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HRC News - March 2011
Joseph Gingell undertook part of this project to obtain his BSc (Honours); Richard Bailey is a senior research technician; Joshua Bradley undertook a summer project involving this research and was funded by a Pacific Health summer scholarship and mentored by Debbie Hay through his medical degree via the HRC Pacific Health Workforce mentoring scheme; and Tao Qi was supported for her PhD research by this project, recently completing her thesis.
Understanding how a hormone implicated in migraines triggers a response in receptors in the brain could provide a key to developing better drugs for the debilitating condition.
Dr Debbie Hay from the School of Biological Sciences at The University of Auckland says her three year HRC funded project focused on the calcitonin family of peptide hormones which also have relevance to other health issues ranging from diabetes to bone diseases.
Each type of hormone acts on its own specific cell surface receptor. These are the cellular sensors for these hormones and effectively control hormone action. Therefore, by adjusting the activity of these receptors it is possible to mimic or hinder the activity of these hormones and successfully treat disease.
Targeting the receptors has its challenges because the hormones themselves can’t easily be given as drugs because they are rapidly broken down in the blood.
Dr Hay says what they need to do is either develop better analogs of these hormones or come up with molecules that can mimic or block their actions.
“The aim of my research is to essentially create a blueprint of the receptor and how those hormones specifically interact, so that we can learn how large a drug might need to be, exactly where in the receptor it might bind, and to drive new drug discovery programmes.
“You can think of this as, deciphering the receptor code for new medicines.”
Drug development can be done in a number of ways, Dr Hay explains: “You can go for the holy grail of an orally bio-available small molecule, which is difficult to obtain, or you can play with the hormone itself to try and improve its pharmacokinetics and bioavailability.”
She is working with more than one hormone and one receptor – but in the case of migraine the receptor is for a neuropeptide hormone called calcitonin gene-related peptide (CGRP).
“We don’t know why, but this hormone has increased concentrations in the blood when people have a migraine headache and if you give someone this hormone they can develop a migraine,” she says.
“Over the past 18-20 years researchers have been trying to develop new drugs to block the actions of CGRP at its receptors to treat migraine and some of my research was related to that.
“We identified specific contact points in the receptor for some first generation drugs which will hopefully soon reach the market and help develop second and third generation drugs that are more specific and have fewer side-effects.”
The project has progressed well. Her PhD student has finished her thesis and they were able to publish plenty of new findings from their HRC funded work.
Dr Hay has also developed new collaborations with the pharmaceutical company Merck to aid in the development of their migraine compounds, so overall it was a very successful project.
She will continue her migraine work and expand into actually understanding how specific neurons sense this hormone CGRP and signal pain.
“This kind of basic biomedical research is really crucial to the development of future drugs.
“The research just with this family of hormones is relevant to diabetes, obesity, bone diseases, cardiovascular disease and lymphatic insufficiency. So whilst we’re only focused on one particular aspect here there are many other possible outcomes that might arise from this research.
HRC News - March 2011
Professor Kerry Chamberlain from the School of Psychology at Massey University’s Albany campus says the three year HRC funded study began with several focus groups where people talked about medications. They then recruited a study group of 60 households.
“Once medicines disappear inside households we have very little idea of what goes on with them and how people use them. We know quite a lot about non-adherence and we know that about half of medications are not taken as directed,” he says.
Professor Chamberlain says they decided not to create a definition of what a medicine is, given the range of supplements and nutriceuticals used, and instead let people talk about anything they regard as functional for health-related purposes.
They visited the households and asked the occupants to talk broadly about how they view medications. They then got them to draw a house plan showing where they are kept and asked them to get all the medications and talk about them to establish who it was for, how did it get in the house, who controls it, and who uses it.
“Having the object in front of them actually produces a whole lot of telling about medicines that we would not otherwise get.”
They also asked them to undertake either a photographic or written diary recording what they see about medications over a one or two week period, what they take and how they feel about it.
Professor Chamberlain says they have only just begun their analysis but it is clear that people are experimenting all the time with medications. “They’re taking them as prescribed but modifying and changing them, worrying about taking a little more or a little less and so on. They are also taking over-the counter and alternative medications alongside these. So there is quite a lot of variability and changeability. It relates to the meanings that medications hold and the uses that people consider appropriate for them.”
