Cure Kids

Cure Kids focus on raising funds to enable high-impact, New Zealand-based medical research to help save, extend and improve the lives of children diagnosed with serious life-impacting and life-limiting health conditions. Cure Kids has helped to shape and vastly improve the way children who live with serious diseases and health conditions are diagnosed and treated. Cure Kids’ funding supports researchers across New Zealand whose work focuses on childhood cancers, inherited heart conditions, epilepsy, infectious diseases, cystic fibrosis, sudden unexpected death in infants (SUDI), stillbirth, burns as well as child and adolescent mental health – and many, many other areas of research.

Amplified MRI to understand pathological brain motion

Supervisor

Samantha Holdsworth (021 834 164)

Discipline

Cure Kids

Project code: MHS134

Amplified MRI (aMRI) is a new imaging method that magnifies very small motion of the brain as the heart beats. The aMRI method takes a standard dynamically resolved MRI sequence (available on all scanners to-date), and produces an amplified movie of brain motion. This approach reveals deformations of the brain parenchyma and displacements of arteries due to cardiac pulsatility, especially in the brainstem, cerebellum, and spinal cord, which have not been observed before. The method has shown early promise for detecting pathological brain motion due to diseases or disorders that obstruct the brain or block the flow of cerebrospinal fluid, such as in Chiari Malformation I (CMI) patients. The project aims to enhance our knowledge about the link between obstructive brain disorders and brain motion.

Skills

  • MATLAB
  • image processing
  • biomechanical modelling
  • data analysis

Child Injury Prevention Network Mapping

Supervisor

Bridget Kool (923 3871)
Melissa Barry

Discipline

Cure Kids

Project code: MHS139

Background

Prevention of unintentional child injury is an area of interest that spans multiple agencies across New Zealand’s public service and not-for-profit sector, including Ministry of Health, the Accident Compensation Corporation (ACC), Housing New Zealand, District Health Boards (DHBs), Healthy Home Initiatives, Family Start, Plunket, St John, Fire and Emergency, landlords, runanga, iwi and other community providers. Safekids currently collaborates with a broad range of these providers to provide training and resources and support community events focused on Home Safety.

The network of unintentional child injury prevention providers is largely informal and dispersed from a geographical, organisational and sectorial basis. While many of the stakeholders are known to individuals working in the field or to groups working in a particular area of interest, there is no collective awareness of the potential weight in numbers and expertise. While forums focused on specific areas of injury continue to function (e.g. The Child Restraint Expert Group, SUDI Prevention Network), historical forums and mechanisms that brought together stakeholders from across child injury prevention to align services, share knowledge and information, build capability and encourage collaboration, have largely fallen by the wayside (e.g. Injury Prevention Network of Aotearoa, Safekids’ Stakeholder Forum) or have limited activity or work programmes (e.g. Pacific Safety and Injury Prevention Network, Paediatric Society Injury Special Interest Group).

Understanding the relationships, networks and patterns of interaction between these organisations and providers will assist connectivity around the common interest of child injury prevention and identify opportunities for extending the reach of initiatives.

Aim

To identify key individuals and organisations involved in child injury prevention in Aotearoa and document the relationships that connect them as a network.

Method

Undertake an unintentional child injury network analysis:

  • Define the focus of the network analysis in terms of the types of groups and individuals, the time period and the geographical area that will be included
  • Determine a data set and design survey
  • Develop a distribution list
  • Collect data
  • Analyse data
  • Validate findings through qualitative interviews

Outputs

  • Unintentional child injury social network map
  • A report describing the methodology and outcomes of the mapping process
  • Presentation of findings to Safekids Aotearoa
  • Presentation of Nga Pou Tamariki Haumaru

Immunomodulatory therapy for preterm brain injury

Supervisor

Associate Professor Mhoyra Fraser (ext 83024)

Discipline

Cure Kids

Project code: MHS140

Brain injury as a consequence of oxygen deprivation while in utero or at birth is very common in premature infants. In addition to its contribution to mortality, it can lead to devastating lifelong effects on neurodevelopment, with increased risks of cerebral palsy, mental retardation, and cognitive deficits. Currently, no effective therapeutic strategies are available to prevent or improve the outcome of preterm infants with brain injury. Our studies using a well-established animal model of preterm brain injury suggest for the first time that delivery to the brain of a therapy that manipulates a critical endogenous neuroprotective anti-inflammatory mechanism can reduce damage to specialised cells, called oligodendrocytes, which produce a fatty substance called myelin that electrically insulates neurons enabling efficient transmission of electrical brain waves. These findings suggest that it is possible to preserve these myelin-producing cells by supporting natural pathways in the brain.

