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Energy is crucial for global development, but the current production and usage of it is contributing to climate change. The burning of fossil fuels harms the environment and human health and must be reduced to reach a sustainable use of energy. Usage of non-renewable and traditional fuels is still common, not least in developing countries. One such country is Nepal, who’s indigenous electricity production is renewable while the country is still heavily dependent on imported fossil fuels. Investigations of energy statistics found no specific documentation on energy use patterns, especially not for smaller communities. However, the statistics showed that the residential sector is the biggest energy consuming sector in Nepal.Therefore, the study aims to map the energy need in the village of Khahare in the Kathmandu District, to answer the question: How could the current residential energy sources in Khahare be complemented or replaced to provide more sustainable, reliable and efficient energy? The study was conducted in three main parts: a field study consisting of interviews with Khahare’s inhabitants, calculations of the energy use in the study area and modelling in HOMER. Through the calculations and modelling in HOMER, three scenarios were created. Scenario 1 would cost $2.03M and assumed that the entire energy need would be covered by the national grid, making it the cheapest but least energy secure alternative. Scenario 2 would cost $4.01M and assumed that the energy need not currently covered by the grid would be replaced by a combination of off-grid solar PVs, biogas, and LPG. This alternative was the optimal solution according to HOMER, but the interviews and local observations indicated that implementing biogas plants would not be a possible approach. In scenario 3, which would cost $5.76M, the biogas and LPG aspect was removed, and it was assumed that the energy need not currently covered by the grid would be replaced by off-grid solar PVs, which was the mos, Energi är avgörande för den globala utvecklingen, men den nuvarande produktionen och användningen av den bidrar till klimatförändringarna. Förbränningen av fossila bränslen är skadlig för miljön och människors hälsa och måste minska för att kunna nå en hållbar energianvändning. Användning av icke-förnybara och traditionella bränslen är fortfarande vanligt, inte minst i utvecklingsländer. Ett sådant land är Nepal, vars inhemska elproduktion är förnybar samtidigt som landets beroende av importerade fossila bränslen fortfarande är stort. Undersökningar av energistatistik hittade ingen specifik information om energianvändningsmönster, särskilt inte för mindre samhällen. Statistiken visade dock att bostadssektorn är den största energiförbrukande sektorn i Nepal. Därför syftar studien till att kartlägga energibehovet i byn Khahare i Katmandu distrikt, för att kunna besvara frågan: Hur kan de nuvarande energikällorna för bostäder i Khahare kompletteras eller ersättas för att ge mer hållbar, pålitlig och effektiv energi? Studien genomfördes i tre huvuddelar: en fältstudie bestående av intervjuer med Khahares invånare, beräkningar av energianvändningen i studieområdet och modellering i HOMER. Genom beräkningarna och modelleringen i HOMER skapades tre scenarier. Scenario 1 beräknades kosta 2,03 miljoner USD och antog att hela energibehovet kan täckas av stamnätet, vilket gör det till det billigaste men minst energisäkra alternativet. Scenario 2 beräknades kosta 4,01 miljoner USD och antog att det energibehov som för närvarande inte täcks av elnätet skulle ersättas av en kombination av solceller, biogas och LPG. Detta alternativ var den optimala lösningen enligt HOMER, men intervjuerna och de lokala observationerna tydde på att en implementering av biogasanläggningar inte vore möjligt. I scenario 3, som beräknades kosta 5,76 miljoner USD, togs biogas- och LPG-aspekten bort och det antogs att det energibehov som för närvarande inte täcks av elnätet skulle ersättas med enbart so

