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.

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

Supervisor

Sarah Hetrick (0211733878)

Discipline

Cure Kids

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 outcomes 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.

Residual beta cells in type 1 diabetic subjects may show defects in exocytosis of insulin:

Supervisors

Dr Shiva Reddy (09 373 7599)
Dr Kevin Sun

Discipline

Cure Kids

Project code: MHS066

Project title

Residual beta cells in type 1 diabetic subjects may show defects in exocytosis of insulin: Direct assessment of the level of the key exocytosis protein in human pancreatic donors with diabetes for therapeutic rescue of insulin secretion

Project description

Type 1 diabetes (T1D) remains a poorly understood serious chronic disorder, can manifest from early childhood and has no cure. Over the last decade, we have been witnessing a rapidly increasing incidence, particularly in younger children. Despite glucose control with daily insulin and strict nutrition and lifestyle regimens, the risk of sudden hyper- and hypoglycaemia, ketoacidosis and premature secondary complications remain stark.

Our studies of rare pancreatic samples from newly-diagnosed and long-term diabetic cases demonstrate persistence of a significant number of insulin-containing islets. However, such beta cells may be functionally impaired and unresponsive to glucose, after meal.

Physiological insulin release is a complex, multi-step process, culminating in exocytosis. During diabetes, beta cell failure may be partly due to defects in the docking and fusion of beta cell granules with the plasma membrane, immediately preceding exocytosis. This process hinges critically on the formation of a trimeric complex between the cytoplasmic insulin granule surface protein and two plasma membrane proteins, one of which is syntaxin-4 (Synt-4).

Here, we will test the novel hypothesis that the insulin secretory dormancy of persisting beta cells in T1D results from low expression of Synt-4.

Techniques

Pathology of diabetes, multiplex immunohistochemistry, microscopy, immunology, image acquisition and processing.

Sudden Unexpected Death in Infancy (SUDI): 2018-2020

Supervisor

John Thompson

Discipline

Cure Kids

Project code: MHS080

Background

Despite a major reduction in overall infant mortality, sudden unexpected death in infancy (SUDI) continues to be of concern in New Zealand, as the rate is high by international standards, and is even higher in indigenous Maori.

A three-year (1 March 2012–28 February 2015) nationwide case-control study was conducted in New Zealand. The combination of maternal smoking in pregnancy and bed sharing with an infant was found to be extremely hazardous for infants.

Aims

All deaths from SUDI are subject to a coronial investigation. The aim is to tabulate the characteristics of SUDI deaths that have occurred from 2018, and compare them with deaths that occurred in 2012-2015.

Skills learnt will include:

• Review of the literature
• Collection of data
• Setup and entry of data
• Simple descriptive statistics
• Report writing

Skills required

Nil, but knowledge of Excel would be helpful.

Biased agonist signalling through melanocortin receptors

Supervisors

Kathy Mountjoy
Shree Kumar

Discipline

Cure Kids

Project code: MHS082

Melanocortin peptides play pivotal roles in numerous physiological responses, including pigmentation, adrenal gland development, the stress response, immune response, appetite, body weight and metabolism. Melanocortin peptides (adrenocorticotropin, alpha, beta or gamma-melanocyte stimulating hormone, desacetyl-alpha-melanocyte stimulating hormone, diacetyl-alpha-melanocyte stimulating hormone) are produced from the large precursor protein, pro-opiomelanocortin, through a co-ordinated, tissue-specific series of proteolytic cleavages and post-translational modifications, which influence the activity of the peptides. These peptides can similarly bind one or more of 5 melanocortin receptor subtypes, resulting in different physiological effects.

This project will investigate biased agonist signalling for these peptides on melanocortin receptors expressed exogenously in HEK293 cells. Ultimately, we will identify specific signalling mechanisms associated with specific melanocortin physiological responses.

Research Impact

The results from this project may lead to identification of new therapeutics for human diseases and ultimately improve health for all New Zealanders.

Skills taught

• Cell culture
• DNA transfection
• Cell signalling
• Data analysis
• Statistical analysis

Preference will be given to students wishing to continue with honours or masters degree.

