Bakgrund: Under pandemin har det varit vanligt förekommande att patienter med COVID-19 får en bedömning av en sjuksköterska i ambulansen och sedan hänvisas att kvarstanna i hemmet med egenvårdsråd. Det finns lite forskning om patienters upplevelse av ambulanssjukvården och ingen om hur den nya situationen som pandemin innebar påverkade hur patienter upplever bemötandet från ambulanspersonal. Ambulanspersonalens bemötande har stor påverkan på patienters upplevelse av vården, vilket gör ämnet viktigt att studera vidare i den nya kontext som COVID-19 innebar. Patientens grundläggande vårdbehov kan beskrivas med hjälp av ramverket Fundamentals of Care’s (FOC) andra dimension utifrån fysiska, psykosociala och relationella aspekter. Syfte: Att beskriva hur patienter med COVID-19 upplever bemötandetfrån sjuksköterska i ambulanssjukvården vid hänvisning till egenvårdsråd i hemmet. Metod: En kvalitativ intervjustudie med innehållsanalys. Deltagarna var sju kvinnor och tre män i åldrarna 38–81. Resultat: Aspekter av de psykosociala behoven som var betydelsefulla var att återfå kontroll över situationen, bli självständig i sin vård, förmedlas lugn och få hjälp med att hantera oroskänslor. Aspekter av de relationella behoven som var betydelsefulla var att få stöttning, bli lyssnad på och att bli förstådd. Den aspekt av de fysiska behoven som var viktig var att känna sig trygg i sin fysiska status. Upplevelsen försämrades när deltagarna inte blev lyssnade på och inte fick hjälp att ta kontroll över situationen. Slutsats: Patienter med COVID-19 som blir hänvisade till att kvarstanna i hemmet med egenvårdsråd upplever ett gott bemötande från ambulanspersonalen när de får sina psykosociala, relationella och fysiska behov tillgodosedda. / Background: During the ongoing pandemic, it’s been common for patients with COVID-19 to receive an assessment from a nurse in the ambulance and then be referred to remain at home with self-care advice. There is little research that sheds light on patients experience of ambulance care. The treatment from the ambulance staff has a great impact on how patients experience their care, which makes the subject important to study further in the new context of the pandemic. Patients basic care needs can be described using the Second Dimension Fundamentals of Care (FOC) framework. Objective: To describe how patients with COVID-19 experience treatment from a nurse in the ambulance service when referring to self-care advice at home. Method: A qualitative interview study with content analysis. The participants were seven women and three men aged 38-81. Results: Aspects of psychosocial needs were to regain control of the situation, become independent in their care, be calmed and get helped to deal with feelings of anxiety. Aspects of relational needs were to receive support, to be listened to and to be understood. The aspect of physical needs was to become reassured in their physical status. The experience deteriorated when the participants were not listened to, received poorly personalized information and did not receive help to take control of the situation. Conclusion: Patient with COVID-19 who are referred to remain at home with self-care advice experience a good response from the ambulance staff when they have their psychosocial, relational and physical needs met.

This is a study on information conveyance, specifically a study on how specific level design techniques can be used to convey information to the players regarding a competitive multiplayer game's “state of play”. Through an analysis of different games, three different level design elements were identified as effective tools for conveying information and these elements are; architectural placement, visual cues and environmental changes. A third-person multiplayer shooter game was then created with the three elements applied in different forms and then tested for their effectiveness. Afterwards, the game was tested by a number of participants who filled out a survey of questions and were interviewed. It was discovered that the methods tested were found to be mostly effective at conveying information, the architectural placement of the capture point in conjunction with the visual cues aspect of it worked well to inform the players of the state of play. The environmental changes were an example where a method had an impact on the game but since the correlations were unclear, the information was not conveyed effectively, but with a few alterations has the potential to work well.

