Abstract This study was undertaken to improve the diagnosis of otitis media and to investigate possible hearing loss caused by middle ear effusion (MEE) in small children. The accuracy of minitympanometry in detecting MEE was evaluated in 162 children. The finding was compared with the amount of effusion found in myringotomy. Minitympanometry proved to be an accurate method to detect MEE in young children, the sensitivity and specificity values being 79% and 93% in cooperative children but it had no value in non-cooperative children. Minitympanometric examination could be performed successfully with good cooperation in 87% of a total of 206 children in paediatric outpatient clinic. Impaired mobility of the tympanic membrane (TM) was the best sign of MEE in pneumatic otoscopy of 76 children, with sensitivity and specificity values of 75% and 90%, respectively. The influence of nitrous oxide (N2O) on MEE was tested by weighting the effusion found in myringotomy during general anaesthesia with and without N2O in 39 and 37 children, respectively. The mean weight of the effusion in the oxygen-air group did not differ from the weight in the N2O group, and thus peroperative findings in myringotomy are reliable. Studies on symptomatology and the temporal development of acute otitis media (AOM) during upper respiratory tract infection (URI) were based on three-month follow-up of 857 children. Symptoms of URI only were compared with symptoms of URI complicated by AOM in the same child in 138 children. The most important symptom associated with AOM was earache, with a relative risk of 21.3. Sore throat, night restlessness and fever at days 3-6 were also significantly associated with AOM, with relative risks of 3.2, 2.6 and 1.8, respectively. In 44 children under two years of age, earache, conjunctival symptoms and cloudy rhinitis were significantly associated with AOM. Temporal development of AOM was assessed from 250 episodes in 184 children. Sixty-three per cent of cases of AOM occurred during the first week after the onset of URI, peaking on days 2 to 5. The onset of AOM in children with a history of recurrent episodes of AOM did not differ from that in those who had experienced only a few episodes of AOM. No individual tendency was noticed among children suffering more than one AOM episode during follow-up. To assess the influence of the quantity and quality of MEE on hearing in small children, transient evoked otoacoustic emission (TEOAE) was performed under general anaesthesia before myringotomy in 185 ears of 102 children. Reduced TEOAEs indicating hearing loss were found in 83% of the ears with mucoid effusion and in 56% of the ears with non-mucoid effusion, the difference being statistically significant (p < 0.01). A significant negative correlation between the reproducibility of TEOAE responses and the amount of effusion was found (Spearman rank correlation coefficient r = -0.589, p < 0.001). Findings in minitympanometry correlated with the responses of TEOAE. Although parents are able to predict AOM quite reliably, various symptoms and the duration of URI seems to be of little value in helping the diagnosis of AOM. Detection of effusion in OM may be improven by minitympanometry in cooperative children. Any kind of effusion may cause hearing loss in small children, which must be considered when treating OM.

The major damage to bridges occurs due to scour of the bed materials around piers and abutments during severe floods. This study involves the experimental investigations of the various scour patterns forming around abutment models tested with and without collars as scour countermeasures. The experiments were conducted in a rectangular channel under clear-water scour conditions. In the first part of this study, 34 experiments were conducted with semi-circular end abutment models with and without a collar for a period of 3 hours. Collars of various sizes were placed at different elevations on the abutment models, and the scour reduction efficiencies of collars were investigated for the different flow depths. Based on the results of the experimental studies, the optimum locations of collars on the abutments, which result in minimum scour depth around the abutments, are obtained at the bed level and below the bed level depending on the flow intensity values. In the second part of this study, the effects of flow depth and abutment length on the temporal development of local scour at bridge abutments were studied. 20 experiments were performed without collars for a time period of 8 hours. It was observed that at the upstream of the abutment, the depth of the local scour increases rapidly within the first three hours of the experiment for the different flow depths.

The general aim of this descriptive study is to investigate how children from 3 to 9 plus 13- year-olds and adults use temporal elements to organize the macro temporal structure of narratives. In order to achieve this general aim, it specifically delineates how the emergence of story units differ relative to age / how the emergence of temporal elements differ relative to age and story units / and how the function of each temporal element differs relative to age and story unit in the narratives elicited from children from 3 to 9 plus 13-year-olds and adults, using Mercer Mayer&amp / #146 / s (1966) wordless, picture-book Frog, where are you? as stimulus. Participants are 98 children from 3 to 9-yearolds, as 14 informants in each age group / fourteen 13-year-olds and 14 adults. The orally collected data were transcribed and episode boundaries were coded according to Labov&amp / #146 / s (1972) story grammar. The occurrence of each temporal element within the coded episodes was counted. Frequency of each temporal element relative to age and story unit was identified. Functions of each temporal element relative to age and story units were analyzed. A great majority of the 3- and 4-year-olds produce narratives that do not count a story. 5- year-olds produce narratives that can be considered a story, however they fail to produce internal components of episodes. 7-year-olds are observed to produce episodes that contain necessary internal components. The emergence and function of temporal elements show differences relative to age and story unit.