Modern society is critically dependent on a reliable and resilient power grid to support essential services such as healthcare, telecommunications, water treatment, transportation, and information infrastructure. Disruptions to the power grid can therefore have severe consequences. At the same time, the ongoing transition toward renewable energy sources, particularly wind and solar power, is fundamentally changing power system operation. The inherent variability and uncertainty of these resources increase the need for flexibility to continuously balance supply and demand and to maintain system frequency within acceptable limits. This flexibility is increasingly provided by a wide range of distributed and large-scale resources, including household assets such as heat pumps, batteries, and electric vehicle chargers, as well as industrial energy storage systems. However, this progress also drives a deeper integration of information technology (IT) with operational technology (OT) in the power grid. This convergence increases new attack vectors as the assets are connected to the internet, potentially allowing attackers to gain remote control of these assets if not properly protected. This thesis examines how Under-Frequency Load Shedding (UFLS) interacts with Load-Altering Attacks (LAAs) in a simplified Nordic power grid model, using the WSCC- 9 bus system with the Power System Analysis Toolbox (PSAT). Both static attacks, where the load was changed at a fixed time, and dynamic attacks, with a continuous change in demand, were investigated. The results show that while load shedding could be effective against sudden, static attacks, its effectiveness against dynamic, feedback-driven attacks is limited and may even be counterproductive in certain scenarios. The work highlights the critical need for further research into improved detection and mitigation approaches for load-altering attacks.

Tonsil and adenoid surgery are among the most commonly performed pediatric procedures in Sweden, yet important knowledge gaps remain regarding indications, outcomes, complication risks, and the associated patient‑reported symptom burden. The overarching aim of this thesis was to examine key aspects of contemporary clinical practice related to pediatric tonsil and adenoidectomy surgery in Sweden, with focus on epidemiology, safety, surgical outcomes, and the development and validation of a Swedish version of a pediatric patient‑reported outcome measure (PROM). The thesis comprises four studies based on register data, clinical outcome analyses, and psychometric validation.

Paper I mapped the national epidemiology of pediatric adenoidectomy between 2004 and 2013 using data from the National Patient Register. Hypertrophy was the most common indication, and combined adenotonsillar surgery was the most common procedure. Adenoidectomy was performed mainly in children aged 2-5 years, with higher incidence among boys.

Paper II examined postoperative morbidity and mortality following adenoidectomy in 51,746 procedures performed between 2007 and 2017. Late postoperative hemorrhage was rare, late bleeding events requiring return to theatre were exceptionally uncommon, and no deaths attributable to adenoidectomy were identified, confirming that the procedure is highly safe in the Swedish context.

Paper III evaluated postoperative bleeding, revision surgery, and caregiver‑reported symptom relief following 1,810 cold steel tonsillotomy procedures with or without adenoidectomy over a 10‑year period. The technique demonstrated low rates of postoperative bleeding, acceptable revision rates, and high caregiver‑reported symptom improvement. At the same time, the technique keeps instrument costs low and reduces environmental impact by avoiding disposable devices and advanced equipment.

Paper IV translated and validated the Paediatric Throat Disorders Outcome Test (T‑14) into Swedish. The instrument demonstrated strong known‑groups validity, an acceptable model fit in confirmatory factor analysis, good internal consistency, and high responsiveness to postoperative changes. The Swedish T‑14 enables structured pre‑ and postoperative assessment of symptom burden and demonstrates potential value for both clinical practice and future research.

Together, the findings demonstrate that pediatric adenoidectomy and cold‑steel tonsillotomy are safe procedures with low complication rates in routine clinical care. The thesis highlights important gaps in national outcome monitoring, particularly the lack of preoperative patient‑reported measures. The findings and the instrument presented may contribute to more informed evaluation, follow‑up, and clinical decision‑making in pediatric adenotonsillar surgery.

Amid escalating sustainability crises, academia has increasingly turned toward knowledge co-creation. This trend is reflected in the growing number of collaborative research initiatives with Indigenous peoples, whose knowledge and perspectives are often regarded as offering valuable contributions to addressing global challenges. In this article, we – five female researchers, who study knowledge creation and strive to conduct research in collaboration with Indigenous groups – reflect on and unpack our own experiences in light of our diverse positionalities. Our aim is to pull back the curtain on the realities of these methodologies. By exposing these ‘behind-the-scenes’ perspectives, we hope to deepen the understanding of what co-creation with Indigenous groups entails and to highlight the challenges and its possibilities in practice. As we reflect on our experiences through the lenses of dialogism, feminist epistemologies, critical STS studies, and perspectives from Indigenous thinkers, we (re)discover co-creation as a process of “becoming subjects together”, one in which the personal, professional, and political are intertwined, sustained by reciprocal engagement, shared values, and the recognition of Indigenous peoples as subjects in their own right. Our experiences underscore both the difficulties and the transformative possibilities of moving beyond established methodologies and confronting the epistemic and institutional constraints that hinder such collaborations.

This chapter explores the unique challenges faced by LGBTQ+ individuals during pregnancy and childbirth, with a particular focus on birth trauma. While birth trauma has not been extensively studied in LGBTQ+ parents, research indicates that this population experiences a higher incidence of factors that increase vulnerability to traumatic birth experiences. Within this chapter, we examine key risk factors for birth trauma among LGBTQ+ individuals, including pre-existing mental health conditions, lower levels of family support, and experiences of poor-quality care during labour and birth, often due to homophobia and transphobia. The chapter then delves into how these vulnerabilities intersect with minority stress and cisheteronormative health care structures to create additional challenges for LGBTQ+ parents while highlighting the importance of building trust between health care providers and LGBTQ+ families. Discussion also addresses specific risk factors during pregnancy and the importance and methods of providing tailored support during and after birth. Strategies for health care professionals to improve care and reduce the risk of birth trauma for LGBTQ+ families include using inclusive language, providing LGBTQ+ specific information, and striving for continuity of care. Overall, this chapter brings to light what constitutes a “good birth” for LGBTQ+ parents, emphasising the need for respectful, individualised care that acknowledges diverse family structures and parenting roles.

The prevention of marine biofouling remains a global challenge due to environmental concerns associated with current biocidal antifouling (AF) agents and increasing regulatory pressure to ban such biocides. Natural products present promising alternatives as effective and eco-friendly AF solutions, with cyanobacteria emerging as a rich source of bioactive compounds due to their remarkable biosynthetic potential. In this study, the AF bio-guided discovery of natural products from the cyanobacterium Leptothoe sp. LEGE 181152 led to the isolation of two nucleosides - adenosine (1) and 2’-deoxyadenosine (2), which were for the first time explored as innovative AF agents. A comprehensive approach was undertaken, including AF efficacy across biological levels, ecotoxicity and ecological risk assessment, and molecular targets elucidation. Compounds 1 and 2 successfully inhibited mussel settlement (EC50 = 6.63; 8.74 µM), without exhibiting lethal effects (LC50 > 200 µM). At these concentrations, both compounds increased the in vitro acetylcholinesterase activity. Functional enrichment analysis revealed effects on proteins associated to ciliary motility and ATP metabolism. Additionally, both compounds inhibited the growth of Navicula sp. ( ̴40 % for 1, and 60 % for 2). In addition to showing no effect on marine biofilm-forming marine bacteria, ecotoxicological assays with nauplii of Artemia salina and Amphibalanus amphitrite revealed no acute toxicity in these species. Furthermore, simulated environmental data indicated a low potential for bioaccumulation and low environmental persistence. Overall, these findings identify adenosine and 2′-deoxyadenosine as novel, low-risk natural AF agents, with real-world applicability as promising candidates for incorporation into marine coatings, thereby contributing to the development of more sustainable solutions for biofouling management.

Remote dielectric sensing (ReDS) technology noninvasively assesses lung congestion, but its value in primary care remains unknown. This study aimed to evaluate the feasibility of a ReDS-guided heart failure (HF) management programme in primary care.The 1-month programme, including ReDS measurements, a decision-support algorithm for diuretic adjustments, follow-up, and support for patient symptom monitoring, was provided to 18 patients with HF (mean age 81 years, mean ReDS values 33.6 ± 6.0 indicating optimal volume status) in one rural primary care centre. The feasibility areas of acceptability, demand, implementation, practicality, and limited efficacy were evaluated in a mixed-methods study. Data were collected from 18 patients with HF and two healthcare professionals (HCPs) at baseline and 1-month follow-up. Acceptability: Patients found the programme satisfactory, while HCPs expressed uncertainty about using the algorithm for patients with deviating ReDS values but no worsening symptoms. Demand: Patients recognized the potential to prevent hospitalizations. Healthcare professionals perceived higher demand in rural settings. Practicality: The ReDS technology was found practical and easy to use. Implementation: Fidelity was partial, with algorithm-recommended clinical actions not always implemented. Limited efficacy: Self-care improved with a medium effect size and N-terminal pro-B-type natriuretic peptide (NT-proBNP), with a small effect size. No adverse events were reported.Our study demonstrates the feasibility of a ReDS-guided HF management programme, which may enable early detection of subclinical congestion and improve outcomes for patients with HF in primary care settings. Further effort is necessary to refine the algorithm and improve its fidelity.