Sjuksköterskor i ambulanssjukvård har i allmänhet möjlighet att hänvisa patienter till egenvård om de saknar ett behov av akutsjukvård eller primärvård. Egenvård innebär att hälso- och sjukvårdsåtgärder utförs av patienten själv eller närstående. Det åligger sjuksköterskan att bedöma och medverka till att patienten omhändertas på rätt vårdnivå med bibehållen patientsäkerhet och delaktighet. Idag söker sig fler patienter direkt till akutsjukvården än tidigare. Tidigare forskning visar att hänvisning till annan vårdnivå kan vara komplext, krävande och medföra ett omfattande ansvarstagande. Syfte: Syftet med studien var att undersöka sjuksköterskors erfarenheter av att prehospitalt hänvisa patienter till egenvård. Metod: Studien har en kvalitativ induktiv ansats. Semistrukturerade intervjuer genomfördes med tio sjuksköterskor som rekryterades från ambulanskliniken i Region Jönköpings län. Materialet har analyserats med induktiv innehållsanalys enligt Elo och Kyngäs modell. Studiens resultat indikerar en varierad upplevelse av hänvisning till egenvård. Samtliga sjuksköterskor strävar efter att göra ett bra jobb och hänvisa patienterna till optimal vårdnivå. Strävan efter att alla parter känner sig trygga tycks vara central. Flera försvårande omständigheter vid hänvisning till egenvård identifieras som äldre patienter, språkförbistringar och överflöd av information. Det råder delad mening bland informanterna kring vilket stöd som upplevs av riktlinjer och ledning. Slutsats: Vissa sjuksköterskor är trygga i sina beslut, medan andra kan vara mer osäkra och reflekterar över sina egna begränsningar. Vi efterlyser utveckling och vidare forskning kring hänvisning till egenvård samt mer utbildning för ambulanssjuksköterskor inom ämnet. / In general, nurses in ambulance care can decide which patients who can be referred to self-care if there is a lack of need for emergency or primary care. Self-care is defined as healthcare measures performed by the patient or their relatives. It's the nurse's responsibility to assess the patient and refer the patient to the optimal level of care with respect to patient safety and patient involvement. Statistics show that the number of patients seeking emergency medical attention has increased in the last few years. Previous research indicates that non-conveyance is a demanding and complex task that is associated with extensive responsibility. Aim: The aim of this study is to examine the RN‘s experience when referring patients to self-care in the prehospital setting. Method: A total of ten RN ‘s participated in qualitative semi-structured interviews. The participants were recruited from Region Jönköpings läns ambulance service. The material was analyzed with inductive content analysis as suggested by Elo and Kynges. The results shows a variation regarding the experience of referring patients to self-care. All the RN’s strive to do a good job and to refer patients to an adequate level of care. The quest for all parties to feel safe seems to be central. Several aggravating factors are identified; older patients, language impairment, too much information etc. There are divided opinions about what support is experienced by management and guidelines. Conclusion: Some RN‘s are confident in their decisions, while others may be more insecure and reflect on their own limitations. We call for the development of guidelines, further research and extended education about non-conveyance.

