This thesis is an exploration of architecture as an active participant in human life, not just as a stage. When architecture is considered a participant it contributes to the improvement of our quality of life as well as aiding  the healing process when we fall ill. As more people are diagnosed with anxiety and sleep disorders, the thesis considered questions of how the places in which we carry out our day-to-day lives improve the prognosis and, further, can architecture be used as a powerful tool for healing? It is possible that our disconnection from nature is partially responsible for our disrupted sleep patterns and misplaced anxieties. Perhaps natural elements and rhythms are too absent in our daily urban lives. But as more of us move into cities and our urban centers become denser, designers must find clever ways to help city owls reset their circadian rhythm. Architecture can help reestablish that bond with nature. This thesis explores an architecture of healing by proposing a program and design that follows the day and night circadian rhythm of our bodies, which in turn follow the sun and other natural phenomena. Located in a tricky triangular site in one of the busiest nighttime neighborhoods of Washington DC, a wellness center and sleep clinic would allow city dwellers to find a peaceful oasis for healing. In parallel, this thesis is also a study of collage as a design tool, as well as designing from details and the human scale. / Master of Architecture

Background: As the population grows older and hard-to-heal wounds are more likely to affect the elderly and frail, it has become a growing global problem. It involves high costs, is resource consuming and suffering for the patient due to long treatment times. About 1–2 percent of the population in well-developed countries suffer from a hard-to-heal wound at some point during their lifetime. Aim: The aim of this study was to highlight nurses' knowledge and experiences of caring for patients with hard-to-heal wounds. Method: A literature review was conducted and data was collected from twelve scientific articles with both qualitative and quantitative methods. Fribergs three-step model was used to analyze the twelve articles. Results: The result presents three main themes and seven subthemes that describes nurses' knowledge and experiences of hard-to-heal wounds. Nurses' knowledge of wound care and hard-to-heal wounds is inadequate and further education is needed. Varying emotions were felt by the nurses, such as happiness, satisfaction, frustration and disempowerment.  Conclusion: More knowledge, training and experience in wound care and hard-to-heal wounds is needed to help nurses feel more confident to provide appropriate wound care.

Bakgrund: Många personer lever idag med någon typ av bensår, varav venösa bensår är de allra vanligaste. Bensåret uppkommer ofta till följd av ett yttre hudtrauma hos de med venös insufficiens. Sjuksköterskan har en viktig roll när det kommer till omhändertagande och behandling av patienter i denna grupp. Syfte: Syftet med litteraturstudien var att undersöka patienters upplevelser av att leva med svårläkta venösa bensår. Metod: Litteraturstudie med kvalitativ ansats där tio studier analyserats. Resultat: Litteraturstudien utmynnade i fyra kategorier samt tio underkategorier. Svårläkta venösa bensår påverkar patienters förmåga att utföra vardagliga aktiviteter, dels på grund av de fysiska symtomen och dels på grund av den negativa psykiska inverkan som känslor av skam och nedstämdhet har. Såret innebär att ingå i ett förhållande med sjukvården, där kontinuitet och delaktighet är viktigt för patienterna. Olika metoder för att hantera situationen framkom. Konklusion: Resultaten visar på vikten av att se på patienten och omvårdnaden ur ett helhetsperspektiv, där inga aspekter får glömmas bort. Reflektioner över litteraturstudiens resultat leder till en bredare kunskap om hur vården kan förbättras för dessa patienter. / Background: Many persons are affected by hard-to-heal wounds with venous leg ulcers being the most common. The ulcer is usually caused by trauma to the leg in patients suffering from venous insufficiency. Nurses carry an important role in caring for this group of patients. Aim: The aim of this literature study was to explore patients’ experiences of living with hard-to-heal venous leg ulcers. Method: Literature study with a qualitative approach, where ten studies have been analyzed. Results: Four categories and ten subcategories emerged. Hard-to-heal venous ulcers greatly affect patients’ everyday life, partly due to the physical symptoms and partly to the psychological impact of feelings of shame and depressive thoughts. Developing an ulcer means entering into a relationship with health care professionals, such as nurses, and the study found that patients place a high value on the continuity of care and involvement. Different strategies to cope with the situation emerged. Conclusion: The results point to the importance of holistic care and provide a broad understanding of the experiences of patients’ living with hard-to-heal venous ulcers; the results can be used to improve care for these patients.

