Bakgrund: Arbetsmiljön för ambulanspersonal är frekvent präglat av stress, trauman och stressfulla situationer som kan leda till både psykiska och fysiska sjukdomar. Hantering och åtgärder mot stress är av stor vikt för att behandla och motverka ohälsa. Vid en allt ökad belastning inom ambulanssjukvården ställs höga kvar på ambulanspersonalen att utföra uppgifter under tidspress, stress och vid lite vila mellan arbetspassen och ärenden. Miljön ambulanspersonalen vistas i har en inverkan på stressnivåerna. Känslan av sammanhang är en central punkt för välmående hos ambulanspersonalen. Stress har en påverkan på ambulanspersonalens funktionsförmåga som kan komma att påverka patientsäkerheten och omvårdnaden för patienten. Syfte: Syftet med denna studie var att belysa ambulanspersonalens upplevelse och hantering av stress.  Metod: Metoden som använts i studien är en litteraturöversikt med systematisk ansats där kvalitativa och kvantitativa vetenskapliga artiklar inkluderades. Sammanlagt användes 15 vetenskapliga artiklar för att besvara syftet.  Resultat: Resultatet delades in i fyra kategorier och totalt åtta underkategorier. Stress och dess påverkan på ambulanspersonalen, patientsäkerhet, utlösande faktorer för stress samt hantering av stress. De huvudsakliga utlösande faktorerna för stress var vårdande av barn samt förlossning, stressorer kopplat till miljön, bristande erfarenhet samt hot och våld. Stress och dess påverkan på ambulanspersonalen kan bero på fysiologiska samt psykologiska aspekter. Stress visade sig bidra till både fysisk och psykisk ohälsa vilket påverkar ambulanspersonalens sociala liv. Stressen hade också en påverkan på patientsäkerheten där stress kan vara en faktor till vårdskada. Ambulanspersonal påverkad av stress ansågs ha en negativ effekt på omvårdnaden. Individuell preferens förkom av vad ambulanspersonalen själva ansågs passa bäst gällande copingstrategier. Slutsats: Stress och stressorer är komplext och individuellt. Gemensamma stressorer ses till bland annat vårdande av barn, förlossning, vårdmiljön samt hot och våld. Stressad ambulanspersonal verkar sämre och effekten ses i privatlivet, den egna hälsan samt patientsäkerheten och omvårdnaden. Adekvat träning i stresshantering är indicerat och behovet av ytterligare forskning ses fördelen i ambulanspersonalens samt patienternas välmående, fritt från vårdskador. / Background: The work environment for ambulance personnel is frequently characterized by stress, trauma and stressful situations that can lead to both mental and physical illnesses. Management and measures against stress are of great importance for treating and counteracting illness. With an increasing workload in the ambulance service, high requirements are left on the ambulance staff to perform tasks under time pressure, stress and at a little rest between work shifts and errands. The environment the ambulance staff stays in has an impact on stress levels. The sense of coherence is a central point for the well-being of the ambulance staff. Stress has an impact on the ambulance staff's ability to function, which can affect the patient safety and the care for the patient. Aim: The aim of this study was to shed light on the ambulance staff's experience and management of stress. Method: The method used in the study is a literature review with a systematic approach where both qualitative and quantitative scientific articles were included. A total of 15 scientific articles were used to answer the aim. Results: The results were divided into four categories with eight subcategories in total. Stress and its impact on ambulance personnel, patient safety, triggers for stress and stress management. The main triggering factors for stress were childcare and childbirth, stressors linked to the environment, lack of experience and threats and violence. Stress and its impact on ambulance personnel could be physiological and psychological aspects. Stress was shown to contribute to both physical and mental illness, which also affects their social lives. Stress also had an impact on patient safety where stress can be a factor in healthcare injury. Ambulance staff affected by stress that the care and nursing against patients was compromised. It was seen to an individual preference of what the ambulance staff considered to suit best regarding coping strategies.  Conclusion: Stress and stressors are complex and individual. Common stressors are seen in, among other things, childcare, childbirth, the care environment and threats and violence. Stressed ambulance personnel had a negative work ability, and the effect is seen in private life, one's own health as well as patient safety and nursing. Adequate training in stress management is indicated and the need for further research is seen in the benefit of the ambulance staff and patients' well-being, free from medical injuries.

