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Patientsäkerhet vid traumalarm : - anestesisjuksköterskans arbete analyserat med resilience engineering som utgångspunktJohansson, Marcus, Nilsson, William January 2017 (has links)
Bakgrund: Vårdskador drabbar närmare 10 procent av alla patienter. I samband med ett traumaomhändertagande kommer anestesisjuksköterskan att arbeta i en miljö som inte är dennes dagliga arbetsplats. Detta ställer höga krav på kompetens, följsamhet till riktlinjer och inövade rutiner för att kunna bibehålla ett patientsäkert och effektiv traumaomhändertagande. Syfte: Att identifiera faktorer som kan inverka på patientsäkerheten i samband med att anestesisjuksköterskan larmas till akutrummet. Metod: Med resilience engineering som utgångspunkt gjordes en flerfallsstudie med holistisk design. Varje fall (n=8) analyserades separat för att sammanställas med en induktiv ansats genom instrumentet Functional Resonance Analysis Method. Följsamheten mot lokala riktlinjerna kontrollerades med en deduktiv ansats. Resultat: Anestesisjuksköterskan har till hälften av fallen den lokalkännedom som krävdes enligt gällande riktlinjer, anestesisjuksköterskan förefaller i flera fall sakna kunskap om den tekniska apparaturen som används. Detta resulterar i att anestesisjuksköterskan inte arbetade självständig utan blev beroende av traumateamet för att slutföra sina uppgifter. Förberedelserna varierade stort, i majoriteten av fallen fanns ingen större följsamhet till de riktlinjer som styrde anestesisjuksköterskans arbete i ett traumaomhändertagande. En hög patientsäkerhet bibehölls genom att arbetsfördelningen och förberedelserna delades på, ofta outtalat inom traumateamets medlemmar. Tack vare stor personalgrupp och hög kompetens inom traumateamet kunde teamets medlemmar komplettera varandra. Slutsats: Flera aspekter som kan påverka patientsäkerhet negativt identifierades. Flertalet av dessa bl.a. lokal- och utrustningskännedom för anestesisjuksköterskor bedömdes kunna minskas eller elimineras om följsamheten till riktlinjerna skärps. I alla analyserade fall bibehålls god patientsäkerhet tack vare traumateamets höga resilience. / Background: Injuries in care occurs in approximately 10 percent of all patients. In a critical trauma care the anaesthetic nurse works in an unfamiliar workplace. This requires high competence and directive guidelines to maintain a high patient safety and effective trauma care. Objectives: To identify factors that can have impact on the patient safety when the anaesthetic nurse is called to the ER. Methods: Through resilience engineering, a multi-case study with a holistic design was conducted. Each case (n=8) analysed separately with an inductive approach with the instrument Functional Resonance Analysis Method. Thereafter, the compliance with guidelines was studied with a deductive approach. Results: The anaesthetic nurse lacked the required knowledge of the ER that is required by the guidelines in half of the cases. The anaesthetic nurse also appeared to lack knowledge of technical equipment. This caused dependency in the anaesthetic nurse to fulfil its duties. Preparations varied greatly, in most of cases there was no major compliance with the guidelines for the anaesthetic nurse. High patient safety was maintained by dividing the labour within the team’s members. Thanks to large staff and level of competence within the team, the members could complement each other. Conclusions: Several aspects that could affect patient safety negatively were identified. Most of these negative aspects could be reduced if compliance with guidelines were tightened. Throughout all cases, good patient safety is maintained thanks to the team's high resilience.
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Rapid Mission Assurance Assessment via Sociotechnical Modeling and SimulationLanham, Michael Jay 01 May 2015 (has links)
How do organizations rapidly assess command-level effects of cyber attacks? Leaders need a way of assuring themselves that their organization, people, and information technology can continue their missions in a contested cyber environment. To do this, leaders should: 1) require assessments be more than analogical, anecdotal or simplistic snapshots in time; 2) demand the ability to rapidly model their organizations; 3) identify their organization’s structural vulnerabilities; and 4) have the ability to forecast mission assurance scenarios. Using text mining to build agent based dynamic network models of information processing organizations, I examine impacts of contested cyber environments on three common focus areas of information assurance—confidentiality, integrity, and availability. I find that assessing impacts of cyber attacks is a nuanced affair dependent on the nature of the attack, the nature of the organization and its missions, and the nature of the measurements. For well-manned information processing organizations, many attacks are in the nuisance range and that only multipronged or severe attacks cause meaningful failure. I also find that such organizations can design for resiliency and provide guidelines in how to do so.