Syftet med den här studien var att undersöka hur en tre veckor lång intervention om multiplikationstabellerna påverkar utvecklingen av den deklarativa kunskapen hos elever i matematiksvårigheter. Studien har en single case-design. De utvalda eleverna har genomfört Skolverkets diagnos AG6 vid fyra tillfällen innan interventionen startade (baslinjemätning), vid varje interventionspass och en gång två veckor efter avslutad intervention (fördröjt eftertest) för att mäta effekten av interventionen. Resultaten på testen presenteras i diagramform. PND och Tau-U har beräknats och visar att interventionen har haft en varierande effekt på eleverna; från mycket hög effekt till måttlig effekt. På det fördröjda eftertestet kvarstår effekten hos alla elever förutom en, vilket får oss att dra slutsatsen att en intervention om multiplikationstabellerna som innehåller explicit undervisning och concrete – representational – abstract (CRA) kan hjälpa elever i matematiksvårigheter att utveckla deklarativa kunskaper om multiplikationstabellerna.

Type 2 diabetes is a global health burden driven by genetic and environmental factors. Continuous glucose monitoring (CGM) can effectively guide lifestyle interventions in non-diabetic. However, predefined CGM metrics fail to fully capture the dysglycemic information contained in the high-dimensional time-series CGM data. This study employed deep learning to learn dysglycemia features from CGM data associated with diabetes and derived a digital biomarker of dysglycemia, validated against traditional dysglycemic biomarkers and diabetes polygenic risk score (PRS). Output of the deep learning model, called the deep learning-score, was significantly associated with multiple existing dysglycemic biomarkers and PRS of diabetes (P = 0.007). Moreover, existing CGM metrics were not associated with prevalent diabetes after adjusting for the deep learning-score, while the deep learning-score remained significantly associated with prevalent diabetes (P < 0.001) in a regression analysis. This digital biomarker demonstrated potential for providing dynamic feedback on dysglycemia and improving long-term intervention adherence.

What is it like to visit the inside of a nuclear power plant? Based on autoethnographic observations at nuclear facilities in seven countries, this article suggests that we as visitors are subject to two parallel rituals: a meta-ritual of security, and a main ritual of performing the nuclear facility as safe. This is done, first, by designating the visitor as unknowing, second, by showcasing the nuclear facility as over-secured, and third, by creating relational trust in the plant staff’s expertise. Given the high numbers of visitors to nuclear facilities worldwide and over decades, these visits are not a neutral activity but an arena where persuasive emotional registers are employed to affect individuals and, by extension, influence broader societal formations of nuclear politics

Aneurysmal subarachnoid haemorrhage is a severe form of stroke with high mortality and many patients left with debilitating sequelae. The first 10-14 days after bled is a period of specific risk for secondary injuries and more research is needed to understand their mechanisms.

We found laser-Doppler flowmetry to be a feasible method for long time recordings of cerebral microcirculatory flow with a low rate of artifacts. Vasomotion of the cerebral vessels could be registered and vasomotion frequencies varied over time and between hemispheres. Correlation between microcirculatory flow and clinically monitored parameters was calculated and trended over time.

In cerebral microdialysate we found the novel biomarkers Transthyretin in nine proteoforms, and Glyceraldehyde-3-Phosphate Dehydrogenase (GAPDH) in four proteoforms. Both Transthyretin and GAPDH proteoforms vary in different pattern over time after subarachnoid haemorrhage.

We also found Erythropoietin (EPO) and Tumor Necrosis Alpha-Related Apoptosis Inducing Ligand (TRAIL) in increasing values among patients who developed vasospasm, while Neurofilament Light chain (NFL), Glial Fibrillary Acidic Protein (GFAP) and Interleukin-6 (IL-6) showed decreasing values. The trend of these biomarkers may reflect metabolic changes and varying protein expression after subarachnoid bled.

The studies forming this thesis are small and hypothesis generating but show that cerebral microcirculation can be studied in a neurocritical care setting and that data can be correlated to routinely monitored parameters. We have also shown that novel biomarkers can shed new light on cerebral metabolism and protein expression during development of secondary brain injuries. Further studies in larger patient cohorts, combining these methods over time and relating them to outcome measures, will have to be performed before they can be introduced into clinical decision making.

The aim of this study was to explore the contact-seeking behaviour of horses using a novel object test and a newly developed human preference test. In addition, all owners completed a survey with information about the horse and the training methods they used. Twenty-two horses participated and were introduced to a novel object, and later to a human preference test where both the owner and a stranger were present. Behavioural data was collected and then analyzed using a predetermined ethogram. The behavioural tests were analyzed and compared and the information from the surveys was also included in the analysis in order to study the effect of sex, size, and training methods. The preference test revealed that the horses in general looked faster towards the owner compared to the stranger (Z=-2.02 P=0.043). This correlation tended to increase in horses trained using positive reinforcement (Rs=0.63 P=0.097). The behavioural data were in line with the owners’ responses in the survey indicating that horse owners have a good understanding of their own horses' curiosity and contact seeking behaviour. Hence, the results suggest that horses prefer their owner when presented with a problem, but the training method used by the owner might affect its behaviour. 

This study explores the viability of FTA-cards as a faecal sampling method for DNAextraction and sequencing. Creating a protocol that yields on average 58% host DNA whilebeing non-invasive towards the individuals being samples as well as a stable sampling methodthat does not require refrigeration making it perfect for hotter field conditions. Resulting in apractical method for gathering genetic data from horse populations not habituated to humancontact. The aim was to investigate the genetic diversity of the studied population to betterunderstand the feralization process through locating single nucleotide polymorphisms (SNPs)by using Restriction-site Associated DNA sequencing (Radseq). As the study found that thisferal horse population was heavily inbred (Fis index = 0.3988) further discussions as to theimplications, consequences and solutions to this were made. As inbreeding depression cannegatively impact survival rates by lowering phenotypic placticity, fecundity and more actionshould be taken to aid the Pottaka population studied here to reach healthier levels of geneticdiversity

Heart failure is a growing health challenge with limited treatment options, where total artificial hearts (TAHs) can offer one potential solution to the current shortage of heart donors by replacing the heart’s function. To evaluate the function of TAHs without implantation in a body, mock circulation loops (MCLs) can be used, but their ability to accurately replicate human physiological conditions remains uncertain.

In this thesis, the aim was to evaluate an MRI-compatible mock circulation loop (MRIMCL) and its potential to provide physiological conditions for testing the function of a total artificial heart, as well as to identify any undesired or non-physiological influences of the MRI-MCL on the TAH’s performance.

To achieve this, measurements of the outlet pressure and flow from the TAH connected to the MRI-MCL were collected. The data was used to tune and validate lumped parameter models (LPMs) of the MRI-MCL to better understand its behavior and key components. An established physiological LPM was modified to include the TAH, thus establishing a physiological baseline for the TAH’s response in the body. The developed MRI-MCL models were consequently tuned to the measured data from the MRI-MCL and the TAH-in-body model to find the optimal system settings for the MRI-MCL to replicate physiological conditions.

The results indicate that the MRI-MCL appears to influence the hemodynamic function of the TAH in both physiological and non-physiological ways. The developed models, while simple in design, seem to capture the overall shape of the MRI-MCL measurements, but miss finer details. Good following of the physiological model highlights the limitation of simulating TAH behavior in the body using LPMs. A higher-complexity model showed a better fit to the measured data from the MRI-MCL, indicating potential for better capturing using such models.

In conclusion, the MRI-MCL appears to replicate key physiological features, such as peripheral resistance and arterial compliance. However, its limitations at the extremes suggest a need for design improvements to achieve higher physiological replication. These findings also highlight the challenge of designing MRI-compatible systems that maintain physiological accuracy, advocating for improved design practices combined with advanced modeling techniques. Such improvements can support the continued development and evaluation of TAHs under realistic physiological conditions, without relying on in vivo testing.

In recent decades, the production and use of biogas and biomethane have increased in many European countries. However, systematic analysis of how EU policies on biogas and biomethane have evolved over time remains limited. This paper addresses this gap by analysing EU policy documents across multiple policy domains. The findings show that the EU recognised the value of biogas and by-products from anaerobic digestion as early as the 1980s, particularly in relation to rural development and agricultural systems. Over time, policy attention has expanded significantly, especially since 2020, with biomethane increasingly positioned in relation to energy security and decarbonisation goals. However, increasing policy attention has not been accompanied by fully coordinated development pathways. While recent policies emphasise the strategic role of biomethane, this reveals a gap between policy ambitions and the mobilisation of sustainable feedstock, which is essential for long-term development. These findings point to the importance of improving policy coherence and coordination across policy domains and governance levels to support the effective development of biogas and biomethane systems in the EU.

