Le défi de la transition vers une énergie sans carbone passe, aujourd’hui, par un recours systématique à l’énergie électrique avec au centre des échanges l’électronique de puissance. Pour être à la hauteur des enjeux, l'électronique de puissance nécessite des composants de plusen plus performants pour permettre un haut niveau d'intégration, une haute efficacité énergétique et un haut niveau de fiabilité. Aujourd’hui, le transistor de puissance, du type MOSFET, en carbure de silicium (SiC) est une technologie de rupture permettant de répondre aux enjeux d’intégration et d’efficacité par un faible niveau de perte et une vitesse de commutation élevée. Cependant, leur fiabilité non maitrisée et leur faible robustesse aux régimes extrêmes du type court-circuit répétitifs freinent aujourd’hui leur pénétration dans les applications industrielles. Dans cette thèse, une étude poussée du comportement en court-circuit d'un ensemble exhaustif de composants commerciaux, décrivant toutes les variantes structurelles et technologiques en jeu, a été menée sur un banc de test spécifique développé durant la thèse, afin de quantifier leur tenue au courtcircuit. Cette étude a mis en lumière des propriétés à la fois génériques et singulières aux semiconducteurs en SiC déclinés en version MOSFET tel qu’un courant de fuite dynamique de grille et un mode de défaillance par un court-circuit grille-source amenant, dans certaines conditions d'usage et pour certaines structures de MOSFET, à un auto-blocage drain-source. Une recherchesystématique de la compréhension physique des phénomènes observés a été menée par une approche mêlant analyse technologique interne des composants défaillants et modélisation électrothermique fine. Une modélisation électrothermique compacte étendue à la prise en compte des modes de défaillance a été établie et implémentée dans un logiciel de type circuit. Ce modèle a été confronté à de très nombreux résultats expérimentaux sur toutes les séquences temporelles décrivant un cycle de court-circuit jusqu'à la défaillance. Ce modèle offre un support d'analyse intéressant et aussi une aide à la conception des circuits de protection. Ainsi, à titre d'application, un driver doté d'une partie de traitement numérique a été conçu et validé en mode de détection de plusieurs scénarii de court-circuit mais aussi potentiellement pour la détection de la dégradation de la grille du composant de puissance. D’autres travaux plus exploratoires ont aussi été menés en partenariat avec l’Université de Nottingham afin d’étudier l'impact de régimes de court-circuit impulsionnels répétés sur le vieillissement de puces en parallèle présentant des dispersions. La propagation d'un premier mode de défaillance issu d'un composant "faible" a aussi été étudiée. Ce travail ouvre la voie à la conception de convertisseurs intrinsèquement sûrs et disponibles en tirant parti des propriétés atypiques et originales des semi-conducteurs en SiC et du MOSFET en particulier / Nowaday, the challenge of the transition to carbon-free energy involves a systematic use of electrical energy with power electronics at the heart of the exchanges. To meet the challenges, power electronics requires increasingly high-performance devices to provide a high level of integration, high efficiency and a high level of reliability. Today, the power transistor, of the MOSFET type, made of silicon carbide (SiC) is a breakthrough technology that allows us to meet the challenges of integration and efficiency through their low level of loss and high switching speed. However, their limited reliability and low robustness at extreme operating conditions such as repetitive short-circuits are now hindering their expansion in industrial applications. In this thesis, an in-depth study of the short-circuit behaviour of an exhaustive set of commercial devices, describing all the structural and technological variants involved, was carried out on a specific test bench developed during the thesis, in order to quantify their short-circuit resistance. This study highlighted both generic and singular properties of SiC semiconductors for every Mosfet version such as a dynamic gate leakage current and a failure mode by a short-circuit grid-source leading, under certain conditions of use and for certain Mosfet structures, to a self-blocking drain-source. A systematic research of the physical understanding of the observed mechanisms was carried out by an approach combining an internal technological analysis of the failed devices and a fine electrothermal modelling. A compact electrothermal modeling extended to failure mode consideration has been established and implemented in circuit software. This model was confronted with numerous experimental results describing a short-circuit cycle up to failure. This model offers an interesting analytical support and also helps the design of protection circuits. Thus, as an application, a driver equipped with a digital processing part has been designed and validated in detection mode for several short-circuit scenarios but also potentially for the detection of the degradation of the power component grid. Other more exploratory work has also been carried out in partnership with the University of Nottingham to study the impact of repeated pulse short-circuit regimes on the aging of parallel chips with dispersions. The propagation of a first failure mode from a "weak" device was also studied. This work paves the way for the design of intrinsically safe and available converters by taking advantage of the atypical and original properties of SiC semiconductors and Mosfet in particular

