Ämnesområdet säkerhet har kommit att få mer utrymme inom verksamhetsområden som ett resultat av det omvärldsläge som förefaller idag, där kriser och olyckor tycks bli en del av det vardagliga sammanhanget snarare än extraordinära händelser som inträffar då och då. Samhället är en dynamisk plats som ständigt utvecklas, vilket innebär att såväl förebyggande arbete som åtgärder inte kommer att vara detsamma för alltid. Begränsad forskning på hur systematiskt säkerhetsarbete bedrivs och förstås utifrån teoretiska utgångspunkter utgör ett incitament att undersöka detta vidare. Universitetet kan likställas med mindre samhällen, sett till exponering och omfång och kräver således ett gediget systematiskt säkerhetsarbete för att säkerställa en trygg och säker tillvaro där risker såväl bedöms som värderas och åtgärdas. Studien syftar till att undersöka hur systematiskt säkerhetsarbete bedrivs och ter sig vid universitet i Sverige och genom detta skapa en uppfattning om såväl framgångsfaktorer som hinder. För att ge svar på studiens syfte har styrdokument samlats in från tre mellanstora universitet i Sverige, för att skapa en kunskapsöversikt och förståelse för hur säkerhetsarbetet bedrivs. I tillägg till detta har yrkesverksamma inom säkerhetsområdet vid samma tre universitet intervjuats. Studiens resultat visar på såväl hinder som framgångsfaktorer vid ett framgångsrikt säkerhetsarbete. Komplexitet föreligger i att nå ut till den stora skalan, och studenter tycks vara den målgrupp som är svårast att nå. Ett intressant fynd i kontrast till detta är att riskmedvetenheten förefaller sig vara lika hög hos studenter som anställda, om än högre. Vidare visar studien att lagar och förordningar sätter ramen för hur det systematiska säkerhetsarbetet bedrivs vid universitet, utöver de universitetens egna ambitioner, och bidrar till en ökad riskmedvetenhet. / Safety has come to gain more attention in operational areas as a result of the current state of the world, whereas crises and accidents seem to have become part of the everyday context rather than extraordinary events that occur every now and then. Society is a dynamic place that is constantly evolving, which means that both prevention work and measures will have to evolve along with society. Limited research on how systematic safety work is conducted and understood based on theoretical starting points constitutes an incentive to investigate this subject area further. The university can be compared to smaller communities, due to risk exposure and scope, that requires systematic safety work to ensure a safe and secure environment where risks are assessed as well as valued with relevant measures being taken. The study aims to investigate how systematic safety work is conducted at universities in Sweden, and by doing so create an understanding of successful factors as well as obstacles and challenges of conducting a successful safety work. To provide answers to the purpose of the study, documents from three middle sized universities in Sweden have been collected to gain knowledge of how the systematic safety work is being conducted. In addition to this, professionals in the security field at the same three universities have been interviewed. The results of the study show both obstacles and success factors in conducting a successful safety work. Complexity appears in reaching out to the large scale, and students seem to be the most difficult target group to reach. An interesting finding in contrast to this is that risk awareness appears to be just as high among students as employees, if not higher. Furthermore, the study shows that laws and regulations set the framework for how the systematic safety work is conducted at universities, in addition to the universities' own ambitions, and contribute to an increased risk awareness.

