Clinical

Project

The use of generative AI systems to produce clinical information and for teaching purposes has become of enormous interest and potential value to medical and health science educators and practitioners. Information can be generated to describe medical complaints in general terms. In addition, the generated output can also create more detailed information related to likely characteristics of the practitioners. Furthermore, the AI generated scripts can include comprehensive information related to the relevant medical complaint, such as prevalence and incidence, aetiology, typology, symptomology, diagnosis and the use of potential testing protocols, management and treatment, prevention, and prognosis.

Role

In this project, we aim to develop a series of scenarios [of around 1000 words] using generative AI and analyse the output to determine its level of accuracy and to see whether the information contains explicit and implicit biases that may affect clinical practice and patient care.

This will require use of generative AI followed by a qualitative analysis, such as employing discourse and content analysis of the scripts, and an estimation of the risks potential biases may present for clinical practitioners and patients.

Project

The Department of Dermatology at Waikato Hospital is undertaking several projects to assess the potential of an artificial intelligence-powered digital hospital to improve access to dermatology in New Zealand.

Role

The studentship aims to determine the attitudes and skills of consumers accessing a mobile app to answer some questions and upload a photograph of their skin disease (with AI support). After triage by AI, our dermatologists will evaluate the diagnostic and treatment potential of the system.

The student will recruit patients attending dermatology outpatients and guide them through online informed consent, consultation, and completion of an online satisfaction survey.

We will particularly focus on three groups of consumers with active inflammatory skin diseases or skin cancers: Maori, Pacific, and older people.

The student will observe the patient interaction with the app and analyse the consumer survey results. They will compare the AI differential diagnosis (5 ranked options) with the dermatologists' diagnosis/es and survey the dermatologists regarding the platform's usability. We expect to publish the results in a prestigious dermatological journal.

Ideal student

We seek a student with good communication and analytic skills interested in Dermatology or primary care. We would particularly welcome Maori or Pacific inquiries.

Project

In previous analyses of debt levels and the cost of continuing medical education it has been identified that on average these two factors are some of the least important influences underlying career choice in the five years after graduation from medical school.

However, in approximately 2% of newly qualified medical graduates debt levels are a significant concern. While this level of concern drops off over the next 5 years, it is unknown who these graduates are, and whether or not they may disproportionately over-represent strategically important cohorts such as Maori or Pasifika graduates.

Role

This summer student project will investigate this question, and better identify the students across the first five years of their careers for whom debt is a significant concern.

Skills learned

Use of large databases – data manipulation and cleaning
Statistical analysis – summary statistics, predictive statistics, Excel, SPSS
Writing for publication – it is intended that this project will result in a published research paper to which the student will contribute and co-author

Project

interRAI (www.interrai.org) is a multinational, not-for-profit, charitable network of researchers, clinicians and policy experts that develops and implements an integrated suite of comprehensive assessment and screening instruments and their related applications with the aim of improving quality of care and quality of life for vulnerable persons of all ages. The suite of assessment systems includes those designed for older adults, adult mental health services, and child/youth mental health.

The interRAI Self-Assessment for Mental Health (SAMH) has been developed to be compatible with and complementary to other interRAI assessment systems. SAMH includes about 100 clinical items dealing with mental health concerns, psychosocial functioning, physical health, economic and environmental factors, informal supports, quality of life, and perceived needs.

Role

Pilot testing of the SAMH is now ready to begin on an international basis. The purpose of this project is to explore the feasibility, acceptability, and cultural appropriateness of the SAMH for use with adults and older adults with mental health needs in New Zealand.

The student can be located in Auckland or Tauranga.

Skills learned

The student will learn about recruitment of participants, administering SAMH, data management and data analysis.

Project

Stroke, a non-communicable chronic disease, can result in neurological deficits including visible and invisible disability, cognitive impairment, and communication difficulties. Stigma creates barriers to seeking and accessing health care and rehabilitation, and avoidance of engaging in and managing treatments. Although much known about the impact of stigma for those with infectious diseases, less is known about the effect upon those with non-communicable diseases, with calls for more research in this field. Maori and Pacific people experience stroke up to 15 years earlier than non-Maori, impacting the opportunity to return to work, increasing dependence upon whanau members.

Skills learned

The student will develop literature search skills, including screening studies, grading study quality, using review tools to screen studies, synthesising diverse information, and writing for publication.

Impact

This will be the first time an integrative review about the effect of stigma upon recovery after stroke in Aotearoa has been undertaken. Findings will inform future research, including an observational study investigating the effect of stigma upon stroke recovery in Aotearoa, informing healthcare organisations and those working with stroke patients about the impact stigma has upon stroke recovery. We aim to privilege the Maori and Pacific experience, developing tools to support recovery.

Project

The aim of the project is to contribute towards the body of evidence regarding Non Ig E mediated food allergy and long term health outcomes, specifically Food Protein Induced Proctocolitis (FPIAP) and long term risk of IgE mediated food allergy.

Does diagnosis of FPIAP increase a child's risk of future presentation with IgE mediated food allergy?

Background

Food protein induced allergic proctocolitis (FPIAP) is a condition presenting in infants during the first 6 months of life. Babies typically present with blood stained stool and symptoms of abdominal distress, which resolve when the food protein involved is removed from the baby's (or their breast feeding mother's) diet. In most infants the protein allergy resolves by 12 to 24 months of age.

