Postgraduate Scholarships

Māori Postgraduate Scholarship

Heart failure (HF) is a chronic condition that disproportionately affects Māori in Aotearoa, with significant and growing inequities in care.1 Disparities in related outcomes may exist but have not been well described and may be driven by various factors.2,3 Recent advances in guideline-directed medical therapies (GDMT) for HF in Aotearoa offer promising improvements in treatment outcomes.4 It is essential that these therapies are accessible and used appropriately to address disparities in outcomes. Pharmacist led HF clinics have been shown to optimise GDMT utilisation and outcomes (including reduction in HF-related hospitalisations / emergency room presentations).5 I aim to describe the prescribing patterns of GDMT for HF among Māori in Aotearoa New Zealand (NZ) and examine the associated outcomes to identify inequalities in access and practice gaps, with the goal of improving outcomes and addressing disparities.

While trial data indicate broad effectiveness of heart failure medicines and are likely generalisable to the NZ population, they do not provide insights into how medicines are used in NZ or their effectiveness for a real-world NZ population across all ages, sexes, and ethnicities. Using routinely collected health data, we can link medication dispensing, hospitalisation, healthcare utilisation, and mortality data to track treatment and outcomes for individuals with heart failure. The de-identified data allow us to describe patterns and variations in both treatment and outcomes and to identify associations, accounting for possible explanatory variables such as other health conditions. This analysis enables us to explore unwarranted variation, including by ethnicity, geographical location, or socioeconomic status which in turn may allow advocacy at practice and policy levels for equitable resourcing and access to GDMT.

This research may identify disparities in access and utilisation of GDMT among Māori, leading to targeted interventions to ensure equitable healthcare delivery, improve clinical outcomes, and inform policy and practice.

Māori/Pacific Postgraduate Scholarship

The Te Mana Ki Tua (TMKT) program, delivered by Health New Zealand Te Whatu Ora Counties Manukau, is an innovative group-based weight management service supporting individuals throughout their weight loss journey. This program is of particular significance for Māori and Pacific communities, who face disproportionately high rates of Type 2 diabetes and obesity due to systemic inequities and historical disruption of traditional lifestyles. 

This research aims to explore the factors influencing participant engagement, satisfaction, and success within the TMKT program, with a focus on its cultural alignment with Māori and Pacific values. The study begins with a systematic literature review to assess the effective components of group weight management programs, particularly those tailored to Indigenous populations. Semi-structured interviews with current and past TMKT participants will provide insights into their experiences, including program content, delivery methods, and cultural relevance. Finally, the research will compile a directory of community-based weight management resources available for long-term support and identify and recommend community resources to support long-term weight management. 

The study adopts a qualitative approach, ensuring participant voices are central to the findings, and aligns with Te Tiriti o Waitangi principles by upholding equity, self-determination, and cultural responsiveness. Outcomes will provide actionable recommendations to enhance the program's cultural safety and effectiveness, promoting better health outcomes for Māori and Pacific peoples. This research addresses critical health inequities and contributes to a broader understanding of how culturally tailored interventions can advance Indigenous health equity in New Zealand and beyond.

Māori/Pacific Postgraduate Scholarship

My summer research project for the Pūtahi Manawa Fatu Malosi programme examined how genetic changes in specific cardiac proteins can lead to life-threatening arrhythmias. In the pilot study at the University of Otago in the lab of Professor Pete Jones, I looked at a gene variant in a European population that has previously been shown to cause arrhythmias. The type of experiment required to examine these variants is very time-consuming. Therefore, determining whether newly identified variants cause arrhythmia is a slow process. Given there is little to no knowledge on the functional impact of genetic variants in the heart that are specific to Māori and Pasifika populations, a different approach is needed. 

Therefore, for my Honours project, I plan to modify the current experiment to enable the development of a higher-throughput screening system. This will allow multiple variants to be screened in parallel in a much less time-consuming manner. If I can develop the system, and time allowing, I will then use it to investigate novel genetic variants specific to Māori and Pasifika populations. I identified these variants as part of the second phase of my summer research project.