Weight Gain and Diet During Pregnancy: Analysis of guidelines across the Asia-Pacific Region

Supervisors

Dr Jacquie Bay
Dr Tomoko Aoyama

Discipline

Cure Kids

Project code: MHS084

Low birthweight has long-lasting negative consequences on an individual’s health. Disparities in birthweight outcomes by ethnicity have been observed globally in both high and low income countries. These disparities largely depend on differences in maternal anthropometrics and gestational weight gain. We are working to identify social, economic and cultural factors that may be associated with variation in gestational weight gain observed in different contexts within the Asia-Pacific region.

The aim of this project is to identify differences in country-specific guidelines on weight gain and diet during pregnancy across the Asia-Pacific region. The research will take the form of a review and descriptive analyses of current guidelines for gestational weight gain and dietary guidelines for pregnant women.

Identifying how guidelines differ across countries will help understand social backgrounds underlying actual differences in gestational weight gain by ethnicity, which can lead to improving birth outcomes for all ethnicities.

The work from this studentship will contribute to a peer-reviewed journal publication.

Skills learnt will include

• Systematic searches of academic databases
• Academic writing
• Analyses of guidelines

“I’m a friendly Chatbot. What’s your name?” What do young people think of chatbot interventions for mental health and wellbeing

Supervisors

Dr Karolina Stasiak (021 385 677)
Dr Sarah Hopkins

Discipline

Cure Kids

Project code: MHS126

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. 

Hauora (health and wellbeing) Maori measures for rangatahi and whanau

Supervisors

Tania Cargo
Karolina Stasiak
Sarah Hopkins
Sarah Hetrick

Discipline

Cure Kids

Project code: MHS143

This project will involve an exploration of hauora (health and wellbeing) Maori measures for rangatahi and whanau. The student will undertake a literature review and develop a draft of an academic paper based on these findings. A key element will be exploring hauora from within a kuapapa Maori environment, including Maori developmental processes such as Tuakana Teina, Potiki Matamua etc and the impact these roles may have on rangatahi development. The student will explore and develop themes within a kaupapa Maori research framework and co-author an academic paper.

This would suit a Maori student who has experience and/or knowledge of kaupapa Maori methodologies and who is wanting to pursue experience within a Maori mental health environment.

Exploring views of rangatahi on types of images of hauora in the digital media

Supervisors

Tania Cargo
Sarah Hetrick
Sarah Hopkins
Karolina Stasiak

Discipline

Cure Kids

Project code: MHS146

This project will involve an exploration of the types of images of hauora (health and wellbeing) that are engaging for rangatahi, in particular those images that are available via digital media. The student will undertake qualitative interviews with Maori rangatahi exploring the types of visual images which they associate with hauora from a Maori rangatahi perspective. They will then undertake analysis and coding of the data through a kaupapa Maori lens and develop a draft of an academic paper based on these findings.

This would suit a Maori student who has experience and/or knowledge of kaupapa Maori methodologies and who is wanting to pursue experience within a Maori digital mental health environment.

Understanding Longitudinal Trajectories and Risks Associated with Birthweight: Relationships from Infancy Through to Early-Adulthood (ULTRABRITE)

Supervisor

Dr Rebecca Slykerman (09 923 1132)

Discipline

Cure Kids

Project code: MHS159

The Auckland Birthweight Collaborative Study enrolled mothers and babies between 1995 and 1997 to examine whether being born small for gestational age had negative consequences for growth and development. Children in the study were assessed at ages 1, 3.5, 7, 11 & 16 years. Approximately 650 of these participants were last assessed when they were 16 years. They are now young adults in their early to mid-20’s and we would like to contact them and conduct a short online survey with them.

The project involves using existing contact details and next of kin details to trace and contact participants to send them a short survey about their current lifestyle and psychological wellbeing. There will also be the opportunity to analyse this data and look at how it relates to previously collected data from these participants when they were younger.

This is an excellent opportunity to get experience in conducting research including data collection, analysis and understanding how longitudinal studies work. The study group includes researchers from different disciplines including biostatistics, paediatrics, psychology, nutrition and endocrinology.

Skills

Excellent communication skills particularly on the phone, able to use social media platforms to trace people, persistence, good time management.

Remote testing of vision in children

Supervisors

Steven Dakin (027 8365 800)
Tina Gao

Discipline

Cure Kids

Project code: MHS167

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 (e.g. on smartphones) acuity tests 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.