The demand for the control of safe food, from consumers the world over, has revolutionized the manner in which wild game meat harvesting occurs. In developed countries, food quality, food and human safety with quality controlling systems embracing environmental carbon footprint issues are constantly improving, for international harmonization at each level of production “from stable to table”, “farm to fork”, “field to yield” as well as from “cradle to grave”. Food industries globally have adopted the in Hazard Analysis Critical control Point (HACCP) system. This is a risk assessment process using Hygiene Assessment Systems (HAS) as a mitigating strategy for risk communication through training. It is also a holistic system that is compatible with international trends designed not only for food safety and quality, but it also embraces other aspects of farming such as animal welfare, environmental management and Occupational Safety and Health. Global marketing for international trade demands quality assurance from trading partners thereby promoting economic growth for developing countries. The watch dog bodies such as the World Trade Organisation (WTO) prohibit trading for non-compliance, therefore trade barriers are in place for uncertified food of animal origin, EU regulations are stringent requirements that need compliance and so too the OIE regulations for disease control, while the Codex Alimentarius Commission maintains trade harmonization. In South Africa Hygiene Assessment Systems (HAS) is a National Hygiene management strategy implemented at abattoirs, that promotes and facilitates quality and hygiene and is reflective of South African quality abroad. It is prescribed under the section, “Essential National Standards” in the Meat Safety Act, 2000, (Act 40 of 2000). This Act covers red meat and includes both domestic animals and game. The Veterinary Procedural Notices (VPN’s) are used for export of game and give far more detailed guidelines than the legislation for game meat sold and consumed locally in South Africa. The objective of the Hygiene Assessment System (HAS) is to create a national awareness of quality to better improve the quality of life of all South Africans, whilst at the same time it is used as an auditing tool for Veterinary Public Health to effectively compare essential standards within the nine provinces. Currently this programme is referred to as the National Abattoir Rating Scheme (NARS), which is only applicable to the high and low throughput Red Meat and Poultry abattoirs in South Africa and not to the Game or Rural abattoirs, thereby further compounding the duality of food standards with food safety being compromised. This study has been undertaken because there are inadequate risk control measures such as introduction of Hazard Analysis Critical Control Point (HACCP) guidelines on primary and secondary meat inspection, specifically on game for local consumption, not only within South Africa, but in the international arena as well. A revision of the HAS document and audit will also be needed to meet with the local (not just export) criteria for wild game harvesting, to enable food safety, thus enabling food security in the remote non - agricultural areas in KwaZulu -Natal. Venison is the meat of today because of health priorities that have arisen over the last ten years. It is low in trans - fatty acids and is regarded internationally as a healthy product produced organically in a free range situation. South Africa has a large potential export market for venison to the European Union because the demand, for venison, exceeds supply in Europe. However, the European Union’s “safe food regulation” that was introduced between 2005 and 2007 with an implementation date of 2008 (Regulation1021/2008) has made it imperative that the HACCP principle is applied to any food or food product of animal origin imported into the European Union or its member states. Also, HACCP specifies that a multidisciplinary team of experts is selected. This then lends itself to a participatory approach to risk assessment as wide consultation is required. This participatory approach was used, including expert opinion surveys and focus group discussions with stakeholders and role-players in the game industry such as commercial hunters, state veterinary services and game ranch owners. Such participants may have better insight into existing conditions than external experts with recognised educational qualifications, usually used in the HACCP team. From this and the relevant Veterinary Procedural Notices for game harvesting, a HACCP process flow and critical control points were derived for the primary phase of meat inspection, including slaughter, primary meat inspection and loading for transport to the abattoir. This was modified during a phase or trial harvesting and then implemented during the harvest of 1758 impala carcasses which were subsequently exported. In addition, environmental risks were considered and a risk mitigation strategy designed, to reduce any possible environmental impacts. In northern