This summer studentship project will seek to establish whether this therapy has a sustainable effect on survival of these myelin-producing oligodendrocyte cells following injury. The project ideally suits students with a strong background in neuroscience and physiology who are considering undertaking an Honours or a MSc project.

Skills

  • Immunocytochemistry and immunofluorescence analysis 
  • Data collection and statistical analysis 
  • Literature review 
  • Report writing 
  • Presentation of results 

Good things come in small packages: a new hope for preterm babies brains

Supervisor

Associate Professor Mhoyra Fraser (ext 83024)

Discipline

Cure Kids

Project code: MHS141

Oxygen deprivation occurring in the womb or during delivery leads to permanent functional impairment of the brain and is one of the most common challenges faced by infants born preterm. Currently, there are no effective therapies to reduce injury. A major therapy limitation is the failure to traverse the blood brain barrier (BBB) and enter the brain. Exosomes, small vesicles, are naturally capable of penetrating the BBB, and have the capacity to communicate with the microenvironment through transfer of proteins, miRNA and other nucleic acids. Importantly, they have an intrinsic neuroprotective therapeutic activity as well as being ideal candidates to deliver targeted therapeutic molecules of choice.

Evidence suggests generation of neural stem cell-derived exosomes would be more likely to exhibit the highest distribution to the brain and confer neuroprotective benefits. A vital step to moving forward with our investigations to test the efficacy of this therapeutic option is to first generate sufficient exosomes from cultured neural stem cells and characterise them.

The aims of this project are therefore to prepare, purify and characterise exosomes from human fetal neural stem cell-conditioned culture media.

Skills required or acquired during the project

  • cell culture
  • size-exclusion chromatography for isolation of exosomes
  • Nanoparticle tracking analysis
  • western blot analysis

Assessment and management of autism spectrum disorder in New Zealand

Supervisor

Lisa Underwood (021 299 2207)

Discipline

Cure Kids

Project code: MHS151

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition that emerges during early childhood and has significant impacts on individuals and their families. It is estimated that ASD affects around 80,000 individuals in NZ. The assessment and management of ASD in NZ is under-researched and we know little about the presentation of ASD among Maori and Pacific families.

Evidence strongly suggests that early identification of ASD is key for improved outcomes. However, assessment and diagnosis varies across the country, as does access to ASD services and interventions. The student for this project will map current clinical practice and explore how this compares with advances in assessment and management of ASD in other countries, including Australia, the US and the UK.

Skills

This project will provide an opportunity for a student interested in child development to learn independent research skills, including literature review, data analysis, presentation of results, and communication of research findings.

Specific skills taught will be:

  • working as part of a multidisciplinary team
  • quantitative research methods
  • data processing 
  • statistical analysis 
  • writing skills for publication

There will also be an opportunity to engage with autism community groups, clinicians and service providers.

The project would most suit a third year student, especially someone interested in continuing with an honours project. Second year students will also be considered. Skills required are enthusiasm and initiative, an ability to communicate, and independence, combined with a genuine interest in research and a demonstrated ability to work in a team environment.

Digital mental health tools: what do young people understand about the data we collect?

Supervisor

Sarah Hopkins (ext 82015)
Sarah Hetrick

Discipline

Cure Kids

Project code: MHS153

We have developed a range of digital mental health interventions for young people and have a programme of research to investigate whether young people like them, use them, and that these interventions are effective at improving wellbeing.

To understand whether young people use them, we collect usage data from the ‘back-end’ of our digital platform. This data is collected ‘passively’ i.e. we can tell from the back-end rather than from survey responses how often young people use them . We want to know from young people whether they are comfortable with us collecting (passively) data about how often and how much they use our digital mental health intervention. We also want to hear from young people about how to best describe to them that this is what we will be doing and why.

