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Our latest and archived media releases and news articles.
23 November 2016
Two Wellington health researchers have been jointly awarded the prestigious Liley Medal for their outstanding contributions to health and medical science at New Zealand’s top research honours awards.
Cell biology expert Professor Mike Berridge (pictured right) from the Malaghan Institute of Medical Research and intensive care specialist Dr Paul Young from Capital & Coast District Health Board and the Medical Research Institute of New Zealand (MRINZ) both received a Health Research Council of New Zealand (HRC) Liley Medal at the Royal Society of New Zealand’s Research Honours Dinner in Christchurch this evening.
This is the first time since 2008 that the HRC Liley Medal has been awarded to two people in the same year. The decision to award two medals was made because the researchers’ studies, while very different, were considered equally important in terms of potential impact.
Professor Berridge was one of the lead researchers in a landmark paper that demonstrated for the first time the movement of mitochondrial DNA between cells in an animal tumour model.
This new transfer to tumour cells, which was published in the high impact biological journal Cell Metabolism last year, showed that after mitochondrial DNA was removed from mouse models of breast cancer and melanoma, replacement mitochondrial DNA was gathered from surrounding normal tissue. After adopting this new DNA, the cancer cells then went on to form tumours that spread to other parts of the body.
Professor Berridge says that he and his research colleague An Tan were expecting tumour growth but were surprised when they found the tumour cells contained mitochondrial DNA from surrounding cells.
“Our initial response was that these cells must have slowly adapted to growing without mitochondrial DNA. When we detected mitochondrial genes in the tumour cells, we thought we had made a mistake, while reviewers of earlier manuscripts thought we must have had some residual mitochondrial DNA in the cells we were using,” says Professor Berridge.
“With the help of our overseas collaborators, we were able to build a solid case for mitochondrial gene transfer between cells and have now shown that it involves the transfer of whole mitochondria.”
HRC Chief Executive Professor Kath McPherson says Professor Berridge and his team’s novel discovery, partly funded through a HRC Explorer Grant that supports transformative research at an early stage, challenges core ideas in science, and opens up new fields for understanding normal human physiology and disease.
“This discovery could offer significant insights into the evolution and spread of cancerous tumours. It also lays important groundwork for understanding human diseases other than cancer, since defective mitochondrial DNA accounts for about 200 diseases and is implicated in many more, including neurodegenerative and neuromuscular disorders,” says Professor McPherson.
Dr Paul Young (pictured right) received his Liley Medal for leading the HRC-funded SPLIT trial, the largest clinical trial ever conducted exclusively in New Zealand intensive care units (ICUs) and the highest impact study in the field of intensive care medicine for 2015.
Published in the Journal of the American Medical Association (JAMA), the SPLIT trial compared the effectiveness of the two most commonly used intravenous fluid therapies for intensive care patients – saline solution and a newer alternative fluid with lower chloride concentrations called Plasma Lyte®.
The study, which was designed by Dr Young and fellow frontline ICU doctors, was in response to recent data suggesting that saline solutions may increase the risk of patients developing kidney failure.
Dr Young says the study showed that the two fluids had similar outcomes, and that using saline did not increase the risk of developing kidney failure compared with using Plasma Lyte®.
“The results are of major significance for global public health because they provide reassurance about the safety of intravenous saline, which is currently administered to more than a million patients around the world every day,” says Dr Young.
“Saline is also cheaper than the newer fluids like Plasma Lyte® by between 50 cents and eight dollars, depending on the country, so this study also has the potential to lead to health care cost savings of millions of dollars every day on a global scale.”
Dr Young says outcomes for ICU patients in New Zealand are among the best in the world, and he hopes this award will highlight to clinicians from other disciplines just what can be achieved through collaborative research.
“I’d like to acknowledge the help and support I’ve received on this study from ICU specialist colleagues from around the country, from the hundreds of ICU nurses who cared for the patients, to the ICU research coordinators who did the real work, and the MRINZ coordinating centre staff. Most of all, I’d like to thank all the patients who participated in the study.”
HRC Chief Executive Professor Kath McPherson says Dr Young’s study, which was coordinated by MRINZ, involved 2,278 patients from four New Zealand ICUs. Remarkably, she says, it was completed in 28 weeks of active recruitment at a cost of $200,000 and yet is likely to save millions of dollars for New Zealand and health systems globally, making it an excellent return on investment.
