Organisationen wie Feuerwehren, med. Rettungsdienste oder Spezialeinheiten der Polizei zeigen auch in Situationen, die durch Unsicherheit, unvollständige Informationen oder eine sehr hohe Dynamik gekennzeichnet sind, eine effiziente und effektive Leistungsfähigkeit. Sie können deswegen als Hochleistungssysteme (HLS) bezeichnet werden. Im vorliegenden Artikel wird dargestellt wie sich Erkenntnisse der High Reliabilty Theory auf die Untersuchung von Hochleistungssystemen auswirken und welche Gemeinsamkeiten und Parallelen bestehen. Dabei wird insbesondere ein Schwerpunkt auf die Thematik des Lernens gelegt.

In the U.S. federal system, 'crisis commissions' are powerful instruments of social learning that actively mediate the politics of disaster and reform. Typically endowed with the legal authority to establish causes of dramatic policy failures and make recommendations to prevent their recurrence, commissions can prompt major governmental reorganizations. Yet commissions are also frequently accused of being influenced by dominant interests and faulted for articulating incomplete or politically expedient narratives of failure. Even when commission conclusions are accepted, the reforms they propose are not always adopted. Using the 9/11 Commission as a conceptual backdrop, this dissertation explores the relationship between disaster, public investigation, and reform by undertaking a detailed study of the Space Shuttle Columbia Accident Investigation Board and Iraq Study Group. Together, the cases constitute a study of the national security state seeking to correct failures across different domains of state power: border security, war-making capability, and dominance in space. I argue that commissions, as one-shot diagnostic and therapeutic instruments, are more effective than standing political institutions at confronting entrenched ways of seeing and knowing in complex systems of the national security state, which are defined by the interaction of ideology, large bureaucracies, and advanced technologies. The ability of commissions to see critically for society itself is not given but rather constructed through investigative and deliberative processes that must overcome the action of political interests. Commission credibility is therefore not an essential trait that derives a priori from the inherent stature of its members, but is rather the output of the investigative phase as commissions identify, compile, and publicize errors made by the state. In this adversarial process, an aggressive professional staff emerges as a determinant of commission success, leading to an important distinction between investigative commissions with 'super staffs' and advisory commissions that lack them. Process tracing recommendations over a multi-year period nevertheless reveals dynamics of agency and resistance at play between commissions and the institutions they attempt to reform, highlighting the partial success commissions are likely to achieve at coercing entrenched institutions to implement their recommendations.