Dans la conception basée sur des modèles on construit un modèle mathématique du système que l'on utilise pour concevoir le système de sorte qu'il présente les propriétés souhaitées. Pour les systèmes de sûreté critique, il peut être d'une importance capitale de vérifier ces propriétés de sûreté sur le modèle, par exemple, pour tenir compte des variations des paramètres. Le calcul d'un nombre fini de comportements du système par le biais de simulation ne suffit pas à garantir des propriétés de sécurité. Avec une analyse d'atteignabilité on peut calculer une couverture de tous les comportements possibles du système, possiblement infinis. Cette analyse peut prendre en compte de non-déterminisme dans le modèle et peut garantir des propriétés de sécurité. Les systèmes d'intérêt présentent souvent à la fois un comportement continu et discret et de tels systèmes sont appelés systèmes hybrides. Le calcul d'atteignabilité est considéré comme difficile pour les systèmes continus et hybrides. Ce n'est que récemment que des méthodes pour le calcul d'accessibilité ont été développées qui peuvent être mis à l'échèlle. Ils sont basés sur des représentations implicites d'ensembles continus à l'aide du concepte mathématique de la fonction de support. Dans cette thèse, nous développons un outil extensible appelé SpaceEx pour le calcul d'atteignabilité des systèmes hybrides. Deux algorithmes d'atteignabilité ont été mis en œuvre dans SpaceEx, l'un basé sur l'outil PHAVer pour les automates linéaires hybrides et l'autre basé sur les fonctions de support pour les dynamiques affines par morceaux. L'algorithme de fonction support a été mis au point et sa mise à l'échelle a été amélioré en basculant entre différentes représentations d'ensembles continus. Nous proposons un algorithme de calcul d'image des transition discrètes amélioré qui réduit l'erreur de sur-approximation et nous illustrons sa précision et son efficacité avec plusieurs études de cas. / In model based design, one constructs a mathematical model of the system and uses it to design the system so that it exhibits the desired properties. For safety critical systems, it can be of utmost importance to verify these safety properties on the model, e.g., to account for parameter variations. Computing a finite number of system behaviors via simulation is not sufficient to guarantee safety properties. With a reachability analysis one can compute a cover of all possible system behaviors, potentially infinite, accounting for any non-determinism in the model, and with which one can guarantee safety properties. Systems of interest often exhibit both continuous and discrete behavior and such systems are called hybrid systems. Reachability computation is considered hard for continuous and hybrid systems. Only recently, scalable methods for reachability computation have been developed based on implicit set representations using the mathematical construct of support functions. In this thesis, we develop an extendable tool called SpaceEx for reachability of hybrid systems. Two reachability algorithms have been implemented in SpaceEx, one based on the PHAVer tool for linear hybrid automata and the other based on support functions for piecewise affine dynamics. The support function based algorithm has been tuned and its scalability has been improved by switching set representations. We propose an improved image computation algorithm for discrete transition that further reduces the over-approximation error and illustrate its accuracy and efficiency with several case studies.

Kostnaden för hälso- och sjukvård i Sverige uppgår årligen enligt Statistiska centralbyrån till drygt 230 miljarder kronor vilket kan anses vara mycket. Den svenska hälso- och sjukvården är viktig för samhället och således blir de interna förhållandena och processerna viktiga för de som arbetar inom hälso- och sjukvården. Denna fallstudie har genom två delstudier undersökt en större hälso- och sjukvårdsorganisation som för drygt 1,5 år sedan genomförde en omorganisering. Specifikt har studien undersökt stödfunktionernas teamarbete och syftar till att öka förståelsen för hur teamens nya organisation teoretiskt kan förstås. Vidare syftar studien till att söka förståelse för hur arbetet som teamen bedriver upplevs fungera och tas emot. I delstudie ett intervjuades 12 medarbetare och chefer och i delstudie två insamlades en webbenkät ifrån 10 verksamhetschefer. Empirin har analyserats tematiskt och visade bland annat att den struktur som teamen verkar inom bättre kan förstås som en matrisorganisation med tillhörande utmaningar. Vidare är några av slutsatserna att den interna kontrollen var bristfällig och att både medarbetare och chefer gavs föga möjligheter till att i förlängningen utveckla ett ansvarsfullt arbetssätt. Diskussion om vad som kan utvecklas har redogjorts. Förslag på framtida forskning är att jämföra planerad- och upplevd styrning med faktisk produktivitet. / The cost of health care in Sweden is annually, according to Statistics Sweden more than 230 billion SEK which can be considered a lot. The Swedish health care is important to the society and consequently, the internal conditions and processes are important for those working within the health care. This case study has been conducted through two sub-studies, examined a larger health care organization, which undertook a reorganization one and a half year ago. Specifically this case study has studied the support functions teamwork, and aims to increase the theoretically understanding of the team's new work organization. Consequently the purpose of this case study has been to seek understanding of the work that the teams engage in and how it is received. In sub-study number one, 12 employees and managers where interviewed and in sub-study two, a web-based questionnaire was distributed to 10 branch managers. The empirical data were analyzed thematically and shows that the team's new organization better can be understood as a matrix organization, with related challenges. Furthermore, some of the conclusions are that the internal controls were inadequate and both employees and managers were given little opportunity to take long term responsibility for their work. A discussion of what can be developed is outlined. Suggestions for future research are to compare planed- and perceived management control with actual productivity.

