Study reveals unique genetic insight into how New Zealand children could age

05 August 2019

Originally posted to Growing Up In NZ website here

Telomere Cartoon (002)

The country’s largest longitudinal study has found that girls, Pacific children and children born to older mothers have a unique genetic advantage that could potentially help them live longer. 

The discovery was made during analysis of DNA samples from children in the Growing Up in New Zealand study, which has been tracking more than 6,000 children since birth.  

The University of Auckland study examined the DNA of more than 4,000 children to record the length of telomeres, an essential part of all human chromosomes.   

Telomeres are like the plastic tips on the end of shoelaces – they protect each strand of DNA from damage. Telomeres shorten as we age and can affect the development of age-related disease.   

Growing Up in New Zealand molecular biologist and senior research fellow, Dr Caroline Walker, says the study is the first to examine telomere length in New Zealand children.  

“This is an important study because it’s the first time we’ve gathered information in children of this age which gives us vital genetic clues about how the next generation of New Zealanders might age,” Dr Walker says. 

The study used a special technique to measure the length of telomeres and discovered:  

  • Girls had significantly longer telomeres than boys. 
  • Pacific children had the longest telomeres, followed by Asian children, Māori children and then European children.  
  • Children born to older mothers had longer telomeres.  

The study is the first to show differences in telomere length between ethnic groups in New Zealand children.  

Dr Walker says the study found that Pacific and Māori children had longer telomeres - a sign of potential longevity, but in reality these two groups have a lower life expectancy on average compared with European New Zealanders.  

“More research is needed to understand how telomere length interacts with other genetic and environmental factors to affect the health and wellbeing of Māori and Pacific peoples,” Dr Walker says.  “We certainly know that stressful or adverse environments can impact the length of telomeres in later life.” 

“The beauty of a longitudinal study like Growing Up in New Zealand is that it means we can potentially track how the length of telomeres change over time to understand the influence of certain environmental factors, such as stress, diet and exercise,” Dr Walker says. 

The research on telomeres was published in the journal Scientific Reports.  You can read the full paper here.

Julia Slark: All care, now responsibility

02 July 2019

If there was a medical instrument to measure passion for the nursing profession, Dr Julia Slark would be off the chart.

Care and collaboration: Dr Julia Slark aims to build on the good reputation of New Zealand nurses.

The new Head of the School of Nursing takes up the role on 15 July, following the resignation of Professor Sandy McCarthy, who was in the job for two years.

Julia has been here for six and a half years, moving to New Zealand from London and taking a Professional Teaching Fellow role for six months. She then became a senior lecturer and academic director of the Bachelor of Nursing Programme about a year later. Four years on, she was Deputy Head and now she will lead the school.

She can’t mask her happiness to have won the role and is also delighted to be living in Auckland.

“It’s magnificent. The coat that I used to wear in England for six months a year, I wear for about a fortnight in Auckland. I love it here.”

She will be taking a week’s break before hitting the ground running, to build on the School’s momentum developed in recent years. In the latest Quacquarelli Symonds (QS) Rankings, the School of Nursing jumped from 41 to 36.

“The way that QS ranking works is they look at the size of the school as well as the research and impact outputs,” says Julia. “We’ve got some amazing researchers, and did really well in the PBRF too. We’re on fire. I’m very proud.”

The School of Nursing is well-known for its postgraduate offerings – it’s the biggest in New Zealand with around 3,000 students undertaking post-graduate study each year. Its undergraduate intake is 100 a year, including five internationals, selected from around 1,400 applicants.

In recent weeks the School has been audited by the Nursing Council for the bachelors and masters of nursing degrees. It’s an important part of adopting a high-quality level of training rather than a bums-on-seats approach.

“Having the Nursing Council here was such an opportunity for the school to shine … to talk about the amazing teaching and learning that goes on here. It’s all about how we prepare future nurses for clinical practice to be a registered nurse. It was just brilliant.”

Julia’s own nursing expertise is in stroke prevention and she was a stroke nurse consultant at London’s Imperial College NHS Trust. A key focus of that was creating awareness of the risk of secondary stroke, a critical factor in risk management. “As a nurse consultant, you see patients at follow-up clinics who’ve had one stroke already and they’ll say things like ‘oh well, I’ve finished all my tablets now’. And I’ll be like, what do you mean? And they’ll say ‘I had a prescription for some aspirin and I’ve finished that’.

She says that kind of thinking led to her PhD study of 600 young stroke survivors who were asked whether they thought they were still at risk.

“The fact that you’ve had a stroke puts you at risk of having another and they all thought they weren’t at risk at all.”

She then did a study of a 1,000 members of the general public, assessing their blood pressure, which is the biggest modifiable risk factor for stroke. “People with a diagnosis of high blood pressure, and taking medications, actually had absolutely no idea what a normal blood pressure should be. They’re walking around with blood pressure of 170 over 100 and had no idea that that’s not normal.”

While there may be a lack of awareness about normal blood pressure, awareness about the signs of a stroke has definitely improved.

“The FAST advertising campaign has had a huge impact on presentations to ED with stroke signs and symptoms. It really does work.”

FAST stands for Face, Arm, Speech and Time – sudden changes such as a drooping face, loss of arm strength, slurred speech, and losing no time in calling an ambulance.

Julia has run the postgraduate stroke course for the past six years and wants to keep it running, but will have to find someone to pick up the mantle. “We’ve created another seven clinical nurse specialists in stroke for New Zealand. So I’m really passionate about continuing that course.”

One of her other wishes is to increase our international significance and attract more students here to do their masters and doctorates.

“The School of Nursing is number 36 in the world already. But we have real potential to grow ... New Zealand nurses have such a good global reputation.”

From the moment she arrived at the University she also recognised the importance of collaboration.

“I got in touch with Professor Alan Barber, a neurologist and stroke specialist, and Professor Cathy Stinear, director of the Brain Research Centre, and told them about my experience as a stroke consultant. We’ve got Dr Joanna Black who’s an optometrist, Dr Clare McCann is a speech language therapist and together we can do more research, and hopefully get more HRC grants. I love that way of collaborating.

“There are opportunities for us to do more joint research projects within the faculty too. We’re moving more towards working with our clinical partners on research projects … I think that really is the future.”

She says as far as Māori and Pacific nursing students go, the department works closely with MAPAS (the Māori and Pacific Admission Scheme) and is aiming to build on the 14 Māori third-year students it has this year.

“We have some amazing Māori and Pacific clinical nurse directors out there so it’s a matter of seeing where the gaps are.”

Her own career trajectory saw her come to postgraduate study after nursing for many years. She started her training at Charing Cross Hospital when she was 17. By the time she was 30 she was a clinical nurse specialist doing her masters, and ten years later got her doctorate.

“I was the first nurse to do a PhD at Imperial College London. The Imperial College NHS Trust was the first academic health science centre in Europe so there were lots of opportunities and I applied and got a grant.

“Imperial’s fourth in the world, but they don’t have a School of Nursing so I had to do it in the Department of Medicine. Talk about a duck out of water! They were all so posh,” she laughs.

She was part of a team that reconfigured stroke services, working in northwest London, and was named as a finalist in the Nursing Times Nurse of the Year awards for her work there.

She says it would be “so productive” if more funding was available to support nurses to do a clinically relevant full-time PhD, as it was for her.

“I did four days a week PhD and a day a week clinical … it was just perfect.”

One of Julia’s early tasks therefore will be a roadshow to DHBs to make sure the programme is delivering what they want, and fulfilling their needs for the future workforce. “That is my number one priority.”

Nationally, the future for nursing has some challenges.

“We know the people who have undertaken postgraduate study are more likely to stay in the profession. But we have to make sure they get the pastoral and financial support to continue their education into their postgraduate studies.