Bakgrund: Ett sår som inte läker inom sex veckor defineras som svårläkt. Prevalensen ökar med stigande ålder och medför stora samhällskostnadersom följd samt långvarigt lidande för patienterna. Sjuksköterskan skall leda omvårdnadsarbetet självständigt men också tvärprofessionellt utifrån omvårdnadsprocessens alla delar samt ansvara för utveckling av eget lärande. Syfte: Syftet var att belysa faktorer som har betydelse för sjuksköterskans omvårdnad av patienter med svårläkta sår. Metod: Studien genomfördes som en allmän litteraturstudoie med induktiv ansats. Sju kvalitativa och två kvantitativa vetenskapliga artiklar analyserades med en innehållsanalys. Resultat: Innehållsanalysen genererade fyra resultatkategorier: Sambandet mellan evidensbaserad vård och sjuksköterskans sårvårdskunskaper, sambandet mellan utbildning och sjuksköterskans sårvårdskunskaper, sambandet mellan teamarbeta och sjuksköterskans sårvårdskunskaper och sambandet mellan organisatoriskt stöd och sjuksköterskans sårvårdskunskaper. Konklusion: För att sjuksköterskan skall kunna utföra evidensbaserad sårvård behövs uppdaterade kunskaper genom sårvårdsutbildningar, kollaboration mellan kollegor och patienter samt organisatoriskt stöd. Sjuksköterskan behöver såväl teoretisk implementering av nya riktlinjer som praktiska övningar för att vara uppdaterad med aktualiserad information. / Background: A wound that does not heal within six weeks is defined as a hard-toheal wound. The prevalence increases with increasing age associating with high,societal costs and resulting in long-term suffering for the affected patients. Nursesmust lead the nursing work independently but also interdisciplinary based on all stepsof the nursing process. Nurses are also responsible for continuing to learn throughouttheir career. Aim: The aim was to shed light on factors that are important for nurseswound care knowledge in nursing patients with difficult-to-heal wounds Method: Thestudy was conducted as a general literature study with an inductive approach. Sevenqualitative and two quantitative scientific articles were analysed with a contentanalysis. Results: Four categories emerged: The connection between evidence-basedcare and nurses wound care knowledge, the connection between education and nurseswound care knowledge, the connection between teamwork and nurses wound careknowledge and also the connection between organizational support and nurses woundcare knowledge. Conclusion: To perform evidence- based wound care, updatedknowledge is needed through wound care training, collaboration between colleaguesand with patients but also organizational support. Nurses needs both theoreticalacquisition of new guidelines and practical exercises to implement the latest updatedinformation.

Mental health struggles and suicide rates in athletic populations have been on the rise for the past two decades, with an even bigger increase since the pandemic. Disorders such as stress, depression, and anxiety have been the main causes for these struggles and fatalities. The growing rates of mental health disorders and suicide within this population indicate that athletes do not have the adequate resources to restore and improve their mental health. In some instances of presenting their troubles to coaches, staff, or teammates, their only advice is to seek help with on-campus resources or resources at home. Although this can be sound advice in some cases, this can also create the sense that there is no escape from what may be the cause of these mental obstacles. The purpose of this thesis is to create a mental health retreat for collegiate, professional, olympic, and retired athletes. Tucked away at the edge of Rock Creek Park in Washington, D.C., in between existing amenities such as the Carter Barron Amphitheatre and the William Fitzgerald Tennis Center, the retreat allows for the continual use of existing amenities along with other resources and practices provided on-site. This retreat aims to provide spaces and resources at a location that teams or individuals can visit to allow for healing and education about these mental health disorders. This serene space in the middle of a chaotic big city will provide space for resting, performing, healing, and overall restoring which begins to break the barriers between what can be overcome in the feelings that may seem indomitable. / Master of Architecture / Mental health struggles and rising suicide rates among athletes have become increasingly concerning over the past two decades, with a significant spike since the pandemic. Stress, depression, and anxiety are the primary issues affecting this population, and current resources appear inadequate to address their needs. Often, athletes are advised to seek help from on-campus or home resources, which may not always be effective and can sometimes exacerbate feelings of entrapment. This thesis proposes the creation of a mental health retreat for collegiate, professional, Olympic, and retired athletes. Located at the edge of Rock Creek Park in Washington, D.C., near amenities like the Carter Barron Amphitheatre and the William Fitzgerald Tennis Center, this retreat offers a peaceful environment for healing and education. By utilizing existing amenities and providing additional on-site resources and practices, the retreat aims to support athletes in their mental health journeys. This serene space in the heart of a bustling city will offer opportunities for rest, performance, healing, and overall restoration, helping athletes overcome mental health challenges.

