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- Eriksson, Per Olof, 1968-
(author)
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Developing otitis media : experimental studies in particular regarding inflammatory changes in the tympanic membrane
- 2004
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Doctoral thesis (other academic/artistic)abstract
- Otitis media (OM), one of the commonest of childhood diseases, causes much suffering. OM exists in a variety of forms, two of which are acute otitis media (AOM) and otitis media with effusion (OME). The clinical courses of these conditions differ, AOM usually presenting with earache, fever and/or aural discharge, and the OME usually with hearing impairment. The tympanic membrane (TM) mirrors the events in the middle ear cavity, and pars flaccida (PF) is the initial site of inflammatory changes in the TM. PF is rich in mast cells (MCs), which by releasing various mediators, may trigger TM inflammation. The aims of the present studies were to investigate early inflammatory changes in the TM in rat models of OM; after mast cell degranulation, in response to AOM, and OME, after myringotomy in AOM and in normal ears. Furthermore, we developed a new rat AOM model, that excludes surgical trauma and resembles the natural route of infection in man. AOM and OME elicited the first inflammatory response in PF of the TM. The response to OME was discrete, but a slight increase in macrophages was found. During the first 48 hours of AOM, the inflammatory response was intense, following a bimodal pattern. This reaction is similar to that found after MC degranulation. In AOM, macrophages were the predominant cell in PF, while in pars tensa (PT), polymorphonuclear cells (mainly neutrophils) predominated. When myringotomy was performed in AOM ears, the healing time was shorter than that of myringotomy in normal ears. The highly inflamed lamina propria seemed to promote healing. During early AOM, as well as following myringotomy, fibrin extravasates into PF and PT. This fibrin deposition may be involved in regulating the inflammatory response. Repeated nasal challenge with the otitis media pathogen Streptococcus pneumoniae provoked AOM and concomitant TM stimulation reduced the number of AOM cases. This new rat AOM model has the advantage of avoiding trauma in the middle ear cavity, while eliciting an intense inflammatory response in the middle ear cavity (MEC).
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| 2. |
- Hellström Muhli, Ulla
(author)
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Att överbrygga perspektiv : En studie av behovsbedömningssamtal inom äldreinriktat socialt arbete
- 2003
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Doctoral thesis (other academic/artistic)abstract
- The aim of the study was to describe and analyse institutional practice in need assessment dialogues. The questions were: How are the dialogues structured? How is the professional dialogue content combined with: the institutional, traditional and personal perspectives? How are communicative problems solved?Mapping, assessing and deciding on social welfare or other aid measures for elderly people is one part of the concretisation of the elderly care policy in the encounter with the individual citizen. This concretisation is not just a simple transfer of political goals but, rather, contains implications for elderly care institutions as a whole, for elderly oriented social work and for processing. Examples of such implications are demands on knowledge growth in elderly oriented social work and demands on professional practice. The institutional actors, the case officers, serve an important purpose for the elderly in the encounter with elderly care. The need assessment dialogue between case officers and elderly persons is thus seen as a communicative activity or practice through which they (re)produce elderly care. It is this that the study attempts to give shape to.The project has its theoretical underpinning in social constructionism and in dialogism, which explain people’s everyday actions and interaction and how people make their knowledge and assumptions comprehensible. The social constructionist theory also explains how social institutions are created and maintained in people’s interaction in institutional talk.Data have been collected in the form of video recordings of 16 need assessment meetings and consist of about 12 hours of recorded need assessment dialogues. Content analyses of interactive courses of events in need assessment dialogues have been performed.The results show that phases constitute the structure of the dialogues and make them comprehensible. The phases serve different functions in the need assessment dialogues. The phase structure can be seen as a sub activity, which has specific aims and solves different tasks that are central to the case officer’s work. The phase structure consists of: opening, framing, mapping of needs, information and counselling, the turning-point in the dialogue and conclusion. A prominent feature of the study is the relationship between institutional order and professional practice. This relationship is the basis of different dilemmas in the encounter with the client. The key task facing the case officer is to bridge these dilemmas by means of different strategies. The case officer’s professional task in need assessments is not only to assess care requirements but also to make the institutional prerequisites of the aid measures comprehensible to the client and to transform care requirements into institutional abstractions. The knowledge contribution consists of an understanding of the complexity of the dialogue and how meaning and perspectives in the dialogue are produced interactively in different ways. An important knowledge contribution is the importance of communication in elderly oriented social work. This is a key factor in establishing a working relationship between the client and the case officer. It is also a key factor in the case officer’s professional practice.
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