I december 2019 rapporterades ett utbrott av lunginflammation i Wuhan, Kina. 7 januari 2020 identifierades det då nya coronaviruset, virusets spreds och 11 mars 2020 klassades covid-19 som en pandemi av världshälsoorganisationen (WHO). Covid-19-pandemin har föranlett stor negativ inverkan på folkhälsan, samhället liksom ekonomin världen över. Sedan upptäckten av viruset har flera osäkerheter följt vilket kommit att känneteckna covid-19-pandemin. Osäkerheter har resulterat i flertalet hanteringsåtgärder, men sedan vaccinets introduktion är det den primära hanteringsstrategin. 29 januari 2021 godkände EU vaccinet från Oxford-Astra Zeneca och fram till 9 april 2021 administrerades ca 17 miljoner doser av Oxford-Astra Zeneca-vaccinet. 7 april 2021 meddelade dock europeiska läkemedelsmyndigheten (EMA) att det finns en koppling mellan vaccinet och risken för trombos i kombination med trombocytopeni (TTS)/vaccininducerad immuntrombotisk trombocytopeni (VITT) (båda avser risk för blodpropp). Symptom som kan uppkomma är bl.a. andnöd, bröstsmärtor och huvudvärk. Det kan även leda till död. Detta är en mycket sällsynt biverkning och EMA förklarar att de övergripande fördelarna med vaccinet överväger riskerna för biverkningar. Studien syftar till att undersöka hur risken med Oxford-Astra Zeneca-vaccinet har hanterats av olika Europeiska länder liksom hur motivet till beslutet formulerats och kommunicerats. Tidigare studier visar att riskkommunikationen påverkar individers vilja att ta vaccin, men ingen studie omfattar kopplingen mellan länders beslut och efterföljande riskkommunikation. Följande frågor besvaras i studien: (1) Vilket beslut har länderna tagit gällande administrationen av Oxford-Astra Zeneca-vaccinet? (2) Hur motiverar olika länder sitt beslut? Vilka beslutsunderlag har betonats? (3) Kan mönster eller tendenser urskiljas vad gäller beslutet och efterföljande riskkommunikation? I så fall vilka mönster eller tendenser kan urskiljas? För att besvara frågorna har en kartläggning av ländernas beslut gjorts som ett första steg. I det andra steget har riskmeddelanden från regeringar till medborgare analyserats med hjälp av 14 frågor som konstruerats utifrån teorin kring riskkommunikation. Detta bygger på riskkommunikationsprocessen liksom mål och strategier inom riskkommunikation. Målet med kommunikationen kan vara allt från att informera till att försöka skapa beteendeförändring. Riskkommunikationsprocessen innebär inflytande från olika aktörer där makt, vetenskap samt politik blir aktuellt. Betydelsen av transparens i riskkommunikation samt öppenhet kring osäkerhet påpekas i flera tidigare studier och utgör en del av diskussionen. Resultatet visar att länder har tagit olika beslut. Fyra beslutskategorier har identifierats: (1) Länder som accepterar risken för biverkning och ger AZ till samtliga medborgare. (2) Länder som delvis accepterar risken för biverkning och infört en åldersgräns för att begränsa risken. (3) Länder som överfört beslutet och ansvar kring risken till medborgarna genom att behålla vaccinet i landet och administrerar AZ-vaccinet till frivilliga. (4) Länder som inte accepterar risken för biverkning och därmed slutar att administrera AZ. Mönster har identifierats t.ex. att länder som ställer sig positiva till Oxford-Astra Zeneca-vaccinet också kommunicerar positiv information kring vaccinet till medborgarna. I länder där medborgare själva får besluta om vaccinet kan ytterligare belastning på sjukvården ges då flera av dessa länder beslutat att hälso- och sjukvård ska hjälpa individen i dennes beslut kring vaccinet. Detta förekommer inte i någon annan beslutskategori. Osäkerhet har fått varierande tyngd i ländernas beslut och kommunikationen kring osäkerhet varierar. Även om det finns osäkerheter kommuniceras dessa inte alltid. Beslutet får konsekvenser och är därmed mer än bara ett beslut om risk. / In December 2019, an outbreak of pneumonia was reported in Wuhan, China. The new coronavirus was identified on January 7, 2020. The virus spread and on March 11, 2020, covid-19 was classified as a pandemic by the World Health Organization (WHO). The Covid-19 pandemic has caused a major negative impact on public health, society as well as the economy worldwide. Since the discovery of the virus, several uncertainties have followed. These uncertainties characterize the covid-19 pandemic. Different management measures have been implemented. Since the vaccine got introduced, vaccination has been the primary management strategy. On January 29, 2021, the EU approved the Oxford-Astra Zeneca vaccine and until April 9, 2021, approximately 17 million