Kwazulu Natal, game ranches and conservation areas are in close proximity to the rural poor where food is scarce and comes at a premium price. These game farms harvest seasonally for either the local or export market, hence there is abundance of game offal and by-products available, yet it is at present left in the field or taken to the vulture restaurants (in line with the VPN). Participatory risk analysis was thus also used to investigate the feasibility of using edible offal from impala (Aepyceros melampus) as a source of renewable protein, to address food security issues in impoverished communities in the study area, the districts of uPongola and Jozini, in northern KwaZulu Natal. Structured interviews on the cultural acceptability of impala offal were held with 162 randomly sampled adult respondents in veterinary districts associated with dip tanks. A two stage cluster design was used where the state veterinary areas were stage one and the dip tanks (with proportional random sampling of community members) were the second stage. Offal is a popular food in South Africa in different cultures, called “ithumbu” in IsiZulu, “ boti” by the Indian group, “afval” in Afrikaans and “tripe” in English. Generally demand outstrips supply of offal at red meat abattoirs in South Africa. It was found that there was no significant difference between those who would eat impala offal and those who would eat the offal of sheep. It was concluded that it is feasible to use inspected game offal from impala as a protein source in much the same way as red meat offal is used and that the current practice of leaving the offal for predators was likely, if it continues, to cause imbalances in the predator/ prey ratio on game farms. It is recommended that the VPN for game be amended to encompass inspected offal being allowed into the formal food chain, in line with the standard operating procedure developed during this study. Also that current fragmentation of legislation and the implementation thereof is revisited for effective control for harmonisation of food safety standards for game meat within South Africa. / Dissertation (MMedVet)--University of Pretoria, 2012. / Paraclinical Sciences / unrestricted

Abortion is a controversial issue. It is subject of heated debates stemming from morality and ethics. Abortion is also, however, a question of rights. Access to abortion weighs the rights of the foetus against the rights of the mother. Women being denied access to safe and legal abortion due to criminalisation and restrictive abortion laws, is also a matter of human rights. Women die every year as the result of unsafe abortion methods. This thesis focuses on access to safe and legal abortion, and examines if and how public international law protects women’s access to abortion. It addresses the topic of reproductive rights and health, and whether this set of rights constitutes any protection for access to safe and legal abortion. Human rights that are actualised in relation to abortion include for example the right to life, right to privacy and right to health. Relevant provisions in CEDAW, ICCPR and ICESCR are analysed, together with general comments and reports issued by the treaty monitoring bodies of the UN. The second part of the thesis focuses on access to safe and legal abortion under the ECHR and examines relevant case-law from ECtHR on the topic. In addition to the legal dogmatic method, a feminist legal theory is used to critically evaluate whether the current protection of access to safe and legal abortion is sufficient from a women’s rights perspective. The author concludes that public international law does not offer any direct protection of access to safe and legal abortion. Instead, access to safe and legal abortion can be protected indirectly by other human rights. Restrictive abortion laws that results in risking the health and life of the mother can violate women’s human rights. Case-law from the ECtHR shows that European states are under a positive obligation to provide an effective access to abortion under the right to privacy, if the national law guarantees such a right. The result from the discussion based on feminist legal theory shows that public international law fails to recognise the abortion issue as a question of gender equality and discrimination against women.

Agile methodology has gained wide adoption. Agile methodology, with its iterative and incremental approach for software development, has gained popularity within IT organizations that are facing a dynamic business environment. Agile software development has emerged as an alternative to the traditional Waterfall model in delivering software at a faster pace and having more receptiveness towards the changing requirements. However, Agile methodology was originally designed for small and individual teams. This makes moving Agile to large-scale organizations a complicated task. In this thesis, we will review the challenges and success factors presented by (Dikert et al., 2016) in their systematic literature review for SAFe (Scaled Agile framework). Our thesis is based on empirical research. The authors have conducted interviews to gather data to underpin or dissent from the findings in the systematic literature review regarding the challenges and success factors of implementing SAFe in organizations.

