Background One of the main demands on Swedish and global health care in general is to meet the patient’s need for safety. By general health care law this also comprises district nurses’ field of responsibility. Although there are numerous studies describing the concept of safety and its different shapes, no research could be found exploring how safety is, or supposed to be, mediated by district nurses’ in a Swedish context. Research about this is therefore needed. Aim The aim of this qualitative study was to explore how district nurses’ mediate safety to their patients. Method Qualitative data were collected from seven district nurses’ by means of semi structured interviews. Thereafter, a concept analysis was carried out. Results Responses revealed that district nurses’ consider themselves mediate safety through a variety of ways. Five major categories emerged: (1) complaisance’s; (2) competence; (3) patient participation; (4) same caregiver; (5) personal characteristics. Conclusion District nurses’ mediate safety through a combination of general attitudes and concrete acts. Preconditions are bound to each district nurse’s individual ability to give a good complaisance, his/her competence and ability to involve patients in treatment and care. Other, less pronounced, are bound to the district nurse’s ability to create continuity in contact with patients’ and his/her personal characteristics.

This thesis investigates social impacts of charcoal use in households in the Tanzanian town Babati. In Tanzania a majority of the population use charcoal and firewood as their main energy source. A part from the environmental problems connected to charcoal use; there are also considerable social impacts on women’s daily lives. Cooking and collection of wood fuel are time-consuming and restricts the possibilities for women to work and study. The thesis includes an investigation on how the Tanzanian government tackles problems connected to charcoal use, social as well as environmental. The result shows that the Tanzanian government is working with charcoal related problems to some extent but as previous studies shows there are still more that can be done. The main efforts made concentrate on information campaigns and promotion of more energy efficient equipments. One important problem is however that wood fuel is the cheapest available energy source and hence the incentives to start using other, more sustainable, energy sources are very small. The thesis also investigates possibilities for Babati households to substitute charcoal use with renewable energy sources available in the town. The result shows that the possibilities to use renewable energy currently are very limited and mainly affordable to richer households.

The purpose with this report was to investigate the possibilities for smaller district heating plants to use recovered wood waste (RT-flis) as fuel. A smaller district heating plant in the north of Sweden (Sorsele värmeverk AB) was the main study object. To be able to incinerate this fuel there are a number of requirements that need to be fulfilled according to the law. In addition to these requirements, the incineration of this fuel also needs to be profitable. The results for this study were obtained through interviews, investigations of the incineration laws and the fuel supply, as well as an analysis of the opinions occurring within the personnel of the heating plants. The results show that the possibility to incinerate RT-flis depends on the appropriate technology; the possibility to fulfill the requirements of the law, as well as it has to be profitable. All these parameters are in close relation to each other. Whether it is technologically possible to use RT-flis largely depends on the construction and technology of the heater, which affects the possibility to fulfill the requirements on, for example, air emissions. Economically, main issues include investments into measuring equipment, but also the accessibility of fuel. The most important aspect is the quality of the fuel (e.g., contaminations).

The importance and benefits of involving community members in health policy making-­-from the first step of needs assessment through to actual policy development--are increasingly being recognized. This thesis describes the evaluation of a community consultation process which was part of a needs assessment conducted by Saskatoon District Health, in Saskatchewan, Canada. In September 1995, a Children and Youth Working Group was formed, made up of volunteers representing service providers, users, and families. Their mandate was to develop and priorize recommendations on ways to improve the health status of children and youth in the District, which has a total population of approximately 300,000. In addition to a comprehensive epidemiological assessment, the Working Group engaged in a community consultation process which solicited input from the general community, with a specific emphasis on key groups such as youth, Aboriginal, immigrant/refugees, and service providers in health, education, social services, and justice. In this process, information on perceived needs of children and youth was collected through 20 focus groups (n=213) and a questionnaire (n=1,985). Based on a synthesis of the quantitative and qualitative data, the Working Group drafted a set of recommendations, which were then discussed at a community meeting for input and feedback. <p> This research evaluates the effectiveness of the consultation process in facilitating community participation using three sources of data: the entire consultation process was observed (from January 1996 until February 1997), including the focus groups, Working Group meetings, and the final community meeting; interviews (2) were held with the Working Group (n=9), with selected individuals who had participated in the consultation (n=7), and with non-participants (n=2); and documentation produced by the Working Group (i.e., minutes, notes, background material) was reviewed. These data were analyzed thematically according to criteria established jointly by the representatives of the member groups of the Population Health Project (Working Group, Coordinating Group, Research Advisory Group) and the researcher. The effectiveness was gauged by comparing the findings with the criteria and with the components of meaningful community consultation as defined by the Working Group (appropriateness, timeliness, completeness, accuracy, representativeness, relevance). The themes which emerged from the analysis deal with the participants' feelings about their participation or non­participation, the success of the consultation process, the nature of the data collected; by-­products of the process, and the consultation's influence on the outcome of the needs assessment. The results of this analysis are presented and conclusions drawn regarding factors that contribute to or impede effective public participation in health needs assessment.