doses of the Oxford-Astra Zeneca vaccine have been administered. However, on April 7, 2021, the European Medicines Agency (EMA) announced a link between this vaccine and the risk of thrombosis in combination with thrombocytopenia (TTS)/vaccine-induced immune thrombotic thrombocytopenia (VITT) (both refer to the risk of blood clots).. Blood clots can lead to breathing difficulties, chest pain, headache, and death. Blood clots are very rare and the EMA explains that the overall benefits of the vaccine outweigh the risks. The study aims to investigate how the risk connected to the Oxford-Astra Zeneca vaccine has been handled by various European countries as well as how they motive and communicate their decisions. Previous studies show that risk communication influence on individuals' willingness to take vaccines, but no study covers the link between countries' decisions and risk communication. The following questions are answered in the study: (1) What decision has each country made regarding the administration of the Oxford-Astra Zeneca vaccine? (2) How do these countries justify their decision? On which bases have the countries made their respective decisions? (3) Can patterns or tendencies be discerned regarding the decision and subsequent risk communication? If so, what patterns or tendencies can be discerned? In order to answer these questions, the countries' decisions have been mapped, as a first step. The second step has been to analyze risk messages from governments to citizens using 14 questions based on risk communication theory. These questions are based on the risk communication process as well as objectives and strategies within risk communication. The goal of the communication varies from informing the receiver to create behavioral change. Risk processes involve debates between various actors where power, science and politics become relevant. The importance of transparency in risk communication and openness around uncertainty is pointed out in several previous studies. The result shows that countries have taken different decisions. Four categories of decisions have been identified: (1) Countries that accept the risk of side effects and provide AZ to all citizens. (2) Countries that partially accept the risk of side effects and introduced an age limit to limit the risk. (3) Countries that transferred the decision and responsibility to the citizens by keeping the vaccine in the country and administering the AZ vaccine to volunteers. (4) Countries that do not accept the risk of side effects and thus stop administering AZ. Patterns have been identified, for example countries whit a positive attitude to the Oxford-Astra Zeneca vaccine communicate positive information about the vaccine to citizens. In several countries, where the citizens decide vaccine, the countries have decided that the healthcare system should help the individual in the decision regarding the vaccine. This can result in an additional burden on the healthcare system. Several of these countries have decided that the healthcare system should help the individual in the decision regarding the vaccine. This does not occur in any other decision category. Uncertainty has been given varying weight in the countries' decisions and communication around uncertainty varies. Even if there are uncertainties, these are not always communicated. The decision has consequences and it is just more than a decision about risk.

In Sweden during the COVID-19 pandemic the Public Health Agency of Sweden assumed the major responsibility for communication and information dissemination about the contagion, and made efforts on preventive work and the risk mitigation. To successfully mitigate the risks it is important for the Public Health Agency to be transparent in their risk communication, in order to gain and strenghten the public’s trust towards their institution, which is a prerequisite for them to be able to work efficiently in changing public behaviour in the population. This study examines what strategies the Public Health Agency of Sweden has used to create transparency within their risk communication, with the theoretical perspective of scholarly communication and information making. The study was conducted by analysing texts in the form of news articles published on the agency’s own website. The study identified eleven different strategies the agency has used in their risk communication, from referring to expert knowledge, to using a language that is accessible to the whole public.