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O papel das atividades terciárias nos processos de resiliência urbana na rua Treze de Maio, na cidade de São Paulo / The role of tertiary activities in urban resilience on 13 may Street in the city of São PauloRodrigues, Ana Paula Preto 19 May 2017 (has links)
Esta tese tem como objetivo geral identificar as atividades de comércio e serviços varejistas, que após sofrerem ações de diversas naturezas se mantêm em funcionamento transformando-se ou resistindo. Neste sentido, identificar a existência destas atividades, ou grupo de atividades responsáveis por iniciar, manter, dinamizar áreas urbanas, predominantemente terciárias (comércio e serviços) faz parte do objeto principal desta tese. O conceito de resiliência foi primeiro utilizado pela física e as ciências sociais tomaram este conceito emprestado definindo a resiliência como a capacidade, de um indivíduo ou de uma organização lidar com problemas, superar obstáculos ou resistir à pressão de situações adversas e ultrapassá-las. Nesta direção iniciou-se um percurso por meio das várias definições de resiliência transpondo-as para os espaços da cidade. Para tanto as frentes de investigação, nesta tese, buscaram entender, a partir da história do desenvolvimento da cidade, a dinâmica do setor de comércio e serviços e a existência de elementos catalizadores dessas mudanças observadas nos processos urbanos iniciais e, em transformação. A verificação empírica seja na formação e manutenção de áreas terciárias diversificadas, ou especializadas tiveram como principal estudo de caso a rua Treze de Maio, na cidade de São Paulo. A identificação destas atividades e seus encadeamentos responsáveis pelos processos de resiliência urbana comercial podem contribuir, sim, na elaboração de políticas públicas para a recuperação de áreas deterioradas. Ao final desta tese foi possível construir um conceito sobre a resiliência urbana comercial, qual seja, \"a capacidade que os sistemas de varejo dispõem na direção de interpretar e evoluir/reagir aos diversos acontecimentos da cidade contemporânea, transformando-se e adquirindo subsídios equilibrados para o desenvolvimento urbano regional\". / This thesis aims to identify the General activities of trade and services retailers, after suffering several actions still remain in operation becoming or resisting. In this sense, identify the existence of these activities, or group of activities responsible for initiating, maintaining, advancing, predominantly tertiary urban areas (trade and services) is part of the main object of this thesis. The concept of resilience was first used by physics and the social sciences have taken this concept borrowed by setting the resilience as the ability of an individual or an organization to deal with problems, overcome obstacles or withstand the pressure of adverse situations and overcome them. This way began a journey through the various settings of resilience across them for the spaces of the city. For both the research fronts, this thesis, sought to understand, from the history of the development of the city, the dynamics of the trade and services sector and the existence of elements catalysts of these observed changes in procedures and in urban transformation. The empirical verification is in the formation and maintenance of diversified or specialized tertiary areas had as main case study 13 may Street, in the city of São Paulo. The identification of these activities and their threads responsible for urban commercial resilience processes can contribute, Yes, in public policy development for the recovery of damaged areas. At the end of this thesis it was possible to construct a concept on urban resiliency, which is commercial, \"the ability of retail systems have to interpret and react to various events/evolve from the contemporary city, transforming and acquiring balanced subsidies for regional urban development\".