Background: The turnover of nurses is a global problem. The shortage of nurses is assumed to increase when many choose to leave, which results in the remaining nurses becoming moreburdened and forced to work extra. This literature study intends to reflect the factors that contribute to the clinically working nurse choosing to leave the profession within the first years as a professional. Aim: The aim of this study was to describe the underlying factors that can lead to nurses leaving their profession within a few years as a nurse. Method: A literature review with thematic analysis that includes 21 articles with both qualitative and quantitative approach. Result: In total, two main themes were identified; Deficiencies in the work environment and Unhealthiness. Subthemes to Deficiencies in the work environment appear as Professional Pride, Career Opportunities and Resources. Stress, Burnout and Compassion Fatigue are described as subthemes under the main theme Unhealthiness. Conclusion: What emerged in this literature review was that the most relevant is that nurses due to circumstances such as work environment and human resources in the clinical work environment are not given opportunities to practice their profession according to their core competence, governing documents, and existing laws globally. The authors of this literature study want to suggest further research in the subject to reduce turnover and to contribute to more nurses wanting to stay in the profession. / Bakgrund: Omsättningen av sjuksköterskor är ett globalt problem. Bristen på sjuksköterskor antas öka när många väljer att lämna som resulterar i att de kvarvarande sjuksköterskorna blir merbelastade och tvingas arbeta extra. Denna litteraturstudie ämnar återge vilka faktorer som kan varabidragande till att den kliniskt arbetande sjuksköterskan väljer att lämna yrket inom de första årensom yrkesverksam. Syfte: Syftet är att beskriva faktorer som kan ligga bakom den kliniskt arbetande sjuksköterskansbeslut att lämna yrket inom några få år som yrkesverksam. Metod: En litteraturstudie med tematisk analys inkluderande 21 kvalitativa och kvantitativa artiklar. Resultat: Totalt identifierades två huvudteman; Brister i arbetsmiljön och Ohälsa. Subteman till Brister i arbetsmiljön framgår som Yrkesstolthet, Karriärmöjligheter och Resurser. Stress, Utbrändhet och Empatitrötthet beskrivs som subteman under huvudtemat Ohälsa. Slutsats: Det som framkom i denna litteraturstudie var att det mest relevanta är att sjuksköterskor på grund av omständigheter i den kliniska arbetsmiljön inte får möjligheter till att utöva sitt yrke ienlighet med kärnkompetenserna, styrdokument och lagar som finns globalt. Författarna till denna litteraturstudie vill föreslå ytterligare forskning inom ämnet för att minska omsättning och för att bidra till att fler vill stanna kvar i yrket.

Bakgrund: Inom EU år 2020 uppskattades det finnas en brist på 970 000 hälso- och sjukvårdspersonal. Samtidigt rapporteras vårdskador som hade kunnat undvikas drabba 93 000–98 000 patienter varje år. Sjuksköterskor rapporterar att omvårdnad uteblir på grund av tidsbrist relaterat till hög arbetsbelastning och låg bemanning. Det är viktigt att alla inom hälso- och sjukvården arbetar för att minska vårdskador och skapa säker vård.Syfte: Att beskriva sjuksköterskors erfarenheter av arbetsmiljöns betydelse för säker vård.Metod: En litteraturstudie där 20 vetenskapliga artiklar med både kvantitativ och kvalitativ design inkluderades i resultatet.Resultat: Sjuksköterskors erfarenheter av arbetsmiljöns betydelse för säker vård beskrivs genom kategorierna organisatorisk arbetsmiljö och psykosocial arbetsmiljö. Det framkommer att chefer och organisation har stor betydelse för att sjuksköterskor ska kunna arbeta för en säker vård. Större lyhördhet krävs från chefer och fler utbildningar för sjukvårdspersonalen, optimala bemanningsnivåer, teamsamarbete, mindre övertidsarbete och mindre arbetsstress.Slutsats: Sjuksköterskans erfarenheter om arbetsmiljöns betydelse för säker vård är att varje organisation och chef anses behöva öka sin lyhördhet och information till arbetstagarna samt ge dem trygghet och kompetens i att använda avvikelserapportering i större utsträckning. En arbetsmiljö med hög arbetsstress och arbetsbelastning påverkar sjuksköterskors förmåga att arbeta mot säker vård då avvikelser, missad