54 resultados para Military hospitals.
Resumo:
I min avhandling undersöker jag av kriget framkallade psykiska störningar hos finländska soldater under fortsättningskriget. Vilka var de psykiskt invalidiserade soldaterna och hurudana var deras traumatiska erfarenheter? Vilken var den bredare upplevelsevärlden vid fronten där störningarna uppstod, och hur kan man förklara att majoriteten av soldaterna ändå klarade sig utan mentala rubbningar i denna av våld präglade miljö? Hur förhöll sig Finlands armé i allmänhet och den krigspsykiatri som utvecklades under kriget specifikt till soldaternas psykiska störningar? Som Matti Ponteva redan 1977 utredde, det totala antalet psykiatriska soldatpatienter under fortsättningskriget var ca 15 700 män. I min undersökning betonar jag att den siffran omfattar endast en del av fenomenet: långt ifrån alla finländska soldater som uppvisade psykiska symptom förpassades från fronten i psykiatrisk vård. De finländska psykiatrerna hade före vinterkriget inte kommit i direkt kontakt med av krig orsakade psykiska störningar. Deras kunskaper kom nästan uteslutande från den tyska krigspsykiatrin, där den ledande tanken framför allt efter första världskriget var att förklara psykiska störningar med soldaternas personliga brister och svagheter. Slutligen resonerar jag, varför synen på soldaternas psykiska störningar på ett så markant sätt skilde sig från synen på andra krigsskador. Att soldater stupade eller sårades fysiskt kunde framställas som yttringar av manligt hjältemod och offervillighet. Att brytas ner psykiskt av kriget blev däremot en tom symbol för våldet och saknade annat innehåll än uttryckligen en meningslöshet. Psykiska störningar associerades med ett moraliskt fördömande och ett stigma av skam, och förutom att man tenderade att förneka och marginalisera deras existens försökte man göra en skillnad mellan dem och den egentliga krigsupplevelsen. Det har varit problematiskt att inkludera de psykiskt rubbade soldaterna i den nationella historieskrivningen fram till våra dagar.
Resumo:
The political environment of security and defence has changed radically in the Western industrialised world since the Cold War. As a response to these changes, since the beginning of the twenty-first century, most Western countries have adopted a ‘capabilities-based approach’ to developing and operating their armed forces. More responsive and versatile military capabilities must be developed to meet the contemporary challenges. The systems approach is seen as a beneficial means of overcoming traps in resolving complex real -world issues by conventional thinking. The main objectives of this dissertation are to explore and assess the means to enhance the development of military capabilities both in concept development and experimentation (CD&E) and in national defence materiel collaboration issues. This research provides a unique perspective, a systems approach, to the development areas of concern in resolving complex real-world issues. This dissertation seeks to increase the understanding of the military capability concept both as a whole and with in its life cycle. The dissertation follows the generic functionalist systems methodology by Jackson. The methodology applies a comprehensive set of constitutive rules to examine the research objectives. This dissertation makes contribution to current studies about military capability. It presents two interdepen dent conceptual capability models: the comprehensive capability meta-model (CCMM) and the holistic capability life cycle model (HCLCM). These models holistically and systematically complement the existing, but still evolving, understanding of military capability and its life cycle. In addition, this dissertation contributes to the scientific discussion of defence procurement in its broad meaning by introducing the holistic model about the national defence materiel collaboration between the defence forces, defence industry and academia. The model connects the key collaborative mechanisms, which currently work in isolation from each other, and take into consideration the unique needs of each partner. This dissertation contributes empirical evidence regarding the benefits of enterprise architectures (EA) to CD&E. The EA approach may add value to traditional concept development by increasing the clarity, consistency and completeness of the concept. The most important use considered for EA in CD&E is that it enables further utilisation of the concept created in the case project.
Resumo:
Cyber security is one of the main topics that are discussed around the world today. The threat is real, and it is unlikely to diminish. People, business, governments, and even armed forces are networked in a way or another. Thus, the cyber threat is also facing military networking. On the other hand, the concept of Network Centric Warfare sets high requirements for military tactical data communications and security. A challenging networking environment and cyber threats force us to consider new approaches to build security on the military communication systems. The purpose of this thesis is to develop a cyber security architecture for military networks, and to evaluate the designed architecture. The architecture is described as a technical functionality. As a new approach, the thesis introduces Cognitive Networks (CN) which are a theoretical concept to build more intelligent, dynamic and even secure communication networks. The cognitive networks are capable of observe the networking environment, make decisions for optimal performance and adapt its system parameter according to the decisions. As a result, the thesis presents a five-layer cyber security architecture that consists of security elements controlled by a cognitive process. The proposed architecture includes the infrastructure, services and application layers that are managed and controlled by the cognitive and management layers. The architecture defines the tasks of the security elements at a functional level without introducing any new protocols or algorithms. For evaluating two separated method were used. The first method is based on the SABSA framework that uses a layered approach to analyze overall security of an organization. The second method was a scenario based method in which a risk severity level is calculated. The evaluation results show that the proposed architecture fulfills the security requirements at least at a high level. However, the evaluation of the proposed architecture proved to be very challenging. Thus, the evaluation results must be considered very critically. The thesis proves the cognitive networks are a promising approach, and they provide lots of benefits when designing a cyber security architecture for the tactical military networks. However, many implementation problems exist, and several details must be considered and studied during the future work.
