title: Association of Single Nucleotide Polymorphisms in Surfactant Protein A and D with Otitis Media.

authors: Barnett, Catherine Margaret Eleanor

subjects: otitis media

abstract: Otitis Media is one of the most common childhood diseases. Recurrent acute otitis media RAOM is characterized by repeated episodes of inflammation of the middle ear in conjunction with middle ear fluid, and often with an inflamed or bulging eardrum. Defective clearance by the Eustachian tube results in mucus build-up and is characteristic of otitis media with effusion (OME). Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, respiratory syncytial virus, and rhinovirus are the most common contributors to otitis media pathogenesis. In New Zealand, OME has been implicated with conductive hearing loss in childhood and has been shown to significantly impact on speech and language development. New Zealand Māori and Polynesian children have displayed significantly higher hearing test failure rates than European-Caucasian children.

The collectins, Surfactant Protein (SP)-A and -D are encoded by three genes (SP-A1, SP-A2, and SP-D) and are host defense proteins present in the middle ear and Eustachian tube. Single nucleotide polymorphisms (SNPs) in SP-A1 and SP-A2 have been associated with increased or decreased susceptibility to otitis media, meningococcal disease, and range of respiratory diseases. Using allele-specific primers and real-time PCR with SYBR  Green I melting curve analysis, four groups of individuals were genotyped for eleven SP-A1, SP-A2, and SP-D SNPs: European-Caucasian individuals with RAOM/OME; New Zealand Māori/Polynesian individuals with RAOM/OME; individuals with meningococcal disease; and a control group. The computer program, Haploview, was employed to perform χ2 analyses and identify statistically significant associations of alleles/haplotypes with RAOM/OME or meningococcal disease.

In the European-Caucasian population, two SP-A1 alleles, one SP-A2 allele, and four haplotypes (CGAGC, 1A3, 1A9, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). Conversely, haplotypes 6A2 and 1A2 were found to be protective against susceptibility to RAOM/OME (P lt; 0.05). In New Zealand Māori and Polynesian individuals, two SP-A1 alleles, three SP-A2 alleles, one SP-D allele, and four haplotypes (6A8, 6A10, 1A3, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). An additional four haplotypes (6A2, 1A0, 1A2, and TA) were determined to be protective against susceptibility to RAOM/OME (P lt; 0.05). However, protective SPA1/SPA2/SPD haplotype 6A2-1A0-TA was significantly under-represented in the New Zealand Māori and Polynesian population (P lt; 0.05). A single allele and haplotype were associated with increased risk of meningococcal disease (P lt; 0.05).

The findings of this study confirm that specific genetic variants of SP-A and SP-D are associated with either increased or decreased risk of developing RAOM and/or OME. Furthermore, it was demonstrated that New Zealand Māori and Polynesian individuals appear to exhibit more haplotypes susceptible to RAOM/OME. This may provide a partial explanation for the higher RAOM/OME-related failure rates of hearing tests in New Zealand Māori and Polynesian children. However, there are numerous socio-economic and environmental factors that also contribute to otitis media pathogenesis which were not considered in this study. The effects of the SP-A1, SP-A2, and SP-D alleles and haplotypes on the bacterial/viral binding efficiencies of SP-A and SP-D need to be investigated by further research, using a large population, to confirm the association with susceptibility or resistance with RAOM/OME.

text: Association of Single Nucleotide Polymorphisms in Surfactant Protein A and D with Otitis Media. Otitis Media is one of the most common childhood diseases. Recurrent acute otitis media RAOM is characterized by repeated episodes of inflammation of the middle ear in conjunction with middle ear fluid, and often with an inflamed or bulging eardrum. Defective clearance by the Eustachian tube results in mucus build-up and is characteristic of otitis media with effusion (OME). Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, respiratory syncytial virus, and rhinovirus are the most common contributors to otitis media pathogenesis. In New Zealand, OME has been implicated with conductive hearing loss in childhood and has been shown to significantly impact on speech and language development. New Zealand Māori and Polynesian children have displayed significantly higher hearing test failure rates than European-Caucasian children.

The collectins, Surfactant Protein (SP)-A and -D are encoded by three genes (SP-A1, SP-A2, and SP-D) and are host defense proteins present in the middle ear and Eustachian tube. Single nucleotide polymorphisms (SNPs) in SP-A1 and SP-A2 have been associated with increased or decreased susceptibility to otitis media, meningococcal disease, and range of respiratory diseases. Using allele-specific primers and real-time PCR with SYBR  Green I melting curve analysis, four groups of individuals were genotyped for eleven SP-A1, SP-A2, and SP-D SNPs: European-Caucasian individuals with RAOM/OME; New Zealand Māori/Polynesian individuals with RAOM/OME; individuals with meningococcal disease; and a control group. The computer program, Haploview, was employed to perform χ2 analyses and identify statistically significant associations of alleles/haplotypes with RAOM/OME or meningococcal disease.

In the European-Caucasian population, two SP-A1 alleles, one SP-A2 allele, and four haplotypes (CGAGC, 1A3, 1A9, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). Conversely, haplotypes 6A2 and 1A2 were found to be protective against susceptibility to RAOM/OME (P lt; 0.05). In New Zealand Māori and Polynesian individuals, two SP-A1 alleles, three SP-A2 alleles, one SP-D allele, and four haplotypes (6A8, 6A10, 1A3, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). An additional four haplotypes (6A2, 1A0, 1A2, and TA) were determined to be protective against susceptibility to RAOM/OME (P lt; 0.05). However, protective SPA1/SPA2/SPD haplotype 6A2-1A0-TA was significantly under-represented in the New Zealand Māori and Polynesian population (P lt; 0.05). A single allele and haplotype were associated with increased risk of meningococcal disease (P lt; 0.05).

