor Jillian Cornish
Dr Steve Waqanivavalagi
Mr Paget Milsom

Discipline

Clinical

Project code: MHS216

The problem

Bioprosthetic heart valves, such as those derived from pigs, are limited by a short lifespan because they elicit a chronic inflammatory response that leads to progressive calcification and graft failure. Pigs possess a unique AO blood group system that is similar to the human ABO blood group. The A antigen from pigs and the A antigen from humans are similar. Therefore, it is possible that patients with an A blood group do not develop the same degree of graft rejection as patients with other blood group types.

The project

The aim of this project is to record and correlate the ABO and rhesus blood group statuses, demographic data, and clinical risk factors, with the longevity of bioprosthetic cardiac valves for patients who have undergone redo valve replacement surgery at Green Lane Cardiothoracic Surgical Unit.

Images of a pandemic: An analysis of news media images associated with COVID-related deaths in Aotearoa, New Zealand

Supervisors

Dr Natalie Anderson
Dr Victoria Egli

Discipline

Clinical

Project code: MHS221

News media portrayals of death, dying and bereavement has been the subject of numerous books, research and discussion papers. The way deaths are described in the media both reflects and shapes societal death attitudes (Fishman, 2017; Hanusch, 2010). During the national lockdown, 21 New Zealanders died as a result of COVID19. News media reporting of these deaths is currently being examined by a funded project at the School of Nursing. As part of that project, both text and images are being collected, and text analysed. This proposed project would involve the analysis of images which had accompanied digital and print news media articles reporting on COVID-related deaths and writing-up these findings for publication.

Skills developed include:

  • Media analysis
  • oral presentation skills
  • manuscript authorship

Duration of breast feeding in graduates of Special care baby unit (SCBU)

Supervisor

Bobby Tsang (09 486 8900)

Discipline

Clinical

Project code: MHS222

The project aims to audit retrospectively the breastfeeding rate in SCBU graduates from Northshore and Waitakere:

  • At discharge (on clinical record)
  • At 6 months after discharge (by phone/(e)mail survey)

The results will be analysed by gestational age and morbidity.

There is evidence that even older preterms (>32w GA) suffer increased incidence of learning disabilities and ASD.

Breast feeding is known to improve IQ and developmental outcomes. Encouraging Breast feeding may be simplest single “early intervention”. Not planning to measure outcomes on this study merely to establish rate of graduates persisting with breast feeding > 6months.

Skills developed and experience gained include:

  • Efficiency and thoroughness
  • The ability to work through and ethics application and complete audit during the scholarship period (We envisage the project will not require full ethics approval but that will be a good exercise with Awhina guidance.)
  • An enquiring attitude
  • Initiating research into literature on breast feeding and developmental outcomes, especially in preterm births