We would like a student to collect data from young people via a survey and via interviews so that we can understand more about the views of young people with regard to the collection of usage data. This will be a significant contribution to our programme of work and international literature. We would value a student who has experience, and feels comfortable, working with young people. 

Incidence of type 1 diabetes from the Paediatric Diabetes Service

Supervisor

Craig Jefferies (021 957 877)
Ben Albert

Discipline

Cure Kids

Project code: MHS154

Type 1 diabetes has a relatively high incidence in NZ, and previous incidence information form our Paediatric diabetes regional service in Auckland evaluated the incidence over 20 years (1990 to 2009). This prior research highlighted the progressive increase in incidence for children <15 years with type 1 diabetes (See Derraik et al, 2012). However there were differential increases in new cases of type 1 diabetes in those 10-14 years compared to younger children, and the highest incidence in new cases were in NZ Europeans.
The aim of this present study is to data mine our Starbase diabetes database that prospectively records all new cases of diabetes in the <15 year age group in the great Auckland region (encompassing ADHB, WDHB and CMDHB); this will be for an additional 10 years from our current data and provide a 30 year incidence in our paediatric population: we are then one of the few sites in the world with such regional longitudinal data.

Sub analysis for Deprivation, Ethnicity, Age, seasonality, and Sex will be done in collaboration with our statistician.

The student would be expected to have ~500 cases to case ascertain for the 10 year period, inclusion criteria will be resident in the Auckland region, a confirmed diagnosis of type 1 diabetes, age <15 years.

References: Derraik et al (2012). Increasing incidence and Age at diagnosis among children with type 1 diabetes mellitus over a 20-year period in Auckland (New Zealand) PLoS ONE 7(2): e32640. doi:10.1371. 

Immunoglobulin replacement in New Zealand children

Supervisor

Annaliesse Blincoe (021 490 611)
Jan Sinclair

Discipline

Cure Kids

Project code: MHS155

Immunoglobulin replacement therapy (IRT) has historically been developed to provide passive protection for children with underlying primary immune deficiency, but with time its use has expanded to include children with a range of autoimmune, auto inflammatory and hematologic conditions. There is no current national guideline as to who should be eligible for IRT in NZ. IRT is a valuable and limited resource, mostly derived from local blood donation.

The aim of the project is to describe children receiving IRT over a 3 year period. Data will include demographics, indication for IRT, dose of IRT, and route of administration. Indication will be audited against both the Australian and UK guidelines.

The successful student will be working with the Paediatric Immunology team at Starship. They will develop skills in data collection, literature review, analysis, presentation of results and communication of research findings. It is anticipated the results will be presented at the annual scientific meeting of the Australasian Society of Clinical Immunology and Allergy (Melbourne, September 2020).

The results will be useful in developing paediatric guidelines for IRT in NZ children and informing clinical practice.

Evaluation of a stillbirth prevention public health awareness campaign in South Auckland

Supervisor

Professor Lesley McCowan (923 9192)
Dr Karen Falloon

Discipline

Cure Kids

Project code: MHS161

New Zealand and international research show that maternal sleeping position is an important modifiable risk factor for the prevention of late stillbirth. A maternal side-sleeping position from 28 weeks of pregnancy halves the risk of stillbirth compared with going to sleep in a supine position.

In 2018 the ‘Sleep on Side; Stillbirth Prevention Campaign’ was developed and initiated. It is a public health messaging campaign by the University of Auckland, Cure Kids and the Ministry of Health.

The evaluation phase of the campaign involves surveying health professionals and expectant women in the third trimester of pregnancy.

The role of the summer medical student will be to conduct surveys in pregnant women in their third trimester throughout birthing units in South Auckland and health professionals working in primary care clinics in South Auckland. This will enable evaluation of the effectiveness of the campaign.

This is an exciting opportunity for a student interested in General Practice, Obstetrics and Gynaecology or Public Health to gain practical “grassroots” research experience and exposure to the primary care and community health-care setting. The ideal candidate would be self-motivated, friendly, professional and culturally-sensitive.