The incidence of FPIAP is between 3% and 10% of children less than 6 months of age, according to published research. There is limited research on the association between infantile FPIAP and adverse health outcomes. Some research has suggested an association between FPIAP and IgE mediated food allergy.

This project will develop the following skills:
– Medical writing: A literature review of papers related to FPIAP and IgE mediated allergy
– Audit design: An audit of presentations using the national data base
– Data interpretation and statistical skills

Project

In New Zealand, 1 in 8 adults are readmitted to hospital after discharge. Each readmission places significant strain on the patient, their whanau and the healthcare system. Yet some readmissions are preventable. As many as 1 in 5 of these readmissions are associated with medication factors, such as medication regimen complexity, polypharmacy and adverse medication events. The risk of medication-related readmission is particularly high in older adults.

Role

This summer research project will explore the role of medication regimen complexity on treatment adherence after discharge and impact on readmissions.

Aims:
– To explore the relationship between medication regimen complexity and the filling of discharge prescriptions
– To explore the relationship between medication regimen complexity and 30 day readmission outcomes

To achieve these aims, you will be collecting information from patients admitted to Te Toka Tumai Auckland (Auckland hospital). This will include learning how to calculate medication regimen complexity and exploring the relationships with medication adherence on discharge and 30-day readmission outcomes.

Benefits

You will have the chance to work in a supportive and multidisciplinary research team at both the University and Te Toka Tumai Auckland, experience real world clinical data collection and analysis, and work with a wide range of stakeholders.

Ideal student

Experience working in a clinical healthcare setting and knowledge of medicines are desirable.

Project

Asthma affects nearly 300 million people worldwide and is one of the most common lung diseases in New Zealand, affecting 1 in 7 children and 1 in 8 adults. Importantly, asthma disproportionately affects Maori and Pasifika, who experience worse symptoms and outcomes.

Asthma management is often suboptimal, with asthma attacks increasing by over a third in the last decade, often requiring courses of oral corticosteroid treatment. Adherence to asthma maintenance therapy is poor, with a reliance on short-acting reliever medications, and underuse of inhaled corticosteroids.

Role

Understanding what matters most to patients with asthma can help facilitate shared decision-making conversations between clinicians and patients. This summer studentship aims to explore using an online survey asking what aspects of their asthma matter most to patients, such as their symptom management and treatment.

The project will involve:
- Literature review
- Online survey development and dissemination
- Participant recruitment
- Data analysis
- Report write up

The student will be working with a clinical respiratory team to develop the online survey. They will have the opportunity to collaborate with international respiratory researchers and work on a publication for a peer reviewed journal if they wish.

Ideal student

Experience with health services research and some basic understanding of respiratory medicine are desirable but not essential.

Project

Aniridia is a genetic condition resulting in abnormal ocular development during embryogenesis, resulting in a spectrum of disease from birth. It presents with a range of ocular abnormalities, which vary in their presence and degree of severity. These may include limbal stem cell failure with subsequent corneal opacity, absent or partially absent irides, a Peter anomaly phenotype, cataract or other lens abnormalities, foveal hypoplasia and optic nerve hypoplasia. Any one of these features contributes to reduced vision. Other syndromic features are also described.

Pathogenic variants can occur in 2 known genes, PAX6, being the most common, but recently variants in a regulatory gene of PAX6, ELP4, are also described.

Role

For patients and families with Aniridia identified from the New Zealand Database of Inherited Retinal and Optic Nerve Disease, the summer student will review clinical notes to determine age of onset, presenting signs and symptoms, visual acuity, and progression. They will also collate imaging (OCT, Optos photos and electrophysiology). In addition, the genetic variants will be collated and degree of pathogenicity determined using online bioinformatics. This work is unique for New Zealand, with novel variants, and the impact and spectrum of Aniridia-associated disease is not characterised.

Project

Each year since 2012, the Medical School Outcomes Database and Longitudinal Tracking (MSOD) project has collected demographic and career intention data from University of Auckland (UoA) MBChB students at entry and exit to their programme, in addition to follow-up surveys in the postgraduate years. As a part of the MSOD project, we can link these data to Ministry of Health information regarding career outcomes in terms of location of practice and specialty.

This study aims to:
i. Relate the career intentions of UoA medical graduates at the end of medical school to their early postgraduate practice outcomes
ii. Describe the patterns in the key factors that influence UoA medical graduate career choices

Skills learned
Data processing and exploration techniques for large datasets
- Anonymised data will be processed to relate career intentions and medical school experiences to career outcomes and identify key predictors

Statistics
- Summary statistics, non-parametric and parametric comparisons, regression analysis

Data visualisation
- Data visualization techniques to illustrate associations between categorical variables and geographical distributions

Writing for publication
- The student is expected to contribute significantly to a research paper

Project

Each year since 2012, the Medical School Outcomes Database and Longitudinal Tracking (MSOD) project has collected demographic and career intention data from University of Auckland (UoA) MBChB students at entry and exit to their programme, in addition to follow-up surveys in the postgraduate years. At PGY1 and beyond, the response rate to these surveys declines significantly. It is very important that the samples collected from these surveys are representative of the overall population of MBChB graduates.

This study aims to:

i. Describe the characteristics of consenting participants in the project who did not respond to the MSOD at the PGY3 and PGY5 survey points but for whom we have other available information
ii. Describe the patterns in the key factors that influence non-response
iii. Determine the extent that the information available from other sources fills key gaps in responses

Skills learned

Data processing and exploration techniques for large datasets
- Anonymised data will be processed to relate demographics, career intentions and medical school experiences to likelihood of subsequent survey participation and identify key predictors.