“Paul and his team’s findings from this study are currently the best evidence that exists in this field and will likely have major implications for health care delivery and the management of ICU patients in New Zealand and around the world,” says Professor McPherson.
“Despite Paul being involved in research for only six years, he’s already achieved so many impressive outcomes with the support of the Australian and New Zealand Intensive Care Society Clinical Trials Group. He’s currently leading six HRC-funded studies, including a HRC-funded trial to find out if saline or Plasma Lyte® leads to a lower risk of death in the sickest ICU patients, and he was just last month awarded a HRC clinical practitioner research fellowship to look into the prevention and treatment of fever in the ICU.”
23 November 2016
A two-dollar oral dextrose gel that has revolutionised the treatment of newborns with low blood sugar has contributed to Distinguished Professor Jane Harding being recognised at New Zealand’s most prestigious research awards.
Professor Harding from the University of Auckland’s Liggins Institute has received the Health Research Council of New Zealand (HRC) Beaven Medal for excellence in translational health research at the Royal Society of New Zealand’s Research Honours Dinner in Christchurch this evening.
Low blood sugar levels in babies are common in the first few days after birth. About 30 per cent of New Zealand babies – or 21,000 babies a year – need testing for low blood sugar under current guidelines. Half of these babies will develop low blood sugar, which can sometimes cause brain damage, and 10 per cent will need to be admitted to a neonatal intensive care unit (NICU) at a cost of about $9.4 million a year.
Professor Harding and her team’s trial of 400 babies born at Waikato Hospital at risk of low blood sugar was published in the Lancet in 2013. Known as the Sugar Babies Study, it was the first study to show that dextrose gel massaged into the inside of a baby’s cheek is more effective than feeding alone for treating low blood sugar. A follow up study of these babies at 2 years of age confirmed that the treatment was safe in the longer term.
HRC Chief Executive Professor Kath McPherson says that Professor Harding’s groundbreaking research is expected to change the way that millions of babies are monitored and treated for this condition around the world.
“Jane and her team’s research has led to the development of a new, simple, safe and inexpensive treatment that significantly reduces healthcare costs by keeping babies out of NICU. It also helps keep mothers and babies together at a critical time for bonding, while supporting breast feeding and its associated benefits for later health and development,” says Professor McPherson.
“Since 2009, Jane and her team have published 17 high impact papers relating to low blood sugar levels in babies. These papers have covered the whole spectrum of translational research, from fundamental research, translation to humans, patients, practice, and finally to population health – a rare feat for a research team.”
A national survey has shown that 75 per cent of birthing units in New Zealand are now using oral dextrose gel to treat low blood sugar levels, and they are reporting a decrease in the number of babies admitted to NICU for this condition. Similar reports are appearing around the world, including in the UK, Australia, and the US.
Professor Harding says the HRC’s Beaven Medal is “great recognition of a multidisciplinary team approach with a resolute focus on how we can make a difference to babies”.
“We’ve tackled many different aspects of the diagnosis and management of low blood sugar levels in babies over the years, and developed several world-first techniques for assessing newborns and pre-school children as a result,” says Professor Harding.
“Low blood sugar is a common problem that should be readily preventable and treatable if we knew more about which babies require what treatment. It’s also an area with a lot of potential to make a difference to babies and their families for their lifetimes. We’ve got the right team of people to address this problem for the world, and it’s very exciting to be part of that.”
The HRC has been a long-time supporter of Professor Harding’s research. Not content with improving treatment, Professor Harding is currently undertaking two HRC-funded projects to see if dextrose gel can also be used to prevent low blood sugar in newborns. Families with at-risk babies are being recruited from Auckland City, North Shore, Waitakere, Waikato, Tauranga, Whakatane, Hawke’s Bay, Whangarei, and Southland hospitals, with four hospitals in Australia expected to join the project trial in the next few months.
21 November 2016
New Zealand’s six-hour target for the time people stay in hospital emergency departments has been associated with hundreds fewer patients dying, according to new research.