eller utebliven vård riskeras. / Background: Within EU in 2020, there was an estimated lack of 970 000 healthcare workers. At the same time, it was reported that 93 000-98 000 patients each year was affected by care injuries that could have been avoided. Registered nurses reported that care is missed due to lack of time related to high workload and low staffing. It is important that everyone in health care work to reduce adverse events as well as to provide safe care.Aim: To describe registered nurses experiences concerning the importance of work environment to provide safe care.Method: A literature review where 20 scientific articles with both quantitative and qualitative design were included in the results.Results: Registered nurses experiences concerning the importance of the work environment regarding providing safe care are described through the categories organizational work environment and psychosocial work environment. It emerges that the managers and the organizations are of great importance in enabling nurses to provide safe care. More responsiveness is required from managers and more education for healthcare workers, optimal staffing levels, teamwork, less overtime work and less work stress.Conclusion: Registered nurses experiences concerning the importance of the work environment in their ability to provide safe care. Every manager and organization should consider increasing their responsiveness and communication with health care professionals and give them security and competence in using incidence reporting to a considerable extent. A work environment with high workplace stress and workload affect nurse’s ability to provide safe care and increases the risk for incorrect, missed care.

Bakgrund: Genom delegering av arbetsuppgifter till annan personalkategori frigörs tid för sjuksköterskor att fokusera på uppgifter av mer komplex natur. Trots att delegering minskar arbetsbelastningen för sjuksköterskor är delegeringsförfarandet också tidskrävande och ställer höga krav på säkerhet och att det är förenligt med en god vård av hög kvalitet. Då läkemedelshantering visats vara det största ansvaret som sjuksköterskor i hälso- och sjukvård i hemmet har samt att arbetsbördan fortsätter öka, är det av stort intresse att undersöka sjuksköterskors erfarenhet av läkemedelsdelegering inom hälso- och sjukvård i hemmet. Syfte: Att beskriva sjuksköterskors erfarenheter av läkemedelsdelegering inom hälso- och sjukvård i hemmet. Metod: En kvalitativ innehållsanalys med induktiv ansats baserat på 13 semistrukturerade intervjuer med sjuksköterskor inom hälso- och sjukvård i hemmet. Resultat: Resultatet visar att sjuksköterskors erfarenhet av läkemedelsdelegering både var positiva och negativa. Delegering i sig underlättade sjuksköterskors arbetssituation samtidigt som sjuksköterskor erfor att omvårdnadspersonal många gånger saknade kunskap, intresse och hade svårt att förstå ansvaret med den delegerade uppgiften. Slutsats: För att patientsäkerheten skall kunna upprätthållas måste sjuksköterskor ges förutsättningar att utbilda, handleda, säkerställa och följa upp läkemedelsdelegeringar. / Background: By delegating tasks to another staff category, time is freed up for nurses to focus on tasks of a more complex nature. Although delegation reduces the workload for nurses, the delegation procedure is also time-consuming and places high demands on safety and that it is consistent with good quality care. Since drug management has been shown to be the greatest responsibility that nurses in home health care have and that the workload continues to increase, it is of great interest to investigate nurses' experience of drug delegation in home health care. Aim: To describe nurses' experiences of drug delegation in home health care. Method: A qualitative content analysis with inductive approach based on 13 semi-structured interviews with nurses in home health care. Results: The results show that nurses' experience with drug delegation was both positive and negative. Delegation itself facilitated nurses' work situation, while nurses experienced that nursing staff often lacked knowledge, interest and had difficulty understanding the responsibility of the delegated task. Conclusion: To maintain patient safety, nurses must be given the conditions to train, supervise, confirm and follow up on pharmaceutical delegations.