“Yes, nurses got a pay rise last year. But they need a safer working environment and to be better resourced. We’re actually starting to struggle to fill the places now because there just aren’t enough nurses in New Zealand.

“By around 2035 we’re going to be short of thousands of nurses.”

That doesn’t mean we’re short of people with the right personality to enter the profession.

“There are definitely people with huge amounts of empathy,” says Julia. “We have incredible people involved in palliative care, for example, including the Te Ārai end-of-life palliative care research group. We have amazingly committed researchers, teachers and health professionals working in the School of Nursing … they’re all so dedicated to the health and wellbeing of others.”

Julia’s own passion for nursing across the board means she’s primed for her next challenge.

“I feel very privileged to lead the dedicated staff in the School of Nursing. I’m just really excited about the future.”

Dr Jemaima Tiatia-Seath, University of Auckland


SUPPORTING THE MENTAL HEALTH OF PACIFIC CLIMATE CHANGE MIGRANTS

Dr Jemaima Tiatia-Seath (Photo: Dean Carruthers)

Media Release

26 June 2016

New Zealand could become a potential relocation destination for many Pacific peoples displaced from their homelands by rising sea levels and other climate-change related natural disasters.

Dr Jemaima Tiatia-Seath, co-head of the School of Māori Studies and Pacific Studies at the University of Auckland, has received a Pacific Project grant from the Health Research Council of New Zealand (HRC) to explore how New Zealand could ready its health system to best support the mental health needs of Pacific ‘climate change migrants’. Her study will involve research sites in New Zealand, Niue and the Cook Islands.

“Very few people in the Pacific region will be unaffected by climate change, particularly as half the population live within 1.5 kilometers of the ocean. Rapid rises in sea level, more severe cyclones and floods, and changes to seasonal weather are all occurring in the Pacific and are attributed to climate change,” says Dr Tiatia-Seath.

“Migration is an indirect impact of climate change. One estimate is that 75 million people from the Asia-Pacific region will be forced to migrate by 2050 because of it. Much of the health research done to date has largely focused on the physical health problems associated with climate change – the mental health impacts have only recently been recognised.”

Dr Tiatia-Seath says Pacific peoples forced to relocate will likely be at higher risk of negative mental health challenges due to the cultural loss and stress of climate-induced migration.

“An understanding of this issue in New Zealand’s mental health sector is vital. Mental health services will need to cater to Pacific climate change migrants in culturally-inclusive ways and recognise the new challenges that migration and forced relocation will bring to the already visible barriers to mental health access for Pacific peoples.”

HRC manager of Pacific research investment, Tolotea Lanumata, says this study is very timely as the New Zealand Government has made looking at the impacts of climate change a priority.

“Climate change is predicted to have a substantial negative effect on global mental health. This study gives New Zealand the chance to get on the front-foot and prepare our health system for the mental health challenges that climate change will likely have on Pacific communities,” says Ms Lanumata.

The HRC has awarded funding for four Pacific project grants worth a combined total of $2.37 million. These grants form part of the HRC’s $81 million investment in new research projects and programmes announced today by Minister Megan Woods.

Pacific Project grants support research that contributes to better health outcomes for Pacific peoples, families and communities. For a full list of the recipients, see below. To view lay summaries of these projects, go to www.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Researcher initiated proposals’, ‘Projects’, ‘2019’.

2019 Pacific Project grants – full list

Dr Allamanda Faatoese, University of Otago
Environmental effects on cardiometabolic biomarkers in Pacific peoples
36 months, $594,804

Professor Steven Ratuva, University of Canterbury
Enrichment of community health through targeted social protection strategies
36 months, $588,534

Dr Gerhard Sundborn, The University of Auckland
Understanding scabies prevalence to improve the health of Pasifika/Māori kids
36 months, $594,346

Dr Jemaima Tiatia-Seath, The University of Auckland
Climate change and mental wellbeing: The impacts on Pacific peoples
36 months, $589,691

Busting fat myths: How new research will revolutionise Māori and Pacific health

Māori and Pacific people have long been told that the state of their health is their fault. Now, genetics is giving scientists new tools to both improve health and fight discrimination. And the results could help us all.

At Auckland Girls’ Grammar School today, you’ll find more sugar in the science room than the tuck shop. The 30 girls who trooped into the ornate old study hall at 8.30am walked out again a couple of hours later with a piece of information that could change their lives: how well they absorb sugar.

They’re part of a research programme being run by scientists who say genetics plays a much bigger role in metabolic diseases than it’s given credit for, and sufferers are being unfairly stigmatised when people blame their condition solely on diet and lifestyle. This year, Auckland Girls’ Grammar is one of about 50 schools whose Year 9 or 10 students will discover how they respond to fructose in their diet – it’s estimated between 20 and 25% will be defined as fructose malabsorbers, which is linked to a lower body mass index (BMI) and may protect against diabetes.

a man wearing a suit and tie smiling at the cameraThe experiment, part of Tātai Oranga, a grassroots-research programme linking communities with scientists, is being run by the Maurice Wilkins Centre, one of the country’s Centres of Research Excellence. The nationwide group of researchers is investigating genetic and other factors that increase or reduce risk of diabetes and change the way patients respond to common treatments.

The Moko Foundation in Kaitaia, founded by GP and former New Zealander of the Year Dr Lance O’Sullivan, is a partner in the Sugar in Schools programme, and other studies that are providing new data linking genetic and other personalised patient-health information in a bid to revolutionise treatment options.

“The opportunity here is exciting,” says O’Sullivan. “We have limited resources as a country and targeting risk-reduction strategies universally gives us really mediocre outcomes, whereas if we have precise information about individual risk through genetic information, we can be really clear about people who need customised treatment.”

At least half his diabetic patients have a problem with side effects of metformin, the mainstay of treatment before insulin. “Māori patients tend to need high doses, which come with a lot of complications, including chronic diarrhoea. Often with these patients we don’t have a second chance. You give them something for their diabetes that’s horrible and has bad side effects and you never see them again, so we should be trying our best option first.”

Diabetes triggers

Knowledge about the triggers for diabetes and gout is expanding rapidly, outpacing what doctors learnt in medical school. “I compare what we are learning now about gout, for example, with what we knew then. We know now it’s a very genetically driven condition in Māori, yet for decades the advice from doctors was, ‘You’ve eaten too much kai moana and you drink too much, so you’ve got to change your lifestyle.’

“I saw a patient yesterday who said, ‘Yeah, it’s my fault, I’m eating and drinking too much.’ The reality is that’s probably not the case, but you’re genetically programmed to process uric acid differently and, regardless of what you eat, you are going to have problems with gout. We can manage it a bit differently. Patients get sick of being told off and treated like a naughty kid, so that’s why I’m excited about these initiatives.”

University of Auckland-based Maurice Wilkins Centre (MWC) deputy director Professor Peter Shepherd hopes the research will break long-held stereotypes. “There’s no doubt exercise and a good diet are helpful, but there are people, including scientists, who will look at the data and say, ‘Well, that’s all very interesting, but we know people can still control their food intake and should be able to’, because for them it’s not a problem. It’s the skinny-white-men-in-bicycle-shorts syndrome – they would never get fat in their life if they tried. You can’t just choose the facts you like if you want to solve the problem.”

Up to 20% of Māori and Pacific people are thought to have a genetic variant that may make them process metformin differently, and another, which occurs in about 15% of men, that increases the risk of high blood pressure. “Anecdotally, there is evidence Māori and Pacific people do worse on metformin, but no one has done the studies in New Zealand because the medical system just says, ‘Here’s a pill, everyone take it.’ Doctors figure we’ll give it to everyone and it’ll work in 80% and that’s good enough. The problem is, a lot of Western medicines were trialled on Western people and we don’t know if they are going to work the same way in Māori and Pacific people.”