Accurate flow measurement is required to effectively manage water resources. California Senate Bill X7-7 (SB X7-7), legislates this need by requiring agricultural water providers serving areas greater than 25,000 acres to develop an Agricultural Water Management Plan (AWMP) and adopt pricing based at least partly on volumetric water deliveries (DWR, 2009). This study focused on two of the most common flow measurement/flow control devices used in California open channel water conveyance systems: the circular meter gate and the rectangular meter gate. Testing was conducted on three Armco-type (round gates over round discharge pipe) gates measuring 12”, 18”, and 24” and two rectangular gates (rectangular gates over round discharge pipe) measuring 18” and 24”. The three round gates used in the study were the Model 101C produced and provided by Fresno Valve and Castings Incorporated. The two rectangular meter gates were manufactured by Mechanical Associates located in Visalia, California and provided by the San Luis Canal Company located in Dos Palos, California. Testing was conducted in an outdoor laboratory setting at the Irrigation Training and Research Center’s (ITRC) Water Resources Facility at the California Polytechnic State University in San Luis Obispo, California under a variety of flow conditions as experienced in the field in order to: 1) evaluate the effectiveness of these gates as flow measurement devices and determine whether they meet the volumetric accuracy requirements outlined in SB X7-7, 2) develop standards for installation and use that improve flow measurement accuracy, 3) configure more accurate gate rating tables based on updated coefficient of discharge values, and 4) determine if additional gate rating tables are needed for “high” supply channel velocities. The meter gate was set perpendicular to the supply channel. Baseline data was first collected through testing with low supply channel water velocities. Additional testing was then conducted with high supply channel water velocities to analyze the effect on the coefficient of discharge. Based on previous studies it was hypothesized that as the Froude number (FR#) in the supply channel increased (water approach velocity increased), the coefficient of discharge would decrease as a result of an increase in energy needed for the perpendicular velocity transition. Data evaluation, however, indicated no statistically significant effect of water approach velocity on the coefficient of discharge for the 12”, 18” and 24” circular gates or the 18” and 24” rectangular gates at an α-level = 0.01. When operating the gates under recommended conditions relative flow uncertainty was within +/- 5%. This meets the accuracy requirements set by SB X7-7 for turnout flow measurement devices. Based on the results of this study, Cd values do not need to be adjusted for Froude numbers up to 0.35 for any of the studied gates. It should be noted, however, that while most meter gates used will be in conditions where supply channel Froude numbers do not exceed 0.35, further research is needed to study potential effects from Froude numbers exceeding the range found in this study.

Bakgrund: Att patienter som ringt efter ambulans inte tas med till sjukhus utan blir hänvisade till en annan vårdnivå än ambulanssjukvård är idag vanligt förekommande. Det finns dock mycket lite forskning som belyser hur patienter upplever bemötandet i sådana situationer. Detta är viktigt att utforska då studier visar att patienters upplevelse av sin vård påverkas mycket av ambulanspersonalens bemötande. Med hjälp av ramverket Fundamentals of Care’s (FOC) andra dimension kan integreringen av patienters grundläggande vårdbehov i mötet med vårdpersonal beskrivas utifrån fysiska, psykosociala och relationella aspekter som är nödvändiga oberoende av sjukdomstillstånd. Syfte: Att utforska patienters upplevelse av bemötandet från ambulanspersonalen vid hänvisning till egenvård eller annan vårdnivå, utifrån fysiska, psykosociala och relationella behovsaspekter. Metod: En kvalitativ intervjustudie med innehållsanalys. Deltagare var fyra kvinnor och sex män i åldrarna 25–75 (44,8). Resultat: Fysiska behov tillgodosågs genom grundlig undersökning och av att göra en plan för fortsatt vård, vilket gav deltagare känsla av säkerhet. Psykosociala behov tillgodosågs genom information, värdighet samt inbjudande till delaktighet. Deltagare kände sig lugnade och bekräftade av att få tydlig, individanpassad information. Relationella behov tillgodosågs av ett professionellt och empatiskt förhållningssätt från ambulanspersonalen. Vårdrelationen och upplevelsen försämrades av dåligt individanpassat bemötande. Slutsats: Patienter upplever ett gott bemötande när de får fysiska, psykosociala och relationella behov tillgodosedda, i situationer där ambulanspersonal hänvisar dem till en annan vårdnivå. / Background: Patients assessed by ambulance staff are on a regular basis referred to a different level of care. However, there is little research that highlights how patients experience treatment in such situations. This is important to explore as studies show that patients' experience of their care is greatly affected by the response of ambulance staff. Using the second dimension of the Fundamentals of Care (FOC) framework, the integration of patients' basic health care needs can be described on the basis of physical, psychosocial and relational aspects that are necessary regardless of medical conditions. Objective: To explore patients' experience of the treatment from the ambulance staff when referring patients to other levels of care, based on physical, psychosocial and relational needs. Method: A qualitative interview study based on content analysis. Participants were four females and six males in ages 25–75 (44,8). Results: Physical needs were met by thorough examination and by making a plan for continued care, which gave participants a sense of security. Psychosocial needs were met through information, dignity and participation. Participants felt reassured and confirmed by receiving clear, personalized information. Relational needs were met by a professional and empathetic approach from the ambulance staff. The care relationship and experience was impaired by poorly personalized treatment. Conclusion: Patients experience a good treatment when they have their physical, psychosocial and relational needs met, in situations where ambulance staff refer them to a different level of care.

