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Hearing evolved as an essential survival sense and is fundamental to modern day quality of life. Tinnitus is a disabling hearing disorder that significantly impacts 7% of us, over 345,000 New Zealanders. "Tinnitus is so challenging to understand and treat because it is so different from person to person," says Associate Professor Grant Searchfield. "Because many people experience it quite catastrophically and it really does affect their life. If you can manage their tinnitus then you can effectively reduce the burden of anxiety and depression as well. That’s another benefit to the research: the broader aspects of better quality of life and wellbeing." During his audiology research career, A/Prof Searchfield has seen high tech hearing aids become smarter and smaller with involvement from high-end consumer electronics companies. These devices can help tinnitus sufferers. But is it a cure? "The search continues for a tinnitus cure in the form of an easy to administer drug, but evidence suggests we may need to personalise treatment – so different therapies for different people based on cause, genetics and lifestyle. "This is the future of tinnitus research." Watch this recent interview with A/Prof Searchfield on Newshub on 17 October: And enjoy this video of A/Prof Searchfield's recent public lecture hosted by AMRF.

"We have recently submitted our protocol paper outlining the plan for our focus groups and the randomised controlled trial (RCT) to JMIR Research Protocols and our paper is currently under review. You can find our preprint here," writes Dr Anna Serlachius of the Whitu app project team who are creating a mobile phone app aimed at providing young New Zealanders with tools to help them tackle anxiety and depression. What does this mean for the study? The methods are freely available for anyone to view, and the early registration of the trial's aims and outcomes can be measured and compared openly when it finishes. This type of open access publication is increasingly common and helpful to many researchers. Want a sneak a peek at the technology? View the Whitu app here on the Google Play store. Dr Serlachius says, "Eva Morunga and Nic Cao (our Maori and Pacific co-investigators) have been integral to helping us recruit and facilitate the focus groups for Maori and Pacific young people and with adapting the app to ensure Maori and Pacific youth find it culturally appropriate and engaging. "We are currently updating the Whitu app based on the feedback both from the pilot study and the focus groups. If all goes according to plan, we hope to have an updated prototype by the end of September after which we’ll start recruitment for the RCT. "And lastly, I also want to acknowledge our fantastic research assistants, David Lim and Anna Boggiss, who keep this project running smoothly. We have a fantastic team and are all very appreciative of the funding from AMRF." Look for more Whitu updates soon!

The 3 Minute Thesis competition is a global initiative to challenge student researchers to succinctly present their work in just 180 seconds. Since its inception in 2008, this career- and skill-boosting competition has grown to include over 900 universities Dr Brodie Elliott recently reached the finals of the local 3 Minute Thesis competition with his AMRF-funded Masters research on barriers faced by rural families in accessing surgical care for children with appendicitis. Dr Elliott is a surgeon and this clinical Master’s project will identify common barriers and whether surgical outcomes of appendicitis are worse for children of rural families compared to urban families on a national scale. His next steps will address getting over those barriers he's identified. Brodie Elliott from The University of Auckland's Faculty of Medical and Health Sciences presents Paediatric Appendicitis: Do rural families get the rough end of the stick? at the University of Auckland 3MT Final in August 2020.

Dr Dan Furkert discusses his search for antiviral drugs that can reduce the impact of the Covid-19 pandemic. He is a Senior Research Fellow at the School of Chemical Science in The University of Auckland. The work of Dr Daniel Furkert and his team forms a small part of an encouragingly rapid and highly cooperative worldwide effort to develop and evaluate many possible antiviral drugs, to identify those few that can be advanced through clinical trials into therapeutic use. The drug class they are investigating has a strong record in successful use against other pathogens including hepatitis, so there is a proven pathway for these agents to be successfully developed using a rational design process. Enjoy this video of our recent free webinar series and read more about this work funded by Auckland Medical Research Foundation's emergency Covid-19 Research Fund.

Professor Peter Stone and Dr Alys Clark at the University of Auckland are leading research using magnetic resonance imaging (MRI) to determine, first, if mum's sleeping position affects blood flow across the placenta, and, second, if those blood flow differences had any effects on oxygen reaching baby. They say, "We collaborated with researchers in the University College Hospital In London UK to explore novel MRI algorithms to assess maternal and fetal haemoglobin and oxygen transfer across the placenta, as this may be affected by the supine position in late pregnancy. The study built on our previous work using MRI to study the effects of maternal position on cardiac output and aortic blood flow. Here we aimed to determine if the blood flow differences had any effects on fetoplacental oxygenation." The results have confirmed significant position effects on the vessels which supply the human uterus and hence the placenta. The researchers are now preparing a manuscript and will give an oral presentation at the Perinatal Society of Australia and New Zealand, then will be published in the Journal of Paediatrics. Prof Stone says, “This is a team project which includes an exciting new collaboration between groups in Obstetrics and Gynaecology, Anatomy and Bioengineering. We have shared interest in how mum delivers all the critical oxygen that baby needs to develop healthily in pregnancy. Because of our unique combination of backgrounds we were able to design a set of studies using magnetic resonance imaging to see inside mum’s uterus, and investigate how oxygen is delivered to baby when mum is lying in different positions when she is late in her pregnancy.” This team has established and refined safe MRI techniques for use in pregnancy to determine how maternal position changes blood flow and in turn affect placental oxygen transfer to the baby. From this important work funded in part by AMRF, they will expand their study to pregnancies with vulnerable babies to help understand how maternal sleep positions may be associated with risk factors for stillbirth.