Bigger not fatter

Another variant, known as CREBRF, which is found in about 30% of Māori and Pacific people but not in Europeans, is associated with higher BMI – usually a measure of obesity and associated ill-health. However, the variant is remarkably protective against diabetes, and recent unpublished research from the MWC indicates that the higher BMI is the result of more muscle, not fat.

“It’s not making people fatter; it’s making them bigger,” says Shepherd. He also points out that BMI varies widely in different ethnic groups, showing again the effect of genetics. People of Asian origin, for example, have very high rates of type 2 diabetes at much lower BMI. The research may have wider implications – another recently identified gene variant that was more common in Māori and Pacific people, but also moderately common in East Asian people, has been found to be associated with increased risk of hypertension. Shepherd believes this will reveal a mechanism that’s never been identified before to regulate blood pressure. It raises the hope of not only early intervention with current drugs, but also a new group of medicines being developed to treat it.

“We have been stigmatising whole parts of the population by BMI,” says MWC and University of Otago researcher Tony Merriman, who has sequenced the genome of dozens of Māori and Pacific people to find genetic information unique to those populations.

“A lot of academic colleagues have this perception that Māori and Pacific people are not comfortable about having their genomes sequenced, but that’s just rot, really. When you get out to the communities, they say, ‘We want you to do this research. But we want you to do it in a way that we have governance and we trust each other.’”

From Auckland north, the Sugar in Schools work is being run by health-science graduate Conor Watene-O’Sullivan, Lance O’Sullivan’s son, out of Waharoa ki te Toi in Kaitaia, a research centre set up in another Moko Foundation-MWC partnership. South of Auckland it is headed by Waikato-based teacher-scientist Crystal Gerring.

Waharoa ki te Toi runs the school-based work, but is also recruiting for a Health Research Council-funded study on genetics and outcomes in diabetes. About 250 Māori and Pacific men and women have so far joined the study, which aims to recruit 1000 participants from Kaitaia, Auckland, Gisborne and Wellington. Participants are phenotyped locally and have their DNA sequenced in Auckland and Otago. “One of the key aspirations is to build a lasting organisation in the Kaitaia community run by people from there to play a deep, meaningful role in the research, rather than having it all done in an ivory tower in Auckland behind closed doors,” says Shepherd.

Bringing jobs back

At Te Puia Springs Hospital on the East Coast, the work is being done from Te Rangawairua o Paratene Ngata, named after Māori health advocate Dr Paratene Ngata. It’s a joint research centre run by the MWC and Ngāti Porou. “It’s a real partnership and it’s bringing jobs back to these communities, which haven’t had a stake in the game,” says Shepherd. “We want this to work on multiple levels, so the mana and the prestige come back to these communities as well as health benefits.”

Anezka Hoskin, a post-graduate genetics student in Merriman’s lab at the University of Otago and Ngāti Porou herself, although she was born overseas, has been investigating genetic variants specific to Māori and Pacific people, but very rare in other populations, to find out if they might have a role in type 2 diabetes.

Otago has the DNA of about 3000 Māori and Pacific people, of whom about 500 are from Ngāti Porou. Hoskin is comparing the genetic information with the physical characteristics of the sample donors. “I’ve learnt an increase in BMI doesn’t necessarily mean an increase in disease burden in these populations, and that’s an assumption we currently hold in clinical healthcare. The correlation is not as strong as it may be in other populations.” Part of the problem is that the genetics of type 2 diabetes before now have all been based on European and Asian populations rather than indigenous minority groups.

“It’s really special being able to walk past the lab and know there is the DNA of 500 people sitting there that is our whakapapa; it is a huge honour. I feel such a responsibility and I want to make sure that it is protected and used in the right way, for research that will help our people, empower our people and increase our knowledge about our health and how our body works and encourage people to take ownership of their health.”

Hoskin chose a career in health and genetics after her sister was diagnosed with type 1 diabetes. She says she’s also faced stigmatisation on the basis of her BMI. “I’ve been at the doctor and my BMI has been calculated and they’ve wagged their finger at me and told me to lose weight and get to the gym. It’s infuriating – I know I have no health issues whatsoever.”

Shepherd says although DNA from 3000 people is stored, the genomes of only 170 have been fully sequenced so far in the Health Research Council-funded research. “From that, decisions are made as to where to focus – dealing with three billion bits of information per person is really hard, so we focus on places where there are gene variants, particularly differences that are statistically associated with risk of disease. In future, we will be looking routinely at only about 300 of the three billion points in the genome for the studies we need to do.”

Different pathways

Bringing the research findings from the laboratory into the doctor’s surgery is a key task for Auckland-based MWC scientist-clinician Dr Rinki Murphy, a diabetes expert who leads its genetic predisposition to obesity and diabetes programme. She’s heading a study investigating how patients respond to two medicines for type 2 diabetes, vildagliptin and pioglitazone, which act on different pathways. Vildagliptin promotes more insulin being released on eating, whereas pioglitazone increases insulin sensitivity in muscle and fat.

She says if doctors can understand which patients will respond better or worse to the medications, based on factors such as age, gender, obesity, lipid profile and ethnicity, they can prescribe more rationally. The study aims to recruit 300 patients by the end of the year, with study sites in Auckland, Kaitaia, Gisborne and Waikato. Anyone being treated with tablets for diabetes, but who is not on insulin, vildagliptin or pioglitazone, can contact the study if they’re interested in taking part, at T2Dmed@auckland.ac.nz.

The study will also look at whether people who develop diabetes despite carrying CREBRF, the normally protective variant, respond to one medicine better than the other. People who carry the variant have a 40% lower risk of developing type 2 diabetes. Women who have it seem to also be protected against gestational diabetes.

If the finding is confirmed, it means Māori and Pacific women may be able to be tested for the variant as part of their routine clinical care and those who have it may need fewer of the burdensome glucose-tolerance tests traditionally given to overweight Māori and Pacific women during pregnancy.

“Being judged by size and ethnicity can be really demotivating,” says Murphy. “We want to be more precise in our estimations of diabetes risk and treatment and to be more compassionate about where different people are at with regard to body weight and health. We’ve always recognised that people vary in their weight threshold before developing diabetes, but we didn’t have a genetic marker.”

The search for genetic pointers for better-targeted treatment is also spreading to general practice. In May, the innovation arm of Midlands Health Network, Pinnacle, which has about half a million patients on its books, launched a programme aimed at using patients’ genetic makeup to drive prescribing decisions. It plans to have about 5000 patients gene-tested in the next year, and although many of these will be self-funding, the network will pay for tests for some of its highest-risk patients. Information from the gene tests will be embedded in patients’ electronic records and linked to a tool that helps doctors decide which drugs are best for patients with certain genetic variants.

“This is Star Trek – not in my lifetime”

Pinnacle chief executive John Macaskill-Smith says that comes with education to better equip GPs who often didn’t learn too much about genetics at medical school. “When you bring it up, they get a bit pale and pasty. Half will go ‘This is Star Trek – not in my lifetime’, and the other half will generally look uncomfortable because they know it’s there and don’t know enough about how pharmacogenomics works.”

He says the primary healthcare organisation decided it needed to be proactive about patient health rather than running clinics like mini emergency departments that waited for sick people to turn up. “We said, ‘How can we keep people well and healthy?’, and one of the things that came up very clearly was personalised, precision medicine, and pharmacogenomics is a big part of that.”

Pinnacle is one of the country’s largest health providers for Māori, who make up more than a quarter of its patient population. “We can see where medical regimes are not working. In some cases, we are getting better results from community coaches and lifestyle interventions than we are from some traditional medicines, so that’s reinforcing some of the work that the Maurice Wilkins Centre is doing.”

He hopes Pinnacle can work with the researchers to help scientists get answers to their questions. “They are excited because no one else is at this scale and co-ordination in introducing pharmacogenomics in New Zealand.”