Māori Postgraduate Scholarship

Macrophages, the most common immune cells in the heart, are essential for maintaining heart health. However, an imbalance in these cells can lead to inflammation and fibrosis, which can contribute to cardiovascular diseases such as heart failure. TMEM176B, a gene active in inflammatory macrophages, has been found to play a critical role in heart inflammation, particularly in conditions like atrial fibrillation. TMEM176B activates inflammatory pathways that recruit additional immune cells, potentially worsening heart damage. While certain genetic changes in TMEM176B have been shown to influence inflammation, little is known about how non-coding genetic variants (which regulate gene activity) affect its expression. Understanding these regulatory mechanisms could reveal new therapeutic targets for heart failure. 

This project focuses on five specific non-coding DNA variants that are linked to TMEM176B activity and markers of inflammation in heart tissue. 

The study has two main aims: 

(1) Test tissue-specific enhancer activity: Using zebrafish models, researchers will identify which variants control TMEM176B expression in heart and immune cells. 

(2) Assess allele-specific enhancer activity: Using human immune cells, researchers will determine if different versions of the variants have varying effects on TMEM176B activity. 

The findings will provide insights into how these DNA variants regulate TMEM176B and contribute to heart inflammation, potentially leading to new strategies for treating heart failure.

Māori Postgraduate Scholarship

This research will explore the transformative potential of targeted breathing protocols on both heart health and mental health. We will focus on the physiological and psychological effects of different rhythmic breathing techniques, such as slow resonant breathing (6 breaths per minute), over-breathing (hyperventilation) and repeated breath holds. Utilising Mātauranga Māori (Māori knowledge) and the breath (te hau) as a consciously controllable access point into our nervous system, we will examine the diverse benefits to our hauora (hollistic wellbeing). 

By examining how specific breathing protocols influence heart health parameters and the levels of important gases (such as carbon dioxide and oxygen) in the blood, this research aims to uncover mechanisms that reduce stress on the heart, enhance cardiovascular efficiency, and improve mental health outcomes. Using breathing exercises to alter the current state of both our brain and body, as well as strengthening the diaphragm – a vital yet often overlooked blood pump – represents a means of achieving both immediate and long-term health improvements. Enhanced diaphragm function could ease the heart's workload and contribute to cardiovascular resilience as a complementary effect of optimised breathing patterns, which are known to improve mental health. 

The findings of this research will support the development of accessible, scientifically proven breathing interventions for individuals facing cardiovascular and/or mental health issues, with an emphasis on equitable solutions for underserved populations, including Māori communities. This work will integrate ancient Māori knowledge with cutting-edge neuroscience, aiming to create global health education programs that promote interconnection and hauora.

Māori Postgraduate Scholarship

Regular exercise has been linked to better health and lowers the risk of heart disease and obesity (known risk factors for poor health). But we don’t know much about how fitness, body type, and heart health work together, especially in Māori people who have different body composition (more muscle) than non-Māori. 

This study looks at these connections in young, healthy Māori men and women. Your fitness level, mainly how well your body uses oxygen during exercise (called cardiorespiratory fitness or CRF), is a strong sign of heart health. CRF can be measured during exercise, but this isn’t often done during regular doctor visits. Body type—such as muscle and fat composition—also affects health. Māori and Pacific people tend to have more muscle and less fat than others, which could mean differences in heart size and function and may mean they are fitter at a given height and weight. 

For this study, 30 Māori students at Otago University (15 men and 15 women) will participate. They’ll undergo tests to measure their fitness, body type, and heart health. These tests include riding an exercise bike while their breathing, heart rate, and blood pressure are checked, as well as scans to look at muscle, fat, and heart size. Simple tests, like grip strength and finger-prick blood samples, will also be done. 

The goal is to gain a deeper understanding of the unique health characteristics of Māori. This exploratory project has the potential to lead to more tailored healthcare approaches and improved future health outcomes for Māori communities.