The effects of housing and home environment on Pasifika child health in the pre-school and primary school age group

Supervisors

Emma Marks (021 304 467)
Malakai ‘Ofanoa

Discipline

Cure Kids

Project code: MHS172

Project aims

To investigate the link between home environment and child health given the rapidly changing housing market in New Zealand. This project specifically aims to compare the impacts of housing quality and type on health outcomes of Pasifika children between the pre-school and primary school period within the context of the Growing Up in New Zealand study. Key indicators to be included will be types of housing tenure among Pasifika families, standard of housing quality and key child health outcomes, such as rates of infection and hospital admissions. This research will also review the potential effects changes to housing policy i.e. the Residential Tenancies Amendment Act, 2016, may have had on Pasifika families in rental accommodation and any subsequent effects on child health outcomes.

Skills taught

This project will provide an opportunity for a student interested in child health and development to be involved in research at in a large, diverse longitudinal cohort study and learn independent research skills, including literature review, statistical analysis, presentation of results, and communication of research findings.

The project would most suit a third-year student. Second year students may also be considered. Skills required are enthusiasm and initiative, ability to work in a large team environment, an ability to communicate, and independence, combined with a genuine interest in child health research for a vulnerable sector of our community.

Seasonal variation in BMI in children and adolescents

Supervisors

Dr Yvonne Anderson (06 753 6139)
Cervantée Wild
Dr José Derraik
Prof Paul Hofman

Discipline

Cure Kids

Project code: MHS184

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.

Suited to 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

Epileptiform transients as a prognostic biomarker for perinatal brain damage?

Supervisors

Dr Guido Wassink
Prof Alistair Gunn

Discipline

Cure Kids

Project code: MHS188

In babies with hypoxic-ischemic encephalopathy (HIE), treatment with therapeutic hypothermia (i.e. brain cooling) reduces death, moderate-severe brain damage, and neurological disabilities. However, cerebral cooling needs to be started within 6 hours after hypoxia-ischemia to be neuroprotective, whereas perinatal brain injury develops and worsens over 72 hours. Ideally, a prognostic biomarker rapidly identifies those infants for hypothermia treatment to minimize brain damage. Epileptiform transients on the electroencephalogram (EEG) are pathological discharges that indicate abnormal excitatory or inhibitory neuronal function, and develop within 6 h after hypoxia-ischemia. However, it is unclear whether they predict damage in subcortical structures commonly injured in term babies with HIE. This research project will investigate whether epileptiforms after severe hypoxia-ischemia are associated with changes in hippocampal excitatory and inhibitory neuronal phenotypes.

For this summer studentship, immunohistochemistry, microscopy and cell quantification will be used to determine changes in hippocampal neuronal phenotypes after hypoxia-ischemia in near-term fetal sheep. This research will advance knowledge on biomarkers for hypoxic-ischemic brain damage.

Please send a CV and academic transcript if interested.

Techniques and skills taught

• Immunohistochemistry
• Bright-Field Microscopy
• Cellular quantification
• Computerized data analysis
• Graphing and statistical analysis

Can we prevent brain damage in babies with mild hypoxic-ischemic encephalopathy?

Supervisors

Dr Guido Wassink
Dr Joanne Davidson

Discipline

Cure Kids

Project code: MHS191

In babies with hypoxic-ischemic encephalopathy (HIE), treatment with therapeutic hypothermia (i.e. brain cooling) reduces death, moderate-severe brain damage, and neurological disabilities. However, it remains unknown whether hypothermia also works for babies that experience less severe hypoxia-ischemia (i.e. oxygen deprivation) around birth. Historically, these babies with mild HIE were thought to not develop significant brain damage, and thus were excluded from the original clinical trials that examined therapeutic hypothermia for term infants with moderate-severe HIE. This research project will investigate whether cerebral cooling provides neuroprotection after mild hypoxia-ischemia, and help establish the working parameters for therapeutic hypothermia in infants with mild HIE.

For this summer studentship, immunohistochemistry, microscopy and cell quantification will be used to determine neuronal and white matter survival, and the degree of inflammation in the parasagittal cortex after mild hypoxia-ischemia in near-term fetal sheep, following hypothermia or no treatment.

Please send a CV and academic transcript if interested.

Skills and techniques taught

• Immunohistochemistry
• Bright-Field Microscopy
• Cellular quantification
• Computerized data analysis
• Graphing and statistical analysis

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

Supervisor

Dr Rebecca Slykerman (09 923 1132)

Discipline

Cure Kids

Project code: MHS193

Aims

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

Attention to detail and some basic familiarity with Excel would be helpful.