Says Shepherd: “We have huge numbers of people with diabetes, but we are using stone-age tools to treat it, and health authorities are just shutting their eyes and hoping it will go away, when we could do so much better.”

Inherited risk

For some people, it's a "bloody struggle".

Brendon Chetham has long suspected he’s inherited genes that increased his risk of diabetes. Diagnosed at 21 – nearly 30 years earlier than the average for Māori at the time – he is one of more than 600 people involved in genetic research at the Maurice Wilkins Centre that’s targeting about 500 genes suspected to be involved in the development of obesity. The genetic mutations have come out of international research, and can predispose to weight gain in several different ways, by increasing feelings of hunger, reducing energy expenditure or a tendency to gain more weight for the same amount of food.

The genetic profile of overweight people with diabetes such as Chetham, who tipped the scales at 253kg between 2005 and 2007, and now weighs 119kg, will be compared with those of middle-aged people who are neither obese nor diabetic. The research may find he’s inherited an increased risk of obesity, but Chetham thinks his weight is “100% in my control, even with the genes. It’s a bloody struggle, but it’s still up to you. You can’t expect doctors to give you a quick-fix pill.”

Unfortunately for Chetham, the researchers aren’t able to release individual results because of concerns that the genetic-risk information could be misunderstood and negatively affect participants’ health behaviour.

Chetham, who works at North Port as a facilities service officer, has lost 30kg in four years. He is not on diabetes medication, after his metformin caused liver damage.

He hopes to work with the Maurice Wilkins Centre to set up a community research base at the Patuharakeke iwi’s Takahiwai marae in Bream Bay for sugar-absorption testing. “This is a two-way street – open communication between science and medicine for our well-being. Knowledge is power and it’s giving people choices backed up by the science.”

Clinician-scientist Dr Rinki Murphy, one of the lead diabetes investigators in the original research, wants to followup Chetham and other participants and randomly assign them to receive lifestyle information with their genetic results, or lifestyle information alone, to see how they fare three months and a year later.

Different genes

How do Pacific populations differ?

A University of Otago anthropologist studying the DNA of Pacific people says more research is needed into the diversity of the genetic profiles of the region’s population.

“The view without much data is that all Polynesians will be the same [genetically],” Professor Lisa Matisoo-Smith says. “We are not seeing that. It helps us tease apart some of the evolutionary history, and the causes for the different mutations when populations adapt in different ways.”

European diseases, for example, had a greater impact in east Polynesia than in the west. “That might have been a selective force that shaped east Polynesian genomes, or [it could be] that there is a different source population for the two groups.”

Her research group wants to compare the Polynesian genome with that of other Pacific populations to try to understand the driving forces that shaped it. That understanding will help remove some of the blame-and-shame mentality that can accompany diagnoses of gout and diabetes. “We can say in our current environment it’s having a negative effect on your health, but perhaps it’s a genetic predisposition that allowed your ancestors to survive malaria or other infectious diseases.

“Modern people carry portions of genome of ancient hominins and Pacific populations carry some of the highest frequencies of these. As anthropologists, we look at that and ask if that’s contributing to the disease and genetic profiles we see in them and the relationship with disease in the Pacific – that’s a deep history a medical doctor wouldn’t consider.”

This article was first published in the June 29, 2019 issue of the New Zealand Listener.

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Successful Launch of Pacific Health Research Partnership in Porirua

Posted by Research Admin 1 on 15 April 2019 here

Media release, Pacific Health Plus, 11 April, 2019

120 people gather in the heart of Porirua to hear about how they
can be part of changing lives in Pacific communities
  

Last Friday, a group of over 120 people gathered on a cold, blustery Autumn night in a hall above a burnt out pub on Bedford Street in Cannons Creek, Porirua, to hear about a ground-breaking project to change health outcomes in one of the neediest Pacific communities in New Zealand.

 In a 'first', the renowned research centre, Maurice Wilkins Centre, hosted by the University of Auckland, will team up with the only Pacific owned & governed health service in the Wellington region, Pacific Health Plus - literally based on the street below in Cannons Creek - to battle very significant health problems faced by Pacific people.  

The project will look to the community to further ground-breaking research which has revealed that Pacific and Māori people have a gene which predisposes them to heart disease, diabetes and obesity and also to study youth to track impacts of sugar.

 Everyone in the room was buzzing to be part of something which will draw attention to Pacific needs with real tangible outcomes and ways to improve quality of life and life expectancy.

 Speaking to the excited and expectant group was an impressive line-up of VIPs:

  • John Fiso, chair of the Fiso Investment Group and Pacific Health Plus
  • Professor Peter Shepherd, Deputy Director of the Maurice Wilkins Centre
  • Hon Kris Faafoi, Member of Parliament for Mana
  • Mayor of Porirua, Mike Tana
  • Paul Eagle, Member of Parliament for Rongotai
  • Dr Rosemary Hall, Endocrine, Diabetes and Diabetes Research Centre, Capital & Coast District Health Board
  • Pastor Teremoana Tauira Maka, Pacific Health Plus Advisory Board, Pastor of the Victory Church
  • Reverend Perema Leasi

Also in attendance was the team from the Maurice Wilkins Centre; representatives from health and social service providers in Porirua; significant church leaders; members of the Cannons Creek community and Pacific Health Plus board members.

Pastor Teremoana, as the first speaker of the evening, explained how Pacific Health Plus, the medical centre in Cannons Creek (previously called Porirua Health Services) had been servicing the community for 10 years but acknowledged that the time had come to take the service to the next level, and that recent investment by the Fiso Investment Group will allow this.

Mike Tana, Mayor of Porirua said the evening was a ‘celebration of Porirua and Pacific Health Plus’ and thanked everyone for their ‘love of Porirua’ and how this next step with a new and meaningful research project was a positive one for the area with lives to be changed for the better. Mr Tana said that self-determination is the best way forward for communities and this project - ‘for Pacific by Pacific is an awesome example of this’.

Hon Kris Fafooi, MP for Mana, acknowledged John Fiso by saying how since the Fiso Group came in to help Pacific Health Plus he had seen ‘nothing but action’, and the speed with which the partnership with Maurice Wilkins was established shows commitment to a community. Minister Fafooi also thanked the Maurice Wilkins Centre for recognition that ‘for Pacific by Pacific’ was the most effective way forward.

John Fiso, chair of the Fiso Group and Pacific Health Plus, thanked the VIPs in attendance and those in the room who had shown goodwill and had helped.  

Mr Fiso acknowledged the importance of data as part of properly understanding problems and determining solutions and that self-determination was critical to the data being used successfully - “with research owned and delivered by the people who will benefit from the outcomes to ensure integrity of the data”.

“This is a milestone for Pacific Health Plus - a project which will bring real change,” said Mr Fiso. “However, we need more debate about solutions for Pacific people and we cannot look at health in isolation - we need to factor in housing, employment and education as part of the real solution.

“We will seek further partnerships as a way forward - but we recognise that building trust and confidence through successful delivery of our projects is key to this,” said Mr Fiso.

Professor Peter Shepherd, Deputy Director of the Maurice Wilkins Centre commented on what a privilege it is to work with Pacific Health Plus. He explained howProfessor Maurice Wilkins, who the Centre is named after, was a New Zealander who won the Nobel Prize for Medicine, and that for Professor Shepherd, the centre’s name signifies the potential for New Zealand to use scientific research to achieve better outcomes for its citizens. 

“It is time to break boundaries and work as one to change the health landscape for Pacific people in New Zealand,” said Professor Shepherd. “And we are not going to change the world from our ivory towers behind university walls - but by working in the community as partners.

