General Practice and Primary Health Care

Screening elite athletes for mental health & lifestyle issues

Supervisor

Felicity Goodyear-Smith

Discipline

General Practice and Primary Health Care

Project code: MHS007

Aims
This project involves working with High Performance Sport at the Millennium Centre with NZ's elite athletes, to test the feasibility, utility and acceptability of an on-line screening package, SportCHAT (Case-finding and Help Assessment Tool for sportsmen and women). SportCHAT screens for substance misuse, anxiety, depression and other lifestyle issues with summary reports assessed by their sports physician. This will be implementation science research, with a co-design approach. Dr Bruce Hamilton, Director of High Performance Sport New Zealand, will be a co-supervisor. While ethics approval is needed, we already have this for other CHAT products and this will be a quick process, probably just requiring an amendment.

Skills taught
• Conducting a systematic literature review
• Engaging with stakeholders (athletes and sports health team)
• Semi-structured interviewing
• Quantitative analysis - basic descriptive statistics and between
group analyses
• Qualitative analysis - general inductive approach and content analysis
• Scientific writing
• Preparing a paper for publication in a peer-reviewed journal

Evaluation of student led discussion forums

Supervisor

Kyle Eggleton
Felicity Goodyear-Smith

Discipline

General Practice and Primary Health Care

Project code: MHS029

In 2016 the Department of General Practice and Primary Health Care introduced a new form of teaching to Year 5 and 6 students undertaking an attachment in general practice. This method of teaching was based around a collegial online discussion forum in which students present cases that they have seen. The educational objectives for undertaking this teaching approach were to encourage students to engage in peer support, peer learning, constructive debate and critical thinking. Anonymised transcripts of the forums were collected during 2016, after consent had been gained from students. During this project the transcripts will be analysed quantitatively looking at total number of messages posted, average word count per post, number of student and GP academic participations per week and activity graphs drawn to detect the links between messages. The text will also be analysed qualitatively identifying and coding themes using a content analysis approach. In addition the project involves a brief literature review on educational theory and discussion forums. Skills taught in this studentship will include: literature review, content analysis and paper write up. Expected output from the summer studentship would be a paper in a medical journal.

Current landscape of cancer patients with febrile neutropenia presenting to a New Zealand tertiary hospital.

Supervisor

Elaine Rogers
Rita Sasidharan

Discipline

General Practice and Primary Health Care

Project code: MHS138

Aims
Febrile neutropenia (FN) is a common complication in patients undergoing anticancer treatments. Defined as the occurrence of a fever during a period of neutropenia. Risk factors for FN include chemotherapy regimen patient is undergoing (high risk =20%, or intermediate 10-20%), age, and underlining co-morbidities.

Patients suspected with this condition are advised that they should be promptly evaluated by a doctor. Currently patients undergoing treatment at Auckland District Health Board contact either ‘oncology acutes’ Monday to Friday 8am to 4pm, or if after hours advised to present to their nearest ED. It is common for no source of infection to be identified when patients have febrile neutropenia, and they are typically hospitalized to allow close monitoring that usually continues until the patient’s neutropenia is resolved.

There has been a recent change in categorising these patients into ‘low-risk’ and high-risk’ patients. Patients that are deemed on assessment to be ‘low-risk’ will receive the first dose of the appropriate antibiotic intravenously, then after a period of observation, discharged home with the remaining antibiotic course orally. This has the benefit of reduced health economic costs to DHB’s. The use of this algorithm will be researched shortly for patients within the ADHB catchment area.

Dr Rita Sasidharan (Medical Oncologist) and Dr Elaine Rogers (Lecturer/Senior Nurse Research Fellow) will be leading a programme of research investigating the benefits and harms of implementing this algorithm.

In order to carry out this larger research project, a clinical audit is required to be carried out to gain data on the current cancer population presenting to Auckland City Hospital with febrile neutropenia. This step will form a summer studentship project.

A clinical audit data tool will be generated, then completed for a pooled population of patients over the last 3 to 5 years. Analysis will then be carried out.

The successful applicant will be required to access patients records and complete the audit data tool, and if time permits to assist in the imputing of data into a central database. Some training will be provided. This work is expected to result in a publication.