The research into the effects of the mandatory six-hour national target on patient outcomes was co-led by Director of Emergency Medicine Research at Auckland City Hospital, Dr Peter Jones, and University of Auckland researcher Dr Linda Chalmers who co-led an investigation team from the university. It was supported by a $1.1 million project grant from the Health Research Council of New Zealand (HRC).
The investigation team examined various indicators of quality of patient care in 18 of New Zealand’s 20 district health boards (DHBs) over a period of seven years (2006–2012), and included an in-depth investigation of four hospitals.
The national target for length of stay in emergency departments was first introduced in June 2009 by the then Minister of Health, Hon. Tony Ryall. The target’s main goal was to reduce crowding in emergency departments, a worldwide problem that is associated with poorer outcomes for all patients regardless of whether they are discharged from the emergency department or admitted to hospital.
Dr Jones says that despite government providing no extra funding to implement the target, the DHBs collectively invested about $52 million in resources between 2008 and 2012 to try to make the target work. As the investigation team did not know what this money would have been used for if not for the target, they were unable to assess if these extra demands resulted in problems elsewhere in the health system.
“The length of time people stay in hospitals across the country has reduced on average by about 7 hours since the target was first introduced. If you multiply that by many patients, it’s a significant number of hospital bed days freed up, which may have created increased capacity for acute admissions,” says Dr Jones.
“Emergency department stays for all patients have reduced by over an hour, and for patients needing admission to hospital by about 3 hours. Where I work at Auckland City Hospital, the average time it takes for patients to get to the ward from the emergency department once the decision to admit them to hospital has been made has reduced significantly, from eight hours to about one and a half hours.”
The most striking finding from the study was the positive effects of the target on crowding and patient mortality.
“We found that the introduction of the six-hour target was associated with a substantial 50 per cent reduction in the number of patient deaths in emergency departments – that’s about 700 fewer deaths than predicted if pre-target trends had continued. This result mirrors the 50 per cent reduction in emergency department crowding,” says Dr Jones.
“There was also no increase in deaths on the wards, so there was no evidence that the observed reduction was due to ‘shifting’ deaths to elsewhere in the system.”
The researchers also found that after the target was introduced, fewer patients left the emergency department before completing their care and that admission rates did not change substantially.
DHBs used two main strategies to achieve the target. Firstly, they focused on process improvements that enabled patients to move more quickly from emergency departments to other parts of the hospital. Secondly, there was considerable investment in new emergency department facilities, and the creation and expansion of ‘short-stay’ capacity in hospitals. Short-stay units are areas where patients are kept under observation before being discharged or admitted to hospital.
Dr Jones says he was initially sceptical about the introduction of the target having witnessed first-hand the adverse effects of a stricter four-hour target in the UK while working there in the mid-2000s. He says that unlike in New Zealand, the UK target was linked to financial incentives and this, coupled with increased pressure on staff to meet the target, led to significant “fiddling of the numbers” and moving of very sick patients from the emergency department inappropriately to make it look like the target had been met.
Although the team’s investigation into New Zealand’s target outcomes was generally positive, Dr Jones says there were some areas of concern.
“We looked at the number of patients readmitted to hospital 30 days after being discharged and found that this figure had increased by about 1 per cent, which is a plausible unintended consequence of reducing the amount of time people spend in hospital.”
“There was also evidence of staff transferring patients to short-stay units so that these patients would not count as ‘breaches’ of the target. This occurred at many sites and seemed particularly evident where heavy pressure on clinical staff to meet the target was not matched by adequate resourcing. However, we haven’t completed this analysis yet.”
HRC Chief Executive Professor Kath McPherson says this comprehensive study will directly inform future health policy in the area of emergency medicine.
“This study has important implications for the way future health targets are implemented by helping identify which DHB management practices lead to success in meeting the target, and more importantly, which improve quality of care for patients,” says Professor McPherson.
14 November 2016
The HRC’s Sir Charles Hercus Health Research Fellowship (SCHF) is an advanced postdoctoral fellowship established in 2003 to support the future leaders of health research in New Zealand. An evaluation of the fellowship began at the end of 2015 to provide the HRC with an understanding of whether the goal of supporting New Zealand’s future health research leaders – with the ability to contribute to health and economic gains for New Zealand – was being achieved, and to identify how this goal could be better supported. When the evaluation began, a total of 33 fellowships had been supported, with the majority (90 per cent) of these fellowships in biomedical research.
