The HCOCT Successful 2019 Research Applications.

The HCOCT Successful 2019 Research Applications.

Novel non-invasive neuromodulation for chronic low back pain.

Dr Divya Adhia

Low back pain (LBP) is the topmost disabling health condition in New Zealand and worldwide. Brain imaging studies demonstrate abnormal electrical activities in specific brain areas associated with sensory and emotional aspects of the pain experience. Normalising electrical activities of the specified brain areas may facilitate better pain modulation. The proposed investigation will evaluate the feasibility, and clinical safety of a novel, non-invasive, brain stimulation technique, specifically targeting multiple areas of the brain simultaneously in people with chronic (> 3 months) LBP. The outcomes of this work will help to design a large randomised controlled clinical trial, to test the short and long-term clinical benefits of the novel brain stimulation intervention when compared to usual care.

Developing and testing a novel values-guided intervention for improving self-management adherence among adolescents and young adults with Type 1 diabetes

Dr Sara Boucher

   Dr Sara Boucher  

Healthy glucose levels are necessary for preventing short- and long-term Type 1 diabetes complications, but young people often struggle to achieve and maintain healthy glucose levels. Identifying what's important to a patient (their values) and providing education to overcome diabetes-specific barriers to what they value might help patients to increase the amount of time their glucose leaves are in an ideal range. The aim of the research is to develop and test a values-guided diabetes self-management intervention for adolescents and young adults with type 1 diabetes (T1D). The single-arm pilot study (n=20) will quantify the impact of a brief (single 30 to 60 minute session) intervention on short-term glycemic control among patients ages 18-25 years with a T1D diagnosis and under the care of Southern District Health Board diabetes services.

IBD

drpaulourbano2

Inflammatory bowel disease (IBD) is a chronic condition affecting ~30,000 New Zealanders. Common symptoms of chronic intestinal inflammation are: frequent recurring diarrhoea, bleeding from the anus, and unexplained weight loss. The clinical aspects of IBD are well known. We also know that if we take an intestinal biopsy from a patient with IBD and analyse it under the microscope, the intestinal barrier, so-called epithelium, is more ‘leaky’ than non-IBD barriers. A leaking gut will lead to chronic inflammation as immune cells will react due to massive exposure to gut bacteria. But what is happening in the cellular level that contributes to the intestinal leakage in the first place? We believe that studying the multiple components of the disease: intestinal epithelium, genetic predisposition, and the local immune response; and how they interact, is likely to lead to a better understanding of the disease. However, we cannot observe this complex interaction inside of a living human being, so how are we going to study the intestines of patients to understand the disease better? We know that in the gut of every human being there are cells, namely ‘stem cells’, that can repopulate the entire human intestine. Stem cells can “transform” into any cell of the gut, forming the intestine as we know it. Therefore, our study will isolate these stem cells from intestinal biopsies from non-IBD and IBD patients. In our laboratory dish, the stem cells will grow in fully mature “mini-guts”, providing the ability to study the patient's intestines safely outside of their body. Next, we will test the effect of one of the primary biological therapies for IBD, the so-called anti- TNF treatment. Anti-TNFs block the inflammatory protein, tumour necrosis factor (TNF), involved in inflammation in the gut. We will also analyse the local immune system of individual patients in the context of their own “mini-gut”. Together, these data will provide information on 1) how the immune system is activated in IBD patients, 2) how the immune system can be modulated, and 3) how the immune system can differ between patients, leading to improved treatments and better diagnostic.