The findings of this study confirm that specific genetic variants of SP-A and SP-D are associated with either increased or decreased risk of developing RAOM and/or OME. Furthermore, it was demonstrated that New Zealand Māori and Polynesian individuals appear to exhibit more haplotypes susceptible to RAOM/OME. This may provide a partial explanation for the higher RAOM/OME-related failure rates of hearing tests in New Zealand Māori and Polynesian children. However, there are numerous socio-economic and environmental factors that also contribute to otitis media pathogenesis which were not considered in this study. The effects of the SP-A1, SP-A2, and SP-D alleles and haplotypes on the bacterial/viral binding efficiencies of SP-A and SP-D need to be investigated by further research, using a large population, to confirm the association with susceptibility or resistance with RAOM/OME.

year: 2007

title: A proposed hauora Māori clinical guide for psychologists: Using the hui process and meihana model in clinical assessment and formulation

authors: Pitama, Suzanne G.

subjects: Māori

abstract: This paper documents a joint initiative of clinical practice educators from four tertiary institutions and their engagement in the design and development of a proposed Hauora Māori Clinical Guide for Psychologists, which outlines how to apply the Hui Process and Meihana Model to applied psychology. It describes the ability for this proposed Hauora Maori Clinical Guide for Psychologists to assist clinicians, professional psychology training programmes and institutions in meeting the expectations of the Health Practitioners Act and The New Zealand Psychologists Board’s (NZPB) Standards and Procedures document. It presents how this proposed guide can support the implementation of clinical and cultural competence and the Code of Ethics for Psychologists Working in New Zealand. It also provides an opportunity for the psychology profession to demonstrate responsivity to Te Tiriti o Waitangi obligations.

text: A proposed hauora Māori clinical guide for psychologists: Using the hui process and meihana model in clinical assessment and formulation This paper documents a joint initiative of clinical practice educators from four tertiary institutions and their engagement in the design and development of a proposed Hauora Māori Clinical Guide for Psychologists, which outlines how to apply the Hui Process and Meihana Model to applied psychology. It describes the ability for this proposed Hauora Maori Clinical Guide for Psychologists to assist clinicians, professional psychology training programmes and institutions in meeting the expectations of the Health Practitioners Act and The New Zealand Psychologists Board’s (NZPB) Standards and Procedures document. It presents how this proposed guide can support the implementation of clinical and cultural competence and the Code of Ethics for Psychologists Working in New Zealand. It also provides an opportunity for the psychology profession to demonstrate responsivity to Te Tiriti o Waitangi obligations.

year: 2017

title: Structural and thermal performance of cold-formed steel studs with slits

authors: Ghosh, Kushal

abstract: Cold-formed steel (CFS) studs in lightweight construction increasingly incorporate web slits to limit thermal bridging, yet these openings can reduce axial strength. This thesis integrates structural and thermal assessments through validated non-linear elasto-plastic finite element analysis (FEA) and complementary heat-transfer modelling. Shell-element FEA models were developed and validated against tests, then used in a 960-case parametric study spanning section dimensions, slit geometry, thickness, and member length to establish the influence of slits on concentric axial capacity. The results were evaluated against the Direct Strength Method (DSM) in AS/NZS 4600, leading to strength-reduction recommendations and modified DSM expressions that achieve reliability indices β ≥ 2.5. The programme was extended to combined axial compression and minor-axis bending using 1,134 FEA models with six eccentricities, demonstrating a systematic discrepancy in current AS/NZS 4600 interaction checks: strengths are generally underestimated at eccentricities of 10–25 mm and overestimated at 50 mm. A new interaction equation incorporating element and web slenderness ratios is proposed and verified within the AISI S100 reliability framework. Subsequently, a parametric three-dimensional heat-transfer study quantified the dependence of heat flux on geometry and slit parameters, providing a quantitative basis for thermal performance gains and their balance with strength. The thesis proposes design recommendations and revised equations for slitted CFS studs that satisfy codified reliability targets and support informed selection of slit configurations to balance energy efficiency and structural capacity in practice.

text: Structural and thermal performance of cold-formed steel studs with slits Cold-formed steel (CFS) studs in lightweight construction increasingly incorporate web slits to limit thermal bridging, yet these openings can reduce axial strength. This thesis integrates structural and thermal assessments through validated non-linear elasto-plastic finite element analysis (FEA) and complementary heat-transfer modelling. Shell-element FEA models were developed and validated against tests, then used in a 960-case parametric study spanning section dimensions, slit geometry, thickness, and member length to establish the influence of slits on concentric axial capacity. The results were evaluated against the Direct Strength Method (DSM) in AS/NZS 4600, leading to strength-reduction recommendations and modified DSM expressions that achieve reliability indices β ≥ 2.5. The programme was extended to combined axial compression and minor-axis bending using 1,134 FEA models with six eccentricities, demonstrating a systematic discrepancy in current AS/NZS 4600 interaction checks: strengths are generally underestimated at eccentricities of 10–25 mm and overestimated at 50 mm. A new interaction equation incorporating element and web slenderness ratios is proposed and verified within the AISI S100 reliability framework. Subsequently, a parametric three-dimensional heat-transfer study quantified the dependence of heat flux on geometry and slit parameters, providing a quantitative basis for thermal performance gains and their balance with strength. The thesis proposes design recommendations and revised equations for slitted CFS studs that satisfy codified reliability targets and support informed selection of slit configurations to balance energy efficiency and structural capacity in practice.

year: 2025