Statistics
- Summary statistics, non-parametric and parametric comparisons, regression analysis

Data visualisation
- Data visualization techniques to illustrate associations

Writing for publication
- The student is expected to contribute significantly to a research paper.

Project

Pneumonia is a big problem for New Zealand from early childhood onwards. We have higher rates of hospital admission for pneumonia during childhood in New Zealand than comparable countries. We also have higher rates of chronic respiratory disease that result from lung damage caused by severe acute respiratory infections (SARI) in early life.

Active surveillance of pneumonia and other SARI started in Auckland in 2012 and has continued since. This surveillance has collected data in a consistent way since then. This allows us to look at time trends for SARI hospital admissions, and answer questions such as which respiratory viruses cause more severe pneumonia.

Role and skills learned

In this project we will help you learn how to describe SARI hospital admissions during the COVID era and how to compare pneumonia in those with COVID compared to other respiratory virus infections. We will show you an easy way of deciding how severe the chest radiograph abnormalities are in SARI patients. We will teach you how to navigate hospital clinical records, and how to analyse clinical data. You will become very skilled in reading chest radiograph reports. Then we will help you to develop cool presentations about your project and advise how to write up your manuscript.

Project

Diabetes is the most common complication of pregnancy, and hyperglycaemia in pregnancy is associated with short and long-term harms for mothers and babies. In Aotearoa, diabetes is most likely to affect pregnancies of Pacific, Indian, Maori and those with socioeconomic vulnerabilities.

While reducing hyperglycaemia is important to minimise pregnancy risks, biomedical and glucose-centric models of care neglect holistic wellbeing. This results in high levels of need, and are a missed opportunity to improve health and wellbeing.

Role

People with diabetes in pregnancy are calling for care that focuses more broadly on their wellbeing. Our collaborators in Australia have developed a tool to assess the holistic needs of women with gestational diabetes. This summer studentship will involve work to validate the tool in a New Zealand population.

This is a clinical project that involves face-to-face patient contact. You will attend antenatal clinics (South Auckland) and clinical education sessions, and you'll be involved in data collection, analysis, and the write-up / presentation of results.

Project

Cardiovascular disease (CVD) is a major cause of death and morbidity for women. Compared to men, primary and secondary prevention of CVD has been largely under-recognised, under-treated or ignored. Traditional teaching on gestational diabetes and preeclampsia is that these conditions resolve with birth of the baby.

There is accumulating evidence that persons who have experienced these pregnancy complications have increased risk of cardiovascular disease in the years after giving birth. Despite this association, many professional bodies do not include gestational diabetes or preeclampsia as factors to consider when evaluating cardiovascular risk.

Role

In this summer studentship you will complete a systematic review of guideline recommendations for cardiovascular risk screening following pregnancy. You will start to collate existing patient information resources about CVD risk.

Your involvement in this study will be important for developing both consumer, whanau, and staff resources, and it will contribute to a larger study of screening for cardiovascular risk after complicated pregnancies.

Skills learned

This studentship offers an excellent opportunity to develop your skills in literature search, writing, and critical thinking.

Project

Drugs with psychedelic properties (notably LSD, psilocybin, and ketamine) are emerging treatments for depression, often administered with psychotherapy. While much is known about the pharmacology of these agents, there remains much uncertainty about the contribution of concomitant psychotherapy to clinical outcomes.

Role

Accordingly, this study will systematically review available evidence of treatment protocols and completed studies to enable a critical appraisal of psychedelic-assisted therapy (PAT) of depression. In addition to antidepressant effects, the review will consider evidence bearing on PAT mechanisms and possible associations with adverse reactions, including ‘bad trips’.

Skills required: Literature search, review, and synthesis; critical appraisal of study quality. The use of online tools such as Rayyan (https://www.rayyan.ai/) or Covidence (https://www.covidence.org/) will be encouraged.

Research impact: By advancing our understanding of PAT and its impacts, this review will provide useful information for both clinicians and researchers. By identifying gaps in the evidence base, the review will focus the research agenda on issues necessary to optimize the efficacy and safety of PAT.

Responsiveness to Maori: Cultural safety is regarded as a key attribute of both clinical practice and ethical research. Cultural variables and their impacts will be assessed, where available, in all included PAT protocols and outcome studies.

Project

Each year since 2012, the Medical School Outcomes Database and Longitudinal Tracking (MSOD) project has collected demographic and career intention data from University of Auckland (UoA) and University of Otago (UoO) MBChB students at entry and exit to their programme in addition to follow-up surveys in the postgraduate years. As a part of the MSOD project, we can link these data to Ministry of Health and Medical Council information regarding career outcomes in terms of specialty and location of practice.

This study aims to:
i. Describe the characteristics of New Zealand medical graduates currently practising medicine in Australia;
ii. Explore how Australian Medical Council data could be integrated into the MSOD project to better aid our complete understanding of the career and location of practice preferences for New Zealand medical graduates.

Skills learned
Data processing and exploration techniques for large datasets
- Anonymised data will be processed to relate career intentions and medical school experiences to career outcomes and identify key predictors

Statistics
- Summary statistics, non-parametric and parametric comparisons, regression analysis

Data visualisation
- Data visualization techniques to illustrate associations

Writing for publication
- The student is expected to contribute significantly to a research paper

Project

Young adults who have made the transition from paediatric to adult Immunology services around the country are able to articulate their experiences and provide us with insights into how the transition process can be improved.