O uso intensivo de áreas do solo provoca alterações na sua qualidade, tornando-se necessária a criação de métodos de avaliação e monitoramento. A técnica de Avaliação do Ciclo de Vida (ACV) é uma importante ferramenta para o cálculo de impactos ambientais, relativos a um sistema de produto com fronteiras delimitadas, sendo o Uso do Solo uma das categorias de impacto avaliada. Na ACV este impacto é avaliado, a partir de fatores de caracterização, os quais utilizam indicadores que quantificam as consequências de modificações na estrutura do solo, levando em consideração a realidade e as características morfológicas de cada país ou região. Este estudo tem como objetivo apresentar adequações relacionadas às condições brasileiras do modelo para a caracterização de impactos provocados pelo uso do solo, a partir da adaptação de fatores de caracterização. De acordo com a pesquisa bibliográfica acerca dos métodos de avaliação do uso do solo na ACV, dois grupos são avaliados a Biodiversidade e as Funções de Suporte de Vida (FSV). Neste estudo foram identificados diferentes métodos que avaliam os impactos nas FSV e a partir de alguns critérios adotados foram posteriormente submetidos a uma análise, a fim de se determinar o método de maior relevância para as condições brasileiras. O método escolhido utiliza como indicador a Matéria Orgânica do Solo (MOS), porém devido à ausência de dados em algumas regiões, podem ser utilizados valores de Carbono Orgânico do Solo (COS), componente essencial da MOS. Os valores para o COS no estado natural foram atribuídos segundo dados de literatura para o bioma Amazônia, os quais foram posteriormente adaptados para se obter o COS para os tipos de uso de solo considerados neste estudo, segundo a realidade brasileira. / The intensive use of land areas cause changes in its quality, making it necessary to create methods for assessing and monitoring. The technique of Life Cycle Assessment (LCA) is an important tool for the calculation of environmental impacts related to a product system with defined borders, and the Land Use category of impact assessed. In this LCA impacts are assessed from factors characterization using indicators that quantify the effects of changes in soil structure, taking into account the reality and the morphological characteristics of each country or region. This study aims to present adjustments related to the Brazilian model for characterizing impacts caused by land use, based on the calculation of characterization factors. In accordance with the literature of the LCA methods, two groups contribute to this category Biodiversity and Life Support Functions (FSV). In this study were discussed and evaluated different methods to calculate (FSV), from some criteria adopted, these were subjected to a comparative analysis, to the method of greatest relevance to Brazilian conditions. The method chosen to use as an indicator of Soil Organic Matter (SOM), but due to lack of data in some regions, can be used values of Soil Organic Carbon (COS) essential component of SOM. The values for COS in the natural state were assigned according to the literature data of the Amazon biome, which were adapted to obtain the COS for the types of land use considered in this study according to the Brazilian reality.