Övergångar i fritidshemmet är något som sker dagligen. Dessa övergångar är intressanta att belysa då många olika processer sker i dessa mellanrum. Övergångar kan ske mellan olika ak-tiviteter, förflyttningar mellan rum och lokaler och så vidare. Semistrukturerade intervjuer med fritidshemspersonalen och samtal i fokusgrupper med eleverna har genomförts i studien. Syftet med studien är att undersöka hur pedagoger och elever beskriver och upplever övergångar i fritidshemmet utifrån strategier, elevers behov, hinder och möjligheter. Studien har utgått ifrån ett sociokulturellt perspektiv. Metoden för att analysera materialet är tematisk analys. Resultatet visar bland annat på att både elever och pedagoger upplever både möjligheter och hinder i fri-tidshemmets övergångar.

The fifth industrial revolution, Industry 5.0, is initiating a paradigm shift in manufacturing and challenging the techno-centric orientation of production seen in Industry 4.0. Industry 5.0 places operators at the centre of the production together with technological development and sustainability, marking a shift that positions them as key drivers of the industry’s digital and green transitions. This study addresses this under-researched topic by examining existing literature on Industry 5.0 with a focus on workplace conditions that support operators’ learning and skills development for digital and green transitions of Industry 5.0. Using a scoping review technique, the search was conducted in the Scopus and Web of Science databases between 2020 and 2025. After applying the inclusion criteria, 43 papers were analysed using descriptive and thematic methods. The thematic analysis identified five conditions facilitating operator learning: redesign work for operator-robot collaboration; immersive technologies as training tools; supportive leadership and management; encourage operators to try new technologies and roles; and collaboration in partnerships to support skill development. By analysing these conditions through a workplace learning perspective, this review concludes that Industry 5.0 is not merely a technological or environmental revolution but a learning-centred paradigm shift. Realising its operator-centric vision requires embedding learning into everyday work. It calls for changes in workplaces such as redesigning work for operator–robot collaboration, adopting innovative training strategies in immersive learning environments, and developing leadership support for transitions to digital and green production.

On January 1, 2020, the United Nations Convention on the Rights of the Child (UNCRC) became law in Sweden. this requires that parents and statutory agencies thus have a duty to act in the best interest of the child. However, for the minority Sub-Sahara African (SSA) migrant families living in Sweden, the Swedish socio‐cultural and political context is causing tension between their traditional definitions of children’s rights and parenting experiences and the new environments definitions particularly when compared with parenting practices and rights of the child. This research employed thematic analysis method to analyze findings from two focus groups (n=15) to probe the perceptions of minority SSA migrants in Sweden. Four major themes emerged from the analysis: (1) Understanding of the right of the child; (2)The role of culture (3)New country context (4)Negotiating Swedish versus African parenting styles. The research found that SSA migrant parents are facing great challenges incorporating the UNCRC to their parenting practices in Sweden and many are concerned about losing their children to the new culture.

Denna uppsats undersöker hur könsroller representeras i barnböcker, med särskilt fokus på hur traditionella könsstereotyper förstärks eller utmanas. Genom en kvalitativ innehållsanalys av ett urval barnböcker granskas både text och bild för att identifiera mönster i hur pojkar och flickor framställs. Resultaten visar att klassiska barnböcker ofta förstärker traditionella könsroller, där pojkar framställs som aktiva och äventyrliga medan flickor är passiva och omsorgsfulla. Moderna barnböcker visar däremot en tydlig förändring, där både flickor och pojkar ges större handlingsutrymme och mer mångsidiga roller. Dessutom inkluderas genusneutrala och könsöverskridande karaktärer i vissa moderna böcker, vilket bidrar till en mer inkluderande och varierad representation av kön. Uppsatsen avslutar med att diskutera de utmaningar som kvarstår och potentialen för barnböcker att bidra till en förändrad syn på kön och identitet. 

Background:  Physical activity plays a central role in the course and progression of chronic conditions in older adults. However, individuals within this population tend to have an inactive lifestyle. Exergaming, which is defined as the integration of physical activity with game-based elements, offers a promising approach to promote physical activity in individuals with chronic conditions. Despite its potential, limited evidence exists on how specific game elements influence behavioral and psychological outcomes in this population.

Objective:  The aim of this study is to explore the behavioral and psychological change techniques experienced by individuals with chronic conditions using a walking-based mobile exergame, called Heart Farming.

Methods:  A cross-sectional qualitative design was used based on a gamification framework, using data from semistructured interviews with 14 participants aged 67 to 92 years who used the Heart Farming exergame for 3 months. Participants with chronic conditions, including heart failure, Parkinson disease, type 2 diabetes, stroke, or rheumatic disease, were recruited from 2 ongoing studies. Data were analyzed using deductive content analysis and presented based on the gamification framework.

Results:  The data analysis revealed increased motivation to walk, which was facilitated by game elements such as goals, rewards, feedback, and planning. Participants valued not only the sense of progression and achievement within the game but also the real-world benefits, such as spending time in nature or feeling a sense of community with others. Exergaming was integrated into daily routines by supporting the planning and structuring of daily activities. It was also perceived as enjoyable, especially due to its farming theme and visual design. Behavioral change techniques such as goal setting, feedback, and social support were commonly experienced, whereas focus on past success (as described in the gamification framework) was not used as a technique by the exergame. Psychological techniques, including self-monitoring and stress management, were mentioned. A feeling of discomfort due to playing in public was reported, and participants varied in terms of the levels of digital literacy. Social interaction features were not adequately used, even though some participants created informal support groups to exergame.

Conclusions:  This study contributes to the exergaming literature by examining behavioral and psychological change techniques from the perspective of individuals with chronic conditions. Exergaming incorporates a variety of behavioral and psychological change techniques, which were experienced by the participants in various ways. Individuals' previous knowledge of exergaming, interests, and illness progression were mentioned as factors that can influence their experiences of exergaming. By increasing the understanding of how game elements are experienced and how they influence health-related behavior, the findings of this study may inform the development of exergames that are better tailored to users' needs. Further research is needed to refine behavioral change techniques and assess condition-specific adaptations to maximize engagement and health outcomes.

The use of information systems in the rail sector has recently accelerated thanks to increasing innovations in digitalization and information technology in different transport sectors. Thus, investments in systems such as traffic information can bring substantial social value to the users, particularly during traffic disruptions. Investments in an efficient sustainable and scalable traffic information system could be an important complement to infrastructure investments and maintenance activities. In this context, we review existing research on traffic information systems, their different effects and more importantly, the assessment of their social value. We focus on the case of disruptions in railway passenger traffic although many discussions are about more general transport situations. The reviewed literature reveals several studies on the valuation of traffic information to passengers under different travel situations. However, we conclude that such valuations are rarely used in the context of cost-benefit analysis for planning investments for traffic information systems.

Construction logistics can be described as the process of coordinating the movement of goods and information from their origin to the point of use within a construction context. In a circular economy (CE), retaining the value of materials across multiple use phases depends not only on the physical management of materials, but also on the availability and coordination of information regarding their production, use, and end-of-use (EoU) management.

Actors seeking to integrate circular materials into production or sales channels require information on available supply for planning, while those managing EoU materials require knowledge of potential demand to enable efficient reverse logistics. Information sharing is therefore essential for matching supply and demand and for planning circular material flows. From this perspective, logistics management plays a key role in enabling circularity at scale, particularly in the construction industry—the largest generator of waste in the European Union. In this context, construction logistics related to construction and demolition waste management (C&DWM) constitutes a critical lever for enabling circular material flows.

Focusing on C&DWM, this thesis investigates logistics-related activities, challenges, and enablers associated with the reutilization of construction materials and products in Swedish new-build and renovation projects. Through semi-structured interviews and case studies, the three studies included in this thesis examine how actors involved in construction logistics perceive circularity, how logistics activities support the reutilization of materials and products, and which challenges and enablers influence their implementation. The thesis addresses the following research questions:

RQ1:

How do actors involved in construction logistics perceive circularity, their role, and the challenges and enablers associated with increasing circular material flows?

RQ2:

What logistics activities can support operations for circular material flows?

Taken together, the findings indicate that enabling circular material flows depends on coordinating not only physical logistics activities, but also information, incentives, and actors across projects, markets, and system levels.