Role

This project will expose a summer student to qualitative research methodology, involving interviews with young people with the experience of transitioning from pediatric to adult services across Aotearoa.

Participants will be invited using the Immune Deficiency Foundation of New Zealand newsletter. They will be invited to a face to face or zoom meeting to answer open ended questions about their positive and negative experience and what could be improved. The generic online transition resources available on the Starship intranet will be used as a basis for any additional interview questions.

Answers will be recorded, transcribed and anlysed using nVivo software and grounded theory methodology will be used as a basis for any additional interview questions.

The long term impact of this will be significant to today's paediatric patients heading to transition, and will inform paediatric doctors about how they can improve their services, in particular to young people with Immune deficiencies.

Project

Vaccines against measles such as MMRs are highly efficacious and safe for healthy tamariki (children) and have been in use in Aotearoa for 30+ years. However, because MMRs contain live-attenuated-viruses they are unsuitable for immunocompromised individuals, including tamariki who are taking immunosuppressant medications or who have immunodeficiency syndromes. These tamariki rely on community-herd-immunity to protect them from measles infections. Critically low community vaccine coverage is currently leaving immunocompromised tamariki vulnerable to severe measles infections.

mRNA vaccines have been successfully developed and deployed to protect individuals, including those who are immunocompromised, against COVID-19 infections. mRNA vaccines against influenza and measles are also being developed. The availability of a mRNA measles vaccine could provide protection to immunocompromised patients and potentially reduce the community-herd-immunity gap.

Role

It is crucial to gain deeper understanding of the views and perceptions of parents and whanau of tamariki who are immunocompromised on the use of mRNA vaccines to protect them against viral infections.

Utilising Kaupapa Maori and qualitative research methods, the student will interview 10 Maori and Pacific parents of tamariki who are immunocompromised. Findings may contribute to more equitable deployment of mRNA vaccines.

Benefits

The student will gain qualitative research, data analysis, results interpretation and academic writing skills.

Project

Health practitioners worldwide have reported difficulties in assessing bilingual children at all ages; however, this difficulty is magnified when assessing very young children and children with developmental delays.

LINGO Study aims to explore how automated language measures can contribute to understanding assessment scores when testing bilingual young children. The study uses a set of pictures and voice-over instructions in Te Reo Maori, Samoan, Mandarin, and English that were developed in consultation with parents of bilingual children to test children’s understanding of words and word combinations by utilising eye tracking to detect their responses.

Role

Families will visit the research clinic when their children are 2 and 2.5 years old. Children will undergo an assessment of cognitive skills, receptive and expressive language, and fine and gross motor domains.

The student will be based in Grafton, Auckland, and will become an essential part of the team while working with families from different linguistic and cultural backgrounds.

Skills learned

They will learn to administer a standardised assessment of development (Bayley Scales of Infant and Toddler Development, 4th Edition), executive function tests, novel automated multilingual measure, and visual acuity and refractive error checks in young children. The student will contribute to the recruitment of participants, data management, and data analysis.

Requirements

Great communication skills and the ability to interact and engage with young children are essential.

Project

Germ cell tumours (GCT) are the most common malignancy affecting adolescent and young adult males. Rates of testicular cancer are increasing and AoNZ has one of the highest rates. The rate of testicular GCT among Maori men aged 15–44 (28/100,000) is substantially greater than for Pacific men (9/100,000), a rare example of difference in the incidence of any disease.

Although most patients with good prognostic features have excellent outcomes, the international cure rates for male patients with advanced disease and intermediate or poor prognostic features are only 79% and 48% respectively.

Role

This retrospective audit (of outcomes for men with GCT [all stages of disease] under the care of the Te Toka Tumai Auckland medical oncology regional service since 2008) will be the first retrospective audit of outcomes for men with GCT from Auckland. It will evaluate disease stage at presentation, ethnicity, treatment received, and survival outcomes.

Skills learned

The summer student will learn skills in data management, excel, use of clinical outcome data, verbal and written reporting, manuscript drafting. Ethics approval is in place. There will be opportunities to work with the clinical genitourinary medical oncology team.

Ideal student

This project suits a student with an interest in oncology and equitable cancer outcomes.

Project

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 18 years and is available for analysis.

Role

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 18 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.

Project

Drugs with psychedelic properties (notably LSD, psilocybin, and ketamine) used in combination with psychotherapy are emerging treatments in palliative medicine especially for people experiencing mental distress related to end of life.

The staff at Dove Hospice (https://dovehospice.org.nz/our-people/) have introduced an innovative treatment combining Ketamine with Psychotherapy over the past year.

Role

The student involved with this project would work alongside the Dove Staff and academic team, helping to review this pilot project and supporting the development of an audit or research project with a focus on safety and treatment outcomes.

Skills required

Literature search, review, and synthesis; communication with members of the team, data analysis

Research impact

By advancing our understanding of this Palliative Medicine intervention pilot, the student will provide useful information for both clinicians and researchers.

Responsiveness to Maori

Cultural safety is regarded as a key attribute of both clinical practice and ethical research. Cultural variables and their impacts will be assessed in the review of this pilot project.

This project is suitable for palliative funding.

Project

Glaucoma is a chronic eye disease and is one of the world's leading causes of irreversible blindness. Typically, visual field testing is required to both detect and monitor changes in patients with glaucoma (among other clinical tests). The clinical standard for visual field testing is the SITA protocol from the Humphrey Field Analyser (Zeiss Meditec, Germany).

