Te Kura Rata o Waikato | Waikato Clinical Campus

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

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

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

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

The human intestine contains a huge range of bacterial species, which collectively are called the microbiome. The gut microbiome is important to many areas of health, including digestion, gut and general health, control of inflammation, immunity, hormone regulation and brain function. People use probiotics to improve gut health by altering the bacteria in the microbiome.

Recent research studies show that the gut microbiome can affect how well some cancer treatments work, especially the ones targeting tumours through the immune system, and can reduce some side effects. Exciting small clinical trials found that transferring samples of the gut microbiome from donors to cancer patients changed their gut microbiome and improved outcomes from specific treatments. The samples of gut microbiome came from the faeces of healthy people or cancer patients.

This project will use questionnaires to ask cancer patients having treatment with chemotherapy, immunotherapy or radiation about their thoughts and feelings if they were offered gut microbiome transfer as part of their treatment, or if they were asked to be gut microbiome donors for other patients.

Project

The optimal method to check for a leak at colorectal anastomoses prior to defunctioning loop ileostomy closure is controversial. Available methods include contrast enema and flexible sigmoidoscopy. In Waikato Hospital both endoscopic examination and contrast enema have been routinely used for 10 years or more, but recent international evidence suggests that when no clinical concern exists contrast enema may not change management and therefore could be an unnecessary resource burden. This project will retrospectively review all patients undergoing ileostomy closure in Waikato Hospital over a 10 year period and determine which method of anastomotic assessment (contrast enema, flexible sigmoidoscopy or both) is most effective at identifying occult anastomotic leak or stricture prior to ileostomy reversal.

Role
The summer student will perform a retrospective review of medical records to collect the clinical data required to answer the study question. The student will acquire skills in data collection and management, basic statistical analyses and presentation +/- publication of research findings.

Project

NTM are environmental organisms mainly found in soil and water. The number of NTM isolates from people who are otherwise healthy is rising both globally and in NZ and is associated with rising disease burden. The lung is the most common site of infection. Patients with NTM-PD are often older with co-morbidities. Including chronic lung disease. Treatment is complex requiring multi drug regimens and prolonged durations. There has been significant variations in care for patients with NTM infection. Consensus international guidelines were published in 2020 and in July 2024 the UK launched NTM standards of care with the aim of improving and standardising care.

Patients with NTM in Waikato are now seen in a dedicated clinic. The first step of this project is to use the international guidelines1 and UK standards of care2 to establish parameters for a database. The next step will be to populate this database with data from NTM patients in Waikato from January 2022 and to commence collecting prospective data. The third step will be to audit the care of these patients using these international standards. The final step to help establish recommendations for future NTM-PD care in Waikato.

1. Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J. 2020;56:2000535 
2. Standards of Care for people living with non-tuberculous mycobacterial (NTM) disease in the UK, July 2024. https://www.ntmnetworkuk.com/standards-of-care

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. 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 completing an online satisfaction survey. We will particularly focus on three groups of consumers with active inflammatory skin diseases or skin cancers: Māori, 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.

We seek a student with good communication and analytical skills who is interested in dermatology or primary care. We would particularly welcome Māori or Pacific inquiries. The project will commence in November 2024.