Iscensättanden av halsfluss : relationella göranden av en sjukdom i medicinska praktiker

Enacting tonsillitis: Relational performances in medical practices In this paper the diagnostic process of bacterial tonsillitis at two Swedish health centres is described and analysed as to how this disease comes into being, or how it is enacted. The concept of enactment implies that disease is constituted in, and through, relational practises involving human and non-human elements. The study is based on interviews with nurses and doctors as well as field observations from the health centres. In the analysis it becomes apparent that different – and sometimes conflicting – enactments of tonsillitis appear in medical practices, depending on the organization of relations between different elements. It is concluded that diagnostic agency is created in relations between both humans and non-humans, and who and what is given diagnostic agency is changeable depending on the relations at hand. The diagnostic process of tonsillitis shows how the most mundane medical diagnoses involves a number of complex relations, that stretches beyond categories such as social and medical.

En studie om rehabilitering - en skamgörande process

The purpose of this essay is using theories about labeling and social bonds to study whether a measure of rehabilitation for the psychically disabled contributes to a return to a normal status as not-labeled. Partly we examine whether the activities organized by the regulation-ruled authorities during the work of rehabilitation lead to shame or pride, and partly how these activities are organized regarding the processes that lead to the emotions pride or shame among the participants. Method: qualitative semi-structured face-to-face interviews with professional rehabilitation-actors at the Public Employment Office (PEO), the Social Insurance Office (SIO), the Social Service (SOS), the Psychiatry and the Division of Labour Market (AME).Conclusions: the Psychiatry clients are treated with respect, may participate, and communication is characterized by attunement, therefore strong social bonds can be built. On the contrary, among the other examined activities, we found many elements that arouse shame. Since these are more ruled by regulations, the result is engulfment and demands on conformity, because the compromise-possibilities are almost non-existent. Psychically disabled persons are met by prejudice, ignorance, disrespect and a non-solidarity-language. To get help, the individual has to accept a label in form of a diagnosis, and this labeling leads to a negative self-image. Furthermore the psychically disabled persons are falling between two chairs because of a weak cooperation between the rehabilitation-actors. Bimodal alienation and triangulation contributes to the difficulties in cooperation.Result: the social bonds are not strong enough to achieve a rehabilitation-effect. Even if the treatment from each administrator is important, we find the explanation-level primarily in laws, rules and government, because the structure rules the rehabilitation-measures, with shame as a consequence. Since we found elements of shame institutionalized in the way of working at PEO, SIO, SOS and AME, it means that social bonds can never reach a level good enough for achieving pride and normalization from a deviance or labeled identity.

Photovoltaic Process Development and innovative Techniques

Photovoltaic processing is one of the processes that have significance in semiconductor process line. It is complicated due to the no. of elements involved that directly or indirectly affect the processing and final yield. So mathematically or empirically we can’t say assertively about the results specially related with diffusion, antireflective coating and impurity poisoning. Here I have experimented and collected data on the mono-crystal silicon wafers with varying properties and outputs. Then by using neural network with available experimental data output required can be estimated which is further tested by the test data for authenticity. One can say that it’s a kind of process simulation with varying input of raw wafers to get desired yield of photovoltaic mono-crystal cells.

An Experimental Study of Submerged Entry Nozzles (SEN) Focusing on Decarburization and Clogging