En så tidig reperfusionsbehandling som möjligt hos patienter med ST-höjningsinfarkt förbättrar prognosen både gällande kardiell status och minskad dödlighet. Arbetet runt patienten måste ske skyndsamt men samtidigt med hög kompetens. Trots tydliga riktlinjer och tidsmål för reperfusionsbehandling uppfylls inte alltid dessa. Med ökad förståelse för faktorer som påverkar tidsflödet från första vårdkontakt till reperfusionsbehandling skapas förutsättningar för ett mer tidseffektivt och därmed säkrare omhändertagande av patienter som drabbade av ST-höjningsinfarkt. Syftet var att identifiera faktorer som påverkar tidsflödet från första vårdkontakt till reperfusionsbehandling vid det akuta omhändertagandet av patienter med ST-höjningsinfarkt. Metoden var en icke systematisk litteraturöversikt. Totalt inkluderades 15 artiklar både av kvantitativ- och kvalitativ ansats. Artiklarna som inkluderades i resultatet kvalitetsgranskades utifrån Sophiahemmets bedömningsunderlag för att klassificera och kvalitetsbedöma de vetenskapliga artiklarna. Artiklarna analyserades med integrerad analysmetod där likheter och olikheter mellan artiklarna identifierades, sammanställdes och delades in i underrubriker samt kategorier. I resultatet framkom fyra huvudkategorier; “Patientrelaterade faktorer”, “System-och organisatoriska faktorer”, “Vårdpersonalens inflytande” och “Kommunikation”. Resultatet från litteraturöversikten visar faktorer som hade både positiv och negativ inverkan på tidsåtgången från första vårdkontakt till reperfusionsbehandling. Faktorer som associerades med förlängd tidsåtgång var: prehospitalt långa transporttider, ospecifika symtom och otillgängligt Percutant Coronar Interventions-lab (PCI-lab). Faktorerna som associerades med tidssparande effekt var: prehospitalt EKG, när patienten transporterades direkt till PCI-lab utan att gå via akuten, prehospital notifikation, fungerande teamarbete, standardiserade arbetssätt och protokoll, organisatoriskt engagemang med regelbunden feedback till personalen samt kompetensutbildning. Slutsatsen är att faktorer som associerades med förlängd tidsåtgång var prehospitalt långa transportavstånd, ospecifika symtom och otillgängligt PCI-lab. Faktorerna som associerades med tidssparande effekt var prehospitalt EKG, direkt transport till PCI-lab utan att passera akutmottagningen, fungerande teamarbete med god kommunikation, standardiserade arbetssätt, organisatoriskt engagemang med regelbunden feedback och utvärdering samt kompetensutbildning för berörd personal. För att identifiera faktorer som är tidsvinnande och skapa nya strategier krävs engagemang och samarbete från samtliga professioner som möter patienten. / As early reperfusion therapy as possible in patients with ST-elevation infarction, the prognosis improves both in terms of cardiac status and reduced mortality. The care around the patient must be done quickly but at the same time with high knowledge precision. Despite clear guidelines and goals for reperfusion, not everyone lives up to them. With an increased understanding of factors that affect the flow of time from initial care contact to reperfusion treatment, conditions are created for more time-efficient and safer care of patients suffering from ST-elevation myocardial infarction. The aim was to identify factors that affect the time flow from first medical contact to reperfusion therapy in the acute care of patients with ST-elevation myocardial infarction. The method was a literature study with a systematic search strategy. A total of 15 articles were included which were both quantitative and qualitative. The articles that were included in the results section were read through several times by both authors and quality reviewed with assessment data for literature studies. The articles were analyzed with an integrated analysis method and divided into subheadings and categories. The results revealed four main categories; "Patient-related factors", "System and organizational factors", "Influence of care staff" and "Communication". The results from the literature review show factors that had both a positive and negative impact on the time required from first medical contact to reperfusion therapy. Factors associated with prolonged time consumption were: prehospital transport times, nonspecific symptoms, and unavailable Percutaneous Coronary Intervention-lab (PCI-lab). The factors associated with the timesaving effect were: prehospital ECG, when the patient was transported directly to the PCI-lab without going through the emergency room, prehospital notification, functioning teamwork, standardized working methods and protocols, organizational commitment with regular feedback to staff and skills training The conclusion is that factors associated with prolonged time consumption were prehospital long transport distances, nonspecific symptoms and unavailable PCI lab. The factors associated with time-saving effect were prehospital ECG, direct transport to PCI-lab without passing the emergency room, functioning teamwork with good communication, standardized working methods, organizational commitment with regular feedback and evaluation and competence training for relevant staff. Identifying factors that are time-saving and creating new strategies requires commitment and cooperation from all professionals who meet the patient.