Reconstruction of bathymetries is a key component of shallow water models, which require accurate estimates of both the bottom topography and its spatial derivative. This thesis studies the reconstruction of a one-dimensional bathymetry \(b:[0,1]\to\mathbb{R}\) from incomplete and noisy observations modeled by the linear system \(\mathbf{d} = \mathbf{F}\mathbf{b} + \mathbf{e}\), where \(\mathbf{F}\) is a forward-operator, \(\mathbf{b}\) is the nodal values of \(b\), and \(\mathbf{e}\) is zero-mean Gaussian noise. Two reconstruction approaches are investigated: cubic B-spline interpolation (implemented via package \texttt{TrixiBottomTopography.jl}) and Tikhonov regularization, with the regularization parameter selected by the discrepancy principle. Accuracy is measured on both a smooth and a piecewise smooth synthetic bathymetry using relative errors in the \(\ell_1\), \(\ell_2\), and \(\ell_\infty\) norms, as well as errors in forward-difference derivative estimates. The results indicate that interpolation can be effective for smooth bathymetries but may introduce oscillations, while Tikhonov regularization typically yields smoother and more stable reconstructions. For sparse data with high noise levels, the inverse problem becomes severely ill-posed and accurate recovery cannot be expected without stronger prior assumptions.

Complexity reduction and reconfigurability are challenges in the design of modern communication system front-ends. Each new generation of communication standards brings more stringent requirements on data rates, bandwidth, synchronization, and spectral efficiency, which in turn can lead to increased power consumption and chip area. To meet these requirements and at the same time prevent a rapid growth in power consumption and silicon area, it is necessary to develop more sophisticated digital signal processing (DSP) algorithms that simultaneously can achieve high performance, flexibility, and low implementation cost, particularly in hardware-constrained receiver and transmitter front-ends. This thesis investigates efficient signal processing techniques for reconfigurable communication system front-ends and presents contributions in three directions: design and implementation of variable digital filters (VDFs), efficient synchronization techniques, particularly sampling frequency offset (SFO) estimation and compensation using VDFs, and analysis and optimization of cascaded power amplifiers (PAs), specifically their accumulated nonlinearities.

Since digital filters form the core of DSP algorithms, a key candidate for efficient reconfigurability in digital front-ends is the class of VDFs, which are capable of real-time frequency response tuning without the need for online filter design. The main advantage of VDFs is that they require only an adjustment of one or a few parameters to change their characteristics, while the majority of filter coefficients remain fixed after the initial design. This property eliminates the need for extensive online computations and makes VDFs particularly attractive for modern adaptive communication technologies, enabling efficient hardware implementation. In this area, various aspects of design and implementation of VDFs are presented in the thesis, including: (i) implementations and systematic design procedures based on minimax optimization for reconfigurable finite-impulse-response (FIR) filters for simultaneous equalization and lowpass filtering; (ii) an analysis of chip area and power consumption for application-specific integrated circuit (ASIC) implementation of the reconfigurable lowpass equalizer with simultaneously variable bandwidth; (iii) low-complexity frequency-domain implementations of VDFs based on the assumption that these filters have been designed using a common time-domain design approach based on optimizing the impulse response coefficients; (iv) efficient frequency-sampling-based design approaches (minimax based and closed-form least-squares) for a variablebandwidth FIR filter implemented in the frequency domain, allowing for direct optimization of the DFT coefficients considering the filter frequency-domain implementation and thereby resulting in a substantial reduction in implementation complexity.

Further, accurate synchronization is essential for reliable operation of communication systems, as synchronization errors can significantly degrade overall system performance. Among these impairments, SFO is critical, especially in modern wideband and high-speed communication systems, where even tiny differences between sampling clocks lead to a noticeable cumulative timing drift, resulting in inter-carrier and inter-symbol interference. While the SFO compensation is commonly carried out in the time domain, most existing SFO estimation methods are formulated in the frequency domain, which are generally quite computationally demanding, and it results in a separation between estimation and compensation stages. In contrast to these traditional approaches, this thesis presents two contributions in this area, specifically: (i) a joint SFO estimation and compensation framework based on a variable-fractional- delay filter, that results in reduced implementation complexity of the SFO estimation and is applicable to arbitrary bandlimited signals; (ii) a generalized accumulator-based approach for efficient computation of time-index powered weighted sums, which is employed in the proposed SFO estimation algorithms to implement computation of time-index and time-index-squared weighted sums in an efficient way leading to eliminating considerable parts of multiplications.

Finally, recent advances in wireless communication systems have shown the need for a reconfigurable number of cascaded power amplifiers (PAs). While PAs generally constitute one of the main sources of nonlinearities in a transceiver that distort the transmitted signal and degrade the overall system performance, in cascaded PAs, the distortions from each amplifier accumulate with those from the preceding stages, leading to severe nonlinear behavior. Considering the requirements on high efficiency and a maximally linear operation regime, this thesis investigates the effect of total nonlinearities occurring in cascaded PAs by providing results on modeling, analysis, linearization, and optimization of cascaded amplifiers.

Outdoor environments are powerful spaces for early childhood development, but are they truly inclusive for all children? This thesis examines how Early Childhood Education (ECE) educators perceive inclusion in outdoor school environments for children with diverse motor abilities. While the benefits of outdoor play and learning are well-documented, physical and systemic barriers continue to limit participation for children with disabilities.

Using a qualitative approach, ten semi-structured interviews were conducted with ECE educators from six European countries (Germany, Austria, Switzerland, Sweden, Norway, and Greece). Thematic Analysis, informed by an abductive approach and guided by Universal Design for Learning (UDL), revealed a nuanced landscape: educators face challenges related to inaccessible infrastructure, limited staffing, and parental concerns, but also recognize the unique potential of nature-based environments to promote inclusion, resilience, and growth.

Educators emphasized that with thoughtful design and adaptive practices, outdoor environments can become spaces where every child, regardless of ability, can explore, play, and thrive. Their insights point to a strong need for inclusive pedagogy, supportive policies, and environments built with all learners in mind.

This study adds depth to the conversation on inclusive education by drawing on educators' lived experiences and highlights outdoor learning as a vital, yet often overlooked, area for inclusive reform.

Background

Central nervous system (CNS) tumors are the second most common childhood malignancy and a leading cause of cancer-related mortality. This national population-based study describes childhood primary CNS tumors diagnosed in Sweden over 40 years, incorporating the latest WHO classification and long-term survival data.

Methods

All primary CNS tumors in children (0-14 years), diagnosed between 1984 and 2021 and registered in Swedish Cancer Registries, were reviewed. Data on tumor location, histology, and the reclassified supratentorial CNS-PNETs were incorporated. Tumors were categorized according to the International Classification of Childhood Cancer, third edition. Incidence and survival rates were analyzed.

Results

Overall, 2954 children (<15 years) were diagnosed with a CNS tumor in Sweden 1984-2021. The average incidence rate was 4.6/100 000 children per year, and it remained stable during the study period. Astrocytomas constituted 49%, embryonal tumors 17%, and ependymomas 7% of cases. Five-year overall survival improved from 75% to 82% over the study period. However, several tumor types showed a continued decline in survival at 30 years of follow-up.

Conclusions

This 40-year population-based study provides comprehensive data on childhood CNS tumors in Sweden. The incidence remained stable during the 4 decades. The distribution of tumor diagnoses is in line with other countries. Survival has improved over time, but for some diagnoses, late mortality is seen many years after primary diagnosis, highlighting the importance of long-term follow-up.

Railway punctuality remains a critical measure of service quality and operational efficiency. Traditional performance metrics, such as on-time performance and delay increments, inform about punctuality goals and guide maintenance planning, but they often overlook the passenger experience due to limited access to disaggregated demand data. This study integrates forecasted ridership data with delay evaluation models to assess passenger delays and their socio-economic impacts. By combining passenger-centric delay contributions with the Swedish framework for socio-economic evaluations, we enable a more informed prioritisation of maintenance interventions. A case study on the Southern Main Line in Sweden illustrates the methodology’s potential to improve maintenance planning, highlighting its relevance for achieving data-driven improvements in train service reliability.

Turkey’s political landscape is characterized by pronounced regional differences, commonlydescribed through a division between western coastal provinces, the central Anatolian heartland,and the Kurdish-dominated southeast. While these regional patterns are well documented inelectoral statistics and survey research, less attention has been paid to how regional politicalcultures are reflected in everyday political news coverage.

This thesis addresses this gap by examining how politics is described in regional news media fromeastern, western, and central Anatolia. Rather than focusing on voting behavior, the study analysespolitical news articles as media narratives that shape how citizens encounter politics in daily life.The empirical material consists of forty-seven articles from regional newspapers published duringthe 2023 parliamentary and presidential elections, the 2024 local elections, and the post-electoralperiod.