Hensikten med denne studien er å få innsikt i hvordan helsesøstrene oppdager og formidler et godt samspill mellom foreldre og barn i alderen 0-3 år. Dessuten er det et mål å få kjennskap til helsesøstrers interesse, kompetanse og muligheter for å gå inn i vanskelige situasjoner i arbeid med foreldre-barn-relasjon. Det kvalitative forskningsintervju er valgt for å samle inn data og det ble gjennomført ti intervjuer av helsesøstrer som representerer fire forskjellige kommuner, og fra åtte forskjellige helsestasjoner i Norge. Alle informanter unntatt en har tatt sin helsesøsterutdanning for mer enn ti år siden. Etter at de tok utdanningen har de stort sett arbeidet som helsesøstrer. Metoden for å analysere datamaterialet er innholdsanalyse i kombinasjon med Kvales tre tolkningsnivåer. Funnene i studien viser at foreldre-barn-samhandling påvirker tilknytningens kvalitet. Barn som opplever en god tilknytning til sine nære omsorgspersoner utvikler en god modell for relasjoner til andre mennesker. God tilknytning betraktes som en viktig faktor for den sosiale, emosjonelle og kognitive utvikling. Samfunnet har i løpet av de ti siste årene vært gjennom store forandringer. Disse forandringene har også påvirket familiemønstrene.Helsetjenesten må i større grad tilpasse seg de nye helsekrav. En konklusjon i studien sier at helsesøstrer kan være viktige omsorgspersoner i situasjoner hvor det er en emosjonell brist i tilknytningen mellom foreldre og barn. Trass i dette viser studiens funn at dette arbeidet lett blir underprioritert p.g.a. alle andre krav og gjøremål som må utføres i løpet av en arbeidsdag. Det er derfor mye som tyder på at denne oppgaven for helsesøstrer med fordel kan styrkes. / The purpose of this study is to gain knowledge of how health visitors discover and affect a happyinterplay between parents and children in the age of 0-3 years. Besides, its goal is also to get insight into health visitors' interest, competence, and possibilities to enter into difficult situations in their work with parent-child-interaction. The qualitative research interview is chosen to collect data. Interviews were undertaken with ten health visitors, who worked in eight different health stations, fromfour different urban districts in Norway. All informants, but one, finished their healthvisitor education for tenyears ago. They have mainly worked as health visitors since they finished their education. The method used to analyze the collected data is content analysis combined with Steinar Kvale’s three levels of interpretation. The study shows that the parent-child-interaction affects the quality of attachment of the latter to the former. The children, who are experiencing a good attachment to the caregivers, care providers close to them, develop a good rolemodel in relations towards other people. A good attachment is considered important to the child’s social, emotional and cognitive development. Norwegian societyhas during the last ten years been through many great changes. These changes have also influenced family patterns. Health services have to adjust in a larger scale to these new demands for health care. One conclusion of the study is that health visitors can be important caregivers in situations, in which there is an emotional flaw in the attachment between parents and children. Another conclusion drawn from the study is that the health visitors’ task or felt duty to improve the child-mother attachment is easily put aside, due to plenty of other duties that have to be done byhealth visitors during a days work. There is however sufficient reason to believe that this particular task for health visitors should be strengthened, since as researches show, a good child-mother attachment plays a fundamental role in the child development. / <p>ISBN 91-7997-103-2</p>

