Disasters and major accidents are a significant cause of distress worldwide. High levels of posttraumatic stress can become chronic after severe and prolonged psychological trauma, raising concerns about the extent of adverse long-term consequences after single events. The present thesis aimed to describe the course and burden of posttraumatic stress in survivors from a ferry disaster in the Baltic Sea, an airliner crash-landing in Gottröra, Sweden, and a bus accident involving Swedish 6th grade schoolchildren in Måbødalen, Norway. The participants were surveyed 1 month to 4 years after the events and again after 14 to 20 years. The follow-up surveys included 33 ferry disaster survivors, 70 airline survivors, and 7 surviving schoolchildren with a comparison group from the same school (n = 33). Short- and long-term changes in posttraumatic stress were estimated separately in generalised regression models refined by linear splines. In-depth interviews were conducted with 22 ferry survivors 15 years after the disaster, including structured clinical interviews and thematic analysis of survivors’ descriptions of consequences of the event and social support. Approximately half of all survivors experienced significant posttraumatic stress at the initial assessments. Significant long-term distress was noted in one fourth of the ferry survivors and one sixth of the airline survivors. The bus crash was not associated with significant long-term posttraumatic stress. A poorer long-term outcome was noted in women and in bereaved survivors. The thematic analysis revealed that long-term consequences not only included negative aspects but also positive ones, including personal growth and existential awareness. There was ample availability of social support, although the need for support extended over a period of several years. Barriers to support from significant others were described in detail by the survivors. The results extend previous research by providing a comprehensive account of long-term consequences of disasters and major accidents in light of early reactions. The interviews provide some new insights into features of social support that warrant further study. Important future challenges include evaluating whether timely attention to survivors at risk for chronic distress and significant others can facilitate recovery. / Allvarliga händelser som katastrofer eller stora olyckor kan leda till svår psykisk belastning på kort sikt. Svåra posttraumatiska stressreaktioner kan bli beständiga efter svår traumatisering som omsorgssvikt eller övergrepp. Det är därför angeläget att undersöka omfattningen av psykologiska konsekvenser efter enskilda händelser som katastrofer och stora olyckor. Denna avhandling syftade till att beskriva utvecklingen av posttraumatisk stress på lång sikt hos överlevande efter förlisningen av MS Estonia 1994, nödlandingen av ett passagerarflygplan i Gottröra 1991 och efter en olycka med en skolbuss medförande en skolklass från årskurs sex. De överlevande tillskickades enkäter 1 månad till 4 år efter händelsen, samt efter 14 till 20 år. Långtidsenkäterna besvarades av 33 överlevande från färjekatastrofen, 70 från flygolyckan samt 7 överlevande från bussolyckan och 33 personer från parallellklasserna. Intervjuer genomfördes med 22 överlevande 15 år efter färjekatastrofen. Ungefär hälften av alla överlevande upplevde betydande posttraumatiska stressreaktioner vid tidpunkten för den första enkäten. Frekventa stressreaktioner fanns kvar hos 27 % fjorton år efter färjekatastrofen, medan andelen var 16 % nitton år efter flygolyckan. Tjugo år efter bussolyckan upplevde de nu drygt trettioåriga svarande låga nivåer av posttraumatisk stress. Förlustdrabbade överlevande upplevde i genomsnitt en mindre återhämtning under det första året och hade också svårare reaktioner efter många år. Kvinnor upplevde i genomsnitt svårare reaktioner än män såväl på kort sikt som på lång sikt, medan återhämtningen inte skiljde sig åt mellan män och kvinnor. Konsekvenser på lång sikt innefattade enligt de överlevande negativa men också positiva aspekter som personlig mognad och existentiell medvetenhet. De flesta intervjuade hade upplevt gott om stöd från närstående, dock kunde ett visst behov av stöd kvarstå i flera år efter händelsen. Många berättade om hinder för att söka stöd, t.ex. att den närstående var känslomässigt belastad.  Avhandlingen utvidgar det som hittills varit känt om posttraumatisk stress hos överlevande efter katastrofer och stora olyckor. Intervjuerna pekar på viktiga aspekter av socialt stöd att utforska vidare. Resultaten visar att dessa händelser är förknippade med övergående stressreaktioner hos majoriteten av de överlevande. Vidare forskning behövs för att bättre förstå den naturliga återhämtningen och närmare vilka insatser till överlevande och anhöriga som kan underlätta återhämtning. / Long-term posttraumatic stress in survivors from disasters and major accidents