“We have to move fast, we can’t waste time,” Professor Shepherd said. “We cannot assume that because medicine is tested on people in the US that it will work for our Māori and Pacific communities - we must look at how genetics influence this. We also need to harness links schools, communities and education to help achieve better outcomes.

“I am excited about the opportunity Pacific Health Plus provides for the community to be part of finding the answers and creating the solutions. The fact we are here tonight opening a cutting edge research centre above a burnt out pub that sits beside a red stickered building in this very needy area of Wellington is symbolic of what Pacific people face - and the Maurice Wilkins Centre wants to be part of changing that and helping the community reach the heights it deserves.”

Dr Rosemary Hall said that Pacific people, who have highest rate of diabetes in NZ, had been failed and their needs were not being met. “We need to better understand the reasons for different rates of diabetes within different groups and see the situation in context of the bigger picture. Having evidence, from research, and having Pacific lead this is critical,” Dr Hall said.

Further information on the Pacific Health Plus and Maurice Wilkins Centre research partnership is below in the Editor's notes.

The Maurice Wilkins Centre is a national Centre of Research Excellence that brings together over 400 of New Zealand’s top scientists and clinicians from all over the country.

Pacific Health Plus is a primary healthcare service in Cannons Creek, Porirua, and is the only Pacific owned and governed healthcare service for Pacific people in the Wellington region. It services over 2000 people in the Cannons Creek community.

New project targets woeful Pacific health stats in NZ

Originally posted by Radio New Zealand, 12:13 pm on 8 April 2019, here.

Scientists in New Zealand are hoping a new project to develop the use of cutting edge genetic research will improve woeful health problems in the country's Pacific people.

DNA sample being pipetted into petri dish with DNA gel in background

Photo: 123RF

Hospitalisation rates for Pacific people are about double that of the general population. Pasifika have twice the rate of diabetes and are eight times more likely to be admitted to hospital for rheumatic fever.

The Maurice Wilkins Centre is a grouping of 500 scientists and clinicians and it's teaming up with a Pacific health provider in Cannons Creek, north of Wellington - Pacific Health Plus - to take the research to the next level.

The centre's deputy director Peter Shepherd said it was a ground-breaking project in treating diseases like diabetes.

"It'll make faster progress, it'll result in the findings being implemented clinically much quicker and it'll have a lot of other benefits of empowering those communities to be part of their own future and decision making around their health," Professor Shepherd said.

"Most drugs have been tested on European people in America and this gives us the opportunity to really show what works for Maori and Pacific people."

The initiative, launched on Friday, gives researchers the chance to work directly with their communities, get their input and feedback about the research and future directions, he said.

"It's very important with our research that we do it with the communities involved and not just from our ivory towers in the university," Professor Shepherd said.

"The early indications are that genetic factors do contribute to the risk of getting diseases like diabetes and high blood pressure and what we want to do is to find how we can link that information to the right medicine or the right treatment, or the right dietary intervention so that we can give people just the right treatment for them based on their genetic profile."

Review: Gene Eating: The Science of Obesity and the Truth About Diets by Giles Yeo — it is hard to imagine a more likeable guide

To curb the fat crisis, we need to look at our genes and bin the faddy diet books

Review by Christina Patterson, Originally posted to The Times UK here

When Giles Yeo appeared on a television programme called What’s the Right Diet for You?, a literary agent got in touch to ask if he would write a diet book. Yeo is a geneticist. His research focuses on the influence of genetics in our relationship with food and on the science of obesity. He hates diet books. He believes they offer “quick and easy answers”, whereas science “is set up to get to the truth … eventually”. So he wrote this book instead.

Obesity, he says, “is perceived by most people on the planet as quite a simple problem”. This book, based on two decades of research in the field, aims to show it isn’t. Sure, we should nearly all eat less and move more, but the real question, he says, is “WHY some people eat more than others” and why some find it harder than others to lose weight. And why our culture offers so many instant answers and “lifestyle gurus”, peddling different versions of what Yeo politely calls “post-truth”.

Yeo starts his quest with some of the science relating to genetics and obesity. He explains, for example, that consuming just seven calories more than you need a day is enough to make you put on 15kg in 30 years. Which is, he says, why “you suddenly find it difficult to control your facial expression as you barely recognise anyone” at your school reunion. He tells us the surprising fact that “heritability of weight is actually close to that of height”. He talks about the Pima Indians in Arizona and the Pacific Islanders, who are now among the heaviest people on the planet.

They are obese, he explains, because their genes evolved over millennia to adapt to food scarcity in harsh or remote conditions, and while their living conditions have changed, their genes haven’t. They are an extreme example of the challenge we all face: that our “drive to consume food” to survive “has been shaped by many millions of years of evolution”. Being overweight in our current environment is, therefore, “the natural — highly evolved, even — response”.

Obese people, Yeo says, “are not morally bereft, lazy or bad”. They are “fighting their biology”, in a food environment that has changed beyond recognition in 30 years. He doesn’t claim, as some “fat activists” do, that being obese is something to be celebrated. He is absolutely clear that it brings huge health risks, such as heart disease, type 2 diabetes and cancer. But he is very careful not to pass judgment. When he uses words such as “wobble”, he is quick to assert that he is “not using any of these terms pejoratively”, and to talk about his own “wobbly belly” and cheeks like “squirrel pouches”. He has, it’s clear, a cool head and a warm heart.

He is a lot less warm towards the “old white dudes” who have built multimillion-dollar empires on food fads. One by one, he takes them on, these men who claim they have found the answer to everything. The paleo diet, the high-protein diet, the wheat-free diet, the plant-based diet, the pH miracle, the juice cleanse and the clean-eating phenomenon are dismantled before our eyes. They are, he shows, not just based on pseudo-science. Some can cause serious harm. Robert O Young, the author of the pH Miracle books, who has no medical qualifications, was jailed for “treating” cancer patients while Yeo was writing his book.

Gene Eating is one of the clearest attempts I have come across to explain complicated science. It is an entertaining read, full of lively anecdotes and self-deprecating humour. When Yeo makes a documentary about “clean eating”, to look at how the half-truths of the “old white dudes” are being echoed and amplified by young, beautiful “lifestyle gurus” and social-media influencers, he joins Instagram and starts posting pictures of his food. A small war breaks out when, one day, his breakfast photo includes a sausage. After #sausagegate, he loses more than 10% of his followers. Yes, it’s a tough old world.

It is hard to imagine a more likeable guide to it than Yeo, or a more level-headed one. But if he sometimes makes us laugh in this wise, sensible book, his message is deadly serious. “We have,” he says, “to find out the truth, tell the truth, and call out untruths whenever and wherever we can.”

Reason Magazine- July 2018

Originally published here.

Pacific carers: resourceful and facing unnecessary hurdles

Preliminary findings from the Tapinga ‘a Maama: Pacific life and death in advanced age study reveal that Pacific people are committed to caring for their older relatives in the home. However, they face several obstacles says Principal Investigator Dr Ofa Dewes. Her interviews with carers indicate that the physical and emotional demands on carers, financial burden, and the need for material supports affects their ability to care. “But faced with these challenges, families are developing resourceful coping strategies,” Ofa said, as well as “relyin on support from extended family and the church community.” The results also indicate that carers have mixed views on their ability to easily access formal support. Ofa interviewed 33 carers (Samoan, Tongan, Cook Island Māori, Niuean, Tuvaluan, Tokelauan, iKiribati and Māori). Seventy-nine percent were female and their average age was 48. She also interacted with 35 stakeholders. She discussed preliminary findings with policy makers, funders and health service providers. One outcome of the study is a resource in the form of five digital stories crafted in a weekend workshop by people who had provided care for a relative. The stories can be found on the ‘We Are the Pacific’ website Ofa created to connect the Pacific community with her Pacific health research. http://
wearethepacificocean.com/digital-stories.php. She will be presenting findings on the project at The Gerontological Society of America’s Annual Scientific Meeting in Boston this November. Tapinga ‘a Maama is funded by the Ministry for Business, Innovation and Employment’s National Science Challenge for Ageing Well. 