The purpose of this study was to identify, describe, and examine the aspirations of Goessel stakeholders for USD 411 and their community using an appreciative inquiry research perspective and the theoretical frameworks of social capital. The data revealed seven aspirations. (1) The Community of Goessel stakeholders and USD 411 stakeholders aspire to a unique and independent identity for USD 411. (2) The Community of Goessel stakeholders and USD 411 stakeholders aspire to maintain a unique and independent school system with high academic standards. (3) The Community of Goessel stakeholders and USD 411 stakeholders shared their aspirations to maintain their high degree of quality of life and sense of safety that they perceive to exist in the community. (4) The Community of Goessel stakeholders and USD 411 stakeholders aspire to maintain a positive relationship between USD 411 and the churches within the community. (5) The Community of Goessel stakeholders and USD 411 stakeholders aspire to embrace diversity. (6) The Community of Goessel stakeholders and USD 411 stakeholders have aspirations for community improvements. (7) The Community of Goessel stakeholders and USD 411 stakeholders hold a positive view toward meeting the challenges they perceive to face the community of Goessel and USD 411. The data also revealed three challenges. (1) The Community of Goessel stakeholders and USD 411 stakeholders recognize the challenges that exist in sustaining a small town atmosphere and are willing to work together to seek a viable community based solution. (2) The Community of Goessel stakeholders and USD 411 stakeholders recognize the inherent challenges of sustaining high academic standards in USD 411 due to potential changes in the community’s demographics if population growth is encouraged. (3) The Community of Goessel stakeholders provided evidence of social capital in the community as expressed through high levels of bonding capital and the need to generate more bridging capital. The findings also suggest that the community of Goessel stakeholders and USD 411 stakeholders are willing to work cooperatively to overcome the challenges they face to sustain the community of Goessel and USD 411. Social capital can be found throughout the community of Goessel and USD 411. The data revealed an abundance of bonding capital. The data also revealed evidence of bridging capital. Establishing linkages and bridging capital to outside resources will help the community of Goessel stakeholders achieve their aspirations. / Thesis (Ed.D.)--Wichita State University, College of Education, Dept. of Educational Leadership. / "May 2005."

