The goal of this thesis was to find out the current state of the operation of the risk management in selected health service providers. For this purpose, there was a questionnaire survey conducted together with a form of interview. There was created a questionnaire for selected health service providers (Annex 1). It was necessary to set certain criteria for the selection of the health services providers. The first criterion was to cover health service providers in the whole Czech Republic. The second criterion set that it should be a inpatient facility. The third criterion definded that only hospitals should be covered. The forth criterion excluded University Hospitals from the selected sample. The fifth criterion required that there will be hospitals with more than 400 medical beds in their facilities. Reviews of annual reports of hospitals were drawn up to implement all the criterions for selecting the sample of health services providers and there were excluded facilities with less than 400 medical beds. The theoretical part deals with health care in the Czech Republic defining the providers of health services and health care system. Furthermore, it deals with crisis management in health care including crisis preparedness of health care, crisis documentation and exercises. There was specified a health risk management and risk analysis methods. There was a questionnaire containing 13 closed and 12 opened questions created for selected providers of health services used in the practical part. The questionnaire was divided into five categories related to the definition of Act No. 240/2000 Coll., crisis management, namely analysis and evaluation of security risks, planning, organization, implementation, control of activities (Annex 1). The questionnaire was distributed via the Click4Survey internet portal, it was an online questionnaire and the interviewed persons were also contacted by telephone. The interviewees were persons engaged in risk management at a particular selected health service providers. There were 18 hospitals out of a total of 33 hospitals surveyed participated in the survey. The results were processed into graphs, tables and interpreted in the discussion section of the thesis. The goal of the thesis was "To find out the current state of the operation of the risk management in selected health service providers." The results show that, risk management in the hospitals surveyed does not reach sufficient knowledge and experience in some cases.

任何國家在面對安全威脅時，其關鍵在於強盛的國防軍力，現代戰爭已由「單純武力戰」轉為「全民總體戰」，而且台海一旦發生戰事，其作戰縱深短淺，已沒有前方和後方的分別，囿於國際情勢使武器外購受限，國防工業發展成為關鍵因素，我們應發展「小而精、小而強、小而巧」的國防武力，並建立全民國防理念與全民防衛動員機制，運用軍民一體的力量，共同來防衛我們的國土。本文將從「綜合性安全」的角度，以文獻分析法，透過國家安全的觀點，探討我國全民國防的建構、運用與軍備發展，並從中華民國國家安全遭受的威脅及全民防衛動員與軍備發展所面臨的挑戰，探討「全民國防」與「軍備發展」之涵義與重要性，並區分政策面、執行面兩個構面加以說明。在「政策面」的層次分析在「全民防衛動員準備法」的基礎上，闡述「全民國防的理念」與「軍備發展」；在「執行面」上，則針對塑造軍民共用之「國防工業發展」，以為「全民國防軍備體系」之實行方向等，說明全民國防與軍備發展的關係。俾整合全國產、學、研資源，推動國防和民生合一，釋出國防科技轉為民用，並藉由民生產業技術的提升，戰時能支持國防的需求，支援軍事作戰。達成「平時國防支持經建」、「戰時經建支持國防」的國家戰略目標。 / First of all whenever a country faces a threat security, the decisive point relies on the strength of its national power. This critical element has evolved over time from tangible arms forces into spiritual “All -out Defense”. Secondly due to our country’s long and narrow geography , as long as hostility breaks out across the straits, short battlefield depth makes no distinct from the area to frontline. Furthermore our foreign procurement for military we apons is subject to the international circumstance. Apparently “small but precise and strong” defense capability and All-out Defense Mechanism should be more suitable as the determining guidelines towards our defense industry. This study aims for the upcoming threats and challenges when it comes to our national security and is divided into 2 aspects: policy guidance and execution. The former focuses on the analysis of All-out Defense and Mobilization Law and sets forth concept and development tendency of the military preparedness. The latter direct at the relationship and interaction between the All -out defense and armament development. In the long term, we hope to consolidate efforts of the private sectors to develop defense technology industries, the public and civilian assets can be merged into a single whole; such combination can prompt the private sectors to support military missions in wartime and vice versa.