Syftet är att analysera självbiografier och sammanställa meningsfulla strategier som vuxna med ADHD använder för att hantera vardagen. Som metod valdes en litteraturbaserad kvalitativ metod. För att välja ut vilka självbiografier som kunde besvara studiens syftet gjordes en avancerad sökning via Libris. Fem böcker valdes ut och vid bearbetning av självbiografierna så användes en kvalitativ innehållsanalys. Resultatet visar genomgående fler gemensamma nämnare av strategier än det som tydligt skiljer sig åt hos personerna i självbiografierna. Analysen resulterade i tre huvudkategorier med nio underkategorier. “Strategier för att organisera, strukturera och planera både digitalt och på lappar” beskrivs som en viktig strategi både i vardagen och på arbetet. “Strategier för att utveckla sig själv” beskrivs som något väldigt viktigt för dessa personer. Det innefattar både stödet från anhöriga och att ta del av andra personers erfarenhet av ADHD. “Strategier för att lindra symtom” sammanfattar personernas behov av att få utlopp för sin kreativitet och rastlöshet. Slutsatsen är att resultatet ger en samlad bild utifrån personernas upplevda erfarenheter och perspektiv. Studien ger kunskap om meningsfulla strategier som vuxna personer med ADHD använder i sin vardag. Strategierna är användbara för vuxna personer med ADHD samt för att arbetsterapeuten och annan vårdpersonal ska kunna utforma effektiva och personcentrerade interventioner., The aim is to analyze autobiographies and compile meaningful strategies that adults with ADHD use to manage everyday life. A literature-based qualitative method was chosen as the method. In order to select which autobiographies could answer the purpose of the study, an advanced search was made via Libris. Five books were selected and when processing the autobiographies, a qualitative content analysis was used. The results consistently show more common denominators of strategies than what clearly differs in the people in the autobiographies. The analysis resulted in three main categories with nine subcategories. "Strategies for organizing, structuring and planning both digitally and on notes" is described as an important strategy both in everyday life and at work. "Strategies to develop yourself" are described as something very important for these people. It includes both support from relatives and sharing other people's experience with ADHD. "Strategies to relieve symptoms" summarizes the person's need to vent their creativity and restlessness. The conclusion is that the results provide an overall picture based on the people's perceived experiences and perspectives. The study provides knowledge about meaningful strategies that adults with ADHD use in their everyday lives. The strategies are useful for adults with ADHD and for the occupational therapist and other healthcare professionals to be able to design effective and person-centered interventions.

In public-health crises, members of multilingual communities must be able to access, understand, trust and act upon behaviour-change messaging. The role of translators is therefore critical, not only for the relaying of information but also in the transcreation of texts, understood as adaptation to suit the characteristics of an intended audience. Failure to use transcreation may produce messaging that is culturally inappropriate and thus ineffective. This study analyses healthcare resources created by governments in Australia with a view to identifying formatting and other visual features that would benefit from transcreation. A mixed-method approach combined numerical evaluation of four documents using the Patient Education Materials Assessment Tool (PEMAT) and a bottom-up thematic analysis of the way the same texts were discussed by 58 members of a broad range of ethnocultural and linguistic groups in Victoria, Australia. The findings point to a need to go beyond the linguistic aspects of the translation and take into account the discourse organisation, layout, images and cultural appropriateness of health messaging. The implications of applying the PEMAT criteria are not only that start texts will become more accessible and better able to facilitate understanding-based trust relations, but also that translators are well placed to participate in the transcreations that may be required in the various target languages.

BACKGROUND AND OBJECTIVES: Bio-medical image segmentation models typically attempt to predict one segmentation that resembles a ground-truth structure as closely as possible. However, as medical images are not perfect representations of anatomy, obtaining this ground truth is not possible. A surrogate commonly used is to have multiple expert observers define the same structure for a dataset. When multiple observers define the same structure on the same image there can be significant differences depending on the structure, image quality/modality and the region being defined. It is often desirable to estimate this type of aleatoric uncertainty in a segmentation model to help understand the region in which the true structure is likely to be positioned. Furthermore, obtaining these datasets is resource intensive so training such models using limited data may be required. With a small dataset size, differing patient anatomy is likely not well represented causing epistemic uncertainty which should also be estimated so it can be determined for which cases the model is effective or not. METHODS: We use a 3D probabilistic U-Net to train a model from which several segmentations can be sampled to estimate the range of uncertainty seen between multiple observers. To ensure that regions where observers disagree most are emphasised in model training, we expand the Generalised Evidence Lower Bound (ELBO) with a Constrained Optimisation (GECO) loss function with an additional contour loss term to give attention to this region. Ensemble and Monte-Carlo dropout (MCDO) uncertainty quantification methods are used during inference to estimate model confidence on an unseen case. We apply our methodology to two radiotherapy clinical trial datasets, a gastric cancer trial (TOPGEAR, TROG 08.08) and a post-prostatectomy prostate cancer trial (RAVES, TROG 08.03). Each dataset contains only 10 cases each for model development to segment the clinical target volume (CTV) which was defined by mul