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<p>The purpose of this dissertation was to examine the use of health risk communications as a strategy to change risk perceptions and motivate leisure time physical activity (LTPA) among people with spinal cord injury (SCI). Guided by protection motivation theory (PMT; Rogers, 1983) and the extended parallel processing model (EPPM; Witte, 1992), two strategies were examined as unique approaches to enhancing the effectiveness of health risk information. First, risk information was tailored to individualized, objective data regarding participants’ health risk. Second, risk information was supplemented with framed leisure time physical activity (LTPA) efficacy messages. Gain-framed messages emphasized the benefits of LTPA, whereas loss-framed messages emphasized the risks of inactivity. The relative effectiveness of gain- versus loss-framed messages was considered within the context of the EPPM (Witte, 1992). A secondary purpose of the dissertation was to explore cognitive processing in relation to framed LTPA messages. The attention and elaboration phases of cognitive processing were examined for gain- and loss-framed LTPA messages following exposure to health risk information. Three experiments were conducted to 1) test the effectiveness of individualized health risk information for changing health risk perceptions and LTPA among people with SCI, 2) test the relative effectiveness of gain- and loss-framed LTPA efficacy messages presented following health risk information for changing LTPA response efficacy and LTPA intentions among people with SCI, and, 3) investigate the relative attention given to gain-framed versus loss-framed LTPA response efficacy messages following presentation of health risk information to university students. The theoretical and pragmatic contributions are discussed.</p> / Doctor of Philosophy (PhD)

隨著氣候變遷與溫室效應影響日益明顯，台灣近年發生極端強降雨颱風的次數越來越頻繁，更造成流域地區嚴重災情，而從莫拉克風災經驗可體會到家戶風險溝通的重要性，也意識到我國實務與學術上相關研究的缺乏，故本研究探討家戶風險溝通機制中各項重要因素與調適行為間的關係，以及找出影響家戶調適行為決策之關鍵因素，進而提出家戶風險溝通策略之改善建議，以促進家戶採取調適行為。 本研究經由文獻回顧建立家戶調適行為之風險溝通概念架構，依循此架構研擬問卷，以高屏溪流域地區家戶為研究對象進行問卷調查，透過結構方程模式(SEM)驗證風險溝通架構，了解風險溝通機制各項因素與影響調適行為各因素之關係，後以面對災害回應之強烈將調適行為積極程度分為「消極或低度積極」、「中度積極」與「高度積極」，運用多項式羅吉斯迴歸模型建立家戶應變措施決策模型與調適措施決策模型，找出影響家戶調適行為決策之關鍵因素。 研究結果顯示，調適行為受到內在認知的影響，而內在認知同時受風險溝通機制與外在環境之影響，就風險溝通機制而言，親友鄰居、村里長與地方政府等社區網絡為重要管道。影響調適行為之關鍵因素以災害認知為主，其次為調適行為認知，居住村里次之，其中災害認知與調適行為認知越高，越有可能採取較積極之調適行為，此外，由於自然社會環境、風險溝通特性與社會經濟背景等因素交互影響下，各村里在調適行為決策上也有所差異。最後依據實證結果，與水患自主防災社區風險溝通現況，提出改善家戶風險溝通之策略建議，期望增進風險溝通機制的完備與促進家戶採取調適行為，以減緩極端氣候造成的衝擊。 / Along with the intensification of global climate change and greenhouse effect, typhoons with extreme rainfall strike Taiwan more and more frequently, which cause severe disasters in watershed area. From the experience of Typhoon Morakot in 2009, we realized the importance of risk communication with households and also the lack of related academic research. As a result, this study aims to discuss important factors in risk communication mechanism and their relationships with adaptive behaviors. It also find out key factors influencing decision-making of adaptive behaviors. Based on literature review, this study build a conceptual framework of risk communication process to describe how to trigger adaptive behaviors and encourage adaptive behaviors with risk communication. This study send out questionnaires to the households in Kaoping River Watershed and use structural equation modeling(SEM) to verify the conceptual framework. Then according to attitude of positive degree, adaptive behaviors are classified into“passive or low”,“medium” and “high” levels. By multinomial logistic regression, an empirical analysis was performed to analyze the key factors influencing decision-making of adaptive behaviors. The results show that adaptive behaviors are affected by internal cognition and at the same time internal cognition are affected by risk communication mechanism and external environment. As for risk communication mechanism, family, friends, neighbors and local governments are crucial communication channel. Key factors influencing decision-making of adaptive behaviors are cognition of disaster and adaptive behavior. People with higher cognition of disaster and adaptive behavior would more likely to take positive adaptive behaviors. Besides, community they lived in is also a key factor. Because the interaction of environments, risk communication patterns and socioeconomic attributes, people from different communities would take different adaptive behaviors. Based on empirical results, this study propose suggestions of risk communication strategies in order to better the risk communication mechanism and encourage households to take adaptive behaviors.