O uso intensivo de áreas do solo provoca alterações na sua qualidade, tornando-se necessária a criação de métodos de avaliação e monitoramento. A técnica de Avaliação do Ciclo de Vida (ACV) é uma importante ferramenta para o cálculo de impactos ambientais, relativos a um sistema de produto com fronteiras delimitadas, sendo o Uso do Solo uma das categorias de impacto avaliada. Na ACV este impacto é avaliado, a partir de fatores de caracterização, os quais utilizam indicadores que quantificam as consequências de modificações na estrutura do solo, levando em consideração a realidade e as características morfológicas de cada país ou região. Este estudo tem como objetivo apresentar adequações relacionadas às condições brasileiras do modelo para a caracterização de impactos provocados pelo uso do solo, a partir da adaptação de fatores de caracterização. De acordo com a pesquisa bibliográfica acerca dos métodos de avaliação do uso do solo na ACV, dois grupos são avaliados a Biodiversidade e as Funções de Suporte de Vida (FSV). Neste estudo foram identificados diferentes métodos que avaliam os impactos nas FSV e a partir de alguns critérios adotados foram posteriormente submetidos a uma análise, a fim de se determinar o método de maior relevância para as condições brasileiras. O método escolhido utiliza como indicador a Matéria Orgânica do Solo (MOS), porém devido à ausência de dados em algumas regiões, podem ser utilizados valores de Carbono Orgânico do Solo (COS), componente essencial da MOS. Os valores para o COS no estado natural foram atribuídos segundo dados de literatura para o bioma Amazônia, os quais foram posteriormente adaptados para se obter o COS para os tipos de uso de solo considerados neste estudo, segundo a realidade brasileira. / The intensive use of land areas cause changes in its quality, making it necessary to create methods for assessing and monitoring. The technique of Life Cycle Assessment (LCA) is an important tool for the calculation of environmental impacts related to a product system with defined borders, and the Land Use category of impact assessed. In this LCA impacts are assessed from factors characterization using indicators that quantify the effects of changes in soil structure, taking into account the reality and the morphological characteristics of each country or region. This study aims to present adjustments related to the Brazilian model for characterizing impacts caused by land use, based on the calculation of characterization factors. In accordance with the literature of the LCA methods, two groups contribute to this category Biodiversity and Life Support Functions (FSV). In this study were discussed and evaluated different methods to calculate (FSV), from some criteria adopted, these were subjected to a comparative analysis, to the method of greatest relevance to Brazilian conditions. The method chosen to use as an indicator of Soil Organic Matter (SOM), but due to lack of data in some regions, can be used values of Soil Organic Carbon (COS) essential component of SOM. The values for COS in the natural state were assigned according to the literature data of the Amazon biome, which were adapted to obtain the COS for the types of land use considered in this study according to the Brazilian reality.

Women’s procreative capacities and the appreciation of birth experiences have always been recognised in civil society and the early days of psychology. Given that our culture is one that emphasises a woman’s capacity to bear children as one of the greatest social achievements, the social responsibility to procreate and ensure collective survival becomes a potent mandate, especially so for Black African women. To fulfil this social responsibility, traditional African culture dictates a very specific process of pregnancy which involves a series of watershed moments, each of which requires that social support, of whatever form, should be available. This study explored the role that social support from significant others and health professionals play in mediating psychological issues during pregnancy, childbirth and postnatally among Black African women in Madadeni Township in KwaZulu-Natal. The study was rooted in the interpretive, qualitative paradigm and a phenomenological research design was used. Purposive sampling was used to select participants who were aged from 18 to 25 years with a baby older than two weeks but less than six months. Semi structured interviews were conducted in the mother tongue of the participants until the point of saturation where no new information arose from the six participants interviewed. Thematic content analysis was used to extract recurrent themes across participants. The results indicate that social support, especially from parents and partners, plays a defining role in helping women to cope with the stress experienced during pregnancy, childbirth and postnatally. / Psychology / M.A. (Psychology: Research Consultation)

Women’s procreative capacities and the appreciation of birth experiences have always been recognised in civil society and the early days of psychology. Given that our culture is one that emphasises a woman’s capacity to bear children as one of the greatest social achievements, the social responsibility to procreate and ensure collective survival becomes a potent mandate, especially so for Black African women. To fulfil this social responsibility, traditional African culture dictates a very specific process of pregnancy which involves a series of watershed moments, each of which requires that social support, of whatever form, should be available. This study explored the role that social support from significant others and health professionals play in mediating psychological issues during pregnancy, childbirth and postnatally among Black African women in Madadeni Township in KwaZulu-Natal. The study was rooted in the interpretive, qualitative paradigm and a phenomenological research design was used. Purposive sampling was used to select participants who were aged from 18 to 25 years with a baby older than two weeks but less than six months. Semi structured interviews were conducted in the mother tongue of the participants until the point of saturation where no new information arose from the six participants interviewed. Thematic content analysis was used to extract recurrent themes across participants. The results indicate that social support, especially from parents and partners, plays a defining role in helping women to cope with the stress experienced during pregnancy, childbirth and postnatally. / Psychology / M. A. (Psychology: Research Consultation)