Bakgrund:Trycksårsproblematiken är omfattande och innebär lidande för patienter som drabbats i form fysiska, psykiska och sociala besvär. Lidandet innefattar även rädsla för smärtsamma och obehagliga behandlingar samt för de konsekvenser som dessa kan medföra i form av infektioner och amputationer eller för att såren inte ska läka. I sjuksköterskans arbete ingår att genom ett holistiskt synsätt och med evidensbaserade metoder söka förhindra och behandla trycksår. Syfte: Att belysa hur patienter med svårläkta trycksår upplever sin tillvaro ur ett livskvalitetsperspektiv. Metod: Uppsatsen har baserats på åtta studier med kvalitativ ansats och två studier med kvantitativ ansats. Materialet har analyserats förutsättningslöst. Vid kategoriseringen av analysinnehållet inspirerades författarna av WHO:s definition av livskvalitet. Studierna som valdes in för analys eftersöktes i CINAHL, Medline, AMED och Academic Search Elite. Resultat: Patienter med trycksår lider av såren på ett psykiskt, fysiskt och socialt plan vilket leder till en signifikant påverkan på upplevd livskvalitet. De patienter som berörs av trycksårsproblematik verkar vara benägna att använda andlighet, religion eller personlig tro för att klara av sin situation Slutsats: Patienter med trycksår upplever stora negativa förändringar i sitt dagliga liv och i hur de upplever sin livskvalitet. Det har framkommit att patienter med trycksår i hög grad påverkas av bemötandet från vårdpersonal och deras kompetens vilket är en indikator på att förbättringar inom dessa områden är av vikt. / Background: Pressure ulceration is a widely spread health issue leading to physical, mental and social suffering for people that are affected by the problem. The suffering also contains fear of numerous painful and unpleasant treatments as well as the possibility of being affected by negative treatment consequences such as infections or amputation. It also includes fear of that the wounds won’t heal properly. The work of the health-care professional contains a holistic approach towards the patient and trying to prevent as well as treat pressure ulceration through using evidence based methods. Aim: To highlight what effect hard to heal pressure ulceration has on individuals perception on their everyday life from a quality of life perspective. Method: This study is based on eight articles with a qualitative approach and two articles with a quantitative approach. The result from the articles was initially analyzed unconditionally. Throughout the categorization of the analyze material the authors of this study were inspired by WHO’s definition of health related quality of life. The studies that were chosen for analysis were searched for in CHINAHL, Medline, AMED and Academic Search Elite. Result: Individuals affected by pressure ulceration suffer on a physical, psychological and social level which has a significant effect on how they perceive their quality of life. In spite of that, these individuals seem to be prone to use spirituality, religion or personal beliefs as a way to cope with their situation. Conclusion: Major negative changes in daily life and in perceptions of quality of life are experienced by people that are affected by pressure ulcers. It has also emerged that people affected by pressure ulceration are highly affected by the approach from health-care professionals and their competence which is an indicator of that improvements in these areas are important.