Dr Matt Roskruge discusses his research into the impact of the Covid-19 pandemic and lockdown on nurses in Aotearoa New Zealand. He is co-director of Te Au Rangahau Māori Business Research Centre at Massey University. Dr Roskruge and his colleagues aim to “change the way we value and support our nurses” and address workforce sustainability with resilience strategies for nursing staff and their employers. He says, “Nurses comprise a large, diverse and essential population within the health workforce. While they are trained to deal with the many challenges working in health presents, this pandemic creates new stressors and vulnerabilities, placing strain on their wellbeing. Nursing staff are central to the provision of clinical and community healthcare, and their wellbeing during times of crises such as the Covid-19 pandemic is of primary importance to the nursing workforce and the entirety of our health system.” Enjoy this video of our recent free webinar series and read more about this work funded by Auckland Medical Research Foundation's emergency Covid-19 Research Fund.

Predicting premature birth via a simple blood test could save thousands of lives globally. Research is being led by Professors Mark Vickers and Lesley McCowan at The University of Auckland who say that the 10% of babies born prematurely will often struggle with multiple risks to their health and ability to thrive. Prof Vickers says, "A reliable blood test for accurate prediction of spontaneous pre-term birth risk would give us the chance to improve care and treat the mother and baby with therapies to prevent it. We hope this results in improved outcomes for both infant and mother." The researchers are working to identify micro RNAs in blood samples that are associated with premature birth. Micro RNAs are a class of molecules that play a multitude of roles in the regulation of gene expression and so can act in development of diseases and disorders, or be harnessed as a tool to protect against them. Prof Vickers says, "Leveraging the outcome of this work has potential for major impact on clinical practice. We're helping to establish a blood test to define the key changes in maternal circulating micro RNA profiles during the early pregnancy of expectant mothers who go on to have a premature birth but previously would not have been identified as 'high risk'. "If our findings are now confirmed in larger validation studies, those mothers and babies identified as being at high risk may then be managed differently. The economic and societal burden of preterm birth is significant. Women identified to be at lower risk may also have their management adjusted and unnecessary interventions reduced." This important work is supported in part by the Auckland Harbourside Rotary Club.

Prof Merryn Gott discusses the impact of social isolation among older people during the Covid-19 lockdown in Aotearoa New Zealand. She leads the Te Arai Research Group into Palliative Care & End of Life Research at The University of Auckland's School of Nursing. Prof Gott says, "This matters because loneliness has a similar impact upon health as smoking or obesity. How people over 70 comply with anticipated long-term restrictions will also be contingent on their response to public health and media messaging. This currently remains unknown, as do their experiences of the lockdown period." Enjoy this video of our recent free webinar series and read more about her work funded by Auckland Medical Research Foundation's emergency Covid-19 Research Fund. Take part in this research by writing a letter: https://www.haveoursay.org

Researchers have observed that increased fat tissue mass results in increased risk of tendon disease and injury ('tendinopathy') which we feel as joint aches, pains and stiffness. The increased load on the tendons could partly explain this association but tendon degeneration also occurs in non-weight bearing sites, such as upper limbs. This means that other factors besides a simple increase in the amount of fat tissue are involved. Dr David Musson leads the Tendon and Mechanobiology Research Programme within the Bone and Joint Research Group of the Department of Medicine at the University of Auckland. In his most recent AMRF project and with funding for his Senior Research Fellowship from the Auckland Medical Research Foundation, he is working to find and understand the mechanisms that are driving the fat related increased risk of tendinopathy. In these studies, they found that animals that were fed fatty diets and had higher percentage body fat had weaker tendons that heal poorly. They also found that exposing tendon cells directly to fat tissue made them grow faster, have higher inflammatory gene expression, and increased expression of genes involved in tendon matrix remodeling. All of these results suggest that increased fat tissue causes negative changes in tendon cell behaviour, but also importantly, they showed that switching back to a normal diet can attenuate some of these changes, although the timing of this is important to see benefits in tendon healing after injury. Dr Musson says: "We now know some of the metabolic hormones and adipokines (fat-derived hormones) that affect tendon cell behaviour and thus affect the mechanical properties that are important for tendons to remain healthy. We are now looking at ways to reduce their impact and keep tendons healthier, longer." Dr Musson says. "We are also collecting and comparing tendons from people with different body mass indices (BMI), so with different fat tissue mass, to determine how these findings translate into the clinical setting so that we can target these factors and work toward the ultimate goal of improving patient wellbeing." "As always, I'm incredibly grateful for the funding received to complete this project and the support of the generous donors to the Auckland Medical Research Foundation." Read more about how tendon research can save millions of dollars for the health system.