BACKGROUND: Evaluations of continuing professional development programs typically focus on short-term knowledge and skill acquisition. There is a need for more comprehensive program evaluation methods that assess a broader range of impacts and can elicit how and why these outcomes occurred. We conducted a qualitative study to investigate the impacts of a multidisciplinary, online health professional postgraduate degree and to gain insights into the factors that led to these impacts. METHODS: Participants were graduates of the University of Melbourne's Master of Cancer Sciences who could participate in an online interview. Semi-structured, qualitative interviews were conducted exploring a broad range of impacts, including changes in professional practice and career trajectory since graduation, and how the degree influenced these impacts. Data were analysed inductively. RESULTS: Fifteen participants (female: 80%, 31-50 years old: 67%) from a range of professions were interviewed. A number of major themes were uncovered. Impacts on career trajectory included expanded career horizons (e.g. increased role diversity and complexity), and increased confidence in their professional identity. Impacts on professional practice included individual improvements in patient care and research, as well as changes in organisational practice. Factors identified as leading to these impacts were: (i) active, interactive and interprofessional learning; (ii) networking, informal mentoring, and role-modelling; and (iii) support at multiple levels. CONCLUSION: This study provides preliminary evidence of the positive impact of a Master of Cancer Sciences on graduate career trajectory and professional practice. In addition, the inductive methodology enabled identification of the curricular features (both planned and emergent) that influenced these impacts, facilitating potential transferability of learnings to other teaching programs.

BACKGROUND: Older patients often have complex medication regimens, which change as they move across transitions of care. Engagement of older patients and families in making medication decisions across transitions of care is important for safe and high-quality medication management. AIMS: To explore decision-making between health professionals, older patients and families about medication changes across transitions of care, and to examine how patient and family engagement is enacted in the process of decision-making in relation to these medication changes. METHODS: A focused ethnographic design was undertaken with semi-structured interviews, observations, and reflective focus groups or interviews. Reflexive thematic analysis was conducted on transcribed data. The study was undertaken at a public teaching acute care hospital and a public teaching community hospital in Australia. RESULTS: In all, 182 older patients, 44 family members and 94 health professionals participated. Four themes were conceptualised from the data: different customs and routines, medication challenges, health professional interactions, and patient and family involvement. Environments had differences in their customs and routines, which increased the potential for medication delays or the substitution of unintended medications. Medication challenges included health professionals assuming that patients and families did not need information about regularly prescribed medications. Patients and families were informed about new medications after health professionals had already made decisions to prescribe these medications. Health professionals tended to work in disciplinary silos, and they had views about their role in interacting with patients and families. Patients and families were expected to take the initiative to participate in decision-making about medication changes. CONCLUSIONS: Patient movements across transitions of care can create complex and chaotic medication management situations, which

The effectiveness of work performed through interprofessional practice is contingent on the nature and extent of communication between professionals. To date, there is little research exploring how the patterns of communication may impact interprofessional work. This study focused on communication during interprofessional meetings to better understand the interprofessional work performed through these encounters. Specifically, it examined how interactional discourse, that is, the patterns of language, influenced work performed during interprofessional meetings. A series of four interprofessional meetings in a rehabilitation unit were observed. Twenty-one participants were observed, including medical, nursing, allied health clinicians, and health professions students. Follow-up stimulated-recall interviews were conducted with five meeting participants. The data collection consisted of video and audio recordings and detailed field notes. Data were analyzed using a combination of genre analysis, a form of discourse analysis, and activity system analysis, drawing on Cultural Historical Activity Theory. This facilitated an in-depth examination of the structure of discourse and its influence on meeting outcomes. The meeting structure was defined and predictable. Two distinct forms of discourse were identified and labeled scripted and unscripted. Scripted discourse was prompted by standardized documents and facilitated the completion of organizational work. In contrast, unscripted discourse was spontaneous dialogue used to co-construct knowledge and contributed to collaboration. There was constant shifting between scripted and unscripted discourse throughout meetings which was orchestrated by experienced clinicians. Rather than fragmenting the discussion, this shifting enabled shared decision making. This research provides further insights into the interprofessional work performed during interprofessional meetings. The scripted discourse was highly influenced by artifacts