Through an online survey we asked past fellowship holders to identify the impediments for career progression; the ways in which they felt emerging and mid-career research fellows could be better supported in the research environment; and where they thought there were gaps in career support. Adding to this information, was an analysis of contractual data, including final reports, which provided information on research advancement and impact.
Since the last evaluation of the SCHF in 2009, 14 SCHFs have been completed and final reports submitted. Of these fellows, 10 completed the online survey (a 71 per cent response rate), all were biomedical researchers, and six were women. Of the 119 applications received for the SCHF, 64 per cent have been from women. However, overall women have had a low success rate (19 per cent) for attaining a SCHF since the inception of the award, compared to the success rate for men (42 per cent). In the past five years, the overall success rate for the award has been 25 per cent.
Over the five-year period (2010/2011 – 2014/2015), SCHFs made up 16 per cent of the HRC’s salaried postdoctoral workforce, with 50 per cent of these contracts in the areas of cardiovascular disease (24 per cent); CNS/neurological disorders (21 per cent) or oncology and cancer (15 per cent).
The following are the key findings from the evaluation:
- Nearly all fellows had advanced their research careers since the inception of their fellowship, and had established themselves as independent researchers leading research teams responsible for staff and students. On completion of the fellowship, 13 fellows were in more senior positions, one of whom had progressed to head of department.
- All 14 fellows secured further research funding, with half being named investigators on both HRC projects and programmes.
- All ten survey respondents are now leading their own research teams, and were positive about the value the fellowship provided in terms of the freedom it allowed them to establish themselves as independent researchers, forming a research team to support their research, and establishing relationships with collaborators without the pressure of teaching and faculty responsibilities.
- Training and mentoring emerging researchers was a major part of the fellows’ role, with all the fellows supervising students (42 in total), of whom 30 are undertaking a PhD.
- Fellows’ research had contributed to expanding knowledge in their field, with the translation of this knowledge into clinical settings, the generation of intellectual property, and the development of new and improved techniques and methodologies.The uniqueness of these methods and techniques were attributed to attracting both national and international collaborators to their research, which had brought new expertise and resources to their research.
- Fellows received significant recognition of their work through awards and prizes, including the Zonta Science Award for an emerging woman scientist; the Prime Minister’s Prize for Science Media Communication; the Royal Society of New Zealand’s Callaghan Medal, and the HRC’s Liley Medal. One fellow attended the Science Foo Camp – organised annually by Google, Nature, Digital Science and O-Reilly Media.This event is by invitation only and brings together 250 people from around the world identified as conducting ground-breaking work.
- Fellows were prolific in the dissemination of their research findings through academic avenues, producing an average of 13 peer-reviewed publications per fellow, which is equivalent to the average output from an HRC programme contract in the HRC’s recent bibliometric survey.
- Although traditional academic avenues of dissemination were high, most fellows did not report activities which had engaged the public in their research.
- While fellows had been successful in advancing their research and careers, they highlighted significant barriers that faced emerging and mid-career researchers. The significant stumbling blocks to career progression were identified as a lack of tenured positions and an over-subscription for these positions, and limited research funding in a highly competitive environment.
- Of the 10 fellows surveyed, five had secured tenured positions at a university, while the remaining five fellows were reliant on external funding to support their salary, and their research.
- Fellows were aware of other postdoctoral fellows having to leave research careers to pursue other professions, or pursuing their research career overseas. Two of the four fellows repatriated through the Hercus fellowship were investigating research opportunities overseas, given the austere funding environment.
- Mid-career was identified by fellows as where the biggest gap in career support appeared, with the mid-career researcher no longer eligible for postdoctoral funding, but without the track record of the senior researcher for whom they must compete for funding.
- Mentors were identified as important in fostering and supporting researchers’ career progression. As such, mentorship programmes, which include career planning and succession planning for researchers, and the development of the skills required to be a successful research leader, were viewed as one means of supporting fellows in their career progression.
- Other suggestions for support were an increase in funding to support mid-career researchers, and to ensure that the fellowship keeps up with the costs of inflation, and that the workplace is a flexible environment supportive of researchers’ responsibilities outside of work.