Open Postgraduate Scholarship

My research project aims to bridge a critical gap in current knowledge regarding sex differences in heart function. 

Utilising isolated myocardial studies and histology of human right atrial trabeculae samples, I seek to understand variations in heart function between men and women. This will also be investigated in terms of muscle fibrosis. Through correlating the functional and structural data with patient clinical data, I aim to gain insights into cardiovascular risk factors, particularly in postmenopausal women. 

The findings of my study will highlight the need for more inclusive representation of female subjects in cardiac research, as well as emphasise the importance of recognising and addressing sex-based disparities in heart health. Eventually, my project will contribute to enhancing equity in health outcomes for women through laying the groundwork for future sex-specific cardiac research.

Māori Postgraduate Scholarship

Cardiovascular and associated metabolic conditions are major preventable causes of health expectancy gaps, particularly for Māori and Pacific people. Combined population-level and individualised interventions can halve cardiovascular-metabolic risk. 

We have already developed and implemented cardiovascular risk prediction algorithms, enabling New Zealand clinicians and policymakers to target at-risk patients and populations. Up-to-date cardiovascular-metabolic risk information for every adult New Zealander is not yet accessible. However, in collaboration with the VAREANZ group, we aim to contribute to the development of a sub-register for cardiovascular-metabolic conditions and to identify areas where significant equity gaps exist in cardiovascular disease. 

One area of interest for the VAREANZ group is assessing the efficacy of bariatric surgery on cardiovascular disease risk remission over the longer-term period (minimum of 10 years post-surgery). 

This study aims to assess the cardiovascular disease (CVD) risk status of all New Zealanders who have undergone bariatric surgery in Aotearoa and to map the changes in CVD, polypharmacy, and CVD risk over a minimum of 5 years. We will also aim to compare these outcomes by ethnicity to determine whether Māori have equitable outcomes after bariatric surgery.

Open Postgraduate Scholarship 

The purpose of this research is to examine the differences in female heart rhythm detection, diagnosis, treatment, and management.

Heart disease is the leading cause of death in women. Atrial fibrillation (AF) is a common heart rhythm that can lead to serious conditions, such as stroke and heart failure. Women generally have more strokes, a worse quality of life, a lower rate of referral for treatment and higher rates for older women. Despite this, our understanding of the sex differences of AF is limited. A primary reason for the lack of understanding is the lower number of women in clinical trials, with an average percentage of 26.8%.

The initial aim is to assess Holter monitor recordings to identify any differences in abnormal heart rhythms. The second aim is to examine a registry of patients who have been treated for AF to see if there are any sex differences in the outcomes of AF therapy. The third aim is to understand patients' experience of AF through a questionnaire to gain insights into women's and men's journey with AF, from symptoms to treatment. Data will be analysed to determine the sex differences for all aims to provide crucial information on why women present with AF later in life and are often more symptomatic.

Pacific Postgraduate Scholarship

Excitingly, we have discovered novel phosphorylation of RyR2 via casein-kinase 2 (CK2), which stabilises healthy cluster organisation and prevents arrhythmia. Unfortunately, in disease, this mode of RyR2 phosphorylation is lost, suggesting that CK2 phosphorylation is cardioprotective. 

The current study uses mice to investigate the efficacy of preserving CK2 phosphorylation and how this contributes to RyR2 cluster organisation following an MI. RyR2 cluster organisation in transgenic mice with permanent CK2 phosphorylation of RyR2 (phosphomimetic mutation) will be compared to wildtype littermates pre- and post-MI. 

Māori and Pacific Populations have the highest prevalence of cardiovascular disease (CVD) in Aotearoa, highlighting the importance of cardiovascular research today. The most lethal form of CVD is myocardial infarction (MI-heart attack) and surviving patients although lucky, suffer as cardiac remodelling post-MI induces further complications, most frequently characterised by arrhythmia. 