Grant to study genetics of metabolic disease

A new $5 million NZ Health Research Council grant will study the genetic risk factors of metabolic disease in Māori and Pacific people. Dr Ofa Dewes, a co-investigator on the project, said the reasons why Māori and Pacific people are at greater risk for type-2 diabetes and obesity compared to New Zealanders of European descent are not fully understood. Genetic differences play a role, and the team will look at the influence of specific gene variants on body mass and risk of type-2 diabetes. They will also explore how these gene variants might influence the response of people to drugs used to treat type-2 diabetes. Peter Shepherd, Professor in Molecular Medicine and Pathology, is the lead investigator.

Family members caring for elderly Pasifika at end of life not getting help - study

By: Barbara Dreaver, 1 News Pacific Correspondent

Originally posted here.

Family members looking after elderly Pasifika at the end of their lives aren’t getting the help they need.

Source: 1 NEWS / Aotearoa Science Agency


Most Pacific Islanders in New Zealand spend the end of their lives being cared for by family members who aren't getting all the help they're entitled to, a new study has revealed.The study which outlines the challenges facing those who give up their own lives to care for their loved ones.Reverend Suamalie Naisali, who cared for his dying wife, said: "She said to me, 'I would like to be at home. It is a better place where there is peace, where there is love'." It was the right decision but it wasn't easy, as family members gave up study and jobs to provide 24-7 care.While they had a lot of community support, Reverend Naisali says the Government needs to provide financial help for those who don't."If they give up their job they can't even support the children to go to school," he said.The study author, Dr Ofa Dewes, says the tasks caregivers perform at home caring for an older loved one are relentless.That's why the Ageing Well National Science Challenge has spearheaded the study of 33 Pasifika families who've been through it.It's hoped the research will help form government policy as it showed how most Pasifika prefer to spend their last days - at home with their family.A group of elders who meet every week as part of the Treasuring Older Adults programme know what they want, but are reluctant to put extra pressure on their families.The study shows most of those families don't know what help is available to them. One recommendation is that family members who are voluntary caregivers for dying loved ones could later fill gaps in the aged care workforce."They've learnt the skills and coping with all the different responsibilities that a caregiver provides at end of life. And this is a resource that is yet untapped," Dr Dewes said.Malia Hamani of Treasuring Older Adults says she believes government can include carers in the funding it allows for older persons and those at end of life.Some footage in the above video was kindly supplied to 1 NEWS by the Aotearoa Science Agency.

Meet the Kiwi DNA detective helping kids across the world

Jamie Morton

By: Jamie Morton, Science Reporter, NZ Herald

Originally posted to New Zealand Herald

World-renowned paediatric geneticist Professor Stephen Robertson has steadily been helping unravel obscure diseases, while giving fresh hope to countless children across the planet.

They include some we'll likely never hear about - let alone be able to say - like macrophagic myofasciitis, faciooculoacousticorenal syndrome and reflex sympathetic dystrophy.

Those ailments number among some 7000 rare genetic diseases that touch the lives of around seven per cent of our population.

A diagnosis with one could be a scary prospect for families, given the sheer lack of knowledge about them, let alone a lack of therapy or cure.

Roberston's run of breakthroughs stretch back to 2002, when he discovered a rare disorder which afflicted a Māori whānau from the Far North he'd met while working at Starship Children's Hospital.

Robertson, now based at the University of Otago, was moved by their tragic history, which involved four of the women losing seven baby sons between them.

The babies were deformed at birth and died soon after.

After years of hard toil, he eventually identified a gene responsible for the babies' deaths, enabling a diagnosis and potential genetic testing to answer some of the whānau's concerns heading into the future.

Professor Robertson, a world-renowned paediatric geneticist based at the University of Otago, has been helping unravel rare genetic disorders affecting countless families. Photo / SuppliedProfessor Robertson, a world-renowned paediatric geneticist based at the University of Otago, has been helping unravel rare genetic disorders affecting countless families. Photo / Supplied

But not only did he find a name and a diagnostic gene test for the disorder, his research helped turn a corner in the understanding of human development and led to insights into many diseases well beyond this single condition.

Waikato University launches Pacific Studies

Originally posted to Radio 531 PI Blog at: http://radio531pi.com/blog/waikato-university-launches-pacific-studies

By Ruci Farrell - ruci.farrell@pmn.co.nz

The University of Waikato has launched an ambitious Pacific Plan to raise the achievements and profile of its Pacific students, researchers and staff.

The Pacific Plan launch at the University of Waikato. Photo/ Aupito William Sio.

This year Waikato introduced a new major in Pacific and Indigenous Studies and is in the process of appointing an Assistant Vice Chancellor Pacific.

Leading Pacific psychologist Dr Byron Malaela Sotiata Seiuli says the Pacific Plan provides a brand Pacific students and academic staff will warm to.

Dr Seiuli is part of the university's Faculty of Arts and Social Sciences and says Waikato is well-placed to raise the academic outcomes for Pacific students and staff.

He says part of the Pacific Plan is about providing a Pacific identity within the University of Waikato for Pacific students.

"It's about increasing the recruitment and the retention of Pacific students so they can access courses that are of high standards given that Waikato is in the top one percent of universities worldwide," he says.

Part of the seven point plan will see Waikato piloting a programme in partnership with two other tertiary institutions and the Tertiary Education Commission.

The Pacific Plan launch at the University of Waikato. Photo/ Aupito William Sio.

College's Pacific Chapter hosts inaugural Pacific Health Day

Originally posted to ePulse, The Royal New Zealand College of General Practitioners, 29 May 2018


Left: Pacific Chapter Chair Dr Api Talemaitoga | Centre: Dr Faoa Gatoloai, College CE Helen Morgan-Banda, Dr Alisi Keppler | Right: Anahila Kanongata'a-Suisuiki - photo credit: We Are The Pacific Ocean

The College's Pacific Chapter hosted a successful one-day learning event in Auckland last week, examining Pacific peoples’ health now, and into the future. 

More than 60 delegates attended and discussed topics such as recruiting a Pacific primary care workforce, assisting Pacific families beyond the 15 minute GP consultation, and Pacific health literacy. Attendees included the Associate Minister of Health Hon Jenny Salesa, who presented on How Pacific GPs can assist the Government in advocating for the communities they serve. 

Attendees also heard from GPEP registrars Dr Faoa Gatoloai and Dr Alisi Keppler, who shared stories of their own journeys into general practice. National MP Hon Alfred Ngaro gave an opening address on the role of Pacific GPs in Aotearoa's health system, while Labour MP Anahila Kanongata'a-Suisuiki shared her thoughts on Pacific health through the eyes of a new MP. 

https://rnzcgp.informz.net/informzdataservice/onlineversion/ind/bWFpbGluZ2luc3RhbmNlaWQ9MTkxMTM2MSZzdWJzY3JpYmVyaWQ9NTE0MTI2ODU2 

Love for the elderly

Siteri Sauvakacolo, The Fiji Times 

WE have heard of so many success stories from various individuals. The struggles they went through from their childhood days and the struggles their parents — the sole breadwinners in the family — went through just because they wanted their children to succeed in life.

At times, when people grow older and become successful in life, they find it challenging to look after their elderly parents, most eventually leaving them under the care of old age or retirement homes.

This is the sad reality the world over and Fiji is no exception.

This may not be the case for many families but it is for some.

The reasons, however, may vary. In spite of the neglect, residents of old age homes often receive special visits from the community.

Last week, members of the Fiji Police Band brought smiles to the faces of more than 40 residents of the Golden Age Home in Natabua, Lautoka as they provided entertainment which was part of the Fiji Police Force 2017 community policing outreach.