Bakgrund: Andelen äldre ökar och för äldre är läkemedelsbiverkningar ett vanligt problem som ger ökad sjuklighet, ohälsa och dödlighet. Ofta är de läkemedel som orsakar allvarlig läkemedelsrelaterad ohälsa vanligt förekommande, biverkningarna är välkända och går att förebygga. Distriktssköterskan är en viktig del i det förebyggande arbetet genom läkemedelsgenomgångar, utbildning och kunskap som ger goda förutsättningar för att effektivt förebygga läkemedelsrelaterad ohälsa och öka patientsäkerheten. Syfte: var att beskriva läkemedelsförskrivningen hos den äldre befolkningen i Blekinge under perioden 2001–2015. Metod: Studien gjordes i samarbete med Swedish National Study on Aging and Care – Blekinge (SNAC-B). Den hade kvantitativ design med tre tvärsnitt mellan 2001–2015 och inkluderade äldre personer 65 år eller äldre. Analysen gjordes deskriptivt och för att se signifikant skillnad i medelantal förskrivna läkemedel genomfördes t-test. Resultat: Den äldre befolkningen hade i snitt lika många förskrivna läkemedel 2001–2015, äldre utan läkemedel ökade procentuellt från 2001–2015 och för äldre med läkemedel syntes en ökad förskrivning. Mellan åldersgrupperna fanns en statistiskt signifikant skillnad i medelvärdet av förskrivningar vid alla tre tidpunkterna, detta fanns mellan könen vid första tvärsnittets tidpunkt, 2001–2003, men kunde inte påvisas vid de två andra tvärsnitten. De fem mest förskrivna läkemedelsgrupperna var samma vid alla tre tidpunkterna. Slutsats: Antal förskrivningar visade sig vara konstant, men andelen äldre utan läkemedel ökade och hos äldre med läkemedel ökade förskrivningarna. Äldre äldre visade sig ha en ökad förskrivning jämfört med yngre äldre, det fanns även en skillnad i förskrivningar mellan könen 2001–2003, för att sedan jämnas ut.

La présence de systèmes et d'objets embarqués communicants dans notre vie quotidienne nous a apporté une myriade d'avantages, allant de l'ajout de commodité et de divertissement à l'amélioration de la sûreté de nos déplacements et des soins de santé. Cependant, les défauts et les vulnérabilités de ces systèmes exposent leurs utilisateurs à des risques de dommages matériels, de pertes financières, et même des dommages corporels. Par exemple, certains véhicules commercialisés, qu'ils soient connectés ou conventionnels, ont déjà souffert d'une variété de défauts de conception entraînant des blessures et la mort. Dans le même temps, alors que les véhicules sont de plus en plus connectés (et dans un avenir proche, autonomes), les chercheurs ont démontré la possibilité de piratage de leurs capteurs ou de leurs systèmes de contrôle interne, y compris l'injection directe de messages sur le bus CAN.Pour assurer la sûreté des utilisateurs et des passants, il faut considérer plusieurs facteurs. La sûreté conventionnelle suggère qu'un système ne devrait pas contenir de défauts logiciels et matériels qui peuvent l'empêcher de fonctionner correctement. La "sûreté de la fonction attendue" consiste à éviter les situations que le système ou ses composants ne peuvent pas gérer, comme des conditions environnementales extrêmes. Le timing peut être critique pour certains systèmes en temps réel, car afin d'éviter des situations dangereuses, le système devra réagir à certains événements, comme l'évitement d'obstacles, dans un délai déterminé. Enfin, la sûreté d'un système dépend de sa sécurité. Un attaquant qui peut envoyer des commandes fausses ou modifier le logiciel du système peut changer son comportement et le mettre dans diverses situations dangereuses. Diverses contre-mesures de sécurité et de sûreté pour les systèmes embarqués, en particulier les véhicules connectés, ont été proposées. Pour mettre en oeuvre correctement ces contre-mesures, il faut analyser et vérifier que le système répond à toutes les exigences de sûreté, de sécurité et de performance, et les faire la plus tôt possible dans les premières phases de conception afin de réduire le temps de mise sur le marché, et éviter les reprises. Cette thèse s'intéresse à la sécurité et la sûreté des les systèmes embarqués, dans le contexte du véhicule autonome de l'Institut Vedecom. Parmi les approches proposées pour assurer la sûreté et la sécurité des les systèmes embarqués, l'ingénierie dirigée par modèle est l'une de ces approches qui couvre l'ensemble du processus de conception, depuis la définition des exigences, la conception du matériel et des logiciels, la simulation/vérification formelle et la génération du code final. Cette thèse propose une méthodologie de modélisation