Skills developed include

  • communication
  • research strategy
  • research design
  • research recruitment 
  • teamwork

Optimising Treatment of Neonatal Hypoglycaemia (Based at Neonatal Unit Middlemore Hospital)

Supervisor

Chris McKinlay (027 472 5099)
Jane Harding

Discipline

Cure Kids

Project code: MHS163

Neonatal hypoglycaemia affects 15% of all babies and can cause permanent brain injury if not treated effectively. Some babies with hypoglycaemia respond to simple measures such as dextrose gel and additional feeding, but around 50% have episodes that are severe or recurrent. These babies are at highest risk for neurological sequelae and currently require admission to neonatal units for intravenous glucose, separating the mother and baby, which adversely impacts on breastfeeding. There are also concerns that rapid correction of hypoglycaemia with intravenous glucose may contribute to brain injury. Better treatment approaches are needed that promote glucose stability and earlier return to sucking feeds. This project will be based at the Neonatal Unit at Middlemore Hospital and will focus on setting up a feasibility trial to assess i) a novel oral approach to management of hypoglycaemia using diazoxide and ii) improved monitoring of neonatal glucose using interstitial monitors and trend analysis.

Specific aims of the studentship will be to establish a placebo comparator for the trial, test blinding procedures, establish a protocol for interstitial monitor use and recording; and assist with setting up trial protocols and procedures. There will be opportunity to participate in other clinical activities in the neonatal unit.

What happens to children with preschool wheeze in Waitemata emergency department?

Supervisor

Arun Gangakhedkar (021 492 065)
Tim Jelleyman

Discipline

Cure Kids

Project code: MHS165

Annually an estimated 250 children present to Waitemata Emergency Departments with preschool wheeze and are managed using treatment protocols. Response to treatment is variable with a proportion requiring admission. Phenotypes associated with bronchodilator responsiveness are described but may be difficult to apply in practice. This study aims to assess treatment outcomes for preschool wheeze using admission as a primary endpoint. Through systematic medical record review a range of relevant demographic and clinical characteristics will be collected to allow comparison between those requiring admission with those discharged from Emergency department. This study will also include an audit of use of treatment protocols in the Emergency Departments. Waitemata Child Health is considering participating in a future multi-centre trial of OM-85 (bacterial lysate) to reduce impact of preschool wheeze, and so this studentship research provides useful descriptive background about pre-school wheeze and management in our setting.

In summary, the research will review clinical records in a cohort of children with preschool wheeze to: 1) assess rate of hospital admission; 2) describe clinical and demographic characteristics for responders/non-responders; 3) audit use of management protocols.

Parental perceptions of child health and wellbeing in the pre-school years: Evidence from Growing Up in New Zealand

Supervisor

Susan Morton (ext 89268)
Caroline Walker

Discipline

Cure Kids

Project code: MHS167

Project aims

Growing Up in New Zealand is a longitudinal study that provides a contemporary, population-relevant picture of what it is like to be a child growing up in New Zealand in the 21st century. Participants (n=6853) were recruited before birth through their pregnant mothers, with 6156 children participating in the 4 year interview.

The aim of this project is to explore the association between parental perception of health and obesity with rates of childhood illnesses and obesity. This will be achieved through quantitative analysis of questionnaire and anthropometric data collected when the children were four years old.

Skills taught

This project will provide an opportunity for a student interested in population health or child health to learn independent research skills, including:

  • Literature review
  • Data analysis
  • Presentation of results and communication of research findings

The project would most suit a third year student, especially someone interested in continuing with an honours project. Second year students will also be considered. Skills required are enthusiasm and initiative, an ability to communicate, and independence, combined with a genuine interest in research and a demonstrated ability to work in a team environment.