It is also clear that the medicine cabinet is a thing of the past.
“Drugs are distributed all over the house according to their useage. Things that are taken regularly typically end up in the kitchen, or if they are taken privately, they end up in the bedroom,” says Professor Chamberlain.
“Things that are from the past will be buried in the bottom drawer of the bathroom or the top cupboard of the pantry or in a back cupboard in a back room. So there is a logic to the placement of medications within houses.”
The research team has also examined medication controversies to see how medicines were shown and debated in the media.
They focused on the Herceptin debate and the thyroid disorder drug Eltroxin which attracted complaints about side-effects when the drug company changed the country of manufacture.
Although some put it down to social contagion caused by media coverage, Professor Chamberlain says it also appears that media involvement effectively changed the channels of reporting and this led to many more people expressing their symptoms.
“We think that the symptoms around changing drugs and the side-effects of drugs and so-on are largely underreported and often dismissed by GPs."
Caption: Alcohol, alternative medicines and prescription drugs are often stored in the same place in homes
8 December 2010
Investment in the development of the future health research workforce is an essential and important activity for the Health Research Council of New Zealand (HRC).
Five emerging health research leaders have been awarded Sir Charles Hercus Health Research Fellowships by the HRC. The Fellowships, worth up to $0.5M over four years, will assist the researchers to complete advanced postdoctoral health research in scientific fields that have the potential to contribute to both the health and economic goals for the Government’s investment in research, science and technology.
Dr Haxby Abbott, from the University of Otago, Dunedin, will investigate what kind of treatment for osteoarthritis is the most cost-effective, and what type of patient is most likely to respond best with one kind of treatment versus another, to reduce disability and cost.
Over three quarters of women diagnosed with breast cancer receive anti-oestrogen therapy. Dr Anita Dunbier, also from the University of Otago, Dunedin, will investigate why some women respond to therapy better than others. She will examine three genes, which are closely related to the oestrogen receptor, to determine how they affect esponse to treatment and genetic susceptibility to breast cancer.
Dr Anna Pilbrow, from the University of Otago, Christchurch, will explore how family history contributes to susceptibility to heart disease. She will investigate biochemical pathways within the heart and blood vessels that are altered in people genetically predisposed to heart disease. This study will allow her research team to develop blood tests that indicate impending risk of a heart attack.
Dr Shieak Tzeng, from the University of Otago, Wellington, will investigate how tobacco smoking, which is a major cardiovascular risk factor, alters Cerebral Autoregulation (CA), the mechanism that maintains brain blood flow within physiological ranges. CA, once impaired, increases the risk of brain haemorrhage, which is a debilitating form of cardiovascular disease and will test the hypothesis that smoking blunts CA.
Dr Mark Bolland, from The University of Auckland, will study how the use of calcium supplements is related to an increase in cardiovascular risk. He will investigate whether the increased risk persists after calcium is stopped, whether co-administered Vitamin D alters that risk, how calcium increases cardiovascular risk, whether the increased risk occurs with a different preparation of calcium, and determine the overall risk/benefit of calcium on health.
“The HRC is committed to investment in the development of the future health research workforce, and addressing the challenge of keeping future health research leaders in careers in New Zealand is an essential part of that,” says HRC Chief Executive, Dr Robin Olds.
“Our Career Development Awards support health research-related awards ranging from Summer Studentships, to advanced Postdoctoral Fellowships. These include Māori and Pacific health research awards, which are aimed at fostering and developing the Māori and Pacific health research workforce in New Zealand,” he says.