The amount of waste in the world increases every year due to an improved living standard andgrowing population. The problem is especially large in poor countries where the ability tohandle the waste is limited due to financial and management problems. If instead wastematerial is seen as a resource it can help reduce the amount of waste on landfill. Byincinerating waste and recover the energy it would also help reducing greenhouse gasemissions from landfill and give electric and thermal energy.Chisinau Municipality in the Republic of Moldova today lacks several important parts fora satisfying waste management. Today most of the waste generated in Chisinau municipalityends up at the municipality landfill. The current contract to use the landfill expires on the 31December 2010, if the municipality won’t be able to renew the contract they have to look forother ways to deal with the waste problem. As the dominating source for energy in Chisinau isimported natural gas, an effective way to reduce the use of gas for electricity and thermalenergy production would be to use waste material for incineration with energy recovery.Therefore, the goal with this thesis is to evaluate the possibility to extract energy from coincinerationof sewage sludge and waste material generated in Chisinau. To reach this goal thesituation in Chisinau where studied on site for two months, quantities and composition of thewaste material was investigated. Based on the data gathered on the waste, a suitabletechnology for the waste-to-energy (WTE) plant is proposed. The proposal is made based onthe assumption that a WTE plant would not be established until 2025.The result shows that the waste material in Chisinau can be used for co-incineration ofwaste and sludge. The calorific value of the waste material was determined to 7.87 MJ per kg.The suggested WTE plant has the total power of 138 MW, the result based on that all wastematerial available 2025 are incinerated. Annually this makes it possible to recover 1152 TJ(320 GWh) electric power and 2650 TJ (736 GWh) heat, based on 8000 operating hoursannually.Even if a WTE plant sounds like a good investment it is a long time before a plant couldoperational. Much is to be made in the waste management to have well-functioninginfrastructure that will work together with an incineration plant. Furthermore, the data used inthis study regarding the quantities is very uncertain and further studies in affected areas arenecessary before a WTE plant can be established. / Den totala mängden avfall i världen ökar varje år som följd av ökad folkmängd ochlevnadsstandard. Problemet är extra påtagligt i fattiga länder med begränsade ekonomiskaresurser för att ta hantera avfallet. Om avfallet istället skulle ses som en resurs skulle detkunna reducera andelen avfall som läggs på deponi. Genom att förbränna avfallet medenergiåtervinning skulle också växthusgaserna från deponering minska och samtidigt geelektrisk och termisk energi.Chisinau kommun i Republiken Moldavien saknar idag flera vitala delar iavfallshanteringen. Idag slutar den största delen av avfallet som produceras i Chisinaukommun på den kommunala deponin. Kontraktet för att använda deponin löper ut den sistadecember 2010, om Chisinau kommun inte tillåts förnya kontraktet är det nödvändigt att sesig om efter nya lösningar för avfallshanteringen. Eftersom den dominerande källan för energii Chisinau är importerad gas, skulle ett effektivt sätt att reducera gasanvändningen vid el ochtermisk energiproduktion att förbränna avfall med energiåtervinning.Av den orsaken är målet med studien att utvärdera möjligheterna att utnyttjasamförbränning med energiåtervinning av avfall och avloppsslam från Chisinau kommun. Föratt nå detta mål har den nuvarande situationen i Chisinau kommun studerats på plats under tvåmånaders tid, detta för att undersöka vilka mängder avfall som årligen produceras och huravfallets fraktionsfördelning ser ut. Baserat på de data som samlats in föreslogs en lämpligavfallsförbränningsanläggning. Förslaget är baserat på antagandet att enavfallsförbränningsanläggning inte är etablerad förrän tidigast 2025.Resultatet visar att det är möjligt att samförbränna avloppsslam och avfall i Chisinau. Detkalorimetriska värmevärdet för avfallet och slammet har bestämts till 7.87 MJ per kg. Det irapporten presenterade förslag på kraftvärmeverk för avfallsförbränning kommer att ha entotal effekt av 138 MW, resultatet är baserat på att allt tillgängligt kommunalt avfall 2025förbränns. Kraftvärmeverket beräknas årligen utvinna TJ (320 GWh) elektrisk energi och2650 TJ (736 GWh) termisk energi, beräknad på 8000 drifttimmar årligen.Även om en avfallsförbränningsanläggning låter som en god investering så ligger detlångt fram i tiden innan en sådan anläggning är möjlig att etablera. Först måste en brafungerande infrastruktur som fungerar tillsammans med avfallsförbränningsanläggningenupprättas. Vidare bör poängteras att de data som använts i denna studie gällandeavfallsmängder är ytterst osäkra och ytterligare studier inom området krävs innan enavfallsförbränningsanläggning kan etableras.