Bakgrund: Svårläkta bensår är symtom på underliggande sjukdom och drabbar cirka två procent av befolkningen. Det är ett plågsamt tillstånd som kräver kontinuerlig omvårdnad under långa perioder.  Syfte: Syftet var att belysa vuxna personers erfarenheter av att leva med svårläkta bensår. Metod: En litteraturstudie genomfördes utifrån tio kvalitativa empiriska studier och analyserades med Fribergs femstegsmodell. Studierna återfanns i CINAHL, PubMed, Scopus och Google scholar. Resultat: Utifrån analysen formades fyra huvudkategorier och tio underkategorier. ’Förlorad makt över kroppen’: ’Outhärdlig smärta’ och ’Outhärdlig lukt’. ’Förlorad kontroll över livet’: ’En begränsad vardag’, ’Svårt att upprätthålla relationer’ och ’Måsta härda ut’. ’Betydelsen av delaktighet’: ’Svårt att känna tillit’, ’Att känna sig nonchalerad’ och ’Att känna samhörighet’. ’Ständig ovisshet’: ’Att inte veta varför’ och ’Rädsla för framtiden’. Bensåren orsakade ett stort lidande i livets fysiska, psykiska och sociala aspekter.  Konklusion: För att lindra lidandet behöver sjuksköterskor ökad kunskap samt förståelse för att kunna ge en god omvårdnad. Vården måste prioritera denna patientgrupp och omorganisera för en bättre struktur vid diagnostisering, behandling och uppföljning. Det behövs fler interventionsstudier om svårläkta bensår. / Background: Hard-to-heal leg ulcers are symptoms of underlying disease and affects about two percent of the population. It is an agonizing condition that requires continuous care for long periods.  Aim: The aim was to shed light on adults' experiences of living with hard-to-heal leg ulcers.  Methods: A literature study was conducted based on ten qualitative studies and analyzed with Friberg's five-step model. The studies were found in CINAHL, PubMed, Scopus and Google scholar.  Results: Based on the analysis, four main categories and ten subcategories were formed. ’Lost power over the body’: ’Unbearable pain’ and ’Unbearable odour’. ’Lost control over life’: ’A limited everyday life’, ’Difficult to maintain relationships’ and ’Must endure’. ’The importance of participation’: ’Difficult to feel trust’, ’To feel neglected’ and ’To feel affinity’. ’Constant uncertainty’: ’Not knowing why’ and ’Fear of the future’. The leg ulcers caused great suffering in the physical, psychological and social aspects of life. Conclusion: To ease the suffering, nurses need to increase their understanding and knowledge to provide a good care. The healthcare organization must prioritize this patient group and reorganize for a better structure in diagnosis, treatment and follow-up. More intervention studies are needed about hard-to-heal leg ulcers.

Bakgrund: Svårläkta sår drabbar cirka två procent av Sveriges befolkning och tar stora resurser från vården där personalkostnaden är den största. Svårläkta sår har också en stor negativ påverkan på patientens livskvalitet i form av smärta, bundenhet till omläggningar och social isolering. Att vårda patienter med svårläkta sår är en komplex uppgift som bland annat omfattar sårbedömning, kunskap om bakomliggande faktorer, sårläkningprocessen, uppföljning, dokumentation och ett holistiskt tänkande. För att kunna utföra sitt arbete på ett bra sätt krävs att sjuksköterskan besitter kunskap och erfarenhet inom området svårläkta sår. Syftet: med studien var att sammanställa och beskriva kunskap om sjuksköterskans erfarenheter av att vårda patienter med svårläkta sår. Metod: En litteraturstudie baserad på åtta kvalitativa studier sökta genom systematisk och osystematisk sökning i vetenskapliga databaser. Artiklarna kvalitetsgranskades utifrån bedömningsformuläret Critical Appraisal Skills Programme och innehållet analyserades enligt Thomas och Hardens metod för att slutligen bilda olika teman. Resultat: Tre huvudteman identifierades; det komplexa såret, att möta hinder på vägen samt vård som håller i längden. Utifrån dessa huvudteman framkom nio subteman; nycklarna till en god sårvård, när kunskapen inte räcker till, styrkan i professionen, känslorna går inte att stänga av, arbeta med eller mot organisationen, det är inte alltid lätt i praktiken, allt borde inte ligga i våra händer, den faktiska och den verkliga kostnaden samt att sätta patienten i första rummet. Slutsats: Distriktssköterskans kompetens behöver tas tillvara på och sårvård med tillhörande utbildning behöver få högre prioritering från arbetsledningen gällande stöd, engagemang och tid. Tydliga riktlinjer kring svårläkta sår behövs och en god samverkan både mellan vårdteam och mellan organisation är nödvändig för att kunna se till patientens bästa. / Background: Hard-to-heal wounds affect about two percent