The full list of 2011 HRC Career Development Award recipients are outlined below:
Sir Charles Hercus Health Research Fellowship
Dr Haxby Abbott, University of Otago
Optimising cost-effectiveness in the management of osteoarthritis
4 years, $500,000
Dr Mark Bolland, The University of Auckland
Effect of calcium supplements on cardiovascular events and other health outcomes
4 years, $400,000
Dr Anita Dunbier, University of Otago
Investigation of genes involved in breast cancer susceptibility and response to therapy
4 years, $500,000
Dr Anna Pilbrow, University of Otago, Christchurch
Blood relations: finding circulating biomarkers for inherited heart disease
4 years, $500,000
Dr Shieak Tzeng, University of Otago
Influence of tobacco smoking on dynamic cerebral autoregulation
4 years, $500,000
Clinical Research Training Fellowship
Mrs Rosalind Case, University of Waikato
The impact of traumatic brain injury on school functioning in children aged 5-11 years
3 years, $250,000
Dr Mandira Chakraborty, The University of Auckland
Peripheral mitochondrial function in the management of acute pancreatitis
1 year, $80,000
Dr Ruth Cunningham, University of Otago
Health outcomes for mental health service users - exploring the case of cancer
4 years, $250,000
Silke Kuehl, University of Otago
The suicide and serious harm risk of 'Mixed Presenters' to emergency departments
4 years, $250,000
Dr Jeffrey Ngu, University of Otago, Christchurch
Autoimmune liver diseases in NZ: population-based epidemiology, genetics and therapeutics
3 years, $250,000
Ms Rachael Parke, The University of Auckland
Can nasal high flow therapy prevent nasal complications following cardiac surgery?
42 months, $145,833
Dr Simon Thornley, The University of Auckland
Cardiovascular disease risk prediction in the era of effective drug treatment
3 years, $250,000
Dr Deborah Wright, The University of Auckland
Prognostic modelling of colorectal cancer using multiple data sources
3 years, $250,000
Dr Tzu-Chieh Yu, The University of Auckland
Targeting peritoneal inflammation and injury in paediatric acute appendicitis
2 years, $170,000
Disability Research Placement Programme:
Ms Elisa Lavelle, AUT University
Developing strategies to better meet the needs of partners of people with brain injury
3 years, $108,027
Ms Elizabeth Mayland, University of Otago
Disability foundations: Anxiety and injury perceptions after upper limb trauma
3 years, $107,105
Ms Janet McDonald, University of Otago
The process and experience of family carers managing nursing procedures at home
4 years, $113,450
Māori Health Career Development Awards
PhD Scholarship in Māori Health Research:
Ms Arna Mitchell, Massey University
The impact of whakapapa exchange on the therapeutic alliance in therapy with Māori clients
36 Months, $106,550
Ms Jennifer Reid, University of Otago
SICK TO DEATH: Māori access to quality health care in Christchurch
18 Months, $78,550
Ms Pania Renati, University of Waikato
Whakapapa: An interpretation of Indigenous theory for the postvention of suicide for Māori families
36 Months, $108,095
Masters Scholarship in Māori Health Research:
Ms Renei Ngawati, AUT University
Capacity building and self-determination in Indigenous communities
12 Months, $11,080
Ms Te Moana Rolleston, Massey University
How do different populations define family wellbeing?
12 Months, $11,600
Rangahau Hauora Award:
Ms Leah Redstone, Ngaitai Iwi Authority
Sustainable Housing Development for Ngaitai families
6 Months, $12,000
Ms Ann Webster, Tu Kotahi Māori Asthma Trust
Primary schools & Māori children with asthma - A pilot
6 Months, $11,997
Erihapeti Rehu-Murchie Research Fellowship in Māori Health
Dr Lillian George, Massey University
Nga ara hou: New pathways toward family wellbeing for incarcerated Māori women
36 Months, $293,198
Dr Laurie Morrison, AUT University
Nga pou wahine: A kaupapa wahine intervention addressing gambling misuse
36 Months, $268,582
Hohua Tutengaehe Research Fellowship in Māori Health:
Ms Mera Penehira, University of Waikato
Mauri tangata: Re-Positioning Māori resistance and wellbeing in sexual and reproductive health policy and service provision
36 Months, $296,297
Māori Health Research Summer Studentships:
The HRC also awarded nine Māori Health Research Summer Studentships, valued at $5,000 each, to the following recipients:
Ms Te Hao Apaapa-Timu, Hapai te Hauora Tapui Limited
Ms Abbey Corbett, University of Otago
Ms Georgia Crosson, Massey University
Ms Chloe Hoeata, The University of Waikato
Mr Pita King, The University of Waikato
Ms Zoe McGavock, Massey University
Mr Brendan McIntosh, University of Otago