The submerged entry nozzle (SEN) is used to transport the molten steel from a tundish to a mould. The main purpose of its usage is to prevent oxygen and nitrogen pick-up by molten steel from the gas. Furthermore, to achieve the desired flow conditions in the mould. Therefore, the SEN can be considered as a vital factor for a stable casting process and the steel quality. In addition, the steelmaking processes occur at high temperatures around 1873 K, so the interaction between the refractory materials of the SEN and molten steel is unavoidable. Therefore, the knowledge of the SEN behaviors during preheating and casting processes is necessary for the design of the steelmaking processes  The internal surfaces of modern SENs are coated with a glass/silicon powder layer to prevent the SEN graphite oxidation during preheating. The effects of the interaction between the coating layer and the SEN base refractory materials on clogging were studied. A large number of accretion samples formed inside alumina-graphite clogged SENs were examined using FEG-SEM-EDS and Feature analysis. The internal coated SENs were used for continuous casting of stainless steel grades alloyed with Rare Earth Metals (REM). The post-mortem study results clearly revealed the formation of a multi-layer accretion. A harmful effect of the SENs decarburization on the accretion thickness was also indicated. In addition, the results indicated a penetration of the formed alkaline-rich glaze into the alumina-graphite base refractory. More specifically, the alkaline-rich glaze reacts with graphite to form a carbon monoxide gas. Thereafter, dissociation of CO at the interface between SEN and molten metal takes place. This leads to reoxidation of dissolved alloying elements such as REM (Rare Earth Metal). This reoxidation forms the “In Situ” REM oxides at the interface between the SEN and the REM alloyed molten steel. Also, the interaction of the penetrated glaze with alumina in the SEN base refractory materials leads to the formation of a high-viscous alumina-rich glaze during the SEN preheating process. This, in turn, creates a very uneven surface at the SEN internal surface. Furthermore, these uneven areas react with dissolved REM in molten steel to form REM aluminates, REM silicates and REM alumina-silicates. The formation of the large “in-situ” REM oxides and the reaction of the REM alloying elements with the previously mentioned SEN´s uneven areas may provide a large REM-rich surface in contact with the primary inclusions in molten steel. This may facilitate the attraction and agglomeration of the primary REM oxide inclusions on the SEN internal surface and thereafter the clogging. The study revealed the disadvantages of the glass/silicon powder coating applications and the SEN decarburization. The decarburization behaviors of Al2O3-C, ZrO2-C and MgO-C refractory materials from a commercial Submerged Entry Nozzle (SEN), were also investigated for different gas atmospheres consisting of CO2, O2 and Ar. The gas ratio values were kept the same as it is in a propane combustion flue gas at different Air-Fuel-Ratio (AFR) values for both Air-Fuel and Oxygen-Fuel combustion systems. Laboratory experiments were carried out under nonisothermal conditions followed by isothermal heating. The decarburization ratio (α) values of all three refractory types were determined by measuring the real time weight losses of the samples. The results showed the higher decarburization ratio (α) values increasing for MgO-C refractory when changing the Air-Fuel combustion to Oxygen-Fuel combustion at the same AFR value. It substantiates the SEN preheating advantage at higher temperatures for shorter holding times compared to heating at lower temperatures during longer holding times for Al2O3-C samples. Diffusion models were proposed for estimation of the decarburization rate of an Al2O3-C refractory in the SEN. Two different methods were studied to prevent the SEN decarburization during preheating: The effect of an ZrSi2 antioxidant and the coexistence of an antioxidant additive and a (4B2O3 ·BaO) glass powder on carbon oxidation for non-isothermal and isothermal heating conditions in a controlled atmosphere. The coexistence of 8 wt% ZrSi2 and 15 wt% (4B2O3 ·BaO) glass powder of the total alumina-graphite refractory base materials, presented the most effective resistance to carbon oxidation. The 121% volume expansion due to the Zircon formation during heating and filling up the open pores by a (4B2O3 ·BaO) glaze during the green body sintering led to an excellent carbon oxidation resistance. The effects of the plasma spray-PVD coating of the Yttria Stabilized Zirconia (YSZ) powder on the carbon oxidation of the Al2O3-C coated samples were investigated. Trials were performed at non-isothermal heating conditions in a controlled atmosphere. Also, the applied temperature profile for the laboratory trials were defined based on the industrial preheating trials. The controlled atmospheres consisted of CO2, O2 and Ar. The thicknesses of the decarburized layers were measured and examined using light optic microscopy, FEG-SEM and EDS. A 250-290 μm YSZ coating is suggested to be an appropriate coating, as it provides both an even surface as well as prevention of the decarburization even during heating in air. In addition, the interactions between the YSZ coated alumina-graphite refractory base materials in contact with a cerium alloyed molten stainless steel were surveyed. The YSZ coating provided a total prevention of the alumina reduction by cerium. Therefore, the prevention of the first clogging product formed on the surface of the SEN refractory base materials. Therefore, the YSZ plasma-PVD coating can be recommended for coating of the hot surface of the commercial SENs.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.