<p>För att kunna erbjuda god och lättillgänglig hälso- och sjukvård vid stora olyckor och katastrofer krävs en katastrofberedskap grundad på planläggning, utbildning och övning. Sjukvårdens särskilda beredskap måste kunna hantera såväl den "lilla vardagsolyckan" som den stora olyckan eller katastrofen. Syftet med denna studie var att undersöka hur enhetschefer och distriktssköterskor vid primärvården i två kommuner i Jämtlands län upplevde sig förberedda inför en katastrof eller en stor olycka där utryckning krävdes utanför vårdinrättningar till olycksplats. Syftet var även att undersöka hur katastrofberedskap prioriteras av enhetschefer. En intervjustudie har genomförts med tre enhetschefer och fem distriktssköterskor. Intervjuerna har analyserats med kvalitativ innehållsanalys. Utifrån analysen skapades två<strong> </strong>kategorier: ”känsla av säkerhet”<strong> </strong>och ”organisation” samt fyra underkategorier ”beredskap”, ”prioritet”, ”förmåga” och<strong> </strong>”kunskap”. Huvudfyndet var att samtliga intervjudeltagare önskade ha övningar för att känna sig mer förberedd vid en stor olycka. I dagsläget övades det inte alls på katastrofberedskap.</p> / <p>In order to provide good and accessible healthcare in case of emergencies and disasters, an emergency plan based on planning, training and practice is required. Special care must be prepared to deal with both the ”small everyday accident” but also the major accident and disaster. The purpose of this study was to examine how unit managers and districtnurses in primary care in two municipalities in Jämtland county experience themselves prepared in case of a disaster or a major accident which requires emergency care facilities outside the unit. The aim was also to examine how emergency preparedness is a priority for the unit managers. An interview study has been carried out with three unitmanagers and five districtnurses. The interviews were analyzed with qualitative content analysis. Based on the analysis two categories were created: 'feeling of security "and" organization "and four sub-categories of" security "," priority "," ability "and" knowledge ". Major findings was that all the interview participants wished to have exercises to feel more prepared for a major accident. For the time being, no practice in disaster preparedness is carried out.</p>

A societal crisis is an emergency that affects many people and large parts of society, threatening life, health, safety and basic values. In a societal crisis, there is a need for coordination between various bodies in the society. Coordination in societal crises has previously been studied mainly from a management perspective. Learning perspectives have been studied to a lesser extent. The main purpose of this thesis is to increase knowledge about the conditions for developing consensus and establish a common understanding of synergy-effects, a surplus value, for knowledge meetings between individuals from different organizations when they cooperate in the emergency management system. The study seeks to understand to the following questions: 1) What images and ideas do participants bring into the coordination group about societal crisis, how have they developed and changed? 2) How do the participants act when they have different pictures and meet? 3) Can the basic ideas of the research circle be used for knowledge building at knowledge meetings in the emergency management-system? 4) Can the basic ideas of the research circle be used to develop consensus and establish a common understanding of synergy-effects before societal crises happen? The main study consists of three case studies in three different-sized municipalities. It is based on 36 semi-structured interviews with participants in local crisis management coordination groups, observations during exercises and meetings, document studies and an experiment with the so-called knowledge meeting. The results are compared with complementary studies from two knowledge meetings and two coordination exercises based on observation, questionnaires and evaluations. The individuals, organizations, and structures have been identified as frame factors for coordination groups. The results show that the participants have different images of societal crisis and that coordination is a time-consuming approach requiring cross-perspective learning, interaction, as well as dialogue and reflection skills. The participants eventually develop their crisis learning, i.e. conflict-filled adaptation. A system's opened nature is important for individual learning.