Novel neurodevelopmental roles for the extracellular sugar hyaluronan: is hyaluronan metabolism altered in developing nerve cells after early hypoxia

Supervisor

Dr Rashi Karunasinghe
Assocate Prof Justin Dean

Discipline

Cure Kids

Project code: MHS199

The targeted growth of neurons is a key event that occurs during brain development, but can become disrupted in infants exposed to low oxygen (hypoxia) near the time of birth. As a result, brain regions such as the cerebral cortex and hippocampus show abnormal neuron growth and activity (typified by seizures and learning problems), affecting functions throughout later life. Yet, scientists and clinicians are still challenged by why and how low oxygen affects neuron development.

Hyaluronan is an extracellular sugar that wraps around brain cells. We recently found that young neurons produce hyaluronan, and this normally regulates the extension of axons and dendrites. However, experimentally restricting blood flow, and thereby limiting oxygen and glucose supply, caused a loss of brain hyaluronan. We hypothesise that an early hypoxia-evoked loss of hyaluronan will lead to abnormal neuronal development.

Using neuronal cultures as a model of development, the main objective of this study is to evaluate the changes evoked by hypoxia on the expression of hyaluronan, the enzymes that regulate hyaluronan metabolism (synthesis and degradation), and hyaluronan receptors.

The student will gain skills in neuronal cell culture, molecular biology, live-cell microscopy, data analysis, report writing and presentations.

Targeting biofilm infection in osteomyelitis

Supervisors

Jill Cornish
Simon Swift

Discipline

Cure Kids

Project code: MHS204

Osteomyelitis is a severe infection localised to the bone. It generally occurs in growing children, and is a particular problem in New Zealand due to high prevalence in Maori and Pacifica children. Treatment often involves surgery and long-term antibiotic treatment. Some children require treatment in intensive care, and in some of these cases, the infection proves fatal. Infections generally become chronic or treatment-resistant because bacteria form biofilm on hard surfaces like bone, which makes them very resistant to treatment. Traditional microbiology techniques do not examine bacterial sensitivity to treatment when they are grown as a biofilm.

In this project, you will test the effect of various treatments on biofilms grown from clinically relevant strains of Staphylococcus aureus which is the most common bacteria found in osteomyelitis. We ultimately hope to understand more about the organisms that cause this devastating disease, and develop more effective treatments to rapidly clear the infection.

Techniques will include: microbiology in a PC2 lab, colony enumeration assays, minimum biofilm eradication concentration (MBEC) assays for different combinations of drugs.

A new method for measuring visual acuity at home

Supervisors

Joanna Black
Jason Turuwhenua
Mohammad Norouzifard

Discipline

Cure Kids

Project code: MHS209

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.

This project will provide an opportunity for a student to develop skills:

• 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

Cure Kids

Project code: MHS214

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.

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.

Outcomes

If the outcomes from this study confirm that A blood group patients who receive pig tissue valves are immunoprivileged, we will have identified an important potential avenue in our ongoing endeavours to tissue engineer a novel heart valve prosthesis that is non-immunogenic.

Skills

Formal writing
Data extraction
Human ethics approval
Statistics
Oral presentation skills

Examination of the Immunogenicity of a Tissue Engineered Heart Valve using a Novel Surgical Model in Rats

Supervisors

Professor Jillian Cornish
Dr Steve Waqanivavalagi
Mr Paget Milsom

Discipline

Cure Kids

Project code: MHS217

Background

Our group is tissue engineering a novel heart valve that we hope will outperform and outlive prostheses currently used for valve replacement surgery. A preliminary scaffold has been engineered using bovine pericardium and decellularised to remove the genetic material of the animal. This scaffold has surpassed preliminary laboratory investigations and is now at a point where its immunogenicity must be interrogated.

Project

To answer this question, experimental samples will be surgically implanted subcutaneously in rats and then harvested at designated time points. Experimental tissue samples will be compared to industry standard samples using histological, biochemical, and architectural techniques that have been perfected within our laboratory.
A surgical rat model has been designed specifically for this project last summer and animal ethics application has been initiated.

Outcomes

The main aim of the study is to prove that the surgical rat model can be used to satisfactorily examine the immunogenicity of experimental tissue engineered heart valves. This summer project will set the scene for a strong Honours project. The project will suit biomedical students interested in regenerative medicine and translational science or clinical students interested in Cardiology or Cardiothoracic Surgery.