Vane-type in-stream structures and step pool storm conveyance (SPSC) are more ecologically friendly alternatives to traditional stream channel stabilization and stormwater conveyance techniques. Vane-type structures have been widely accepted as elements of stream restoration projects and are regularly implemented in streams throughout the United States. However, these structures commonly experience partial or total failures of function or stability, often due either to improper installation or misapplication. This study undertook a thorough review of the available design guidance for the single-arm vane, j-hook vane, cross vane, and w-weir, which revealed that the existing guidance is composed of non-standardized recommendations largely based on practitioner experience and rules of thumb. Existing guidance was synthesized with current structure research and practitioner surveys to create factsheets for each of the four structures and the SPSC, with the intent of improving structure application and offering concise general guidance. This study also endeavored to improve the design of the SPSC by determining the most accurate of several common prediction methods for Manning's roughness coefficient n, used in SPSC design velocity calculations. This was done by using Rhodamine WT dye tracer experiments to determine n values during storm flows in two SPSC structures in Annapolis, MD, which were then compared to predicted n values. Values of Manning's n determined in the SPSCs at low flows (0.28-12) often exceeded the predicted n values (-0.17-3.9) by several orders of magnitude. Though the applicability of these results is limited, an increase in design n to 0.1-0.2 is still recommended. / Master of Science / Vane-type in-stream structures are stone or wood structures installed within a stream channel for purposes such as streambank stabilization or aquatic habitat creation. Step pool storm conveyance (SPSC) is a technique which converts an existing steep stream or gully into a step-pool channel. Both of these techniques are more ecologically friendly than many traditional stream channel stabilization or stormwater conveyance techniques such as riprap or concrete storm drains. Vane-type structures in particular have been widely accepted as elements of stream restoration projects and are regularly implemented in streams throughout the United States. However, these structures commonly experience partial or total failures, either through structural collapse or failure to function properly. This is often either because they were improperly installed or because they were installed at a stream site where they were inappropriate or unnecessary. A review of the available guidance for the design of these structures revealed that the existing guidance is composed of non-standardized and sometimes contradictory recommendations which are largely based on designer trial and error and rules of thumb, rather than on the results of scientific experiments or modeling. The goal of this study was to improve the success of vane-type in-stream structures and the SPSC by providing factsheets offering clear and concise general design guidelines and sound recommendations for structure application. Flow studies of two SPSC structures in Annapolis, MD were also conducted to improve the design of that structure by measuring its flow characteristics in the field.