Methodologically, the study applies a qualitative comparative content analysis guided by Robert M.Entman’s framing theory. By integrating the “Three-Way Partition” concept mentioned in Akarca &Baslevent’s 2010 and 2011 studies with Entman’s framing theory, which focuses on differences infocus, tone, and values, the thesis contributes to research on the perception and delivery of politicalevents by different outlets in the context of regional variation. The findings indicate systematicregional variation in how political actors, conflicts, and the role of the state are framed, reflectingbroader differences in regional political culture.

Autism börjar bli ett vanligt inslag i skolan idag, varför det är viktigt att lärarnas kunskap om ämnet är så uppdaterat som möjligt. Syftet med den här studien är att undersöka hur verksamma lärare och lärarstudenters attityder till elever med autism-diagnos ser ut. Studien genomfördes som en litteraturundersökning där Erving Goffmans stigma-teori har använts som analysverktyg samt Agenda 2030. Undersökningen riktar in sig främst på Sverige, men har med resultat från andra länders studier för att bredda perspektivet. Resultatet visar att attityden är relativt positiv, dock finns det de som har en negativ association till ämnet. Dock var många villiga till att lära sig mer. Avslutningsvis diskuteras hur skolorna och lärarutbildningar kan jobba med att vidga kunskapen hos skolpersonalen, för att bättre ge stöd men även förstå hur deras attityd kan påverka vardagen hos elever med diagnos. Autism börjar bli ett vanligt inslag i skolan idag,1 varför det är viktigt att lärarnas kunskap om ämnet är så uppdaterat som möjligt. Syftet med den här studien är att undersöka hur verksamma lärare och lärarstudenters attityder till elever med autism-diagnos ser ut. Studien genomfördes som en litteraturundersökning där Erving Goffmans stigma-teori har använts som analysverktyg samt Agenda 2030. Undersökningen riktar in sig främst på Sverige, men har med resultat från andra länders studier för att bredda perspektivet. Resultatet visar att attityden är relativt positiv, dock finns det de som har en negativ association till ämnet. Dock var många villiga till att lära sig mer. Avslutningsvis diskuteras hur skolorna och lärarutbildningar kan jobba med att vidga kunskapen hos skolpersonalen, för att bättre ge stöd men även förstå hur deras attityd kan påverka vardagen hos elever med diagnos. 

Advanced microscopy and imaging techniques are essential for investigating cellular and subcellular architecture and chemical composition. In this thesis, Photoemission Electron Microscopy (PEEM) is developed and applied as a surface- and chemically sensitive imaging modality for biological systems, with a particular focus on neutrophils. Neutrophils are the most abundant white blood cells in humans and constitute a first line of defence in the innate immune system. Upon activation, they perform key antimicrobial functions, including phagocytosis, degranulation, and the release of neutrophil extracellular traps (NETs), which trap, immobilize, and neutralize invading pathogens using DNA and antimicrobial agents.

In this work, NETs formation in combination with iron oxide (FeO_x) nanoparticles is investigated, including the magnetically guided assembly of linear and cross-shaped NETs-FeO_x nanoparticle μ-threads, induced by magnetic nanoparticles and externally applied magnetic fields. These engineered extracellular structures hold potential for materials with intrinsic antibacterial properties and, under magnetic control, exhibit a high degree of orientational order. The ability to impose controlled macroscopic alignment on DNA-based structures further suggests opportunities for the development of robust, oriented macromolecular systems, with relevance for structured organic and conjugated materials.

Work-function mapping based on surface-sensitive contrast in PEEM is a powerful and well-established technique in surface physics and materials science; however, its application in the life sciences, particularly for subcellular imaging, remains largely unexplored. To increase the information content of cellular imaging, this thesis introduces a photoemission-based strategy that integrates three-dimensional spatial reconstruction with pixel-resolved spectral (work-function) contrast, enabling quantitative insight into cellular composition and organization. Local variations in the work function provide intrinsic contrast between subcellular structures based on their molecular composition, allowing visualization of the polylobulated nuclei, intracellular granules, and membrane structures of neutrophils.

The thesis further includes the development and surface modification of gadolinium-incorporated cerium oxide nanoparticles for use as contrast agents in magnetic resonance and X-ray imaging. Two functionalization strategies are presented to enable targeting and therapeutic functionality. X-ray Photoemission Spectroscopy (XPS) is employed for chemical characterization of both nanoparticles and biological structures, highlighting the broader potential of photoemission-based methods within the life sciences.

Background

The growing number of older adults presenting to the Emergency Department (ED) challenges traditional models of acute care, which are often poorly aligned with the complex and heterogeneous needs of this population. Frailty, characterized by decreased physiological reserve and increased vulnerability to stressors, has emerged as a key determinant of adverse outcomes in older patients. However, frailty is not systematically integrated into ED assessment and decision-making, which could be explained by persisting knowledge gaps. Comparison among various frailty assessment instruments in ED settings, has demonstrated good prognostic ability regarding adverse outcomes. Their ease of use in this time- and resource-pressured environment has been evaluated, in which the globally used assessment tool CFS was gauged as usable in the ED. Focus on specific patient groups and research personnel conducting the CFS assessments have limited the generalizability of previous research, resulting in lacking evidence of the instrument’s applicability and usability in actual emergency medicine.

Aim

Since uncertainty remains regarding the instrument’s usefulness in EDs, this thesis aims to answer (1) whether frailty assessment performed by regular ED staff retains prognostic validity in real-world conditions, (2) whether frailty adds relevant predictive value beyond established triage systems, (3) how feasible and acceptable frailty assessment with CFS is within time-pressured ED workflows, and (4) whether frailty-informed routines, assessed with CFS early during the ED visit, can improve operational performance.

Method

This thesis consists of Studies I-IV with observational, both prospective and before-and-after, as well as mixed-method designs. Study I was a prospective observational multicentre study conducted in three EDs in the council of Östergötland, Sweden. Study II was a secondary analysis of Study I. Study III, a mixed-method study, was carried out in the same three EDs as Study I. Study IV was a single-centre observational before-and-after study conducted in the Emergency department of University Hospital of Linköping, Sweden.

Study I investigated the prognostic ability of CFS assessments made by regular ED staff during real-life clinical work. All assessed patients aged 65 years and above were eligible for inclusion. The primary outcome was mortality at 30 days, and secondary outcomes were mortality at 7 and 90 days, admission rate, ED and hospital length of stay (LOS). Outcomes were compared between patients living with frailty (CFS>4) and robust patients (CFS<5). Confounders were adjusted for using logistic regression

Study II investigated the prognostic performance of CFS alone or in connection with the existing warning scores: national early warning score (NEWS), triage early warning score (TEWS) or the rapid emergency triage and treatment system (RETTS) triage tool. The prognostic ability was analysed using logistic regression and the primary and secondary outcomes were the same as Study I and are reported as area under the receiver operating curve (AuROC) scores with 95% confidence intervals (CIs).

Study III was a mixed-method study that examined the feasibility and acceptability of CFS in ED by collecting completion rate of assessed patients and by analysing staff experience gathered via an electronic questionnaire. Open-ended questions in the questionnaire rendered free-text comments which were analysed using qualitative content analysis. Quantitative data were analysed to identify patient-related and organisational factors and reported as descriptive data.

Study IV was a before-and-after observational study of the effects of a frailty-informed routine where patients with CFS >4 were recommended to be prioritised for physician assessment among patients with the same acuity after triage. The primary outcome was ED LOS, and secondary outcomes were time to physician and admission rate. Outcomes were compared between a pre-implementation group (control) and a post- implementation group (intervention).

Results

Mortality was significantly higher in patients with CFS >4 at 30 days (7.9% vs 0.9%) with an adjusted odds ratio of 6.0 (95% CI 3.0-12.2, p < 0.001) in the total of 1840 ED visits that were included in the analysis. There were significant differences in mortality at 7 and 90 days, where mortality was higher for patients living with frailty. The differences remained even after adjusting for confounders. Patients living with frailty also had higher admission rates, longer ED LOS, and longer in-hospital LOS, compared to the robust patients.

A total of 1832 patients were included in Study II, where the association between mortality at 30 days and CFS >4 showed a significant association with an odds ratio of 6.0 (CI 95% 3-12, p < 0.01). Prognostication models demonstrated better prognostic ability in those models with CFS compared to those without and were overall similar in AuROC-values ranging from 0.82-0.83 (95% CI 0.77-0.88, p < 0.05).

Feasibility investigation showed a completion rate of 47% in 4235 ED visits. Assessments were made more frequently if the patients were aged >80 years, arrived by ambulance or during the forenoon. The questionnaire revealed that CFS was thought to be a relevant tool but high workload, unclear purpose for use and critical illness, were barriers for usability in the ED.