För att kunna erbjuda god och lättillgänglig hälso- och sjukvård vid stora olyckor och katastrofer krävs en katastrofberedskap grundad på planläggning, utbildning och övning. Sjukvårdens särskilda beredskap måste kunna hantera såväl den "lilla vardagsolyckan" som den stora olyckan eller katastrofen. Syftet med denna studie var att undersöka hur enhetschefer och distriktssköterskor vid primärvården i två kommuner i Jämtlands län upplevde sig förberedda inför en katastrof eller en stor olycka där utryckning krävdes utanför vårdinrättningar till olycksplats. Syftet var även att undersöka hur katastrofberedskap prioriteras av enhetschefer. En intervjustudie har genomförts med tre enhetschefer och fem distriktssköterskor. Intervjuerna har analyserats med kvalitativ innehållsanalys. Utifrån analysen skapades två kategorier: ”känsla av säkerhet” och ”organisation” samt fyra underkategorier ”beredskap”, ”prioritet”, ”förmåga” och ”kunskap”. Huvudfyndet var att samtliga intervjudeltagare önskade ha övningar för att känna sig mer förberedd vid en stor olycka. I dagsläget övades det inte alls på katastrofberedskap. / In order to provide good and accessible healthcare in case of emergencies and disasters, an emergency plan based on planning, training and practice is required. Special care must be prepared to deal with both the ”small everyday accident” but also the major accident and disaster. The purpose of this study was to examine how unit managers and districtnurses in primary care in two municipalities in Jämtland county experience themselves prepared in case of a disaster or a major accident which requires emergency care facilities outside the unit. The aim was also to examine how emergency preparedness is a priority for the unit managers. An interview study has been carried out with three unitmanagers and five districtnurses. The interviews were analyzed with qualitative content analysis. Based on the analysis two categories were created: 'feeling of security "and" organization "and four sub-categories of" security "," priority "," ability "and" knowledge ". Major findings was that all the interview participants wished to have exercises to feel more prepared for a major accident. For the time being, no practice in disaster preparedness is carried out.

This project used data from the School Readiness Survey (SR) of the 2007 National Household Education Surveys Program collected by the National Center for Education Statistics Institute of Education Science. A subsample of 1,712 to 2,622 subjects who participated in the survey was used for this project. The purpose of the study was to examine parent perceptions, behaviors, and reported child ability related to school readiness and the effect ethnicity and socioeconomic status (SES) had on each comparison. Variables from the existing data were matched to one of the five domains of School Readiness: Health and Physical Development, Social and Emotional Development, Approaches to Learning, Communication, and General Knowledge. Data were analyzed by means of Pearson correlations and Moderate Multiple Regression analyses. Findings revealed weak, but significant, correlations among parent perceptions, parent behaviors, and parent reported child ability in specific domains. SES and ethnicity were found to be a moderator of parent perceptions and parent behaviors. SES was also shown to affect the relationship between parent behaviors and parent reported child ability in the domains of communication and general knowledge. Several limitations are presented, including possible reasons for the significant but weak results. Findings from this study suggest much more can be learned regarding parent perceptions across ethnicity and SES and the influence it has on school readiness.

The aim of this dissertation is to explore how informal caregivers for people with dementia (PWD), who are community dwelling (i.e., not in nursing homes), prepare and plan for disasters. The research site is a particularly hurricane-prone region of Florida, second only to New Orleans in its vulnerability. An underlying assumption of this research is that caregivers for PWD have to plan and anticipate problems that are unique to their role. The rationale for the study described here is that disaster planning and mitigation save lives (Tengs et al. 1995), but there is little or no literature on disaster planning for the frail elderly and their caregivers. Mixed methods design which includes: 1) participant observation; 2) staff interviews (n=8);3) preliminary caregiver interviews (n=5); 4) baseline chart/disaster plan review (n=290);5) intervention (presentation to staff and administration) and form revision; 6) follow-up chart/ disaster plan review (n=259); 7) caregiver survey(n=253);8) final caregiver interviews (N=15- total number of caregiver interviews 20); 9) disaster literacy testing (n=20); 10) final group interview with ACC administration. This work documents the way that caregivers talk about disaster planning and say they will do if a hurricane strikes and reflects on their past hurricane experiences. Major findings include gaps in the county run Special Needs Shelter services available in Florida for people with dementia. The response and difficulty that caregivers might face can depend on the stage of the disease.

The Strategic National Stockpile (SNS) is a program that provides medical countermeasures during a public health emergency. A public health emergency can be a natural or man-made disaster, an act of terrorism, or a pandemic. The Cities Readiness Initiative (CRI) was created to help the nation’s largest metropolitan regions develop the ability to provide SNS life-saving medications in the event of a large-scale bioterrorist attack or naturally occurring disease outbreak. To address the risks associated with a public health emergency the Center for Disease Control and Prevention (CDC) requires a comprehensive emergency response plan for distributing SNS/CRI materials quickly and efficiently. The Fulton County Department of Health and Wellness (FCDHW) is tasked with responsibility for distributing and dispensing of SNS/CRI medical assets delivered during a public health emergency. FCDHW is also tasked with the development of a comprehensive response plan. Past TAR scores revealed that passing SNS/CRI audits has been a challenge for FCDHW. A case study was conducted to note if the development of an information management system could facilitate successful future SNS/CRI audits. A needs assessment revealed that an information management system for emergency preparedness and response compliance was needed. Microsoft SharePoint 2007 was used to develop the information management system. SharePoint contains a secure document repository that linked the work products of all relevant internal and external stakeholders and revealed compliance deficiencies early enough to allow for corrective actions. The result was a passing TAR score that was a 59 point increase from the last published score.