Pochi studi hanno indagato le conseguenze psicologiche di incidenti stradali che coinvolgono adolescenti e giovani adulti (Blanchard at al., 2005; Steil et al., 2001). Attraverso un approccio multi-metodo la ricerca indaga le reazioni psicologiche di genitori e ragazzi ad incidenti stradali, le risposte familiare in grado di svolgere una funzione protettiva e l'impatto psicologico delle modalità di comunicazione del personale sanitario. 50 ragazzi (13/23 anni), vittime di incidenti stradali e i rispettivi genitori hanno risposto a 3 questionari e ad un'intervista narrativa. La reazione dei ragazzi risulta indipendente dalla gravità dell'incidente, mentre la risposta familiare è organizzata in funzione di tale gravità. Emerge un effetto di mediazione della comunicazione del personale sanitario. / Few researches focused on psychological impact of motor vehicle accidents on adolescents and young adults (Blanchard et al., 2005; Steil et al., 2001). This research uses a multi-method approach to explore adolescents' and their parents' psychological reaction to motor vehicle accidents and family patterns protective. The study also investigates the impact of doctors' and nurses' communication strategies. 50 subjects aged 13-23 involved in motor vehicle accidents and their parents answered to 3 questionnaires and a narrative interview. Adolescents' stress response is not related to severity of physical injuries. Severity of physical injuries organizes family answer. The research underlines a mediation effect of doctors' and nurses' communication strategies.

No description available.

No description available.

The theme of this student thesis is {\clq}qAnalysis of the machinery as a component of the accident system in the area of traffic operations of self-propelled motor vehicles``. It deals with problems of traffic and main causes of deaths and injuries in road accidents, and proposes a possibility of their elimination. The solution is based on the fact that most of the road accidents are caused by drivers themselves who don´t pay enough attention by driving or their behaviour behind the wheel isn´t sufficient. The proposed solution is supposed to monitor the traffic in real time and in co-operation with specially-designed program installed in the electronic control unit of the vehicle it´s able to notify the driver of dangers around him. The system is also able to dynamically control the traffic in order to prevent traffic-jams, accidents on pedestrian crossings, etc. As a result of system implementation the author estimates rapid decrease in fatal road accidents, serious injuries and physical damages.

The thesis discusses the roads in lanes 2 + 1 arrangement in the country and abroad. It focuses primarily analogy of this type of arrangement in our situation, ie on stretches of roads I. classes with an increased number of lanes for slow vehicles to climb. Part of this work is to verify some of the traffic, including traffic flow characteristics compared to conventional two-lane roads, especially in terms of: sectional speed; overtaking; Accident and dependence longitudinal gradient. The work aims to evaluate the foreign experience and achievements of domestic communications options for application configuration 2 + 1 in the Czech Republic.

No other government agency receives as much attention as the National Aeronautics and Space Administration (NASA). The high-profile agency frequently captures attention of the media in both positive and negative contexts. This thesis takes a case study approach using organizational learning and sensemaking theories to investigate crisis communication within NASA's 2003 Columbia tragedy. Eight participants, who in some capacity had worked for NASA during the Columbia tragedy in a communication centered position, were interviewed. Using a grounded theory framework, nine themes emerged pertaining to organizational learning, leadership, structure, and organizational culture. The results of the study aid in understanding how high risk organization's (HROs) can learn from previous failures and details how organizational culture can hinder organizational change.