Resumo:
The goals of the study were to describe patients’ perceptions of care after experiencing seclusion/restraint and their quality of life. The goal was moreover to identify methodological challenges related to studies from the perspective of coerced patients. The study was conducted in three phases between September 2008 and April 2012. In the first phase, the instrument Secluded/ Restrained Patients’ Perception of their Treatment (SR-PPT) was developed and validated in Japan in cooperation with a Finnish research group (n = 56). Additional data were collected over one year from secluded/restrained patients using the instrument (n = 90). In the second phase, data were collected during the discharge process (n = 264). In the third phase, data were collected from electronic databases. Methodological and ethical issues were reviewed (n = 32) using systematic review method. Patients perceived that co-operation with the staff was poor; patients’ opinions were not taken into account, treatment targets collated and treatment methods were seen in different ways. Patients also felt that their concerns were not well enough understood. However, patients received getting nurses’ time. In particular, seclusion/restraint was considered unnecessary. The patients felt that they benefited from the isolation in treating their problems more than they needed it, even if the benefit was seen to be minor. Patients treated on forensic wards rated their treatment and care significantly lower than in general units. During hospitalization secluded/restrained patients evaluated their quality of life, however, better than did non-secluded/restrained patients. However, no conclusion is drawn to the effect that the better quality of life assessment is attributable to the seclusion/restraint because patients’ treatment period after the isolation was long and because of many other factors, as rehabilitation, medication, diagnostic differences, and adaptation. According to the systematic mixed studies review variation between study designs was found to be a methodological challenge. This makes comparison of the results more difficult. A research ethical weakness is conceded as regards descriptions of the ethical review process (44 %) and informed consent (32 %). It can be concluded that patients in psychiatric hospital care and having a voice as an equal expert require special attention to clinical nursing, decision-making and service planning. Patients and their family members will be consulted in plans of preventive and alternative methods for seclusion and restraint. The study supports the theory that in ethical decision-making situations account should be taken of medical indications, in addition to the patients’ preferences, the effect of treatment on quality of life, and this depends on other factors. The connection between treatment decisions and a patient’s quality of life should be evaluated more structurally in practice. Changing treatment culture towards patients’ involvement will support daily life in nursing and service planning taking into account improvements in patients’ quality of life.
Resumo:
The Swedish public health care organisation could very well be undergoing its most significant change since its specialisation during the late 19th and early 20th century. At the heart of this change is a move from using manual patient journals to electronic health records (EHR). EHR are complex integrated organisational wide information systems (IS) that promise great benefits and value as well as presenting great challenges to the organisation. The Swedish public health care is not the first organisation to implement integrated IS, and by no means alone in their quest for realising the potential benefits and value that it has to offer. As organisations invest in IS they embark on a journey of value-creation and capture. A journey where a costbased approach towards their IS-investments is replaced with a value-centric focus, and where the main challenges lie in the practical day-to-day task of finding ways to intertwine technology, people and business processes. This has however proven to be a problematic task. The problematic situation arises from a shift of perspective regarding how to manage IS in order to gain value. This is a shift from technology delivery to benefits delivery; from an ISimplementation plan to a change management plan. The shift gives rise to challenges related to the inability of IS and the elusiveness of value. As a response to these challenges the field of IS-benefits management has emerged offering a framework and a process in order to better understand and formalise benefits realisation activities. In this thesis the benefits realisation efforts of three Swedish hospitals within the same county council are studied. The thesis focuses on the participants of benefits analysis projects; their perceptions, judgments, negotiations and descriptions of potential benefits. The purpose is to address the process where organisations seek to identify which potential IS-benefits to pursue and realise, this in order to better understand what affects the process, so that realisation actions of potential IS-benefits could be supported. A qualitative case study research design is adopted and provides a framework for sample selection, data collection, and data analysis. It also provides a framework for discussions of validity, reliability and generalizability. Findings displayed a benefits fluctuation, which showed that participants’ perception of what constituted potential benefits and value changed throughout the formal benefits management process. Issues like structure, knowledge, expectation and experience affected perception differently, and this in the end changed the amount and composition of potential benefits and value. Five dimensions of benefits judgment were identified and used by participants when finding accommodations of potential benefits and value to pursue. Identified dimensions affected participants’ perceptions, which in turn affected the amount and composition of potential benefits. During the formal benefits management process participants shifted between judgment dimensions. These movements emerged through debates and interactions between participants. Judgments based on what was perceived as expected due to one’s role and perceived best for the organisation as a whole were the two dominant benefits judgment dimensions. A benefits negotiation was identified. Negotiations were divided into two main categories, rational and irrational, depending on participants’ drive when initiating and participating in negotiations. In each category three different types of negotiations were identified having different characteristics and generating different outcomes. There was also a benefits negotiation process identified that displayed management challenges corresponding to its five phases. A discrepancy was also found between how IS-benefits are spoken of and how actions of IS benefits realisation are understood. This was a discrepancy between an evaluation and a realisation focus towards IS value creation. An evaluation focus described IS-benefits as well-defined and measurable effects and a realisation focus spoke of establishing and managing an on-going place of value creation. The notion of valuescape was introduced in order to describe and support the understanding of IS value creation. Valuescape corresponded to a realisation focus and outlined a value configuration consisting of activities, logic, structure, drivers and role of IS.