This thesis provides an ethnographic account of the journey from diagnosis with a life-limiting illness to the end of life. It tracks the lives and eventual deaths of eight people and 83 family members for a period of three and a half years in total. Culture is located as a central element or lens by which to view this journey. The role, function and issues for social work as a profession are discussed in various chapters. The theoretical underpinnings of the thesis are informed by the ecological perspective combined with psychosocial theories of loss and grief. Drawing on a broad social systems theory, in conjunction with an ethnographic methodology and grounded theory analysis, contributes to the development of research which firmly takes culture into account. Four primary topic areas are presented: a narrative exploration of diagnosis, the changing landscape that participants encounter, the embodiment of new places and spaces, and finally, the journey’s end. The themes from the four topic areas contribute to the development of the two core categories “time and place” and “preparedness for death”. A schematic representation of the paths participants took is provided in the discussion of the core categories. Lastly, the New Zealand Palliative Care Strategy (Ministry of Health, 2001) is drawn on to aid the discussion of issues arising from the research and the implications for practice in this field.

Bakgrund: Våld i nära relationer innebär fysiskt, psykiskt och/eller sexuellt våld. Det anses vara ett stort hälsoproblem som främst drabbar kvinnor och ger fysiska, psykiska och sociala konsekvenser. Hälso- och sjukvården har ett stort ansvar gällande att upptäcka och hjälpa utsatta kvinnor samt förebygga våld i nära relationer, men många kvinnor upplever att de inte fått adekvat stöd och hjälp från hälso- och sjukvården. Syfte: Att belysa faktorer som påverkar sjuksköterskors beredskap inför och agerande vid mötet med kvinnor som misstänks vara eller är utsatta för våld i nära relation. Metod: Allmän litteraturöversikt med analys och sammanställning av tio vetenskapliga artiklar med både kvalitativ och kvantitativ data. Resultat: Faktorer som påverkade beredskap och agerande var dels relaterade till sjuksköterskan som person; attityder och tankar kring sjuksköterskans professionella roll, sjuksköterskans känslor samt personliga och professionella erfarenheter av våld i nära relationer. Dels påverkade också faktorer som var relaterade till sjuksköterskans omgivning och förutsättningar; utbildning och praktiska färdigheter, miljö samt organisation. Slutsats: Fördjupade kunskaper, erfarenhet och en mer öppen, förstående attityd hos sjuksköterskor visade sig kunna vara avgörande för kvaliteten på vården av kvinnor som har blivit utsatta för våld i nära relationer. Klinisk betydelse: Utbildning inom våld i nära relationer skulle kunna utvecklas, attityder diskuteras och handlingsplaner införlivas på ett tydligare sätt i vården. / Background: Intimate partner violence involves physical, psychological and/or sexual violence. It is viewed as a major health problem that mainly affects women and has physical, psychological and social consequences. The health care system has a great responsibility in identifying and helping subjected women and in preventing intimate partner violence, yet many women feel that they do not get adequate support and help from the health care services. Aim: To illuminate factors affecting nurses‟ preparedness for and interaction with women who may be or are subjected to intimate partner violence. Method: General literature review with analysis and synthesis of ten research articles with both qualitative and quantitative data. Results: Factors were partly related to the nurse in person; attitudes and conceptions about the nurses‟ professional role, the nurses‟ feelings, and personal and professional experiences of intimate partner violence. Other factors were related to the nurses‟ environment and conditions; education and practical skills, environment and organization. Conclusion: Enhanced knowledge, experience and more open-minded and understanding attitudes among nurses could be determining for the quality of care of women subjected to intimate partner violence. Clinical significance: Education about intimate partner violence could be developed, attitudes discussed and guidelines implemented in a more explicit manner in healthcare.