of Sweden´s population and take large resources from the healthcare, where staff costs are the largest. Hard-to-heal wounds also have a major impact on the patient´s quality of life in form of pain, attachment to diversions and social isolation. Caring for people with hard-to-heal wounds is a complex task as it includes many different parts such as wound assessment, knowledge of underlying factors, wound healing, follow-up, documentation and holistic thinking. In order to perform their work in a good way, the nurse must possess knowledge and experience in the field of hard-to-heal wounds. The aim: of the study was to compile and describe the knowledge about nurse´s experience of caring for patients with hard-to-heal wounds. Methods: A literature review based on eight qualitative studies searched through systematic and unsystematic search in scientific databases. The articles were quality checked based on the Critical Appraisal Skills Programme assessment questionnaire and the content was analyzed according to Thomas and Harden´s method to finally form different themes. Results: Three main themes were identified; The complex wound, Encountering obstacles on the way and Sustainable care. Based on these main themes nine subthemes emerged; The keys to good wound care, When knowledge is not enough, The strenght of the profession, The feelings can not be turned off, Work with och against the organization, In practice it is not always easy, Everything should not be in our hands, The actual and the real cost and Put the patient first. Conclusion: The district nurse´s competence needs to be utilized and wound care with associated training needs to be given a higher priority from the management in terms of support, commitment and time. Clear guidelines on hard-to-heal wounds are needed and a good collaboration both between care teams and between organizations is necessary to be able to ensure the patients´ best interest.

Les piles à combustible à membrane échangeuse de protons (PEMFC) permettent de convertir efficacement de l'énergie chimique en électricité. Pour cela l'hydrogène s'oxyde sur une des électrodes de la pile, les protons ainsi créés traversent l'électrolyte (membrane) tandis que les électrons parcourant le circuit extérieur fournissent l'énergie électrique. Tous ces éléments se recombinent à la seconde électrode qui, à l'aide de la réduction de l'oxygène, va former de l'eau. Le rendement n'étant pas parfait, une partie de l'énergie des réactifs est aussi dégradée sous forme de chaleur. Malgré de récents progrès, la commercialisation à grande échelle des piles à combustible est toujours entravée par des problèmes de durabilité, liés notamment à la gestion de l'eau et de la température au sein de ce système. Afin de quantifier le comportement thermique et son effet sur le transport de l'eau, une pile à combustible a été instrumentée, permettant la mesure de la température aux électrodes, des flux de chaleur et d'eau. Les résultats montrent que de forts gradients de température (jusqu'à environ 30 K/mm) peuvent exister pour une pile fonctionnant dans des conditions standard. Il a été observé une nette influence du champ de température dans le coeur de pile sur le transport de l'eau qui se fait vers la partie la plus froide de la pile (généralement les canaux d'alimentation), l'eau traversant les couches de diffusion poreuses sous forme vapeur dans nos conditions expérimentales / Proton exchange membrane fuel cells (PEMFC) make it possible to convert efficiently chemical energy into electricity. For this, hydrogen is oxidized at one of the electrodes of the cell, created protons pass through the electrolyte (membrane) while electrons flow across the external circuit provide the electrical energy. All these elements recombine at the second electrode, with oxygen, to produce water. Performance is not perfect within a cell and a part of the reactants energy is also degraded as heat. Despite recent advances, the large scale commercialization of PEMFC is still hampered by durability issues, some of them being related to water and thermal management. In order to quantify the thermal behavior and its effect on the water transport, a fuel cell has been instrumented for the electrodes temperature, water and heat fluxes measurement. The results show that high temperature gradients (up to about 30 K/mm) can exist in a cell operating under standard conditions. It was observed a clear influence of the temperature field in the cell on the water transport. Water flows towards the coldest part of the cell (usually the channels), passing through the porous layers in vapor phase in our experimental conditions