pour une conception sûre et sécurisée, basée sur la méthodologie SysML-Sec, qui implique de nouvelles méthodes de modélisation et de vérification. La modélisation de la sécurité est généralement effectuée dans les dernières phases de la conception. Cependant, la sécurité a un impact sur l'architecture/allocation; les décisions de partitionnement logiciel/matériel devraient être prises en fonction de la capacité de l'architecture à satisfaire aux exigences de sécurité. Cette thèse propose comment modéliser les mécanismes de sécurité et l'impact d'un attaquant dans la phase de partitionnement logiciel/matériel. Comme les protocoles de sécurité ont un impact négatif sur le performance d'un système, c'est important de mesurer l'utilisation des composants matériels et les temps de réponse du système. Des composants surchargés peuvent entraîner des performances imprévisibles et des retards indésirables. Cette thèse traite aussi des mesures de latence des événements critiques pour la sécurité, en se concentrant sur un exemple critique pour les véhicules autonomes : le freinage/réponse après la détection d'obstacles. Ainsi, nos contributions soutiennent la conception sûre et sécurisée des systèmes embarqués. / The presence of communicating embedded systems/IoTs in our daily lives have brought a myriad of benefits, from adding conveniences and entertainment, to improving the safety of our commutes and health care. However, the flaws and vulnerabilities in these devices expose their users to risks of property damage, monetary losses, and personal injury. For example, consumer vehicles, both connected and conventional, have succumbed to a variety of design flaws resulting in injuries and death. At the same time, as vehicles are increasingly connected (and in the near future, autonomous), researchers have demonstrated possible hacks on their sensors or internal control systems, including direct injection of messages on the CAN bus.Ensuring the safety of users or bystanders involves considering multiple factors. Conventional safety suggests that a system should not contain software and hardware flaws which can prevent it from correct function. `Safety of the Intended Function' involves avoiding the situations which the system or its components cannot handle, such as adverse extreme environmental conditions. Timing can be critical for certain real-time systems, as the system will need to respond to certain events, such as obstacle avoidance, within a set period to avoid dangerous situations. Finally, the safety of a system depends on its security. An attacker who can send custom commands or modify the software of the system may change its behavior and send it into various unsafe situations. Various safety and security countermeasures for embedded systems, especially connected vehicles, have been proposed. To place these countermeasures correctly requires methods of analyzing and verifying that the system meets all safety, security, and performance requirements, preferably at the early design phases to minimize costly re-work after production. This thesis discusses the safety and security considerations for embedded systems, in the context of Institut Vedecom's autonomous vehicle. Among the proposed approaches to ensure safety and security in embedded systems, Model-Driven Engineering is one such approach that covers the full design process, from elicitation of requirements, design of hardware and software, simulation/formal verification, and final code generation. This thesis proposes a modeling-based methodology for safe and secure design, based on the SysML-Sec Methodology, which involve new modeling and verification methods. Security modeling is generally performed in the last phases of design. However, security impacts the early architecture/mapping and HW/SW partitioning decisions should be made based on the ability of the architecture to satisfy security requirements. This thesis proposes how to model the security mechanisms and the impact of an attacker as relevant to the HW/SW Partitioning phase. As security protocols negatively impact performance, it becomes important to measure both the usage of hardware components and response times of the system. Overcharged components can result in unpredictable performance and undesired delays. This thesis also discusses latency measurements of safety-critical events, focusing on one critical to autonomous vehicles: braking as after obstacle detection. Together, these additions support the safe and secure design of embedded systems.