"Over the past couple of months, and with the valliant efforts of our game developer extraordinare, Tarique Naseem, our team has completed the prototype version of the app and it is now available via the play store (Android) and app store (Apple)." writes Dr Hiran Thabrew of the Whitu app project, a mobile phone app aimed at providing young New Zealanders with tools to help them tackle anxiety and depression. "You can sneak a peek at the app here on the Google Play store: https://play.google.com/apps/testing/com.carbonimagineering.whitu" Following a successful Facebook recruitment campaign, the researchers introduced all 20 participants for the open trial of the prototype app within a week and they are hopefully making good use of it as you read this. Dr Thabrew and colleague Dr Anna Serlachius are currently in the process of organising a series of focus groups for late July, including some especially for Maori and Pacific Island young people that will be led by Dr Eva Morunga (Maori) and Nic Cao (Pacific Island) members of the research team. Following feedback from the prototype users and focus group participants, they will refine the app to its final version and refine the methodology to successfully undertake the randomised controlled trial (RCT), hopefully commencing in August-September this year. Anna Boggis and David Lim-Tua, two young and bright research assistants have done an excellent job of coordinating efforts and designing the online survey forms used for the pilot study and forthcoming RCT. "Our whole team has really enjoyed working on this app.​ Thanks again for AMRF's generous support."

VIDEO: Learn more in Dr Furkert's AMRF Webinar The current global COVID-19 pandemic has dramatically limited the ways that people, businesses and institutions may conduct their regular activities, and imposed devastating social and economic burdens on all parts of society. Without an effective vaccine and clinical antiviral agents for control and treatment of the SARS CoV 2 viral pathogen, it will not be possible for life to return to normal, with regular social contact or large public gatherings. The work of Dr Daniel Furkert and his team forms a small part of an encouragingly rapid and highly cooperative worldwide effort to develop and evaluate many possible antiviral drugs, to identify those few that can be advanced through clinical trials into therapeutic use. The drug class they are investigating has a strong record in successful use against other pathogens including hepatitis, so there is a proven pathway for these agents to be successfully developed using a rational design process. The team will use new advances in computer hardware to design and optimise candidate drug compounds using high-level molecular modelling techniques, including dynamic simulations that can address the flexible and fluid nature of protein structures, and then prepare the best of these for antiviral testing by colleagues. Through their work they aim to build new drug molecules that can bind specifically and tightly to key parts of the virus to prevent its replication in a human host. This information will help the team and other groups worldwide to understand how the SARS CoV-2 can be targeted, and identify and prepare the exact chemical structures that should be used to assemble an effective antiviral drug.

While New Zealand’s Covid-19 lockdown has ended, it has left behind a significant impact on our society. For many of New Zealand’s older population, as the most at-risk group for Covid-19 infection, the lockdown created significant uncertainty, anxiety and a deterioration in mental and physical health as they found themselves cut off from loved ones, familiar routines and support systems. Dr Gary Cheung is a researcher working with the interRAI Home Care program, working to assess the wellbeing of older people within New Zealand. interRAI is a comprehensive standardised geriatric assessment that is used for all older people assessed for publicly funded home support services and aged residential care. New Zealand has a state-of-the-art system of collecting, storing and reporting of interRAI data, which can be used to inform us about the physical, psychological and social wellbeing of our older people at an individual-, regional- and national- level. This information can then be used to improve services to better meet the needs of our older people. There has been a call for urgent action to mitigate the physical and mental health consequences of COVID-19 self-isolation in older adults. Levels 2-4 advised high-risk people to remain at home (e.g. those over 70 or those with other existing medical conditions). Without this rapid translation of routinely collected interRAI data, the health and psychosocial well-being of vulnerable older New Zealanders will be left un-monitored. The rates of suicide among older adults spiked during the period of the 2003 SARS epidemic in Hong Kong. In New Zealand, suicide rates of older men aged 85 years and above between 2011 and 2019 were the second highest amongst all age groups. Physical illness and depression are well-recognised risk factors for late-life suicidal behaviour. interRAI includes information on self-rated health and depressed mood, which are two of the indicators we will report on. Many of the evidence based late-life suicide prevention programmes target better screening and treatment of depression. If COVID-19 indeed has had an impact on the health and psychosocial well-being of our older generation, the New Zealand public health and social services and non-government organizations can ramp up their resources to address and minimize these problems at a national and/or community level as soon as our quarterly interRAI indicators become available. These rapid responses could prevent further deterioration of the health of older New Zealanders, reduce their suffering and ease pressure on New Zealand health services. Finally, learning from this project can be shared with other countries that use interRAI, enabling them to prepare vital health and social services for similar epidemic/pandemic in the future.