Ms Parewahaika Erenora Te Korowhiti Harris, University of Waikato
Ms Mariana Whareaitu, Massey University
Pacific Health Research Career Development Awards
Post Doctoral Fellowships:
Dr Gerhard Sundborn, The University of Auckland
Changing the food, built and social environments with policy to address obesity in New Zealand
36 months, $350,000
Mr El-Shadan Tautolo, AUT University
Development & validation of a method to assess Pacific fathering behaviour & involvement
36 months, $350,000
Dr Jemaima Tiatia, The University of Auckland
Suicidal Behaviours and Ideation Amongst Samoan people: The Journey Towards Prevention
36 months, $245,000
Ms Marianna Churchward, Victoria University of Wellington
An investigation of the intersection between resilience and risk factors for Samoan women living in Aotearoa/New Zealand during pregnancy, childbirth and early motherhood
36 months, $107,150
Miss Radilaite Delaibatiki, University of Otago
Knowledge, attitudes and practices of family planning for Fijian women living in Fiji and NZ
36 months, $110,510
Ms Carmel Peteru, The University of Auckland
E Mapu i Fagalele: Landscapes of Wellbeing for Samoan Elderly People Living in New Zealand
12 months, $34,485
Mr Faasisila Savila, AUT University
Environmental Associations of Overweight and Obesity for Pacific Island Children in New Zealand
60 months, $91,338
Mr Byron Seiuli, University of Waikato
Gapatia i le maliu ma le tagiaue: Examining customs that support Samoan men
36 months, $102,950
Pacific Summer Studentships:
The HRC also awarded six Pacific Summer Studentships, valued at $5,000, each to
the following recipients:
Ms Shavonne Duffy, The University of Auckland
Mr Rhys Faavae, University of Otago
Ms Jessica Gosche, University of Waikato
Ms Shivanjali Lingam, University of Otago
Ms Fialupe Lotoala, Massey University
Ms Monique Palaone, The University of Auckland
2 December 2010
The inaugural HRC Beaven Medal for excellence in translational research was presented to Dr Martin Than, a consultant specialist in Emergency Medicine at the Canterbury District Health Board, for research that will provide an innovative and workable change to the medical decision-making process for patients presenting acutely to Emergency Departments with chest pain that may be due to a heart attack.
The Minister of Health, Hon. Tony Ryall, presented Dr Than with the Beaven Medal at a function to celebrate the 50th anniversary of the Canterbury Medical Research Foundation in Christchurch on 2 December 2010. Minister Ryall said he was “delighted to present the inaugural Beaven medal to Dr Than in recognition of his innovative research project, which will make a significant contribution towards translational health research.”
The Beaven Medal, named after the late Professor Sir Donald Ward Beaven, KNZM, CBE (1924 – 2009), recognises Sir Don’s long time interest in translating research into clinical practice and will be awarded annually by the HRC.
“The HRC’s new Beaven Medal is a way of ensuring that Sir Don’s incredible life and association with diabetes and translational medical research is remembered,” Mr Ryall said.
“I am confident that Dr Than’s research project will contribute to a primary outcome of improved health service delivery over the short-to-medium term, at local, regional and national levels,” says HRC Chief Executive, Dr Robin Olds.
In a randomised trial, current care will be compared with a new ‘fast-track’ pathway.
Preliminary research suggests that an accelerated pathway with early blood tests in a targeted low-risk group of presenting patients, can be used to rule out the diagnosis of a heart attack approximately 10 hours earlier than with conventional diagnostic assessment. This would allow earlier progression to the next phase of chest pain investigations, prevent unnecessary hospital admissions and facilitate early discharge home. This outcome will be extremely beneficial for patients, who will be reassured earlier that a heart attack has been ruled out and avoid the inconvenience of hospital admission. It also has the potential to change clinical practice in a costeffective way, by reducing unnecessary admissions, duplication of staff activities and pressure upon urgent care services.
“Professor Sir Donald Beaven had a prestigious career, but it was his passion for medical education, medical research and diabetes that he will be most remembered for. His passion for learning will continue to be an inspiration for students and teachers across New Zealand and I hope that it will inspire many of our health researchers to follow in Sir Don’s footsteps,” said Mr Robert Stewart, Chair of the HRC Board.