Suite aux notifications de cas de comportements suicidaires associés aux antidépresseurs (ADs) chez les jeunes, une mise en garde réglementaire a été émise en mai 2004 au Canada, et deux guides de pratique clinique ont été publiés dans la littérature en novembre 2007. L'objectif de ce mémoire fut d'évaluer l’association entre ces interventions de communication et le suivi médical de la population pédiatrique traitée par ADs au Québec. Une étude de cohorte rétrospective (1998-2008) a été menée chez 4 576 enfants (10-14 ans) et 12 419 adolescents (15-19 ans) membres du régime public d’assurance médicaments du Québec, ayant débuté un traitement par AD. Le suivi médical dans les trois premiers mois de traitement a été mesuré par l’occurrence et la fréquence de visites médicales retrouvées dans les banques de données de la RAMQ. Les facteurs associés à un suivi conforme aux recommandations ont été évalués à partir de modèles de régression logistique multivariés. Seuls 20% des enfants ou adolescents ont eu au moins une visite de suivi à chaque mois, en conformité avec les recommandations. La probabilité de recevoir un suivi médical conforme était plus élevée lorsque le prescripteur initial était un psychiatre. L’occurrence et la fréquence des visites n’ont pas changé après la publication de la mise en garde ou des recommandations. De ce mémoire on conclut que d'autres interventions visant à optimiser le suivi médical devraient être envisagées. / Following reports of a potential association between antidepressants (ADs) and suicidal behaviour in youth, a regulatory warning was issued in Canada in May 2004, and clinical practice guidelines on recommended medical follow-up were published in the literature in November 2007. This Master's thesis aimed at assessing the association between these communication interventions and medical follow-up practices. A retrospective cohort study (1998-2008) was conducted among 4,576 children (10-14 years) and 12,419 adolescents (15-19 years) members of the Quebec public drug plan. Medical follow-up was ascertained through patterns of physician billing practices found in the RAMQ medical services databases. Study outcomes consisted of occurrence and frequency of visits in the first three months of AD treatment. Factors associated with follow-up consistent with recommendations were identified through multivariate logistic regression models. The main independent variable was exposure to each of the communication interventions. Covariates included: gender, class of AD, number of concomitant chronic diseases, psychiatric conditions, prescriber’s specialty, and potential exposure to each intervention. Only 20% of children or adolescents received at least one visit each month. The probability of receiving adequate follow-up was greater when treatment was initiated by a psychiatrist. Occurrence and frequency of visits did not change after the warning nor the publication of the recommendations. From this thesis, one may conclude that further interventions to optimize medical follow-up practices should be envisaged.

十八世紀的工業發展富裕了人類的物質生活，生態環境卻也逐遭破壞 ；人們因科技文明引發的現代風險的多樣性、全球性、不易衡量與不易預 測性，遂將傳統注重資源分配的「階級社會」帶領到新的注重風險如何在 社會中平等並合法分配的「風險社會」(Risk society) (Beck,1992)，社 會風險概念乃應運而生。從社會文明演進來看，現代風險與過去風險在本 質上有著極大差異，過去風險多以自然災害的威脅為主，而現代風險則以 科技進步帶來的威亦即公害佔多數，綜言之為風險的不確定性、風險承擔 的不公平性、影響的遲延性與風險產生的社會妥當性。也因如此風險管理 則具相當的「利益衡量」與「政策決擇」色彩，風險溝通遂乃成為有效風 險管理的主要因素，成為綜合其他風險議題如風險認知、風險評估、風險 管理等的橋樑。風險溝通與其他溝通議題的最大差別，前者尤強調人文層 面因素重於科學分析結果。建立一個合理可接受的風險水準與風險認知息 息相關，專家的科學分析結果固然重要，民眾對風險的了解卻多以一般知 識與過去生活經驗認知，再加上現代風險多涉及高度的科技性，專業術語 常令民眾產生距離與不信任感，在公害問題上糾紛多因而產生。風險溝通 除了儘量降低衝突外，更積極地為建立風險的正確認知，加強自我防禦機 能，故公共介入、民眾的參與對於事前與事後溝通的成效，可避免糾紛爭 端的發生。 從７０年代起公害糾紛屢見不鮮，抗議者手段皆多由緩和 後因意見得不到適切回應始引發衝突性高的行動；抗爭者與被抗議者亦多 有組織化趨勢；不管是「事前預防型」或「事後補救型」活動，政府的溝 通方式多仍停留在技術層面單向說服性的宣導亦多為被動；反觀國外對溝 通的努力較為積極，坦誠公開的溝通態度，重視一致、簡明的訊息揭露， 並考慮到居民心理壓力的疏解，強調風險溝通的地方時效性，這是國內糾 紛處理不足之處。由於糾紛事件中多有金錢賠償、健康檢查之訴求，故糾 紛處理與公害賠償制度在事後溝通上就佔極重要角色。日本的公害糾處理 與健康受害補償制度是除了民事訟訴外另闢之行政救濟管道，為衝突解決 與公害損害補償提供了訊速有效的溝通管道。我國有關公害糾紛處理已於 ８２年二月完成立法，至於公害補償卻散見於法令中，盼儘快建立污染者 付費原則、賠償基金的設立及加強公害保險功能，健全風險溝通的角色。