To better understand the underlying mechanism of extracellular vesicles extruding from placenta during pregnancy

Supervisor

Qi Chen (923 5645)
Larry Chamley

Discipline

Cure Kids

Project code: MHS170

There is rapidly growing interest in extracellular vesicles (EVs) and their potential role in biology and medicine. The EVs produced by most cells/tissues are separated by size into nano-vesicles (including exosomes), micro-vesicles and macro-vesicles. During pregnancy, large quantities of placental EVs are extruded from syncytiotrophoblast into the maternal circulation. These EVs contain proteins and nucleic acids and could contribute to the mal-adaptation of maternal immune and vascular systems to pregnancy. A large number studies have shown that in the pathological conditions, placental EVs contain increased danger signals and vasoactive substances. Our previous studies showed that mitochondria and caspase pathway are involved in this process. However, the underlying mechanism of this process has not been well investigated. Therefore in this study, we aim to investigate how caspase pathway, in particular caspase 8 is involved in placental EVs extruding from placental syncytiotrophoblast.

The aims of this project are to investigate (1) blocking caspase 8 pathway could affect the nature of placental function by measuring endoplasmic reticulum stress, total MLKL levels and the concentration of placental EVs that are extruded from first trimester placenta in both physiological and pathological conditions. (2) Whether other potential molecules are also co-ordinated with caspase 8.

Skills

  • Cell and tissue culture
  • Western blotting
  • Immunohistochemistry
  • General laboratory skill

Mental health and wellbeing education in schools

Supervisor

Hiran Thabrew (021 402 055)

Discipline

Cure Kids

Project code: MHS171

Children and young people in New Zealand receive varying degrees of mental health/wellbeing education and preventative interventions at primary and high school. However, the evidence base regarding the most appropriate school-based interventions that should be delivered by schools is currently unclear.

This summer student project involves conducting a systematic review of the literature to identify evidence-based school-based mental health interventions that could inform more coherently delivered mental health education in schools.

The successful student would be guided to conduct such a review and summarise the results. They would also be listed as an author on the resulting paper.

As most of the activity on this project will be conducted online or on a computer, the student would be able to undertake most of the required work in a flexible manner, either within the university or elsewhere, allowing for some vacation time over the Christmas period.

Complementing this project will be a national survey or qualitative study of school-based health practitioners. Both pieces of research will hopefully inform the development of new mental health/wellbeing resources for schools.

Health seeking and unmet need for New Zealand children: Identifying the barriers and contributing factors

Supervisor

Fiona Langridge (021 242 4362)

Discipline

Cure Kids

Project code: MHS177

Growing up in New Zealand has followed approximately 7,000 children during their mothers’ late pregnancy and, so far, up to eight years of age. This longitudinal study aims to understand the needs, life trajectories, developmental experience and aspirations of our participants and their families in New Zealand today.

Unmet need and health seeking influence whether children do or do not access health care. Understanding and identifying the determinants contributing to those children experiencing barriers to care is essential in order to ensure equitable access to services.

The aim of this summer project is to explore the factors affecting health seeking and unmet need for New Zealand children within the context of the Growing Up in New Zealand study. This will be achieved through quantitative analysis of questionnaire data collected during mother’s pregnancy up to when the children were four years old.

Applications from students with an interest in Maori, Pacific and Asian themes are especially welcome.

This project will provide an opportunity for a student interested in population health or child development to learn independent research skills, including literature review, data analysis, presentation of results, and communication of research findings.

Skills required include

  • communication
  • initiative
  • independence 
  • an ability to work well within a team

Dietary diversity and its relationship with nutritional status among children in New Zealand: Evidence from Growing Up in New Zealand

Supervisor

Carin Napier

Discipline

Cure Kids

Project code: MHS180

Project aims

Growing Up in New Zealand is a longitudinal study that provides a contemporary, population-relevant picture of what it is like to be a child growing up in New Zealand in the 21st century. Participants (n=6853) were recruited before birth through their pregnant mothers, with 6156 children participating in the 4 year interview. The 8 year data collection wave included eating patterns and food behavior as an indicator of dietary diversity.

The aim of this project is to explore the eating patterns of the children and how their dietary diversity is related to their nutritional status. This will be achieved through quantitative analysis of questionnaire data collected from the children.

Skills taught

This project will provide an opportunity for a student interested in population health or child health to learn independent research skills, including:

  • Literature review
  • Data analysis
  • Presentation of results and communication of research findings

The project would most suit a third year student, especially someone interested in continuing with an honours project. Second year students will also be considered.