Role

This project will consist of developing and validating a SITA Faster equivalent protocol for the Medmont perimeter (Medmont Pty, Australia), a more common perimeter used in Australia and Aotearoa NZ.

Skills: Clinical, data and statistical analysis, report writing

Project

Keratoconus (KC) is an eye condition which can cause severe visual impairment, and disproportionately impacts Maori and Pacific people. This study aims to describe demographic, clinical and health service-related characteristics of patients with KC, who are supported by Maori and Pacific health navigator services.

Role

This project will involve data extraction from clinical records and ophthalmic imaging systems, and its analysis. These findings will help improve eye care equity and clinical outcomes in KC

Project

In New Zealand, Pacific Island peoples (PI) are disproportionally over-represented in those with diabetes and cardiovascular disease (CVD). The reasons for this disparity remain unclear. The ‘hunger’ hormone ghrelin is known to protect against CVD, in part, by silencing the ‘sympathetic’ nerves that stress cardiovascular function. Preliminary clinical data reveals that ghrelin is adversely reduced in people with diabetes.

Role

This study aims to show that ghrelin is lower in PI compared to non-PI, which would explain why PI are predisposed to CVD. We will measure ghrelin in blood samples from healthy PI and NZ European subjects, as well as people with diabetes, and determine whether reduced ghrelin levels drive a dangerous increase in sympathetic activity and impairments in blood vessel function, which are known to underpin many cardiovascular morbidities.

This project will be undertaken with Prof Daryl Schwenke (University of Otago) and Dr Allamanda Faatoese (University of Otago).

This study will establish novel foundational knowledge identifying ghrelin as a significant contributor to the unacceptably high prevalence of CVD morbidity selectively in NZ-based PI people. In doing so, Pacific-centric treatment of the ghrelin pathway has the potential to have significant medium to long-term benefits on the quality of life for PI, as well as alleviating the current economic burden that NZ district health boards face due to the exorbitant costs associated with ongoing clinical treatment.

Ideal student

This project will be of interest to students with a strong interest in human research, cardiovascular physiology and Pacific Health. Experience of collecting data from human volunteer participants and data analysis (excel, R, labchart) would be beneficial.

Project

In Aotearoa, interRAI assessments are required to access publicly funded home care and aged residential care. Over 1.2 million assessments have currently been completed, yet there is a little research describing the utility of data at person, facility and organisation level in New Zealand. Anecdotally, clinicians report difficulty in accessing and interpreting interRAI assessments which are presented in raw formats and minimal use of interRAI assessments to inform care planning.

This project aims to:

– Describe how clinicians currently utilise interRAI data
– Identify clinicians’ ideas for how interRAI data could be better presented to inform care planning

Role

The summer student will be working with survey data (quantitative and qualitative) to address the project objectives. They will also be able to participate in, and present back to, working group meetings with geriatricians, GPs, nurses, care staff, older people and researchers. This work will contribute to the co-creation of useful information for clinicians who work with older people. There will be opportunities to take part in activities in the Centre for Co-Created Ageing Research (CCREATE-AGE).

Skills learned

The student will learn data cleaning and management skills, quantitative and qualitative data analysis skills, and verbal and written presentation skills in a clinical research setting.

Project

Degenerative cervical myelopathy (DCM) typically presents with significant upper and lower motor neuron dysfunction. A gradual stepwise progression in symptoms is typical and surgery the only available treatment for halting disease progression.

Despite the significant impairment and disability associated with DCM, little is known about the incidence of surgery or associated outcomes in the New Zealand setting. Maori and Pacific patients may be more predisposed to developing DCM due to ethnic variation in the dimension of the cervical spinal canal.

Role

In this retrospective outcomes analysis, the summer student will gather clinical data in a retrospective fashion from both electronic and written medical records. Outcomes of interest include complications, 30-day and 1-year mortality. Analyses will be geared toward finding predictive variables for these outcomes.

Skills learned

The summer student will learn skills in developing datasets, Excel spreadsheet work and basic statistical analyses. Attendance at the daily trauma handover is encouraged for clinical exposure and attendance in the OR possible if/when DCM cases arise. Clinical Audit Support Unit approval has already been obtained.

Project

Cardiovascular disease in women is underrecognised and understudied. The major clinical trials also have a significant underrepresentation of women, with an average of only 26% female participation. Here we aim to examine the experience of New Zealand wahine who are affected by cardiac arrhythmia, specifically atrial fibrillation.

This research will examine data from holter monitor recordings, ablation and pharmaceutical treatment outcomes, as well as experience to diagnosis. The goal is to identify whether female-specific differences occur in the diagnosis and treatment pathways, and whether and when differences in female heart function occur.

Role

The project will involve qualitative and quantitative analysis of heart monitor recordings, treatment outcomes, and questionnaires of patients who have atrial fibrillation.

Project

This project will estimate the prevalence of obstructive sleep apnoea (OSA) among pregnant people around Auckland and will assess whether completion of sleep testing is feasible during pregnancy. Currently, pregnant people are not screened for OSA, so this condition is likely underdiagnosed.

OSA occurs when a person’s airway is blocked during sleep, resulting in intermittent hypoxia. OSA during pregnancy increases the chance of high blood pressure/preeclampsia and may also impact fetal growth. Preeclampsia can be deadly. Preeclampsia complicates up to 8.3% of Maori, 3.7% of NZ European, and 8.3% of Pacific pregnancies. The only treatment for preeclampsia is delivery, which can result in preterm or previable birth. Preeclampsia also increases the lifetime risk of cardiovascular disease.