A total of 542 ED visits were analysed in the before-and-after study with 248 patients in the pre‐implementation and 294 in the post‐implementation group). Post-implementation showed a reduction in Time to physician from 44 min (IQR 20, 94) to 31 min (IQR 15, 65) (p < 0.001). ED LOS was shortened from 352 (IQR 266, 515) to 319 (IQR 240, 458) minutes (p = 0.014). There was no change in admission rate at 59% versus 60% (p = 0.4).

Conclusion

This thesis confirms the robustness and validity of CFS as a prognostic tool outside of controlled research settings and demonstrates that addition of frailty to conventional triage tools captures risk and vulnerability not reflected in vital signs and chief complaint alone. The CFS provides a more accurate risk prognosis which is valuable for establishing realistic goals-of-care and individualising medical planning. A clear ED routine including early frailty identification and connected actions could improve ED flow and decrease avoidable risks associated with prolonged ED stays, which in turn would benefit both the patients and the ED organisation as a whole. 

Ska jag välja något som det mest centrala för mitt intresse måste det bli social ordning. Hur gestaltar sig social ordning; hur utmanas den; vad händer då (Garfinkel, 1967)? När sociala praktiker är undersökningsobjekten (och det är som en social praktik jag studerar samtal) vill jag hävda att det egentligen är felaktigt att tala om ett ”mikrointresse”. Samhällelig förändring åstadkoms i varje handling människor emellan. Det som hänt tidigare bidrar till att det som händer i framtiden tar en specifik vändning och inte en annan. ...

Background

Prolonged emergency department waiting times are associated with increased mortality among older patients. In January 2025, the ED of Linkoping University Hospital, Sweden, implemented a low-resource routine to expedite the workup of older patients living with frailty by prioritized physician assessment and subsequent workup.

Aim

To investigate if a frailty alert using the Clinical Frailty Scale followed by prioritized clinical assessment influences ED operating metrics.

Design

This was an observational before and after study of a pre-implementation group (control) and a post-implementation group (intervention) between October 2024 and February 2025.

Setting/Participants

Consecutive patients aged >64 years, with a documented CFS assessment during the ED visit at the Linkoping University Hospital, Sweden, who consented to participation, were included.

Method

Standard ED operating metrics, Time to physician, ED length of stay (LOS), and admission rates were compared between a pre-implementation group and a post-implementation group.

Results

A total of 542 ED visits were analyzed (248 pre-implementation, 294 post-implementation). Time to physician was shorter in the post-implementation group at 31 min (IQR 15, 65) versus 44 min (IQR 20, 94) (p < 0.001). ED LOS was reduced from 352 (IQR 266, 515) to 319 (IQR 240, 458) minutes (p = 0.014). The admission rate was unchanged at 59% and 60% (p = 0.4).

Conclusion

Frailty alerts based on the CFS with prioritized workup reduced ED LOS and time to physician in older patients living with frailty in this single center study and may be a low-resource intervention to reduce the risks of adverse events in the ED.

Trial Registration

ClinicalTrials.gov identifier: NCT06869148

This bachelor thesis examines how the role of the project manager has changed during the transition from traditional to agile approaches in IT projects. This is explored and structured around three core components: communication, leadership, and management. The purpose is to highlight which personal characteristics of the project manager are particularly important in agile projects. The thesis is based on five semi-structured interviews with project managers from a global IT consulting firm. All respondents have experience working in both traditional and agile projects.

The results show that the project manager’s role in agile projects becomes more facilitative and coaching oriented. Consequently, the importance of the project manager’s personal characteristics also changes. Greater focus is placed on team responsibility, communication practices evolve, and the need for flexibility increases. Examples of personal characteristics that become more important include the ability to build trust, adaptability, attentiveness, and stress management.

This thesis contributes to a deeper understanding of how the project manager’s role evolves during the transition to agile project methodologies and can serve as a framework to support project managers who are new to agile projects. 

Orthognathic surgery is frequently used to correct dentofacial deformities (DFDs) in skeletally mature, non-growing individuals and has a history spanning over more than 150 years. Despite previous research, questions remain about how this treatment affects the patient’s quality of life, upper airways, and respiratory function.

The overall aim of this PhD thesis was to achieve a greater understanding of how orthognathic surgery affects patients’ quality of life in a Swedish context, with additional aspects regarding upper airway function and breathing.

The thesis comprises four studies.

In Study I, the recommended guidelines were used to translate the English-language Orthognathic Quality of Life Questionnaire (OQLQ) into Swedish (OQLQ-S). A group of 121 patients in four diagnostic groups participated in reliability and validity evaluations of the translated Swedish version of the instrument. The main conclusion was that the data supported the OQLQ-S’s validity, reliability, and comparability with the original English version.

Studies II and IV were prospective longitudinal studies of 62 consecutive patients undergoing orthognathic surgery for aesthetic and functional indications. In Study II, respiratory function was assessed using home cardiorespiratory polygraphy on three occasions: prior to orthognathic surgery and at 3 months and 1 year after surgery. None of the patients had previously been diagnosed with obstructive sleep apnoea (OSA). Surgical displacements were evaluated based on measurements in three dimensions using pre- and postoperative computed tomography. There were only minor changes in respiratory parameters such as the apnoea–hypopnoea index (AHI), the apnoea–hypopnoea index in the supine and non-supine positions, the oxygen saturation index (ODI), and the snore index. There was no significant correlation between surgical displacement and AHI, supine AHI, non-supine AHI, and ODI. There was a weak but significant correlation between vertical displacement of the anterior mandible and the snore index. The main conclusion was that the risk for iatrogenic obstruction of the upper airways seemed low in patients without OSA treated with orthognathic surgery.

In Study IV, oral health-related quality of life (OHRQoL) was evaluated with four questionnaires – OQLQ-S, Oral Health Impact 14 (OHIP-14), the Jaw Function Limitation Scale (JFLS), and the Oral Esthetic Scale (OES) – both before and after surgery and in comparison, to a control group comprising 31 patients without DFDs. On average, DFD subjects who underwent orthognathic surgery reported improvements across all scales and subscales, indicating that the surgery was beneficial. At baseline, the DFD group rated their OHRQoL significantly lower than the control group, but this difference levelled out at follow-up. However, some patients reported unchanged or worse outcomes on some of the instruments’ subscales, mainly decreased jaw mobility and an increased postoperative score in the psychosocial impact domain. The main conclusion was that orthognathic surgery has a positive impact on OHRQoL in DFD subjects.

Study III was a retrospective study of 165 adult OSA patients treated with a mandibular advancement device (MAD). Data on AHI, supine sleep, age, sex, body mass index (BMI), Epworth Sleepiness Scale (ESS) scores, mandibular protrusion, patient-reported use, and adverse effects of the MAD were retrospectively collected from medical records or the Swedish Sleep Apnoea Register. Among the included patients, 27.3% (45/165) had both positional OSA at baseline and a ≥50% difference in the proportions of supine sleep between baseline and follow-up. A generalised linear model indicated that changes in the proportion of supine sleep time had a statistically significant effect on the change in overall AHI from baseline to follow-up, comparable in magnitude to the effect of the MAD. The main conclusion was that changes in the proportion of supine sleep are an important determinant of changes between measurements in overall AHI in many patients treated with MADs. Positional OSA must be acknowledged not only in OSA diagnostics but also in MAD treatment follow-up.

Aneurysmal subarachnoid hemorrhage (aSAH) is a severe type of stroke associated with high mortality and morbidity. Although neurocritical care has improved over recent decades, delayed cerebral ischemia (DCI) remains a common yet difficult-to-predict complication with current clinical tools. Affecting approximately 30% of patients, it contributes substantially to poor outcome.

The aim of this thesis is to investigate cerebrovascular reactivity (CVR) as a method for assessing cerebral blood flow regulation and identifying patients at risk of ischemic complications after aSAH.

To enable studies across the full patient population, a novel method for controlled carbon dioxide challenges during both mechanical ventilation and spontaneous breathing was developed and applied in subsequent work. CVR measured with magnetic resonance imaging was evaluated in healthy volunteers to systematically investigate methodological factors affecting repeatability. Finally, CVR was assessed using transcranial Doppler ultrasound and magnetic resonance imaging in patients with aSAH to evaluate feasibility, safety, and potential clinical utility.

The developed system for controlled carbon dioxide challenges proved reliable and robust in achieving predefined stimulus levels during both mechanical ventilation and spontaneous breathing. Several important methodological considerations affecting the performance and interpretation of CVR measurements were identified. Magnetic resonance-based CVR using controlled inspired carbon dioxide was shown to be feasible in sedated and mechanically ventilated patients with aSAH. Preliminary results further suggest that CVR measurements may allow monitoring of ischemic evolution and early detection of DCI following aSAH.