Cette thèse étudie la modulation des circuits neuronaux spinaux impliqués dans les fonctions motrices et leur contrôle corticospinal lors de la locomotion chez l’Homme sain et après accident vasculaire cérébral (AVC). Dans ce contexte, la stratégie utilisée a consisté à moduler les comportements de ces circuits en modifiant soit les volées afférentes d’origine suprasegmentaire ou les volées afférentes d’origine périphérique et d’étudier le retentissement de ces modifications sur le comportement des circuits neuronaux spinaux au cours de différentes tâches motrices dont la marche.Trois grands thèmes émergent de ce projet :« L’influence combinée des entrées corticospinales et de l’inhibition réciproque sur l’activité des motoneurones des fléchisseurs plantaires de la cheville » a été étudiée en station debout et lors de la marche stabilisée. Les résultats ont suggéré que l'interaction entre les motoneurones spinaux, les interneurones inhibiteurs Ia et les volées motrices corticospinales descendantes ainsi que leur contribution relative à l'activité des motoneurones des fléchisseurs plantaires de la cheville dépendent de la tâche motrice. Plus d’interaction entre les entrées descendantes et les interneurones Ia pendant la station debout était présente, probablement pour renforcer l’activation tonique des motoneurones du soléaire.« La modulation liée à la tâche de l’inhibition spinale croisée entre les membres inférieurs chez l’Homme » a été étudiée au niveau des muscles soléaires en position assise, debout et lors de la marche stabilisée. Nos résultats suggèrent que la transmission neurale croisée, via les interneurones commissuraux des groupes I et II, est déprimée par les entrées descendantes bilatérales du cortex moteur ou pendant le mouvement volontaire. La modulation spécifique de l’inhibition croisée du groupe II au cours de la locomotion suggère un contrôle des structures mésencéphaliques monoaminergiques et son rôle dans la coordination des jambes pendant la locomotion. « L’influence de la musique sur les automatismes locomoteurs après un Accident Vasculaire Cérébral » a été étudiée durant la marche stabilisée chez les patients atteints d’AVC. Nos résultats préliminaires suggèrent que l’écoute musicale modulerait les réseaux neuronaux médullaires impliqués dans les automatismes locomoteurs. / This thesis investigates the modulation of spinal neuronal circuits involved in motor function and their corticospinal control during locomotion in healthy humans and after stroke. In this context, the strategy was to modulate the behavior of these circuits by modifying either the afferent volleys from suprasegmental origin or from peripheral origin and to study the impact of these changes on the behavior of spinal neuronal circuits during different motor tasks such as walking.Three major themes emerge from this project:« Combined influence of corticospinal inputs and reciprocal inhibition on ankle plantar flexor motoneuron activity during walking » was investigated during standing and during stabilized walking. The results suggested that the interaction between spinal motoneurons, Ia inhibitory interneurones and motor corticospinal descending volleys and their relative contribution to the activity of plantar flexor motoneurons of the ankle depend on the motor task. More interaction between descending inputs and Ia interneurones during standing was present, presumably to strengthen the tonic activation of the soleus motoneurons.« Task-related modulation of crossed spinal inhibition between human lower limbs» has been studied at the soleus muscles in sitting, standing and during stabilized walking. Our results suggest that crossed neural transmission via commissural interneurones of groups I and II, is depressed by bilateral descending inputs of motor cortex during voluntary movement. Specific modulation of the crossed inhibition by group II afferents during locomotion suggests a control from monoaminergic mesencephalic structures and its role in legs coordination during locomotion.« The influence of music on locomotor automatisms after stroke» was investigated during stabilized locomotion in stroke patients. Our preliminary results suggest that music modulate the spinal neuronal networks involved in locomotor automatisms.

This graduation thesis focuses on the insurance of sports events and professional athletes. It represents the sum of possible insurance products in the given area. The goal of the thesis is to present this marginal part of insurance market and, by using actual data, to show the trends in the number of insurance agreements contracted by professional sportspeople and their proportion in the total of life insurance. The first part lays the theoretical background of the work. The second part compares insurance agreements of two different companies with the same insurance company. The last part concentrates on the insurance of major sports events, i.e. the Ice Hockey World Championship and the Olympic Games.

The purpose and object of this thesis was to investigate and research the utility and effect of the application of the doctrine of res ipsa loquitur to medical negligence cases. More particularly, it was endeavoured to establish conclusively that the approach of the South African courts that the doctrine can never find application to medical negligence cases is untenable and out of touch with modern approaches adopted by other Common law countries. It was further endeavoured to provide a theoretical and practical legal framework within which the application of the doctrine to medical negligence cases and related matters can develop in South Africa, in future. The research includes a comprehensive comparative survey of the diverging approaches with regard to the application of the doctrine to medical negligence cases between the legal systems of South Africa, England and the United States of America. The most important conclusions which the investigation revealed were the following: 1. There are substantial differences with regard to the application of the doctrine between the three legal systems, with regard to the requirements for, the nature of, the procedural effect on the onus of proof and the nature of the defendant's explanation in rebuttal. These differences are further compounded by differences between the principles enunciated by the courts and the opinions of legal commentators on the subject. 2. Whereas the approach adopted by the South African courts with regard to the application of the doctrine to medical negligence cases is outdated and untenable, more legal clarity, however, exists in South Africa with regard to the application of the doctrine to personal injury cases in general, so that the existing principles which are applied provide a structure within which the extension of its application to medical accidents can be readily accommodated. 3. The current approach adopted by England, where provision is made for the application of the doctrine to obvious medical blunders as well as more complex matters, where the plaintiff is permitted to buttress evidence relating to the res with expert medical evidence, commends itself for acceptance. Such an approach not only alleviates the plaintiff's burden of proof but also provides adequate protection to the defendant by endorsing the principle of honest doubt in the form of letting the defendant prevail if he comes to court and explains that despite due care, untoward results do sometimes occur especially in the practice of medicine. 4. The approach adopted by the majority of jurisdictions in the United States of America is probably too liberal and unstructured so that it may in some instances result in the imposition of liability in medical context, in a arbitrary fashion. 5. Constitutional principles such as procedural equality, policy and other considerations support the extension of the application of the doctrine to medical negligence cases in South Africa. There are also substantial grounds for advancing a persuasive argument that the majority judgment in the Van Wyk v Lewis case should be overruled and that the general application of the doctrine of res ipsa loquitur should not only be extended to cases of medical negligence, but also to related legal procedures which follow a medical accident such as medical inquests, criminal prosecutions and disciplinary inquiries instituted by the Health Professions Council of South Africa. / Thesis (LLD)--University of Pretoria, 2007. / Public Law / LLD / unrestricted

