Childhood otitis media - risk factors and surgical management

Background: Otitis media (OM) is one of the most common childhood diseases. Approximately every third child suffers from recurrent acute otitis media (RAOM), and 5% of all children have persistent middle ear effusion for months during their childhood. Despite numerous studies on the prevention and treatment of OM during the past decades, its management remains challenging and controversial. In this study, the effect of adenoidectomy on the risk for OM, the potential risk factors influencing the development of OM and the frequency of asthma among otitis-prone children were investigated. Subjects and methods: One prospective randomized trial and two retrospective studies were conducted. In the prospective trial, 217 children with RAOM or chronic otitis media with effusion (COME) were randomized to have tympanostomy with or without adenoidectomy. The age of the children at recruitment was between 1 and 4 years. RAOM was defined as having at least 3 episodes of AOM during the last 6 months or at least 5 episodes of AOM during the last 12 months. COME was defined as having persistent middle ear effusion for 2-3 months. The children were followed up for one year. In the first retrospective study, the frequency of childhood infections and allergy was evaluated by a questionnaire among 819 individuals. In the second retrospective study, data of asthma diagnosis were analysed from hospital discharge records of 1616 children who underwent adenoidectomy or had probing of the nasolacrimal duct. Results: In the prospective randomized study, adenoidectomy had no beneficial effect on the prevention of subsequent episodes of AOM. Parental smoking was found to be a significant risk factor for OM even after the insertion of tympanostomy tubes. The frequencies of exposure to tobacco smoke and day-care attendance at the time of randomization were similar among children with RAOM and COME. However, the frequencies of allergy to animal dust and pollen and parental asthma were lower among children with COME than those with RAOM. The questionnaire survey and the hospital discharge data revealed that children who had frequent episodes of OM had an increased risk for asthma. Conclusions: The first surgical intervention to treat an otitis-prone child younger than 4 years should not include adenoidectomy. Interventions to stop parental smoking could significantly reduce the risk for childhood RAOM. Whether an otitis-prone child develops COME or RAOM, seems to be influenced by genetic predisposition more strongly than by environmental risk factors. Children who suffer from repeated upper respiratory tract infections, like OM, may be at increased risk for developing asthma.

Producing interactivity : Does media convergence promote interactivity and audience participation?

This study investigates the process of producing interactivity in a converged media environment. The study asks whether more media convergence equals more interactivity. The research object is approached through semi-structured interviews of prominent decision makers within the Finnish media. The main focus of the study are the three big ones of the traditional media, radio, television and the printing press, and their ability to adapt to the changing environment. The study develops theoretical models for the analysis of interactive features and convergence. Case-studies are formed from the interview data and they are evaluated against the models. As a result the cases arc plotted and compared on a four-fold table. The cases are Radio Rock, NRJ, Biu Brother, Television Chat, Olivia and Sanoma News. It is found out that the theoretical models can accurately forecast the results of the case studies. The models are also able to distinguish different aspects of both interactivity and convergence so that a case, which at a first glance seems not to be very interactive is in the end found out to receive second highest scores on the analysis. The highest scores are received by Big Brother and Sanoma News. Through the theory and the analysis of the research data it is found out that the concepts of interactivity and convergence arc intimately intertwined and very hard in many cases to separate from each other. Hence the answer to the main question of this study is yes, convergence does promote interactivity and audience participation. The main theoretical background for the analysis of interactivity follows the work of Came Fleeter, Spiro Kiousis and Sally McMillan. Heeler's six-dimensional definition of interactivity is used as the basis for operationalizing interactivity. The actor-network theory is used as the main theoretical framework to analyze convergence. The definition and operationalization of the actor-network theory into a model of convergence follows the work of Michel Callon. Bruno Latour and especially John Law and Felix Stalder.

Global capitalism meets national spirit: Discourses in media texts on a cross-border acquisition

In this article, the authors explore media coverage of a recent acquisition across national borders. Their starting point is that the media represent a key arena of “discursive strategizing” for actors such as corporate managers. They illustrate and specify how global capitalism, as discourse relying on economic and financial rationale and exemplified here by the acquiring firm’s attempts to expand, meets national spirit, exemplified here by the complexity in selling the acquisition target to foreigners. The main contribution of this study lies in identifying how key actors draw on and mobilize rationalistic and nationalistic discourses in public discussion. The analysis illustrates that the same actors can draw on different—even contradictory—discourses at different points in time. Furthermore, different actors—even with opposing objectives—may draw on the same discourse in legitimizing their positions and pursuing specific ends.

Discursive (de)legitimation of a contested Finnish greenfield investment project in Latin America

Despite the central role of legitimacy in corporate social responsibility debate, little is known of subtle meaning-making processes through which social actors attempt to establish or de-establish legitimacy for socially contested corporate undertakings, and through which they, at the same time, struggle to define the proper social role and responsibility of corporations. We investigated these processes in the context of the intense socio-political conflict around the Finnish forest industry company Metsa¨-Botnia’s world-scale pulp mill in Uruguay. A critical discursive analysis of Finnish media texts highlights three types of struggle that characterized the media coverage: legalistic argumentation, truth fights, and political battles. Interestingly, this case illustrates how the corporate representatives — with the help of the national media — tend to frame the issue in legalistic terms, emphasize their expert knowledge in technical and environmental evaluations, and distance themselves from political disputes. We argue that similar tendencies are likely to characterize corporate social responsibility debates more generally.