A problem in the field of district heating is the oil burners needed to provide power when a peak load occurs. One possible way of reducing the needed amount of oil is to reduce the power demand for space heating in the district-heating substations when the need for district heating water exceeds a certain limit. This can be done by use of a locally working controller function. In this Thesis the options concerning load priority are evaluated. To evaluate the potential for using controller functions concerning peak load priority an experiment was brought out in a chosen district-heating substation. The impact on the indoor thermal comfort during a heat reduction was also taken into account. With simulations and mathematical models the building and the indoor air cool down was evaluated. Also a survey was given to the residents to validate how the indoor thermal climate was affected during the experiment. Possible savings by using these kinds of functions were also accounted for. The result demonstrates that a simple controller function provides a possible way of reducing the power demand, but is not sufficiently reliable. This is mainly due to the used regulating parameter. With modifications or by adding additional regulating parameters such as water flow into the controller, the functionality can be improved. The result from the survey shows that during the experimental period the residents experienced a minor impact on the thermal comfort. Parameters, such as ventilation and heat losses also have a major impact on the building´s thermal inertia, especially at the lowest occurring outdoor temperatures. The simulations confirm the theory regarding the building heat capacity to prevent a negative impact on indoor thermal comfort. In addition, the indoor air temperature can initially decrease faster than the building framework, especially under the influence of ventilation. This must be taken into account when applying functions for load priority. Calculations indicate that the economical benefits by adapting functions for load priority are primarily for the heat-producer, due to reduced oil dependence and also other system aspects. The current ownership structure in Uppsala provides for a possible obstacle when it comes to expanded use of load priority functions. More incentives for the consumer are needed to provide for an increased usage of load priority functions in their district-heating substations.

Syftet med studien var att beskriva nyutbildade distriktssköterskors upplevelse av första tiden i yrket. Studien genomfördes som en semistrukturerad intervjustudie och hade en deskriptiv design. Intervjuerna genomfördes med tio nyutbildade distriktssköterskor inom primärvården i ett län i Mellansverige. Materialet analyserades med hjälp av kvalitativ innehållsanalys. Resultatet redovisas utifrån tre kategorier: Utbildningen förbereder för yrkesrollen men det mesta lärs genom att utöva yrket, Inställning och tidigare erfarenhet påverkar upplevelsen av att vara nybliven distriktssköterska och Viktigt med praktiska förutsättningar för att lära sig yrket. Distriktssköterskorna ansåg att utbildningen saknade vissa viktiga områden eller innehöll för lite om vissa områden vilket ledde till osäkerhet inför nya arbetsuppgifter. De distriktssköterskor som arbetat inom primärvården eller inom kommunal vård innan utbildningen upplevde inte distriktssköterskearbetet som svårt. De med enbart erfarenhet från slutenvård/akutsjukvård innan utbildningen upplevde det som krävande att vara nybliven distriktssköterska.Distriktssköterskorna beskrev distriktssköterskekunnandet som något som växte fram under och efter utbildningen i kombination med tidigare erfarenhet. Det innebar ett lärande under hela yrkeslivet. En viktig förutsättning för lärandet var att få praktiska förutsättningar på arbetsplatsen via introduktion och stöd från kollegor. / The purpose of this study was to describe how newly qualified district nurses' experience their first time in the profession. The study was carried out as a semi structured interview study with descriptive design. The interviews were conducted with ten newly qualified district nurses in primary care in central Sweden. Data was analyzed based on qualitative content analysis. The study resulted in three categories: Education prepares for the professional role but most is learnt by practicing the profession, Attitude and previous experience affect the experience of being a newly qualified district nurse and The importance of getting practical conditions to learn the profession. District nurses considered that the education lacked some important areas, or contained too little of certain areas resulting in uncertainty in facing new tasks. Those with prior experience from primary care or community care before the education experienced it as easy to become a district nurse. Those with experience only from emergency care before the education perceived it as challenging to be a newly qualified district nurse. District nurses considered the profession of district nursing as something that based on past experience grows and develops when practicing the occupation. That involves a lifelong learning. An important prerequisite for learning is introduction and support from colleagues.