Objetivo: Avaliar o uso de antitrombóticos em pacientes com fibrilação atrial (FA) em hospital cardiológico no Brasil (InCor).Métodos e resultados: Um estudo observacional transversal analisou os prontuários de todos os pacientes atendidos no InCor em cada um de 5 dias separados no ano de 2002 (Fase 1), sendo prospectivamente reanalisados após 1 ano (Fase 2). A prevalência da FA nos 3764 prontuários analisados foi de 8%. Antiplaquetários foram prescritos para 21,26% e 19,93%, anticoagulantes para 46,51% e 57,81%, e 32,23% e 22,26% não usavam nenhum antitrombótico nas Fases 1 e 2, respectivamente. Somente 15,60% e 23,25% apresentavam níveis de RNI terapêuticos.Conclusão: A anticoagulação é subutilizada nos pacientes com FA apesar do fato de serem tratados por cardiologistas em um hospital universitário / Objective: To assess antithrombotic therapy among atrial fibrillation (AF) patients in a Brazilian University Heart Hospital (InCor).Methods and results: A cross sectional study analyzed the charts of all patients treated at InCor in 5 separate days of 2002 (Phase 1), and prospectively reviewed them after one year (Phase 2). The prevalence of AF in the 3,764 assessed charts was of 8.0%. Antiplatelets were prescribed to 21.26% and 19.93%, anticoagulants to 46.51% and 57.81%, and 32.23% and 22.26% were not receiving any antithrombotic in Phases 1 and 2, respectively. Only 15.60% and 23.25% were within INR therapeutic range.Conclusion: Anticoagulation is underused in AF patients besides the fact of being treated by cardiologists in a University Hospital

京都大学 / 0048 / 新制・課程博士 / 博士(農学) / 甲第21826号 / 農博第2339号 / 新制||農||1067(附属図書館) / 学位論文||H31||N5198(農学部図書室) / 京都大学大学院農学研究科地域環境科学専攻 / (主査)准教授 髙橋 知之, 教授 北山 兼弘, 准教授 刑部 正博 / 学位規則第4条第1項該当 / Doctor of Agricultural Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22337号 / 医博第4578号 / 新制||医||1041(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 佐藤 俊哉, 教授 福原 俊一, 教授 鈴木 実 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The diploma thesis „Circumstances and Legal Consequences of Daytime Road Accidents with Pedestrian“ deals with the interpretation of legal decisions on traffic accidents causes by the vehicle during the day and where the other participant was a pedestrian. The main aim of this work is to find the established limits for the assessment of fault in comparable accident situations. Basic concepts, as a traffic accident, participants of traffic accidents and the position of an expert in the criminal proceedings, are defined within the theoretical part of the thesis. It also deals with the biomechanical aspects of a pedestrian – vehicle collision and the violation of specific regulations. Approximately 1,530 judical decisions were studied and analyzed in the analytical part, of which 40 were selected, that correspond to the requirements of this thesis. In the analytical part there are also 4 expert opinions provided by the Institute of Forensic Engineering of Brno University of Technology, where the above – mentioned limits for the assessment of accidents were applied, as well as the decision according to the jurisdiction.

The doctoral thesis deals with problems of a safe longitudinal distance between vehicles. It includes an analysis of a set of factors influencing the safe distance between vehicles and is concerned with a research of effect of many of these factors on observance of the safe longitudinal distance between vehicles. In connection with these factors, this work deals with the solution of this issue in neighbouring countries through statutory measures, then with statistical analysis of traffic accidents in the Czech Republic caused by non-observance of the safe distance, also problems of assistance systems operating in this area, and subsequently, based on the findings, there are recommended suggestions of actions to increase safety in this area of road transport.