Skills required are enthusiasm and initiative, an ability to communicate, and independence, combined with a genuine interest in research and a demonstrated ability to work in a team environment.

Beliefs about antibiotics – an interview study in Maori

Supervisor

Dr Amy Chan (ext 85524)
Assoc Prof Matire Harwood

Discipline

Cure Kids

Project code: MHS183

Antimicrobial resistance (AMR) is one of the biggest public health threats. Inappropriate use of antibiotics is a key driver of AMR. One reason for inappropriate use is patient expectation and demand for antibiotics, particularly where antibiotics are not needed, such as for cold/flu.

In Maori, antibiotic use may be particularly high for conditions where antibiotics are of no benefit (e.g. cold/flu), but low for conditions where antibiotics are needed (e.g. strep throat). This may be driven by individual treatment beliefs, but we do not know what beliefs influence antibiotic use in Maori, and how these beliefs may differ to non-Maori.

Identifying and understanding the beliefs that Maori hold about antibiotics and how these influence patients' decisions to seek antibiotics (or not) is key to informing the design of effective interventions to ensure appropriate antibiotic use.

The aim of this project is to identify the beliefs Maori hold about antibiotics and their role in treating infections commonly seen in primary care. We will do this by 1:1 and focus group interviews with Maori recruited from a GP practice.

Useful skills

  • Knowledge of Kaupapa Maori research
  • Understanding of primary care
  • Interpersonal skills – particularly verbal/ interview skills
  • Organisational skills

Is there a change in in weight status of caregivers 5 years post baseline in a family-centred intervention for children and adolescents with weight issues?

Supervisor

Dr Yvonne Anderson (06 753 6139 ext 8736)
Tami Cave
Cervantée Wild

Discipline

Cure Kids

Project code: MHS187

Whanau Pakari is a multi-disciplinary assessment and intervention programme for children and adolescents with weight issues that commenced in Taranaki in 2012.1 As part of the assessment process, voluntary height and weight measurements of the primary caregiver of the children were collected at the baseline, 12 month, 24 month and 60 month (5 year) assessments. BMI was subsequently calculated.

The aim of this secondary analysis is to determine whether there was a change in accompanying adult BMI over time in participants of the Whanau Pakari programme (from baseline to 60/12). Secondly, whether any change affected BMI SDS outcome of participants in the trial. A literature review is also proposed looking at what is currently published with regards to the accompanying adult BMI of children/adolescents with obesity at long term follow up, both nationally and internationally.

This project would be ideally suited to a candidate who is interested in learning about and gaining skills in health research. A supportive team environment is provided, and the ideal candidate would be based in Taranaki for the duration of this project.

Whilst full supervision will be provided, the ideal candidate would be self-motivated, with a willingness to learn. Basic word and excel skills essential.

Sugars versus sweeteners: Analysis of ingredients used to replace sugar in reformulated packaged foods

Supervisor

Leanne Young (027 341 4202)
Cliona Ni Mhurchu

Discipline

Cure Kids

Project code: MHS190

Reformulation of the ingredients in packaged foods has potential to improve the nutritional quality of foods and population diets. Consuming foods low in added sugar is recommended as part of a healthy eating pattern associated with lower risk of diet-related disease. As an added ingredient, sugar has many different forms including glucose syrup, sucrose, honey, and fructose and is found naturally in some foods. Approximately one third of packaged foods in NZ contain some form of added sugar.

This project aims to investigate the effect of reformulation on the sugar and sweetener content of NZ packaged food products. The first objective is to identify and report on the number and category of food and beverage products in the Nutritrack database where added sugar content has decreased over time. Methods will involve examination of low-sugar claims on products and review of ingredient lists and Nutrition Information Panel data. The second objective is to investigate the types of ingredients used to replace added sugar in reformulated foods and beverages, especially replacement of added sugar with non-nutritive sweeteners, and the effect on overall product nutrient profile.

Research skills

  • Literature searching
  • Development of nutrition knowledge and skills in food composition and labelling
  • Data analysis and reporting