There is emerging evidence that treating OSA may reduce the chance of developing preeclampsia. If so, treating OSA would represent a modifiable, treatable risk factor for preeclampsia. Diagnosing and treating OSA may potentially reduce health inequity in preeclampsia and lifetime sequelae.

Role

The student's responsibilities will be to:

1) Assist with recruitment by explaining the study and reviewing the informed consent document

2) Enter data

If interested, the student would be able to learn about overnight sleep tests and would have O&G&Sleep shadowing opportunities.

Project

Aim

The aim of this research is to identify healthcare needs and characteristics of 100 women under the care of specialist maternal mental health services.

Methods

In this ethics approved study, a randomised sample of women who have presented to maternal mental health services within a one-year timeframe (2023-2024) will be drawn. The student will collect information on demographics, psychiatric, medical, social and substance use history, role in parenting, family violence and health resource utilisation using REDCap.

Analysis

The summer student will be involved in data collection and analysis that will inform interventions to support maternal-infant attachment.

Significance to Health

The findings from this study will build on a foundation of research to understand the health status of 100 women accessing maternal mental health services at Te Whatu Ora Counties Manukau. The analysis will assist with understanding concerns for these women and formulate key questions for future research.

Project

Dysphagia (difficulty swallowing) is a symptom of an overarching cause, including a neurological event or condition, head and neck cancer, or gastroesophageal disease. Dysphagia has significantly negative implications for the physical, emotional, and spiritual health of an individual and their collectives, such as whanau (family) and wider community. Dysphagia assessment and swallowing rehabilitation are managed by speech-language therapists.

In Aotearoa New Zealand, dysphagia services are embedded in a colonial health system that was not designed for Maori. It is unknown whether acute dysphagia services meet the needs and rights of Maori adults with dysphagia and their whanau. It is also unknown whether health workers are adequately supported to achieve equitable outcomes for Maori with dysphagia.

Role

A questionnaire was disseminated to speech-language therapists and Maori health workers about their role in supporting Maori with dysphagia and their whanau. The summer student’s role involves supporting the data analysis of the questionnaire responses and writing a summary of the findings.

Skills learned

The summer student will develop their skills in data management, quantitative and qualitative data analysis, writing, and oral presentation. Findings will be shared with speech-language therapists and other health workers to guide the future directions of dysphagia research that benefits Maori.

Project

Infective endocarditis is a potentially life-threatening condition involving infection of the heart valves and endocardium with the potential for metastatic spread and embolic phenomena.

Waikato Hospital is the tertiary referral centre for the Midland Region, providing cardiology, infectious disease and cardiothoracic surgical services to over 1 million people. Despite this, the rates, microbiological profile and outcomes of endocarditis in the region are poorly understood.

Role

This study aims to replicate the methodology of “The economic and health burden of infective endocarditis in Northland, New Zealand" (Birrell et al, NZMJ 2022) within the Te Manawa Taki. The aim was to understand the demographics, inequities, complications and burden of this disease. This study identified a mortality rate of 18% within 6 weeks of diagnosis, and a total cost of >$6 million on direct patient care.

Benefits

It is hoped that the student would gain at least one publication from this study, with abstract presentations at national meetings (CSANZ2025 Rotorua). The results will also help to inform future policy development within Te Manawa Taki.

Project

We offer a summer research studentship for a motivated student to join our team for a project evaluating the feasibility, cost-effectiveness and equitable delivery of care through a nurse-led atrial fibrillation (AF) clinic. This project aims to explore innovative healthcare delivery models to improve patient outcomes and healthcare efficiency.

Role

The successful candidate will assist with various research activities under the guidance of experienced healthcare professionals and researchers, including:

– Data Collection and Analysis: Collecting and analysing data to assess the cost-effectiveness and viability of nurse-led AF clinics, including reviewing patient outcomes, healthcare costs and resource utilization
– Equitable Care Delivery: Investigating the equitable delivery of care to different patient populations, identifying barriers to access, and ensuring high-quality care for all patients
– Guideline Implementation: Reviewing current guidelines for AF management and assessing their application within nurse-led clinics

Key Responsibilities:

– Collaborate with a multidisciplinary team
– Participate in data collection and analysis
– Contribute to the development of strategies for equitable care delivery
– Assist in preparing reports and presentations on findings

Ideal student

We are looking for an enthusiastic and detail-oriented student with strong analytical skills. Previous experience in healthcare research or data analysis is advantageous but not required. This studentship offers a valuable opportunity to gain hands-on experience in healthcare research.

Duration and Support

The studentship is designed for a 10-week period over the summer, providing a stipend to support the student's research activities.

Benefits

This project not only contributes to academic knowledge but also has the potential to inform future healthcare practices, making it a significant learning and professional development opportunity.

Project

By interweaving attachment theory with the empirical realities of the modern disconnection from the natural environment, this research aims to contribute strategies for nurturing psychological well-being within an increasingly urbanised global landscape.

Initial scoping literature review drawing upon history, social psychology, anthropology and religion to examine the extent that diverse cultures have traditionally held the natural world as a place of refuge, worship, and healing.

Role

To construct a suitable measurement tool designed to determine the strength of attachment to nature and its association with mental-wellbeing.

To design a pilot study examining this impact and analyze the results.