A presente dissertação tem por objetivo analisar as normas que disciplinam as transferências intergovernamentais no ordenamento jurídico brasileiro implantado com o advento da Constituição Federal de 1988, mostrando a sua importância como instrumento tendente a assegurar a autonomia dos entes federativos. O trabalho tem início com o estudo do Estado Federal e suas principais características, do estudo do Federalismo Fiscal, assim como a definição, principais características, objetivos e justificativas das transferências intergovernamentais no ordenamento jurídico brasileiro. Em seguida, haverá a demonstração e a sistematização de algumas das transferências intergovernamentais no federalismo fiscal implantado pela Constituição Federal de 1988, verificando as formas de distribuição de receita entre os entes federativos, de modo a possibilitar o alcance da efetiva autonomia financeira de cada um. Por fim, os principais pressupostos teóricos decorrentes da análise do texto positivo serão aplicados na prática, com o breve exame de alguns casos controvertidos na doutrina e na jurisprudência. / This masters´ thesis has the purpose of analyzing the provisions which rule the intergovernmental transfers in the Brazilian legal order implemented with the establishment of the Federal Constitution of 1988, showing its importance as instrument to ensure the independence of the federal units. The work started with the study of the Federal State and its main characteristics, the study of the Fiscal Federalism, as well as the definition, main characteristics, goals and justifications of the intergovernmental transfers in the Brazilian legal order. Then, there comes the demonstration and systematization of some intergovernmental transfers in the fiscal federalism implemented by the Federal Constitution of 1988, checking the income distribution of forms between the federative units, in order to allow each one to achieve its effective financial independence. Finally, the main theoretical assumptions resulting from the analysis of the positive text will apply in practice, with the brief examination of some controversial cases in the doctrine and in the jurisprudence.

A presente dissertação tem por objetivo analisar as normas que disciplinam as transferências intergovernamentais no ordenamento jurídico brasileiro implantado com o advento da Constituição Federal de 1988, mostrando a sua importância como instrumento tendente a assegurar a autonomia dos entes federativos. O trabalho tem início com o estudo do Estado Federal e suas principais características, do estudo do Federalismo Fiscal, assim como a definição, principais características, objetivos e justificativas das transferências intergovernamentais no ordenamento jurídico brasileiro. Em seguida, haverá a demonstração e a sistematização de algumas das transferências intergovernamentais no federalismo fiscal implantado pela Constituição Federal de 1988, verificando as formas de distribuição de receita entre os entes federativos, de modo a possibilitar o alcance da efetiva autonomia financeira de cada um. Por fim, os principais pressupostos teóricos decorrentes da análise do texto positivo serão aplicados na prática, com o breve exame de alguns casos controvertidos na doutrina e na jurisprudência. / This masters´ thesis has the purpose of analyzing the provisions which rule the intergovernmental transfers in the Brazilian legal order implemented with the establishment of the Federal Constitution of 1988, showing its importance as instrument to ensure the independence of the federal units. The work started with the study of the Federal State and its main characteristics, the study of the Fiscal Federalism, as well as the definition, main characteristics, goals and justifications of the intergovernmental transfers in the Brazilian legal order. Then, there comes the demonstration and systematization of some intergovernmental transfers in the fiscal federalism implemented by the Federal Constitution of 1988, checking the income distribution of forms between the federative units, in order to allow each one to achieve its effective financial independence. Finally, the main theoretical assumptions resulting from the analysis of the positive text will apply in practice, with the brief examination of some controversial cases in the doctrine and in the jurisprudence.

Turismen är en av världens största och mest expansiva branscher. Intresset för kulturturism har ökat under de senaste årtiondena och turisternas efterfrågan på upplevelser som involverar ursprungsfolk växer. På många håll i världen är det västerländska turistföretag som ställer villkoren för hur denna kulturförmedling ska se ut. Detta medför att en stereotyp och missvisande bild av ursprungsfolk många gånger bibehålls, vilket får negativa följder för ursprungsgrupperna. Andra följder av turismens expansion är exempelvis tvångsförflyttningar av ursprungsbefolkningar. Åtminstone tidigare var förhållandena liknande för Sveriges ursprungsfolk - samerna. I denna uppsats intervjuas fem samer, som på olika sätt arbetar med samisk turism och kulturförmedling. Syftet är att undersöka deras syn på samisk kulturturism, både i relation till det samiska samhället och till samhället i övrigt. Jag vill ta reda på vilka möjligheter och risker informanterna anser att samisk turism kan medföra för det samiska samhället. Informanternas syn på och erfarenheter av makt och kulturförmedling belyses. Frågor kring turism och autenticitet ventileras. Med historiska skeenden och teoretiska diskussioner som bakgrund diskuteras uppsatsens empiriska del. / Tourism is one of the largest and most expansive industries in the world. The interest in cultural tourism has increased over the last few decades, and the demand for indigenous tourism is growing. In many parts of the world, indigenous tourism is conditioned by western tourist companies. This means that a stereotyped and misleading picture of indigenous peoples many times is maintained, with negative consequences for indigenous communities. Other consequences of tourism expansion is, for example, forced relocations of indigenous groups. At least in the past, the conditions were similar to the indigenous people of Sweden - the Sámi. In this study, five Sámi - who in various ways are working with Sámi tourism and cultural conveyance - are interviewed. The purpose is to examine their view of Sámi cultural tourism, both in relation to the Sámi society and to society as a whole. I want to find out what opportunities and risks the informants believe that Sámi tourism may entail for the Sámi society. The informants perspective on power, indigeneity and cultural conveyance is highlighted. Issues concerning tourism and authenticity are discussed. With historical events and theoretical discussions as a background, the empirical part of the paper is discussed.