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O papel das atividades terciárias nos processos de resiliência urbana na rua Treze de Maio, na cidade de São Paulo / The role of tertiary activities in urban resilience on 13 may Street in the city of São PauloAna Paula Preto Rodrigues 19 May 2017 (has links)
Esta tese tem como objetivo geral identificar as atividades de comércio e serviços varejistas, que após sofrerem ações de diversas naturezas se mantêm em funcionamento transformando-se ou resistindo. Neste sentido, identificar a existência destas atividades, ou grupo de atividades responsáveis por iniciar, manter, dinamizar áreas urbanas, predominantemente terciárias (comércio e serviços) faz parte do objeto principal desta tese. O conceito de resiliência foi primeiro utilizado pela física e as ciências sociais tomaram este conceito emprestado definindo a resiliência como a capacidade, de um indivíduo ou de uma organização lidar com problemas, superar obstáculos ou resistir à pressão de situações adversas e ultrapassá-las. Nesta direção iniciou-se um percurso por meio das várias definições de resiliência transpondo-as para os espaços da cidade. Para tanto as frentes de investigação, nesta tese, buscaram entender, a partir da história do desenvolvimento da cidade, a dinâmica do setor de comércio e serviços e a existência de elementos catalizadores dessas mudanças observadas nos processos urbanos iniciais e, em transformação. A verificação empírica seja na formação e manutenção de áreas terciárias diversificadas, ou especializadas tiveram como principal estudo de caso a rua Treze de Maio, na cidade de São Paulo. A identificação destas atividades e seus encadeamentos responsáveis pelos processos de resiliência urbana comercial podem contribuir, sim, na elaboração de políticas públicas para a recuperação de áreas deterioradas. Ao final desta tese foi possível construir um conceito sobre a resiliência urbana comercial, qual seja, \"a capacidade que os sistemas de varejo dispõem na direção de interpretar e evoluir/reagir aos diversos acontecimentos da cidade contemporânea, transformando-se e adquirindo subsídios equilibrados para o desenvolvimento urbano regional\". / This thesis aims to identify the General activities of trade and services retailers, after suffering several actions still remain in operation becoming or resisting. In this sense, identify the existence of these activities, or group of activities responsible for initiating, maintaining, advancing, predominantly tertiary urban areas (trade and services) is part of the main object of this thesis. The concept of resilience was first used by physics and the social sciences have taken this concept borrowed by setting the resilience as the ability of an individual or an organization to deal with problems, overcome obstacles or withstand the pressure of adverse situations and overcome them. This way began a journey through the various settings of resilience across them for the spaces of the city. For both the research fronts, this thesis, sought to understand, from the history of the development of the city, the dynamics of the trade and services sector and the existence of elements catalysts of these observed changes in procedures and in urban transformation. The empirical verification is in the formation and maintenance of diversified or specialized tertiary areas had as main case study 13 may Street, in the city of São Paulo. The identification of these activities and their threads responsible for urban commercial resilience processes can contribute, Yes, in public policy development for the recovery of damaged areas. At the end of this thesis it was possible to construct a concept on urban resiliency, which is commercial, \"the ability of retail systems have to interpret and react to various events/evolve from the contemporary city, transforming and acquiring balanced subsidies for regional urban development\".
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Investigation of organizational resilience through team operations in challenging conditionsSenturk, Melike January 2018 (has links)
In this study, I investigated the precursors and the outcomes of team resilience. In contrast to many resilience studies, which focus on low-probability, high-impact challenges, I investigated resilience in the face of high-frequency, low-impact challenges that teams can face in their operational environments. I conducted an extensive literature analysis of the field of resilience and on the basis of this constructed a model of team resilience by integrating insights from high reliability organizing, positive organizational scholarship, sensemaking and disaster resilience studies. I then tested and improved this model through an exploratory study of team behaviour in two 'Escape Game' settings in which teams of 5 people worked through a series of puzzles under time-constrained and somewhat stressful conditions. Following the exploratory study, I developed the resilience model into an operationalizable format and tested it using seven runs of a simulation study involving 547 individuals in 68 teams. In the simulation, teams had to work both quickly and accurately whilst adapting to the changing conditions of a turbulent, competitive environment. Quantitative and qualitative data were collected on various team attributes, team resilience and team performance. I have used quantitative data as the main source of analysis and qualitative data as a supporting tool. Self-completion questionnaires, objective performance indicators, direct observation and post-simulation team and individual reflections were among the data collection tools that were used to obtain data. Team resilience shows highly significant associations with a range of objective measures of team performance. In turn, resilience is supported by several team attributes, including collective mental models, effective channels of communication and systems of information gathering and team cohesion. When teams faced challenges outside of their existing action repertoires their ability to improvise also contributed to resilience. Finally, when teams overcame (novel) challenges, this fed back into their accumulated knowledge through collective learning, enriching action repertoires. Together, these features bestow teams with resilience, which, in turn, enables them to overcome disturbances that might otherwise impede operational performance. In its final form, my resilience model serves as an explanation of the mechanisms of resilience and identifies its antecedents and outcomes. It can inform teams operating in uncertain, ambiguous and volatile work conditions about the capacities and capabilities they need in order to create and sustain resilience in daily operations.