Within New Zealand Maori history, Tane (the God of the forest) created woman from red clay, and the legend of Papatuanuku (Tane’s mother) literally personifies the earth. Maori are ancestrally imbued with a sense of protection (kaitiakitanga) towards the land and its constituents as taonga (treasures). Ultimately, Maori have long identified as tangata whenua (people of the land), but this literal sense of identity is becoming eroded via displacement, urbanisation (with consequential loss of fertile land) and the multitude of other disenfranchising impacts associated with the aftermath of colonisation. Therefore addressing this recent and enforced disconnection will hopefully work for the betterment of Maori.

Project

Join our experienced research team investigating pregnancy-induced hypertension at Te Toka Tumai Auckland Hospital. We have developed a large retrospective cohort which we are utilizing to assess both the management of, and outcomes from, pregnancies affected by pregnancy-induced hypertension.

Role

We are looking for a student to assess the risk of pregnancy-induced hypertension in subsequent pregnancies for people in the cohort.

This project has already been a success, supporting one trainee in completing their RANZCOG research requirement and a medical student in their completion of a project on preterm pre-eclampsia. This student went on to present their findings at an international conference.

Ideal student and skills learned

We are looking for someone interested in the health of pregnant people and their babies. The ideal person will enjoy clinical medicine, show attention to detail and work well within a research team. We anticipate that this person will gain a new appreciation for clinical databases, statistical methods and scientific writing. We anticipate findings will be suitable for conference presentation and publication.

Project

Fetal scalp blood sampling (FBS) is performed as an adjunct to continuous cardiotocograph (CTG) monitoring where there is suspicion of fetal acidosis or hypoxia during labour. This test is performed as some believe that it may increase safety for the fetus or alternatively decrease the need for unnecessary caesarean births. However, there is very little information showing these theories to be true.

Role

We would like to partner with a motivated student to complete work on a cohort assessing outcomes from labours in which babies were born with or without the use of fetal scalp blood sampling. This work is important as it will provide some of the first evidence regarding outcomes of pregnancies where this test is utilized in New Zealand.

Ideal student

The ideal student will have an interest in the health of pregnant people and their babies, show attention to detail and be interested in working with a team of researchers.

Skills learned

We will support you in gaining knowledge about cohort studies, clinical data systems, statistics and scientific writing. We intend that the work will be presented at a conference and published.

Project

International research suggests neurodivergent and disabled physicians bring valuable lived experience to their practice of medicine. However, disabled students experience significant barriers in the structure, culture, and climate of medical education. Currently, little is known about neurodivergent and disabled medical students in Aotearoa.

Role

As part of a larger programme of research regarding disability-inclusion and anti-ableism in medical education, we will analyse extant data about medical students in Aotearoa to understand the prevalence of disability and neurodivergence, associated demographics, and trends in disability disclosure over time.

In this project you will assist with cleaning quantitative data and conducting descriptive analysis. If you have advanced skills in statistical analysis, there will be opportunities to do more advanced analysis (e.g., cohort analysis and logistical regression). You will also contribute to literature review, interpretation of findings, and writing a report related to this project. Depending on your interest and contribution, you could be a named author on a publication resulting from this analysis.

Ideal student

We particularly welcome applications from students with lived experience of neurodivergence or disability, and/or interest in matters of disability and neurodivergence in health professional education and health equity.

Project

Dry eye is an increasingly common, chronic ocular condition that adversely affects quality of life. Tear film imbalance and instability are major components of the underlying mechanism of dry eye. These are often managed with lubricating eye drops. Lipid-containing drops have been increasing in popularity in recent years because the most common reason for a dry eye has been found to be suboptimal functioning of the meibomian glands, the lipid-producing glands in the eyelids.

Role

These drops are often prescribed to be used multiple times a day, depending on the severity of signs or symptoms. This study aims to investigate the short-term changes in the lipid layer thickness measured using a quick and non-invasive interferometer over a period of 1 hour at (15 minutes interval) post instillation of a lipid containing eye drops when compared with a non-lipid containing eye drop.

As a student eager to expand your knowledge of clinical research, you'll have the chance to contribute to this research project and work closely with a dedicated team of experienced researchers.

Project

Biopharmaceuticals have revolutionised care for patients with immune-mediated diseases, but at a significant cost to healthcare systems. Biosimilars create brand-to-brand competition, which can drive down costs and encourage innovation from manufacturers (e.g., improved preservatives and devices).

Extensive research has been conducted on patients’ and providers’ perceptions of biosimilars, but there is less understanding of how biosimilars should be integrated into healthcare systems to minimise disruption to patients and healthcare providers.

Role

This narrative/scoping review aims to identify and summarize key literature assessing the process of transitioning to biosimilars, with a focus on system-level factors.

A narrative/scoping review will be conducted to determine the scope of literature in this area, as no overview of the literature has been undertaken. Scoping reviews provide an overview of a body of literature, identify the volume and types of evidence available on a topic, highlight gaps in the research and map the findings.

Skills learned and ideal student

Under guidance of the supervisors, students will undertake the literature search, complete data extraction, and undertake a narrative synthesis. This project will provide training in literature review and medical writing, and would be particularly suitable for students interested in internal medicine (dermatology, rheumatology, gastroenterology, and oncology).

Project

Each year since 2012, the Medical School Outcomes Database and Longitudinal Tracking (MSOD) project has collected demographic and career intention data from University of Auckland (UoA) MBChB students at entry and exit to their programme in addition to follow-up surveys in the postgraduate years. As a part of the MSOD project, we can link these data to Ministry of Health information regarding career outcomes in terms of specialty.