Fiji police chief operations officer ACP Rusiate Tudravu was also present at the event and shed tears upon witnessing the entertainment from the band and the enjoyment it brought to residents of the home.

He said such events reminded members of the public about the importance of appreciating our parents and elderly in the community.

"When we see the residents of these homes, they remind us of our parents and we think of how sad it is to abandon our parents like this," ACP Tudravu said.

"And when we compare them with those in our own homes, our own parents and we are looking comfortably after them, it is very emotional thinking of such things.

"We, as children, have honourable duties to look after our parents.

"The different situations they face and even the status they are in as they grow old, they are still our parents and we should always treat them right and look after them."

ACP Tudravu said personally, it would be a sin if he did not look after his parents.

He shared that there was no point for children to leave their parents in retirement homes as they had an important responsibility to look after them.

"Our parents have done enough to get us where we are today and for us to be successful," he shared.

"It is very important to look after our parents. They have done enough upbringing, we should look after them and stay with them as they are the reasons we are here today."

Last year, Health Minister Rosy Akbar, who was previously Minister for Women, Children and Poverty Alleviation believed it was every family's responsibility to look after their elderly citizens.

While opening the National Council for Older Persons Institutional Forum in Suva, Ms Akbar had said she was not in favour of building new homes for elderly citizens, saying that as a society with cultural values "we should be able to look after our elderly citizens".

She had urged NGOs, community-based organisations and families to work together to address the neglect and rejection of elderly citizens by their families.

She had said Fiji's Constitution providesd equal rights and opportunities to everyone including senior citizens and that matters concerning the welfare of senior citizens were treated with urgency.

She said every religion taught its followers to honour, respect and take care of their parents, and that they belonged with their families.

Most Pacific Island societies and its peoples are taught to value, respect and care for their elderly.

It's one of the things that are instilled in children at an early age.

The decision to place a parent or an elderly in a nursing home is sometimes not the easiest of things to do and there are many factors that contribute to this decision. At the end of day, the care and love for our elderly stems from the values an individual holds near and dear to their hearts.

http://www.fijitimes.com/story.aspx?id=429252

Dr Faga Titifanua Panapasa

BY: Siteri Sauvakacolo

A young Rotuman boy who left his Noatau home in Rotuma 82 years ago in search of better education opportunities celebrated his life's most significant achievement over the weekend — his 90th birthday.

Hundreds of relatives and family members from Hawaii, New Zealand, Australia and other parts of the country gathered to celebrate the life of retired medical doctor, Dr Faga Titifanua Panapasa, a man described by many of his relatives to be loving, kind and caring.

Emotions overflowed, family bonds rekindled and many family members got the opportunity to meet and acknowledged the achievements they have set so far at the event, which was held at Nadi's Tanoa International Hotel last Sunday.

In 1927, Jotama and Kiji Panapasa of Noatau welcomed a healthy young boy into their family, who was the fifth of seven siblings.

Faga was educated at Rotuma's Malhaha Primary School during his early primary school years before moving over to Suva to enrol in Class Three. Because he had very little knowledge of English at the time, he was put back to Class One. He then completed Class 1-7 at the then Suva Toorak Boys School.

At the celebrations, his son, Fatiaki Panapasa, a manager quality assurance with Air Terminal Services shared a piece of history about his father and his journey to success.

"World War II and its threat to Fiji in 1942 was real so preparations for war required urban schools to be evacuated and relocated to facilitate the accommodation of soldiers and support services," Mr Panapasa shared.

"Toorak Boys closed and its missionary teacher and principal, a Mr William Earnest Donnelly, then asked for volunteers from the senior classes who wished to continue their schooling, to accompany him in a shift to Davuilevu.

"Fifty students moved and met up with the principal on March 3, 1943 at the new site and the two master bedrooms in the Davuilevu Technical School principal's residence became their classrooms."

There were only two classes and two teachers — Dr Faga was one of those students and the teachers were Mr Donnelly and Semesa Sikivou.

The Methodist Church conference of 1943 gave Mr Donnelly the permission to expand the school and together with the students built three large bure. Following a directive that was also given during the conference, this new complex was named Lelean Memorial School, the largest Methodist school in the country.

Dr Faga was one of the pioneering students of Lelean where he then made his way up to successfully pass his Senior Cambridge exams at Form Four.

While he was schooling at Davuilevu, another prominent person was teaching at the Davuilevu Teachers College, his uncle who famously became known as Rotuma's first senator Wilson Inia.

Dr Faga then went on to successfully attain his medical qualification as a doctor where he was awarded the gold medal for surgery at his graduation.

The retired doctor, who has nine children, has been posted to various parts of the country during his tenure with the Health Ministry and he remained at the PJ Twomey Hospital until his retirement in 1987.

He was also given many awards during his career as a doctor, an achievement in itself that gave his children and family members the drive to do better and achieve the best in life. Upon his request, he was reposted to Ahau Medical Centre on Rotuma for 20 more years before his 80th birthday celebration 10 years ago.

On February 12, 1959, Dr Faga appeared on the front page of The Fiji Times with three winning entries in a poster competition organised by the National Association for the Prevention of Tuberculosis. He was one of the judges for the competition and his participation was a reflection of a man who continued to dedicate his life to the community.

A niece of Dr Faga, Ofa Dewes, came all the way from New Zealand to be part of this significant celebration. She remembers her childhood days at her Nabua home in Suva where Uncle Faga was always their family doctor.

"We have fond memories of families sharing food together, meeting each other during those happy times and attending to birthdays and weddings together," Mrs Dewes said.

"When I was a child, I had fallen off a terrace at home and so they took me to CWM Hospital and the first person to visit me was Uncle Faga so it was always memories of him always being there for us when we were unwell and that caring side of him which I see in the family.

"He was a very important connection for us and this is why I came especially for this occasion."

Another family member and retired teacher, Susana Tevita, said Dr Faga was someone who always had time to meet with family members even through his busy schedule.

"He never had excuses despite being a doctor. He is so caring and he always reaches out to people and makes time for them.

"He is a life-mentor to all of us who are related to him and we have a close relationship (with him). His parents were lay preachers on Rotuma and he grew up in a family centred on Christ," Mrs Tevita said.

If there was any advice Dr Faga would like to offer to those pursuing a career in medicine, it would be to "know your body!"

Fiji Times

http://www.fijitimes.com/story.aspx?id=417600

Curious Minds Profile

Ofa Dewes

Ofa (Fiji-born Rotuman/Tongan/Tuvaluan, Ngāti Porou affiliate) is a Pacific health researcher at the Maurice Wilkins Centre for Molecular Biodiscovery and at Auckland University's School of Nursing.

Ofa - portraitWhat do you do on an average work day?

My average office day begins very early with a coffee and quick catch up on “news” and a laugh with colleagues over something funny I’d read, such as in The Giant of the Senate by Senator Al Franken.

My diary lists a variety of daily activities which I check along with my mailbox for urgent replies. I also read current publications I’m interested in, meet with our research team to discuss progress and follow-up actions, participate in other project meetings or teleconferences, review transcripts, analyse data, and draft an ethics or grant application, or work on writing a manuscript.

If I'm collecting data, I'll spend most of the day in the community meeting participants (e.g. at home, school, in a clinic, or workplace), talking through the study again and answering any further questions before obtaining informed consent, then conducting interview/completing questionnaires and, if required, collecting blood samples.

What did you study at school? And after high school?

I went to a Catholic Girls’ school in Fiji where I studied a variety of subjects including English - my second language. I also learned about the Catholic religion (I’m a Methodist). Other subjects included social studies, health science, geography, mathematics, bookkeeping, and home economics. We had time for sports too. Outside of school, I learned to read music and play the piano (classical). My favourite subjects were social science and biology.