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Cryptographic techniques for hardware securityTselekounis, Ioannis January 2018 (has links)
Traditionally, cryptographic algorithms are designed under the so-called black-box model, which considers adversaries that receive black-box access to the hardware implementation. Although a "black-box" treatment covers a wide range of attacks, it fails to capture reality adequately, as real-world adversaries can exploit physical properties of the implementation, mounting attacks that enable unexpected, non-black-box access, to the components of the cryptographic system. This type of attacks is widely known as physical attacks, and has proven to be a significant threat to the real-world security of cryptographic systems. The present dissertation is (partially) dealing with the problem of protecting cryptographic memory against physical attacks, via the use of non-malleable codes, which is a notion introduced in a preceding work, aiming to provide privacy of the encoded data, in the presence of adversarial faults. In the present thesis we improve the current state-of-the-art on non-malleable codes and we provide practical solutions for protecting real-world cryptographic implementations against physical attacks. Our study is primarily focusing on the following adversarial models: (i) the extensively studied split-state model, which assumes that private memory splits into two parts, and the adversary tampers with each part, independently, and (ii) the model of partial functions, which is introduced by the current thesis, and models adversaries that access arbitrary subsets of codeword locations, with bounded cardinality. Our study is comprehensive, covering one-time and continuous, attacks, while for the case of partial functions, we manage to achieve a stronger notion of security, that we call non-malleability with manipulation detection, that in addition to privacy, it also guarantees integrity of the private data. It should be noted that, our techniques are also useful for the problem of establishing, private, keyless communication, over adversarial communication channels. Besides physical attacks, another important concern related to cryptographic hardware security, is that the hardware fabrication process is assumed to be trusted. In reality though, when aiming to minimize the production costs, or whenever access to leading-edge manufacturing facilities is required, the fabrication process requires the involvement of several, potentially malicious, facilities. Consequently, cryptographic hardware is susceptible to the so-called hardware Trojans, which are hardware components that are maliciously implanted to the original circuitry, having as a purpose to alter the device's functionality, while remaining undetected. Part of the present dissertation, deals with the problem of protecting cryptographic hardware against Trojan injection attacks, by (i) proposing a formal model for assessing the security of cryptographic hardware, whose production has been partially outsourced to a set of untrusted, and possibly malicious, manufacturers, and (ii) by proposing a compiler that transforms any cryptographic circuit, into another, that can be securely outsourced.
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Leadership Attributes and Behaviors as Predictors of Organizational Resilience in Academic Health Care SystemsBesuner, Patti Lynn 01 January 2017 (has links)
Research intentionally addressing how leadership attributes and behaviors collectively contributed to the socioecological perspective of organizational resilience were not found. This is a problem for organizations who must hire without benefit of how a collective leadership effect might influence their psychological capital. The purpose of this study was to explore whether or not self-efficacy, psychological empowerment, personal resilience, and leadership style were associated with or predicted organizational resilience among clinical managers in an academic medical center setting. Metatheory of resilience and resiliency was used to frame the study. A quantitative correlational design was used. Self-reported data was collected via the Leader Efficacy Questionnaire, Psychological Empowerment Instrument, Connor and Davidson's Resilience Scale, Multifactor Leadership Questionnaire, and Workplace Resilience Instrument. Intellectual stimulation (rs .480, Ï? .432, p = .00), personal resilience (rs .483, Ï? .465, p = .00), and self-efficacy (rs .522, Ï? .462, p = .00) had the highest statistical correlations to organizational resilience. Negative predictor effects were found for personal resilience and idealized attributes ascribed to self-oriented versus other-oriented resilience qualities, x2(2) = 50.70, p < .01, and p < .05 respectively. Resilience is important for organizational survival and adaptation to the external and internal forces of change. Resilient organizations with available reserves can collaborate with community leaders to optimize the social, environmental, and economic determinants of health foundational for community resilience and positive social change.
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The other voice of Climate Change:A case study of community-based adaptivecapacities, through the analysis of activists’networks, building resilience, in South AfricaAUREOLES GEYMONAT, SOFIA January 2019 (has links)
The concept of climate change has been in the debate, not only at the international level, but also locally, for decades. However, activists around the world have come together to raise their voices and address once and for all the environmental crisis that we are facing today. In that sense, the following research analysed the voices of activists, and their network, in South Africa. With the aim to understand the formation of community-based adaptive capacities in relation to climate change, in communities. This Thesis was conducted as a case study in Bloemfontein, South Africa. The study included five semi-structured interviews directed to activist from Bloemfontein, as well as, secondary data conformed by five interviews conducted to members of the eco-building project ‘Qala Pheland Tala. Start Living Green’, and story-telling videos. As well as, the employment of participant observation, as part of the methodology. The study looked at climate change adaptability and resilience in different communities, based on the resilience theory proposed by Carl Folke. And itaimed to understand the influence that the activists’ network is having incommunity-based adaptation strategies to climate change. Further, the results were categorized with the framework that suggests a Resilience Model, as a set of networked adaptive capacities, designed by Norris et al. (2007). The analysis of the results concluded that the link between the activists’network and the communities, has helped to build adaptive capacities and resilient societies. At the same time, it proved that we need new strategies of action towards climate change, that foresee regenerative societies.