This study aims to:

i. Describe how prepared for practice and satisfied with their medical training NZ medical graduates are at the end of medical school and into their post-graduate years

ii. Describe the patterns in the key factors that influence medical graduates' preparedness for practice

Skills learned:

Data processing and exploration techniques for large datasets
- Anonymised data will be processed to relate career intentions and medical school experiences to career outcomes and identify key predictors

Statistics
- Summary statistics, non-parametric and parametric comparisons, regression analysis

Data visualisation
- Data visualization techniques to illustrate associations

Writing for publication
- The student is expected to contribute significantly to a research paper

Project

Magnetic resonance imaging (MRI) is well established for imaging the organs of the abdomen and pelvis. In recent years it has been having an increasingly important role in the evaluation of the pancreas. Although abdominal computed tomography remains valuable, the contemporary emphasis on decreasing patient radiation exposure is driving practice toward non-ionising modalities such as MRI.

Role

The inherent dynamic properties of MRI, its superior tissue contrast, and cross-sectional capabilities offer additional advantages. The aim of this project is to contribute to advancing our knowledge on clinical usefulness of quantitative imaging biomarkers derived from MRI of the pancreas.

Depending on the learning goals of the successful candidate, the project may involve a quantitative analysis of the existing images or a meta-analysis of published studies. Either way, it is expected that results will be published in an international peer-reviewed journal.

The project is part of a larger research theme of the COSMOS (Clinical and epidemiOlogical inveStigations in Metabolism, nutritiOn, and pancreatitic diseaseS) group. The group offers a vibrant research environment, comprehensive research training, and clinical research experience.

Skills Learned

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

Project

Optical coherence tomography imaging of optic nerves provides high resolution, detailed measurements for diagnosing and monitoring a number of different conditions, including papilloedema and demyelinating optic neuropathy.

Normative databases have been created for adults but there are limited studies to date for children.

Role

This project will create a paediatric reference database that can be used in the clinic to help better interpret children’s scans and improve patient care.

There will be opportunity for presentation and publication.

Project

Gastric neuroendocrine tumours (NETs) are a rare cancer type arising from the stomach. They can present as small indolent polyps through to aggressive and metastatic. Classifying gastric NETs following endoscopic biopsy or polypectomy is key to determining follow-up, however current classification systems do not seem to capture the diversity of phenotypes observed. This poses a significant challenge to pathologists, gastroenterologists, surgeons, endocrinologists, oncologists and other members of the multi-disciplinary team when recommending follow-up and treatment for patients with gastric NETs.

Role

The aim of this study is to correlate the classification of gastric NETs, and the disease course and long-term outcomes of patients.

The summer student will work with the NET multidisciplinary team to review the gastric NETs presented at the national NET MDM and in the NETwork! registry (a national registry of neuroendocrine tumours). The study will involve looking at the classification of gastric NETs.

Skills learned

– Working with a multidisciplinary team to draw on multiple areas of expertise
– An introduction to histological features and disease classification
– Data collection and analysis

Project

Healthy aging is accompanied by increases in inflammation, especially in the brain. Research into this neuroinflammation has been primarily focused on neurodegenerative diseases such as Alzheimer’s or Parkinson’s.

However, neuroinflammation of the optic nerve can lead to glaucoma, a heterogenous group of diseases responsible for the most cases of permanent blindness worldwide, affecting up to 110 million people in the next decade. So if we use eye disease as a model of brain injury and brain age, can we then better understand and predict other neuroinflammatory diseases?

In spite of well-established treatments for glaucoma (i.e., lowering intraocular pressure), onset and progression often remains undetected and asymptomatic. This is because glaucoma, like many neurodegenerative diseases (Alzheimers, Parkinsons, etc), remains asymptomatic until severe neuronal damage (in this case, to the optic nerve) has already occurred.

In fact, as diagnosis is made by thorough ophthalmological review, the exact symptoms that define early stages are controversial, and diagnosis mostly happens only after a clinical visit initiated due to vision loss. Therefore, we want to know which clinical and genetic factors predispose individuals to a loss of visual acuity, including risk factors for glaucoma.

Role

The successful applicant will learn how to develop novel machine learning models such as logistic regression, random forest, and adaptive boosting. They will utilise data on nearly 500,000 individuals, as input into these predictive models, including thousands of environmental, physical, and biological parameters (such as genetics).

Project

In vivo confocal microscopy (IVCM) of the cornea allows direct non-invasive visualisation of small fibre corneal nerve microstructure in living human cornea. The technique has been used in the assessment of corneal dystrophies and disorders, and following corneal and cataract surgery, and importantly, in addition to diabetic corneal neuropathy.

Corneal dendritic cells (DCs), located in the subbasal nerve plexus of the epithelium, are the primary resident immune cells of the cornea. These cells initiate specific immune responses to potential threats through their unique ability to present antigens from invading pathogens. Changes in the ocular surface, particularly in the density of corneal DCs and the morphology of corneal nerves, have been observed in ocular allergic and inflammatory conditions, including vernal keratoconjunctivitis and dry eye disease.

Role

The aim of the study is to utilise the anonymised historical images obtained using IVCM to detect patterns associated with diabetic corneal neuropathy and ocular surface allergies.

Skills learned

The student will gain experience in image processing, including ImageJ, Neuron J and Adobe photoshop software, along with data processing and basic statistical analysis.