Arrhythmias are irregular heartbeats that can occur because of ryanodine receptor (RyR2) dysfunction. In a healthy heart, RyR2 forms clusters on the sarcoplasmic reticulum (SR) that control calcium (Ca2+) release (a crucial ion for cardiac contraction). RyR2 also undergoes numerous post-translational modifications (PTMs) and is regulated by accessory proteins. The most studied form of RyR2 modification is phosphorylation, which generally increases RyR2 function. In disease, however, RyR2 phosphorylation becomes exaggerated (hyper-phosphorylated), causing cluster re-arrangement and uncontrolled Ca2+ release, which are both arrhythmogenic events. 

Preliminary data suggest that CK2 phosphorylation is cardioprotective, and findings from this study may support CK2 as a future anti-arrhythmogenic drug target 

Pacific Postgraduate Scholarship

This project focuses on how our novel pacemaker, which restores the respiratory sinus arrhythmia (RSA), affects the structure of muscle cells in the failing heart. This RSA pacemaker doubles the pumping capacity of the heart relative to current optimal medical therapy. Recent data from our group shows that RSA pacing works by modulating proteins linked to energy metabolism in the heart. However, we do not know where these proteins are located within the muscle cells of the heart. 

In a recently completed Summer Research Studentship, I identified that a key cellular structure improved by RSA pacing was the mitochondria, intracellular organelles that are the powerhouses of cells. I hypothesise that RSA pacing is reparative to mitochondria. 

In this research project, I will use a novel kind of fluorescence imaging called Stimulated Emission Depletion (STED) microscopy that provides a tenfold increase in resolution compared to other microscopes (e.g. confocal) to map the location of identified protein targets, providing nanoscale details on how the structure of the mitochondria is recovered by RSA pacing. These data will provide the first mechanistic insight into how the RSA pacemaker works.

Pacific Postgraduate Scholarship

Since Māori and Pacific populations are at a higher risk for Cardiovascular disease (CVD), this research aims to develop CVD predictive datasets for these groups through pulse wave velocity (PWV) analysis and to investigate the accuracy of bioelectrical impedance analysis (BIA) technology for measuring PWV, thereby improving CVD risk detection.

Arterial stiffness is defined as the gradual loss of elastin fibres within the arterial wall, resulting in the accumulation of stiffer collagen fibres. It refers to the reduced capability of physiological expansion and contraction of arteries in response to changes in blood pressure (BP). Arterial stiffness is measured as carotid-femoral pulse wave velocity (cf-PWV) and is well established as an additional, independent predictor of cardiovascular disease (CVD) events, particularly in individuals with diabetes, obesity, or a history of stroke.

There is limited information about the normal reference values of PWV in the New Zealand population, as the current normative PWV utilised is based on overseas datasets. Bioelectrical impedance analysis (BIA) is a technique for estimating body composition by sending an electric current through the body, and measuring the voltage to calculate the impedance (resistance and reactance). This method can be used to measure pulse wave velocity, which does not require a skilled operator to measure or locate the femoral artery.

Māori/Pacific Postgraduate Scholarship

Cardiovascular and associated metabolic conditions are major preventable causes of health expectancy gaps, particularly for Māori and Pacific people. Combined population-level and individualised interventions can halve cardiovascular-metabolic risk.

We have already developed and implemented cardiovascular risk prediction algorithms, enabling New Zealand clinicians and policymakers to target at-risk patients and populations. Up-to-date cardiovascular-metabolic risk information for every adult New Zealander is not yet accessible. However, in collaboration with the VAREANZ group, we aim to contribute to the development of a sub-register for cardiovascular-metabolic conditions and to identify areas where significant equity gaps exist in cardiovascular disease.

One area of interest for the VAREANZ group is assessing the efficacy of bariatric surgery on cardiovascular disease risk remission over the longer term (minimum of 10 years post-surgery). This study aims to assess the cardiovascular disease (CVD) risk status of all New Zealanders who have undergone bariatric surgery in Aotearoa and to map the changes in CVD, polypharmacy, and CVD risk over a minimum of 5 years. We will also aim to compare these outcomes by ethnicity to determine whether Māori have equitable outcomes after bariatric surgery.