Dans les systèmes mécaniques ou mécatroniques, les actionneurs sont les composants utilisés pour convertir l’énergie d’entrée, généralement l’énergie électrique, en tâche mécanique telles que le mouvement, la force ou une combinaison des deux. Actionneur analogique et actionneur numérique sont les deux types d’actionneurs les plus communs. Les actionneurs numériques possèdent les avantages du contrôle en boucle ouverte, faible consommation d’énergie par rapport aux actionneurs analogiques. Cependant, les actionneurs numériques présentent deux inconvénients majeurs. Les erreurs de fabrication de ces actionneurs doivent être contrôlées précisément parce que, contrairement à des actionneurs analogiques, une erreur de fabrication ne peut pas être compensée par la loi de commande. Un autre inconvénient est leur capacité à réaliser les tâches continues en raison de leur corse discrète. Un assemblage de plusieurs actionneurs numériques peut néanmoins réaliser des tâches multiples discrètes. Cette thèse porte sur la caractérisation et l’optimisation d’une conception expérimentale actionneurs tableau numériques pour l’application planaire de transport. Le premier objectif principal de la présente thèse est axé sur la caractérisation de l’ensemble des actionneurs existants et aussi une application planaire de transport sur la base du tableau des actionneurs. A cette fin, une modélisation de la matrice des actionneurs essais expérimentaux ont été effectués afin de déterminer l’influence de certains paramètres sur le comportement des actionneurs de tableau. Le deuxième objectif est de concevoir une nouvelle version du tableau actionneurs sur la base de l’expérience du premier prototype. Une optimisation de la conception a ensuite été réalisée en utilisant des techniques d’algorithmes génétiques tout en tenant compte de plusieurs critères. / In mechanical or mechatronical systems, actuators are the components used to convert input energy, generally electrical energy, into mechanical tasks such as motion, force or a combination of both. Analogical actuator and digital actuator are two common types of actuators. Digital actuators have the advantages of open-loop control, low energy consumption and etc compared to analogical actuators. However, digital actuators present two main drawbacks. The manufacturing errors of these actuators have to be precisely controlled because, unlike to analogical actuators, a manufacturing error cannot be compensated using the control law. Another drawback is their inability to realize continuous tasks because of their discrete stroke. An assembly of several digital actuators can nevertheless realize multi-discrete tasks. This thesis focuses on the experimental characterization and optimization design of a digital actuators array for planar conveyance application. The firs main objective of the present thesis is focused on the characterization of the existing actuators array and also a planar conveyance application based on the actuators array. For that purpose, a modeling of the actuators array and experimental test has been carried out in order to determine the influence of some parameters on the actuators array behavior. The second objective is to design a new version of the actuators array based on the experience of the first prototype. An optimization of the design has then been realized using genetic algorithm techniques while considering several criteria.