Modern civilizations have evolved to be highly dependent on electrical energy. The exponentially growing renewables market has signaled transitions in electricity sectors that have traditionally been dominated by fossil fuel electricity. Various theoretical debates have recently emerged surrounding the processes of socio-technical transition, focusing on the pathways of transition, the levers for radical change and path-dependencies within these systems. The Multi-Level Perspective on Socio-technical Transitions is one such theory. This perspective views socio-technical change as a factor of interdependent shifts between three analytical levels observed within the system: the socio-technical regime, the socio-technical niche and the landscape. In accordance with this theory, radical change is generally observed as originating at niche level. Irregularities within the dominant regime and landscape pressures allow for niche innovations to break through into the dominant regime in processes of socio-technical transition. Toward understanding actor influences on energy transitions, considerable attention has been paid to actor's impact on governance processes through: patterns of consumption, the shaping of legislation and technical innovations, by socio-technical transitions theories. However less attention has been paid to the ways in which actors in renewable electricity markets are: forming networks toward the establishment of new regimes and governing processes at niche level, and consequently how actor governance has impacted the established perceptions and available pathways for realizing electric security. This thesis, builds on the Multi-Level Perspective, through an exploration of how actors govern socio-technical systems at niche level, paying careful attention to the modalities of power giving and power taking that allow for the development of networks of people and things toward the stabilization of novel socio-technical practices, innovations and developmental trajectories. It does this through a networked analysis of how different actors with different interests cooperate to open up innovative social and technological pathways.

Bakgrund: Amyotrofisk lateralskleros (ALS) är en svårdiagnostiserad och ovanlig sjukdom som påverkar patientens hela tillvaro. Till följd av det snabba sjukdomsförloppet utsätts patienten för en stor omställning på kort tid. Det skapar starka känslor i relation till förändringarna i kroppen och till omgivningen.  Syfte: Beskriva patienters upplevelse vid amyotrofisk lateralskleros. Metod: Genom en allmän litteraturöversikt har resultatet från sju kvalitetsgranskade artiklar analyserats och sammanfattats till ett nytt resultat. Artiklar från Cinahl och Pubmed har analyserats och sammanfattas för att forma ett resultat. Vid sökning efter artiklar har systematisk sökstrategi använts samt manuell sökning. Efter dataanalys har teman och subteman utformats.  Resultat: Teman som presenteras är: tappa fotfästet, lidande, relationernas inverkan på patienten och vägen vidare. Samt två subteman: ensamhet och tankar om åldrande. Många patienter beskrev att insjuknandet gav en känsla av förlorad kontroll och att de fysiska förändringarna var svårhanterliga. Symtom av sjukdomen skapade bland annat lidande, oro och kontrollförlust. Delaktighet för närstående var essentiellt för patienten. Att identifiera sig som sjuk var många gånger svårt. Olika strategier användes för att anpassa sig till den nya situationen. Slutsats: Att få diagnosen ALS upplevdes olika beroende på patientens livssituation. Under sjukdomens utveckling förändrades bland annat personens identitet och det uppstod olika känslor. Bland annat upplevdes förlust av kontroll som en svår del av sjukdomen men det beskrivs också att strategier kunde hjälpa patienten att hantera den nya tillvaron.

PURPOSE: The purpose of this qualitative descriptive study was to explore the experiences of emerging adults with idiopathic CAS, as they reflected on their transitions through childhood, adolescence, and young adulthood. SPECIFIC AIMS: Describe the experiences of emerging adults with idiopathic CAS as they reflect on developmental stages of childhood, adolescence, and young adulthood, including the situational experiences of transition occurring between elementary, middle, high school, and post-secondary education, training, or work. Identify strategies and the effectiveness of the strategies utilized by emerging adults with idiopathic CAS to manage experiences during different developmental stages and situational experiences of transition occurring between elementary, middle, high school, and post-secondary education, training, or work. FRAMEWORK: Meleis’ Transitions Theory. DESIGN: A qualitative descriptive design with purposive sampling was used. Data was analyzed using thematic analysis. RESULTS: Findings support the use of Transitions Theory. Three major themes were identified: The Child’s Environment, Implications of CAS, and Strategies. The school environment contributed to many implications for children. Older children were able to develop strategies to overcome challenges. In the school setting, children did not access nurses for concerns related to their CAS. CONCLUSIONS: CAS creates many challenges for children. Emerging adults with CAS report that environments in which people are knowledgeable, patient, understanding, accepting, and supportive help them express themselves freely despite their speech impairment. The nurse’s role in supporting children with CAS during grade school is untapped as they were largely invisible to the children as a potential resource for anything other than an injury or illness. To better facilitate supportive environments in which children with CAS can flourish, nursing assessment and interventions are needed.

Bakgrund: En amputation innebär ett avlägsnade av en kroppsdel. De flesta amputationer utförs i de nedre extremiteterna. I Sverige sker årligen ungefär 2250 amputationer i de nedre extremiteterna. Orsaken till amputation kan vara kärlsjukdomar, diabetes samt trauma. Sjuksköterskan har i sin profession en betydande roll i mötet med patienten. Syfte: Syftet var att beskriva patienters upplevelser efter amputation av nedre extremitet. Metod: En litteraturöversikt genomfördes utifrån Fribergs metodbeskrivning. Tio kvalitativa originalartiklar inhämtades via databaserna PubMed och Cinahl Complete. Primära sökord som användes var amputation, nedre extremitet och livsförändrade händelser med begränsningar såsom engelska och peer reviewed. Resultat: Fyra teman identifierades: Upplevelsen av psykiska och fysiska förändringar, Att uppleva rollförändring och förlust av självständighet, Förändrad kroppsuppfattning och känslan av sårbarhet samt Vägen tillbaka efter amputation. Resultatet visade att patienterna upplevde en förlust av självständighet vilket gav upphov till en känsla av att vara en börda för sin familj. Den fysiska förmågan försämrades vilket bidrog till att de inte kunde ta sig utanför hemmet. Detta resulterade i att de kände sig ensamma och isolerade. Slutsats: Patienter upplevde känslomässig chock och rädsla inför framtiden. Att inte kunna prestera till fullo, bidrog till en känsla av förlust av identitet och självständighet. Vikten av stöd från familj, vänner och vårdpersonal har en central betydelse för återhämtning efter amputation. Amputation innebär att patienten genomgår en övergång till en ny fas i livet, en transition. / Background: An amputation implies a removal of a body part. Most amputations transact at the lower extremities. In Sweden approximately 2250 lower extremity amputations are made a year. The causes of amputation may be vascular diseases, diabetes or trauma. The profession of a nurse has a major role in the relation to the patient. Aim: The aim was to investigate patients’ experiences after an amputation of lower extremity. Method: To approach the aim a literature review was performed by the method of Friberg. Ten qualitative original articles were collected by the databases PubMed and Cinahl Complete. Primary keywords were amputation, lower extremity and life change events. Limitations were English and peer reviewed. Results: Four themes were identified: Experience of psychological and physical changes, To experience changes of identity and loss of independents, Changes of self-perceptions and the feeling of being vulnerable and How to recover after an amputation. The result showed that the patients’ experienced a loss of independence which resulted in a feeling of being a burden. The physical ability was impaired and contributed to a feeling of being isolated and lonely. Conclusion: The patients’ experienced emotional shock and a fear for the future. Not being able to perform to the fullest produced a loss of identity and independence. Support from family, friends and healthcare professionals has a central value for the recovery. To be amputated results in a transitioning and a new phase in life.