By developing a method for controlled carbon dioxide challenges in mechanically ventilated patients, this work enables CVR investigations in previously understudied patient populations beyond aSAH. The systematic methodological investigations also contribute to greater transparency and standardization within the field. Although the clinical utility of CVR for risk stratification after aSAH could not be fully established, this thesis provides a methodological framework for future studies.

Uppsatsen är en kvalitativ litteraturstudie vars syfte är att se vad litteraturen säger om att användaskolval som pedagogiks verktyg med fokus på dess effekter på valdeltagande och allmänt politisktdeltagande. Med utgångspunkt i att de flesta gymnasieskolor i Sverige anordnarna skolval isamband med de allmänna valen, därför känns det viktigt att se om skolval är ett effektivtpedagogiskt verktyg. Att sedan flera samhällskunskapslärare för det övergripande ansvaret för attanordna skolvalet, skapar en efterfrågan kring denna metod är värd tiden som skolvalet upptar.Skolverket (2025, 2.1) skriver i gymnasiets läroplans andra kapitel om skolans mål, att elever ska haförutsättningar för att delta i demokratiska beslutsprocesser. Därför behöver skolan lära elever hurman röstar i våra allmänna val och då behöver vi som även ska bygga på beprövad erfarenhet ochvetenskaplig metod se om metoden skolval är en vetenskapligt bekräftad bra metod. Efter syftet ochingången så valdes tre frågeställningar som kollade på vad forskningen sa om skolval som metodför att öka valdeltagandet och för att öka allmänt demokratisk deltagande och slutligen vilkafaktorer som kan hjälpa och hindra skolvalet med fokus på anordnandet.

Med skolval så menas den modell som vi har i Sverige som går ut på att man i skolan håller ett val ianslutning till allmänna val (riksdags, region, riksdag och EU), där eleverna för att rösta och skolanblir som en extra valkrets, men som ej räknas med i det allmänna valet. Ett ord som används iforskningen är ”mock elections” vilket är samma sak men ett bättre beskrivande ord. Då detförklarar att skolval handlar om fiktiva eller påhittade val.

Uppsatsen fann att skolval har en tydlig effekt på att öka det demokratiska deltagandet blandeleverna. Då eleverna lär sig mer om politik och börjar diskutera politik mer efter skolval. Elevernakänner även att deras röst i valet spelar större roll efter skolvalet. Däremot så verkar effekterna påvaldeltagandet var små och ens några. För att få ut alla dessa effekter krävs dock att eleverna fårvara med och planera och att ungdomsförbund får möjligheten att träffa eleverna så att eleverna seratt politiker även kan vara unga som dem. Själva resultatet i skolvalet är inte det viktigaste, dåmånga elever inte ser skolvalet som ett sätt att utrycka sin åsikt utan som en skoluppgift. Däremotså har skolval starka möjligheter att fostra framtida demokratiska medborgare och minska distansentill politiken från eleverna.

Benign peripheral nerve tumours of the upper limb, predominantly schwannomas, pose unique diagnostic, therapeutic, and psychological challenges. The literature on diagnostic accuracy, surgical outcomes, patient experiences, and proteomic composition is inconclusive. This thesis aims to comprehensively evaluate the symptomatology, diagnostic precision, surgical outcomes, patient experiences, and explore the proteome heterogeneity of these tumours.

A multifaceted approach was employed across five studies, utilising retrospective clinical data, national quality registry data (HAKIR; hakir.se), prospective longitudinal patient-reported outcome measures (PROMs), qualitative semi-structured interviews, and exploratory proteomic analysis using two-dimensional gel electrophoresis and mass spectrometry.

Preoperative magnetic resonance imaging (MRI) demonstrated high sensitivity (85%) but low specificity (50%) for identifying schwannomas, highlighting the persistence of diagnostic uncertainty prior to surgery. While preoperative tumour size did not correlate with presenting symptoms, larger schwannomas were significantly associated with persistent postoperative sensory dysfunction at last follow-up. Surgery provided robust symptomatic relief, significantly reducing overall upper limb disability, improving daily activities, and decreasing multiple pain modalities, with improvements maintained up to 12 months postoperatively.

Furthermore, long-term follow-up (median 6 years) confirmed that residual disability remains low, although mild numbness, tingling, weakness, and cold sensitivity can persist. Importantly, no significant seasonal variation (colder versus warmer seasons of the year in Sweden) was observed in postoperative symptoms, and simple linear regressions showed no significant association between documented preoperative symptoms and long-term patient-reported outcomes.

From a patient perspective, the diagnostic and treatment trajectory is frequently accompanied by profound psychological strain and anxiety, often driven by fears of malignancy and uncertainty regarding surgical risks. Patients navigated these challenges using various coping strategies and emphasised the need for clear communication and shared decision-making with healthcare providers.

At the molecular level, exploratory proteomic profiling of histologically uniform schwannomas revealed pronounced inter-tumour heterogeneity. Tumours clustered into distinct proteomic subgroups, driven by coordinated differences in proteins associated with keratinocyte differentiation, iron handling, innate immunity, and cellular metabolism, suggesting the existence of unique biological states beyond routine histopathology.

In summary, surgical excision of benign upper-limb nerve tumours is highly effective for pain relief and functional restoration, though patients should be counselled about the potential for persistent, albeit mild, sensory disturbances. To optimise care, clinicians should integrate clinical assessments with empathetic, patient-centred communication to mitigate preoperative anxiety. Finally, the discovery of underlying proteomic heterogeneity in schwannomas challenges the traditional view of these tumours as a uniform entity, paving the way for future molecular stratification that may ultimately improve diagnostic accuracy and possibly refine treatment prognosis.

Background: Swedish naval forces personnel operate continuously under demanding and unpredictable conditions. When on naval operations, employees are exposed to stressful challenges in a constantly moving environment. Training is important to maintain and increase preparedness and can be performed in different ways, for example, in different simulation environments or settings, and the level of realism in the scenario, referred to as low or high fidelity, can vary.

Aim: The overall aim of this thesis was to explore stress and the experience of stress during training and naval operations, foreign and domestic, by measuring workload and demands of Swedish naval forces personnel.

Methods: This thesis comprises five studies. Studies I and II were qualitative, using individual notes of events during an international deployment and in-depth interviews 8 months later. Both studies explored stressors and coping among members of the Swedish naval specialized boarding element. Content analysis was used in the first study, and constant comparative analysis in the second. Studies III, IV and V were quantitative. Study III examined workload among Swedish Special Forces operators during stress week using the National Aeronautics and Space Administration Task Load Index (NASA-TLX). The different tasks were compared using ANOVA. Study IV investigated workload, combat readiness and situation awareness in a naval command and control (C2) team exposed to low- and high-fidelity simulation-based training (SBT), using repeated measures and non-parametric analyses. Study V assessed perceived learning in the same C2 team during low- and high-fidelity SBT using a within-group design. ANOVA, descriptive statistics with means and standard deviation were used for the analysis.

Results: Studies I and II highlighted the importance of preparedness, particularly leadership and team cohesion, for managing stress during naval operations. In Study III, firefighting scenarios generated a higher workload than medical scenarios, likely due to differences in previous training. Studies IV and V showed that low-fidelity SBT produced comparable workload and supported learning similarly to high-fidelity training, indicating cost-effectiveness. Study V may be a springboard for changes in education and learning based on the results presented in this thesis, and thereby may be of benefit to employees in the Armed Forces. The studies have mapped the demands placed on Swedish naval personnel and identified factors that shaped stress, workload and learning.

Conclusions: Strengthening team-building, leadership, and structured SBT can reduce stress and enhance operational readiness. Low-fidelity SBT offers a viable and efficient option for training within the Swedish Armed Forces.

Background: Sweden has been part of Operation Atalanta four times since 2009. Being part of an international naval deployment means acting in a substantially different context and environment. The Swedish Armed Forces leadership training includes the use of Wheelan’s IMGD model, whereby trust is a significant part of group dynamics.

Materials and Methods: Interviews took place after deployment when the respondents had been back in Sweden for 8 months. The constant comparative analysis method according to Glaser was used to answer the aim of the study.

Results: Trust was seen as the core of the interviews and was based on three categories: leadership, preparedness and endurance.

Discussion: The core category trust, and the lack of trust, may be a result of poor preparedness. The respondents expressed that they felt safe and secure within their own group. The “us and them” mentality was an important finding, and the cause should be examined more closely to increase trust and team spirit.

Conclusion: The Swedish Navy could benefit from improvement in education, team building and pre-deployment training to increase trust and the level of readiness and to reduce stress.