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Stöd på väg mot självständighet : En studie om ungdomars och personals uppfattningar om stödjande insatser på KollboTonér, Emmie, Lidström, Emma, Bergmark, Yvonne January 2008 (has links)
<p>Idag satsas allt mer på stödboenden i olika former och man föredrar placeringar i närmiljö. Föreliggande studie syftar till att undersöka ungdomars livssituation minst ett år efter avslutad placering på Kollbo, ett stödboende tillhörande Ungdoms- och familjeenheten i Örebro kommun. Syftet är vidare att undersöka vilka komponenter i verksamheten ungdomarna har uppfattat som positiva respektive negativa, samt att se hur deras uppfattningar överensstämmer med personalgruppens. Studien har en kvalitativ ansats och bygger på intervjuer med ungdomar samt ordinarie anställda på Kollbo. Intervjuguiderna har utformats utifrån studiens syfte, verksamhetsbeskrivning samt tidigare forskning. Av resultatet framkommer att de komponenter ungdomarna menar har haft en positiv inverkan är personalens generella stöd och tillgänglighet och särskilt kontaktpersonen har haft stor betydelse. De är positiva till de regler som fanns och menade att personalgruppen var sammansvetsad och konsekvent. Flera respondenter upplever att Kollbos personal genom sitt stöd har haft del i att deras relationer med familjen förbättrats. Den komponent som framför allt uppfattades ha en negativ påverkan var tillämpningen av avvisning som konsekvens för regelbrott. Detta var även den komponent om vilken uppfattningarna i ungdoms- respektive personalgrupp skilde sig åt i störst utsträckning. Resultatet visar att ungdomarna, med ett undantag, idag är nöjda med sin livssituation. Majoriteten menar att placeringen har gjort en avgörande skillnad för deras nuvarande situation.</p> / <p>Today there is an increased use of supportive residential homes of different types and placements close to home are preferred. The purpose of this study is to examine the present situation of youths at least one year after completing their placement at Kollbo, a supportive residential home within the social welfare service of Örebro municipality. The purpose is also to examine which components have been regarded as positive respectively negative by the youths and how their views agree with the staff’s. The study has a qualitative approach and is based on interviews with youths and the regular staff at Kollbo. The interview guides have been formulated on the basis of the study’s aim, the statement of activity and previous research. The results of the study show that the components that have been positively regarded by the youths are the general support and availability provided by the staff and especially their contact person have had a special meaning to them. They are also in favour of the rules and have experienced the staff as united and consistent. Several respondents’ experience is that the staff at Kollbo has had an active part in helping to improve the youths’ family relations by their support. The component regarded as having the most negative influence was the use of refuse of entry as a consequence of breaking the rules. This was also the component were the staff’s and youths’ opinions differed the most. The result further shows that the youths, with the exception of one person, are pleased with their present life situation. The majority believes that the placement has made a significant difference for their present situation.</p>
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Naturvårdshänsyn i boreal bruksskog : En studie om avverkningar och avverkare i skogarna runt Saxdalen i södra DalarnaDahl, Ida January 2011 (has links)
As the past century’s technological development has progressed the Swedish boreal forests have transformed into dense, highly productive, homogenous and coniferous forests. The area around Saxdalen in Ludvika municipality has long been dominated forests which have been heavily worked since the 18th century. There are in Ludvika 119 000 hectares of productive forest land. Around 70 percent are owned by forest companies and 20 by private forest owners. The forestry is governed by national laws and instructions from the Swedish Forest Agency. Foresters may also choose to abide by certification systems such as FSC and PEFC. 80 percent of Swedish productive forest is certified. This thesis is based on literature review and 8 field studies of regeneration fellings in Saxdalen. The purpose of this thesis is to understand to what degree environmental considerations are taken during regeneration fellings to preserve biodiversity. The focus of the thesis has been the preservation of storm sturdy trees, deciduous trees and standing dread trees, larger tree stumps and protected zones around watercourses. The protected zones were found severely lacking in practically all the observed fellings. The quality the trees preserved varied greatly between the fellings. In this study there were no found links between the ownership form or certification system and the considerations taken during regeneration fellings. A lot of parties are involved in fellings and those responsible aren’t always in full control. The work of preserving boreal forests resilience and biodiversity must be conducted in more strategic and coordinated fashion. There must be common criteria and strategies for large forest areas so that species can spread and survive the forestry, especially considering future climate change.
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