Syfte: Att beskriva hur distriktssköterskor inom hemsjukvården upple­ver sitt arbete och sin arbetsmiljö ur ett fysiskt, psykiskt och socialt perspektiv. Metod: Studien hade en beskrivande design med kvalitativ ansats. Åtta distriktssköterskor verksamma inom hem­sjukvård i tätort eller på landsbygd i Mellansverige deltog i studien. Data samlades in via semi-strukturerade intervjuer och analyserades genom kvalitativ innehållsanalys. Resultat: Temat ”Att arbeta för patientens bästa, en utmaning för distriktssköterskan i hemsjuk­vård” bildades ur fyra kategorier. Utmaningar som distriktssköterskorna i studien beskrev som den fysiska arbetsmiljön i patienternas hem, att ha ett professionellt förhållningssätt, att hålla sig uppdaterade, prioritera och planera sitt arbete. Utmaningarna fanns också i kra­ven ställda från olika håll och strävan efter ett gott samarbete med många olika instanser och yrkeskategorier, allt för patientens bästa. Temat bildades ur kategorierna ”Ditt hem är min arbetsplats – att vara nära men ändå ha distans”, ”Att känna sig som en admi­nistratör men prioritera patientkontakten”, ”Att uppleva stöd och sträva efter samar­bete” samt ”Ambitioner och förväntningar inför framtidens hemsjukvård”. Slutsats: Distriktssköterskorna inom hemsjukvården upplevde många utmaningar i sin strävan efter att arbeta för patientens bästa. Distriktssköterskornas upplevelser gav ett helhetsperspektiv på arbetet inom hemsjukvården och kunskap om detta är ett viktigt redskap för att optimera hemsjukvår­dens framtida kvalitet. / Aim: To describe how district nurses in home care experience their work and their working environment from a physical, psychological and social perspective. Method: The study had a descriptive design with qualitative approach. Eight district nurses working in home care in urban or rural areas in central Sweden participated in the study. Data were collected through semi-structured interviews and analyzed by qualitative content analysis. Results: The theme "Working for the patient's best, a challenge for the district nurse in home care " was formed out of four categories. Challenges that district nurses in the study described as the physical environment in the patients’ home, having a professional approach, to stay updated, prioritize and plan their work. Challenges were also in the requirements asked from various quarters and the quest for a good cooperation with many different instances and professions, all for the patient's best. The theme was formed from the categories "Your home is my workplace - to be close but still have a distance", "To feel as an administrator but prioritize the patient contact", "To experience support and strive for cooperation" and "Ambitions and expectations for the future of home care". Conclusion: District nurses in home care experienced many challenges in their efforts to work for the patient's best. District nurses experiences gave an overall perspective of the work in home care and knowledge of this is an important tool to optimize future home care quality.

Cultural clusters with an agglomeration of heritage and historic assets represent national or local history, culture and tradition. Hence, they often become distinctive urban tourism resources supplying multifunctional places for tourists to visit and enjoy. However, the designation of a cultural district by government is not merely a strategy for the preservation of cultural assets and tourism development because a variety of stakeholders, with divergent goals and objectives, are usually involved in the process of converting cultural resources into marketable products. The number of tourists to Insadong, a representative traditional cultural district in Seoul, Korea, has increased rapidly in the last decades with many issues and problems. Insadong is a place where Koreans and foreigners alike experience Korean tradition and it is a unique area where the atmosphere combines both the historical and modern in the centre of the city. The area is also multi-functional, offering a mix of history, entertainment, cuisine, shopping etc. for a mixed clientele. This area has a long history as a cultural business district which was organically generated, but numerous issues and changes have occurred in relation to the commercial development and policy of government. Since this area gained fame as a tourism destination after it was designated as a cultural district, it also encountered problems like rising rental fees, change of space use, modifications in the items for sale, and destruction of small traditional art-related shops, which created the traditional atmosphere. This study examined the policies of the public sector and the role of the private sector in the development of Insadong through examining the government’s assessment and perspectives, the NGO’s perspectives and the entrepreneurs’ situation and expectations for business. Through analyzing crucial events, NGO’s activity, and the initiation of government policies, my research reveals dramatic change under the impact of tourism and government policies, as well as recent problems that have occurred at the cultural district. This study also examined aspects of heritage tourism in an evolving culture cluster in a major city. To the author’s knowledge, this type of research has not been undertaken previously in Korea and is rare in Asia. However, it is difficult to generalize from a case study. Thus, there is a need to undertake similar studies elsewhere to determine if what has been observed in Insadong is unique or if it is an example of a phenomenon that can be observed in other places.