In a recent paper, Tsiakiri (2025) defends the use of luckegalitarianism (LE) in health-care priority setting againstthe charge of disrespect. She claims that a ”responsibilitysensitive healthcare system”, that is, a healthcare systemthat relies upon or is in accord with certain luck-egalitarianprinciples regarding priority setting decisions, can be compatible with respect for patients. She supports this claim byalluding to the Doctrine of Double Effect and Kant’s Formula of Humanity. The argument is further underpinned bythe idea that people have a perfect duty (towards themselvesand/or others) to promote their health in certain ways, whichincludes refraining from certain health-damaging activities

Since the inception of The People’s Republic of China’s (PRC) in 1949, it has had a long-standing conflict with the Republic of China on Taiwan, following the Kuomintang (KMT)government’s retreat to the island. This thesis aims to apply Campbell’s poststructuralisttheory to the PRC–Republic of China (ROC) conflict through a discourse analysis of PRCpolicy documents, speeches, and state-affiliated media. Epistemic realism struggles to explainwhy the world’s second-largest military power perceives a comparatively small anddiplomatically constrained island as an existential threat. This thesis therefore argues that apoststructuralist perspective is more suitable for explaining the conflict.Drawing on Campbell’s theory, the analysis demonstrates how PRC foreign policy discourseconstitutes national identity through the construction of a political ‘self’ and ‘other’. Taiwanindependence is articulated as a site of danger not primarily because of material militarythreats, but because it challenges the ontological foundations of the PRC as the solelegitimate China. By insisting on reunification through legal, historical, and moral narratives,the PRC stabilizes its national identity and disciplines alternative interpretations ofsovereignty. Consequently, the thesis concludes that the PRC cannot relinquish its claim toTaiwan without facing existential consequences for its political identity, rendering peacefulcompromise structurally constrained under the current identity formation.

This chapter argues the need to expand media and communication research in two ways. We first indicate the necessity of broadening current media and communication approaches to AI and automation to include analyses of their material underpinnings. We then propose expanding discussions of AI to examine it as an analytical phenomenon along its infrastructures, encompassing the manifold relations that actors have with AI from mineral mining to the AI commodity. Situating AI infrastructures as a key concern for media and communication research will help account for the inequalities, economies and societal conflicts that emerge within AI-saturated futures. In other words, AI must be explored at the intersection of infrastructure and sustainability.

This chapter discusses what a good digital infrastructure for AI could mean, and for whom. It explores the frictions that emerge when communities, industries and public institutions collectively try to imagine and materialize multiple versions of the “good”. Drawing on the concept of “friction” and valuation studies, we analyse the establishment of a data centre for AI systems with a sustainability profile in Östersund in Sweden. We show how such digital infrastructure emerges from the friction between differing local understandings of liveable futures and between quantifiable and non-measurable qualities of the good, such as sense of place, belonging, trust and living a life with nature. Ultimately, we propose an expansion of the ongoing discussion on the sustainability of digital infrastructure and a reorientation of attention from questions of quantifiable and measurable harms, such as carbon emissions, to concerns with power and valuations through which the different qualities of “good” infrastructure come to fruition and contention.

Teknik har en central roll i det moderna samhället, där teknologisk utveckling sker i en allt snabbare takt. Förmågan att förstå, använda och kritiskt granska teknik är en grundläggande kompetens som skolan har i uppdrag att utveckla hos eleverna. Denna studie syftar till att undersöka hur tekniklärare på mellan- och högstadiet arbetar med undervisningsmetoder som kan öka elevernas engagemang och intresse för teknikämnet. 

Genom semistrukturerade intervjuer med sex tekniklärare, samt en kompletterande enkät till elever, undersöks vilka undervisningsmetoder som används av lärarna och hur de påverkar elevens engagemang. 

Resultaten visar att lärarna uppfattar att praktiskt arbete, elevinflytande och samarbete starkt ökar elevers engagemang i teknik. Enligt lärarna påverkar lärares trygghet i ämnet hur mycket dessa metoder används. Samtidigt beskriver lärarna att könsnormer kan begränsa flickors delaktighet, vilket gör inkluderande undervisning extra viktig. 

Studien bygger på Fredricks, Blumenfeld & Paris (2004) – Tredimensionell modell för engagemang. Denna modell visar att engagemang formas genom beteendemässiga, känslomässiga och kognitiva aspekter. 

Slutsatsen är att en engagerande teknikundervisning kräver enligt lärarna en balans mellan praktiska moment, begreppsarbete, elevdelaktighet och strukturerat samarbete, samtidigt uppfattar lärarna att de aktivt behöver motverka könsnormer och skapa trygga, inkluderande lärmiljöer.

Högläsning är en vanligt förekommande aktivitet i skolans tidigare årskurser och lyfts ofta som betydelsefullt för både sociala och språkliga aspekter. Studiens syfte är att bidra med kunskap om hur lärare i årskurs F-3 beskriver att de arbetar med högläsning i undervisningen och varför de använder den. Studien baserades på kvalitativa intervjuer med verksamma utbildade lärare i årskurs F-3. Resultatet visade att högläsning främst betraktades som en lugn och gemensam aktivitet med ett språkutvecklande syfte. Andra centrala delar som framkom var interaktion genom samtal och frågor, liksom inlevelse vid läsningen. Samtidigt visade det sig att högläsningen i många fall inte systematiskt planerades, även om bokvalet lyftes av lärarna som en viktig del i planeringen. Sammantaget visar studien att högläsning präglas av fokus på genomförandet, medan den pedagogiska planeringen ofta framträder i mindre utsträckning.

This study examines how companies in the Swedish agri-food sector develop business models based on residual streams and what factors influence their ability to contribute to a circular transition. Drawing on frameworks such as Multi-Level Perspective (MLP) and Strategic Niche Management (SNM), the analysis explores the interaction between niche actors, intermediaries, and the established linear regime.

Empirical data from interviews and literature studies show that small, value-driven niche firms act as key carriers of circular innovation through learning, collaboration, and experimentation. However, they face structural barriers such as limited access to capital and institutional lock-ins. Intermediaries like clusters and universities play a crucial role by providing legitimacy, knowledge exchange, and coordination between actors.

The study concludes that circular transition depends not only on technological innovation but also on relational innovation- the capacity to build and maintain cross-sectoral collaboration supported by long-term structures, clear regulations, and targeted incentives.

This thesis investigates how national cultural differences influence corporate sustainability outcomes by comparing large firms in Sweden and Japan. Drawing on Hofstede’s cultural dimensions and Hall’s context theory, the study combines analysis of quantitative indicators of environmental, social, and economic sustainability from corporate reports with qualitative insights from semi-structured interviews. The results show that cultural traits such as hierarchy, risk tolerance, and communication context shape not only how firms pursue sustainability, but also how outcomes are reported and interpreted. Sweden’s low power distance and individualism foster transparency and participation, while Japan’s high uncertainty avoidance and long-term orientation promote disciplined, incremental efficiency improvements embedded in organizational routines. Together, these findings position culture as an explanatory mechanism behind some degree of observed differences in sustainability outcomes and reporting asymmetries. The study contributes to cross-cultural management and sustainability literature by bridging cultural theory with measurable company-level outcomes, and offers practical insights for investors and policymakers seeking to interpret sustainability performance across diverse cultural contexts.

This thesis offers an empirically grounded critique of laws that present themselves as protective in the contemporary Swedish welfare state, based on the experiences of young men who sought refuge in Sweden around 2015. Drawing on ethnographic and participatory methods, it is based on accounts from more than 90 young men, through interviews and survey responses. Starting from their experiences of violent victimisation and search for safety and justice, the study situates these accounts within a changing welfare state. Tracing responsibility for migrant victimisation back to the state, it positions young men seeking refuge as both victims of crime and survivors of state violence. Victim protection, often framed as the flipside of criminal justice, constitutes an understudied site where wider transformations of the welfare state manifest. The system of migrant victim protection spans criminal justice, social welfare and migration control. This layering, which stretches across multiple scales, produces a disorienting legal and institutional landscape where protective and punitive dimensions of law become entangled.

The thesis introduces the metaphor of the Upside Down as a conceptual frame for examining victim protection as an alternative dimension that sits beneath, or deeply within, the Swedish welfare state. The metaphor illuminates an upside-down welfare state in which racism animates the punitive dimensions of ostensibly protective legal regimes, held together by the racialising underside of law. It captures not only the structural conditions of this landscape, but also how young men seeking refuge navigate it. 

The findings demonstrate the harmful effects of purportedly protective laws. While policies and practices of abandonment facilitate violent victimisation, attempts to engage purportedly protective laws and institutions often intensify suffering in the aftermath of interpersonal violence. At the same time, relying on law can still provide moments of respite and refuge, especially when aided by practices of friendship, solidarity and informal support. The thesis highlights the limits and ambivalent potential of protective laws, while showing how struggles for safety and justice unfold both within and far beyond the reach of the state.