Tuberkulos var år 2022 världens näst största dödsorsak från ett och samma smittämne. Tuberkulos kan orsakas av olika bakterier inom släktet Mycobakterium och framför allt förorsakar Mycobakterium tuberculosis sjukdomen hos människor. M. tuberculosis orsakar långvarig inflammation genom celldöd. Bakterien är ungefär 0,4 × 3 µm, stavformad, rak eller lätt krökt, strikt aerob och har en komplex cellvägg, som gör att efter färgning med ett basiskt färgämne kan de inte avfärgas med oorganiska syror eller alkoholer. Denna förmåga är ett klassiskt kännetecken för mykobakterier och kallas att bakterierna är ”syrafasta”. Med hjälp av grundfärgningen Ziehl-Neelsen kan mykobakterier färgas in och får då färgen röd medan den omkringliggande vävnaden färgas blå. I dagsläget snittar Rättsmedicinalverket formalinfixerad paraffininbäddade vävnader misstänkt smittad med mykobakterier på 6 µm. I denna studie undersöktes om den optimala snittjockleken för vävnad med Mycobacterium species var 3 µm, 4 µm eller 6 µm genom att åtta vävnadsklossar snittades på de olika snittjocklekarna. Dessutom utfördes tre olika varianter av bakgrundsfärgningar av Ziehl-Neelsen färgningen, vilka var metylenblått, light green SF yellowish och utan bakgrundsfärgning. Oberoende av varandra utfördes två visuella bedömningar av snitten i ljusmikroskop. En bedömning gjordes av studenten tillsammans med en biomedicinsk analytiker och den andra av en medicinsk chef/rättsläkare. Utifrån de visuella bedömningarna, negativa och positiva faktorer om de olika snittjocklekarna samt bakgrundsfärgningarna, kunde slutsatsen dras att den mest optimala snittjockleken var 4 µm med bakgrundsfärgen metylenblått., In 2022, tuberculosis was the world's second largest cause of death from a single infectious agent. Tuberculosis can be caused by various bacteria within the genus Mycobacterium, with Mycobacterium tuberculosis primarily causing the disease in humans. M. tuberculosis induces prolonged inflammation through cell death. The bacterium is approximately 0.4 × 3 µm in size, rod-shaped, straight or slightly curved, strictly aerobic and has a complex cell wall that makes it impossible to decolorize with inorganic acids or alcohols after staining it with a basic dye. This resistance is a classic characteristic of mycobacteria and is referred to as the bacteria being "acid-fast". Using the basic Ziehl-Neelsen staining method, mycobacteria will be stained red while surrounding tissue is stained blue. Currently the Swedish National Board of Forensic Medicine sections formalin-fixed paraffin-embedded tissues suspected of being infected with mycobacteria at 6 µm. This study investigated whether the optimal section thickness for tissue containing Mycobacterium species was 3 µm, 4 µm, or 6 µm by sectioning eight tissue blocks at the different thicknesses. Additionally, three different variations of background staining of the Ziehl-Neelsen stain were performed: methylene blue, light green SF yellowish and without background staining. Two visual assessments of the sections were independently conducted under a light microscope. Based on the visual assessments, considering negative and positive factors regarding the various section thicknesses and background stainings, the conclusion could be drawn that the most optimal section thickness was 4 µm with methylene blue as the background stain.

Combustion engines today are primarily powered by fossil fuels, resulting in emissions of pollutants that pose significant environmental challenges. Therefore, transitioning to alternative fuels that reduce these emissions is crucial. One promising alternative fuel is ammonia, which, in addition to being carbon-free, benefits from an already developed infrastructure. However, switching to new fuels creates a different chemical environment inside the engine, and the impact on engine materials has not been well studied. Thus, in this master’s thesis, nine different engine materials (copper, brass, aluminum, cast iron, ball bearing steel, stainless steel, titanium, titanium nitride, and diamond-like carbon (DLC)) were studied before and after ammonia exposure, as well as after a tribological test, to increase the knowledge in this field. The materials were analyzed using SEM and EDS before and after exposure, and additional techniques, LOM and XPS, were also used after the exposure. All materials showed some degree of reaction in the ammonia solution. Copper, brass, and aluminum were altered to a depth of many micrometers, and the surface layer broke under tribological contact. Cast iron also reacted, but to a lesser extent, as parts of its surface remained unchanged. Ball bearing steel, stainless steel and titanium reacted mildly, primarily superficial oxidation of the surfaces. Titanium nitride and DLC were almost unaffected by ammonia. This suggests that titanium nitride, DLC, ball bearing steel, stainless steel, and titanium are more suitable for use in an ammonia driven combustion engine than copper, brass, aluminum, and cast iron.