Translating a diagnostic tool for eating disorders to an online platform for a 10-year follow-up cohort

Supervisor

Dr Marion Roberts

Discipline

General Practice and Primary Health Care

Project code: MHS185

Eating disorders have the highest mortality rate of any mental health presentation, yet understanding of the illness lags behind that of other fields. This project will assist in a 10-year follow-up of a cohort of patients with an eating disorder collected in London in 2006/7, to investigate whether neurocognitive profile has any role in illness state at 10-year follow-up. Key to the follow-up is the translation of a typically clinically administered diagnostic tool to the online format.

The student must have a high degree of computer fluency, in particular competency/familiarity with SPSS and development/management of google forms.

A general understanding of data syntax principals would be an advantage, but not essential. It is expected that the project will involve building the online assessment tool and, time permitting, sending this tool out to the 10-year cohort and collating responses.

A Scoping Review of 'Trainee-in-Difficulty’ Pathways for Healthcare Trainees

Supervisor

Dr Fiona Moir
Dr Jill Yielder

Discipline

General Practice and Primary Health Care

Project code: MHS217

The aim of this scoping review is to identify and map evidence that informs ‘trainee-in-difficulty’ policy and practice, for trainees working in the healthcare sector.
The review questions are:
• “What evidence (quantitative and qualitative) is available that could inform ‘trainee in difficulty’ pathways for healthcare trainees (undergraduate and postgraduate)?”

• ‘What types of ‘trainee-in-difficulty’ (TID) pathways have been developed and implemented for healthcare trainees (undergraduate and postgraduate)?”

The term ‘trainee-in-difficulty’ can be used to describe a student or postgraduate trainee who is struggling academically, and this can commonly be due to health, competence and/or conduct issues. Many institutions, colleges and professional bodies develop their own guidelines to assist trainees.
The objective of the research is to collate current TID documents internationally, to look at similarities and differences in their recommendations, and to represent this data by mapping it. Similarly, a second map of TID research will be created (research purpose? date? methodology? geographical area?). These policy maps will be used to identify gaps and to inform future TID research and guideline development.
Skills taught:
• To become familiar with scoping review methodology
• To develop a protocol with inclusion and exclusion criteria that relate clearly to the objectives and review questions
• To undertake a literature review, including the grey literature
• To create a PRISMA flow diagram for the scoping review process
• To present the results in a in logical, diagrammatic or tabular form, and/or in a descriptive format that aligns with the objective and scope of the review

A Systematic Review of Peer-led Interventions for Mental Health in Secondary and Tertiary Students

Supervisor

Dr Fiona Moir
Marcus Henning

Discipline

General Practice and Primary Health Care

Project code: MHS218

There is evidence to show that students choose to approach peers for psychological support rather than seeking help from health professionals or Faculty members, due to stigma and fears about confidentiality. Peer-led initiatives have been shown to be a cost-effective way of improving the health of young people, and there is evidence of their effectiveness in substance use prevention, HIV prevention and eating disorder management in student populations. It is timely to undertake an SR of all peer-led initiatives for mental health in both secondary and tertiary student populations.
An SR has been undertaken previously on this topic (2011), but now needs to be updated.
The summer student undertaking this project will become familiar with systematic review methodology:
• By using a protocol with inclusion and exclusion criteria
• By undertaking a literature review
• By collating studies in referencing software
• By using a critical appraisal tool to analyse the studies
• By creating a PRISMA flow diagram
• By drawing conclusions about the strength of the evidence
• By discussing implications for future research and practice

The student can be one of the authors on a publication of this work.

Audit of Cannabis prescribing

Supervisor

Bruce Arroll

Discipline

General Practice and Primary Health Care

Project code: MHS221

The prescribing laws around the use of cannabis have been relaxed. Dr Graham Gulbransen is a senior GP and is specialising in prescribing cannabis and has the largest prescribing database in Australasia. He is keeping a record of his prescribing and routinely measuring outcomes for his patients.
Most clinicians in NZ have no experience in prescribing cannabis products he is keen to do an audit of his patients to see who seem to be the ones who are improving and those who do not. The summer student will be supervised by Professor Bruce Arroll and Professor Brian McAvoy (a drug and alcohol specialist).

The student will get experience in doing an audit and publishing the findings as well as getting an idea about the issues of prescribing cannabis. The student will gain experience in analysing data as well. This will be a welcomed audit for NZ clinicians.