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Associate Professor Sarah Hetrick
Dept. of Psychological Medicine, The University of Auckland
Self-harm in adolescents is prevalent, and is a key risk factor for suicide. However, these young people rarely seek formal help. The urge to self-harm fluctuates, and is situation dependent. Therefore traditional face-to-face therapy cannot always offer a timely intervention. There is a pressing need for innovative treatments for self-harm in young people. Given that most young people in New Zealand own a smart phone there is an enormous potential to make psychological self-care tools accessible when and where needed. We propose to design a smart phone application (app) specifically aimed to help adolescents manage distress and urges to self-harm, and ultimately to prevent episodes of self-harm. We will use a co-design process with young people, including interviews about their needs, and design workshops where young people will develop the content, interface (‘look and feel’, format, functionality etc.), and wireframes (sketches that represent the interface) for the app. We will engage clinicians to ensure that the app can be meaningfully integrated into the face-to-face clinical work with young people who self harm. We will then pilot test the app with young people to ensure its usability and safety and to ensure that it decreases distress and urges to self-harm.
Funded by: William Douglas Goodfellow Charitable Trust.
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Dr Brigid Ryan
Dept. of Anatomy and Medical Imaging, The University of Auckland
Imagine that you are diagnosed with dementia. You’re told that it will progressively deprive you of your ability to think, your personality, and your independence. Now imagine that your doctor tells you that your condition could have been treated if it was diagnosed 10 years earlier, but the damage to your brain now is too extensive. This is the problem that we are trying to solve: how to identify dementia years or decades before clinical diagnosis, so that intervention is possible. To do this we need to identify pre-clinical biomarkers of dementia. We have a unique opportunity to search for these biomarkers in a large Auckland family with a genetic mutation that is known to cause frontotemporal dementia. We will search for biomarkers that are both non-invasive and time- and cost-effective, namely blood tests, tests of cognition, and sense of smell. This family has a mutation that causes clumping of the ‘tau’ protein inside brain cells, leading to cell death (this is known as ‘tauopathy’). Our rationale is that biomarkers identified in this family may be generalizable to other tauopathies that cause dementia, including Alzheimer’s disease. If not, they will still be useful biomarkers of frontotemporal dementia, a common cause of early-onset dementia in New Zealand.
Funded by: Edith C Coan Trust.
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Dr Brie Sorrenson
Dept. of Molecular Medicine and Pathology, The University of Auckland
The major function of pancreatic b-cells is to secrete insulin, which regulates blood glucose levels in the body. Diabetes arises when the function of these b-cells is compromised and they can no longer appropriately secrete insulin. Many factors contributing to defective insulin secretion are not known and while b-cell replacement therapies work well, there is a severe lack of donor tissue for transplant. This research will study how genetic factors influence b-cell function and whether gene-editing can improve function of patient derived cells. There is increasing evidence that insulin secretion is similar to synaptic vesicle release and we have preliminary data showing that the synaptic protein Shank3 affects insulin secretion from b-cells. The mechanism for this will be explored and the relevance to whole body metabolism studied using a mutant mouse model. We also have the unique opportunity to study a patient with an insulin gene mutation that causes diabetes very young in life. Cells from the patient will be reprogrammed back into stem cells, the genetic defect repaired and differentiated into b-cells to assess whether insulin secretion function is improved. This will provide proof-of-principle to indicate whether this approach has therapeutic potential for diabetes caused by single gene defects.
Funded by: David and Cassie Anderson Medical Trust.
Dr Matthew Glasgow
Liggins Institute, The University of Auckland
Low blood sugar in newborn babies (known as neonatal hypoglycaemia) affects half or more of babies in some groups in New Zealand, including those who are born early, are large or small at birth, or are born to mothers who have diabetes. Most often, this happens shortly after birth when the baby uses up its store of ready blood sugars and before it is able to burn its own fat stores. It can cause permanent brain damage if not treated promptly. Brain damage results in financial and societal costs that may persist across a lifetime. Treatment of neonatal hypoglycaemia itself also incurs financial cost, particularly if the baby is admitted to intensive care, which also separates the mother and baby and makes early breastfeeding difficult. An assessment of the long term health burden and costs of neonatal hypoglycaemia has not previously been undertaken. We will undertake a series of economic analyses looking at these aspects of neonatal hypoglycaemia, in order to better understand the costs and benefits of different management options, including the use of dextrose gel for treating or preventing neonatal hypoglycaemia. This will help guide healthcare policy and resource allocation, both nationally and internationally.
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Ms Tamsin Robb
Dept. of Molecular Medicine and Pathology, The University of Auckland
Understanding tumour heterogeneity remains one of the most important questions in oncology. Tumour heterogeneity encompasses the differences between all of a patient’s tumour cells in one or more tumours of their body. This variability covers genetic and molecular differences in the full range of cancer hallmarks, including metastasis and treatment resistance. We are now armed with genomic technology that may be used to answer some of the most pertinent questions in oncology. Why do some people’s tumours spread rapidly around the body while others remain dormant and cause minimal harm? How do our differing genetic backgrounds affect our inherited cancer risk and the range of tumours developing in our families? What underlies the differences in individual patient responses to promising new drugs? By gaining a deeper understanding of cancer as a heterogeneous, varied, multifaceted disease within a single patient, we have greater hope of providing successful therapeutic strategies to that patient. The overarching aim of this research is to understand the effect and interplay of tumour heterogeneity in individual patients right down to the cell-level, in order to find new biomarkers for diagnosing and monitoring patients with neuroendocrine tumours in New Zealand, which will be widely applicable to cancer.
Funded by: Anonymous donor.
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Mr James Hucklesby
School of Biological Sciences, The University of Auckland
Stroke is a major cause of death and disability worldwide. If seen early enough patients with acute ischaemic stroke can be treated with a drug to dissolve the blood clot blocking circulation to the brain or the clot can be removed surgically. However, there is an urgent need to identify new therapies to increase the efficacy of these treatments and achieve higher levels of functional recovery. The blood-brain barrier is the gatekeeper of the central nervous system and functions as an interface separating the blood from the brain. Loss of blood-brain barrier integrity is a prominent pathological event in stroke resulting in uncontrolled entry of blood-borne products and fluid into the brain and contributing to a poor clinical outcome. This project explores new ideas on how the integrity of the blood-brain barrier is maintained. Our preliminary data suggest that an enzyme circulating in the blood can strengthen the barrier and may be able to reduce barrier damage following stroke. The proposed study will determine how this enzyme contributes to barrier integrity and may provide insight into whether it could be used as an adjunct therapy to improve health outcomes after stroke.
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Mr Oliver Scott
Dept. of Epidemiology and Biostatistics, The University of Auckland
The burden of cancer in New Zealand is high, and was one of the leading causes of death in 2013. There is a high and increasing prevalence of New Zealanders taking medication for high blood pressure and high cholesterol, as well as a high and increasing prevalence of risk factors for both cancer and IHD such as obesity, lack of physical activity, and unhealthy diets among NZ adults. As such, many New Zealanders are expected to suffer from both cancer and IHD in the coming years. Cardiovascular medications such as antihypertensive drugs, statins, and aspirin have tended to have positive effects on cancer outcomes in overseas studies, but this association may not be directly applicable to New Zealand patients. Hence, this PhD aims to examine the association between the use of cardiovascular medications and cancer outcomes in New Zealand, focusing on patients with breast cancer or lung cancer. The findings will inform health practitioners on what medications to prescribe cancer patients, and in turn, improve survival outcomes for cancer patients in NZ medicated for cardiovascular conditions.
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