Resumo:
Kartta kuuluu A. E. Nordenskiöldin kokoelmaan
Resumo:
Puolustusvoimien fyysisen koulutuksen tavoitteena on tuottaa toimintakykyisiä sotilaita kriisi- ja sodanajan joukkoihin. Liikuntakoulutuksella tuetaan varusmiesten fyysistä koulutusta, ja yhtenä tavoitteena on aktivoida liikunnalliseen elämäntapaan myös reservissä. Varusmiesten lähtökunto palvelukseen astuttaessa on ollut laskusuhdanteessa jo useamman vuosikymmenen ajan, joten sen valossa uusien harjoittelumuotojen ja lajien tutkiminen on ajankohtaista. Tutkimustyön aiheena olevan Military Crosstraining -harjoittelun voidaan sanoa olevan CrossFitin® sotilassovellus, joka urheilu- ja harjoittelumuotona kehittää mahdollisimman monipuolisesti harjoittelijan suorituskykyä eli kestävyyttä ja lihaskuntoa. Tutkimustyön tarkoituksena oli selvittää, millaisia vaikutuksia toiminnallisella ja korkea intensiteettisellä Military Crosstraining -tyyppisellä fyysisellä harjoittelulla (MCH) on varusmiesten fyysisen suorituskyvyn kehittymiseen voimassa olevien normien mukaiseen koulu-tukseen (NH) verrattuna. Työssä vertailtiin kahden samankaltaisen, mutta eri tyyppistä lihaskunto- ja kestävyysharjoittelua tehneen varusmiesjoukon fyysisen suorituskyvyn kehittymistä kuuden kuukauden varusmiespalveluksen aikana. Koehenkilöt olivat jääkäri- ja panssarintorjuntaohjusjoukkueissa palvelleita miehistöön kuuluvia varusmiehiä (n=110, ikä 20,1 ± 0,4, paino 79,3 ± 12,3 kg, pituus 1,81 ± 0,06 m, BMI 24,3 ± 3,3). Kvantitatiivinen tutkimus perustui normin mukaisten varusmiesten kuntotestien sekä kehonkoostumuksen tulo- ja lähtötestien tuloksiin. Tilastolliset analyysit tehtiin SPSS 22 ohjelmalla. Muuttujien välisiä yhteyksiä selvitettiin Pearsonin sekä Spearmanin korrelaa-tiokertoimilla. Ryhmien keskiarvojen välisiä eroja sekä muuttujien muutoksia selvitettiin kaksisuuntaisella T-testillä sekä mediaanitestillä. Lähtötilanteessa ryhmät olivat fyysiseltä kunnoltaan käytännössä samantasoisia. Tutkimuk-sessa ei havaittu merkitseviä eroja (p<0.05) ryhmien välillä kuntotestien lopputuloksissa eikä kestävyys- ja lihaskunnon kehityksessä, vaikkakin kehitys molemmilla oli huomattavaa (p<0.001). Suurimmat erot havaittiin kehon painoissa ja BMI:ssa ja niiden muutoksissa (p<0.001). MCH:n kehonpainossa ja BMI:ssa ei tapahtunut juuri muutoksia. Kehonpainojen erotus kasvoi oli 6,5 %:sta 9,4 %:iin (p>0.001), NH:n painon ollessa pienempi. BMI:n erot kasvoivat vastaavasti 5,2 %:sta 8,4 %:iin (p<0.001). Johtopäätöksenä todettakoon, että mahdollisesti Military Crostraining -tyyppinen harjoittelu lisää lihasmassaa normaalia liikuntakoulutusta enemmän aerobisen kunnon siitä kuitenkaan kärsimättä. Tällä olisi positiivisia vaikutuksia moniin sotilaan kenttätehtäviin, kuten haavoittuneen evakuointiin, taakaan tai kuorman kantoon sekä raskaiden tavaroiden nostamiseen.