I wanted to train as a nurse or teacher in Fiji, but instead my parents sent me to Christchurch to learn commerce and office administration, and continue with piano lessons.

                                            Ofa and her sons

Was your study directly related to what you do now?

My initial studies enabled me to work in the public and international sectors (United Nations Development Programme Regional Office) in Fiji, and the private sector in New Zealand.

Strong personal and professional links with a number of Pacific countries influenced the direction of the research in my doctoral thesis, Obesity Prevention among Pacific adolescents: Is there a role for the church? 

In this, I combined both quantitative and qualitative methods. The data for the quantitative component came from the Obesity Prevention in Communities (OPIC) four-country regional study, for which I managed the New Zealand baseline data collection. In addition to analysing the data from 2,495 Pacific students, I conducted a community meeting with 50 church leaders, individual meetings with the ministers of 20 churches, and a separate qualitative survey of 23 church leaders to gain a deeper understanding of the issues associated with obesity in Pacific church communities in Auckland.

These work and study opportunities established a strong platform for what I do now, especially in Pacific health research leadership, developing a talent pool of Pacific research scientists, strengthening research collaborations, and engaging communities for better health and education results.

Ofa with Women Rugby Champions

What would you like to share with young women who are thinking about their career choices right now?

Have fun thinking about your career choices and know that you’re not alone.

Think about who you'd like to tell your dream job to - friends, family, teacher, lecturer, supervisor, or careers counsellor? Their support can provide a useful guide as you think through your career choices. Do you need information on pathways to your chosen career, scholarships you may apply for, summer studentships/short-term training programmes to consider, or opportunities for work experience? Would it be helpful to ask for feedback on your performance?

Enjoy the process of thinking through your career choices and opportunities to put your talents to work not only for your own benefit, but also for the benefit of others.

And don’t be afraid to change course if it’s the right thing to do – follow your heart!

What are some of your career highlights so far?

Some of my career highlights include securing career development funds to support young Pacific women in STEM (science, technology, engineering, maths), engaging high school students in a real world scientific research project, and participating in leadership positions for the Health Research Council and the National Science Challenges (Healthier Lives and Ageing Well).

Ofa and Programme Manager Health Science Academies at Auckland ExpoWhy do you believe engaging in science, technology, engineering and maths (STEM) is important to New Zealand?

Everyone in New Zealand has the freedom of choice to engage with STEM and apply their learnings in so many different ways at home, school, work, or in service to community – it is not limited to the laboratory.

Exercising our choice effectively is an important way of motivating people to enjoy and value life-long learning, put their learning to good use, create employment opportunities and reduce inequalities for the overall benefit of New Zealanders.

Why is it important to have more women working in STEM?

We need more women working in STEM if we are to achieve the United Nations sustainable development goals that value diversity, gender equality, easy access to quality education, health services, and work opportunities.

More women in STEM will also drive effective partnerships that lead to justice for women and girls in NZ, the Pacific region, and the world.

Ofa Dewes is Fiji-born of Rotuman/Tongan/Tuvaluan ethnicity, with affiliation to Ngāti Porou. She is a Pacific health researcher of the Maurice Wilkins Centre/Department of Molecular Medicine & Pathology, and the School of Nursing’s Te Ārai Palliative Care and End of Life Research Group, University of Auckland. For more information, see wearethepacificocean.com or follow Ofa on Twitter @Pasifik_Ocean

Photos (from top): Portrait of Ofa; Ofa and her sons; Ofa supporting the Oriental Bay Rongotai Women's Rugby champions; Ofa (right) with colleague at the Auckland Expo for high school students.

https://www.curiousminds.nz/profiles/ofa-dewes/

South Auckland woman part of study about palliative care for Pacific people

Tilisi Paniani spent more than 20 years caring for her mother and father.

Emily Ford

She never got to finish high school, but Tilisi Paniani has no regrets about nursing her parents until their deaths.

The south Auckland woman was 17-years-old when her mum first had a stroke and she had to stop school to look after her.

The youngest child of 11, Paniani grew up in the Cook Islands and her siblings were all living overseas by then.

Reoreka and Tilisi Paniani moved to New Zealand from the Cook Islands to look after Tilisi's sick mother.

"I didn't have a choice. My Mum was struggling ... she needed me," Paniani says.

"I would cry a lot. Sometimes I would see my friends and I missed sports ... I was doing the washing and cooking, life was so tough for me."

Her mum's health got worse and her parents moved to New Zealand for better healthcare, while Paniani stayed in the Cook Islands.

Then, some years later, her dad asked her to move to New Zealand to look after her mum again.

She and her husband, Reoreka, uprooted their lives and moved to a new country and Paniani looked after her mum while raising her young children.

Her mum eventually went to a rest home when it became too hard for Paniani and her father to look after her and she died in 2010.

"When she left it was like she took half of my heart with her," Paniani says.

She and her husband then helped look after her father until he died in 2016.

Paniani is one of the participants in a study to improve end-of-life care for older Pacific people, led by University of Auckland research fellow Dr Ofa Dewes.

Dewes' study began this year and is looking into people's experiences with palliative care and the challenges faced by family who carry out the bulk of care.

Paniani says it was a huge job looking after her parents, but she's glad for government assistance and that her parents got to meet all of her children.

"It's all about love and patience looking after old people. You have to be patient." 

Paniani says it's important for teenagers to make the most of their parents and grandparents now, not just on their birthdays or wait until they get sick.

"Remember it's going to come back to you one day.

"Give them a phone call, take them out for coffee, tell them how much you love them."

 - Stuff

http://www.stuff.co.nz/national/health/93675975/south-auckland-woman-part-of-study-about-palliative-care-for-pacific-people 

                                                                             

Improved care aim for older Pacific people study

15 December 2016

Image of Research Fellow, Dr Ofa Dewes

A study to improve end-of-life care for older Pacific people will begin early next year at the University of Auckland as part of the Ageing Well, National Science Challenge.

“Pacific older adults have high levels of unmet need and poor access to palliative care while dying,” says research fellow Dr Ofa Dewes from the University’s School of Nursing.

“This study will provide urgently-needed information on Pacific people’s experiences in palliative care,” she says. “It will also research the experiences and challenges faced by their aiga [family] who carry out the bulk of their care.”

“The research aims to improve end-of-life care for older Pacific people,” says Dr Dewes.

The study is one of four projects nationally, announced recently by the Ageing Well National Science Challenge (NSC) with total new funding of $3.25 million for the four innovative research projects.

In recognition of the specific challenges and opportunities faced by Māori and Pacific people to age well, the focus of this year’s Ageing Well NSC contestable funding round was research that investigated aspects of ageing that are prevalent for these groups of people.

The two-year study by Dr Dewes is titled, ‘Tapinga ‘a Maama’: Pacific Life and Death in Advanced Age, and is funded for $450,000 by the Ageing Well NSC.

“This research is crucial given the concerns raised by Pacific communities about dissonances between the nature of care and support preferred by Pacific older adults and their aiga at the end-of-life, and the provision of palliative care services,” says Dr Dewes.

“Our study draws on Pacific health models to address that knowledge gap and explores the end of life circumstances of Pacific people dying in advanced age,” she says.

“Using rigorous qualitative methods, interviews will be conducted with about 30 bereaved aiga of people dying at more than 75 years old,” says Dr Dewes.

“Our research will deliver outcomes that impact: health and wellbeing to end of life, and during bereavement for aiga; age-friendly environments; increased health equity; integrated health care and social support services; and culturally-appropriate and systems-based approaches to support ageing (and dying) in place.”

The project team carrying out the research and led by Dr Dewes, includes academics from the School of Nursing and the School of Population Health at the University of Auckland, a facilitator for Pacific aged care services, and an international community liaison from Hawaii.